HomeMy WebLinkAbout5300 Quail Street( ily ul
lop-CITYOF WHEAT RIDGE BUILDING AND INSPECTION SERVICES DIVISION
7500 W 29th Ave Wheat Ridge, CO 80033.8001 p. 303.235.2855.f 303.237.8929
Proof of Submission for Permitting/Pian Review
(Water and Sanitation only)
A copy of this form must be completed by each water and sanitation agency indicated on the Permit Submittal
Checklist for the project type and be attached to the Building Permit Application at the time of submission.
Applications presented for submission without a completed Proof of Submission form from a required
agency will not be accepted or processed.
Date: 12-11-2019
Project address: 5300-5230 Quail Street
Name of Firm/individual submitting documents: Travis Frazier, Redland
Project Type/Description. Travis Frazier, Redland
the construction of 14 s
in buildings of four and -1
mily detached homes, and 42 townhomes
Signature of Firm Representative or Individual: _ J f" -
DO NOT WRITE BELOW THIS POINT - FOR AGENCY USE ONLY
6Url fel /11?1�(//L//
indiEated below grid do, by my signature bE
and approval -of the project indicated above.
Agency represented: (Please check one)
o Wheat Ridge Water District
o ,consolidated Mutual Water District
V Valley Water District
o Denver Water
Agency Notes:
, am a duly authorized representative of the agency
)wledge receipt of documents necessary for review
o Wheat Ridge Sanitation District
o Clear Creek Sanitation District
o Fruitdale Sanitation District
o Westridge Sanitation District
o Other
Signature: / J/(9.-1�i'�! /f Date:
�,,fAaencveo�res n ativaY ='Z
~oF""E?Tq City of Wheat Ridge Building Division
m 7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 " Fax: 303-237-8929
oO<oROao Inspection Line: 303-234-5933
Property Address:
Date:
Plan
Permit
K0%33
Property Owner tease print
(please print) f7f 7 far ;51641-5 Phone: 37o3
Mailing Address: (if different than property address)
Address:
State, Zip:
Contractor:
Contractor License
Building Permit Application
Phone:
Sub Contractors:
Electrical City License
Company:
Plumbing City License
Company
Mechanical City License
Company:
Exp. Date: Exp. Date: Exp. Date:
Approval Approval:
Approval:
Use of space (description): Construction Value: $
Description of world (as calculated per the Building Valuation Data sheet)
T•..1,42/ Guf/mil g- W 4, S ~ C LrY6~ Plan Review (due at time of submittal): $
Sq. Ft./L.Ft added: Squares BTU's Gallons Amps
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances,
rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and
allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full
responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
under this permit. Plans subject to field inspection.
CIRLCE ONE:: (OWNER) (CONTRACTOR) or PERSONAL REPR NT VE of ( w R) CONTRATOR)
PRINT NAME: SIGNATURE:
~ „tom Date:
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