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Home My WebLink About4070 Estes StreetINSPECTION RECORD Inspection online form: http://www.ci.wheatridge.co.us/inspection Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Inspections will not be performed unless this card is posted on the project site Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business day PERMIT:c7,/0/ E''t 03&3 ADDRESS: �® "%CU � JOB COD Foundation Inspections Date Inspector Initials Comments 102 Caissons / Piers 103 Footing / P.E. Letter 104 Foundation Setback Cert. 105 Stem Walls 106 Foundation wall Insulation Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground / Slab Inspections Date Inspector Initials Comments 201 Electrical / Cable/ Conduit 202 Sewer Underground Int. 203 Sewer Underground Ext. 204 Plumbing Underground Int. 205 Pitimbing Underground Ext. 206 Water Underground j Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections Rough Inspection Date Inspector Initials Comments 301 Rough Framing 302 Wall Sheathing 303 Roof Sheathing 304 Sheer Inspection 305 Insulation 306 Mid -Roof j 307 Metal / Lath / Stucco 308 Rough Electrical Residential 309 Rough Electrical Commercial 310 Electrical Meter Residential 311 Electrical Meter Commercial 312 Temp. Const. Meter 313 Rough Plumbing Residential 314 Rough Plumbing Commercial 315 Shower Pan SEE OVER FOR ADDITIONAL INSPECTIONS PERMITy /9j>b3&3 ADDRESS: 1096 JOB CODE: e,2f-- Rough Inspection (continued) Date Inspector Initials Comments 316 Rough Mechanical Residential 317 Rough Mechanical Commercial 318 Boiler / Furnace 319 Hot water tank 320 Drywall screw and Nail 321 Moisture board / shower walls 322 Rough Grading 323 Miscellaneous Final Inspections Date Inspector Initials Comments 402 Gas Meter Release 403 Final Electrical Residential 404 Final Electrical Commercial 405 Final Mechanical Residential 406 Final Mechanical Commercial 407 Final Plumbing Residential 408 Final Plumbing Commercial 409 Final Roof 410 Final Window/Door 411 Landscape/Park/Planning* Inspections from these entities shall be requested one week in advance. "For landscaping and parking inspections please call 303-235-2846 **For ROW and drainage inspections please call 303-235-2861 ***For fire inspections please contact the Fire Protection District for your project. 412 Row/Drainage/Public Works''* 413 Flood plain Inspection** 414 Fire Insp. / Fire Protection*** 415 Public Works Final** 416 Storm Water Mgmt.** 417 Zoning Final Inspection* 418 Building Final Inspection Note: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building Inspection does not constitute authorization of occupancy. For Low Voltage permits please be sure that rough inspections are completed by the Fire District and Electrical low voltage by the Building Division. i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: qUq_ Final Rwr Job Address: q670 E ., fj e S -f, Permit Number: -201&,,)034.3 t ❑ No one available for inspection: Time 7J PM Re -Inspection required: Yes /N� When corrections have been made, call for re -inspection at 303-234-5933 Date: / / U Inspector: bane- Love DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE _:�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: L) ---) C1 r - i2,� Job Address: 4J --7(n E ,h,5 Permit Number: a0 ) jS O J 3(,-, 3 r n —fit �nvP/P ;(I J1101i ❑ No one available for inspection: Time AM/ NI Re -Inspection required: & No When corrections have been made, call for re -inspection at 303-234-5933 Date: Q K, Inspector:) DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: _306-1114 Rog Job Address: NI170 F_R S-te Permit Number: 281$00363 ❑ No one available for inspection: Time6V/PM Re -Inspection required: Yes Flo" When corrections have been made, call for re -inspection at 303 -234 - Date: 2 /1 Y/ 03-234- Date:2/1Yf 1 ' Inspector: RT DO NOT REMOVE THIS NOTICE M City of Wheat Ridge Residential Roofing PERMIT - 201800363 PERMIT NO: 201800363 ISSUED: 02/06/2018 JOB ADDRESS: 4070 Estes ST EXPIRES: 02/06/2019 JOB DESCRIPTION: Residential re -roof and shed with laminated asphalt composition shingles. 29.5 squares at 4/12 pitch; 1.95 squares at 10/12. Total number of squares is 32. *** CONTACTS *** OWNER (720)518-5736 FLOREZ MARIAN T SUB (720)447-1152 Thomas Stephen Wiles 160246 Modern Classic Remodelers Inc *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 18,000.00 FEES Total Valuation 0.00 Use Tax 378.00 Permit Fee 331.10 ** TOTAL ** 709.10 *** COMMENTS *** *** CONDITIONS *** Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be required for both the midroof and final inspections. The 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the Homeowner. REGARDING ROOF VENTILATION: Roof ventilation shall comply with IBC Sec. 1203.2 or IRC Sec. R806. The installation of ridge venting requires the installation or existence of soffit venting. For calculation purposes, one hat or turtle vent equal to one-half of one square foot of opening. Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) is required on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and mid -roofs may be called in at the same time, one hundred percent of the sheathing must be complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. City of Wheat Ridge Residential Roofing PERMIT - 201800363 PERMIT N0: 201800363 ISSUED: 02/06/2018 JOB ADDRESS: 4070 Estes ST EXPIRES: 02/06/2019 JOB DESCRIPTION: Residential re -roof and shed with laminated asphalt composition 29.5 squares at 4/12 pitch; 1.95 squares at 10/12. Total number is 32. shingles. of squares I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications= applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this pen -n . I further attest that I am legally authorized to include ali entities named within this document as parties to the work to be performed and hat a�lo be performed is disclosed in this document and/or its' accompanying approved plans and specifications. lg Signature of OWNER or COKITRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and maybe subject to a fee equal to one-half of the originalpermitfee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of 1 ennit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable cod r any Ord ma ce or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. ")a/ g, zt) & ?- & 3 Dina Kemp From: no-reply@ci.wheatridge.co.us Sent: Monday, February 5, 2018 5:35 PM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Dina Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received and due to the volume of requests, time to process varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. c For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes residential roof? How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address 4070 Estes Street Property Owner Name Marian Florez Property Owner Phone 720-518-5736 Number (enter WITH dashes, eg 303-123-4567) Property Owner Email Address Do you have a signed contract to reroof this property? Applications cannot be submitted without an executed contract attached below. Attach Copy of Executed Contract mar_303@yahoo.com Yes Florez.pdf CONTRACTOR INFORMATION Contractor Business Name Contractor's License Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone Number (enter WITH dashes, eg 303-123-4567) Contractor Address (Primary address of your business) Modern Classic Remodelers, Inc 160246 720-595-8405 2899 W 119th Avenue, Unit 204, Westminster, OC 80234 Contractor Email Address gldduggan@gmail.com Retype Contractor Email gldduggan@gmail.com Address DESCRIPTION OF WORK TOTAL SQUARES of / 2 the entire scope of work: �-- Project Value (contract 18000.00 value or cost of ALL materials and labor) Are you re -decking the No roof? Is the permit for a flat Pitched roof (2:12 pitch or greater) roof, pitched roof, or 2 both? (check all that apply) What is the specific pitch of the PITCHED roof? How many squares are part of the PITCHED roof? Describe the roofing materials for the PITCHED roof: Type of material for the PITCHED roof: Provide any additional detail here on the description of work. (Is this for a house or garage? Etc) 4:12 and 10:12 29.5-4:12/1.95 sq 10:12 Laminated comp shingles Asphalt house and detached shed SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that this Yes application is NOT a permit. I understand I will be contacted by the City to pay for and pick up the permit for this property. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have been Yes authorized by the legal 3 owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Name of Applicant Thomas Wiles or Rick Duggan Email not displaying correctly? View it in your browser. MODERN CLASSIC REMODELERS, INC. 2899 W 11911 Ave, Unit 204 Westminster, CO 80234 720-595-8405 CONTRACT CUSTOMER: DATE OF CONTRACT�� ADDRESS: HOME PH: ADDRESS: 4O ~7/ CELL PH (MR):_ ��/ (INSTALLATION STREET ADDRESS) CELL PH (MRS): CITY STATE ZIP EMAIL: P0WP- 3D F r 1/o`r 'ram INSURANCE INFORMATION Customer(s) have filed a claim: Yes 1�1` No ❑ Insurance Company:,_STa r� y,,-( Date of Loss: Claim l T/ 7 Insurance Phone #: THIS CONTRACT IS SUBJECT TO FINAL APPROVAL OF AN AUTHORIZED OFFICER OF THE CONTRACTOR; IF REJECTED, CUSTOMER WILL RECEIVE WRITTEN NOTICE OF CANCELLATION OF THE CONTRACT AND ANY ADDENDUMS There are no verbal agreements or representations that are part of this Contract and Addendums ANY PORTION OF THIS CONTRACT AND ADDENDUMS NOT COVERED BY INSURANCE COMPANY WILL BE VOID. THIS IS NOT A TIME PERFORMANCE CONTRACT AND WILL NOT BE DISCOUNTED FOR DELAYS OR ANY OTHER REASONS. MODERN CLASSIC REMODELERS. INC Agrees to represent in full, the above stated Customer(s) for the above claim in a professional and timely manner_ MODERN CLASSIC REMODELERS, INC will make all attempts to communicate with the adjuster and designate personnel for the completion of said claim. Which includes, but is not limited to, damage assessment, insurance revisions, code regulations, material management, invoicing and the completion and clean-up of all labor and material. Customer(s) agree to provide original and updated copies of the insurance claim paperwork. Customer(s) give MODERN CLASSIC REMODELERS, INC the right to act on their behalf to settle the insurance claim with the insurance company. Customer(s) agrees to pay MODERN CLASSIC REMODELERS, INC all monies received from the insurance company for their services performed including deductible. Customer(s) acknowledges that MODERN CLASSIC REMODELERS, INC (MGR) is a General Contractor, and as a general contractor, MCR is entitled to invoice insurance company for industry standard (10%) overhead and (10%) profit, (GCOP), supplement increases, permit costs, and PWI (paid when incurred) items to contractor. Customer agrees, that if contractor supplements for a trade and customer decides not to have contractor complete that trade, the customer will pay (25%) percent consulting service fee to cover time and expenses of the company. The (25%) Consulting fee will be assessed based off of the Replacement Cost Value (RCV) of the trade supplemented for. Customer(s) is also responsible for paying their insurance deductible, any extra work not covered by insurance, and any upgrades. By signing this agreement, the property owner authorizes MODERN CLASSIC REMODELERS, INC to pursue the customers best interest for storm damage repairs at a "price agreeable" to the insurance company and MODERN CLASSIC REMODELERS, INC with no additional costs to the customer, except the deductible. When "Price agreeable" is determined, it shall become the final contract price and Customer acknowledges MODERN CLASSIC REMODELERS, INC, as sole General Contractor, and shall not contract with any other entity or person for repairs contemplated to be completed by MODERN CLASSIC REMODELERS, INC. Any and all monies received from the insurance company as supplements, cost increases, and for General Contractor overhead and profitwill be paid to MODERN CLASSIC REMODELERS, INC, in addition to the contract price. If Customer has an ACV policy only, customer must pay the difference between the RCV and ACV plus their deductible. Any code upgrades not covered by insurance company is the financial responsibility of the Customer. Customer shall have the right to cancel this Agreement, but only within seventy two (72) hours following the execution of this Agreement (see attached rescission form for more details.) Contractor shall hold in trust any payment from the property owner until the contractor has delivered materials to the jobsite or has performed work on the property. CONTRACT PRICE: $ (RCV lnsumnceAllowance +Deductible) Deposit: Amount Ck# Date General Business Liability Policy #MP000500006517 General Contractor License #238964 Worker's Compensation Policy #4186103 720-309.5111 303J61-4000 s rr{ �V,6 (.r..: l 5 / 1 I X 4 ��l,t_:`+--bi ! ,-X' i)L '' ( ✓ t'? r! _ Gi _r'J a (3--u t orn"er) -^� (Date) (Signature of Authorized Re`pustentative) (Date) 1tCty.'�: {{ f-e'ta J' (Customer) (Date) (Print - Authorized Repr9geofative) (Date) Customers) agrees and understand both sides of this contract and all addendums Lome No: ` rt r k. r' est;.: 2 i' j CMPW. rr r s s w; aKr a i#M &f ;wi: r P : r t 4 Da..ur a .+r Vt. � d Y. ,. n yr r r i . #, I tt Sqtrt%"q t►-oC uadxa soiNeS pita" WU: WZ/9VAON 6 INSPECTION RECORD I INSPECTION LINE: (303) 234 -5933 Sheathing Inspections will not be made unless this card is posted on the building site Call by 3:00 PM to receive inspection the following business day. I L Lath /Wall tIe `j 10 Mid -Roof 1 2 6 � - INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB FOUNDATION INSPECTIONS DATE ..INSPECTOR -. INITIALS COMMENT S.- - Footings /Caissons -, Plumbing Stemwall / (CEG) Concrete :Encased Ground Mechanical - Reinforcing or Monolithic Roof ,CP Weatherproof / French Drain Building Final - Sewer Service Lines Fire Department Water Service Lines R O.W& Drainage POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED CONCRETE SLAB FLOOR Electrical (Underground) "`NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT :CONSTITUTE AUTHORIZATION ' OF A. CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. Plumbing (Underground) Heating (Underground) DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ROUGHS Sheathing Insulation Lath /Wall tIe Drywall Screw Mid -Roof Electrical Service .Electrical. Rough Electric Plumbing Rough Plumbing Mechanical - Gas Piping Roof ,CP Rough Mechanical r1. Building Final 'ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING Framing ;. Insulation Drywall Screw FINALS .Electrical. Plumbing Mechanical Roof ,CP Building Final Fire Department R O.W& Drainage INSPECTIONS FOR PLANNING R ZONING, FIRE AND PUBLIC WORKS SHOULD BE CALLED AT LEAST ONE. WEEK PRIOR TO FINAL INSPECTIONS. Parking & Landscaping "`NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT :CONSTITUTE AUTHORIZATION ' OF A. CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY' IS ISSUED PROTECT THIS CARD FROM THE WEATHER ♦ i CITY OF WHEAT RIDGE s Building Inspection Division (303) 234 -5933 Inspection line _ (303) 235 -2855 Office • (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type: 1 -YL Rl-wl= Job Address: 'fD79 /S'2 S7 Permit Number: AA1� a�>� ❑ No one available for inspection: Time aa.' 'a � PM Re- inspection required: Yes "When corrections have been made, call for re- inspection at 303 -234 -5933 i Date: a iv Inspector: DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE Building Inspection Division r000 (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type: 6141AL R6_o/� Job Address: 0� 70 f_S7L5 <7 Permit Number: ❑ No one available for inspection: Time AM 'P Re- Inspection required: es No When corrections have been made, call for re- inspection at 303-234-5933 Date: �,�3dh g Inspector: DO NOT REMOVE THIS NOTICE i .5 . v �L /7 sir/ ♦ i CITY OF WHEAT RIDGE fj- Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type: •r. �, Job Address: 4 f �5¢ Permit Number: 1 - ❑ No one available for inspection: Time i G.Y'i — QM /9 M Re- Inspection required: ; Yes No �� `- When corrections have been made, call for re- inspection at 303 - 234 -5933 Date: /0 Inspector: r, I DO NOT REMOVE THIS NOTICE 06/29/2010 13:49 FAX FAX COVER f Date: o� To: • Company: 1l. Fax #: From: ✓� Company: All Phone #: (3( Fax #: (3( Comments: 4909 ALL ROOFTOP SERVICES 001 I i L4 ROOFTOP SERVICES No. of Pag hs Inc. Cover e l - � v Claim #: Claim Address: 59 %7 :op` Services 5 -7331 Al /I 96/29/10 Leslie E 062918 TO ed66 06/29/2010 13:49 FAX <k C:�6 rw..� 3r3 -9 >5. - J 33/ or 935 4909 ALL ROOFTOP SERVICES rA- M sl ;e Eve a mj ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type: Ags t/ A�91 Job Address: Permit Number: 14�91,2.�25 /�JSr.SA.�i i0.6' 7 Py l z<, ss r ¢ Y Ai1/S��LT /Z�lZ3 �Sz �+AJ7` - .tJT ✓�G� P� /N PM9 A -960 7z ❑ No one available for inspection: Time /1 L!S A PM Re- Inspection required: (& No When corrections have been made, call for re- inspection at 303 - 234 -5933 Date: jz� io Inspecto DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE l ei Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office - (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type: 'O@f r7��ff, Job Address: yo7o sS; Permit Number: In -125' I ❑ No one available for inspection: Time J,i' 9 AN ) Re- inspection required: Yes When corrections have been made, calf force inspection at 303 Date: 5 2� -i&, Inspector: DO NOT REMOVE THIS NOTICE 05/13/2010 16:20 FAX 303 935 4909 ALL ROOFTOP SERVICES 0 001 MY Of Wheat Ridge Building Division Date: m 75 )0 Vt. 29 Ave., Wheat Ridge, CO 80033 _ Of ice: 303 -235 -2855 " Fax: 303 -235 -2857 Plan A In pecl ion Line: 303 - 234 -5933 Permit Ill.- Building Permit Application Property Address: 4 n r 7c, Property Owner (,p l ease print): Mnli p y Phone: Mailing Address: f diffe than property address) Address: City, State, Zip: Contractor: Sub Contractors: Electrical City Lice Company: Exp. Date: Approval: Use of space (des Description of we (aNd layer t Sq. FL /L Ft added- _ Plumbing City License #: Company Exp, Date: Approval: :&m36 - P:AoJ �•c6 Squares j TU's Gallons Amps OWNERICONTRAC I hereby oenlfy that rules or regulations allegations made a resp onsibility for co under this permit. PI OR a ae f the accu plian no su GNATURE OF UNDERSTANDING AND AGREEMENT ack distances proposed by this permit application are accurate, an Ity of Wheat Ridge or covenants easements or restrictions of rebo ate; that I have read and a gree to abide byy all conditions printed on a with the Wheat Ridge Building Code (LB.C) and all other appliCa Ject td fleld Impaction. n. do not violate applicable ordinances, that all measurements shown, and tits applicaton and that I assume full a Wheat Ridge Ordinances. for worK ON O ER CONTRACTOR) or PERSONAL REPRESENTATIVE of OWN ) ( CONTRATOR) Zoning: PRINT NAME: M sr SIGNATURE: Date: z D Mechanical City License #: Company: Exp, Date: Approval: Construction Val fas ca c Par th 0: $ * 2 t • `I ' auifdtng v� Data shee0 DEPARTMENT USE ONLY time or submittal): S ZONING COMMENTS; Zoning: Reviewer: PUBLIC WORKS COM ENTS Reviewer: BUILDING DEPARTMENT CO MENTS: OCCUPANCY; _ Reviewe r. Valuation; $ FIRE DEPARTMENT:: 0 ap roved w/ comments 0 disapproved Q no review required 131d Mechanical City License #: Company: Exp, Date: Approval: Construction Val fas ca c Par th 0: $ * 2 t • `I ' auifdtng v� Data shee0 Ian Review (due e' time or submittal): S 3