HomeMy WebLinkAbout4005 Independence CourtCity of Wheat Ridge
E -Res. Water Heater Replcmnt PERMIT - 202002336
PERMIT NO: 202002336 ISSUED: 11/12/2020
JOB ADDRESS: 4005 Independence Ct EXPIRES: 11/12/2021
JOB DESCRIPTION: Replace 50 gallon, 40K BTU gas water heater in basement
*** CONTACTS ***
OWNER ( 7 2 0) 341-2323 DOWELL PATRICIA M
SUB (303)280-5765 LARRY BENAVIDEZ 100318 SQUEAKS SERVICES
*** 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: 11600.00
FEES
Hot Water Heater 40.00
Total Valuation 0.00
Use Tax 33.60
** TOTAL ** 73.60
*** COMMENTS ***
*** CONDITIONS ***
Both the front and back of this permit are required to be posted on the job site at all
times. If the complete permit is not present, inspections WILL NOT be performed.
Work shall comply with 2018 IRC & 2020 NEC. Smoke alarms shall comply with 2018 IRC Section
134. Interior alterations, repairs, fuel -fired appliance replacements, or additions, any of
which require a building permit, occurs or where one or more rooms lawfully used for
sleeping purposes shall have an operational carbon monoxide alarm installed within fifteen
feet of the entrance to each room lawfully used for sleeping purposes.
1* � � i City of Wheat Ridge
E -Res. Water Heater Replcmnt PERMIT - 202002336
PERMIT NO: 202002336 ISSUED: 11/12/2020
JOB ADDRESS: 4005 Independence Ct EXPIRES: 11/12/2021
JOB DESCRIPTION: Replace 50 gallon, 40K BTU gas water heater in basement
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 permrt. I further attest that I am leg ally authorized to include all entities named within this document as parties to the work to be
performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (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 may be subject to a fee equal to one-half of the original permit fee.
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 and��procedures 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 change of 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 requ�ired
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 a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any
applicable code or any ordinance 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.
From: no-reolv(alci.wheatridae.m. us
To: CommDev Perm is
Subject: Online Form Submittal: Water Heater Replacement Permit Application
Date: Wednesday, November 11, 2020 2:26:26 PM
Water Heater Replacement Permit Application
This application is exclusively for RESIDENTIAL REPLACEMENT WATER
HEATERS - LIKE FOR LIKE ONLY.
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN
ORDER FOR THE PERMIT TO BE PROCESSED.
Your Permit will be emailed to the email address provided below once it is
processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
Is this application for a Yes
replacement water
heater like for like?
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Address (Leave blank if
not known)
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
4005 Independance Ct
I=i�1TOMW I
720-341-2323
patmd52@yahoo.com
CONTRACTOR INFORMATION
Contractor Business Squeaks
Name
Contractor's License 100318
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 Email
Address
Retype Contractor
Email Address
DESCRIPTION OF WORK
Number of gallons
workorder@squeaksservices.com
workorder@squeaksservices.com
1.9181
Is the water heater Gas
GAS or ELECTRIC?
If GAS, enter # of 40,000
BTUs. If electric, enter
n/a
Where is the water basement
heater located (for
example, basement,
crawlspace, etc)?
Project Value (contract 1600.00
value or cost of ALL
materials and labor)
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 work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal 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.
Person Applying for
Permit
Leah Benavidez
Email not displaying correctly? View it in your browser.
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: n : 1 t �' �✓ JG
Job Address: ` f Clf_ "> Vii'; t ,e{ _� r ✓x C
Permit Number:
10
❑ No one available for inspection: Time �� AM/PM
Re -Inspection required: Yes LN
When corrections have been made, call for re -inspection at 303-234-5933
�i
Date: Inspector: i
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Resid. Windows/Doors PERMIT - 201801962
PERMIT NO: 201801962 ISSUED:
JOB ADDRESS: 4005 Independence CT EXPIRES:
JOB DESCRIPTION: Replacing 8 windows, like for like, u -value = .28
*** CONTACTS ***
OWNER (720)341-2323 DOWELL PATRICIA M
SUB (303)237-1687 John McDade
07/10/2018
07/10/2019
021066 Conservation Construction
*** 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: 6,258.00
FEES
Window Replacement 50.00
Total Valuation 0.00
Use Tax 131.42
** TOTAL ** 181.42
*** COMMENTS ***
*** CONDITIONS ***
Windows shall comply with all applicable codes, have a .32 or better U -factor and shall be
safety glazing if within a tub enclosure, less than 18 inches above the floor or within 24
inches of a vertical edge of a door.
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 ermrt. I further attest that I am legally authorized to include al
I entities named within this document as parties to the work to be
performed and that all work to be performed is disclosed in this document andlor its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (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 may be subject to a fee equal to one-half of the original permit fee.
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 and procedures 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 change of 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 4 permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applicable code or any ordnlce or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of1CiiefBuilling Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
k: -Ar 45,
�_ '1 ♦"�I_ :LIC I''_S�:L2 ._..-rte
iL
iJ1•�ry •J�a _.JJJv l.ii.�'�
City of
� Wheat I�dge
COMMUNi-ry DEVELOPMENT
Building & Inspection Services Division
7500 W. 291 Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits&?ci.wheatridge.co.us
FOR OFFICE USE ONLY
Date:
Plan/permit # au
Plan Review Fee:
Building Permit Application
Please complete all highlighted areas on both sides of this form. Incomplete applications
may not be processed. ***
Property Address:
Owner
Property Owner
4005 Independence Court, Wheat Ridge, CO
Patricia Dowell
Tenant (Commercial Projects Only)
Property Owner Mailing Address: (if different than property
Address: SAME
City State Zip:
IM -11f M ._1 7
Architect/Engineer E-mail:
Phone:
Contractor: Conservation Construction
City of Wheat Ridge License #: # 021066 Phone: 303.237.1687
Contractor E-mail Address: kkimbercc@gmail.com
For Plan Review Questions &
CONTACT NAME (please
CONTACT EMAIL(please
(please print):
Katherine Kimber
kkimbercc@gmaii.com
Sub Contractors (Must provide Wheat Ridge License No.):
Electrical: Plumbing:
W. R. City License # W. R. City License #
720. 341. 2323
ne: 303. 237. 1687
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Mechanical:
W.R. City License #
❑ COMMERCIAL 0 RESIDENTIAL
Description of work: For ALL projects, provide a detailed description of work to be performed,
including current use of areas, proposed uses, square footage, existing condition and proposed new
^"Ai+i^^ S^r%lii2nr-c size and efficirinru WnP and amount of materials to be used, etc.
Nv11V U%05I YY nw„vv J s y P
Replacing 8 windows with no changes to the structure. U Values on glass are 0.28
Commercial Projects Only: Occupancy Type: Construction Type:
Sq. FULF
Amps
_ 'BTUs
SquI�res _
Gallons
Project value: (Contract value or the cost of all materials and labor included in the entire project)
$ 6258.00
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 applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that 1 am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. 1. the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) (CONTRACTOR) (AUTHORIZED REPR ), of (OWNER) (CON RAC
7/10/18
Signature (first and last name):
Printed Name:
ARTMENT
ZONING COMMMENTS:
Reviewer.
BUILDING DEPARTMENT COMMENTS:
Reviewer.
PUBLIC WORKS COMMENTS:
Reviewer.
ONLY
DATE:
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Building Division Valuation:
onservation 8101 W. Colfax Ave., Lakewood, CO 80214
Phone: 303-237-1687 Fax: 303-237-1580
onstruetion conservationco@gwestoffice.net
conservationconstruction. com
Name: Y— 00'0 C..2 e- l/ Email:
Address 700S CZ� Ga. Zip:'6
Primary 7,?o—.3 i4/ #2: —!j / y— -7 Jr `I
#4: HOA Approval Needed? YES N9
Window Brand: �j�t�dUri mom- Window Color: 4,,% r A Quantity �
Qnty. Location Model Type Glass Grids Vert. Horz. Screens Width Height
Ulf 1 I II r f [_ f 1r if 1
—i I Z� 10 L55 C_r f I if if i
fvj kr �"''� v-2�f a 1000— [— U[ if if 1
L,LJI 4,d J1 11-1-0- Le t 11 1 1 1 1 if if 1
L/-Jl 464 1L Son if _�I I f if 1[ i
LLJf /,f6 1 I f r: 1(_ I I f I if if 1
L I-il AV -1 �' 1L 11 5 C 11 1 J
U��3 1[ �vUf��UUUUL_]�Ur lr lr 1
jf lr 1[ 1
I 1[ if 1
UU[—�U—]UUf if if 1
UI if C --1[_ I f f I if if 1
Uf 11 r [—UI f I I if 1f 1
Clean up all job related debris. No painting, staining, or disconnection/reconnection of alarm systems to be done. To have a 2 year warranty on
installation and warranty from the manufacturer. Conservation 5 windows to have welded comers, night vent latches, and steel
reinforcement in all meeting rails Glass to be double pane, double strength, gas filled "neat' glass system with white super spacer seal. C5 windows
to have push button steel cam lock and BetterVue screen (unless otherwise specified). Inside removable slider track with metal reinforcement. Price
includes accidental glass breakage and screen repair — see warranty for exclusions. DIAGRAMS:
�n , . i. ! - - — ------ -
a ,<
Contract Price: o '``' Down Payment: Z� 5 `" Payment Due Upon Completion:
Amount Financed: Finance Terms: Min. Mo. Pymt. (Approx.) S
(Subject to the approval of the Credit Sales Department)
Company Approval: Any alteration or deviation from above specifications must
be made in writing. All surplus materials belong to Conservation Construction Corp.
Notice To Buyers
In the event that the Purchaser defaults on any of the terms stated herein, Conservation Construction Corp. shall be entitled to recover all expenses incurred; including
but not limited to the following: retail cost ot'custom built products, supplier restocking charges, and job acquisition / loss of revenue. Purchaser understands that
Conservation Construction Corp. has and/or will expend considerable time and expense in connection with the activities mentioned in the prior sentence. Should legal
action be taken for any reason associated with this contract, parties agree that such action will be taken in Jefferson County, CO; which shall be the exclusive venue for
any legal action. Failure of Conservation Construction Corp. to enforce any condition or term of this agreement shall not negate our right to enforce any other terms or
conditions of this agreement. Conservation Construction Corp, shall not be responsible for delays caused by strikes, weather conditions, delays in obtaining materials,
HOA or permitting delays, or other causes beyond its control.
You have received a "notice of right to cancel" if this agreement was solicited at your residence. If you no longer wish to purchase the goods or
services, you may cancel this agreement by mailing the "notice of right to cancel' that was given to you with this contract to the above address. The
notice must be mailed before midnight on the 3rd business day after the agreement is signed. Any alteration or deviation from the specifications stated
herein must be made in writing; and must be signed by both the Purchaser and a representative of Conservation Construction Corp.
I have read and agree to be bound by the termsofthis contract: Q�
Purchaser/Homeowner C.��Xit �zt-� . ' )�J� Date D
Purchaser/Homeowner Date
If needed, a digital copy win suffice in place of the original document.
7/3/2018 1:03 PM FROM: Fax Server TO: +17177352840 P. 1 SENt
en ax,
WINDOWS & DOORS
A Division of Euramax International, Inc.
ACKNOWLEDGEMENT
SALES ORDER NO. DATE ORDERED
1707460 107/03/18
CUSTOMER P.O. PRICE CLASS
DOWELU062218
604
3950 MEDFORD DRIVE Phone: 800-827-4369 SHIPPED VIA FOB POINT
LOVELAND, CO 80538 Fax: 800-601-3227 DENVER WAREHOUSE ORIGIN
www.AmerimaxWindows.com PAYMENTTERMS TAX CO
NET 30 CO
CON101 CON103
CONSERVATION CONSTRUCTION CORP CONSERVATION CONSTRUCTION
SOLD 8101 WEST COLFAX AVE SKIP 5360 WASHINGTON ST
ATTN: ACCOUNTS PAYABLE DENVER, CO 80216
TO LAKEWOOD, CO 80214 TO USA Ph:(303) 237-1687
USA Ph:(303) 237-1687 FAX:(303) 237-1580
LINE ( PRODUCT / DESCRIPTION I QTY. REQUESTED I UNIT PRICE I EXT'D. PRICE
ORDERED DELIVERY DATE
001 VW38002L 1 07/16/18
3800 2 LITE
Craftsman Portrait 2 -LITE (XO) WHT
Stucco -Frame 71-3/&'x 47-5/8" Oriel:50.000% of Op.Sash 119 -UI
Left Glass: 3/4" -Double 1/8 LOWE 366 NEAT & 1/8 CLEAR
Rgt. Glass: 3/4" -Double 1/8 LOWE 366 NEAT & 1/8 CLEAR
Mixed Gas WHITE Spacers
Screen: Extruded HALF BETTERVUE
**U-Value=0.27 SHGC=0.22 VLT=0.51**
002 VW38002L 1
3800 2 LITE
Craftsman Portrait 2 -LITE (XO) WHT
Stucco -Frame 34-7/8" x 35' Oriel:50.000% of Op.Sash 70 -UI
Left Glass: 3/4" -Double 1/8 LOWE 366 NEAT & 1/8 CLEAR
Rgt. Glass: 3/4" -Double 1/8 LOWE 366 NEAT & 1/8 CLEAR
Mixed Gas WHITE Spacers
Screen: Extruded HALF BETTERVUE
**U-Value=0.27 SHGC=0.22 VLT=0.51**
003 VW38002L 1
3800 2 LITE
Craftsman Portrait 2 -LITE (XO) WHT
Stucco -Frame 71-1/4" x 35-3/4" Oriel:50.000% of Op.Sash 107 -UI
Left Glass: 3/4" -Double 1/8 LOWE 366 NEAT & 1/8 CLEAR
Rgt. Glass: 3/4" -Double 1/8 LOWE 366 NEAT & 1/8 CLEAR
Mixed Gas WHITE Spacers
Screen: Extruded HALF BETTERVUE
**U-Value=0.27 SHGC=0.22 VLT=0.51**
004 VW38002L 1
Please respond IMMEDIATELY with any corrections. DO NOT re-
seed original Order Form. Thank you.
Page 1 of 3
07/16/18
07/16/18
07/16/18
SUBTOTAL
TAX
TOTAL: CONTINUED
7/3/2018 1:03 PM FROM: Fax Server TO: +17177352840 P. 2 SENt 8
en ax,
WINDOWS & DOORS
A Division of Euramax International, Inc.
3950 MEDFORD DRIVE Phone: 800-827-4369
LOVELAND, CO 80538 Fax: 800-601-3227
www.Am erimax Windo ws. com
CON 101
CONSERVATION CONSTRUCTION CORP
SOLD 8101 WEST COLFAX AVE
ATTN: ACCOUNTS PAYABLE
TO LAKEWOOD, CO 80214
USA Ph:(303) 237-1687 FAX:(303) 237-1580
LINE I PRODUCT/ DESCRIPTION
ACKNOWLEDGEMENT
SALES ORDER NO.
DATE ORDERED
1707460
07/03/18
CUSTOMER P.O.
PRICE CLASS
DOWELL1062218
CONTACT
SLS REP CODE
604
SHIPPED VIA
FOB POINT
DENVER WAREHOUSE
ORIGIN
PAYMENT TERMS
TAX CODE
NET 30
CO
CON103
CONSERVATION CONSTRUCTION
SHIP 5360 WASHINGTON ST
TO DENVER, CO 80216
USA Ph:(303) 237-1687
QTY. REQUESTED UNIT PRICE ExT'D. PRICE
ORDERED DELIVERY DATE
Craftsman Portrait 2 -LITE (XO) WHT
Stucco -Frame 59-1/4" x 35-5/8" Oriel:50.000% of Op.Sash 95 -UI
Left Glass: 3/4" -Double 1/8 LOWE 366 NEAT & 1/8 CLEAR
Rgt. Glass: 3/4" -Double 1/8 LOWE 366 NEAT & 1/8 CLEAR
Mixed Gas WHITE Spacers
Screen: Extruded HALF BETTERVUE
**U-Value=0.27 SHGC=0.22 VLT=0.51**
005 VW38002L 1 07/16/18
3800 2 LITE
Craftsman Portrait 2 -LITE (XO) WHT
Stucco -Frame 59-3/8" x 35-3/4" Oriel:50.000% of Op.Sash 96 -UI
Left Glass: 3/4" -Double 1/8 LOWE 366 NEAT & 1/8 CLEAR
Rgt. Glass: 3/4" -Double 1/8 LOWE 366 NEAT & 1/8 CLEAR
Mixed Gas WHITE Spacers
Screen: Extruded HALF BETTERVUE
**U-Value=0.27 SHGC=0.22 VLT=0.51**
006 VW38002L 1 07/16/18
3800 2 LITE
Craftsman Portrait 2 -LITE (XO) WHT
Stucco -Frame 71-3/8" x 35-3/8" Oriel:50.000% of Op.Sash 107 -UI
Left Glass: 3/4" -Double 1/8 LOWE 366 NEAT & 1/8 CLEAR
Rgt. Glass: 3/4%13ouble 1/8 LOWE 366 NEAT & 1/8 CLEAR
Mixed Gas WHITE Spacers
Screen: Extruded HALF BETTERVUE
**U-Value=0.27 SHGC=0.22 VLT=0.51**
007 VW38002L 1 07/16/18
3800 2 LITE
Craftsman Portrait 2 -LITE (XO) WHT
Stucco -Frame 47-1/4" x 35-3/4" Oriel:50.000% of OD.Sash 83 -UI
Please respond IMMEDIATELY with any corrections. DO NOT re-
seed original Order Form. Thank you.
Page 2of3
SUBTOTAL
TAX
TOTAL: CONTINUED
7/3/2018 1:03 PM FROM: Fax Server TO: +17177352840 P. 3 SENt 8
men ax -
WINDOWS & DOORS
A Division of Euramax International, Inc.
ACKNOWLEDGEMENT
SALES ORDER NO. DATE ORDERED
1707460 07/03/18
CUSTOMER P.O. PRICE CLASS
DOWELU062218
604
3950 MEDFORD DRIVE Phone: 800-827-4369 SHIPPED VIA FOB POINT
LOVELAND, CO 80538 Fax: 800-601-3227 DENVER WAREHOUSE ORIGIN
www.AmerimaxW!ndows.com PAYMENTTERMS TAX CODE
NET 30 CO
CON101 CON103
CONSERVATION CONSTRUCTION CORP CONSERVATION CONSTRUCTION
SOLD 8101 WEST COLFAX AVE SHIP 5360 WASHINGTON ST
ATTN: ACCOUNTS PAYABLE DENVER, CO 80216
TO LAKEWOOD, CO 80214 TO USA Ph:(303) 237-1687
USA Ph:(303) 237-1687 FAX:(303) 237-1580
LINE
PRODUCT I DESCRIPTION
QTY.
ORDERED
I REQUESTED
IDELIVERYDATE
(SNIT PRICE
EXT D. PRICE
Left Glass: 3/4" -Double 1/8 LOWE 366 NEAT & 1/8 CLEAR
Rgt. Glass: 3/4" -Double 1/8 LOWE 366 NEAT & 1/8 CLEAR
Mixed Gas WHITE Spacers
Screen: Extruded HALF BETTERVUE
**U-Value=0.27 SHGC=0.22 VLT=0.51**
008
VW38002L 1
07/16/18
3800 2 LITE
Craftsman Portrait 2 -LITE (XO) WHT
Stucco -Frame 35-3/8" x 23-5/8" Oriel:50.000% of Op.Sash 59 -UI
Left Glass: 3/4" -Double 1/8 LOWE 366 NEAT TEMP & 5/32 NARROW REED TEMP
Rgt. Glass: 3/4' -Double 1/8 LOWE 366 NEAT TEMP & 5/32 NARROW REED
TEMP
Mixed Gas WHITE Spacers
Screen: Extruded HALF BE17ERVUE
**U-Value=0.27 SHGC=0.22 VLT=0.51**
009
VW610101 8
07/16/18
CAULK NOVA SLCN CW
010
VW620021 4
07/16/18
FoamTape 3/4x1 -1/2x50'
Black
SUPPLEMENTAL GLASS
WARRANTY CHARGE
Please respond IMMEDIATELY with any corrections. DO NOT re-
seed original Order Form. Thank you.
Page 3of3
SUBTOTAL
TAX
TOTAL:
City of Wheat Ridge
Residential Roofing PERMIT - 201703690
PERMIT NO: 201703690 ISSUED: 07/11/2017
JOB ADDRESS: 4005 Independence CT EXPIRES: 07/11/2018
JOB DESCRIPTION: Residential Re -roof to install IKO Cambridge asphalt shingles - 23 sq.
*** CONTACTS ***
OWNER (720)341-2323
DOWELL PATRICIA
M
SUB (303)942-1539
Phil Theriault
130200 Top That Roofing
*** 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: 5,911.00
FEES
Total Valuation
Use Tax
0.00
124.13
PAID
Permit Fee
140.90
** TOTAL **
265.03
I
*** COMMENTS ***
*** CONDITIONS ***
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) requires an approved inspection
prior to installation of ANY roof coverings and is require on the entire roof when spaced
or board sheathing with ANY gap exceeding one half inch exists. 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.
Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd
party inspection report will be collected at final roof inspection performed by City of
Wheat Ridge. If report is not available the final inspection will not be completed.
City of Wheat Ridge
Residential Roofing PERMIT - 201703690
PERMIT NO: 201703690 ISSUED: 07/11/2017
JOB ADDRESS: 4005 Independence CT EXPIRES: 07/11/2018
JOB DESCRIPTION: Residential Re -roof to install IKO Cambridge.asphalt shingles - 23 sq.
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 permit. I further attest that I am le ally authorized to include all entities. named within this document as parties to the work to be
peiforr%t d aid that iso if to be performed is disclosed in this document *d/or hs' accompanying approved plans and specifications.
nature of OWNER or CONTRACTOR (Circle one) Date
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.
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 may be subject to a fee equal to one-half of the original permit fee.
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 and procedures 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.
No work of an manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
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.
The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applicable co
any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
10
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Dane Lovett
From: no-reply@ci.wheatridge.co.us
Sent: Wednesday, June 28, 2017 2:38 PM
To: Permits CommDev
Subject: Online Form Submittal: Residential Roofing Permit Application
Categories: Dane
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.
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
Property Owner Name
Property Owner Phone
Number
Property Owner Email
Address
4005 Independence Ct
Patricia Dowell
720.341.2323
jackieroofing@gmail.com
Do you have a signed Yes
contract to reroof this
property?
It will need to be
provided at the time of
permit pick-up.
CONTRACTOR INFORMATION
Contractor Name
Contractor's License
Number (for the City of
Wheat Ridge)
Contractor Phone
Number
Top That Roofing
130200
3039421539
Contractor Email Address jackieroofing@gmail.com
Retype Contractor Email jackieroofing@gmail.com
Address
DESCRIPTION OF WORK
Are you re -decking the No
roof?
Description of Roofing IKO Cambridge
Material
Select Type of Material: Asphalt
If "Other" is selected Field not completed.
above, describe here:
How many squares of the 23
material selected above?
Does any portion of the No
property include a flat
roof?
If yes, how many squares Field not completed
on the flat roof?
TOTAL SQUARES of all 23
roofing material for this
proj ect
Provide additional detail house roof
here on the description of
z
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
Project Value (contract 4-a p
value or cost of ALL
materials and labor
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
owner of the property to
submit this application
and to perform the work
described above.
Name of Applicant Phil Theriault
Email not displaying correctly? View it in your browser.
3
'40 �_W TOP THAT ROOFING
TOP THAT 9940 E. Costilla Ave., Suite N • Centennial, CO 80112
nn
Q C I N Ir_ T. 303-927-6585 • F: 303-997-2109
�' t
:CCRECR'C
BUSH: E55
ro spa--su mi a tp:
`moi
op t of g . stima or , i
ate r
v
-/ =l'f
Street
Job Location/Community j J
I171�3urance Adjuster
City/State/Zip E
Ins u "ce Company /
Policy
} ,' �'-�,•'-, . 1.�.,1s;(rt� "✓�' e',) �J, ;.
LC , f�? r' ' i` _� t ✓r�,--
( f t' ! i S f .v% / � j i...
Home Phone2 j /
Work Phone
Claim # j
Off: j a
Roof
Color:
❑ NewValleys!w1,90# Reinforcement.
❑ W -Valley:
aRidge:
❑ NaiL ❑ 1 Y• Ell 1h ❑ 13l+
aReplace Roof Stacks: ❑ 1.5" ❑ 2" ❑ 3" ❑ 4" 05"
❑ Paint Roof Stacks:
O Ridoe Vents:
❑ Cleanup & Haul Off Trast
❑Cleanup Around Bushes:
❑ Low Profile Vents: (( !�-Exti�W_Qrk:
❑ Counterflash: f t !--: ` i • J__
❑•Roll Yard with Magnetic Roller
❑ Protect Landscaping:
a,Clean Out Gutters:
®`/Bad Decking to be Replaced at an Additional:
> sq. ft.
O 5 Year Workmanship Warranty from Top That Roofing, Inc.
❑Permit Furnished by Top That Roofing, Inc.
We propose hereby to furnish material*d labor and complete in accordance with the above
r
Payment to be made as follows:
("Delivery Instructions:- )
for tate sum of $
,.This estimate does not obligate the homeowner or Top That Roofing, Inc. in any way unless it is approved by the Insurance Company and accepted by Top That Roofing, Inc. By signing
this agreement the homeowner authorizes Top That Roofing, Inc. to pursue homeowners best interest for a roof replacement or repair at a price agreeable to the insurance company and
! to Top That Roofing, Inc. with no additional cost to the homeowner except for the deductible. When the insurance company and Top That Roofing, Inc. agree upon a price,
that price will become the final contract price and Top That Roofing, Inc. will receive all insurance proceeds for the work completed by Tap That Roofing, Inc. (Initiaq
'Ale propose to complete in accordance with the above specifications and subject to conditions found above on this proposal. Payment to be made as follows:
Pro_ pi rtyLner / ❑ is not intending to make payment from the proceeds of a property and casualty insurance policy.
Check to be mail payable to Homeowners and Top That Roofing, Inc. -"N Alai)
GENERAL CONTRACTOR: Homeowner acknowledges Top That Roofing, Inc. as a General Contractor and as such will be entitled to a l O% profit and 10% overhead, as allowed by
insurance industry standards.
Top That Roofing, Inc. shall hold in trust any payment received from you until Top That Roofing, Inc. has delivered roofing materials at the site or has performed a majority of
the roofing work on your property.
Top That Roofing, Inc. carries workers' compensation, automobile and commercial general liability (bodily injury and property damage) insurance. A Certificate of Insurance
identifying our insurance carrier and the types and amounts of coverage and our insurance contact information is attached or will be provided to Customer and is
incorporated herein by reference and should be considered as part of this contract.
You have the right to rescind this contract and obtain a full refund of any deposit within 72 hours after entering the contract If you plan to use the proceeds of a property
and casualty insurance policy to pay for the roofing work, you may rescind this contract within 72 hours after you receive written notice from the property and casualty
insurer that your claim has been denied in whole or in part. However, Top That Roofing, Inc. is entitled to retain payments or deposits to compensate Top That Roofing, Inc.
for roofing work actually performed in a workmanlike manner consistent with standard roofing industry practices. Top That Roofing, Inc. cannot pay, waive, rebate, or
promise to pay, waive or rebate all or part of any insurance deductible applicable to the insurance claim for payment for roofing work on your property.
ACCEPTANCE OF PROPOSAL: This proposal becomes the legal and binding contract 72 hours from date of acceptance.1 lh%per month interest will be added to all accounts 30 days
past due. In addition, costs and reasonable attorney's fees for collection may be charged on any account past due over 30 days. Payment is to be made at time of completion. Warranty
will be void if payment is not made in full within 30 days. Failure to pay can constitute a mechanical lien filed against the property. All material is guaranteed to be as specified. All
work to be completed in a workman like manner to standard practices. All interior damages to buildings are excluded 9D days after completion date and the owner is notified that any
damage to contents will be the responsibility of the owner and his insurance company. All damages to the building, which occurred while roofing was in progress, will be covered by the
contractor. All agreements are contingent upon strikes, accidents, or delays beyond our control. Owner is to carry fire, tornado, and other necessary insurances. Top That Roofing, Inc. is
not responsible for broken driveways. Scheduling will be done based upon date signed but limited by availability for material, crews, and weather conditions. Re -roofing does not include
decking. „
Purchaser signature:
Top That Roofing Inc.
Date: S `
Date: f'
City of Wheat Ridge
Residential Roofing PERMIT - 201703690
PERMIT NO: 201703690 ISSUED: 07/11/2017
JOB ADDRESS: 4005 Independence CT EXPIRES: 07/11/2018
JOB DESCRIPTION: Residential Re -roof to install IKO Cambridge asphalt shingles - 23 sq.
*** CONTACTS ***
OWNER (720)341-2323
DOWELL PATRICIA
M
SUB (303)942-1539
Phil Theriault
130200 Top That Roofing
*** 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: 5,911.00
FEES
Total Valuation
Use Tax
0.00
124.13
PAID
Permit Fee
140.90
** TOTAL **
265.03
I
*** COMMENTS ***
*** CONDITIONS ***
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) requires an approved inspection
prior to installation of ANY roof coverings and is require on the entire roof when spaced
or board sheathing with ANY gap exceeding one half inch exists. 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.
Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd
party inspection report will be collected at final roof inspection performed by City of
Wheat Ridge. If report is not available the final inspection will not be completed.
City of Wheat Ridge
Residential Roofing PERMIT - 201703690
PERMIT NO: 201703690 ISSUED: 07/11/2017
JOB ADDRESS: 4005 Independence CT EXPIRES: 07/11/2018
JOB DESCRIPTION: Residential Re -roof to install IKO Cambridge.asphalt shingles - 23 sq.
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 permit. I further attest that I am le ally authorized to include all entities. named within this document as parties to the work to be
peiforr%t d aid that iso if to be performed is disclosed in this document *d/or hs' accompanying approved plans and specifications.
nature of OWNER or CONTRACTOR (Circle one) Date
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.
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 may be subject to a fee equal to one-half of the original permit fee.
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 and procedures 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.
No work of an manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
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.
The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applicable co
any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
10
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Dane Lovett
From: no-reply@ci.wheatridge.co.us
Sent: Wednesday, June 28, 2017 2:38 PM
To: Permits CommDev
Subject: Online Form Submittal: Residential Roofing Permit Application
Categories: Dane
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.
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
Property Owner Name
Property Owner Phone
Number
Property Owner Email
Address
4005 Independence Ct
Patricia Dowell
720.341.2323
jackieroofing@gmail.com
Do you have a signed Yes
contract to reroof this
property?
It will need to be
provided at the time of
permit pick-up.
CONTRACTOR INFORMATION
Contractor Name
Contractor's License
Number (for the City of
Wheat Ridge)
Contractor Phone
Number
Top That Roofing
130200
3039421539
Contractor Email Address jackieroofing@gmail.com
Retype Contractor Email jackieroofing@gmail.com
Address
DESCRIPTION OF WORK
Are you re -decking the No
roof?
Description of Roofing IKO Cambridge
Material
Select Type of Material: Asphalt
If "Other" is selected Field not completed.
above, describe here:
How many squares of the 23
material selected above?
Does any portion of the No
property include a flat
roof?
If yes, how many squares Field not completed
on the flat roof?
TOTAL SQUARES of all 23
roofing material for this
proj ect
Provide additional detail house roof
here on the description of
z
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
Project Value (contract 4-a p
value or cost of ALL
materials and labor
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
owner of the property to
submit this application
and to perform the work
described above.
Name of Applicant Phil Theriault
Email not displaying correctly? View it in your browser.
3
'40 �_W TOP THAT ROOFING
TOP THAT 9940 E. Costilla Ave., Suite N • Centennial, CO 80112
nn
Q C I N Ir_ T. 303-927-6585 • F: 303-997-2109
�' t
:CCRECR'C
BUSH: E55
ro spa--su mi a tp:
`moi
op t of g . stima or , i
ate r
v
-/ =l'f
Street
Job Location/Community j J
I171�3urance Adjuster
City/State/Zip E
Ins u "ce Company /
Policy
} ,' �'-�,•'-, . 1.�.,1s;(rt� "✓�' e',) �J, ;.
LC , f�? r' ' i` _� t ✓r�,--
( f t' ! i S f .v% / � j i...
Home Phone2 j /
Work Phone
Claim # j
Off: j a
Roof
Color:
❑ NewValleys!w1,90# Reinforcement.
❑ W -Valley:
aRidge:
❑ NaiL ❑ 1 Y• Ell 1h ❑ 13l+
aReplace Roof Stacks: ❑ 1.5" ❑ 2" ❑ 3" ❑ 4" 05"
❑ Paint Roof Stacks:
O Ridoe Vents:
❑ Cleanup & Haul Off Trast
❑Cleanup Around Bushes:
❑ Low Profile Vents: (( !�-Exti�W_Qrk:
❑ Counterflash: f t !--: ` i • J__
❑•Roll Yard with Magnetic Roller
❑ Protect Landscaping:
a,Clean Out Gutters:
®`/Bad Decking to be Replaced at an Additional:
> sq. ft.
O 5 Year Workmanship Warranty from Top That Roofing, Inc.
❑Permit Furnished by Top That Roofing, Inc.
We propose hereby to furnish material*d labor and complete in accordance with the above
r
Payment to be made as follows:
("Delivery Instructions:- )
for tate sum of $
,.This estimate does not obligate the homeowner or Top That Roofing, Inc. in any way unless it is approved by the Insurance Company and accepted by Top That Roofing, Inc. By signing
this agreement the homeowner authorizes Top That Roofing, Inc. to pursue homeowners best interest for a roof replacement or repair at a price agreeable to the insurance company and
! to Top That Roofing, Inc. with no additional cost to the homeowner except for the deductible. When the insurance company and Top That Roofing, Inc. agree upon a price,
that price will become the final contract price and Top That Roofing, Inc. will receive all insurance proceeds for the work completed by Tap That Roofing, Inc. (Initiaq
'Ale propose to complete in accordance with the above specifications and subject to conditions found above on this proposal. Payment to be made as follows:
Pro_ pi rtyLner / ❑ is not intending to make payment from the proceeds of a property and casualty insurance policy.
Check to be mail payable to Homeowners and Top That Roofing, Inc. -"N Alai)
GENERAL CONTRACTOR: Homeowner acknowledges Top That Roofing, Inc. as a General Contractor and as such will be entitled to a l O% profit and 10% overhead, as allowed by
insurance industry standards.
Top That Roofing, Inc. shall hold in trust any payment received from you until Top That Roofing, Inc. has delivered roofing materials at the site or has performed a majority of
the roofing work on your property.
Top That Roofing, Inc. carries workers' compensation, automobile and commercial general liability (bodily injury and property damage) insurance. A Certificate of Insurance
identifying our insurance carrier and the types and amounts of coverage and our insurance contact information is attached or will be provided to Customer and is
incorporated herein by reference and should be considered as part of this contract.
You have the right to rescind this contract and obtain a full refund of any deposit within 72 hours after entering the contract If you plan to use the proceeds of a property
and casualty insurance policy to pay for the roofing work, you may rescind this contract within 72 hours after you receive written notice from the property and casualty
insurer that your claim has been denied in whole or in part. However, Top That Roofing, Inc. is entitled to retain payments or deposits to compensate Top That Roofing, Inc.
for roofing work actually performed in a workmanlike manner consistent with standard roofing industry practices. Top That Roofing, Inc. cannot pay, waive, rebate, or
promise to pay, waive or rebate all or part of any insurance deductible applicable to the insurance claim for payment for roofing work on your property.
ACCEPTANCE OF PROPOSAL: This proposal becomes the legal and binding contract 72 hours from date of acceptance.1 lh%per month interest will be added to all accounts 30 days
past due. In addition, costs and reasonable attorney's fees for collection may be charged on any account past due over 30 days. Payment is to be made at time of completion. Warranty
will be void if payment is not made in full within 30 days. Failure to pay can constitute a mechanical lien filed against the property. All material is guaranteed to be as specified. All
work to be completed in a workman like manner to standard practices. All interior damages to buildings are excluded 9D days after completion date and the owner is notified that any
damage to contents will be the responsibility of the owner and his insurance company. All damages to the building, which occurred while roofing was in progress, will be covered by the
contractor. All agreements are contingent upon strikes, accidents, or delays beyond our control. Owner is to carry fire, tornado, and other necessary insurances. Top That Roofing, Inc. is
not responsible for broken driveways. Scheduling will be done based upon date signed but limited by availability for material, crews, and weather conditions. Re -roofing does not include
decking. „
Purchaser signature:
Top That Roofing Inc.
Date: S `
Date: f'
CITY OF WHEAT RIDGE
06/29/12 10:81 AN cdha
Timothy Bartels
RECEIPT NO:CDA@87410
AMOUNT
PSP Install a aaa cooler
81.40
20120786
Permit Faye
Use Tax
41.40
P¢A ` 1 ,RECEIVED
ANDUNT
E 7281
81.48
Rath Code
062891(
TOTAL
1 .
m:Nikki (13032378929)
11:18 06/29112 EST Pg 2-2
City (A
iUNT
1 9r, "
Squares _ BTU's _ Gallons _ Amps _ Sq Ft,
Date.*
Plan #
Pe it #
IIIIIIIMI N "'��� +�►
* a ," jpficaflon
Electrical" Pl b Mechanical:
uming:
City License # City Ucense # City License #
♦ A s CITY OF WHEAT RIDGE
Building Inspection Division
r (303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: i~ <7
Job Address:
Permit Number: /Old i 7
t
ti
❑ No one available for inspection: Time /f L - AM! M
Re-Inspection required: Yes No
*When corrections have been made, call for re-inspection at 303-234-5933
r
Date: /0 Inspector '
DO NOT REMOVE THIS, NOTICE
01/19/2010 15:28 1-303-231-9655 KDBRANCH30
~okWSar City of Wheat Ridge Building Division
3'.;° 7500 W. 29 h Ave., Wheat Ridge, CO 80033
Office: 303-2352855 * Fax: 303-235-2857
a; o Inspection Line: 303-234-5933
p
LO ap
Property Address:
QQ~
Property Owner (p/ease print):
Building Permit Application
Mailing Address: (ifdltfefent than property address)
PAGE 02102
Dat®:
Plan
Permit#:
Exp. Date: Exp. Date: Exp. Date:
Use of space (description): Construction Value. S 019 7 • (Oy
Dam/ scriptf'on of work. (as calculated perthe Building Valuation Data shoot)
J/ ~ &F~.uT lC l e n a~s...,,,~/~. r . frN~... \ • Plan Review (due at time of submittal): 3
Sq. Ft./L.r/Ftt WC added: 7 Squares BTU's Gallons Amps
OWNERICONTRACTOR 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 byy 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 sub)setto field inspection.
CIRLC47 ONE:: (OWNER) (CONTRACTOR) or PERSONAL REPRESENTA (OWNER CONTRATOR)
PRINT NAME: SIGNATURE: Date:
ZONING COMMENTS:
Zoning;
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
DEPARTMENT USE ONLY
BUILDING DEPARTMENT COMMENTS: OCCUPANCY;
Reviewer:
FIRE DEPARTMENT:: 0 epproVed w/ comments 0 disapproved ❑ no review required
Sub Contractors:
Electrical City License plumbing City License Mechanical City License
Company: Company Company:
♦ i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
J (303) 235-2855 Office • (303) 235-2857 Fax
INSPECTION NOTICE
'Inspection Type: H
JobAddress-
Permit Number:
❑ No one available for inspection: Time AM/PM
Re-Inspection required: Yes (N
`When corrections have been made, call for r - nape ion ` at 303-234-5933
Ci
Date: ~ 4 fnspector:
DO NOT REMOVE THIS NOTICE
♦ i CITY OF WHEAT RIDGE
r Building Inspection Division
1 (303) 234 -5933 Inspection line
(303) 235 -2855 Office • (303) 235 -2857 Fax
INSPECTION NOTICE
Inspection Type: / I ?� kC` op
Job Address: _ lP�f� �� t 1 L C r
Permit Number: Oq A I ;q
❑ No one available for inspection: Time AM /PM
Re- Inspection required: Yes No
"When ( corrections have been made, call or re- Inspection at 303 -234 -5933
Date: - I -1 -n 0 I Inspector:
DO NOT REMOVE THIS NOTICE
PERMIT NO: .092154.
JOB ADDRESS:: 4005 2ND
DESCRIPTION: Remove 'a
y of Wheat Ridge
I
idential Roofing PERMIT - 092154
ISSUED: 09/09/2009
PENDENCE CT 1. EXPIRES: 03/08/2010
d replace 26,sgs. of ; asphalt shingles
16-3977 Mike Essary 09- .0139. Shield Const. &- Exteriors
**
UA ':..USE: UA
0263 BLOCK /LOT #: 0/
VJC
* *
TO
JMMARY ** ESTIMATED :PROJECT .VALUATION: - 4,602.0.0
FEES
Fee 144.70
aluation .00
82.84
* *. %227.54
shield required fr(
ct to field inspect.
IS:
Istallation & mid roof inspection required. Board sheathing spaced more
oy certify that the setback
aces, rules or regulations:
=ments shown, and allegatic
ation and that I assume -ful
)n
ignature of contractor /owner
work under this perm
I
. Plans Tsubject 't
to
. Ice and
5
t'Ridge Building Code i(I.B.C) an,
o. field inspection.
icable
11
>n this
Cher?