HomeMy WebLinkAbout4395 Dover StreetFrom: no-reolv(alci.wheatridae.m. us
To: CommDev Perm is
Subject: Online Form Submittal: Residential Window/Door Replacement Permit Application
Date: Wednesday, April 7, 20211:08:59 PM
Residential Window/Door Replacement Permit Application
This application is exclusively for RESIDENTIAL REPLACEMENT WINDOWS and
DOORS - LIKE FOR LIKE ONLY.
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM AND
WINDOW/DOOR CUTSHEET (SPEC SHEET) 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 Yes
replacement window(s)
and/or door(s) like for
like?
PROPERTY INFORMATION
Property Address 4395 Dover Street Wheat Ridge, CO 80033
Property Owner Name Christine Metzger
Property Owner Phone
303-895-9212
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Field not completed.
Address
Attach City of Wheat
Electronic Payment Form 4395 Dover St Metzaer 04 -07 -
Ridge Electronic
2021.Ddf
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business
Egress, Inc dba Dischner Construction Services
Name
Contractor's License 060085
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
What is being replaced
Number of window
and/or doors being
replaced
Location of
window(s)/door(s)
being replaced (for
example, master
bedroom, kitchen,
bathroom, etc):
What is the u -value of
the window(s)/door(s)?
City of Wheat Ridge
requires the u -value to
be .30 or better on
windows..
Attach copy of
window/door cut sheets
showing sizes and u -
value
1918191 E,
answers@egressinc.net
answers@egressinc.net
NVA Morel,
®.
Permit Aoolication U -factor 4395 Dover St. Metzaer 04-07-
2021 ndf
Project Value (contract 2024.00
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 Loretta L Casey
Permit
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 rr
Inspection Type: 31 -� 1
Job Address: 32 d� GVe _S ,
Permit Number: 9L L2 (fid `7 %
❑ No one available for inspection: Time /PM
Re -Inspection required: Yes No
When corrections have been ma , 11 for re -inspection at 303-234-5933
Date: Ins
DO NOT R OVE THIS NOTICE
City of Wheat Ridge
Residential Electric PERMIT -201900071
201900071 ISSUED: 01/14/2019
PERMIT N0: EXPIRES: 01/14/2020
JOB ADDRESS: 4395 Dover St
JOB DESCRIPTION: Residential electrical -new 200 AMP main service.
*** CONTACTS ***
OWNER (303)895-9212 METZGER CHRISTINE D 018601 ULTIMATE ELECTRIC, INC.
SUB (720)331-1998 JOHN T. SMITH
*** PARCEL INFO ***UA / Unassigned
ZONE CODE: UA / Unassigned
USE:
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 3,700.00
FEES
Total Valuation 0.00
77.70
Use Tax 109.20
Permit Fee 186.90
** TOTAL **
*** COMMENTS ***
*** CONDITIONS ***
Must comply w/ 2012 IRC & 2017 NEC. Subject to field inspection.
Iand
, by my signature, do hereby attest that the work to municipal
performed shall comply with all accompanying approved plans and specifications,
applicable building cobees, and ertl anpolam authorized to obtamphis ermitolicies da d perform the work described bed and approved n conjunctioowner or have been n with
be
by the legal owner of p p Y
this�penmt. I further attest that I am legally authorized to include all entities named within this document as partes to the work to io
perform and that Il w r to be performed is disclosed in this document��a//nd/or its' accompanying approved plans and specifications.
,14 ' /19
Signat e of OWNER or be
(Circle one) Date
I This ermit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subj ct to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and made in procedures.
2. rThis eceived prior tolthe date of exire 365 p ration.tAn extension he date of no missuance oredthan 180 days less of madRequests
be granted at thfor e dion scretion retioust n of he Chief tB Building
Official and may be subject to a fee equal to one-half of the original permit fee.
3, If this pen -nit expires, a new pennit 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 Offial and is not guaranteed.
cl
4, No work of any manner shall be performed that shall results in a change. of the natural flow of water without prior and spre ecific
approval.
5. The permit holder shall notify the B Gilding and
w thout wrction rtteneapproval of such wsion in ork from thewith Buildingtablished and1lnspecof non Services
Ins
inspections and shall not pro
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision o any
ap ble code or a `y 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.
City of
`)`!heat ic�ge
COMMUNITY DEVELOPMENT
Building & Inspection Services
7500 W. 2911 Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 " Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(a)ci.wheatridge.co.us
FOR OFFICE USE ONLY
Date1- jq l
Plan/Permit #
Plan Review Fee:
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address: q3°►t) tpyk�-rrL J
Property Owner Email;
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address:
City, State, Zip:
Architect/Engineer E-mail: Phone:
Contractor Name: ORK. f_- �( �, I NC.
City of Wheat Ridge License #: (% ( 00 (10 1 Phone: IZZ - 331—1 q O
Contractor E-mail Address:_'�o �
63& .- /A (qN� ftV4,k ul-J.�, I tJCb (0i0
For Plan Review Questions S Comments (please print):
�ee
CONTACT NAME (please print):1V�� 1 {A Phone: :ic 2.Q -
CONTACT EMAIL(p/ease print):
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Complete all highlighted fields, if applicable.
❑COMMERCIAL
RESIDENTIAL
Provide 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 condition, appliance size and efficiency, type and amount of materials to be used, etc.
dew P00AWf Mlv(\� st4al'c e- - ix* Pte►El ATL
Sq. FULF
BTUs
Gallons
Amps Squares For Solar: KIN # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
ZM , Wo
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 I 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. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) (CONTRACTOR or A THORIZEDREPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and laZ
me): 1 DATE: ! 1Ll i
Printed Name: _ 1) — !
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
Building Division Valuation:
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:
Job Address:
Permit Number:
if n,l .r -t
ti
i
❑ No one available for inspection: Time %PM
Re -Inspection required: Yes Mp
When corrections have been made, call for re -inspection at 303 -234 -
Date: 111-2 6V1 Inspector: n
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Sewer Repair PERMIT - 201803038
PERMIT NO: 201803038 ISSUED: 11/19/2018
JOB ADDRESS: 4395 Dover St EXPIRES: 11/19/2019
JOB DESCRIPTION: Sewer service repair up to 10 ft in front yard only
*** CONTACTS ***
OWNER METZGER CHRISTINE D
SUB (303)981-0079 Carlo Sais 110007 Payless Rooter/Mato Plumbing
*** 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: 2,200.00
FEES
Total Valuation 0.00
Use Tax 46.20
Permit Fee 93.35
** TOTAL ** 139.55
*** COMMENTS ***
*** CONDITIONS ***
ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive
written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection
by any Sanitation District representative. Inspection and approval of work by any
Sanitation District representative DOES NOT grant authority to cover work without the
approval of the Building Division.
**For trenchless sewer replacements - The contractor will verify proper slope of new sewer
piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed
specifically by the applicable code. The plumbing contractor will provide verification of
proper slope and drainage in writing as a condition of approval of the permitted work.**
City of Wheat Ridge
Residential Sewer Repair PERMIT - 201803038
PERMIT NO: 201803038 ISSUED: 11/19/2018
JOB ADDRESS: 4395 Dover St EXPIRES: 11/19/2019
JOB DESCRIPTION: Sewer service repair up to 10 ft in front yard only
I'
by my signature, do hereby attest that the work to be performed shall comply with all accompanyingg approved plans and specifications;
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am t1�e 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 a rther attest that I am legally authorized to include all entities named within this document as parties to the work to be
pe , rmed an hat 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 pe it 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
Oficial 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 androcedures for approval of any new pen -nit. 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 a 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 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.
w City of
Wheatljdge
CQMMUNiTY 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: i)ermits@ci.wheatridge.co.us
FOR OFFICE USE ONLY
Date: 11
I I ) Fr
Plan/Permit # ao
I �/ O / 11Plan Review Fee: ✓�
Building Permit Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications
may not be processed. ***
Property Address: _L+Y[S Q o 4 -P_ r; C„e_
Property Owner (please print): Phone:
Property Owner Email:
Tenant (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address:
City, State, Zip:
Architect/Engineer:
Architect/Engineer E-mail:
Contractor:-
City of Wheat Ridge License #:
Phone:
Phone: 9& 1 M- ICI
Contractor E-mail Address: \2 (1
C�
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): JOf)-f_ CZ Phone:(?-) n, ` n
CONTACT EMAIL(p/ease print): �Qc5e E M� � Q'�S rap+eJr i^t (-'fl r. o'r) "-\
Sub Contractors (Must provide Wheat Ridge License No.):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
❑ COMMERCIAL
❑ 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
condition, appliance size and efficiency, type and amount of materials to be used, etc.
A-0 10 Y� s' G �
l
Commercial Projects Only: Occupancy Type: Construction Type:
Sq. FULF
Amps
BTUs
Squares
Gallons
Project Value:
�(Contract
tv�value or the cost of all materials and labor included in the entire project)
$ 'D,�VV
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 1 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 I 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. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER)
Sienature (first and last name):
Printed Name:
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer.
or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
DEPARTMENT USE ONLY
DATE:
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Building Division Valuation:
City of Wheat Ridge
Residential Roofing PERMIT - 201700886
PERMIT NO: 201700886 ISSUED: 05/25/2017
JOB ADDRESS: 4395 Dover ST EXPIRES: 05/25/2018
JOB DESCRIPTION: Remove existing layer down to deck; install 6 ft of ice & water shield with
proper synthetic dry in above; install new permiteer edge metal, new jacks
and vents; install 21 squares certainteed landmark (silver birch) with
proper high wind nailing on house + 1.3 on shed (detached) - 22.3 squares
*** CONTACTS ***
OWNER METZGER CHRISTINE D
SUB (303)659-3735 Ralph Bolyard 170214 Paramount Enterprises Inc.
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY ***
Total Valuation
Use Tax
Permit Fee
Investigative Fees
** TOTAL **
*** COMMENTS ***
ESTIMATED PROJECT VALUATION
FEES
0.00
106.37
140.90
140.90
388.17
5,909.50
*** 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 X1/2 -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 manufacturera€ms 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's 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 - 201700886
PERMIT NO: 201700886 ISSUED: 05/25/2017
JOB ADDRESS: 4395 Dover ST EXPIRES: 05/25/2018
JOB DESCRIPTION: Remove existing layer down to deck; install 6 ft of ice & water shield with
proper synthetic dry in above; install new permiteer edge metal, new jacks
and vents; install 21 squares certainteed landmark (silver birch) with
proper high wind nailing on house + 1.3 on shed (detached) - 22.3 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 roperty and am authorized to obtain this permit and perform the work described and approved in conjunction with
this permit. I further attesthat I am legally authorized to include alI 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 OWN'o/ CONTRACTOR (Circle one) Date /
1. This pen/nit wa sued 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 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 a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any
applicable code ora rdmance 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.
Inspection time requests will be accepted by email only. Please email requests to insptimerequestgei.wheatridge.co.us
between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line.
City of
Wheat P__,'d
e
C;cingRll_�N►T1' L)I;,ti'I1�?I'h1LM1l1
Building & Inspection Services Division
7500 W. 291h 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#
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: C��d AN &W �_Qovr - q.3q'5- 1_.)Gy ,U' 5j-
Property
j
Property Owner (please print): ( Al �'15i11111L.
Property Owner Email: C h ,,5't' a N Q,4 -
Mailing
, T
Mailing Address: (if different than property address)
Address:
Citv, State, Zip:
Architect/Engineer:
Architect/Engineer E-mail: Phone:
Contractor: (a (0,tV 01" s A,�14'ri ��S-S, 11-�C
Phone:
Contractors City License #: r Phone: C 3 o JJ 55V` S
Contractor E-mail Address: ft, AV rN � Of a Vt Jg U 00 iC%�'✓t
Sub Contractors:
Electrical:
W.R. City License #
Other City Licensed Sub:
City License #
Plumbing:
W.R. City License #
Other City Licensed Sub:
City License #
Mechanical:
W.R. City License #
Complete all information on BOTH sides of this form
❑ COMMERCIAL RESIDENTIAL
Description of work: (Check all that apply)
❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE
❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING
❑ COMMERCIAL ADDITION .@I�ESIDENTIAL ROOFING
❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT
❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ OTHER (Describe)
(For ALL projects, please provide a detailed description of work to be performed, including current use of areas,
proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and
amount of materials to be used, etc.) - 4M(Uv1 �" �Jz ii "V -�J C kd( t VU.i ,,n n � , a f
I
IL W" SWi P(gJr 54,1t�t4c J(J ;V1 Mk" - Iv�AW rte," d,�t
Sq. FtdLF
Amps
Btu's
Squares
Z Z- 3 i -
Gallons
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
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 I 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) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Electronic Signature (first and last name): DATE: 1 7
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
Building Division Valuation: $
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: Vkl 10
Job Address: L! 3 �S n o 5 7
Permit Number: 2 a 170 0 8F (®
❑ No one available for inspection: Time �� A /P
Re -inspection required: Yes
* When corrections have been made, call for re -inspection at 303-234-5933
Date: s/61/ Inspector: U
DO NOT REMOVE THIS NOTICE
(1ty of
�
Building & Ins pection D ivision
7500 W, 2V Ave., Wheat Ridge, CO 80033
Office 303-235-2855 * Fax: •
Ins R equest
s • r<: � � az! • r
Da
Farr
Property Addross: ijL,� e/
&
P roperty Owner (please print): 14- tS 7 �� ::. hone;
Ph
Z RIMEM
City License # City License City License #
Q d ,1 4 �A C-6, V /`("44- t J >r* Contract 'Vales of all or -
' 5 7 ( ,
Review Faye (due at time of ssr€ mittaf),
Squares - BTU's -- Gallons __ Amps ___ Sq Ft, ____ I $
OWNER/CONTRACTOR SIGNAWltE OF UNDERSTANDING ING A1`+ AGRLENIEN
I herelV cct•tif, that the setback cltstaaraco proposed by this lacrnt t aappliaaa on arc, accurate and do not cioltatc a pplictabic carciiaaaancc,„
odo or rc ul tionc of the City of Wheat Ricda?e aar co cnaaata„ caaserneaats or restrictions ofrcvord, that all ineasurements shown and
allegations made arc aaccur< that l have read and agree to abide, by all conditions printed on this application and that I aa,,ownic full
responsibility for complianix with applic<abic City of "!aa'he at Ridge co dcs and ordinances for work un dcr aana per•tnit issued based on
this applicaat otr, that l tarts the tvgaai assayer or lr via fvn authori7cd by the It fg ad crag area° of'the property to tacrforsaa the cdcscr'the d +ca +rla
and ,arts ako authorized by the dct;<ad wvnc.r of an) entity inclucde d on this application to lost that entity on this application.
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City of 7 -
W heat K 1C1Sse Date:
- COMMUNITY DEVELOPMENT
Plan #
Building & Inspection Services Division permit #
7500 W. 29t" Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Building, Permit Application
Prop`,ertyAddress`; r'1"~-I~ ~ O~!'~'
Property Owner (please print): Phone: 363 -(olg- 5-(q-8
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Contiractor: S~~Clarl, ~ st;i"-~/lG~ ~~1
Contractors City License Phone:
a~_z.vnua4'14[~;'l
Electrical: Plumbing: Mechanical:
City License # City License # City License #
~e§¢rtptton`~of.uvork:K.
t• ~&rrtcvE 3.t-ab, tKS,l-alt tc~ ~ tr~rk~r S6tEt~ e~rcT
l►JS~trSL KFut (E iaFkpA.I tnfS( fall 30 jt~t,{ Contract Value:
uS~Dll 35 r /~~LOS PiHKazAc ilrr 5Hi t s-
1 er S
K s U014 1 '°I'
Uf 1~ '1? wrx t Ste"'
Z. 6 e wKS ` Review Fee (due at time of submdtaq:
L &I T4 aa''r1 t~r~ u~14 :1040 M" I `FVo M`A- 5y
Squares
2T BTU's Gallons Amps Sq Ft. $
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 Ihave 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 I 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.
CIRCLE ONE: (OWNER) (CONTRACTOR) of (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
PRINT NAME: Y. SIGNATURE: DATE: D
FIRE pj PARTA3ENT : approved w/>coo me is D disapproved, O_jto revte~a fegulred_;`,~ Bldg Valuation; $