HomeMy WebLinkAbout4540-4550 Independence StreetA i CITY OF WHEAT RIDGE
1� ' Building,Inspection Division
(303) 234 -5933 inspection line
(303) 235 -2855 Office • (303) 237 -8929 Fax
INSPECTION NOTICE
Inspection Type: ` t .
Job Address:
Permit Number:
❑ No one available for inspection: Time <% ' AM! M
Re- Inspection required: Yes No
* When corrections have been made, call for re inspection at 303
Date: t. i i -1': Inspector: < 6
DO NOT REMOVE THIS NOTICE
1 I i-.��
oF "�T City of Wheat Ridge Building Division Date:
�` ° 7500 W. 29 Ave., Wheat Ridge, CO 80033
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Office: 303 - 235 -2855 * Fax: 303 - 235 -2857 Plan #:
2 e o Inspection Line: 303 - 234 -5933
otoRao Permit #:
Building Permit Application
Property Address: 6 t/ 6 � 7 6 –T yd rkgd C& e 1 5T —
Property Owner (please print) ({�� 5 Phone: �ff �e�(9 l YGG
/
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Contractor: J CC ca✓ t fr a ( il 6 -�7 t+
Contractor License #: Phone: b "0 3 j `74 J
Sub Contractors:
Electrical City License #: Plumbing City License #: Mechanical City License #:
Company: Company Company:
Exp. Date: Exp. Date: Exp. Date:
Approval: n Approval: Approval:
Use of space (description): K le �d Construction value: $ 1 3
Description of work: , o ^ � (as calculated per the Building V Iuation Data sheet)
P � _` 6r ° ,� / -5 (Ct y rr_ 5 Plan Review (due at time of submittal): $
t 5 46, I 7 5f s d'F 3, y( G-19 I
Sq. Ft. /L.Ft added : 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 by all conditions printed on this application and that I assume full
responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
under this permit. Plans subject to field inspection.
CIRLCE ONE:: (OWNER) W (CONTRACTOR) or PERSONAL REPRESE ATIVE of (OWNER) (CONTRATOR)
PRINT NAME: l eR6l4 k4 SIGNATURE � Date: �l lV llF