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Home My WebLink About9280 W. 45th Avenue#_"VIL 17 6 5750 1;W NV - INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 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 11:59 p.m. (midnight) to receive an inspection the following business day.** Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Comments Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter UO Not tour Concrete mor 10 Annrnvai tit 1 hp_ Ahnva Incnacfiinnc Underground/Slab Inspections Date Inspector Comments Initials Electrical Sewer Service Plumbing uo NOt yover unaerarounci or Below/in-Slab Work Prior To Annrnval f1f Tha Ahnva Incnarfinna Rough Inspections Date Inspector Initials Comments Wall Sheathing Mid -Roof Lath / Wall Tie Rough Electric Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw / Nail Final Inspections Date Inspector Initials Comments Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical Roof Final Window/Doors Final Building 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. rvr ww vonaye permits - riease ue sure tnat rougn inspections are compietea from the Tire uistrict and electrical low voltage by the Buildinn Division. City of Wheat Ridge Residential Roofing PERMIT - 201705750 PERMIT NO: 201705750 ISSUED: 08/09/2017 JOB ADDRESS: 9280 W 45th AVE EXPIRES: 08/09/2018 JOB DESCRIPTION: Residential Re -roof at 9280 and 9290 W 45th Ave to install Tamko Dimensional asphalt shingles - 26sq *** CONTACTS *** OWNER (303)526-8418 REYES CELSO JAIME SUB (720)300-2200 Ray Mollna 170229 K.O. Roofing Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2002 / KIPLING, I-70 & CLEARCREEK ARE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,500.00 FEES Total Valuation 0.00 Use Tax 157.50 Permit Fee 172.60 ** TOTAL ** 330.10 *** 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) 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. 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. A r City of Wheat Ridge r Residential Roofing PERMIT - 201705750 PERMIT NO: 201705750 ISSUED: 08/09/2017 JOB ADDRESS: 9280 W 45th AVE EXPIRES: 08/09/2018 JOB DESCRIPTION: Residential Re -roof at 9280 and 9290 W 45th Ave to install Tamko Dimensional asphalt shingles - 26sq *** CONTACTS *** OWNER (303)526-8418 REYES CELSO JAIME SUB (720)300-2200 Ray Mollna 170229 K.O. Roofing Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2002 / KIPLING, I-70 & CLEARCREEK ARE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: FEES PA I I "Li F Total Valuation 0.00 Use Tax 157.50 Permit Fee 172.60 ** TOTAL ** 330.10 *** 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) 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. 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. IV � 4 City of Wheat Ridge r Residential Roofing PERMIT - 201705750 PERMIT NO: 201705750 ISSUED: 08/09/2017 JOB ADDRESS: 9280 W 45th AVE EXPIRES: 08/09/2018 JOB DESCRIPTION:. Residential Re -roof at 9280 and 9290 W 45th Ave to install Tamko Dimensional asphalt shingles - 26sq 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 owner of the property dam authorized to obtain this permit and perform the work described and approved in conjunction with this ermit. h ttestt e ly authorized to include all entities named within this document as parties to the work to be per rmed and th all work erred is disclosed in this document and/o�ts' accopanying approved plans and specifications. Sigqature,O OWNER IvoVCONTRACTOR (Circle one) Date 1. cTWpermit 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 Budding Official and may be subject to a fee equal to one-half of the originalpermit 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 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 a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code o ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. _ R4A4. I Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. 9220 RACE ST. THORNTON,CO Work order and Authorization KO Roo mg, Inc. proposes to furnish material and labo - COm lete in accordance with specifications below: For the Total amount of: $rl the total Contract Amount will be termineo accordingt I surance Allowance agreement below. Payment to be made as follows: '56 Dow Balance upon completionf work cis scope of Work: described below (only those items with an X in the left column) 1fround preparation tarps0 eh r: (acs: C 2�ar of existing roof # of layers nd Type of layers Q` le— L _'1-3. underlayment: Type of felt� Ice & W hield & Location: Z, (F" 4. Metals: Head wall - Step flashing - Counter flashing - Drip metal eave and gable (Note: Additional Charges may result if any siding, stucco, brick or other removal is needed for proper installation of roofing materials). l6-, 5. Install r of covering: Typ — Manufacture: 1 i� Color: �'— Ridge Type: Starter course: 6. Chimney, Skylight, Flashir 4 ✓Pipe flashings & es -:1 RV vents: —# of vents: Total # ridge venting Type & location: Total linear feet: Z'9. Additional Items: 151, Options: 11. Clean up and haul off all roofing debris from the surrounding area, including drive ways, bushes, gutters & downspouts. Collect loose roofing nails with a magnetic roller. Insurance Allowance Agreement IF INIATIALED BY CUSTOMER HERE u CUSTOMER AGREES TO THE FOLLOWING ADDITIONAL PROVISIONS: A. Work performed by Company (KO Roofing, Inc.) will be completed at no cost to Customer other than the insurance Deductible, unless (1) Customer request upgrades or additional work that is not approved by insurer; or (2) Customer's insurance Policy does not provide for total replacement cost coverage or required building code upgrades, in which event Customer agrees to pay For the difference between total Replacement Cost Value (RCV) and the Actual Cash Value (ACV) of Company's work as determined by Insurer. B. Customer authorizes Company to discuss Company's pricing and scope of work for the services described herein at a price acceptable to insurer. e C. Total Contract Amount will be the total Replacement Cost Value (RCV) as listed on the final approved insurance Scope of Loss (or final approved KO Roofing, Inc. Scope of Work) including all U11 CLL LU3L3, 1aL)U1 d11U II1aL, ld1J, UC P1 CLiaLLU11, LU3LU111C1 UCLIULLIMe, LdXCs, UdNe NeiV1Le L71a1-ges, Uverneau anurofit; plus any approved insurance supplements; plus any upgrades, options or additional work performed at the rep quest of the Customer. D. KO Roofing, Inc. is a contractor and not a licensed public insurance adjuster. Therefor, Customer agrees to provide all necessary documents, information and assistance for timely submission of claims and receipt of payments to/from insurer and mortgagee(s) without delay. Company reserves the right to receive additional payments from insurer due to material or labor increased due to storm environment, or if insurance and/.or information provided by Customer or Insurer are incorrect. E. Customer hereby assignes all amounts due from insurer for Company's work to Company, Customer appoints Company as its pr�en at've to collect and receive all insurance payments related to om an w r M2 Insurance company: ( t� Policy#: Claim# _ O Adjuster Name: Phone# Email: I (we) agree to the terms and condiq'ons of Customers Signature: Customers Signature: Company's Representative: Agreement, igOuding all terms and conditions on the reverse side: Date: Date: Phone#: 30 ASIN lib' S3Wf}SS`d a3WO1Sn0 0NV S103c113 HOGS 30 03114803N I N338 Sb'H NMNoisno lb'Hl S390371MONNOb' H3Wois-no ,A}Jadoud ay} ;o saoepns Jo!ua;xe pue Joau!u! 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AJessaoaN panlosauun ;ey; paaJ6e s! 11 loJ;uoo Jno puoAaq sAelap Jo s;uap100e 'a�l!J;s uodn lua6u!luo0 sluawaaJ6e pal;;as aq p!nn sa;nds!p d!ysuew�lJom Jano a6uey0 e4xa ue awooeq ll!Aa pue 'siepio uallpm uodn Aluo palnoaxe eq ll!m s}soo eulxa u9UJ9nui uiaJay suoGlege0y!qsq oads1 0 al uogen ap Jo uo!;eu ie uelAuV •p98J6e 338 J y;o ssalun )lJonn;o uo!;noaxa pue 6u!6e;s Jo; Apadoid aJ!;ua ay; o; ssao0e 11n; slueu6 Jaunno Apadoud s901;0eud pJepuels o; 6u!puo00e Jauuew a>I!luew>luonn a u! Peleldwoo eq of )pom Iib' -payloads se eq of Peelueuen6 si le!Jalew py BU11M0lio;ey�Re `(s 1e001e41Pue o eio o :suo1llpuoapueswia; P 1 0;o alte;g ay;;o seaueulpJo ue snnel 'suol}ein6ei 'seine eigeolidde Po; ;oe(gns 91 pue `epic esienei ay; uo eweu) iewoisno ey; puW .oui '8ul;ooa ON ueem4eq 91 ;ueweei6y sly} Dane Lovett 7o l j US 7 50 From: no-reply@ci.wheatridge.co.us Sent: Wednesday, August 2, 2017 9:S0 PM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application 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 9280-90 w. 45TH Ave. Property Owner Name Property Owner Phone Number Property Owner Email Address Celso Reyes 303-526-8418 Field not completed. Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. Attached Copy of Field not completed. Contract CONTRACTOR INFORMATION Contractor Business KO Roofing INC. Name Contractor's License 170229 Number (for the City of Wheat Ridge) Contractor Phone 7203002200 Number Contractor Email Address koroofinginc@yahoo.com Retype Contractor Email koroofinginc@yahoo.com Address DESCRIPTION OF WORK Are you re-decking the No roof? Description of Roofing Tamko Dimensional Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 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 26 (pitched + flat) of all 2 roofing material for this project Provide additional detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract value or cost of ALL materials and labor) remove damged 3tab shingles and install new dementional shingles 7500 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 Ray Molina Email not displaying correctly? View it in your browser. 3 I* � 4 CITY OF WHEAT RIDGE o _1�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: fl UJ _ Job Address: 4 U q Permit Number: r r f ❑ No one available for inspection: Time �M/PM Re -Inspection required: Yes �No When corrections have been made, call for re -inspection at 303-234- Date:- �` �Inspector: DO NOT REMOVE THIS NOTICE 7 i CITY OF WHEAT RIDGE _1�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE 1142 Inspection Type: t4 Job Address: Permit Number: - Sy ❑ No one available for inspection: Time '� yr AM/PO Re -Inspection required: Yes . When corrections have been made, call for re -inspection at 303-234-5933 Date:` rf ,f Inspector: ` DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: l c lejo-P- Job Address: LIC7' 4) Permit Number: 4 L ❑ No one available for inspection: Time AM/PM Re-Inspection required: Yes No * When corrections have been made, calf for re-inspection at 303-234-5933 Date: Inspector: /wLjZ W&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 ac y, F c .'Y,' INSPECTION NOTICE Inspection Type: f 7Ao/ .Zo<= Job Address: 9~gO r,~ X5 r~ SUE Permit Number: ®2/g6'G ❑ No one available for inspection: Time e.' MIPM Re-Inspection required: Yes No When corrections have been made, caH for re-inspection at 303-234-5933 Dater Inspector: f r DO NOT REMOVE THIS NOTICE { ♦ ♦ CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax: INSPECTION NOTICE` Inspection Type: f'i NF4-c Job Address: ot ~'FYD ld -7 Permit Number: Oq Iag d /fr &C,EY No one available for inspection: Time AM/PM Re-Inspection required: a No When corrections have been made, cafl for re-inspection at 303-2345933 Date: -10-n9 Inspector: Sz/ DO NOT REMOVE THIS NOTICE S ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: j~5.4&t jer,-)F Job Address: g2 fro . sir 4,ze Permit Number: er~cV>sps G Al-ZZGZ'J lJu ivy rs~T~ss~ _,Z~1 B f~/d -l7E ~1t~~~a.~fCtlcnl ❑ No one available for inspection: Timer., sc AM/PM Re-Inspection required: _~~Y~es No "When corrections have been made, call for re-inspection at 303-234-5933 Date: 1,061oI? Inspector DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE? Inspection Type: c Job Address: Permit Number:} f ❑ No one available for inspection: Time AM/PM Re-Inspection required: Yes No When corrections have been made, call for re-inspection at 303-2345933 Date: " o Inspector: DO NOT REMOVE HIS NOTICE ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: $ I?_ (n! iz- Job Address: t'€ ,~-~96 (A 4E i 3 A Permit Number: LJ~?( ❑ No one available for inspection: Time AM/PM Re-Inspection required: Yes No When corrections have been made, call for spec n at 303-234-5933 Date: _ Inspector: i a ~ DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE Building Inspection Division / (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: .rwo.,L F Job Address: 7;2 b'~ g . V,5-77-1 Permit Number: 017 /dal Ity- k7-i2. 511,61i> ~ e.,'~'0 ' ' /n1f//a ~')17% u/1t-11,e 2P S~L~di~Ti/1L ❑ No one available for inspection: Time s15 AM/PM Re-Inspection required: No *When corrections have been made, call for re-Inspection at 303-2345933 Date: Z&le9' Inspector: DO NOT REMOVE THIS NOTICE 9) 174,~Ap O/ll~ =La, . F7- ijf yTrv 71-zm./ 11d/E City of Wheat Ridge Residential Roofing PERMIT - 091886 PERMIT NO: 091886 ISSUED.: 09/01/2009 JOB: ADDRESS: 9280 `W :45TH AVE -:EXPIRES: '.02/28/2010 DESCRIPTION: Reroof'27.66."sqs `CONTACTS owner 303/431-9174 Celso Reyes, sub 303/355-5097 James Linehan 09-0162 Storm Guard Restoration PARCEL. INFO ZONE..'.. CODE: UA 'USE: UA SUBDIVISION:' 0046 BLOCK/LOT#: ,0/ FEE SUMMARY ESTIMATED PROJECT VALUATION: 6,915.0.0. FEES Permit Fee 181.10 Total Valuation , pp e~ Use Tax 124.47 * * TOTAL 305.57 Conditions:' 6 nail installation mid-roof inspection required. Board sheathing spaced more than a 1/2 of an inch apart requires plywood overlay on entire roof. Ice. and water shield required from eave edge to 2' inside' exterior: walls. Subject to field inspections. 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 Iassume full: responsibility forcompliance with the wheat Ridge Building Code.,(I.B.C) and all other. a licable wheats Ridge` -Ordinances, for work under this permit. Plans subject to field inspection. rDQ2A A CSPo - q I I Signature of co t actor/owner ;date 1. This permit was issued in accordance with the provisions. set forth in your application and is subject to the ;laws of the state of Colorado and to the Zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable ordinances of the City.!'. 2. This permit shall expire 180 days from the issue date. Requests for an extension must be received prior to expiration .'date. An extension may.. be granted at the discretion of the Building Official. 3. if this permit. expires,; a new permit may be acquired for a fee of one-half the amount normally required, provided no changes have been or will be made in the original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes have been.. or if suspension or abandonment exceeds one (1) year, full fees .:shall be.. paid for al: new.. permit. 4. No :work of any manner shall be done that will change the natural flow of water causing a. drainage :problem. 5. Contractor shall notify. the. Building Inspector twenty-four (24) hours in advance for.. all inspections and 'shall receive - written approval on inspection card before proceeding with successive phases'. of the job.' 6. The issuance of a permit. or the approval of drawings and'.. specifications shall not be construed to be a permit for, nor an approval of, any violation of the provisions of the'. building codes or any other ordinance, law, =Is or regulation. All.. plan review i subject to field inspections. Signature f. Building; Official date INSPE ION REQUEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855 REQUETS MUST: BE MADE BY 3PM.. ANY..BUSINESS DAY FOR .INSPECTION . THE. FOLLOWING BUSINESS DAY. a City of Wheat Ridge Building Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-235-2857 Inspection Line: 303-234-5933 Date: ~CT G7 //6 Plan Permit W~i Building Permit Application Property Address: qS W. W\,+h psye b Property owner (please Mailing Address: (if different than property address) Address: State, Contractor Contractor License #:0qC`` 2k Phone:3---5- ll Sub Contractors: Electrical City License Plumbing City License Mechanical City License Company: Company Company: Exp. Date: Exp. Date: Exp. Date: Approval: Approval: Approval: Use of space (description): Description-of work: re- c-oc~rc- Construction Value: $ 5r (as calculated per the Building Valuation Data sheet) Plan Review (due at time of submittal): $ Sq. Ft./L.Ft added: SquaresBTU's Gallons Amps OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work under this permit. Plans subject to field inspection. CIRLCE ONE:: (OWNER) (CONTRACTOR) or PERSONAL EPRESENtrTATIV ,I(OWNER) (CONTRATOR) PRINT NAME:-'ys ~J~•[_..A-r 1 SIGNATURE of k k ~ DatEQ,_J. )J CpDq