HomeMy WebLinkAbout6550 W. 46th AvenueCity of Wheat Ridge
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Residential Roofing PERMIT - 201800551
PERMIT NO: 201800551 ISSUED:
02/28/2018
JOB ADDRESS: 6550 W 46th AVE EXPIRES:
02/28/2019
JOB DESCRIPTION: Reroof with dimensional asphalt shingles, 5/12 pitch, 21 squares
*** CONTACTS ***
OWNER (303)425-9014 FINCH MARIANNE
SUB (720)236-5659 Michael Duran 170337 Endurance
Roofing LLC
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE:
UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#:
0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION:
6,127.00
FEES
Total Valuation 0.00
Use Tax 128.67
Permit Fee 156.75
Investigative Fees 156.75
** TOTAL ** 442.17
*** COMMENTS ***
*** CONDITIONS ***
**PERMIT FEE DOUBLED FOR SWO POSTED 2/27/2018**
MUST HIRE THIRD PARTY INSPECTOR FOR COMPLETED ROOF WITHOUT MIDROOF INSPECTION
Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be
required for both the midroof and final inspections. The 3rd party inspection report AND
THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat
Ridge. The report MUST BE SIGNED by the Homeowner.
REGARDING ROOF VENTILATION: Roof ventilation shall comply with IBC Sec. 1203.2 or IRC Sec.
R806. The installation of ridge venting requires the installation or existence of soffit
venting. For calculation purposes, one hat or turtle vent equal to one-half of one square
foot of opening.
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) is required on the entire roof
when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and
mid -roofs may be called in at the same time, one hundred percent of the sheathing must be
complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required
to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield
is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturer installation instructions,
whichever is more stringent. In order to pass a final inspection of elastomeric or similar
type roof coverings, a letter of inspection and approval from the manufacturer technical
representative stating that "the application of the roof at (project address) has been
applied in accordance with the installation instruction for (roof material brand name) roof
covering" is required to be on site at the time of final inspection.
City of Wheat Ridge
Residential Roofing PERMIT - 201800551
PERMIT NO: 201800551 ISSUED: 02/28/2018
JOB ADDRESS: 6550 W 46th AVE EXPIRES: 02/28/2019
JOB DESCRIPTION: Reroof with dimensional asphalt shingles, 5/12 pitch, 21 squares
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this ermit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be
performed�and that SII work to be:.�rform'ed i� disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNERS CONT eCITOR (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 ermit 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 an 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 note construed to be a permit for or an approval of, any violation of any provision of any
applicable code or any ordinance or regulati t�of this jurisdiction. Approval of work is subject to field inspection.
9.
Signature of Chief Building Official r Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Kimberly Cook CW
m-,)
D6G�
From: no-reply@ci.wheatridge.co.us
Sent: Tuesday, February 27, 2018 5:29 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
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-4567)
Property Owner Email
Address
6550 W 46th Ave
Marianne Finch
303-425-9014
mariannefinch1 @aol.com
Do you have a signed
Yes
contract to reroof this
property?
Applications cannot be
submitted without an
executed contract
attached below.
Attach Copy of Executed
New Doc 2018-02-27.pdf
Contract
CONTRACTOR INFORMATION
Contractor Business
Endurance Roofing LLC
Name
Contractor's License
170337
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone
720-236-5659
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address
11522 Macon St Henderson CO 80640
(Primary address of your
business)
Contractor Email Address
mike@enduranceroofing.net
Retype Contractor Email
mike@enduranceroofing.net
Address
DESCRIPTION OF WORK
TOTAL SQUARES of
21 Squares Reroof
the entire scope of work:
Project Value (contract
6127
value or cost of ALL
materials and labor)
Are you re -decking the
No
roof?
Is the permit for a flat
Pitched roof (2:12 pitch or greater)
roof, pitched roof, or
both? (check all that
apply)
2
and to perform the work
described above.
I attest that everything Yes
stated in this application
is true and correct and
that falsifying
information in this
application is an act of
fraud and may be
punishable by fine,
imprisonment, or both.
Name of Applicant Mike Duran
Email not displaying correctly? View it in your browser.
What is the specific pitch
of the PITCHED roof?
How many squares are
part of the PITCHED
roof?
Describe the roofing
materials for the
PITCHED roof:
Type of material for the
PITCHED roof:
Provide any additional
detail here on the
description of work. (Is
this for a house or
garage? Etc)
5/12
21
Dimensional Shingles, Synthetic Felt,
Asphalt
house and garage
SIGNATURE OF UNDERSTANDING AND AGREEMENT
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.
I understand that this
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
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have been
authorized by the legal
owner of the property to
submit this application
Yes
Yes
Yes
Yes
3
/ 11522 Macon St., Henderson, CO 80022
Phone: 720-236-5659
www.EnduranceRoofmg.net
Customer Name: Tr PlAnne—, Date: - I
.Job Location/Address: _ A��Q (lei
City: t Zip:
Contact Info: Home:
Email:
Ci rn/ Cell:
Work:(
C-0 -k''y Sales Rep.: I/G_7 /Z --
Claim Number tf� ;' Gh /� .1 Adjuster Rep.:
Endurance Roofing LLC shall provide all materials, labor and equipment necessary to perform the following work at the job location. Prices
include all applicable sales taxes, clean up and removal of roofing debris.
Price is based upon using driveway access for uploading roofing materials and downloading all roofing deb
[ P.,muminum
ear off �_ layers of existing roofing [ ] Install In. Ft. [ 5" [ 1 6" [ ] Steel
[ gutters
[ decking using 7/16" OSB decking [ ] Install [ ] 2x3 [ ] 3x4 downspouts. Attach location drawing
[ eplace water damage sheeting [ ] Clean Gutters
[ ] O rlay CDX over existing decking [ ] Install lb. felt
[
ns all standard ridge shingles [ ] Promotion/ Discount $ r' 1-1 �-
[[ ]stall High Profile ridge shingles
stall 3,0 Ib. felt
[ I &all ft. of ridge vent
[ ] Replace all necessary wall pipes and vent flashing to meet all applicable code requirements
[ ] Re -flash Swamp Cooler [ ] Re -flash chimney
[ ] >JKstall Metal Valleys[ ] Install 901b. valley
[ VI stall Ice and Water Shield at: [ / eaves [ Lwileys [ J"'f'rickets ~
Haul off trash, including a magnetic sweep of property
[ ] Jwstall metal at: [ ] eaves [ ] Gable ends [ ] to meet all applicable code requirements r
[ 5ar workmanship warranty
[ ndurance Roofing LLC will provide general liability insurance of east $1,000,000
( S ' gle Style Z�&o ey-,c,; e--' Pte` �— 41 hingle Color Z-4,fp.
[JAubtotal pending insurance supplements q05-8' bo
ADDITIONAL WORK OR SPECIAL INSTRUCTIONS:
INSURANCE CLAIM AGREEMENT:
This agreement authorizes Endurance Roofing LLC to represent your interests and negotiate your insurance claim to ensure that the Damaged
property to be repaired or replaced with NO ADDITIONAL COST TO YOU, the homeowner, except for your Deductible. This Agreement is for
the FULL SCOPE OF INSURANCE REPLACEMENT COST PROCEEDS, including supplements. The final price agreed on between the
insurance company and Endurance Roofing LLC shall become the final contract price which you the homeowner will be responsible to secure
payment.
THIS PROPOSAL MAY BE WITHDRAWN BY THE HOMEOWNER WITHIN 3 DAYS FROM THE TIME OF ACCEPTANCE.
ACCEPTANCE:
THE PROPOSED PRICES, SPECIFICATIO SAND TERMS AND CONDITIONS ARE SATISFACTORY AND HEREBY ACCEPTED. 1,
OWNER/BUYER AUTHORIZE ENDURANCE ROOFING LLC, TO PROCEED WITH THE INSURANCE CLAIM. PAYMENT WILL
BE MADE AS INDICATED ABOVE.
OWNER/BUYER SIGNATURE: DATE: /�in.e-
SALES REP. SIG E: DATE: O�
TERMS AND CONDITIONS
PLEASE MAKE ALL CHECKS FOR PAYMENT PAYABLE TO ENDURANCE ROOFING LLC.
THESE TERMS AND CONDITIONS are in addition to those stated in Endurance Roofing LLC's Estimate, attached hereto and made a part hereof. To Wit:
I. Endurance Roofing LLC (hereinafter referred to as "Contractor") assumes no responsibility for structural integrity of the roof deck or the building on which the
roofing is to be installed. Customer represents all structures to be in sound condition capable of withstanding normal roofing construction and operations.
2. This Estimate and contract is based upon the work to be performed by Contractor not involving asbestos or toxic materials and that such materials will not be
encountered or disturbed during the course of performing the work. In the event that such materials are encountered, Contractor shall be entitled to reasonable
compensation for all additional expenses incurred as a result of the presence of asbestos or other toxic material.
3. Customer shall be entitled to order changes and the contract price shall be adjusted accordingly. Upon removal of the existing roof, conditions which require
additional work, such as rotten or deteriorated wood, are sometimes encountered. If the scope of work outlined on the face of this Estimate does not contemplate such
conditions, Contractor will promptly report the condition to the Customer and a change order will result that is reasonable and necessary to protect the structure.
4. Force Majeure. Contractor shall not be responsible for loss, damage or delay caused by circumstances beyond its reasonable control, including but not limited to acts
of God, weather, accidents, fire, vandalism, regulation, strikes, failure or delay of transportation, shortage of or inability to obtain material. Contractor is not required to
remove snow, ice or water from roof.
5. Workers are fully covered by workmen's compensation insurance. Owner affirms having property and casualty insurance, including coverage for fire, wind damage
and vandalism.
6. Customer acknowledges that re -roofing may cause vibration, disturbance, dust or debris to fall into the interior. Customer agrees to remove or protect property
directly below the roof in order to minimize potential interior damage. Contractor shall not be responsible for disturbance, damage, clean-up or Joss to interior property
that Customer did not remove or protect prior to commencement of roofing operations. Customer shall notify tenants of re -roofing and the need to provide protection
underneath areas being re -roofed. Customer agrees to hold Contractor harmless from claims of tenants who were not so notified and did not provide protection.
7. Contractor and Owner are committed to acting promptly so that roof leaks are not a source of potential interior mold growth. Customer will make periodic
inspections for signs of water intrusion and act promptly; including notice to Contractor if Customer believes there are roof leaks, to correct the condition. Upon
receiving notice, Contractor will make repairs promptly so that water entry through the roofing installed by Contractor is not the source of moisture. Contractor is not
responsible for indoor air quality. Customer is to maintain the interior of the property in a manner to avoid the growth of mold and shall hold Contractor harmless for
same.
8. Contractor is not responsible for adequacy of drainage or ponding, on the roof due to the existing structure.
9. Contractor shall not be responsible for incidental or consequential damages.
10. All materials and work shall be furnished in accordance with normal industry tolerances for color, variation, thickness, size, weight, amount, finish, and texture and
performance standards. Specified quantities are intended to represent an average over the entire roof area.
11. Contractor may at its discretion engage subcontractors as needed to perform work hereunder, provided Contractor shall fully pay said subcontractor and in all
instances remain responsible for the proper completion of this Contract.
12. Contractor shall furnish Owner appropriate releases or waivers of lien upon receipt of the full and final payments due and cleared of this Contract.
13. All written change orders are due at time of completion.
14. If the signer of this agreement is not the owner of the residence stated herein, the signer of affirms he/she has actual authority from the owner to bind the owner to
this agreement.
15. In the event Owner shall fail to pay any periodic or installment payment due hereunder, Contractor may cease work without breach pending payment or resolution
of any dispute. Furthermore, Owner will not hire any other Contractors or workmen to finish said work until the dispute is resolved.
16. Contractor warrants all installation work for a period of 5 years. This warranty only pertains to materials and labor, once the balance of this contract and all change
orders have been paid in full. Contractor is not responsible for any damage occurring to his work from others workmanship or any other circumstances. The acceptance
of this proposal by the Customer signifies his agreement that this warranty shall be and is the exclusive remedy against Contractor pertaining to the roof installation.
17. In the event this contract is referred for collection to a collection agency and/or an attorney or Contractor chooses to pursue collection on its own, Owner agrees to
pay a reasonable fee as collection and/or attorney's fees, plus a finance charge on all unpaid amounts, equal to 1.5% per month, accruing from the date notice of
collection is served on Owner.
18. Entire Agreement. This Agreement constitutes the entire agreement among the parties and supersedes all prior agreements, representations and understandings
among the parties hereto.
19. Both parties acknowledge the place of performance of this Agreement is Adams County. For the purpose of any dispute, exclusive venue and jurisdiction shall be
Adams County.
20. Contractor will remove debris and leave the premises in broom clean condition.
Any additional money due as a result of change orders to this Agreement is due with the final payment of this Contract at the time of completion.
Name Date
41 CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: S W zz:.
Job Address: 5 S o -) • 4 (. Vv\
Permit Number:
❑ No one available for inspection: TimeQ 'AM,(P )
Re -Inspection required: es No
When corrections have been made, call for re -inspection at 303-234-5933
Date: a. tam 11�, Inspector:
DO NOT REMOVE THIS NOTICE
A 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
Inspection Type: A1� �.PX
Job Address: M A1�G
Permit Number: '2611 "% 0 -Z ?
tFj u 4 L- I
❑ No one available for inspection: Time
Re -Inspection required: YesNo
When corrections have been made, call for rein pection at 3'0,q-234-5933
Date: 12-1, Inspector:
DO NOT REMOVE THIS NOTICE
I NSP_s ECO:RD Occuoancvrrvpe
'INSPECTION LINE: 303) 234 -5933
Inspections will not be made unless this card is posted on the building site
Call by 3:00 PM to receive inspection the following business day.
CONCRETE SLAB FLOOR
Electrical (Underground)
Heating (Underground)
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ABOVE
ROUGHS
Sheathings.
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB
FOUNDATION INSPECTIONS
DATE
INSPECTOR.
INITIALS
COMMENTS:
Footings /Caissons
_—
Stemwall / (CEG) Concrete
Encased Ground
Q
Rough Electric
Reinforcing or Monolithic
Rough Plumbing
Weatherproof/ French Drain
Gas Piping
Sewer Service Lines
Rough Mechanical
Water Service Lines
---- * 'NOTE: - -ALL iTEMS - AND APPROVED�6Y AND ZONING, BUILDING AND PUSLIC WdRKS BEFORE�A -
CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION
-- - - OF A- CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY.
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ABOVE
ROUGHS
Sheathings.
- Lath/Walltie
Mid -Roof
_—
Electrical Service
Q
Rough Electric
Building Final
Rough Plumbing
Fire Department
Gas Piping
R.O.W & Drainage
Rough Mechanical
Parking _ &. Landscaping _
Framing
Insulation
Drywall Screw
ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PRO6EEDING
FINALS. '.. _. ...
Electrical
Plumbing
Mechanical
Roof
Q
Building Final
Fire Department
R.O.W & Drainage
INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS
SHOULD, BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
Parking _ &. Landscaping _
---- * 'NOTE: - -ALL iTEMS - AND APPROVED�6Y AND ZONING, BUILDING AND PUSLIC WdRKS BEFORE�A -
CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION
-- - - OF A- CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY.
OCCUPANCY NOT PERM!T7
- -- PRO ;E
1 INTu, ^PgTlFIf ATF.OP OCCUPANCY IS ISSUED
♦ i CITY OF WHEAT RIDGE
Bung Inspection Division
~ (303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: F6 -dt- + r,
Job Address: (~530
Permit Number: 1 ass
V
❑ No one available for inspection: Time-
Re-Inspection required: Yes o~
*When corrections have been made, call for ,
re-inspection at 303-2345933
I I (4
Date: 1 s 1 -R Inspector:
DO NOT REMOVE THIS NOTICE
7 ~ l
♦ 16 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:
❑ No one available for inspection: Time AMk
Re-Inspection required: Yes Z
*When corrections have been made, callfor re-inspection at 303-234-5933
Date: i o Inspector: L4
DO NOT REMOVE THIS NOTICE
6 A 4' City of Wheat Ridge
roooor Residential Roofing PERMIT - 093805
PERMIT NO: 093805 ISSUED: 11/03/200.9
JOB ADDRESS:'. 6550 W'46TH AVE 'EXPIRES: 05/02/2010
DESCRIPTION:; Reroof -:20 sqs
CONTACTS
owner 303/425-9014 Marianne Finch
sub 303/697-8550 George Gibson 09-0088 Frontier Restoration
PARCEL INFO
ZONE CODE: UA 'USE: UA
SUBDIVISION:: 0377 '.BLOCK/LOT#: 0/.
FEE SUMMARY ESTIMATED PROJECT VALUATION: <5,650.00.
FEES
Permit Fee 162.90
Total Valuation ,00
Use .`Tax 101.70
TOTAL .:264.60 .,r
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 21 inside exterior:. walls.
***Contractor/Property owner shall provideladder(s) secured in place for -
inpsections.`
Subject to field inspection..
I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate: applicable
ordinances, rules lations of the City of Wheat Ridge or covenants, easements or restrictions : of record; ' that all
egations made are accura
te; that I have read and agree to abide by all conditions printed on this
applicatio and me full responsibility for compliance withthe Wheat Ridge Building Code (I.B.C) andall other
measurements 16 1i~
applicab nances, for this pexmit. Plana subject tofield inspection.
Signatur of c ner date 11 . This t wn 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 anyother applicable
ordinances of the City.
This permit shall expire 180 days from the issue date. Reauests for an extension must he rere,vPe nr,nr rn a,..,, ra r,~„
W HEgT
City of Wheat Ridge Building Division
m 7500 W. 291h Ave., Wheat Ridge, CO 80033
Office: 303-235-2855` Fax: 303-237-8929
c0<ORPOO Inspection Line: 303-234-5933
Building Permit Application
Property Address: .4!v 4J e -z Y 04r/,W
Property Owner (please print): J~&AFR j 0A.-Ave ~j
Mailing Address: (if different than property address)
Address:
Date:
Plan
Permit (1~~~//rte
- 303
Phone: e1Z S~-
State,
Contractor:
Contractor License 09 oQ Phone: 3rd 3- 49 P 7 ~,9;-a1V-Q
Sub Contractors:
Electrical City License
Company:
Exp. Date:
Plumbing City License
Company
Exp. Date:
Mechanical City License
Company:
Exp. Date:
Use of space (description):OAF
D' cc ption of w r
Construction Value: $ 4r-4 J-& r1
(as calculated per the Buildinq Valuation Data sheet)
Plan Review (due at time of submittal): b
Sq. Ft./L. Ft added: Squares ZED BTU'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
PRINT NAME: ro! tiP A fov
(CONTRATOR)
Date:
Bldg Valuation: $