HomeMy WebLinkAbout6895 W. 32nd PlaceCity of Wheat Ridge
Residential Roofing PERMIT - 201701424
PERMIT NO: 201701424 ISSUED: 06/02/2017
JOB ADDRESS: 6895 W 32nd PL EXPIRES: 06/02/2018
JOB DESCRIPTION: Replace 10' of sewer line and install clean outs
*** CONTACTS ***
OWNER (720)872-2288 WHEELER DENNIS JOHN PERSONAL R
SUB (303)981-0079 Carlo Sais 110007 Payless Rooter/Mato Plumbing
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 1,250.00
FEES
Total Valuation 0.00
Use Tax 26.25
Permit Fed 53.70
** TOTAL ** 79.95
*** 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 k/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 - 201701424
PERMIT NO: 201701424 ISSUED: 06/02/2017
JOB ADDRESS: 6895 W 32nd PL EXPIRES: 06/02/2018
JOB DESCRIPTION: Replace 10' of sewer line and install clean outs
I, by my signature, do hereby attest that the work to be per
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 erre I further attest that I am leoally 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
I , '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 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 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 grantin 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 ora rdinance or regulatio oft is jurisdiction. Approval of work is subject to field inspection.
z
� kfee 9
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 insptimerequest@ci.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
Whcatl?,
id ,c
COMMUNITY DEVELOPMENT
Building & Inspection Services Division
7500 W. 29th 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
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: 6 ,1? y
Property Owner (please print): �� (,,ly, ���� Phone: 7zo r7Z 2Z6
Property Owner Email:
Mailing Address: (if different than property address)
Address
State. Zia:
Arch itect/EIng! neer:
Architect/Engineer E-mail:
Contractor: / C ylCs,�
Contractors City License #:
Contractor E-mail Address:
Sub Contractors:
Electrical
W.R. City License #
Other City Licensed Sub:
City License #
Plumbing:
W.R. City License #
Phone:
Phone: 3O& W/ oel�_y
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 ❑ RESIDENTIAL 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
❑UMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
RLECTRICAL SYSTEM/QPPLI�NCE REPAIR or REPLACEMENT
OTHER (Describe)_M W G
(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.)
�c�(o
Sq. FtJLF
Amps
/0( 6f 3 c wt r -
Btu's
Squares
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
1 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,yuarrant the
truthfulness of the information provided on the applicokim- 7—
CIRCLE ONE. (OWNER) (CONTRACTOR) o TATIVE) o (OWNER) (ONT/RACTOR)
Electronic Signature (first and last name): DATE: t— - z/ 7
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
Building Division Valuation: $
� 4 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: ,
.V
Job Address: 9 32—&"a
(_
Permit Number: 2.0/f70/'01 1
❑ No one available for inspection: Time J) �.'' _ AM/PM
Re -Inspection required: Yes N
*When corrections have been made,
�L_
Date: s' Inspecto
call for r!i"nspection at 303-234-5933
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
r00000r'(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address: '1 5 '3;� 1410
Permit Number: t4z
OIX
❑ No one available for inspection: Time .4� U AI�PM.�
Re -Inspection required: /Yes,_INo
When corrections have been made, call for re -ins ction at 303-234-5933
1
1 % �
Date :U r, Inspector:
AJ'
DO NOT REMOVE THIS NOTICE
.. r CITY OF WHEAT RIDGE -
'/l Building Inspection Division
(303) 234 -5933 Inspection line
(303) 235 -2855 Officer ` (303) 237 -8929 Fax
INSPECTION NOTICE
Inspection Type _6" 646�e-46 77-Tr
Job Address 6 4e-�
Permit Number o.2,7o,9
A=40M
A=40M
" ' City of Wheat Ridge
� Residential Plumbing PERMIT - 102708
PERMIT NO: 102708 ISSUED: 12/08/2010
JOB ADDRESS: 6895 W 32ND PL EXPIRES: 12/08/2011
DESCRIPTION: Gas line testing
* ** CONTACTS * **
owner 303/946 -6631 Chris Freebury
sub 303/424 -1054 Michael Enright 01 -7953 AAA Service Plumbing
** PARCEL INFO **
ZONE CODE: UA USE: UA
SUBDIVISION: UA BLOCK /LOT #: 0/
** FEE SUMMARY ** ESTIMATED PROJECT VALUATION: 1,168.00
FEES
Permit Fee 50.30 '
Total Valuation .00
Use Tax 21.02
** TOTAL ** 71.32
Conditions:
Both front and back of permit need to be posted on job site. If one or the other
is not present, INSPECTION WILL NOT BE PERFORMED.
Subject to field inspections.
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 legally 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 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 or any ordinance or regulation of this jurisdiction. Approval of work is subject
to field in ect' n.
o
Signature o Building Offical Date
INSPEC ON REQUEST LINE: (303)234 -5933 BUILDING OFFICE: (303)235 -2855
REQUES S MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
INSPECTION RECORD
Occupancy/Type
IN - 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.
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS .JOB
FOUNDATION INSPECTIONS
DATE
INSPECTOR
INITIALS
COMMENTS:
Footings /Caissons
Insulation
Sarah Enright
Stemwall / (CEG) Concrete
Encased Ground
Reinforcing or Monolithic
AMOUNT
-
Weatherproof / French Drain
FINALS
102708
Sewer Service Lines
Pe'rBit Fee
50.30
Water Service Lines
21.02
Plumbing
CONCRETE SLAB FLOOR
Electrical (Underground)
Plumbing (Underground)
Heating (Underground)
ABOVE HAS BEEN
ROUGHS
Sheathing
Lath / Wall tie
Mid -Roof
Electrical Service
Rough Electric
Rough Plumbing
Gas Piping
Rough Mechanical
Fire Department
R.O.W & Drainage INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLIC WORKS SHOULD
Parking & Landscaping BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
' * NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A
CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION
OFA CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY.
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED
PROTECT THIS CARD FROM THE WEATHER
ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PR CITY OF WHEAT RIDGE
Framing
122/08/10 11:47 AM cribb
Insulation
Sarah Enright
Drywall Screw
RECEIPT ti0tCDB005557
AMOUNT
BPSP Gas line testing
71.32
FINALS
102708
Electrical
Pe'rBit Fee
50.30
Use Tax
21.02
Plumbing
PAYMENT RECEIVED
AMOUNT
Mechanical -
VS 3884
71.32
Roof
Code:
0062
006202
Building Final
TOTAL
71.32
Fire Department
R.O.W & Drainage INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLIC WORKS SHOULD
Parking & Landscaping BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
' * NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A
CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION
OFA CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY.
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED
PROTECT THIS CARD FROM THE WEATHER
DEC /09/2010/THU 01:48 AM
11/ 10/2010 weD 14 133 8AA 3,03 237 8929 303 Heat wdy
P. 001 /001
/2001 /001
City of R �
ool Date:
COMMfJNCIYDl;VE1.OrM.ENT O Permit
Building Divisian
7500 W. 29" Ave., Wheat Ridge, CO 80033
Office: 303 -235 -2855 * Fax: 303 -237 -8929
Inspection Line: 303 - 234 -5933
Facsimile Building Permif Application'
95 u i 3 J .
Property Owner (please print): Photte: q - NON
Mailing Address: (f different than property address)
Address:
City, State, Zip: v2
I� - r�, .. ` .: � ._. _ .._.... ..
_contractorLi #: �� 5 hone :��
`'s�S> �- -'ASR '
rnpanY Name: I-Icense #: Expiration Date* Trade /Profession: .Approval:
Use of space (descri fion):
Q:
Plan Review (due at time ofsu6mftteq: $
Sq. Ft./L.Ft added: Squares ST(Ps Gallons Amps
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
f hereby certify that the setback distances proposed by this permit application are accurate, and do pat violate applicable ordinances,
mles Or regulations of the City of Wheat Ridge or covenants easements or rest(iotlons of record• that all measurements shown, and
allegations made are 2cc0rate' that I have read -and agree to abide by an cendifions printed on flits application and that I assume full
reaponsbillty for compliant* With the Wheat Ridge Building Code (1.9,G) and all other applicable Wheal Ridge Ordinanozs, for work
under this pennlL Plaits subject to field inspection.
C /R/CE ONE:: (OWNER). (CONTRACTOR) or PERSONAL REPRESENTATIVE of (OWNER) (CONTRATOR)
PRINT NAME SIGNATURE: Date:
Credit. Card Payment Use cre 't card listed on
Print name- c J rz li- 6/t7'/ _ Signatui
t31dg ValuaE7on: S
bat v i0
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.
Electrical
Plumbing
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS J OB
FOUNDATION INSPECTIONS
DATE
INSPECTOR
INITIALS
COMMENTS:..
.Footings /Caissons
Roof
Pb
Stemwall / Concrete
Encased Ground
.'Building Final
Reinforcing or Monolithic
`Fire Department
Weatherproof/ French Drain
R.O.W & Drainage
Sewer Service Lines.-
Parking & Landscaping
Water Service Lines
' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -
CONCRETE SLAB FLOOR
Electrical (Underground)
Plumbing (Underground)
Heating (Underground)
'DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
"ROUGHS
{Sheathing
g; lath /Wall tie
'K,
Mid Roof �.
Electrical Service
S'
Rough Electric
1 Rough Plumbing
Gas Piping`
Rough Mechanical
ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING
Framing
�a .Insulation
Drywall Screw
FINALS
Electrical
Plumbing
!Mechanical.
Roof
Pb
.'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 .MUST BECOMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS 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.
�y
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED
PROTECT THIS CARD FROM THE WEATHER
♦ 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: ,Df,
Job Address: Vo Cis a
Permit Number: �. ?a
llftrl'R��a
❑ No one available for inspection: t ° Time /xfff,) AM6 M
f
Re- Inspection required: Yes f'
"When corrections have been made, call for re- insirotion at 303 - 234-5933
Date: fi Inspector: ,ur
T
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Roofing PERMIT - 091359
PERMIT NO: 091359 ISSUED:. 08/17/2009
JOB ADDRESS: 6895 W 32ND PL EXPIRES: 02/13/2010
DESCRIPTION: Reroof 19.,sgs with 30 yr dimensional shingles
CONTACTS
owner Dennis Wheeler
sub 720/350-2876 Robert Goettl 09-0232 Goerrl Industries Inc.
PARCEL INFO
ZONE CODE: UA
SUBDIVISION: UA
I FEE SUMMARY
Permit Fee
Total Valuation
Use Tax
TOTAL
USE: UA
BLOCK/LOT#: 0/
ESTIMATED
PROJECT VALUATION:
FEES
126.50
.00
@
't 6h'„e„J
'
60.53
2
a
k__T
18 7 . 0 3
)Mz,,
3,363.00 -
Conditions:
> 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 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.
Signature of contractor/own date
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.
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:
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 a new permit.
No work of any manner shall be done that will change the natural flow of water causing a drainage problem.
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.
The issuance of a permit or. the approval of drawings and specifications shall not be. construed to be apermit for, nor
an approval of, any violation. of the provisions of the building. codes or any other ordinance, law, rule or regulation.
All plan reviesubject to field inspections.
ignature o Building Official date
NSPEC ON REQUEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855
.EQUES SMUST BE MADE BY.` 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of Wheat Ridge Building Division
m 7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
00 - o Inspection Line: 303-234-5933
~ORPO
Building Permit Application
Date: ( J
Plan
Permit Z?C IY~ 1
Properly Address: M15 AL
Property Owner (please print): Da L[4a-e~ Phone:
Mailing Address: (if different than property address)
Address:
Contractor: G b e- f-f L Z17) MCI
Contractor License V`/ Phone:
Sub Contractors:
Company: Company Company:
Exp. Date: Exp. Date:
Approval: Approval:
Use of space (description):
Description of work,* ,
91.r*-7,rr -r~,-92 oPF
'30 Yr Clow nfivr11714-
Exp. Date:
Approval:
Construction Value: $
(as calculated per the Buildinq Valuation Data sheet)
Plan Review (due at time of submittal): $
Sq. Ft./L.Ftadded: Squares 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.
C/RLCE ONE:: (OWNER) (CONTRACTOR) or PERSONAL REPRESENTATIVE of (0
PRINT NAME: 2yba r1 1 6! D,e7T L SIGNATURE: .L'Y04" Date: 19 °q°
Bldg Valuation: