HomeMy WebLinkAbout3780 Fenton StreetINSPECTION RECORD
Inspection online form: http://www.ci.wheatridge.co.us/inspection
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 MIDNIGHT (11:59 PM) to receive an inspection the following business day
PERMIT: ADDRESS:3-7Yb ce,- l J4- JOB CODE: f"`r
Foundation Inspections
Date
Inspector
Initials
Comments
102 Caissons / Piers
103 Footing / P.E. Letter
104 Foundation Setback Cert.
105 Stem Walls
106 Foundation wall Insulation
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground / Slab Inspections
Date
I �spea sor
Comments °
201 Electrical / Cable/ Conduit
202 Sewer Underground Int.
203 Sewer Underground Ext.
204 Plumbing Underground Int.
205 Plumbing Underground Ext.
206 Water Underground
Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections
Rough Inspection
Date
Inspector
Initials
Comments
301 Rough Framing
302 Wall Sheathing
303 Roof Sheathing
304 Sheer Inspection
305 Insulation
306 Mid -Roof
30T Metal / Lath / Stucco
308 Rough Electrical Residential
309 Rough Electrical Commercial
310 Electrical Meter Residential
311 Electrical Meter Commercial
312 Temp. Const. Meter
313 Rough Plumbing Residential
314 Rough Plumbing Commercial
315 Shower Pan
SEE OVER FOR ADDITIONAL INSPECTIO',
PERMIT: ADDRESS: �JZ�G ��,./1 JOB CODE:
Rough Inspection (continued)
Date
Inspector
Initials
Comments
316 Rough Mechanical Residential
317 Rough Mechanical Commercial
318 Boiler / Furnace
319 Hot water tank
°
320 Drywall screw and Nail
321 Moisture board / shower walls
322 Rough Grading
323 Miscellaneous
7
Final Inspections
Date
Inspector
Initials
Comments
402 Gas Meter Release
403 Final Electrical Residential
404 Final Electrical Commercial
405 Final Mechanical Residential
406 Final Mechanical Commercial
407 Final Plumbing Residential
408 Final Plumbing Commercial
409 Final Roof
7
410 Final Window/Door
411 Landscape/Park/Planning*
Inspections from these entities shall be requested
one week in advance.
*For landscaping and parking inspections please
call 303-235-2846
**For ROW and drainage inspections please call
303-235-2861
***For fire inspections please cont�.ct the Fire
Protection District for your project.
412 Row/Drainage/Public Works**
413 Flood plain Inspection**
414 Fire Insp. / Fire Protection***
415 Public Works Final**
416 Storm Water Mgmt.**
417 Zoning Final Inspection*
418 Building Final Inspection
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.
For Low Voltage permits please be sure that rough inspections are completed by the Fire District and
Electrical low voltage by the Building Division.
�?i
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: 1-1 2 � - EIn es -
Job Address: 3 -7 8 y t- e r 4, ,,, S �-
Permit Number: C J -7 5 o C -7
t- r\e� ;7[�:.��� cl
❑ No one available for inspection: Time ` = 74:;�&PM
Re -Inspection required: Yes
When corrections have been made, call for re -inspection at 303-234-5933
Date: i 1///-2 Inspector:
DO 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
INSPECTION NOTICE
Inspection Type:
Job Address: cr, en SY.
Permit Number:
❑ No one available for inspection: Time(7' 'K, -AMPM
Re -Inspection required: Yes /, N6�j
When corrections have been made, call for re -inspection at 303-234-5933
/ 1
Date:-,-" �/ Inspector:
DO 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
INSPECTION NOTICE
Inspection Type:
JobAddress:
Permit Number: 12-Q'10'1 O 0
IV �b � VID
❑ No one available for inspection: Time 3 AM PM
Re -inspection required: Yes (No
When corrections have been made, call f re-inspe� crtion at 303-234-5933
') C
Date: I i (5 ! inspector: `1
DO NOT REMOVE THIS NOTICE
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION
City of Wheat Ridge
Residential Roofing PERMIT - 201709007
201709007
3780 Fenton ST
Permit to remove
Asphalt shingles.
ISSUED: 11/13/2017
EXPIRES: 11/13/2018
and replace 7 squares 30 year HD shingles with Weatherwood
*** CONTACTS ***
OWNER (720)230-7682 3780 FENTON LLC
SUB (720)298-1832 Juan Mandonado 110079 MJF Construction
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 331 / General Retail; 1 BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 1,799.00
FEES
Total Valuation 0.00
Use Tax 37.78
Permit Fee 70.70
** TOTAL ** 108.48
*** COMMENTS ***
*** CONDITIONS ***
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 - 201709007
PERMIT NO: 201709007 ISSUED: 11/13/2017
JOB ADDRESS: 3780 Fenton ST EXPIRES: 11/13/2018
JOB DESCRIPTION: Permit to remove and replace 7 squares 30 year HD shingles with Weatherwood
Asphalt shingles.
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
permed and ll X11 work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Z-1ZI-
signature of OWNEeor 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, po Flans
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 originalermit 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 shal ` t be construed o be a ermit for, or an approval of, an violation of any provision of any
applicable code or any ordinance or re ti AAL14' juris ics o : oval of work is subject to field inspection.
�..
Sigi afire of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Antoinette Kulick
2AD I—t ;Z) Cc �D o-�
From: no-reply@ci.wheatridge.co.us
Sent: Sunday, November 12, 2017 7:23 PM
To: CommDev Permits
Subject: Online Form Submittal: Residential Roofing Permit Application
Categories: Antoinette
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 t
� 5
Property Address 3780 Fenton st C)
Property Owner Name ick property manse �� <
_
Cc)
Property Owner Phone 202307682 �,) l
Number (enter WITH
dashes e 303-123-4567
g )
25 � / uK,qS/
Property Owner Email
Field not completed.
Address
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
20171112 191317.0pg
Contract
CONTRACTOR INFORMATION
Contractor Business
MJF Construction
Name
Contractor's License
110079
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone
7202981832
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address
6551 w.73rd pl
(Primary address of your
business)
Contractor Email Address
bmandonado@icloud.com
Retype Contractor Email
bmandonado@icloud.com
Address
DESCRIPTION OF WORK
TOTAL SQUARES of
7sq
the entire scope of work:
Project Value (contract
1,400
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
26
both? (check all that
apply)
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)
4/12
7sq
30 yr HD shingles weatheredwood
Asphalt
Remove and replace with 30 -year HD shingles
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
27
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.
Name of Applicant Juan Mandonado
Email not displaying correctly? View it in your browser.
28
N1 r) Ii C 011 s t z• .�-e•
xon
Rooting, Inc,
Date: _ _ .- I
Cell:
PROPOSAL Office:
%f "OPOSAL SUBMITTED TO: ---
NAME,
PHONE
WORK TO BE PERFORMED AT.
We hereby propose to furnish the materials and perform the labor necessary for the completion of
All material is guaranteed to be as specified, and the above wnrk to be performed in accordance with the drawings and specifications
submitted for above work, and completed in a substantial workmanlike manner for the sum ooars (,�
with payments to be made as follows:C��� /��� 0-1-7
Respectfully submitted
�,Y atteratron or deviation from above spealkait becns ome
any extra costs onY u upon written order. and will become an exlra charge Per
Will be executed reernenls contingent upon stakes, ac,
over and above the e d our coMrmale lolag
dents. or delars beyond Note - This proposal may be ithdrawn
- by us it not accepted with` days.
'�- ACCEPTANCE OF PROPO
The above prices, specifications and conditions are satisfartory and are hereby
as specified. Payments will be made as outlined above.
Signature __,ft'
are authorized to do the work
Signature — u , — _ u
INSPECTION RECORD Occupancy/Type
INSPECTION LINE: (303) 234 -5933 -
[I"'I'll
I
rte'
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.
t
Electr ical
-
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB
FOUNDATION INSPECTIONS
DATE
INSPECTOR
INITIALS
COMMENTS:
Footings /Caissons
-
.
Stemwall / (CEG) Concrete
Encased Ground "
Fire Department
Reinforcing or Monolithic
R.O.W & Drainage
Weatherproof /French Drain
INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS
SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
Parking .& Landscaping
Sewer. Service Lines
"`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
OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY
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`
Lath / Wall tie "
Mid -Roof
Electrical Service -
-
Rough Electric
Rough Plumbing
Gas Piping
- / e9
G:CS 61.1,91512
Rough Mechanical
ABOVE
INSPECTIONS TO BE SIGNED
PRIOR TO PROCEEDING
ffDrywall
rew
FINALS
Electr ical
-
Plumbing
Mechanical'
-
Roof
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 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
OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY
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: r',4S 1, ¢ F,.r „� •� , cam
Job Address: zzv.
Permit Number:
E
❑ No one available for inspection: Time pis: Va AM /PM
Re- Inspection required: Yes
When corrections have been made, call for re- inspection at 303-234-5933
Date: 5?/// . 7 Inspecto
DO NOT REMOVE THIS NOTICE
i FORM (M) 414 -02 -1723 t R
ADg,t Dt+Cejf �N/O�R COUJJiV 6 f'° '°`w^' EL
CUSTOM G NAA f ME(PRINT) - ♦ A q / Y ` /{-' ACTION—TAKEN
cj d.6 A A El NO SHUT OFF
C- ' SPECIFY ❑ APPLIANCE OFF
OWNER TENANT. J AGENT ❑ OTHER OTH APPL. & METER
METER SHUT OFF
HAZARD
CONDITION TO BE CORRECTED AS SHOWN BELOW CREATES AN IMMEDIATE HAZARD. THIS EQUIPMENT MUST NOT BE PUT BACK It
I SERVICE UNTIL REPAIRS AND THOROUGH INSPECTION HAVE BEEN MADE BY A QUALIFIED CONTRACTOR CONTACT YOUR LOCAI
BUILDING DEPARTMENT FOR CODE AND PERMIT REQUIREMENTS PRIOR TO PERFORMING REPAIR WORK.
�NAMEAN TYPEO�FJAPPPUANCE 'µ pg pp v4
CON TIO TOBECOR CTED y
FOR FURTHER INFORMATION, PHONE'
� DAT / •`
C RG MER�OCWPANTS NAN E DA$F�
REOTIONSHIP OF Oc.w /
City of Wheat Ridge
I Residential Mechanic PERMIT - 091809
PERMIT NO: 091809 ISSUED:; 08/31/200.9
JOB-ADDRESS: 3780 FENTON ST' `EXPIRES: 02/27/2010
DESCRIPTION: Install. U/G gas'line but not :connecting furnace only lines
:CONTACTS
owner 361/551-9085 May 'Me Dainell
sub 303/935-1617 Ronald Florez 02-2421 Florez Heating & Gas Works
PARCEL INFO
ZONE "CODE: UA FUSE: UA
SUBDIVISION: 0456 BLOCK/LOT#: 0/
FEE SUMMARY ESTIMATED PROJECT VALUATION: 2,000.00
FEES
Permit Fee 90.10
Total Valuation .00
Use Tax 36.00
TOTAL 126.10
Conditions:
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/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, Cfull fees shall
be paid for anew permit.
4. No 'work of any manner shall be done that will. change the. natural flow of water causing adrainage 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 jobs.
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 ofthe provisions of the building codes or any, other ordinance, law, =Is or 'regulation.
All:. plan review is subject to field:. inspections.
signature of Chief: Building (official .:date
INSPECTION REQUEST LINE: (303)234-5933 BUILDING. OFFICE: (303)235-2855 REQUESTS MUST: BE `MADE BY 3PM ANY BUSINESS DAY FOR. INSPECTION THE FOLLOWING BUSINESS DAY.
City of Wheat Ridge
Residential Mechanic PERMIT - 091809
i 0918•) :ISSUED:.: 08/31/2009
3780 -.EXPIRES: 02/27/2010
Install L,t-s" gas'line but not connecting furnace only lines
NETS:
.1 0,
k 1-9085 M ,.Me Dainell
45 1617 Rcxlald Florez 02-2421 Florez Heating & Gas Works
..,.1
s
USE:UA
'!.BLOCK/LOT#: 0./.
ESTIMATED PROJECT. VALUATION: 2,000.00
FEES
90.10
.00
36.00 126.10
„`a ~•.,-r
r
etback digtances proposed by this permit application: are accurate, and do not violate applicable
tions 'y}~e City of Wheat Ridge or covenants, easements or restrictions of record; that all
bons made are accurate; that I have read and agree to abide by all conditions printed on this
11 responsibility for compliance with`. the Wheat:. Ridge : Building Code (I.B.C) and all other
na s, for work under this permit Planajf ject to. 'field inspection.
n accordance with the provisions set forth in your application: and is subject to the laws of the
the Zoning Regulations and Building Codes of Wheat: Ridge, Colorado or any other applicable
?BO days from the issue date. Requests for an extension must be received prior to expiration
be granted at the discretion of the Building Official
3'new permit may be acquired for a fee of one-half the amount normally required, provided no
4;be made in the original plans. and specifications and any suspension or abandonment` has not
f clv,nges. have been or if suspension or 'abandonment exceeds one (1) yearfull fees
,Pshall
k be.,Idone that will change the natural flow of water causing a drainage problem.
'lding Inspector twenty-four (24) hours in advance for all inspections and shall receive
ec! trd before proceeding with successive phases of the job.
or tt,~ s,Iproval of drawings and specifications shall.: not be construed to. be a permit for, nor
atic `.7e provisions of the building codes or any other ordinance, law, role or regulation.
ct to tii3:q inspections.
official date
INE: (303)234-5933 BUILDING OFFICE:: (303)235-2855`
oe""EATR City of Wheat Ridge Building Division
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-235-2857
c ~ o Inspection Line: 303-234-5933
OGORPO
Building Permit Application
=Permit 55
Prope
rty Address: Fa,,~Tp y~ -t-lr
Property Owner (please print): M A`I Ma nArt yJ G l l Phone: 635
Mailing Address: (if different than property address) a0-:s-96(P-5S-72>
Address (a00 E - r V ~2S
City, State, Zip: TX _ 78382
Contractor:
r t
Contractor License Phone: qZI,
Sub Contractors:
Electrical City License
Company:
Plumbing City License Mechanical City License
Company Company:
Exp. Date: Exp. Date: Exp. Date:
Approval: Approval: Approval:
Use of space (description):~i.~ Construction Value: $
Description of work: (as calculated per the Building aluation Data sheet)
Sl1 STIrl.d~. IAZ e✓L ri 2o u yJp ~-,,ws L+ yJ Plan Review (due at time of submittal): $
S~},o+n~ ►aS LtrJ2~Cb A0114;, IGudsJ 15Th Q-) i. stcE rT~
G \ p~ spa 741C Sq -~1 rn~ ~x Two Fu o~-~J cE
b'Sq. Ft~L.Ft a eduaresU"s~Galions 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) CONTRACTO or PERSONAL REPR S NT o O NER) (CONTRATOR) *1101
PRINT NAME' ?0 URI,C~ ~l-O(L~Z SIGNATURE: Date: ZONING COMMENTS:
Zoning
Reviewer:
W"r,
PUBLIC WORKS COMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS.
Reviewer
FIRE DEPARTMENT" ❑ approved wl comments ❑ disapl
_Y
OCCUPANCY:-
ved no review required Bldg Valuation: