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Home My WebLink About4005 Miller Court7c S7 q C INSPECTION RECORD Occupancy/Tune INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection ►'� f INSPECTION REQUEST LINE: (303) 234-5933 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 Sewer Service Concrete Encased Ground (CEG) Plumbing Foundation / P.E. Letter Rough Electric .'r -MA RS a T,71S JVfiTi n_�.TravFa t a I ME 210111`11 0101v1:4111 I I &161:4" 4 LOJ I !- Underground/Slab Inspections Date Inspector Comments Initials Electrical cG Sewer Service Plumbing n„ Kl,# !`.,vnr I Inrinrnrnllnd nr Rnlnw/1n-5lah Work Prior 10 Approval VT i ne Above ln5vecliunb Rough Inspections Date Inspector Comments Initials Wall Sheathing cG 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. `For low voltage permits — mease oe sure tnat rougn inspections are UATIPIeieu nUiii LilC Flit; LJJJLl ILA Cli 1u Z;l UULI R.QI wV v vvnayc by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather City of Wheat Ridge Residential Roofing PERMIT - 201703903 PERMIT NO: 201703903 ISSUED: 07/13/2017 JOB ADDRESS: 4005 Miller CT EXPIRES: 07/13/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration asphalt shingles - 17.35 sq *** CONTACTS *** OWNER (720)609-4394 MORALES FILIBERTO SUB (719)985-2110 Brad Griebenow 170132 DBA Storm Guard of Co. Sprgs *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT*: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,981.50 FEES Total Valuation 0.00 Use Tax 146.61 Permit Fee 156.75 ** TOTAL ** 303.36 *** 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 one half 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 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. i CITY OF WHEAT RIDGE. _:�9rBuilding Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Pt i Job Address: %4 Permit Number: '), 0 t `j b -3 9 el X 7 J" < ra ❑ No one available for inspection: Time AM/PM :a Re -Inspection required: Se No r � j- { When corrections have been made, call for re -inspection at 303-234-5933 Date: 7 Inspector: _.�-_ �.. DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE'- Building IDGE'Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: G 0 1n i i t Ct Permit Number: z ❑ No one available for inspection: Time �o AM/PM Re -Inspection required: Yes No When corrections have been made, call for rejpspecti at 303-234-5933 Date: inspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Roofing PERMIT - 201703903 PERMIT NO: 201703903 ISSUED: 07/13/2017 JOB ADDRESS: 4005 Miller CT EXPIRES: 07/13/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration asphalt shingles - 17.35 sq *** CONTACTS *** OWNER (720)609-4394 MORALES FILIBERTO SUB (719)985-2110 Brad Griebenow 170132 DBA Storm Guard of Co. Sprgs *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,981.50 FEES �Ail h, Total Valuation 0.00 Use Tax 146.61— Permit Fee 156.75 ~� ** TOTAL ** 303.36 *** 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 one half 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 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. I* � A ® City of Wheat Ridge Residential Roofing PERMIT - 201703903 PERMIT NO: 201703903 ISSUED: 07/13/2017 JOB ADDRESS: 4005 Miller CT EXPIRES: 07/13/2018 JOB DESCRIPTION: Residential Re—roof to install Owens Corning Duration asphalt shingles 17.35 sq 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 her attest that I am leg ally^authorized to include all entities named within this document as parties to the work to be perform and t t all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOrcle one) Date 1. This permit was issued based on the inf6miation. provided in thepermit application and accompanying plans and specifications and is subject to the compliance witLthose documents, and all applicable statutes, ordinances, regula ions, 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 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 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, an violation of any provision of any applicab�ode or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Oficial ® Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dane Lovett zo i7o3903 From: no-reply@ci.wheatridge.co.us Sent: Friday, June 30, 2017 2:29 PM To: Permits CommDev 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 4005 Miller Court Wheat Ridge CO 80033 Property Owner Name Filiberto Morales Property Owner Phone 720-609-4394 Number Property Owner Email filimor2@msn.com Address Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. CONTRACTOR INFORMATION Contractor Name Storm Guard Contractor's License 170132 Number (for the City of Wheat Ridge) Contractor Phone 303-223-5792 Number Contractor Email Address jlopez@stormguardrestoration.com Retype Contractor Email jlopez@stormguardrestoration.com Address DESCRIPTION OF WORK Are you re -decking the No roof? Description of Roofing OC Duration Shingles, synthetic underlayment, ice & water Material barrier. Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 17.35 material selected above? Does any portion of the i No property include a flat roof? If yes, how many squares Field not completed. on the flat roof? TOTAL SQUARES of all 17.35 roofing material for this project Provide additional detail Re -roof home. Pitch 4/12. here on the description of 2 work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract6981.50 value or cost of ALL materials and labor) 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 and to perform the work described above. Name of Applicant Yes Yes Yes Yes Email not displaying correctly? View it in your browser. 3 Office/Fax: 303-223-5719 11152 Huron Street #211 Northglenn, CO 80234 www.stormguardrestoration.com EXTERIOR RESTORATION 2 Licensed • Bonded • Insured 1352 Contingency Contract (This Co tract is ontin ent U ,onn Your I surance Company's Approval of Your Claim) � � �-y`Q}��(� Homeowner Na��y�m��e 1: eown r Na e 2: �� ' Address: ` � �.-e t��..�.I�. City: ,-W Zip: Contact Home: 4 0- -� l �.Il � Work:_ 6( Cell: _ Email Address:�tl h0l(� 5 A ____ ____ EXISTING ROOF SPECIFICATIONS Roof Condition: - 3 tabArch. YR ----Other *Col r - - ------ -- -- Pitch _—_ /12 *2 Story Yes - No ------ _Tear Off: _ Felt -Lb. LF Valley --_ LF Ridge - 750 Vents # Power Vents # Plumbing Boots Total # _- 1" _ 2" - 3" LF Drip Edge —_Color Remove Debris _— Roll Yard _ Protect Landscape -__ Furnish Permit NEW SHINGLE COLOR BRAND 3 tab Archt. Customer EXISTING SIDING SPECIFICATIONS Siding Condition: Type of siding: Brick -__ _ Vinyl _ _ -_ - _ Wood ____ — Steel - Aluminum Style of Siding: Lap - _ Dutch Grained _ __- Foam Backer _ Wrap _____None LF Fascia Color LF Soffit Color Vented Plain NEW SIDING COLOR BRAND STYLE Customer Int. SPECIAL CONCERNS: ----------------------------------------------- Acknowledgement: Payment Schedule: Payments Received: By signature below, Homeowner agrees to Deductible $Date: Amount $ _._ _ pay Storm Guard the RCV/ACV amount Cust. Suppl. $ Date: Amount $ _ — - -- specified in the statement of loss for ; - - -_" Mat. Upgrades $ _ Date: Amount $_ _ roofing/siding as a materials deposit prior ; -- - - --- to construction. Homeowner agrees Storm Material Deposit $_ _ _ Date: _ Amount $ - -- j Guard is entitled to contractors' "Overhead & Mat. Tax Base Service Charge $._ _ Date: Amount $ -.-_ Profit", material tax and base service charge Final Payment $ TBD that is aid b the insurance comp - an by Insurance Company Date: _ _Amounts _ p y -----y-------- — **Your warranty rights are contingent upon our receipt of full payment for the Work. See Terms and Conditions, Section 3, on the reverse side of this contract. ACCEPTANCE OF AGREEMENT By signing this Contingency Contract, you agree to authorize Storm Guard to assist you in your pursuit of a claim under your insurance policy and your efforts to reach agreement with your insurer on project scope and price. You may cancel this contract with no penalty by providing written notice before midnight on the third business day after the date of your signature below, or any time before your insurer approves your claim, whichever is later. You have no obligation to Storm Guard _under _this Contract -unless your insurer approves Your claim and Storm Guard- approves_ the scope and price identified on the loss statement you receive from your insurer. If your insurer approves your claim, and if Storm Guard approves the scope and price identified on the loss statement you receive from your insurer, then, by signing below, you authorize Storm Guard to complete the replacement of damaged property identified on the loss statement with no_additional cost to you except for your insurance_ deductible, subject to the terms and conditions on the reverse side of this Contract. Payments must be made as outlined above. If this proposal is not accepted within thirty (30) days, it shall be automatically withdrawn. Accepted by Homeowner on date__�/ Homeowner Signature #1 t%` omeowrier Signature #2 __ Insurance Company: �_ _Claim Number: � f-9 --� �� Mortgage Company: _ Loan Number: ___ Phone: Sales Representative: 2_k� l �` /�G JI) _Field Manager:_ CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 9 O F Job Address: 6 6 �` rA i to 4. Cl Permit Number: e) D I '7+0 3 ?03 ❑ No one available for inspection: Time, / -F- • AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date ` /7 Inspector: DO NOT REMOVE>TTHIS NOTICE INSPECTION RECORD OccupancvlTVpe 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. n L� INSPECTOR MUST SIGN ALL S ACES ERTAINING TO THIS JOB FOUNDATION INSPECTIONS DATE INSPECTOR INITIALS COMMENTS: Footings /Caissons Lath / Wall tie Stemwall / (CEG) Concrete Encased Ground Mid -Roof G 7 Reinforcing or Monolithic Electrical Service Weatherproof/ French Drain Rough Electric Sewer Service Lines Rough Plumbing Water Service Lines Gas Piping INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. CONCRETE SLAB FLOOR Electrical (Underground) Heating (Underground) ROUGHS Sheathing Plumbing Lath / Wall tie Mechanical Mid -Roof G 7 Roof Electrical Service Building Final Rough Electric Fire Department Rough Plumbing R.O.W & Drainage Gas Piping INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. Parking & Landscaping Rough Mechanical ** NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A' <_. CERTIFICATE OF OCCUPANCY I515SUED. FINAL INSPECTION By THE BUILDING UIVISIbN DOES NOT CONS III'UTEAUTHOR/ZATION OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. Framing Insulation Drywall Screw FINALS - Electrical 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 I515SUED. FINAL INSPECTION By THE BUILDING UIVISIbN DOES NOT CONS III'UTEAUTHOR/ZATION OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. _.._ I PPnTFCT :ATE OF OCCUPANCY IS ISSUED WEATHER ♦ ♦ CITY OF WHEAT RIDGE Bung Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: K 00 Job Address: Z~ AN IL, Permit Number: OaPr,g, Na , P ❑ No one available for inspection: Time V/r., AWN) Re-Inspection required: Yes P2) "When corrections have been made, call for re-inspection at 303-234-5933 Dater tl ? Inspector: z,snrj. DO NOT REMOVE THIS NOTICE 77, ♦ 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: Pnr~ r Job Address: wo(z `L,4 f/.rrr { Permit Number: I~ ( r ❑ No one available for inspection: Time AM P Re-Inspection required: ~Yesl No When corrections have been made, calf for re-inspection at 303-234-5933 Date: f ~s l~ Inspector: P I` 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: / 7f 5I ~tl-rr O W Job Address: YtllnS A4;1' r tri, Permit Number: , a';~ g0--, ccPP..~~ t . [I No one available for inspection: Time ) AM/MI) 4 ~ Re-Inspection required: Yes < o When corrections have been made, call for e-inspection at 303-234-5933 Date: in-D-Pa Inspector. la S DO NOT REMOVE THIS NOTICE I E, City of Wheat Ridge r4000or Residential Roofing PERMIT - 092896 PERMIT NO: 092896< ISSUED: 10/01/2009 JOB "ADDRESS: 4005 MILLER CT EXPIRES: 03/30/2010 DESCRIPTION: Re deck w/ 60 sheets. Reroof `18.6 sqs ***'CONTACTS owner 303/261-6853 Filbert: Morales U sub 303/756-4400 Arik Connell 09-0152 Connell's Custom Exterior Inc * * PARCEL !INFO ZONE CODE: UA USE: UA SUBDIVISION: 0207 'BLOCK/LOT#: 0/ FEE SUMMARY ESTIMATED PROJECT VALUATION: '.6,600.00. FEES Permit Fee 162.90 Permit fee :additiona 70.25 Total Valuation .00 Use Tax 91.80 Use -:tax additional ' .127.00 -J 'TOTAL '.351.95 Conditions: 6 nail installation mid-roof inspection required. Board sheathing spaced more r, than la 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 inspection; I hereby certify, that the setback distances proposed by this permit application are accurate, and do not violate applicable F ordinances, rules or regulations of the city of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and allegatio made are accurate; that I have read and agree to abide. by all conditions printed on this applicatio dthat I ass me 1 expo i ility for compliance with the Wheat iRidge Building Code -(I.B.C) and all other 1. applicabl eat.Ridge O in ce for r under this permit. Plans: subject to field inspection. C 9i at e of contractor /own r :.relate 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 r 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 r; 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 lshall E be ?paid for anew permit. 4 No lwork of any manner shall be done that will change the. natural flow of water causing a drainage problem. r' S 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 f an approval of, any violation of the provisions of the building codes or any other ordinance, law, rule or regulation. ' All plan review is subject to field inspections Signature of ilding Official date INSPECT VEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855 REQUEST MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. FEE SUMMARY ESTIMATED PROJECT VA FEES Permit Fee 162.90 `,ems Total Valuation ,00 1 1 Use :Tax 91.80 ~ * * TOTAL .'254.70 Comments: Conditions: inside e: ica' :e. ~i M, 3x ~oF""E9Tp, City of Wheat Ridge Building Division 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 OO~ORP~O Inspection Line: 303-234-5933 Property Address: Property Owner (plea Date: Plan Permit D~ se print): vS Phone: _ _ 853 Mailing Address: (if different than property address) Address: City, State, Contractor: Contractor License Phone: 343 Building Permit Application Sub Contractors: Electrical City License Company: Exp. Date: Plumbing City License Company Exp. Date: Mechanical City License Company: Exp. Date: Use of space (description): Description of work, G Sq. Ft./L.Ft added: el~ ~ lo~ Squares B~lB~'lg's- Construction Value: $ '!~-l oc) (as calculated per the Building Valuation Data sheet) Plan Review (due at time of submittal): b 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 pennit. Plans subject to field inspection. CIRLCE ONE:: (OWNER) CONTRACTO or PERSONAL REPRESEN TIVE of ~R) (CO ATOR) PRINT NAME: .J SIGNATURE: Date: G" 'd DEPARTMENT USEONLI' ' SONING.COMMENTS'' . Zoning' Reutewer, PUBLIC WORKS CQMMEFITS- - - z s 2 BUILOINGDEPARTMENT COMMItN6 V { r 5 ' - ~S ~ ~ 000l7PANCY c A Revtewer , ~ ~ -FfRE OEPARTMEtJ T G1 approved.),vX cemments ❑ dlsapp'r`oved D rto [ewew regprred Bldg Va luation: $