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Home My WebLink About4450 Moore Court-201707 Iii I INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Occupanc�e L 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 Initials Comments Pier �� 0, Concrete Encased Ground (CEG) Foundation / P.E. Letter Lath / Wall Tie Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Sewer Service Plumbing Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing �� 0, Mid -Roof 7✓26cZ Lath / Wall Tie Fire Inspection / Fire Protection Dist. Rough Electric Final Electrical Rough Plumbing/Gas Line Final Plumbing Rough Mechanical Final Mechanical Rough Framing Roof (') Rough Grading Final Window/Doors Insulation Final Building Drywall Screw / Nail 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. 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 L(- 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 — Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather The City of Wheat Ridge Third Party Form Check List Property Address Permit Number Ih V? P7 I Permit Issued Date jTj 2 Ig Owner Information // �� Property Owner Information La,'r ,m Property Owner Address Sc� /�,t.c) 0', e_ Inspection Company Inspector Name Inspector Contact info. — Inspector Statement and Acknowledgement * I hearty acknowledge the roof I am inspecting is 6/12 or over all roofs that are under 6/12 must be inspected by the City of Wheat Ridge Buiding Dept. * I hearby acknowledge the roofing system for the referenced building has been inspected and found to be in compliance with the minimum requirements of the 2012 IRC and 2012 IBC as well as all City of Wheat Ridge Policies and Procedure and Manufaurer's recommendation an ti _ q I Inspector: Date: Pro44 Owner Statement of Acknowled ement *1 hearby acknowledge that I am the owner of the building referenced above and I give my consent for the listed third 6arty ir�pection company to perform my roof 'nspec ion in lieu of the City of Wheat Rid. uild' g iAion inspection. Propery Owner/ Agent: J Date: ". This original document as well as the roofing check list, must be submitted to the Chief Building Offical within seven days of the final inspection. Drop off in person Submit via Email Permit counter 2nd floor oo xtoJi.wheatridge,co. u s 7500 W. 29th Ave Wheat Ridge CO 80033 Drafted Date: 7/26/17 Please add note to reverse side The City of Wheat Ridge inspection Check List notes Mid -Roof Roof Inspection O N/A A Pass 0 Fail Structural roof components 0 N/A Pass 0 Fail than 2 layers of shingles exist 0 N/A Pass 0 Fail Pass 0 Fail Verify that no more Flashing for roof and walls C7 N/A If new sheathing is installed verify that it is listed in the 0 Pass 0 Fall permit description (Valuation must be adjusted) 0 Fail Verify sheathing nail pattern ( See policy & Proceedures) N/A Q Pass Crickets and saddles where needed N/A €3 Pass 13 Fail 0 Verify B vent must have boot same gauge as pipe C] N/A Pass Fail q N/A Pass 0 Fail Verify vent caps 0 Fail Verify no flashings are damaged or rusted Is N/A , Pass Fait •N/A Step flashing shall be min. of 4x4 piece per shingle Pass � •p 0 Fail Verify scuppers allow for proper drainage N/A �K Pass 0 Fail Ice and water shield 2' in heated wall spaces N/A/I; Pass •• Underlayments must follow 2012 IRC / 2012 IBC N/A , Pass 0 Fall 0 Verify roof slope for proper drainage R N/A / Pass Fail a Fail Dripedge shall have min of 2" overlap c N/A Pass 13 Fail •N/A Dripedge should extend down min 2" past roof deck • Pass Fa;, Dripedge shall be mechanicaly fastened 12" OC n N/A paw 90 LB roll roofing shall not be applied to roof slopes "/A D Pass 0 Fail less than 2:12 slope: Exception, detached garages, patios, carports, open on three sides with min, slope of 1:12 Modified Bitumen, EPDM, TPO min slope 1/4:12 slope N/A €3 Pass 0 Fail Above roof insulation R-25 N/A 0 Pass C1 Fait Below roof residential R-38 N/A 0 Pass p Fail Below roof commercial R-32 N/A o Pass Q Fail Modified Bitumen, EPDM, TPO min slope 114:12 slope f N/A 0 Pass p Fall r must be installed in accordance with the manufacturers specifications- Must have manufactures letter of warranty with the address on the letter for final inspection Metal Roof Shingles Requirements s Metal roof shingles m all not be installed on slope less N/A 0 Pass ❑ Feil 3:12 Metal valley flashing shall be the same material as roof N/A 0 Pass 0 Fail Metal valley flashing shall extend a min of 8" from the /A CE Pass R Fail centerline with a min. of 3/4" high splash diverter rib built-in at the flow line with sections overlapping a a min. of 4" _Tile Roofs Regulrements Clay and concrete tile shall have a min. 2-1/2:12 slope /A Q Pass p Fail under require double underlayment Slopes 4:12 and The City of Wheat Ridge Inspection Check List notes Mid -Roof N= Company Name: inspector signature:-' Date of Inspection: The City of Wheat Ridge Inspection Chea List notes Final Roof .1300f 102222119M a/A a Paz � pas a Fall 0 Fait Structural roof components VA 1!A � Pass 0 Fail Verify that no more than 2 layers of shingles exist )`Pass 0 Fail Flashing for roof and walls i/A D Fail If new sheathing is installed verify that it Is lasted In the 13 PaSS permit description (Valuation must be adjusted) 0 Pass 13 Fail Verify aheahing nail pattern ( See polio $ Proceedures) d!A am a Past, o W Crickets and saddles where needed pan a Farr Verily B vent must have boot same gauge as pipe VA ,� VA Pas a Fair Verify Vent caps V/,gyp 0 Fail Verify no flashings are damaged or rusted VA o Fair Step flashing shall be min. of 4x4 piece per shingle v/A 11, Pass c Fail Verify scuppers allow for proper drainage VA 0 Farr loe and water shield 2' In heated gall spaces "ICPass )If- pan a Farr Underlayments must follow 2012 IRC 12012IBC NIfA pan 0 Fall Verify roof slope, for proper drainage VSA 14/A Pass 0 Fail Dripedge shall have rain of 2" overlap Pass ❑ Fall Orlpedge should extend down min 2" past roof deck 14/ n Farr Dripedge shall be mechanicaly fastened 12" OC v/A Pass a lass a Farr 90 LB roll roofing shall not be applied to roof slopes 4/A less than 2:12 slope: Exception, detached garages, patios, carports., open on three s}des WIM min. slope of 9:12 a Pass 0 Farr Modified Bitumen, EPDM, TPO min slope 114:12 slope N/A 0 Pass o Fair Above roof insulation R-25 N/A a Pass a Farr Below roof residential R-38 N/A a Pass a Farr Below roof commercial R-32 N/A a Pass 0 Fail Modified Bitumen, EPDM, TPO min slope 114:12 slope NIA must be installed in accordance with the manufacturers specifications- Must have manufactures letter of warranty with the address on the letter for final inspection Mslail aggfihingles C Fail RegULMMe;�ts Metal roof shingles shall not be installed on slope less N/A a Pau 3:12 l ve y %imsh„ng shsh bs Alb@ Sarre mst eAst as rw VA a Paas 0 Fail Farr Metal valley flashing shall extend a miry of 8" from the N/A a PM ! 0 centerline with a min. of 314 " high splash diverier rib built-in at the flow line with sections overlapping a a min. of 4" 11® -agm Bomb R Fall Clay and concrete file shall have a min. 2-112:12 slope WA R pass Slopes 4:12 and under require double undedayment The City of Wheat Ridge Inspection Check List notes Final Roof Note Company Name: x' ` 3 C�,/i � t�t�=.r.L�,�•''�1' � S'T'S Inspector signature: Date of Inspection: A r City of Wheat Ridge V, Residential Roofing PERMIT - 201707191 PERMIT NO: 201707191 ISSUED: 09/12/2017 JOB ADDRESS: 4450 Moore CT EXPIRES: 09/12/2018 JOB DESCRIPTION: Residential Re -roof to install Atlas Stormmaster asphalt shingles - 34 sq Pitch = 5/12 *** CONTACTS *** OWNER (303)424-4414 LAIRD NANCY SUB (303)757-5555 Brian Cung 100121 Rocky Mountain Roofing & Rest. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2408 / FRUITDALE, LEES, STONERIDGE BLOCK/LOT*: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,738.00 FEES Total Valuation 0.00 Use Tax 183.50 Permit Fee 188.45 ** TOTAL ** 371.95 *** 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) 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. Midroof & Final Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, 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. City of Wheat Ridge 'Residential Roofing PERMIT - 201707191 PERMIT NO: 201707191 ISSUED: 09/12/2017 JOB ADDRESS: 4450 Moore CT EXPIRES: 09/12/2018 JOB DESCRIPTION: Residential Re -roof to install Atlas Stormmaster asphalt shingles - 34 sq Pitch = 5/12 I, by in 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 d that all work to be erformed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature f 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 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 re uired inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance ox granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicabler, any ordrnor regqla on of this jurisdiction. Approval of work is subject to field inspection. Nr��rti Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dane Lovett From: no-reply@ci.wheatridge.co.us Sent: Friday, September 8, 2017 1:26 PM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Follow Up Flag: Follow up Flag Status: Completed 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 Property Address 4450 Moore Ct. Property Owner Name Nancy Laird Property Owner Phone 303-424-4414 Number (enter WITH dashes, eg 303-123-4567) Property Owner Email Address Do you have a signed contract to reroof this property? Applications cannot be submitted without an executed contract attached below. Attach Copy of Executed Contract Field not completed. Yes 4450 MOORE CT CUSTOMER AGREEMENT.i)df CONTRACTOR INFORMATION Contractor Business Rocky Mountain Roofing & Restoration Name Contractor's License 100121 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone Number (enter WITH dashes, eg 303-123-4567) Contractor Address (Primary address of your business) 720-490-5747 1685 s Colorado Blvd. S176 Contractor Email Address edith@rkymtnroofing.com Retype Contractor Email Address DESCRIPTION OF WORK TOTAL SQUARES of the entire scope of work: edith@rkymtnroofing.com 34 Project Value (contract ,8500--00. value or cost of ALL materials and labor) Are you re -decking the No roof? 38 Does the scope of the project include a flat roof (less than 2:12 pitch)? Does the scope of the project include a pitched roof (2:12 or greater pitch)? What is the pitch? 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) M Yes 5:12 34 remove & replace comp. shingle with Atlas Stormmaster in Pewter. Asphalt House, Garage & Shop 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. Yes Yes Yes 39 I certify that I have been Yes authorized by the legal owner of the property to submit this application and to perform the work described above. 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 Brian Cung Email not displaying correctly? View it in your browser. 40 CUSTOMER AGREEMENT ROCKY MOUNTAIN I � � 1685 S. Colorado Blvd. Unit 5-176 Denver, CO 80222 3578 Hartsel Dr. Unit E-122 Colorado Springs, CO 80920 Office 303-757-5555 Fax 303-757-0027 Office 719-792-4245 M RkWtnRoofina_cnm - I ir_pnsfnd fL Incrrrori Property Owner Email Date /V#/y4y Gft-r-,eo Street Address RMRR Estimator f L/L/ S O /}7 od2€ GT City, State Zip a4ao &, Co of 3 Insurance Company �� 7E ,� '► Horne Phone IWork Phone Claim # 30 3.1-1 -/- !y 0&0 / 17 C 5-& 59"No Deposit Required M3 year Roof Labor Warranty ERrGen. Liability/ Workers' Corn p. grIBB13 Accredited I - e � <a Partial Repair Damage: di' no Type dn -X-L OUSEARAGE PATIO SHED SHED2 Roof Type: /q 5 A11 # L -r Drip Edge Color [Inspect Decking [inspect Flashings Clean Up & Remove Trash — zsvDOW S , De UC cN Z1i/13o*•1 sC div S ftN Payment Options PER Z Full Partial Damage: yes no Type: Repair STUCCO VINYL WOOD OTHER: Style: Color: Full Partial Repair 5" - R . 6- - Comm. Alum. Steel Lf: Color_ Work to be completed according to the above specifications in the amount of.- (not f:(not to include insurance supplements, permit costs or any onforeseen construrlion costs) d ❑ Balance due upon completion ❑ CASH SALE Eg- NSURANCE AGREEMENT. The homeowner authorizes Rocky Mountain Roofing & Restoration to represent their best interest in pursuit of full replacemerrt costs for damages believed to be covered under homeowner's insurance and allows Rocky Mountain Roofing & Restoration to deal directly with the insurance company regarding this claim. This contract does not obligate the homeowner or Rocky Mountain Roofing & Restoration until the claim is approved by the insurance company, and accepted by Rocky Mountain Roofing & Restoration. Upon approval of claim, Rocky Mountain Roofing & Restoration will complete all specified work at a price agreeable to the insurance company (RCV only) and Rocky Mountain Roofing & Restoration, with no additional cost to the homeowner except for the deductible. Final agreed upon price will become the final contract price, regardleass of estimated contract price above, and we request that all payments also be made payable to Rocky Mountain Roofing & Restoration. I (We) agree, by signing bek�or,-to;iiiii the contract drtlgrr� on both front and back, of this agreement Horneowner's Horneowner's Date of Representative INSPECTION RECORD Occupancy /Type INSPECTION LINE: (303) 234 -5933 CONCRETE SLAB FLOOR Electrical (Underground) Plumbing (Underground) ROUGHS Sheathing Lath / Wall tie Mid -Roof Electncal Service v Rough Electric Rough Plumbing Gas Piping ,- Rough Mechanical r, R' Framing Insulation Drywall Screw r, 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 SPACEM "PERTAINING TO THIS JOB FOUNDATION I MDrain INSPECTOR ECOMMENTS: - INITIALS Footings /Caiss Stemwall / (CE Encased Groun Reinforcing or Weatherproof/ Sewer Service L -- Water Service Lines POUR NO C ONCRETE UNTIL ABOVE HAS BEEN SIGNED DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED 1I n _- I ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING FINALS gR.O. l :�'. G is i�d- al ment ainage INSPECTIONS FOR PLANNING S. ZONING, FIRE AND PU BLICE WORKS Parking & Landscaping SHOULD 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 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) 237 -8929 Fax INSPECTION NOTICE `Inspection Type: Arzy Job Address: C T Permit Number: Z9 - / 7z ❑ No one available for inspection: Time a Re- Inspection required: Yes When corrections have been made, call for re- inspection at 303 -234 -5933 Date: L/ G 1,119 Inspector: DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE r Bung Inspection Division 1 (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NO CE Inspection Type: k^, \ 174` Job Address: 44-&-o ti ~OC7l~ ~ C Permit Number: CfaIg1 -i No one available for inspectioUime IX, AM/ M Re-Inspection required: Yes When corrections have been made, calf for re-inspection at 303234-5933 fd Date: 4-2--M Inspector: (,Ok z DO NOT REMOVE THIS NOTICE " ' City of Wheat Ridge Residential Roofing PERMIT - 093199 PERMIT NO: 093199- ISSUED.:.. 10/09/200.9 JOB ADDRESS: 4450:MOORE CT .'.EXPIRES: 04/07/2010 DESCRIPTION: Reroof.-23 sqs for house and 7 sgs garage ***'CONTACTS owner 303/456-0361 Nancy Laird sub: 303/554-8833 John Moore< 09-0403 Moore Roofing, Inc.' * * `PARCEL INFO ZONE. CODE: UA USE: UA SUBDIVISION: 0143 BLOCK/LOT#: 0/. FEE SUMMARY ESTIMATED PROJECT VALUATION: <5,310.00. FEES Permit Fee 162.90 j-, Total Valuation 00 + r Use '.Tax 95 58 TOTAL .,..258.48 Conditions:.' 6 nail installation mid-roof inspection required. Board sheathing spaced more than :.a 1/2 of an inch apart requires plywood overlay on entire roof. Ice and water shield' required from'eave edge to 2'.inside :exterior walls.`- ***Contractor/Property owner shall provide 'ladder(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 or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all messur ments shown, and allegations made are accurate; that I have read and agree to abide.: by all conditions printed on this applia ion a d that I assume full responsibility for compliance with the Wheat Ridge :Building Code '(I.B.C) and all other: appli a 1 at ge Ordinances, for work under th/s p rmit. Plans subject to field inspection. Signatu a of cchEractor/owner date 1 s 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. n maybe granted at the discretion of the Building Official. ires,a new permit may be acquired for a fee ofone-half the amount normally required, provided no or will be made in the original plansand specifications and any suspension orrabandonment'has not ,2UI5bI6 YIULrl BB MPUE BY 3PM ANY BUSINESS :DAY FOR :INSPECTION THE'-. FOLLOWING :BUSINESS DAY.'' ~oF "'"TRo City of Wheat Ridge Building Division Date: m 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Plan °o<oRPO° Inspection Line: 303-234-5933 / r/ fy Permit 1 L Building Permit Application Property Address , Property Owner (please print): ` Phone: 3 Mailing Address: (if different than property address) Address: City, State, Zip: Contactor: . ~~e~- ` Contractor License #:-601 Phone 6 j Sub Contraddrs: Electrical City License Plumbing City License Mechanical City License Company: Company Company: Exp. Date: Exp. Date: Exp. Date: Approval: Approval: Approval: Use of space (description): rb Construction Value: $ DCSCrIptlOn of wocryk=~ 7~ (as calculated per the Building Valuation Data sheet) t c ~ Plan Review (due at time of submittal): $ Sq.Ft./L.Ftadded: Square J tTU's Gallons Amps WNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, les or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and legations 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 complia nce with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work der this permit. Plans subject tofieldiinsppection. RLCE ONE:: (OWNER) NTRO AC OR) r PERSONAL REPRE E T VE f WNER)., (CONTRATOR) PRINT NAME: SIGNATURE, vG{ Date:6O-1 Bldg Valuation: $