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Home My WebLink About3520 Lee Streeti CITY OF WHEAT RIDGE _:�9rBuilding Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: (Z 6 F Job Address: 3 d, 0 L e e Sir t -,Q Permit Number: 2o/76/S83 ❑ No one available for inspection: Time. I AM/PM Re -Inspection required: Yes 60) When corrections have been made, call for re -inspection at 303 -234 - Date: () 617// ') Inspector: 6 y DO NOT REMOVE THIS NOTICE „� -r-, Z_c) ,S +_ _Z -u [ 1 C3 f C sY '� INSPECTION RECORD V— INSPECTION REQUEST LINE: (303) 234-5933 Occupaicv'T,�e 0,,� Inspections will not be performed unless this card is posted on the project site. Call the inspection request line before 11:59 p.m. to receive an inspection the following business day.** Inspector Must Sign ALL Spaces pertinent to this project Sewer Service Foundation Inspections Date Inspector Initials Comments 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. Pier b Concrete Encased Ground (CEG) Lath /Wall Tie Foundation / P.E. Letter Rough Electric ” Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Comments Sewer Service Plumbing 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. Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing 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. Mid -Roof b Floodplain Inspection (if applicable) 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 Final Window/Doors Rough Grading Final Building Insulation 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. 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 — Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. "For Inspection Time Window — Please email insptimerequeSt@Ci.Wheatridge.CO.US by 8:00 A.M. the morning of the inspection with the property address in the subject line of the email. Time window is based on the inspector's route. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather City of Wheat Ridge M� T Residential Roofing PERMIT - 201701583 PERMIT NO: 201701583 ISSUED: 06/06/2017 JOB ADDRESS: 3520 Lee ST EXPIRES: 06/06/2018 JOB DESCRIPTION: Complete re -roof, certainteed, Landmark asphalt shingles 27 squares. *** CONTACTS *** SUB (303)877-4955 REGINA HILL 022126 Sunny Contractors & Roofing *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,900.00 FEES Total Valuation 0.00 Use Tax 186.90 Permit Fee 188.45 ** TOTAL ** 375.35 *** 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 A1/2 -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. 41 CITY OF WHEAT RIDGE Building Inspection Division / (303) 234-5933 Inspection line (303) 235-2855 Office - (303) 237-8929 Fax - INSPECTION NOTICE Inspection Type: 11f �1 Job Address: 3 -5-2d g f� S Permit Number: 2-0 /'7 1-5'K3 ❑ No one available for inspection: Time AMJ:P:�) Re -Inspection required: Yes No * When corrections have been made, call for re -inspection at 303-234-5933 Date: Inspector: _ / DO NOT REMOVE THIS NOT/ E City of Wheat Ridge Residential Roofing PERMIT - 201701583 PERMIT NO: 201701583 ISSUED: 06/06/2017 JOB ADDRESS: 3520 Lee ST EXPIRES: 06/06/2018 JOB DESCRIPTION: Complete re -roof, certainteed, Landmark asphalt shingles 27 squares. *** CONTACTS *** SUB (303)877-4955 REGINA HILL 022126 Sunny Contractors & Roofing *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,900.00 FEES Total Valuation 0.00 Use Tax 186.90 Permit Fee 188.45 ** TOTAL ** 375.35 *** 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 Alh-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. 1 1 Y' PERMIT NO: JOB ADDRESS: JOB DESCRIPTION City of Wheat Ridge Residential Roofing PERMIT - 201701583 201701583 3520 Lee ST ISSUED: 06/06/2017 EXPIRES: 06/06/2018 Complete re -roof, certainteed, Landmark asphalt shingles 27 squares. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this 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 I . This permit was issued based on the information provided in thepermit application and accompanying Flans 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 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 granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any g�applicable code or any ordinance or re ofthisjurisdiction. Approval of work is subject to field inspection. 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. jCity of Watlj,dg,e COIvtr4 UNrry I)EVELCMIM N r Building & Inspection Services Division 7500 W. 29" Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits ci.wheatridge.co.us FOR OFFICE USE ONLY Date: C91(' Plan/Permit # (_ 1 Plan Review Fee: Building Permit Application I Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: Property owner (please print): C� `� Q� 1 Phon ° r{ - Property owner Email: Mailing Address: (if different than property address) Address: City, State, Zip: TV (� Architect/Engineer: Architect/Engineer E-mail: Phone: Contractor:U. Contractors City License #: '� ;i, (�)) I P, (n Phone: 'S0 I ` "I � 4 �) � (p Contractor E-mail Address: '�-' U 2 Sub Contractors: 1�_9 I f\ Electrical: W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # 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 ❑ RESIDENTIAL ADDITION WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ OTHER (Describe) (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..) co,it LI�rJ �� - ►LOCA } C1L�.-al �� Q 4)a t1-c� j)(1 V( V-cx U Sq. Ft./LF Amps Btu's Squares Gallons Other Project cValue: (Contract value or the cost of all materials and labor included in the entire project) 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 applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that 1 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. 1, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) ! (CONTRACTOR) r (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) L ` Electronic Sienature (first and last name): u ZCN Y r �_v\ "� , _ L DATE: >. ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer. DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Building Division Valuation: $ ♦ 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: r 1VT Job Address: 7� P e �. Permit Number: ? 3 No one available for inspection Time A / M Re- Inspection required: Yes ` No "When corrections have been made, call for re - Ins cdo at 303 - 234 - 5933 Date: /L 7-O Inspector: L DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE 1� Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office'' (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type Awl= Job Address ..n5,p ls� 57' Permit Number o 5' lwfr - 7Ad �a T : ! rd rtJT> �7 '`Jl z✓ 7y oAee� 7- ❑ No one available for inspection: Tim d AMA�I� Re- Inspection required: es� No When corrections have been made, call for re- inspection at 303 -23 DO NOT REMOVE THIS NOTICE " ' City of Wheat Ridge r o w, Residential Roofing PERMIT - 093357 PERMIT NO: 093357 ISSUED: 10/15/2009 JOB ADDRESS: 3520 LEE ST EXPIRES: 12/31/2010 DESCRIPTION: Reroof 20 sqs * ** CONTACTS * ** owner 303/278 -1665 Beverly Grall sub 303/296 -1009 LM Ramirez 09 -0279 Central Roofing Service Inc. ** PARCEL INFO ** ZONE CODE: UA USE: UA SUBDIVISION: 0642 BLOCK /LOT #: 0/ ** FEE SUMMARY ** Extend Expired Permi Permit Fee Total Valuation Use Tax ** TOTAL ** ESTIMATED PROJECT VALUATION: 7,200.00 FEES 99.6 199.30 .00 ebnCGj?� 129.60 428.55 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., 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 he 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. G. 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 ins ec io Signature of qVi ilding Offical 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. INSPECTION R INSPECTION LINE: (303) Inspections will not be made unless this card is Call by 3:00 PM to receive inspection the CORD Occupancy/Type G -5933 Ited on the building site ving business day. INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB FOUNDATION INSPECTIONS DATE INSPECTOR INITIALS COMMENTS: - Footings /Caissons Stemwall / (CEG) Concrete Encased Ground Reinforcing or Monolithic Weatherproof / French Drain Sewer Service Lines Water Service Lines POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED CONCRETE SLAB FLOOR Electrical (Underground) , Plumbing (Underground) Heating (Underground) gElec ice ic Rough Plumbing Gas Piping Rough Mechanical Insulation Drywall Screw DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - OR TO PF FINALS Electrical Plumbing Mechanical Roof Building Final Fire Department R.C.W & Drainage INSPECTIONS FOR F Parking & Landscaping BE CALLED AT LEAF ** NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZOr CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DI OFA CERTIFICATE OF OCCUPANCY NOR PERMISSION OCCUPANCY NOT PERMITTED UNTIL CERTIFICATI PROTECT THIS CARD FROM THE W 11/23!10 CITY 4:39NPH RIDGE cdba Central Roofing RECEIPT NO:CDA005315 RPSP Reroof 20 sqs 09335) — Extend Expired Perini PAYMENT RECEIVED CK 25561 TOTAL AMOUNT 99.65 99.65 AMOUNT 99.65 99.65 Central Roofing Service, Inc. 4880 Leaf Court Denver, CO 80216 303- 296 -1009 City of Wheat Ridge 7500 W. 29` Avenue Wheat Ridge, CO 80033 RE: Permit 093357 Dear Melissa, Thank you for your assistance in clearing up the matter of permit number 093357. Central Roofing Service, Inc. had noted that thebM roof was completed and passed on 10/20/2009. As we discussed the attached fee will reactive the permit please set the inspection for Wednesday, November 24, 2010. 1 will call you Tuesday, November 23, 2010 to confirm our supervisor can meet the inspector. Sincerely, c::, y)( Lydia M. Ramirez Office Manager Central Roofing Service, Inc. ♦ i CITY OF WHEAT RIDGE f~ Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: € D Job Address: Permit Number: tk t- LE:41-h y ❑ No one available for inspection: Time AM/PM Re-Inspection required: Yes No "When) corrections have been made, calPf r -inspe/Qcttiion at 303-234-5933 Date)046 U ~ Inspector: ' DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division mr r' (303) 234-5933 Inspection line (303) 235-2855 Office (303) 237-8929. Fax INSPECTIO(N~ NOTICE Inspection Type: ell Job Address: ~SPC7 ~PF SF, Permit Number: ("ill 539 73,1,r - T ` f trP~~r' fli,`~`tPf n fG~'ita/9 6/74 ["L"Ij ❑ No one available for inspection: Time lr f AM,PM Re-Inspection required: Yes No `When corrections have been made, cafl for re-inspection a+`(t/ 303-234-5933 Date: f ;,r(( inspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge _r- Residential Roofing PERMIT - 093357 PERMIT NO: 093357'' `ISSUED: 10/15/2009 JOB ADDRESS:. 3520 LEE ST EXPIRES: 04/13/2010 DESCRIPTION:. Reroof. 20 sqs ***CONTACTS owner 303/278-1665 Beverly Grall sub 303/296-1009 LM Ramirez - 09-0279 Central Roofing Service Inc. **.PARCEL INFO ZONE, CODE: UA USE: UA SUBDIVISION:. 0642 BLOCK/LOT#: 0/ FEE SUMMARY ESTIMATED PROJECT VALUATION: `7,200.00 FEES Permit Fee 199.30 Total Valuation .00 -"A46' t Use Tax 129.60 ies TOTAL 328.90 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'shieldrequired from eave edge to 2':inside -exterior 'walls. - ***Contractor/Property owner shall 'provide ladder(s) secured in place for inpsections.T 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 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 app 'cable Who Ridge Ordinances, for work :under thispermit. Plans subject to field inspection. r D_/ 5 -0C/1 Signature of 'c tractor/owne =date 1. This permit was issued in a ccrda.ce 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. r This permit shall expire 180 days from the issue date. Requests for an extension must he received :prior to expiration date. An extension may be granted; at the discretion of the Building Official. f. 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 anew permit. k. 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. )V47 ignatur f C of Building Official date NSPB ION REQUEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855 EQUESTS MUST. BE MADE BY 3PM ANY BUSINESS DAY FOR 'INSPECTION THE FOLLOWING BUSINESS DAY. ~oF""~?T9 City of Wheat Ridge Building Division Date: °m 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 " Fax: 303-235-2857 Plan A °OCORro° Inspection Line: 303-234-5933 Permit#: Building Permit Application Property Address,: 3-5- U 4(a)(2- S- f, i Property Owner (please print): L) C4 Phone: 303 "-,)7p 0 b t` I Mailing Address: (if different than property address) Address: City State Zip: =421 j~ 1r4 JS~~ C f~ Z!) e66 313 contractor: C' } y~ ~,pp f • 1 r\ fr- S f 1l) 1 1;= ,J- ~O C-- Contractor License 0 q ^ 0 2 7 41 Phone: 3 0 3 2-26 0 0 9 Sub Contractors: 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): V Construction Value: $ C) Description of work: t c? C~0 -F4-- COP) p~ (as calculated per the Building Valuation Data sheet) of rtr~ R t= p l clG e- W I't b TLC)%J?CS I Plan Review (due at time of submittal): $ Roop 1 h9 Sq.Ft./L. Ft added: Squares ( BTU's Gallons 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 Wheal 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) ONnTRACTO or PERSONAL REPRESENTATIVE o OWNER) (CONTRATOR) PRINT NAME:I~t)iD R`Aty~1? 2 SIGNATURE: ( AA. Date:; Bldg Valuation: $