HomeMy WebLinkAbout3885 Parfet StreetPERMIT" 20lW1 C ADDRESS: �q'P`' )-,4r4t .fit JOB CODE: R 12F
r
INSPECTION 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
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
Inspector
Initials
Comments
201 Electrical / Cable/ Conduit
202 Sewer Underground Int.
203 Sewer Underground Ext.
204 Plumbing Underground Int.
205 Plumbing Underground Ext.
206 Water Underground
-, `t, ,- 1"7
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 ;
-, `t, ,- 1"7
307 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 INSPECTIONS
-4, (-)/ -0,v& S
�JS /`tel l T S7L-
RoughInspection (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
_ 1-7
7-7
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 ,
_ 1-7
7-7
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 contact 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. Appro- 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 CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: L) 0 q ` P7,',, ,. I
Job Address: �3 ` S 5— Po,rt e5-�-
Permit Number: -a o l'-7 0 g 7 & S—
❑ No one available for inspection: Time c6 -:-3--/ PM
Re -Inspection required: Yes
When corrections have been made, call f6r re -inspection at 303-234-5933
Date: f 1 i7 Inspector: 7
DO NOTREMOVE THIS NOTICE
City of Wheat Ridge
Residential Roofing PERMIT - 201708165
PERMIT NO: 201708165 ISSUED: 10/10/2017
JOB ADDRESS: 3885 Parfet ST EXPIRES: 10/10/2018
JOB DESCRIPTION: Residential Re -roof to install Tamko asphalt shingles - 35 sq Pitch =
5/12
*** CONTACTS ***
OWNER (303)888-7924 MONTOYA TROY
SUB (303)777-0333 Ron Tutton 021585 Homestreet Roofing Inc.
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,800.00
FEES
Total Valuation 0.00
Use Tax 226.80
Permit Fee 220.15
** TOTAL ** 446.95
*** 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 - 201708165
PERMIT NO: 201708165 ISSUED: 10/10/2017
JOB ADDRESS: 3885 Parfet ST EXPIRES: 10/10/2018
JOB DESCRIPTION: Residential Re -roof to install Tamko asphalt shingles - 35 sq Pitch =
5/12
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 ermit and perform the work described and approved in conjunction with
this permit. I a es at I am le ally authorized to include al entities named within this document as parties to the work to be
perforn} and th al rk t be p_ e� e�1 �� its ocument andfor its' ccompanying approved plans and specifications.
!!
Signature of OWN�CONTRACTOR (Circle one) Date '
1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Off-cial 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 gran�t_i.n__g 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 orO y durance or regulation of this jurisdiction. 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.
Dane Lovett
From: no-reply@ci.wheatridge.co.us
Sent: Sunday, October 8, 2017 11:25 AM
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 fora Yes
residential roof?
How many dwelling units Single Family Home
are on the property?
PROPERTY INFORMATION
Property Address 3885 PARFET ST.
Property Owner Name TROY MONTOYA
Property Owner Phone 303-888-7924
Number (enter WITH
dashes, eg 303-123-4567)
101
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
montoya.pdf
Contract
CONTRACTOR INFORMATION
Contractor Business
HOMESTREET ROOFING INC.
Name
r
Contractor's License
021585
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone
303-777-0333
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address
9797 E. EASTER AVE
(Primary address of your
business)
Contractor Email Address
rontutton@msn.com
Retype Contractor Email
rontutton@msn.com
Address
DESCRIPTION OF WORK
TOTAL SQUARES of
35
the entire scope of work:
Project Value (contract
10800
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
102
both? (check all that
apply)
What is the specific pitch 5:12
of the PITCHED roof?
How many squares are 35
part of the PITCHED
roof?
Describe the roofing tamko 30 year
materials for the
PITCHED roof:
Type of material for the Asphalt
PITCHED roof.
Provide any additional house
detail here on the
description of work. (Is
this for a house or
garage? Etc)
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
owner of the property to
103
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 RON TUTTON
Email not displaying correctly? View it in your browser.
104
9797 E. EASTER AVE. SUITE B
CENT AL, CO 80112 I J�� �`� �� $$$
Pt," 303-777-0333
HomeStreet q �,�
l U�,�� 33� 3 ROOFING. INC. Z ����,
"Find us at Trou6leshooter.com on . 1� C �� _
Tom Martino's exclusive referral list" V
NAME Y1rv1�
E-MAIL ADDRESS
STREET33,b5' Pc4 a -f -j.4, 455
DATE f--7__--
CITY WUt ' r2 �� goo -33
_J_APPROXIMATE
ESTIMATOR
PHONE cc77
DATE OF SERVICE
We Propose �� r �
To furnish material and labor complete in accordance with specifications below for the sum of: $— t L _
Payment to be made as follows: _._ _ dowrr� N iO D G e '• _ balance upon completion of work.
SPECIFICATIONS FOR LABOR AND MATERIAL
TERMS AND CONDITIONS
(please r d car fully 4"
ci-
L1 Recover roof with
U Tear off
❑ Install felt i
:-1 Style of shingles _ Cj Ill
=.t Color of shingles _
❑ New Valleys yf
❑ Ridge V
T
❑ Galvanized Nails or Staples
.:.1 Replace plumbing jacks]
❑ Paint roof stacks r�5
❑ Install l etal edging
❑ Turbine vents '
❑ Tar and gravel
❑ Year'
on abor
HomeStreet Roofing, Inc. to furnish all
material and labor
Permit furnished by HomeStreet Roofi Inc. I,0
Clean-up & haul off all trash from roof
Roll yard with magnetic roller
Gutters cleaned of roofing debris
U Extra work �LZr;Tt t. I(ZIJ OA
HomeStreet Roofing, Inc. will hold in trust any payment from
the property owner until the contractor has delivered the
roofing materials to the jobsite or has performed a majority
of the roofing work on the property.
INSURANCE ALLOWANCE AGREEMENT
IAva agree to retain Homestreet Roofing, Inc. to replace and/or repair the roof on
the property aforontenlioned, contingent upon HomoStreet Rooting, Inc. obtaining my
insurance company's approval and payment to have said work done. It is understood
and agreed that HomeStreet Rooting, Inc. is to contact my Insurance carrier and meet
with their representative In order to discuss the repair or replacement work to be done to
the property. Upon insurance carrier's and HomeStreet Roofing, Inc. agreement to the
extent of the damages and cost of fixing them, HomeSlreel Roofing, Inc. may begin to work
on said property. HOMEOWNER'S OUT-OF-POCKET EXPENSE WILL NOT EXCEED
HOMEOWNER'S INSURANCE POLICY DEDUCTIBLE FOR WORK AGREED UPON
BETWEEN THE INSURANCE CARRIER AND HOMESTREET Roaring. Inc. Homeowner
also agrees to provide all necessary documentation for claim (also providing all pertinent
documentation to facilitate payment from insurance carrier and/or Mortgage Company.)
HomeStreet Roofing, Inc. reserves the right to file for settlement claim due to material or
labor increases due to a storm environment or insurance measurements are proven to be
incorrect.
All material is guaranteed to be specified. All work is to be completed In a workman-
like manner according to standard practices. Homeowners hereby acknowledge that
HomeStreet Roofing, Inc. may be subject to delays occasioned to inclement weather,
labor disputes, material shortages and/or insurance carrier delays which are beyond the
control of HomeStreet Roofing, Inc. and hereby accepts any delays occasioned by one or
all at these circumstances in the installation of your root. Homeowner grams full access to
the entire property for staging and execution of work unless otherwise agreed.
Alteration or deviations from the above specifications involving extra costs will be
executed only upon written orders, and will become an extra charge over and above the
limate. Also, HomeStreet Roofing, Inc. reserves the right to file for supplement claim
d e to material or labor price increases due to the storm environment or it insurance
easurements are proven to be incorrect. Labor and material warranty covers siding.
omeowner to carry fire, tornado and all necessary insurances. HomeStreet Roaring.
Inc. will not be responsible for any compression or decompression of the home that may
result in walls or floors cracking. An extra charge will result, if any siding, stucco or brick
removal is needed for proper installation of roof flashing or gutter replacement. We will
not be responsible for damages to those materials, if materials need to be replaced. If a
dispute comes up and legal action is required, homeowner agrees to pay Homestreet
Roofing's attorney fees and court cost he court rules in favor of Homeslreal Roofing,
Insurance Company:atSL jlj/►�3'rj,
Policy No.#: _
Date:
Claim No.#: _ :QO
Signature:
Date:----/---� --'
ACCEPTANCE OF PROPOSAL
You have the right to rescind this contract and obtain a full refund of any deposit within
72 hours after entering into the contract. If you plan to use the proceeds of a property
insurance claim to pay for the roofing work you may rescind this contract within
72 hours after you recieve notice from the insurer that the claim has been denied in whole or in
part. Homestreet Roofing cannot pay, waive, or rebate the homeowner's insurance deductible
in part or in whole. Cancellations occurring after the third day will incur a charge of
20 percent of the full con�ra�t amqu Moor insurance claim amount, whichever is
applicable. j
Signature __ - r" - -
HomeStreet Roofing, Inc. Representative
OUR SURETY & LIABILITY INSURER;
David Leigh DBA 4 Corners Insurance Service
1657 Ensenada Way, Aurora, CO 80011
Ph: 720-984-2471, Fax: 303-223-3350----�
Signatures' -
Signature
Date of Acceptance / Z 5 //,7
(-7
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Insiiection line
(303) 235-2855 Office • (303) 237-8929 Fax
I
INSPECTION NOTICE
Inspection Type: 3 0
Job Address: 3 8 S T- PIC,- I C S4 -
Permit Number: a o r -7 p 9 16 S" `
M�19M
❑ No one available for inspection: Time 1 a = AK/PDM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303 -234 -
Date: e f L9 6 i 7 Inspector: -7-t>
DO NOT REMOVE THIS NOTICE
INSPECTION RECORD OccupancylType
®°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.
t � Y `o,� , I T TV fit; 1 _ . �11
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB
INSPECTIONS
DATE
INSPECTOR
INITIALS
COMMENTS:
L ION
Caissons
/ (CEG) Concrete
Ground
�a7
g 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)
D(1 Nl1T Pllllo R nno I InlTll AOn \/C lJne Rvv�� Cir_e¢n
ROUGHS
Sheathing
all
Lath / W tie
Mid -Roof
�a7
Electrical Service
Rough Electric
Rough Plumbing
-
Gas Piping
Rough Mechanical
ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING
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 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
J (303) 235 -2855 Office • (303) 235 -2857 Fax
INrEC�TION NOTICE
Inspection Type: �j Q e2
Job Address:
Permit Number: r
�l n ,s�t�
<u2rT e� �
❑ No one available'for inspection: Time i AM/
Re- Inspection required: Yes
€ * When corrections have been made, call fo e' sp ion gt 03 - 2 ,?
Date: t I Inspector:, d
EE€ DO NOT REMOVE THIS NOTICE
♦ A 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: L°
Job Address: 21
Permit Number:
❑ No one available for inspection: Time T V AM PM'
Re Inspection required: Yes "(N0 ;
When corrections have been made, call or re inspec at 303
f ) t { p ' Jr
Date: 9'n 7 Inspector: �i .fir✓
DO NOT REMOVE THIS NOTICE
" ' City of Wheat Ridge
r4000r- Residential Roofing PERMIT - 091592
PERMIT NO: 091592'. 'ISSUED: 08/24/2009
JOB ADDRESS:: 3885 `PARFET ST EXPIRES: 02/20/2010
DESCRIPTION: Reroof=32 sqs
CONTACTS
owner 303/888-7924 Troy Montoya
sub 303/922-7663 Chuck Cooper 02-2034 Kape. Roofing
PARCEL INFO
ZONE CODE: UA :USE: UA
SUBDIVISION: 0190 BLOCK/LOT#: 0/
FEE SUMMARY ESTIMATED PROJECT VALUATION: 14,500.00.
FEES
Permit Fee 326.70 e~w
Total valuation oo
Use -.Tax 261.00-^~
TOTAL .....587.70 r
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
watershield -required from eave edge to 21 inside exterior walls.
Subject to field inspections.
I hereby certify that the setback distances proposed by this permit application. are accurate, and do not violate applicable
ordinances, :rules or regulations of the City of wheat Ridge: or covenants, easements or restrictions. of record; that all
measurements shown, and allegations made are accurate; that I have read and agree to abide by all conditions printed on this
application and that I assume full responsibility for compliance with the Wheat Ridge Building Code :(I.B.C) and all other
applicabl t Ridge ordinances, for work under this p emit. Pi ns subject to field inspection.
7:4Mign cont ctor/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 mayf 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,.. full 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 a drainage problem.
5. Contractor, shall notifythe 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
an approval of., any violation of the provisions of the building codes or any other ordinance, law, rule or regulation.
All.. plan review i ject to field inspections.
Signature of uilding: Official date
INSPECT REQUEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855
REQUEST MUST: BE MADE BY 3PM ANY. BUSINESS 'DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of Wheat Ridge Building Division
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
°O<orxr°° Inspection Line: 303-234-5933
Building Permit Application
Property Address; 3 7ce, 5- -P a4 s4 6 )Lee.
Property Owner (please print):
Mailing Address: (if different than property address)
a
Address:
City, State, Zip:
Contractor:
Contractor License
Sub Contractors:
Electrical City License
Company:
Date: U6 L-tj(;" .
Plan M
Permit L)q 164,9-.
Cc Tocog3
- cc/c~_
Phone: Zl,2 -
Plumbing City License Mechanical City License
Company Company:
Exp. Date: Exp. Date: Exp. Date:
Approval: Approval: Approval:
Use of space (description): Construction Value: $
Description of work: (as calculated per the Building valuation Data sheet)
Plan Review (due at time of submittal): $
Sq. Ft./L.Ft added: Squares .32 BTU's Gallons Amps
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances,
rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and
allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full
responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
under this permit. Plans subjec spection.
CIRLCE ONE:: (OWNER) ( NTRACTO or PERSONAL REPRES JVE of (OWNER) (CONTRATOR) /
PRINT NAME: -c(o*. 1W ~6Lh i/./ SIGNATURE: Date:
Bldg Valuation: $