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HomeMy WebLinkAbout3741 Tabor CourtCity of Wheat Ridge _ 4�w Residential Roofing PERMIT - 201706422 PERMIT NO: 201706422 JOB ADDRESS: 3741 Tabor CT ISSUED: 08/22/2017 JOB DESCRIPTION:Residential Re -roof to install asphalt Eshingles - 18.67 sq *** CONTACTS *** OWNER (303)431-7653 LECLERE DONALD B JR SUB (303)502-9999 Ed Jacobs 160069 Gorilla Roof, Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: UA / Unassigned 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,400,00 Total Valuation FEES Use Tax 0.00 Permit Fee 113.40140.90 ** TOTAL ** 254.30 *** 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. 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. o (706 X2-2 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 Occupancy/T ype 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 nspector Comments Foundation Inspections Date IInitials Pier Concrete Encased Ground (CEG Foundation / P.E. Letter Do Not Pour Concrete Prior To Approval Of The Above Inspections Inspector Comments Underground/Slab Inspections Date Initials Electrical Sewer Service Plumbing Do Not Cover Underground or Below/In-Slab Work Prior To A roval Of The Above Ins Date Inspector Comments Rough Inspections Initials Wall Sheathing Mid -Roof Lath / Wall Tie Rough Electric Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw / Nail Inspector Final Inspections Date Initials Landscaping & Parking / Planning Dept. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical , Roof Final Window/Doors Comments ons 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. Final Building 1 1-- 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 ® City of Wheat Ridge Residential Roofing PERMIT - 201706422 PERMIT NO: 201706422 ISSUED: 08/22/2017 JOB ADDRESS: 3741 Tabor CT EXPIRES: 08/22/2018 JOB DESCRIPTION: Residential Re -roof to install asphalt shingles - 18.67 sq *** CONTACTS *** OWNER (303)431-7653 LECLERE DONALD B JR SUB (303)502-9999 Ed Jacobs 160069 Gorilla Roof, 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: 5,400.00 FEES Total Valuation 0.00 Use Tax 113.40 Permit Fee 140.90 ------ --.t ** TOTAL ** 254.30 *** 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. 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. City of Wheat Ridge `k Residential Roofing PERMIT - 201706422 PERMIT NO: 201706422 ISSUED: 08/22/2017 JOB ADDRESS: 3741 Tabor CT EXPIRES: 08/22/2018 JOB DESCRIPTION: Residential Re -roof to install asphalt shingles - 18.67 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 further attest that I am Iegally 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. �z-4r�� 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 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 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 issgMpe 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 applied le kpde foorr any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. L Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dane Lovett <-�'V—, 706 qt� From: no-reply@c i.wheatridge.co.us (� Sent: Friday, August 18, 2017 9:48 AM C To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Follow Up Flag: Follow up Flag Status: Completed Residential Roofing Permit Application O 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 3741 tabor or ct Property Owner Name Don LeClare Property Owner Phone 303-431-7653 Number (enter WITH dashes, eg 303-123-4567) 113 I 2s%3o 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 20170818 093127 001.%Pg CONTRACTOR INFORMATION Contractor Business Gorilla Roof Name b L, Contractor's License 160069 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) 720-947-9722 7421 S. Telluride Ct Foxfield Co 80016 Contractor Email Address robert@gorillaroof.com Retype Contractor Email robert@gorillaroof.com Address DESCRIPTION OF WORK TOTAL SQUARES of 18.67 the entire scope of work: Project Value (contract E406 value or cost of ALL materials and labor) Are you re -decking the No roof? 114 Does the scope of the No project include a flat roof (less than 2:12 pitch)? Does the scope of the Yes project include a pitched roof (2:12 or greater pitch)? How many squares are 18.67 part of the pitched roof? Describe the roofing tamko heritage materials for the pitched roof: Type of material for the Asphalt pitched roof: Provide any additional 4/12 detail here on the description of work. (Is this for a house or garage? What is the roof pitch? 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. 115 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 robert vichkon Email not displaying correctly? View it in your browser. 116 7421 S. Telluride Ct Foxfield, CO 80016 www. Gorilla Roof com 303-502-9999 Property Owner P Q1-1 LC-Q--AP-6 Date -7-7-17 Street Address -37�1 T/44SOP- C'T, Gorilla Roof Representative City. State Zip' - W WeA-r - i LD- ir--t 5oC>3-3--53K1 nsurance Company Main Phone 303, Alternative Phone Claim # Email Work to be completed as follows: XCIosed Valley Tear off Mayer of compositions 4syers4Wsdar-- / � nspect Decking 0 Install Decking )�Ilnstall Drip Edge, Color P> f k) Install Ice & Water Shield (per code) QM=*AXW,-ft)<Install Synthetic Underlayment Idshingle Type A154Z / 7-A6� &hi,gIeColor R0 -577e- P-C=PW0(01> manufacturer's Warranty C) Initial for Approval_ 11 ,:9z 15-ep-rV."e7- )< High Profile Ridge B-Rewto� Kristall Rubber Pipe JaQhs AInstall Turtle Vents X Install Furnace Caps I P�Paint Pipe Jacks & Turtle Vents to Match MMWV"9- ^Clean up & Remove Trash El Clean Out Gutters XSweep yard with Magnet ')X: Permit Furnished 1?�Gorilla Roof Inc. Five Year Labor Warranty )<Gorilla Roof Inc. $1,000,000 Liability Insurance )Eq�work to be completed according to the above specifications in the amount of: $ ,EIC lvl� Tj4CV,5AAtj) , S,5Vz9A1 A(I'AlP &4rD 7&JgA-f --/ --4AII X"addition to the above amount, any and all supplements billed on behalf of the insured by Gorilla Roof Inc and approved by the Insurance Carrier will, me a part of this contract and will be paid to Gorilla Roof Inc in addition to contact amount stated above, Initial, You, the Buyer, may cancel Down payment: this transaction at any time 1$ Upon this of Material prior to midnight of the third business day after the date `Cost of Permit to be added to total of this transaction, I (We) agree, by signing belom to all-lhe contract conditions on both front and back- of this aureemprit i CITY OF WHEAT RIDGE - Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: = r cl l -r<< ho(' 4 - Permit Number: 0 2- ❑ No one available for inspection: Time 17) 6 AN!I/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 � �. -..__- ter, � i Date:0 );�� Inspector''-- 6 DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office - (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number:2 w ❑ No one available for inspection: Time �' ! AM/,PM" Re -Inspection required: Yes _IVq When corrections have been made, call for re -inspection at 303-234-5933 Date:_ ��/ Inspector: -t - DO NOT REMOVE THIS NOTICE x %,a ii ing tzus ;ne s aay. � ". �N$��CT0f2��VI{J5T`g'iI�N ��L.L'SP�CE9 F?f1�tr41NIVG T ©�,CCS J�8 3,�' FOUNDATIO,N 1NSPECTI0N$ DA7E� COMMENS� t r" FoofingslCaissons - +' "'.`° 'Stemwa(I / (CE.G) Concre {e Encased Grourid �. Remtorcing:orMOnolijhlE'` r, Weatherwoof /French Dram .) sewer Service Lines -- _ `` ° Water-service Lines - §+ X [3 fop CONCRETE uNm ABOVE H& zt:N SieNEb ' CONCRETE SLAB FLOOR' 'Electrical (Underground):; _ $' Plumhing {Underground); , L Heating (Underground) a QYi NpTPOtJR'FLOd $OVE I{9'S BEEN S,ISMED' + ' 0 UEmc; ' Shea Lath / Md R t -.. Y Electn rtn6 Fled.,.:: CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line ��J (303) 235 -2855 Office ' (303) 235 -2857 Fax INSPECTION NOTICE r Inspection Type: go / Job Address /Permit Number: 7`7,1 ningn.�t i a: E i ❑ No one available for inspection: Time ? f AM LM Re- Inspection required:. "Yes 'No When corrections have been made, call for re- inspection at 303 - 234 -5933 r V . .Date: r, Inspector: DO NOT REMOVE THIS NOTICE ♦ 1, 4 ♦ CITY OF WHEAT RIDGE ,0 Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 235 -2857 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: ❑ No one available for inspection: Time AM /PM Re- Inspection required: Yes No "When corrections have been made, call for re- inspection at 303 - 234 -5933 Date: el Inspector: v , DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE =!j Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 235 -2857 Fax INSPECTION NOTICE Inspection Type: K Job Address: Permit Number: ❑ No one available for inspection:- Time AM /PM Re- Inspection required: Yes No * When corrections have been made, call for re- inspection at 303-234-5933 Date: a" spector: 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: - ' Job Address: Permit Number: ❑ No one available for inspection: Time AM /PM Re- Inspection required: Yes No When corrections have been made, calf for re- inspection at 303 - 234 -5933 Date: Inspector: DIANOT REMOVE THIS NOTICE " 1 City of Wheat Ridge Faxed Roof Permit PERMIT - 091400 PERMIT NO: 091400 - ISSUED: 08/18/2009 JOB 'ADDRESS: 3741 TABOR CT 'r EXPIRES: 02/14/2.010 DESCRIPTION: Reroof 19.27sgs and redeck ***-CONTACTS owner 303/431-7653 Don. LeCleve sub 303./733-.7663 'John E. Hopper 09-0140 lst Choice Roofing PARCEL INFO ZONE CODE: UA USE: UA. SUBDIVISION: 0690 BLOCK/LOT#: 0./' FEE SUMMARY ESTIMATED PROJECT VALUATION: `6,452.00 FEES Permit Fee 181.10 Permit fee additiona 101.3 Total Valuation .0~~ )C} "L~gvg( Use Tax 116.14 G. ,a -o TOTAL `398.56 Conditions: Both ..front and back of permit need to be posted on job site. If one or the other is not present, INSPECTION WILL NOT BE PERFORMED. 6 nail installation mid roof inspection required. Board sheathing spaced more thana 1/2 of an inch apart requires plywood overlay on'entire roof. Ice and water shield 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 -theWheat Ridge Building Code (I.B.C) and all other app icable Whey/apt Rr gel Ordinan as for work under this permit. Plans subject to field inspection. Signature of contrac-tor/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. ? -This permit shall.. expire 180 days from the issue date. Requests : for an extension must be received prior to expiration date. An extension may -be: granted at the.. discretion of,the -Building. Official. 3. If this permit. expires,. a new. permit may be acquired for 'a fee. of one-half the amount normally required, provided no changes have been or will be made in the original plans and :specifications and any suspension or abandonment has not exceeded one (1) year 'If changes have been or if. suspension or.' abandonment exceeds one (1) year,.. full fees. shall be paid for 'a. new permit. k. No work of any manner, shall be done that will. change the natural flow of water causinga drainage, problem. lContractor' 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. 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; a violation of she provisions of the building codes or any. other ordinance, law, ,rule or regulation. Allplan r v' subject to field inspections. Signature of hie j Official date CNSPECTI N REQUEST LINE: (3.03)234-5933 BUILDING OFFICE:' (303)235-2855 REQUESTS MUST BE MADE BY '3PM`ANY 3USINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of Wheat Ridge Faxed Roof Permit PERMIT - 091400 PERMIT NO: 091400 ISSUED: 08/18/2009 JOB ADDRESS: 3741 TABOR CT EXPIRES: 02/14./2010 DESCRIPTION: Reroof 19.27 sqs CONTACTS owner. 303/431-7653 Don LeCleve r sub. 303/733-7663 John E. Hopper 09-0140 1st Choice Roofing * * PARCEL INFO..* ZONE CODE: UA USE: UA SUBDIVISION: 0690 BLOCK/LOT#:.0/ FEE SUMMARY.** ESTIMATED PROJECT VALUATION: 6,452.00 FEES Permit Fee 181.10 Total Valuation .00 Use Tax 116.14 TOTAL 297.24 05, Conditions: '.Bothfrontand back of permit need to be posted on job site. If one or the other is not present, INSPECTION WILL NOT BE PERFORMED.. 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 awater shield required from eave edge to 2' inside exterior walls. Subjectto -field inspections. - - y; 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 able a t Ridge Ordinances, for work under this permit. plans subject to field inspection. ap rte(, ~ Signature oP c n or/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 {`v date. An extension may be granted at the discretion of the Building Official. 3.. If this permit expires, a new permit may be acquired for a fee of one-half the amount. normally required, provided no changes have been or will be made in the original plans. and specifications and any suspension or abandonment has not.. exceeded one (1) year. If changes have been or if suspension or abandonment exceeds one (1). year, full fees shall be paid for a new permit. ` - S` 4. No work of any manner shall be done that will change the natural flow of water causing a drainage problem. 5. Contractor shall notify.. the Building Inspector twenty-four (24) hours in advance for all inspections and shall receive.. W, 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 planrev'ew subject to field inspections. _ a,. . Signature Building Official date --`.INSPEC ON REQUEST LINE: (303)234-5933 'BUILDING OFFICE: (303)235-2855 :REQUESTS MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. city of G 8 J g a~ Date; COlwttalUt~Ii T 1' I II;VELOq'IWtENT Permit "vq I Litt) ~rFt(A ; Office: 303-235-2855 * Fax: 303-2378929 Inspection Line: 303-234.5933 Facsimile Building Permit Application Property Owner (please print): p t/\ ~(APhone: Malting Address: (f different han prop@\rtyaddress) Address: !'A AIR p 1 City, State, ~~LCs D ~o G~ - Contractor License n °i n i u 7 Phathe. ~Z~ Use of s ace (description)= q j 'j7,e3'4ab~iwr mot. s /r~//ry/~~ . Sq. Ft. Ft added: Squares ( ! rt c~ Plan Review (due at 6me ofsubmittao! $ BTU,* Gallons OWNEWCONTRACTOR 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 ail measurements shown, and allegations made are accurate; that l 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.surkiing Code (W.C). and all other applicable Wheat Ridge Ordinances, for work under this permit Plans subject to Reid inspection. CIRLCE ONI=: (OWNER) (CONTRACTOR) or PERSONAL REPRESENTATIVE of (OWNER) (CONTRATOR) PBItj NAME Credit Card Payment: Use. Print name: yOrJi/"z4 / SIGNATURE: listed on die: Signature: Date: Bldg Valuation: