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Home My WebLink About3945 Eaton StreetI* � 1 i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address:�l- Permit Number: U 1 ❑ No one available for inspection: -,,Time AM/PM Re -Inspection required: Yes LNd When corrections have been made, schedule for re -inspection online at: http://www. ci. wheatridge. co. usv'inspection Date: �� ' !� e ` �Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: &v o �_ w V1_1 Job Address: Cr L Permit Number: 0 0d 0 0 ❑ No one available for inspection: Time t, ';'� ) _ AM/PM Ij Re -Inspection required: )Vs No When corrections have been made, schedule for re -inspection online at: http://www.ci. wheatridge.co. usrnspection Date: --) ' 1 ")'c4o` Inspector: b; DO NOT REMOVE THIS NOTICE City of Wheat Ridge Aw AV E -Res. Furnace Replacement PERMIT - 201803300 PERMIT NO: 201803300 ISSUED: 12/27/2018 JOB ADDRESS: 3945 Eaton St EXPIRES: 12/27/2019 JOB DESCRIPTION: Replacement of 90K BTUs/80 percent efficent Gas Furnace. *** CONTACTS *** OWNER (720)480-1656 BERUMEN GARY L/PATRICIA ALLEN SUB (720)870-1580 Dean Peterson 022447 Summit Heating & A/C Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 2,500.00 FEES Furnace Replacement 40.00 Total Valuation 0.00 Use Tax 52.50 ** TOTAL ** 92.50 *** COMMENTS *** *** CONDITIONS *** Both the front and back of this permit are required to be posted on the job site at all times. If the complete permit is not present, inspections WILL NOT be performed. Work shall comply with 2012 IRC & 2017 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. 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 thispennrt. I further attest that I an 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 pen -nit 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 maybe subject to a fee equal to one-half of the original per t fee. 3. If this permit expimib res, anew permit maybe required to be obtained. Issuance of anew 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 pennit 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 if a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicablewde or any or Oance 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. La enia Reimer Zo/ 9� 5506 From: no-reply@ci.wheatridge.co.us Sent: Thursday, December 27, 2018 10:29 AM To: CommDev Permits Subject: Online Form Submittal: Residential Furnace/Boiler Replacement Permit Application Categories: Gina Residential Furnace/Boiler Replacement Permit Application This application is exclusively for RESIDENTIAL REPLACEMENT FURNACE or BOILER - LIKE FOR LIKE ONLY. YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN ORDER FOR THE PERMIT TO BE PROCESSED. Your Permit will be emailed to the email address provided below once it is processed. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes replacement residential furnace or boiler like for like? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123-4567) Property Owner Email Address Attach Credit Card Authorization Form - **DO NOT ATTACHED RANDOM FORMS** 3945 Eaton St Wheat Ridge, CO 80212 Patricia Allen 720-480-1656 alIpatric@comcast.net CC Auth Form.pdf CONTRACTOR INFORMATION Contractor Business Summit Heating & AC Name Contractor's License 022447 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 720-870-1580 Number (enter WITH dashes, eg 303-123-4567) Contractor Email Address frenecy@summitheatingco.com Retype Contractor Email Address DESCRIPTION OF WORK frenecy@summitheatingco.com What type of unit is being Furnace installed? Number of BTUs What is the efficiency (%) of the unit? Is the unit GAS or ELECTRIC? Where is the furnace or boiler located (for example, basement, crawlspace, etc)? 90,000 80% Gas Basement Project Value (contract 2500 value or cost of ALL materials and labor) 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 work Yes may not begin on this property until a permit z has been issued and posted on the property. 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. Person Applying for Jennifer Trim Permit Email not displaying correctly? View it in your browser. �a City of W heaticige COMMUNITY DEVELOPMENT City of Wheat Ridge Municipal Building 7500 W. 29th Ave. Wheat Ridge, CO 80033-8001 P: 303.235.2846 F: 303.235.2857 December 27, 2019 OFFICIAL ADDRESS NOTIFICATION NOTIFICATION is hereby given that the following address has been assigned to the property/properties as indicated below: NEW ADDRESS: 4209.5 Yarrow Street NOTES: This i AUTHORIZED BY: DATE: DISTRIBUTION: 1. Property Owner 2. Xcel Energy, sandra.cardenasgxcelenerg 3. Wheat Ridge Building Division 4. Log File NOTE: Please notify all other parties concerned. ADDRESS MAP UPDATED BY: DATE: www A.wh eatridgexo.0 s Vicinity Map 1 772 7 1 c 1-2, f. Ell. TA tr 4273 sme MA 43" sc, OF 4!1 - 4�4 4C - 4213T" -t--a J= rt 42 1? —T L fll coo L L 714 01 - 1w I 9k INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/forms.aspx?fid=79 INSPECTION REQUEST LINE: (303) 234-5933 OccyEp ncv/Type kKE 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 Foundation Inspections Date Inspector Comments Initials Pier Floodplain Inspection (if applicable) Concrete Encased Ground (CEG) Final Electrical Foundation / P.E. Letter Final Plumbing -IUM VIVA = �61 61=�§1 M I W ff"9 .JYf.l'a fSW)4aar.XV4IW M L1\LTrA7fST_T _T'�7 Underground/Slab Inspections Date Inspector Comments Landscaping & Parking / Planning Dept. Initials Electrical Floodplain Inspection (if applicable) Sewer Service Final Electrical Plumbing re_ we_a �__ _ Final Plumbing 100 Nut L,uver under round or Eselow/ln-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Comments Initials Wall Sheathing Mid -Roof Lath / Wall Tie Rough Electric " Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw / Nail Final Inspections Date Inspector Initials Comments Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For NOW and drainage inspections call 303-235-2861. For fire inspection$ 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 r if 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. F. - „u L—L I VUVII 1110N0%,L1V11b d,e wiiiNieMa from me rare uistnct ano eiecincai iow voltage by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy -is Issued Protect This Card From The Weather . 16 A City of Wheat Ridge Residential Roofing PERMIT - 201702241 PERMIT NO: 201702241 ISSUED: 06/20/2017 JOB ADDRESS: 3945 Eaton ST EXPIRES: 06/20/2018 JOB DESCRIPTION: RESIDENTIAL RE -ROOF W/ MALARKEY VISTA ASPHALT SHINGLES - 27 SQ. *** CONTACTS *** OWNER (720)480-1656 ALLEN PATTI GC (303)425-7531 John Borfitz 019983 J & K Roofing Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,659.00 FEES ?, Total Valuation 0.00 Use Tax 160.84 Permit Fee 172.60 .� ** TOTAL ** 333.44 *** 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 k/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€rms 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. City of Wheat Ridge Residential Roofing PERMIT - 201702241 PERMIT NO: 201702241 ISSUED: 06/20/2017 JOB ADDRESS: 3945 Eaton ST EXPIRES: 06/20/2018 JOB DESCRIPTION: RESIDENTIAL RE -ROOF W/ MALARKEY VISTA ASPHALT SHINGLES - 27 SQ. I, by my signature, do hereby attest that the work 0b c 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 ermit. I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be perfoped and that all wor to be pe ormed is disclosed in this document and/oc its' accompanying approved plans and specifications. nature of OWNER or CONACTOR (Circle one) Date 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. 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. 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. 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. 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. The issuance or granting of a permit shall not be construed to be a permit for, or an��a�ppproval of, an violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of wdfAis 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. Kimberly Cook J From: no-reply@ci.wheatridge.co.us Sent: Monday, June 12, 2017 1:12 PM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received. 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. Permits are currently being processed within 3-5 business days, subject to change based on volume. 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. PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number Property Owner Email Address Do you have a signed contract to reroof this property? It will need to be provided at the time of permit pick-up. 3945 Eaton St Patti Allen 720-480-1656 Field not completed. Yes I C 1 z S CONTRACTOR INFORMATION Contractor Name J&K Roofing Contractor's License 019983 Number (for the City of Wheat Ridge) Contractor Phone 3034257531 Number Contractor Email Address kathyv@jkroofing.com (permit pick-up instructions will be sent to this email) Retype Contractor Email kathyv@jkroofing.com Address DESCRIPTION OF WORK Is this application for a Yes new permit for a residential roof? Are you re -decking the No roof? Description of Roofing Malarkey Vista Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 27 material selected above? Does any portion of the No property include a flat roof? If yes, how many squares Field not completed. on the flat roof? TOTAL SQUARES of all 27 roofing material for this proj ect z Provide additional detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract value or cost of ALL materials and labor) house - pitch 4/12 with 2 smalls sheds 7659 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 submit this application and to perform the work described above. Name of Applicant Kathy Vendegna Email not displaying correctly? View it in your browser. 3 CONTRACT J&K Roofing 1313R ` 13000 W. 43rd Drive •Golden, CO 80403 - tssa-u Phone: 303-425-7531 • Fax: 303-425-1562 `'•' www.jkroofing.com Representative F-Kq� Iac-AO Contact) -721c'iy2,49 Date - 20/7 Name Aa'_'r I� i471"�tj Phone U ' Ilo Co email ALIL I C° � �'� (� EX Address 3 ys- -on -I. City W/KaT zip 8G2.1'2-- Pinnacol Assurance Cincinnati Sp ialty Underwriters 303-361-4000 303-653-0023 Workers Compensation Insurance General Liability Insurance Policy #4079290 LABOR AND MATERIAL SPECIFICATIONS, TERMS, AND CONDITIONS. PLEASE READ CAREFULLY: Wover roof with / v Ul�gk'ey V"3:rA':Z 'SK5 !7� maZor of shingles 5 f EAIM�' 0�AI _ nufacturer's Warranty Tear off �AY�X- In:11 UnderlaymentDoule all Eaves E H ash Chimney and/or Skylights ow Valleys Replace Ridge LTJ V tilation AIDQ %!) 47VA—: Zvanized Fasteners Replace ALj_ Plumbing Jacks 1 P 'nt roof stacks to match It �XoZ ..t y Metal Edging (A.1}'t' 05 P to or flat roof Year Warranty on labor t�J J�`K Roofing to furnish all material and labor C�1P rmit: Included NOT Included 211 an-up debris and haul off all trash from roof yard with magnetic roller cleaned of roofing debris cking Repairs $ �. $� per SF Hidden Layers (tear off) $ C per layer PewSQ <'77�}'��M . (cam (Policy Number) 06 - I (Claim k) (Adjustor) (Mortgage Co.) (Mortgage Loan NumW %� Policy #CS00061742 w H l fz' WJ Extra work t�a.1i TT -FU PE(� jN5t4r? Wq__- 7Q gR ET _-IS D 13 E Fa QF_ t-b2k B 1% t WS FPM13 RQDT- `-T$b RE17o9TEL 1W_k- XC10S The property owner is %/ is not using proceeds from property and casualty insurance policy. QE�V -�s. sy Deductible if applicable $ S et ft Per Colorado State Law CRS § 6-22-105 which states1000 the responsibility of the homeowner to pay this amount. J & K Roofing will not reimburse or promise to reimburse in whole or in part any amount of the deductible. Estimated Start Date 3-9 we J� TOTAL ESTIMATE $13 1 4031 .712— 6,pft ``r+ qtr + ;>w= ALL PROPOSALS ARE SUBJECT TO MANAGEMENT APPROVAL J & K Representa Date C�1-1 i f A Homeowner Date- /— 1,9 Homeowner e,� Date Expiration Date 1 You have the right to recind this contract and obtain a full refund of any deposit within 72 hours after entering the contract. If you plan to use the proceeds from a property and casualty insurance policy to pay for the roofing work, you may rescind this contract within 72 hours after receiving written notice from your insurance carrier that your claim has been denied in whole or in part. However, J&K Roofing is entitled to retain payments or deposits to compensate for roofing work actually performed in a workmanlike manner consistent with standard roofing practices. PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION i CITY OF WHEAT RIDGE _��9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: /VU!9 Job Address: Permit Number: c �i7vZ z w/ ❑ No one available for inspection: Time c 3 AM/EM Re -Inspection required: Yes fly o When corrections have been made, call for re -inspection at 303 -234 - Date: 71z 9 % Inspector: KJ� DO NOT REMOVE THIS NOTICE ill A i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax .4. INSPECTION NOTICE Inspection Type: hF Job Address: 3 M - (l c.v i Permit Number: 7 l ❑ No one available for inspection: Time ' i )( M/PM Re -Inspection required: Yes N When corrections have been made, call for re -inspection at 303-234-5933 Date: ;vto y Inspector: DO NOT REMOVE THIS NOTICE e s CITY OF WHEAT RIDGE Bung Inspection Division . j~ (303) 234-5933 inspection line (303) 235-2855 office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: p F r'i! Job Address: a-°eb. ih Permit Number: r~7 n No one available for inspection: Time AM/ Re-Inspection required: Yes No "When corrections have been made, call for r,,q-inspectlon at 303-234-5933 iqg, tf Date:. Inspector: (A-k-4 DO NOT REMOVE THIS ~OTICE ♦ 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: I\A 4 , Job Address: 3~5 lam? S Permit Number: i h ❑ No one available for inspection: Time AM/PM Re-Inspection required: Yes When corrections have been made, calf for re-inspection at 303-234-5933 Date: Inspector: AA-i t I DO NOT REMOVE THIS NOTICE " City of Wheat Ridge -ter INSPECTION RECORD OccupanDV/TVpe 'W 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. 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 CONCRETE SLAB FLOOR Electrical Plumbing ROUGHS Lath / Wall tie Electrical Service NA5 GLEN JIGNEU Rough Plumbing Gas Piping Rough Mechanical I I. ABOVE INSPECTIONS TO BE SIGNED PRIOR TO, Framing ` Insulation CITY F H T. RID Drywall Screw 8 25 AAM 10/01/09 cdbb James Cappelleri - FINALS 4 RECEIPT_NMED8802721 AMOUNT Electrical DPSP Reroof 31 sqs- House 558.30 r Plumbing 092897 Permit Fee 308.50 " Mechanical Use Tax 249.80 Roof PAYMENT RECEIVED AMOUNT ` Building Final VS8094 - - 558.30 Auth Code: ` Fire Department 086241 - TOTAL 558.38 R.O.W & Drainage INSPECTIONS F------ Parking & Landscaping - SHOULD BE CALLED Al LEAST ONE WEEK PRIOR T'O 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 PROF. r:T THIS CARD FROM THE WEATHER Oct 01 2009 8:15AM CEDAR VALLEY EXTERIORS 7637555390 P.2 "e* City of Wheat Ridge Building Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855' Fax: 303-235-2857 Inspection Liner 303-2345933 A ~Q Building Permit Application Prlipetty!A<IeJ3reSS:`3&5: ~ S7 GC/ Property Owner (please pfin*AA Z A-#V 141k4? /rte// Mailing Address: (if different than property address) Address: Y.U~ City, State, Zip: Contractor: ( rYl[.d i~ VGL/l~l o DYS. z , 'O Contractor License#: Q (~D Phone: 7 ~g?~~ ~~~j= s Sub'Gontrac#ots 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): Construction Value, S 7 b.dodtlption of'wdrk (as calculatedW the Bulming luatforr Data sheet) ~h ~L1Cl a~'LC /r^ dry Plan Review (due at time ofsubmittal): $ W -J= 77P 3~ //~O ~ eJi fl+~" ~ Sq. Ft./L. Ft added: Squares 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 ap tion and that I assume full responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable at idge Ordinances, for work under this permit Plans subject to field Inspection. CIRLCEONE:: (O/WNNS RACTOR 1PERSONAL REPRES NT TIVE f (ow f ) PRINT NAME: _!~f/ _-JU/ I SIGNATURE: -ate!V lJ Date: Plan Permit - m 1 1 ~ =w3t~; /Gi