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HomeMy WebLinkAbout5190 Simms Placei CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: --f' n/ l 1 Job Address: Permit Number:) `3 ❑ No one available for inspection: Time. ft >;` AM/- r~' Re -Inspection required: Yes, No When corrections have been made, call for re -inspection at 303-234-5933 Date: 3 -,510 - /q Inspector: �-----�. 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: `-� i �/ r►?�^� �.- Permit Number: ;2q75 / ee,7 ❑ No one available for inspection: Time -. AMFM,--) ,� a Re -Inspection required -Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: —7, ` Inspector:-----� 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: ay I i 0 ❑ No one available for inspection: Time !' `1 AM/PM Re -Inspection required: Yes N_o When corrections have been made, call for re -inspection at 303-234-5933 Date::. -i Iji Inspector: ` > DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office a (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: C( (Y) L! No one available for inspection: Time I d AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: Inspector: 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: Yy^ ► Y-00 Job Address: `} 1 c1 O Permit Number: ❑ No one availablefor inspection: Time AM/FV Re -Inspection required: No When corrections have been made, call for re -inspection at 303-234-5933 Date: Inspector: ®O NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Roofing PERMIT - 201802931 PERMIT NO: 201802931 ISSUED: 11/05/2018 JOB ADDRESS: 5190 Simms P1 EXPIRES: 11/05/2019 JOB DESCRIPTION: Reroof with OC Duration Storm asphalt shingles, 4/12 pitch, 22 squares total - house and shed *** CONTACTS *** OWNER (720)346-1637 GONYEA DAVID L SUB (303)386-4649 Steve Burns 130239 Exceptional Exteriors LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2320 / APPLERIDGE ESTATES, STANDLEY H BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,940.00 FEES Total Valuation 0.00 Use Tax 124.74 Permit Fee 140.90 ** TOTAL ** 265.64 *** 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% 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% 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 - 201802931 PERMIT NO: 201802931 ISSUED: 11/05/2018 JOB ADDRESS: 5190 Simms P1 EXPIRES: 11/05/2019 JOB DESCRIPTION: Reroof with OC Duration Storm asphalt shingles, 4/12 pitch, 22 squares total - house and shed 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 thepermit 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 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 applicable code or any ordinance or regIlltion of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE NADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. r � 0 1 � �)� , Kimberly Cook 0 (� From: no-reply@ci.wheatridge.co.us Sent: Monday, November 5, 2018 1:41 PM / To: CommDev Permits 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 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. The Building Division permit counter is open from 7:30 am to 3:30 pm, 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 -��i` I a� �/� residential roof? - How many dwelling units Single Family Home �` A are on thero ert p p Y• I ri/ PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123-4567) 5190 Simms PI, Wheat Ridge, CO 80033 David Gonyea 720-346-1637 Property Owner Email davidgonyea8@gmail.com 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 Gonvea Contract-pdf Contract CONTRACTOR INFORMATION Contractor Business Exceptional Exteriors Name Contractor's License 130239 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 720-413-5706 Number (enter WITH dashes, eg 303-123-4567) Contractor Address 7940 S University Blvd Suite 100 (Primary address of your business) Contractor Email Address permits@exexco.com Retype Contractor Email permits@exexco.com Address DESCRIPTION OF WORK TOTAL SQUARES of 22 the entire scope of work: Project Value (contract 5940 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 both? (check all that apply) 2 What is the specific pitch of the PITCHED roof? How many squares are part of the PITCHED roof? Describe the roofing materials for the PITCHED roof: Type of material for the PITCHED roof: Provide any additional detail here on the description of work. (Is this for a house or garage? Etc) 4/12 22 OC Duration Storm Asphalt Main Roof and Shed SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that this application is NOT a permit. I understand I will be contacted by the City to pay for and pick up the permit for this property. I understand that work may not begin on this property until a permit has been issued and posted on the property. I certify that I have been authorized by the legal owner of the property to submit this application Yes Yes Yes Yes 3 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 Kenny Kim Permit Email not displaying correctly? View it in your browser. Rough Inspection (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 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 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. Approval 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. PERMIT: �V1707L6ADDRESS:. �!?0��3��JOB CODE: 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 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 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 City of Wheat Ridge i. Residential Electric PERMIT - 201707606 PERMIT NO: 201707606 ISSUED: 09/22/2017 JOB ADDRESS: 5190 Simms PL EXPIRES: 09/22/2018 JOB DESCRIPTION: Residential Electrical service upgrade to 200 amps *** CONTACTS *** OWNER (720)346-1637 GONYEA DAVID L SUB (303)422-6805 John S. Kruse 019894 Kruse Electric Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2320 / APPLERIDGE ESTATES, STANDLEY H BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 2,500.00 FEES Total Valuation 0.00 Use Tax 52.50 Permit Fee 93.35 ** TOTAL ** 145.85 *** COMMENTS *** *** CONDITIONS *** Must comply w/ 2012 IRC & 2014 NEC. 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 per C ed 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 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 maybe subject to a fee equal to one-half of the original permit fee. 3. If this pen -nit expires, anew permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5, The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all 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, any violation of any provision of any ap code or any or gncq.% r ulation of this jurisdiction. Approval of work is subject to field inspection. 4u'.- Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of y;rWheatRj,0ge COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(o-)-ci.wheatridge.co.us FOR OFFICE USE ONLY Date: 11-7 Plan/Permit # c D I Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: Property Owner (please print): `j G rl \/ C{' Phone: Property Owner Email: Mailing Address: (if different than property address) Address City, State, Architect/Engineer: Architect/Engineer E-mail: Contractor: _ �' USE �_Is, C i -y i C "I Phone: Contractors City License #: C, I "-18 9 q Phone: _,y ) a lP Uzi -4-)- Contractor Contractor E-mail Address: VS (4-T-) C: C6 t'L l Sub Contractors: Electrical W.R. City License # G 19 E;cl � 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 M ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESDENTIAL 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.) v\ �a&)-Q � Zvi C-�- @OO P\, -Y7-) P Sq. Ft./LF Amps Btu's Squares Gallons Other Project Value: (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 I 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. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE): )of (OWNER) (CONTRACTOR) Signature (first and last name): \ Ix&1A DATE: C� _ I DEPARTMENT USE ONLY ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: 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: ly?.9�310 %:�;� Job Address: P S; M M,5 L Permit Number: a % O �� a ❑ No one available for inspectDNo Time /J�V AM/PM Re -Inspection required: Yes When corrections have been made, call for re -inspection at 303-234-5933 Date: -P/96// / Inspector: M DO NOT REMOVE THIS NOTICE ♦ 4 4 , CITY OF WHEAT RIDGE r Building Inspection Division 1 (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 235 -2857 Fax INSPECTION NOTICE Inspection Type: Job Address: ,i Permit Number: 41&0 ❑ 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 . - Inspector: O NOT REMOVE HIS NOTICE ♦ ♦ CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 235 -2857 Fax INSPECTION NOTICE Inspection Type: ,,r,. 'mil° Job Address: .5790 �ssysrx.� ST Permit Number: 0 { t>scaAq An91 �7 T Sf_ !rg si.�er L t3 . /✓-. � .7 ✓ T1�.E.�a- t' =G'�ir! f✓1 eS,e�� ,h+'aedla>c ❑ No one available for inspection: Time r a5 AM /PM Re- Inspection required: Yes No "When corrections have been made, call for re- inspection at 303 - 234 -5933 Date: V Inspector: DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE Building Inspection Division l~ (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: yr l,-r Job Address- (Lill "7" V, Permit Number: font/"a ❑ No one available for inspectio Time ;ff tl &/'PM Re-Inspection required: Yes No 1 "When corrections have been made, call f re ffnspection at 3034345933 R Date: Inspector: sr t ^ b fr, 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: klt'k- rf; f Job Address: � "at �;'Yvl� pl. Permit Number: 60//,'l) ��, /• it tin M ❑ No one available for inspection: Time r/ AW M j Re- Inspection required: (Ys) No * When corrections have been made, call for re- inspection at 303-23 Kl r , 7' P / Date: f� t� 04 Inspector: ,-; l . DO NOT REMOVE THIS NOTICE r I.. ~ 4 41 city of Whn--It AidrrA INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB FOUNDATIONINSPECTIONS 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) DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED q.. ROUGHS Sheathing Lath / Wall tie Mid-Roof Electrical Service ` Rough' Electric r~ Rough Plumbing k Gas Piping Rough' Mechanical _ ABOVE INSPECTIONS TOBE'SIGNED PRIOR TO:I Framing r, Insulation Drywall Screw a, ~itL ..,r a^ .`FINALS Electrical " Plumbing _ Mechanical - s Roof . °Quilding Final - Fire Department R.O.W & Drainage INSPEC F _ i Ail UPI Parking & Landscaping sHOUL _,d CAI A • ru sa ' *NOTE. }ILL'{TEMS-MUST;BECOMPLETEDAND AP.RROVEDBYPLANIVINGAM a `i 61ILj7N( ! FINAL INSPECTION BYTNE 8 CEIMi4CATE OFOCCUPANCY ISISSOED . , , NOR PERMM5 OF'-A CERTIFICATE OF OCCUPANCY , . OCCUPANCY NOT' 'PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED PROTECT THIS GARD FROM THE WEATHER :QO G/ ` heatd ~E Date CommuNnyDEWLOPMENT Permit#:QG~~~(~ louv VV. Bui/rlina.~L{LNS%p1,1 Ve., VVHeAt Ridge, GO 80033 Office: 303-235-2855 " Fax: 303-237-8929 Inspection Line: 303-234-5933 Facsimile Building Permit Application S 19D s~rr..rr-s P~,n~` wr~~ro ~ ~ ~~03~ Property owner (please print): b fiV.Dp L, C-14r 'f e A Phone; 30~ - yai- b ~a Mailing Address: (if different than property address) Address: S'e ~ 6. a .Ram: ~ trm e SC~~ ~o ~ ~ Sc~~ ANC , Contractor license o a 50 Phone: J' a3 `7'7 7- 033 aN+ C'onipanY blame: License Expiration Date: Trade/Profession: Approval: Use of s ace descri tion): Te-e.4. o Ff- •11 SidQG. y 'S nt\ q'w- 3a'tz Qre\SL 59no°-' Plan Review (due at time ofsubmittaq: $ Sq. Ft-/L.Ft added: Squares t 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 regulatlons 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 1 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 subjeGLto-Tieldinso on. IVE f ER) (CONTRATOR) CIRLCEONE:: (OWNER 6CONTRACTOR r PERSONALRE.7n PRINT NAME: SIGNATUR - Date: I7I d% Bldg Valuation: $ 16 Credit Card Payment: Use credit card listed on filet: Print name: F UyJ T~ Cl Signature: