HomeMy WebLinkAbout5515 W. 32nd Avenuee A 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: _V:� �( \
Job Address:c-
Permit Number:.(
V Cera +tr t (-A +� 0 ry �� C_ ✓'
c'I VV -A,
❑ 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 -
Date: Inspector:
`1 c
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: �M_ p� lla I Rcyi
Job Address: 55'15' L./.32,iJ Lt.
Permit Number: '101007 f)3 5"
#G`
❑ No one available for inspection: Time �` F
Re -Inspection required: Yes llVoj
When corrections have been made, call for re -inspection at 303 -234 -
Dated 0131 f 11b Inspector:.y+n& krl°-ff
DO NOT REMOVE THIS NOTICE
!^oo�J�C
r ..
❑ No one available for inspection: Timer :j AM�'M�
Re -Inspection required: Yescc1
When corrections have been made, call for re -inspection at 303-234-5933
Date: ( 0/74/ 1� Inspector: Aline, (dam ff
DO NOT REMOVE THIS NOTICE
CITY OF WHEAT RIDGE
-
Building Inspection Division
(303) 234-5933 ,Inspection line
/ x(303) 235-2855 Office' • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
30d` /1/1;A1_00
Job Address:
552 5- L-/ 3(_^d Atc,
Permit Number:
Z-0l90 f)9 S
!^oo�J�C
r ..
❑ No one available for inspection: Timer :j AM�'M�
Re -Inspection required: Yescc1
When corrections have been made, call for re -inspection at 303-234-5933
Date: ( 0/74/ 1� Inspector: Aline, (dam ff
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Roofing PERMIT - 201802835
PERMIT NO: 201802835 ISSUED: 10/24/2018
JOB ADDRESS: 5515 W 32nd Ave EXPIRES: 10/24/2019
JOB DESCRIPTION: Reroof with GAF Armorshield II asphalt shingles; 4/12 pitch; 35 squares
total
*** CONTACTS ***
OWNER (303)274-8150
RICCIARDI EUGENE
J JR
SUB (303)741-2561
Marcus McDermett
170349 American
Heritage Restoration
*** PARCEL INFO ***
ZONE CODE:
UA / Unassigned
USE:
UA / Unassigned
SUBDIVISION CODE:
2412 / LAKESIDE,
STEWART GARDENS,
OLI BLOCK/LOT#:
0 /
*** FEE SUMMARY ***
ESTIMATED PROJECT VALUATION:
10,500.00
FEES
Total Valuation
0.00
Use Tax
220.50
Permit Fee
220.15
** TOTAL **
440.65
*** 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 - 201802835
PERMIT NO: 201802835 ISSUED: 10/24/2018
JOB ADDRESS: 5515 W 32nd Ave EXPIRES: 10/24/2019
JOB DESCRIPTION: Reroof with GAF Armorshield II asphalt shingles; 4/12 pitch; 35 squares
total
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 legall authorized to include all entities named within this document as parties to the work to be
performed771
ll v�ork be perfo d is disclosed in this document and/or its' accompanying approved plans and specifications.
—� _ a /Q9 I an
Signature OWNER or KONTRACTOR rcle one) Date
I . This permit was issued b h2rrt7 ormation 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 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 grantin f a permit sha of be construed to be a permit for, or an approval of, an violation of any provision of any
applicable code or any r an a or re tion 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.
Kimberly Cook
a olU:�S3S
From: no-reply@ci.wheatridge.co.us
Sent: Wednesday, October 24, 2018 12:35 PM
To: CommDev Permits
Subject: Online Form Submittal: Residential Roofing Permit Application
Categories: Kim
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 for a Yes
residential roof?
How many dwelling units Single Family Home
are on the property?
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-4567)
5515 W. 32nd Ave.
Gene Ricciardi
720-274-8150
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
Contract.pdf
Contract
CONTRACTOR INFORMATION
Contractor Business
American Heritage Restoration
Name
Contractor's License
170349
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone
303-741-2561
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address
3380 S. Knox Ct. Englewood, CO 80110
(Primary address of your
business)
Contractor Email Address
Victoria@AHRRoofing.com
Retype Contractor Email
Victoria@AHRRoofing.com
Address
DESCRIPTION OF WORK
TOTAL SQUARES of
35
the entire scope of work:
Project Value (contract
10500
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
z
both? (check all that
apply)
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
35
GAF Armorshield II Shingles
Asphalt
It's a residential house
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
3
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 Victoria Compo
Permit
Email not displaying correctly? View it in your browser.
COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number : 16539
BUILDING INSPECTION LINE -(303-234-5933) Date : 10/14/2003
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
Property Owner: EUGENE RICCIARDI
PropertyAddress : 5515 W 32ND AVE
Contractor License No. :
Phone : 239-6545
Company : Phone :
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I Construction Value : $325.00
I hereby certify that the setback distances proposed by this permit application are accurate, and
Permit Fee :
$30.55
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 alle9ations
Plall ReviBw F0e :
$19.86
made are accurate; that I have read and agree to abide by all conditions printed on this
50
$6
application, and that I assume full respo9 K~ for compliance with the Wheat Ridge Building
h
USB T8X :
.
Code (U.B.C.) and all other applicabJe~7V
~qt Ridge ordinances, for work under this permit.
(OWNER)(CONTRQCTOR)SIGDATE~! l~'-~% Total: $56.91
~ Use :
Description : PATIO COVER ADD ON TO EXISTING PERMIT FOR ROOF REPLACEMENT (#16075)
Approval : MR
Zoning : R-1C
~
, ilding;C~,amme s:
Approval: DM
Afililiffiffio~ffil
Approval :
Occupancy:
Electrical License No
Company:
Expiration Date :
Approval:
BUILDING DEPARTMENT USE ONLY 'I
SIC : Sq. Ft. :
ADD'N TO BE BUILT IN LINE W/ THE EXISTING HOUSE. MUST
MAINTAIN A 5' SETBACK FROM THE WESTERN PROPERTY LINE.
Please Nutz:
OK. 10/13/03 Ownei / contractor is responsiblc "or ~';r^r'=r';.
linesandconsttuctingimprovcmer.ts
approved plan and required developi ii,,,lac 9r: d:,..
The City is not responsible ior ;r.accuraie, irfcc,
submitted within the plan se[ ar:d any censiru"i:;:: accurat- Walls : Roof : Storiesnors resultin fs,dential Units ~nform;tion.
Plumbing License No :
Company:
Mechanical License No :
Company :
Expiration Date :
Approval:
Expiration Date :
Approval:
(7) This permit vras issued in accordance with the provisions set forth in yopur application and is subject to the laws of ihe State of Colorado and to the Zoning
Regulations and Building Code of Wheat Ridge, Colorado or any other applicable ordinances of the City.
(2) This permit shall expire if (A) the work authorized is not commenced within sixry (60) days from issue date or (B) the building authorized is suspended or
abandonetl for a period of 120 days (3) If this permit expires, a new permit may be acquired for a fee of one-half ihe amount normaily required, provided no changes have heen or wili be made in the original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspension or abandonment
exceeds one (1) year, full fees shall be paid for a new permit.
(4) No work of any manner shall be done that will change ihe naWral Flow of water causing a drainage problem. -
(5) Contrador shall notifythe euilding Inspector lwenty-four (24) hours in advance for all inspections and shall receive writlen approval on inspection card before
proceediing with successive phases of ihe job.
(6) The issua ~ of a permit o{ the approval of drawings and specifications shall not be construed to be a permit for, nor an approval of, any violation of the
pro of he,by tdes or any other ordinance, law, rule or regWation.
Chief Building In ector
Please sign Terms and Conditions on reverse side of page.
o` WHEqr COMMUIVITY DEVELOPMENT DEPARTMENT
BUILDING INSPECTION LINE - 303-234-5933
CITY OF WHEAT RIDGE
7500 V1'EST 29TH AVENliE
WHEAT RIDGE, CO 80033 - (303-235-2855)
5~ 5/~/irq~I+/~
iP4ppL13~ f
i l~f ♦
Building Permit Number.
Date:
PropertyOuMer. FC.I F•~'c Rrcci4, 7z p/
Property Address: 3-3-/5- 1 L)Z`5 ~j2 w'v
Phone.o''3O Z 5 ~ --l
Contractor License Ko.:
Company: Phone:
O\\'NER/C05TRAC70R SIGNA7UAE OF GNDERS7ANDING A.KD AGREEMENT
1 hereby cmify that the setback distanca proposed by this pertnit appliwtion are accurate,
and do not violam applicablc ordinanccs, rula or regulalions olthc Ciry of Kfieat Ridge or
covrnants, eazcmrnls orrestnctions ofrceord; fiat aIl mrasuremcn6 shown, and alkgations
madc arc accuratr, that 1 havc read and agrcc to abidc by all conditions prinud on this
application and that ] assumc (ull ttsponsibiliry for compliancc with the 1;'heat Ridge
Building C9de (U.B.C) and ali other ap IlUcab e Wheat Ridge Ordinances, tor work undtt
thispertnil. f ~
(ONTERxCOTTRACTOR): PRI!.71]
ja e- _3
[o. J5-0
Construction Value:$
Permit Fee:$
Pian Review Fee:$
Use Tax:$
TOIaI:$
DESCRIPTIO\: c'`~f ~ ~/~r~tf°Ff/(on7~
-y-0 S T/Ft/,/-' piEWft< ~
BUILyDIr PUSE Y {}(+r IC: • Sq.FC: 0
ZONIHG COMMENTS: ~
Approval: w ~ n
Zoning: '
Z~
BVILDINGCOMMENiS: F ,
Approval: 0-i - ~h
~
PU6lJC WORI(S COMMEM3:
Approval:
Occupancy: Walls: Roof: Stories: Residential Uniu:
Electrical License No: Plumbing License No: Mechanical License No:
Company: Company: Company:
Expiration Date: Expication Date: Expuation Date:
Approval: Approval: Approval:
(1) This permii was issued in accadance with the provitans ut forih in yow appliuuon and u subj«t b the 6ws of ihe Suu otCobrado nnd m Lhe Zoning
Regukciom and Building Coda of Nrbot Ridgr, Cobndo m any other applicabk ordinancu of tTe Ciry.
Thu yermn shall expiie if(A) die work auNOrized'u not commrnced within sixry (60) days fran issue dau or (B) ihc building amhorized is susyended or
abandoned tor a penod of 120 days. ,
If Uiis pemiil eVircs, a new prnna may be acquiied fa a f« of one-IwU the amount nomnlly requirtd, yroiided iw changa hare bcen or will bc made
in the original pWz and ryetificauoos eM any susyen5ion m abandonmrnnt hu va excecdcd onc (7) year. If chmges luve been or i(suryertvion or
abandonmrnt eueeds om (i) year, tull fees shall be pnid fw a new pmmii
(a) no work of any manna shail be done Ihai will chaoge the mmrd Ibw of wattt causing a dnimge probkm.
(3) ContraetOr shall notify the SuiMing Impcclor twrnry-four (20) hours in ad%anc< fw all in5pe[boni and shall receive wrineo appmval on impecuon wd
befine proceeding witT successi.s piiasses of the job.
(6) Thc issuarc< of a pemnit ur 16t appmval of Mxings atd specificauort 5ha➢ not be consvuedb be s pertnit (or, nor an aypmval of, any riolauon of the
pmvisions 0 b.iWing coda or any ochn ordinance, la.v, mle or eeyuLuoa Chief Buildin nspector
Colorado Chapter of the International Code Council
How to Use this Guide
Provide two sets of plans and complete the following:
1 Complete this Building Guide by filling in the blanks on pagf two, and indicating
which construction details will be used. ~
2 Provide 2 Plot Plans (site plan) showing dimensions of your project or addition
and its relationship to existing buildings or structures on the property and the distance
to existing property lines drawn to scale.
3 Fill out a building permit application.
The Coloredo C pter of ihe International
Code Council i profesyiynai
organizatio,` seeking to promote the public
heatth, safeVipRd welfare to building
construction. Wetappreciate your feedbadc
and suggestions. To obtain a master copy ~
~~uild~~yide, please write to the
C bf the Intemational Code
Council, P.O. Box 961, Arvada, CO 80001.
This handout was developed by the Colorado
Chapter of the International Code Council as a
basic plan submittal under the 2000 International
Fesidential Code. It is not intended to cover all
circumstances. Check with your Department of
Building Safety for additional requirements.
CitY 0/ YYlKQt ~R*C ` wNE4t
~Buu~ ~ ~Divisian ~ ° "o .
7500 `W. 29'" Ave. ~ ' ° 4Nheat 12,itCge, CO 80033
(303) 235-2855 . coioRpoo
Fxisfing roo( rafters or trusses
Galvanized metal joist or ratter hangers
iii ~ Eztend underlayment from
iii new roof a minimum of 78'
onto existing roof
Lap underlayment a minimum of 18' under existing roofing fetts
Solid Dc blocking
Roof tie downs required
Femove existing fascia Existing
Cont.2xledger wall
Secure ledger ro wall wiN 4112' x 3/8' min. lag bolts @ ~
16' O.C. Locate lag bolts to penetrate top plate or studs
Note: Remwe bnck veneer at rop of wall
wall before insqlling continuous 2z ledger
Solid 2x blocking
tie downs required
Galvanized metal
posUbeam connector
Ecisting Roof
Cont. 2x6 secured ro exisGng roof with
fasteners at each rafter or truss
Roof tie downs required Solid 2x fire blocking
5/8' type °X' exterior~
gypsum sheaThing
Galvanized metal I
posUbeam connector ~
E#erior siding -
infill between posts w/
2x4's @ 16' O.C.
facia
No doser than 2 feet
to property line
5/8' rype "X" eMerior
gypsum board soffit
Treated or decay Bottom plate shall be treated Infill between posts
resistive post wood or Foundation redwood w/ 2x4's @ 16" O.C.
Minimum 3 1/2" Galvanized Minimum 3 1/2"
concrete siab column base w/ concrete slab 2- Gatvanized column
1" spacer to base w/ 1" spacer
a ~MYt, ,.',a, +'-e+t,. ¢ ~ . •'iP concrete concrete
- ,A~rt
Isolate Isolate
from Slab Anchor bolt from Siab Anchor bolt
7" minimum 7" minimum
minimum ~.•:i:s 3'-0" penetration Check local • e, .3_; penetration
:
diameter minimum building 3'-0°
concrete department for
swelling soils.
caisson caissonsmay
berequired. iFoofing
g.
This handout was developed by the Colorado Chapter of the
International Code Council as a basic plan submittal under
the 2000 International Residential Code. It is not intended
to cover all circumstances. Check with your Department of .
Building Safety for additional requirements.
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COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
01 Correction Notice
Job Address: ~ S/
COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number : 16075
BUILDING INSPECTION LINE -(303-234-5935) Date : 8/15/2003
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
Property Owner. E GENE J. RICCIARDI ~~15 t,.;32I~~t'`U
Property Address . 5515 W 32ND AVE ~ Phone : 239-6545
Contractor License No. :
Company : Phone :
OW NER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are acarate, 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 (U.B.C.) and all other applicable Wheat Ridge ordinances, for work under this permit.
(OWNER)(CONTRACTOR)
TE
Construction Value :
$2,200.00
Permit Fee :
$108.30
Plan Review Fee :
$0.00
Use Tax :
$44.00
Total:
$152.30
Use:
Description : TEAR OFF 2 LAYERS OF APPROX 400 SQ FT ROOF. REPLACE W/ NEW DECKING &
COMPOSITION ROOF. EXTEND EAVES FRONT & SIDE OF HOUSE
BUILDING DEPARTMENT USE ONLY
Zonin mm'ents:; SIC : Sq. Ft. :
Approval :
Zoning :
ilding;Co, : e ts ' OK. 8115103
Approval: DM
t a~ ~u b~ icMorkstCom ments:
Approval:
Occupancy : Walis : Roof : Stories : Residential Units :
Electrical License No :
Company:
Plumbing license No :
Company:
Mechanical License No :
Company :
Expiration Date :
Approval :
Expiration Date :
Approval :
Expiration Date :
Approval:
(1) This permit was issued in accordance with the provisions set forth in yopur application and is subjecl to the laws of the State of Coloado and to the Zoning
Regulations and Building Code of Wheat Ridge, Colorado or any olher applicable ordinances of the City.
(2) This permit shall expire if (A) the work authorized i~ not commenced within sixty (60) days from issue date or (B) the building authonzed is suspended or
abandoned for a penod of 120 days.
(3) If this permit expires, a new permit may be arquired for a fee of one-half the amount nortnally required, provided no changes have been orwill be made in the.
original plans and specifcations and any suspension or abandonment has not ezceeded one (7) year. If changes are made or if suspension or a6andonment
exceeds one (1) year, full fees shall be paid for a new pertnit. (4) No work of any manner shall be done Ihatwill change the naturai Flow of water causing a drainage problem.
(5) Contractor shall notify the Building Inspeclor twenty-four (24) hours in advance for all inspections and shall receive wntten approval on inspedion card before
pmceediing with successive phases of the job. (6) The issuance of a permit orthe approval of drawings and specifcations shall not be construed to be a pertnit for, nor an approval of, anyviolation of the
provisions of the building codes or any other ordinance, law, rule or regulation.
Chief Building Inspector
Please sign Terms and Conditions on reverse side of page.