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DEPARTMENT OF GOMMUNITY DEVELOPMENT
7500WEST29thAVENUE BUILDING INSPECTION DIVISION PERMIT N0. 197r-jS
234-5933 P.O. BoX638 CITY OF WHEAT RIDGE, COl.O.
THIS PERMIT VALID ONLY WHEN SIGNEO BY THE CHIEF BUILDING INSPELTOR AND RECEIPTED BEL'JW.
!1 APPLICATION FOR MISCELLANEOUS PERMIT
JOB ADDRESS 9 G 2 f~c7 3l ~ /R OWNER ~ c ~Se ` (q Cr~ ~1't1nOti1J
CONTRACTOR S It n ADDRESS S b'Z- V u 9 3 r ~ r ,/-11'o
ADDRESS G(o2) PHONE 4 2-3-4302' ZIPCODE ~$C'~0•
CITY ~s^ ~~n,v~F Znc+S ZIP CODE .!A E-103-2-~- . CONTRACT PRICE $
PHONE 1423,`1rn~ LICENSENO. DATE J/9 I45~
TYPE Ground❑
1
Woll❑
Proiecfinp❑
Other
SorDFOCe
.
2. MATERIAL
Total Squars Feet
$IGNS
ILLUMINATION Yea❑ No❑
3
Type
Eleef
Permit No
.
4, SET BACN FROM PROPERTY LINE N
(Specify which ia front )
_
❑
S_ E
❑
- W
❑ ❑
.
Zone_
.
Approvad,2one inspeetor
DisoDDroved
1. TYPE Solid[:] More Thon 80% Open❑
Lest TAOn 80% Open
.
2 MATERIAL
Hsiphf
FENCES
3. SET BACK FROM PROPERTY LINE N
(Specify which ia front)
_
❑
S_ E
❑
_ W
❑ ❑
Zone_
Apprwed,Zone Inspacta
DieaDProved
I
.
Z
OTHER
'
3
.
DRAW SKETCH OR SHOW BELOW, THE FENCE,SIGN,OR OTHER STRUCTURE, GIVIM1G DISTANCES fROM PROPERTY LINES.
(SETBACKS OR PROJECTIONS INCI.UDEO)
~
SPECIFY NORTH
FR(1NT
STREET NAME
SNOW DISTANCES FROM THE MAIN BUILDING TO- ADJOINING HOUSES,STREETS, AND PROPERTY LINES; ON IRREGULAR lATS,SHOW LEAST
DISTANCE TO PROPERTY LINES, NOT MA%IMUM OR AVERAGE DISTANCE.
APPLICATION FOR PLUMBING; ELECTRICAL; MECHANICAL PERMIT
THIS APPLICATION WILL BECOME A PERMITTO PERFORM THE INDICATED WORK ONLY UPON VALIDATION BY THE BUILDING INSPECTION DIVISION.
PERMIT WILL EXPIRE 780 DAYS fROM THE DATE OF ISSUANCE IF WORK IS NOT STARTED WITHIN THAT TIME.
ELECTRICAL PERMIT
STATE LICENSE N0.
PLUMBING PERMIT
STATE LICENSE NO.
MECHANICAL PERMIT
ALUMINUMWIREUNDERSIZEBILLE6AL
FLOOR
BSM
IST
2ND
3RD
4TH
N0.
FIIELC'rccbOnaGaShcPropone ElxSolar
Np,
WATER CIASET
FORCED AIR - BTU
TEMPORARY METER
WASH BOWL
HOT WATER - BTU
NEW SERVICE AMPS
BATH TUB
STEAM - 8TU
CHANGE SERVICE-AMPS
SHOWER
AIR CONDITIONING-BTU
LIGHTING
SINK
OTHER
HEATING
GARBAGE DISP
REFRIGERATION SYSTEM
POWER SUB-CIFCUITS
WATER HEATER
Retri ernnf Group
UTILITY(RANGE,DISPOSER,ETC.)
AUTO.WASHER
Pounds Char e
fIXTURES
DISH WASHER
AUTOMATIC SPRINKLER SYSTEM
WIRING MOTOF25 9 CONTROLS
FLOOR DRAIN
ELEVATOR
SIGNS
URINAL
TRANSFORMERS 9 RECTFIERS
SEWERS
ADDITION TO OLD WORK
OTHER
MOTORS OVER I HP
TOTAL FI%TURES
I hsreby acknowledge that this appiica-
fion is correot and understond ihaf I
tannot sfart tAis projbct until this oDPli-
eotion ie approved. I shall comply wifh
iha lowa of Ihe Stafe o1 Colorado and to
the Zoninq Repulations ond Buildinq
Code offhe City of Wheat Ridqe. Any
violotion of ihe above terme will couse
immediote revocation of this permif
1.e-z An Q 1,. 1~ fd
IiLan 9iynalun
PERMIT FEE
USE TAX
TOTAL FEE
APPROVED
DISAPPROVED_
CHIEF BUILDING
$ ~g W7 M3
,Cityof Wheat Ridqe
' CALL 234-5933
24 HOURS IN ADVANCE
D0t¢ ISSUEd ! I FOR INSPECTIONS