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Home My WebLink About4360 Upham StreetINSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/forms.aspx?fid=79 41)uo (Jj1CJ7EC ION REQUEST LINE: (303) 234-5933 UA- iQ a ro z 1 lft C Occupanc�/T�e Inspe ions 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 Concrete Encased Ground (CEG) Foundation / P.E. Letter Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Sewer Service Plumbing Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing Mid -Roof G 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 ROW and drainage inspections call 303-235-2861. For fire inspections 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 I Final Window/Doors 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. *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 - 201702565 PERMIT NO: 201702565 ISSUED: 06/26/2017 JOB ADDRESS: 4360 Upham ST EXPIRES: 06/26/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Timberline 30 year asphalt shingles with 35 sq. *** CONTACTS *** OWNER (303)424-3239 CARVER AMY MARIE SUB (303)646-3977'Mike Essary 090139 Shield Const. & Exteriors *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 11,250.00 FEES Total Valuation 0.00 Use Tax 236.25 Permit Fee 236.00 ** TOTAL ** 472.25 *** 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 A/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€ms 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. 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: _qO q RO F Job Address: l L1,760 V ht�aj Permit Number: 2-o/ 7 O ;)- 5-6 67 ❑ No one available for inspection: Time ' i 0 AM/PM Re -Inspection required: Yes No,' When corrections have been made, call for re -inspection at 303-234- Date:- 10h 17 Inspector: M DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Roofing PERMIT - 201702565 PERMIT NO: 201702565 ISSUED: 06/26/2017 JOB ADDRESS: 4360 Upham ST EXPIRES: 06/26/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Timberline 30 year asphalt shingles with 35 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 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. u� Signature of OWNER or CONTRACTOR (Circle one) bate I. This permit was issued based on the information provided in the permit application and accompanying )Tans 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 uil received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Bding Official and may be subject to a fee equal to one-half of the original permrt 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 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 an 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 ap!�;` of, an violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work icpt t�o�.fie�ld ins on. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11t59PM 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. 4 City of Wheat Ridge Residential Roofing PERMIT - 201702565 PERMIT NO: 201702565 ISSUED: 06/26/2017 JOB ADDRESS: 4360 Upham ST EXPIRES: 06/26/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Timberline 30 year asphalt shingles with 35 sq. *** CONTACTS *** OWNER (303)424-3239 CARVER AMY MARIE SUB (303)646-3977 Mike Essary 090139 Shield Const. & Exteriors *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 11,250.00 FEES Total Valuation 0.00 Use Tax 236.25 Permit Fee 236.00 ** TOTAL ** 472.25 *** 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 A/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. Dan Schultz t� d S^ From: no-reply@ci.wheatridge.co.us Sent: Wednesday, June 14, 2017 3:12 PM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Danny 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. 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 4360 UPHAM ST RICHARD CARVER 3034243239 Property Owner Email Field not completed. t Ln Address Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. CONTRACTOR INFORMATION Contractor Name Contractor's License Number (for the City of Wheat Ridge) Contractor Phone Number Shield Construction 090139 3036463977 Contractor Email Address rarnold(cDshieldconstruction.net (permit pick-up instructions will be sent to this email) Retype Contractor Email Address DESCRIPTION OF WORK Are you re -decking the roof? Description of Roofing Material rarnold(o)shieldconstruction.net No GAF TIMBERLINE 30 YEAR Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 35 material selected above? Does any portion of the property include a flat roof? If yes, how many squares on the flat roof? No'/ Field not completed. z TOTAL SQUARES of all 35 roofing material for this prod ect Provide additional detail HOUSE here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract 11250 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 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 Rick Arnold Email not displaying correctly? View it in your browser. SHIELD L.ON5TRUCTION & REL a ORATION "' 2795 South Shoshone Street • Suite A • Englewood, Colorado 80111 DATE: 5/ZL/ 7 Phone: 303.646.3977 • Fax: 303.646.0571 Customer 9 l LH- n Cft12-� CitylNi-1-P—..; Stated Zip Mortgage Company Insurance Company, �`1 l%�� v.) / J2 Street Address �3�.0 L,rfH1jjv 5 i — Home Phone (32 -3, -)— Work Phone ( ) — Claim # Ze-)y i, F — Description of Services: Siding Roofing ❑ Existing- )f'Tear Off 4e4 ❑ Install ,.Roof Pitch VA -5 # Stories _ -QJ � �z2�' �� Ll Style 5"heathing _ It 0151b ❑ 301b ❑ Foam Board _ Brand of Shingle 6A f1iM &eA1t ❑ Wrap Window -Color of Shingle ❑ Chimney ❑ Vinyl ❑ Aluminum ❑ Steel ❑ Other Wrap Fascia-- Soffits ascia— Soffits A Ridge Type 11nJ J�-& (,O all . W4 fh ❑ Height Allowance Blocks Gutters ;YMetal Edge CJ Use Existing ;`Replace w/ IP Existing_ /alleys tvA1W Vents Pg/4❑ Install _ rubor Warranty Yrs. ti.Special Instructions y) �- r .II work to be completed for the RCV (replacement cost value) Insurance proceeds unless otherwise specified below. lean up includes picking up nails with magnet and hauling away all debris from work performed.` ' I --- L // Total Contract Price$ )tj 9r ` 5 �' ✓ `7 — Payable as follows: lt> 5 c.',`~l ''S`'`Q-'4`vt �� c`L`'� `'} I agree and promise to pay Shield Construction & Resortation upon completion of work. e, r� +- Shield Construction & Resortation will furnish materials and labor in accordance with above specifications, for the amount of �t dollars ($ __ ) 1. All contracts subject to the approval of management of Shield Construction & Restoration. 2. Customer further agrees that the equity in the subject property is security for this contract. 3. Replacement of deteriorated decking, fascia boards, roof jacks, flashing ventilations, gutters or material are not included and will be charged as an extra on a time and material basis. Unless otherwise stated in this contract, Shield Construction & Restoration is not responsible for damage to hidden Freon, alarm, telephone or electric lines. 4. This contract constitutes the entire understanding of the parties, and no other understanding, collateral or otherwise, shall be binding unless in writing and signed by both parties. 5. Any and all material left over is the property of Shield Construction & Restoration. 6. Customer hereby acknowledges that Shield Construction & Restoration may be subject to delays occasioned by weather, labor disputes and material supply shortages which are beyond the control of Shield Construction & Restoration and Customer hereby acknowledges that all such delays do not constitute abandonment and are not included in calculating time frames for payment and performance. 7. Payment is due upon completion. Any portion remaining unpaid will bear the interest of the rate of 18% per annum commencing 30 days after completion. Customer agrees to pay all collection fees and/or attorney fees needed in pursuit of collecting any remaining unpaid portion. All payments and checks shall be made payable to Shield Construction & Restoration. 8. All warranties are void if payment is not made hereunder when due. Labor and materials warranty is nontransferable. 9. Labor warranty does not cover damage caused by strong winds, lightning, hail or other acts of God. 10. Shield Construction & Restoration shall hold in trust any payment received from Customer until Shield Construction & Restoration has delivered roofing materials at the site or has performed a majority of the roofing work on your property. Terms: This contract does not obligate the homeowner or Shield Construction & Restoration in anyway unless it is approved by the insurance company and accepted by Shield Construction & Restoration. When price is agreeable and is determined, it shall become the final contract price of $ and the homeowner authorizes Shield Construction & Restoration to obtain labor and m �'arials in accordance with the price agreement and the specifications set out herein to accomplish the above replacement or repair. Owner Signature: f !' U Date of Acceptance: Owner Signature: Date of Acceptance: Xl Subject to insurance company approval: Initial /T Date( 1: J / By Shield Construction & Restoration Signature: �— r— Date: i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (30311237-8929 Fax INSPECTION NOTICE Inspection Type: 1A f I� Job Address: 3�Q 4-4M Permit Number: Zs) i � QZ: 565 ❑ No one available for inspection: Time 1320 AM/62 Re -Inspection required: Yes 00 When corrections have been made, call for re -inspection at 303-234- Date:- 6/20// 7 Inspector: GAP DO NOT REMOVE THIS NOTICE z FOR OFFICE USE ONLY City of' Clete. „ rWh6atf4.jdge Building & Inspection Services Division 7500 W. 29" Ave., Wheat Midge, CO 80033 Plan ReviewFee: Office: 303-235-2355 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Building Permit Application Address: City, State, E i Complete all information on IOTA sides of this farm gr!ofloh of �� (Check all that apply) NEW COMMERCIAL STRUCTURE KCELECTRICAL SERVICE UPGRADE NEW RESIDENTIAL STRUCTURE COMMERCIAL ROOFING COMMER IAL ADDITION 0 RESIDENTIAL ROOFING RESDENTIAL ADDITION 0 WINDOWREPLACEMENT COMMERCIAL *STRUCTURE (Garage, shed, deck, etc.) RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) MECHANICAL ♦ra►s REPAIR REPLACEMENT PLUMBING SYSTEM/APPLIANCE REPAIR El ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT [I OTHER • 41 1-)1611elf )1950 lz' Bq.. FULF Btu's Gallons Amps Squares Other FOR OFFICE USE ONLY Mailing Address;: (if different than property address Address: NEW COMMERCIAL STRUCTURE ELECTRICAL SERVICE UPGRADE NEW RESIDENTIAL STRUCTURE « . ROOFING COMMERCIAL ADDITION RESIDENTIAL ROOFING RESDENTIAL ADDITION WINDOW REPLACEMENT COMMERCIAL « STRUCTURE mow. shed, deck, 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 #THER •. Sq. FtJLF Stu's Gallons Amps Squares Other INSPECTION RECORD Occupancy /Type 'ZINSPECTiON LINE: (3 03) 234 -5933 Inspections will not be made unless pis card is posted on the building site Call by 3:00 PM to receive inspect;,:)n the following business day. P . 1 �� INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB '< FOUNDATION INSPECTIONS DATE :. INSPECTOR NITIALS I COMMENTS: Footings /Caissons: Stemwall / (CEG) Concrete Encased Ground -. Reinforcing or Monolithic Drywall Screw Weatherproof /. French Drain Sewer Service Lines FINALS Water: Service. Lines '.Electrical ROUGHS Sheathing Framing' Lath / -Wall he Insulation Electrical Service Drywall Screw Rough Electric Rough.Plumbing FINALS Gas Piping '.Electrical Rough Mechanical '.. OF A CERTIFICATE OF OCC UPII N 1 1 05' PERMISSION FOR OCCUPANCY. OCCUPANCY NOT PERMITTED Ur - "Te. � 'iTIFICATE OF OCCUPANCY IS ISSUED TMU.1tla -:1Hh 'JM THE WEATHER ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING Framing' Insulation Drywall Screw FINALS '.Electrical Plumbing ! Mechanical ? Roof H o � + Building Final Fire Department R.O W &'Drainage PIOS FOR PLANNINGHo ZONING, FIRE AND PUBLIC WORKS SHOULD 8 CALLED ATLEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. Parking &.Landscaping ' * NOTE: . ALL ITEMS MUST BE COMPLETED AND APPROVE- ' VING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A CERTIFICATE OF OCCUPANCY IS ISSUED ;FINAL INSPECT. ' -' BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZAT ION OF A CERTIFICATE OF OCC UPII N 1 1 05' PERMISSION FOR OCCUPANCY. OCCUPANCY NOT PERMITTED Ur - "Te. � 'iTIFICATE OF OCCUPANCY IS ISSUED TMU.1tla -:1Hh 'JM THE WEATHER ♦ i CITY OF WHEAT RIDGE f Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type: — Job Address: ST" Permit Number: 149oa1 %I l ❑ No one available for inspection: Time f Lld Ml M Re- Inspection required: Yes "When corrections have been made, call for re-inspection at 303 -234 -5933 Date: XV 11. 2 Ile? Inspector m 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: WIPE!' Job Address: V360 UP,#A �7 Permit Number: lk� S> y ❑ No one available for inspection: Time tL f AM%PM Re- Inspection required:s A0 * When corrections have been made, call for re- inspection at 303 -234 -5933 Date: y /3 /n 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: rra»Glt= Job Address: Permit Number: ❑ No one available for inspection: Time _Ld 3n tAM Re- Inspection required: Yes No When corrections have been made, call fo re- Inspection at 303-234,5933 Date: < 8 7o Inspector: 4 7" 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 N TICE Inspection Type: Job Address: X1;1,,1,yu -SZ Permit Number: /J J1 `f ❑ No one available for inspection: Time AM/PM Re-inspection required: ei) No "When corrections have been made, call for re-inspection at 303-234-5933 Date: Sr Inspector: ~J%~ DO NOT REMOVE THIS NOTICE " ' City of Wheat Ridge Residential Roofing PERMIT - 100814 PERMIT NO: 100814 :ISSUED: 04/01/2010 JOB ADDRESS: 4360 UPHAM ST EXPIRES: 09/28/2010 DESCRIPTION:: Reroof t30 sqs with 30 yr 'GAF/ELK CONTACTS owner 303/424-3239 Richard Carver sub 303/697-85SO George Gibson 09-0088 Frontier Restoration PARCEL :INFO ZONE -CODE: UA .:USE: 'UA SUBDIVISION:` 0350 BLOCK/LOT#: 0/ FEE SUMMARY ESTIMATED PROJECT VALUATION: 9,800.00 FEES Permit Fee 235.70 Total Valuation .00 f Use 'Tax 176.40~ID>x~,`- * * TOTAL * * 412.10 Conditions: 6 nail installation mid-roof inspection required'. Board sheathing spaced more thanes 1/2 of an inch apartrequires plywood overlay on entire roof. Ice and water shield: required from..eave edge to 2' inside exterior walls. ***Contractor or Property owner shall provide ladder(s) secured in place for inpsections. It is the responsibility of the person/firm requesting the inspection to insure roofs are clear for inspection. Scheduled inspections that cannot). be performed due to inclement weather must be cancelled prior to 8:30 a.m. on the day of inspection or a re-inspection fee of $61.0.0 will be assessed. I hereby certify that the setback 'stances proposed by this permit application are accurate, and do not violate applicable ordinances, rules o elatio he City of Wheat Ridge or covenants, easements or restrictions` of record; that all measurements s and ade are accurate; th at I have read and agree to abide by all conditions printed on this application a dthat I asponsibility for compliance with the WheatRidge Building Code (I.B.C) andall otherapplicable w atRi r work r this permit an= ec a to field inspection 0540 Signature of contr to /ov r ''date ya~a City of Wheaty,jdge COMMUN ITy DEVELOPMENT Building & Inspection Services Division 7500 W. 29t" Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Building Permit Application Property Owner (please print)`.. Mailing Address: (if different than property address) Address: Date: Plan Permit# City, State, Zip: Corifractor: ~0,~ 10 O fly Contractors City License M Phone: lO 77~--~ Suti~ohtracta_rs Electrical: Plumbing: Mechanical: City License # City License # City License # Desertptton o#workz e~~~ Contract Value: C-j Review Fee (due at time of submittal): Squares BTU's Gallons Amps Sq Ft. $ 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. CIRCLE ONE.- (OWNER) ( NTR,A/C~TO/)nor ~/HOR/ZED REPRESE o OWNER) (CONTRACTOR)/ PRINT NAME:/I{' eC{/'~O/(gIGNATORE:` DATE: i FIRE DEPAR7rrlENT 'L72pp7oveC w/ comrnents~ ❑ dtSpRraYed~ T7o reOleYJ'Cg13RRd Bldg Valuation: $ 7500 WES72gth AVENUE DEPARTMENT OF COMMUNITY DEVEIAPMENT 237-6944 Ex7. 255 P.O. Box 63e BUILDING INSPECTION DIVISION PERMIT N0. THIS PERMIT VALIO ONLY WHEN SIGNED BY THE CHIEF BUILDIONG INSPECTOR ADND RECEOIPTOED JOB BEL'JW, M92~~1$Q13 PRLIChTIpPd FOR MISCELLANEOU PERMIT ADDRESS ~ - OWNER h4~'rI f-I4a ,'c: 0 CONTRACTOR , t "'7~ , a't P j" ADDRESS7 ADDRESS CITYG~flL 1'lvjpr- PHONE ` ~3~ ZIPCODE ZIP CODE ~7.1dY SONTRi1CT PR ~L7-~ J~ 14 PHONE ' ICE $ LICENSE NO C" 7 1. Ground ❑ Wall❑ ProisUinO❑ OtASr SorDFate SON Yea❑ No❑ T Totoi Squore Faee YDS Eleef. Psrmit No. FROM PROPERTY LINE N_,_, 5__ E Zone__ ApprwaE, Zom ins whioA ie frwtl n f"l I'1 r-~ W~for 1. TYPE SolidO MoreTAOn80% FENCES ? MATERIAL 3. SET BACH FROM PROPERTY LINE N_ S (Spsei}y whioh is }rOnf) ❑ n I. OTHER 2 3. DRAW SKETCH pR SHOW BELOW,THE FENCE, SIGN, OR OTHER STRUCTUR (SETBACKS OR PFtOJECTIONS INCIUDED) LOSi Thon 80% W Zone__ APDrwed,ZOM InspeNw El DiSapprovad INSPECTION TICKET c JOB ~ ADDRESS ~ 2, Cv CL-" DATE: q -a9 p`Pa BLDO. PERMITX PERMITM BLDG. CONTR. C `I SUBCONTRACTOR STREET NAME DATE INSP. REQ. I~ SHOW DISTANCES FROM THE MAIN BUILDING TPA WOINING HOUSES, STREE' DISTANCE TO PROPERTY LINES, NOT MAXIMUM OR AVERAGE DIST4NCE TYPE OF INSP. APPLICATION FOR PLUMBING, ELECTI INSPECTioN THIS APPLICATION WILL BECOME A PERMIT TO PERFORM THE INDICATED N 0 P[F!Mil' y'~/i_L EXP;RE 1iL DAYS FROA4 pATE OF ISSUANCE REMARKS(~ ;ELECTRICAL PERMIT PLUMBING F STATE CENSE N0STATE LICENSE N0:LJFR1AIUw:R;: t)pfutpl ^aIZF 8 i1.LEGAL FLOOR BSM I$ ro. - WASH DISF ~ (L' W.R. FORM 619 DN. e Sola vocrt aun- t,ntcUilS WATERHEATER - - - TIUTY(RANGE,DISPOSER,ETC.) AUTO. WASHER Rairi ront Group FIXTURES DISH WASHER ~~0f ~ WIRING MOTORS 9 CONTRpLS FLpOR DRAIN AUTOMATIC SPRINKLER SYSTEM SIGNS ELEVATOR URINAL TRANSFORMERS 9 RECTFIERS SEWERS ADDIT~ON TO OLD WORK OTHER MOTORS OVER 1 MP TOTAL FIXTURES