HomeMy WebLinkAbout4685 Teller StreetFrom: no-reolv(alci.wheatridae.m. us
To: CommDev Pets
Subject: Online Form Submittal: Sewer or Water Line Repair Permit Application
Date: Tuesday, April 13, 20218:26:19 AM
Sewer or Water Line Repair Permit Application
This application is exclusively for SEWER OR WATER LINE REPAIR - IN YARD
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.
Right of Way permits must be applied for with the Public Works Department.
Is this application for Yes
sewer line or water line
repair - in yard only?
PROPERTY INFORMATION
Is this Residential or
Residential
Commercial?
Property Address
4685 Teller St Wheat Ridge
Property Owner Name
Tim Kram
Property Owner Phone
720-633-5725
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
nia
Address
Attach City of Wheat
WRP 4-9-2021 Ddt
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business
The Elite Pipe MD
Name
Contractor's License 120161
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
720-662-4381
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
david@elitepipemd.com
Address
Retype Contractor
david@elitepipemd.com
Email Address
DESCRIPTION OF WORK
Is this a sewer line or
sewer Line
water line repair?
Length of repair
60
Location of repair
Front yard
(backyard, frontyard,
etc)
Provide additional
Install dual sweep clean outs 5'-9' deep Customer is out of
details Including
service/draining very slow.
installation of clean-
o uts.
Project Value (contract
4200
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
has been issued and
posted on the property.
I certify that I have Yes
been 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 David salvidrez
Permit
Email not displaying correctly? View it in your browser.
1* � � i City of Wheat Ridge
�� E -Res. Sewer/Waterline Repair PERMIT - 202100674
PERMIT NO: 202100674 ISSUED: 04/13/2021
JOB ADDRESS: 4685 Teller St EXPIRES: 04/13/2022
JOB DESCRIPTION: Install dual sweep clean outs 5'-9' deep. 60 total feet, front yard
*** CONTACTS ***
OWNER (720) 633-5725 KRAM TIM
SUB (303)519-0240 R. ANDREW RUSSELL
120161 THE ELITE
PIPE MD
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned
USE:
UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#:
0 /
*** FEE SUMMARY ***
ESTIMATED PROJECT VALUATION:
41200.00
FEES
Total Valuation
0.00
Use Tax
88.20
Permit Fee
125.05
** TOTAL **
213.25
*** COMMENTS ***
*** CONDITIONS ***
ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive
written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection
by any Sanitation District representative. Inspection and approval of work by any
Sanitation District representative DOES NOT grant authority to cover work without the
approval of the Building Division.
**For trenchless sewer replacements - The contractor will verify proper slope of new sewer
piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed
specifically by the applicable code. The plumbing contractor will provide verification of
proper slope and drainage in writing as a condition of approval of the permitted work.**
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.
1* � 4 41'
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION:
City of Wheat Ridge
E -Res. Sewer/Waterline Repair PERMIT - 202100674
202100674
ISSUED: 04/13/2021
4685 Teller St EXPIRES: 04/13/2022
Install dual sweep clean outs 5'-9' deep. 60 total feet, front yard
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�permrt. I further attest that I am leg ally authorized to include al entities 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.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.
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 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 requ�ired
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, anviolation of any provision of any
�pplicabje code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
04/13/2021
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
FOR OFFICE USE ONLY
City of pate: ,
COMMUNITY DEVEL0PM]CN7'-jg P1Sn*wM1t#
Building & Inspection Services Division
7 500 W. 29th Ave,; Wheat Midge, CO 80033 Ptah Review
Office. 303-235-2855" : 303-237-8929
Inspection Line; 303-234.5933
Building r it Application
Please complete all highlighted areas, on both sides of this form. Incompteia aWications trus t not be procsssedd
Address: .�
Property neer (please print): sPhone: 0 - ' ?
Property nerEmail:
Mailing Address: (if different than property address
Address.
City, State, Zip:
ite Engin 'E-mail.- Phone*
Contractor:
C -
Contractors City License M l "h+r l e. � 7
ContractorE-mailAddress:
Sub Contractors:
Electrical. Plumbing: Mechanical:
W.R. City License # W.R. City License # W,k City License
Other City Licensed Sub: tither City Licensed Sub.
City License# City License
Complete all information on BOTHsides of this far
w" d r;. fir. w w: ®*, ,. ..• U:.
A A A P11 it A YR • A 1M � N". '► A
# � d..tlM • A '. r YIM d Y � • MF A
mount of materials to be used, etc.}
q. FULF Stu' � ' , f a ., Gallon
Amps Squares Other
`t1,Q b5 aQ,3r ` rcyy"u I W1" I t-)--
INSPECTION RECORD
INSPECTION REQUEST LINE: (303) 234-5933
Occupancy Tvpc
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
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
rin Nnt Pnur rnncrata Prior To Annroval Of The Above Inspections
Underground/Slab Inspections Date
Inspector
Initials
Comments
Electrical
Wall Sheathing
Sewer Service
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.
Mid -Roof
Plumbing
Fire Inspection / Fire Protection Dist.
nn Nnt rnvar l Inrlarnrniinrl or Relnw/ln-Slah Work Prior To Annroval UT I lie ADOve Inspections
Rough Inspections
Date
Inspector
Initials
Comments
Wall Sheathing
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.
Mid -Roof
Fire Inspection / Fire Protection Dist.
Lath / Wall Tie
Final Electrical
Rough Electric'
Final Plumbing
Rough Plumbing/Gas Line
Final Mechanical
Rough Mechanical
Roof
Rough Framing
Final Window/Doors
Insulation
Final Building��--
/
Drywall Screw / Nail
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.
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.
Fire Inspection / Fire Protection Dist.
Final Electrical
Final Plumbing
Final Mechanical
Roof
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 - Nlease oe sure tnat rougn inspections are corrlpieteu born 0 I rI[C viauIL, l 011U cici,u vvv vvnayc
by the Building Division.
"For Inspection Time Window Requests - Please email insptimereguestCc�ci.wheatridge.co.us by 8:00 A.M. the day of the
inspection with the property address in the subject line of the email.
Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued
Protect This Card From The Weather
i CITY OF WHEAT RIDGE
��9rBuilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office - (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: A P I
Job Address: _ L4 t, � 5 —(.e I It f, ST
Permit Number: a-- 0/ L 0
12 roe u
❑ No one available for inspection: Time A /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
7
Ub Qtier 7tt 011U (V u l (— 1
l• _ INSPECTIOW RECORD
C. bu WIf I INSPECTION REQUEST LINE: (303) 234-5933
Occupancy/Type
Electrical
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
Mid -Roof
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Lath / Wall Tie
n., KIM Pniir (`nnrrrato Prinr Tn Annrnval Ot I hP AhOve InSDection5
Underground/Slab Inspections Date Inspector
Initials
Comments
Electrical
Comments
Sewer Service
Plumbing
nr. AIS,+ r`wnr 1 Inrinrrnrni anA nr Rclnuu/In_Slah Wnrk Prinr In Annrnval UT 1 ne Aoove In5pectivri5
Rough Inspections
Date
Inspector
Initials
Comments
Wall Sheathing
Mid -Roof
Lath / Wall Tie
Rough Electric '
Rough Plumbing/Gas Line
Rough Mechanical
Rough Framing
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.
Fire Inspection / Fire Protection Dist.
Final Electrical
Final Plumbing
Final Mechanical
Roof
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 rougn inspections are compietea Tram me ruts uiau gut d, 1u v u -3 UVV vunayo
by the Building Division.
"For Inspection Time Window Requests - Please email insptimerequest(a-�ci.wheatridge.co.us by 8:00 A.M. the day of the
inspection with the property address in the subject line of the email.
Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued
Protect This Card From The Weather
A i CITY OF WHEAT RIDGE
��9rBuilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: E r I
Job Address: �� 6 B S' TE L_ c f ,z
Permit Number: 2o! o / `7 57
�le /r1 of go a
❑ No one available for inspection: Time L1 AM/PM
Re -Inspection required: Ye!CNo
*When corrections have been made, call for re -inspection at 303-234-5933
!/-ffi-/l:
p, t /
Date: / . 5-6 Inspector: ,; t
DO NOT REMOVE THIS NOTICE
FOR OFFICE USE ONLY
ut
ate.
VCity of Ct
] Wh6atRjgie
r��C(OrMAMOUNtTy DEvELot,M'ENT plan1permit #
Building 8r#n Inspection Services Division " �0 1
7500 W. 29 Ave., Wheat Ridge, CO 80033 Marr Review
Office: 303-235-2555 * Fax; 303-237-5929
Inspection Line. 393-234-5933
Email:errnits ci.wheatrici e.c o.
Building er `it Application
Please complete alf highlighted ' on both sides of this form. Incomplete plete 3t t ons may not be processed.
------
Property Owner % rr"rat:
Mailing Address:; (if different than property address)
Address-
City,
ddress,Cit , Mete, Zip:
MkoEngimc
Architectt igine r E- rm i k Phone.
Contractors City License .. Phone.- -3C -
Contract -mail Ad+dto ss.
StabContractors:
Electrical: Plumbing: Mechanical:
W,R. City License # WR City License # W.R. City License #
Other City Licensed Sub. Other City Licensed Sub:
City License # City License #
Complete all information on BOTH sides of this far
• s . .IIi
.. x ysr ♦. a. m�,. # xr rx a
d a � n � � :» a � �� � �:: -. ®p r r 8 r a# �• to -s :� a .�
amount of materials to be used, +,. 4
. c.,
I '
Sq. FULF � ,. Stu's Gallons
Amps Squares Other
City of . I
h6at d
I I . # # M
s'*1 pental Iss 1 1. ne appro7wa. kLewl HIM or ft-
o`�
Wheat Ridge, Attn: Building Division, 7500 W. 29" Ave., Wheat Ridge, CO 80033.
Company NameName (to whom check should be made out to):
ci
Address:
City: 11 1 C--�b V -L VA — State:- ( c) — zip:-.�
Phone& Fax: -�-'Email: hotw9-cj
Permit #: Q0 k (.0 C� � 0-1 a Permit Address: �/-
Printed Name:-S�\Cg �ja- Signature:_ Date.-�I�
For office use only
This request has been: ApTarcrlred 0 Denied Refund Amount: $,-30
Approved Date:--�111?a M[r
wwwxi.wheatridge.co.us
View Pemit "1601072 i _ tion
Parcel- 39-231-06-W Address: 4685 Teller ST, wheat pidge, co33
vow . e, lea 153,00
LLMIJEEMERIMM
Shming i TO 3 Of 3 Recoras
0
1.1
In Update Mode
201601072 CDBO13455 07/22/16 PRM Permit Fee 150.76-
201601072 CDBO13455 07/22/16 USE Use Tax 153.00 -
TOTAL 303 . 76-
01-101 BPS PERMIT PAYMENTS 303,76- 0,00
01.-500-02-505 BPS PERMIT PAYMENTS 0.00 153,00
61--510-00-516 EFS PER141T PAYMENTS 0.00 1:50.75
TOTAL 303.76-. 303.76
City c
k. A
W- �atR�id...,,
hc-
DUVROPMENT
CCOM,
Property Owner Emall.,
Plan/Pormit U4
Building Permit Application
ArioNtectlEhol",eer E-rhail, Phone,
Phone,
Contttiotom City Lli:enst M .
Contractor E-mail AdS: d—reSWI-1111-NIII
Plumbing:
�V.J, �ijy, License
Other City Licensed S&
City License #
Complete all information on BqrHqides of thIIq form
0 COMMERCIAL RESIDENTIAL
NEW COMMERCIAL STRUCTURE ELECTRICAL SERVICE UPGRADE
NEW
OFING
COMMERCIAL
ROOFING
RESDENTIAL ADDITIONWINDOW
COMMERCIALOg shed, deck,
PLUMBINGRESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
MECHANICAL SYSTEMIAPPLIANCE REPAIR or REPLACEMENT
rr, a REPLACMENT
SYSTE,�-IPIAPPLIANCE
REPAIR REPLACEMENT
* . � ,� R. � ,.:.T ♦ • # w „. s... X a •... M < ' # • M N 14 • Y M k . � 11
•MND �#'i, '. • .:, N'at »!n
h
4
e
ns
tl« Squares
+t WN 1iPCON ii'aACTOR $16NATURE Of VNDER TANDING AND AGREE EN
# #acreby certify that the setback di t rteMcs proposed by this permit application are accurate anti do na t violate aPpli Ab# Ordi"Atlets, rules Or
regulations of the City of Wheat Ridge or covenants, uttsetracnts or restrictions of regard, that all ntunsurctrsent shaawtt and ll "tatatts made are
accurate, that # have read and :agree to abide by all conditions printed on this application and that E assume full responslbi#ity for Compliance
with applicable City ct#°wheat triage v-odcs and Ordinances for work under any permit isiucsd based on this asptps#i� atria*tt4 that l am the legal owner
or have been authorized by the legal owner of the property to perform the described word and not also authorized by the legal owner of any
cattily included oil ttais application to list that entity on this application, L the t pplicant for this building permit aappl ° €€rtt, waa•rastt the
truthfulness of the: inttlrtrtntiutt provided Ott the application,
tv"ia�t+�LEONN; � (OWNER)(CO . `, i:" `OR) —rr C, "islt�a d C" f' S 1YT Itf 1 of ftp f` d�} {t C►14t� � �j
(t`#rst artd East ataaste)w� ".. "",,,�.��.....,...�.�,��„��.��.....�
DATE;
Building Permit Application
(Completed hfighlighted areas)
V
S :j
J I
0 ("3 Y
OrO O (please print }: JQ � Q, L Phon-eiL
Mallf0i A40n�ie: (if different than property address)
Address:
5 C- Vf ,} Kec
contf*t�: �I Ai
MRXM��
r Squares
Maus=
Plan #
Permit#
i
NO=
BTU's Gallons Amps
. . , ..e. .?-DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : 3155
BUfL.DING INSPECTION DIVISION - 235-2855
CITY Of WHEAT RIDGE Date : 5/28/96
7500 WEST 29TH AVENUE
VIHEAT RIDGE, CO 80215
Property Owner
Property Address
Contractor License No.
Company
HAZEN WAYNE W
4685 TELLER ST
17152
Precise Plumbing
OWNERlCONTRACTOR SIGNATURE OF UNDERSTAND{NG AND AGREEMENT
1 heroby certlry thet.the aetback dbtancea proposed by this pertnit application are accurate,
and do not violato ap aabb nrdinencea, rulos or regulaGons oi Ne CRy of Wheat Ridge or
coveneMS, easeme~ oe reatrk.Gons W recoM; that all measuremants shown, and albgations
made ere accurate; that 1 have roed arW a to abfde by ell cornlitlons printed on this
appYCetlon, and th~ 1 asaume full rOSponsi ility Tor compliance wiM the Wheet RMge Building
Code (U.B.CJ and all otherapplicebb Wheat Ridge ordinances, torwork urMerthis pertnK.
(OWNER)(CONTRACTOR) SIGNED DATE
Description : REPLACE WATER HEATER
Phone : 420-1608
Phone: 534 0881
ConstrucHon Value :
$410.00
Pertnit Fes:
$15.00
Use Tax:
$0.00
Total:
$15.00
BUILDING DEPARTMENT USE ONLY
SIC : Sq. Ft. :
Approval :
Zoning :
Approval :
Approval:
Occupancy : Walls : Roof : Stories : Residentlal Units :
Eiectrical License No : Plumbing License No : Mechanical License No :
Company : Company : Company :
Expiration Date : Expiration Date : Expiretion Date :
Approval : Approval : Approval :
0 -r 0 m
c1l TTb Pem* wae iasued inaccordance wKh tlro PaAsiDns aet MM in yopw epplication entl la wea ro me iewa a me sreu a caoraao aod m aro zomrg
ttegulauons ww code a wheee R", caor.ao w arn on,er applieaWe adWIences a e ctty.
(2) ro aa~~ N1 ~e wak auMOraed k not wmmenced wNhm Wcly (80) dari hom ieaue tlate or (B) the Milld'mg aWhorizacf ie suapantled or
30 ~
(3) M Mls pemtlt axdres, e Mwp xmt may be acquind tor a tee ot ona-haM the amount nortnaly repuire4 provMed rw chanpea haye been w will be metle in the
aiyMN plans and epadfiutlon anC airy wsDamWn or abantlonment has nd exceeded orre (7) year. If chanpas are made a rf suepenaSOn a abantlaiment
axceeds afs (1) y~r, IWl fMa eh9N bs pald (or a,nwpetm1t.
(4> No work d erry manMr BMaB be tlorro Met wiN Uutpe iha natural llow Mweter ceusi a dreinapa proWarn.
(s) contruwr snaa rwmy me BuMhq Ina~ectorMronly-four (24) hou~s In advance tor atlnapeeuons arw anan race~va w~;nen approval on+napecuon cerd berore
riw' tl+ eu agealw~ pl~aaes oi the bb
(e) M a pem+it or tlie approvaof tlrawinps ard spedRcations shall irot ba conshuetl to be a pertnit tor, rror an approvai M, ury violatlon M Me provisiaa
eotlotlier wtlinance. law, ivh or repuletlon. hief Building Inspector
TH{3 PERMIT VALID ONLY 1NHEN SIGNED BY THE CHIEF BUIIDING INSPECTOR AND MAYOR
CALL: 2345933 24 HOURS PRIOR TO INSPECTION
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number :
BUILDING INSPECTION DIVISION - 235-2855
CIN OF WHEAT RIDGE Date :
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
PropertyOwner: /l2, S`~~'-~ l•c~ °
Property Address : y6 fPhone: L(,zO-
Contractor License No. : / y-'~-
Company : P c e l Z ~ Phone : g~ Fr /
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
1 hereby certAy that the eelbadc tlisUnces proposed Oy tNS pertnrt appuwtion are acwrete.
antl tlo not vlolate apphcable ommanxs. rules or reguianons of the CRy of Wheat Ridge or
mvenan[s. easemenb ror restnctions of recortl: that atl measurcments shown. ano allegauons
maCa are accunte: Nat I nave rcaa end agree to a0ae ey all eonartions pnnted on this
apphcauon. ana that I assume full msponsiodiry for compuance wnh the Wheat Ritlge Building
CoCe (U.B.C.) ana all oMer appueabk VJheat ommanxs, for work untler Mis partnrt.
7 -~7
(OWNER)(CONTR4C70R) SIGNED DATE
c
Descnption : /--F
Approval :
Zoning :
BHlLdfiio°CS6imsi~~H!
Approval :
Approval :
Occupancy:
ConsWctionValue:
171i0"-
Pertnit Fee :
Use Tax :
S-" 5
TOMdI:
BUILDING DEPARTMENT USE ONLY
Walis : Roof : Stories : Residential Units :
Electncat License No : Plumbing License No : Mechanical License No :
Company :
Expiration Date :
Approval:
~ rPlibis RS-qufred~
Company :
Expiration Date :
Approval:
2 - PlMhs Required yl
Company:
Expiration Date :
Approval :
(t) This permn was rssuaa m aaordance wnm me oronswns sei rorm m yoour aeoi"oon and ia suqsa m the iaws W tne Stap ot Cobraao ana to the Zoiurg
ReguWnons ana BuilCrtg Caae of NTeat RiCge 6o:onao or aM omer aePlKaCIe oromances of the Ciry.
(2) This pertnrt snan exwre d IAi tne wonc aumorizna is not commenaa w,mm sixry (60) daya mom issue aate u (e) the DwiCing auuanzeo is suspsrwsd a
aeanaonea ror a oenoa of +zo aayc.
(7) If this pertnrt eaoiroa. a new permtt may x acqwroa lor a Ise of one-naM the emount normalN MUVatl. prwitlatl rq cYmanpaa naw Dean a xnll De matls n Ms
onglml plans antl speafifeCOns an0 arry suspsnaan a aeanaonmMt nas not excaaoetl one (1) year. If Uyrpy ore maGS a d suapensqn w awn0onmint
eatcee05 one (1) yeer. NII IOeO stull De piq fpr a new permR.
(a) No wone or any manner snan oe aone mat vnll cnanqe me namni now or water wusing a aramaqe promem.
(5) Conmaor snan nouy me eunoing maocaor nvmry-fow (TS) nours in aavance for au inspecuons ana anau reonve wnnen appmvai on insoeaon aro Oetoro
proceeonng wim successrve onases of tne pb.
(6) The issuance Of a pe/mii or Ne aDDroval ol Grawinqs an0 sDeafiC20ons Snall not De mnslrue0 to De a permit for, npf an apgrovel ol. any vida0on of the qOwspns
. ol tne Dwleing coees or any omer ortlmana. law. rue or rcquuuort .
Chief Building Inspector
For Mayor
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION