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FOXM IKI 41402-1123 pUBLIC SERVICE COMPANY OF COLORADO 04
AOOPESS ~J J Ciiv - LOWN ON([OUNTCIN~V 1/'~
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AFT. NO.
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CUSTOMEF NRME IPflINTI / I
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OWNER
TENANTE]
AGENT ~
$GELIfY
OTHER ~
- HAZARD -
CONOITION TO BE COflRECTEO AS SHOWN BELOW CREATES AN IMMEOIATE HAZAAO. THIS EOUIPMENT MUSi NOT BE PUT BACK IN
SEHVICE UNTIL FEPAIqS ANO A THOHOUGH INSPECTION HAVE BEEN MAOE BY A QUAlIF1ED CONTRACTOH. CONTACT YOUH LOCAL
BUILDING OEPAflTMENT FOfl COOE ANO PENMIT HEUUIflEMENTS PHIOP TO PEAFOHMING NEPAIP WOflK.
NAME FND TVFE OF AGPIIANCE
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'CONDITION O BE COj~flEQEO:
FOR FURTHER INFORMATION, PHONE: I
iAGGE~ BV _ ^
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7
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OAiE
2,3.
1
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TIME
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EL TIONSMIP Of OCCU NT YO~[IISTOMEfl
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DEPARTMENT OF COMMUNITY DEVELAPMENT
7500 WEST 29tn AvENUE BUILDING INSPEC710N DIVISION PERMIT N0. ME91I14730
237-8944 ExT. 255 P.O. BOX 638 CITY OF WHEAT RIDGE, COLO.
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND RELEIPTED BELOW.
JOB ADDRESS
CONTRACTOR
ADDRESS
CITY4,
PHONE
1. TYPE GrounC
2. MATERIAL_
ZIP CODE -
LICENSE NO.
SIGNS 13. II.WMINATION Yea❑ No❑ Typa_
4. SET BACK FROM PROPERTY LINE N_
(Soeeifv whioh is fronl) ❑
FENCES
1. TYPE
4. MATERIAL
OWNER
PHONE ZZ, ~ 4
OONTRACT PRICE $
Woll❑ ProieCfinp❑
Mon Than 80% OOenU Loss Thon BO'
3. SET BACK FROM PROPERTY LINE N_ S_ E_ W-
(SDeci}y whieh ie trOnt) ❑ ❑ ❑ ❑
OTHER 12
ZIP CODE
Otnsr 5 or D Foo*
Totol Squere Faae
Eleet. Psrmif No.
Zone_ ApprwM, 2au Inspeata
n:.wnw..A
INSPECTION TICKET
JOe 2-7
ADDRESS 363( .S6'1dd4
DATE: w "CO BLDG. PERMITN
DRAW SKETCH OR SHOW BELOW,THE FENCE,SIGN,OR OTHER STRUCTURE,GIVIhn DI!
(SETBACKS OR PROJECTIONS INClUDEO)
PERMITA
BLDG. CONTR. ~~D
SUBCONTRACTOR
15U
DATE INSP. REQ.
TYPE OF INSP.
INSPECTION MADE 9-6i /
STREET NAME
SHOW OISTANCES FROM THE MAIN BUILDING TOADJOININ6 HOUSES, STREETS, AND PI
DISTANCE TO PROPERTY LINES, NOT MAXIMUM OR AVERAGE DISTANCE.
APPLICATION FOR PLUMBING; EIECTRICAL; M
THIS APPLICATION WILL BECOME A PERMIT TO PERFORM THEINDICATED WORN ONL`
PERMIT WILI EXPIRE 60 DAYS FROM DATE OF ISSUANCE !F WORK
REMARKS `~I/l~ YZI- J333
gc-L c-s` Z l2c-w.Y~ m c- ~cv. -5
W.R.FORM 619
ELECTRICAL PERMIT
STATE LICENSE N0.
ALUMINUM WIRE UNDERSRE B ILLEGAL
PLUMBING PERMIT
STATE LICENSE N0.
FLOOR BSM IST 2ND 3RD 4TM NQ FUE4CirdoOnsi IPropar E Solm
Np,
WATER CIASET
FORCED AIR - BTU
TEMPORARY METER
WASH BOWL
HOT WATER - BTU
NEW SERVICE AMPS
BATH TUB
STEAM - BTU
CHANGE SERVICE-AMPS
SHOWER
AI1' ' 'U
LIGHTINfi
SINK
OTHEn
HEATING
GARBAGE DISP
REFRIGERATIVN aYS'rM
POWER SUB-CIRCUITS
UTiLITY(RANGE,DISPOSER,ETC.)
FIXTURES
WATER HEATER
AUTO. WASHER
DISH WASHER
Refri eront Gra
Pounds CMr e
AUTOMATIC SPRINKLER SYSTEM
WIRING MOTORS 8 CONTROLS
FLOOR DRAIN
ELEVATOR
SIGN$
URINAL
TRANSFORMERS fi RECTFIERS
SEWERS
ADDITION TO OLD WORK
OTHER
MOTORS OVER I HP
TOTAL FI%TURES
REMARKS .OD/`J A-
PERMIT FEE
CRU
e tnat tnis applica-
k
l
d
b
now
s
a
y ac
I nsre
tion u eonect and understand tnat i
li-
USE TAX
tonnot ttarf this prOlect until this opp
eation is apOroved. I shall comply with
TOTAL FEE
$'j
1M lowf of Ihe Stote ot Colorodo and to
the 2oninp Requlations and BuildinQ
ApPROVED
Z f
A
Rid
DI$APPR6HED
ny
Qe.
Code of tAe City ot Wheat
violation ot the above terme will cauee
CHIEF BUILDI
.
NSPECTOR,Cify o Wheot Ridqe
immadiate revocation of inis permit.
i
1 l.IAU 4
Date IssuPd
VALID UNLESS RECEIPTE
7 ~-3-~~ 21
CALL 237-6944 EXT. 255
24 HOURS IN ADVANCE
FORINSPECTIONS
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