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HomeMy WebLinkAbout3050 Webster StreetINSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection (�— INSPECTION REQUEST LINE: (303) 234-5933 Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Occupancy/Type Inspections will not be performed unless this card is posted on the project site. **Request an inspection before 11:59 p.m. (midnight) 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 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. Mid -Roof Fire Inspection / Fire Protection Dist. ie le Rough Electric Final Mechanical Rough Plumbing/Gas Line Roof Final Window/Doors Rough Mechanical Final Building • 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 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 The City of Wheat Ridge Third Party Form Check List Property Address jO &V k,4k,*J4v Permit Number Permit Issued Date Owner Information/ Property Owner Information ...�'{� (�//�, Property Owner Address r" ,� �` `(� a r- io Inspector Information Inspection Company Inspector Name Inspector Contact info. Inspector Statement and Acknowledgement " I hearby acknowledge the roof I am inspecting is 6/12 or over. All roofs that are under 6/12 must be inspected by the City of Wheat Ridge Buiding Dept. * I hearby acknowledge the roofing system for the referenced building has been inspected and found to be in complianc h the minimum requirements of the 2012 IRC and 2012 IBC as well as all City of Ridge Policies and Procedure and Manufacturer's recommendations 2;� Inspector: Date: f^(4-% *1 hearby acknowledgegbat I am the owner of the building referenced above and I give my consent for the listed third -party inspection company to perform my roof inspection Xin lieu of the City of Wheat Ri e Build' Q Division ins ection. Propery Owner/Agent: j U Date: Q 14" 1 `f This original document and permit card, as well as the roofing check list, must be submitted tc the Chief Building Official within seven days of the final inspection. Drop off in person Permit counter 2nd floor 7500 W. 29th Ave Wheat Ridge CO 80033 Draft Date: 7/26/17 Please add note to reverse side The City of Wheat Ridge Inspection Check List notes Mid -Roof Roof Inspection ❑ N/A Pass ❑ Fail ❑ N/A Pass ❑ Fail Structural roof components ❑ N/A Pass ❑ Fail Verify that no more than 2 layers of shingles exist ❑ N/A Pass ❑ Fail Flashing for roof and walls Pass ❑ Fail If new sheathing is installed verify that it is listed in the permit description (Valuation must be adjusted) ❑ N/A Pass ❑ Fail Verify sheathing nail pattern (See Policy & Procedures) ❑ N/A ❑ Pass ❑ Fail Crickets and saddles where needed ❑ N/A Pass ❑ Fail Verify B vent must have boot same gauge as pipe ❑ N/A Pass ❑ Fail Verify vent caps ❑ N/A Pass ❑ Fail Verify no flashings are damaged or rusted ❑ N/A Pass ❑ Fail Step flashing shall be min. of 44 piece per shingle ❑ N/A ❑ Pass ❑ Fail Verify scuppers allow for proper drainage ❑ N/A Pass ❑ Fail Ice and water shield Z in heated wall spaces ❑ N/A Pass ❑ Fail Underlayments must follow 2012 IRC / 2012 IBC ❑ N/A [4 Pass ❑ Fail Verify roof slope for proper drainage ❑ N/A N Pass ❑ Fail Dripedge shall have min of 2" overlap ❑ N/A Pass ❑ Fail Dripedge should extend down min 2" past roof deck ❑ N/A Pass ❑ Fail Dripedge shall be mechanically fastened 12" OC ❑ N/A ❑ Pass ❑ Fail 90 LB roll roofing shall not be applied to roof slopes less than 2:12 slope: Exception, detached garages, patios, carports, open on three sides with min. slope of 1:12 ❑ N/A ❑ Pass ❑ Fail Modified Bitumen, EPDM, TPO min slope 1/4:12 slope ❑ N/A ❑ Pass ❑ Fail Above roof insulation R-25 ❑ N/A ❑ Pass ❑ Fail Below roof residential R-38 ❑ N/A ❑ Pass ❑ Fail Below roof commercial R-32 ❑ N/A ❑ Pass ❑ Fail Modified Bitumen, EPDM, TPO min slope 1/4:12 slope must be installed in accordance with the manufacturers specifications- Must have manufactures letter of warranty with the address on the letter for final inspection Metal Roof Shingles Requirements ❑ N/A ❑ Pass ❑ Fail Metal roof shingles shall not be installed on slope less 3:12 ❑ N/A ❑ Pass ❑ Fail Metal valley flashing shall be the same material as roof ❑ N/A ❑ Pass ❑ Fail Metal valley flashing shall extend a min of 8" from the centerline with a min. of 3/4 " high splash diverter rib built-in at the flow line with sections overlapping a a min. of 4" Tile Roofs Requirements ❑ N/A ❑ Pass ❑ Fail Clay and concrete the shall have a min. 2-1/2:12 slope Slopes 4:12 and under require double underlayment Company Name: Inspector signature: Date of Inspection: The City of Wheat Ridge Inspection Check List notes Mid -Roof Notes q-lN- The City of Wheat Ridge .3070 k.V_hSA"'- Inspection Check List notes Final Roof Roof Inspection ❑ N/A ❑ Pass ❑ Fail ❑ N/A ❑ Pass ❑ Fail Structural roof components ❑ N/A Pass ❑ Fail Verify that no more than 2 layers of shingles exist ❑ N/A Pass ❑ Fail Flashing for roof and walls ❑ Pass ❑ Fail If new sheathing is installed verify that it is listed in the permit description (Valuation must be adjusted) ❑ N/A ❑ Pass ❑ Fail Verify sheathing nail pattern (See Policy & Procedures) ❑ N/A ❑ Pass ❑ Fail Crickets and saddles where needed ❑ N/A ❑ Pass ❑ Fail Verify B vent must have boot same gauge as pipe ❑ N/A Pass ❑ Fail Verify vent caps ❑ N/A Pass ❑ Fail Verify no flashings are damaged or rusted ❑ N/A Pass ❑ Fail Step flashing shall be min. of 4x4 piece per shingle ❑ N/A ❑ Pass ❑ Fail Verify scuppers allow for proper drainage ❑ N/A fX Pass ❑ Fail Ice and water shield 2' in heated wall spaces ❑ N/A IX Pass ❑ Fail Underlayments must follow 2012 IRC / 2012 IBC ❑ N/A Pass ❑ Fail Verify roof slope for proper drainage ❑ N/A Pass ❑ Fail Dripedge shall have min of 2" overlap ❑ N/A Pass ❑ Fail Dripedge should extend down min 2" past roof deck ❑ N/A Pass ❑ Fail Dripedge shall be mechanicaly fastened 12" OC ❑ N/A Pass ❑ Fail 90 LB roll roofing shall not be applied to roof slopes less than 2:12 slope; Exception: detached garages, patios, carports, open on three sides with min. slope of 1:12 ❑ N/A ❑ Pass ❑ Fail Modified Bitumen, EPDM, TPO min slope 1/4:12 slope ❑ N/A ❑ Pass ❑ Fail Above roof insulation R-25 ❑ N/A ❑ Pass ❑ Fail Below roof residential R-38 ❑ N/A ❑ Pass ❑ Fail Below roof commercial R-32 ❑ N/A ❑ Pass E] Fail Modified Bitumen, EPDM, TPO min slope 1/4:12 slope must be installed in accordance with the manufacturers specifications - Must have manufactures letter of warranty with the address on the letter for final inspection Metal Roof Shingles Requirements ❑ N/A ❑ Pass ❑ Fail Metal roof shingles shall not be installed on slope less 3:12 ❑ N/A ❑ Pass ❑ Fail Metal valley flashing shall be the same material as roof ❑ N/A ❑ Pass ❑ Fail Metal valley flashing shall extend a min of 8" from the centerline with a min. of 3/4 " high splash diverter rib built-in at the flow line with sections overlapping a a min. of 4" Tile Roofs Requirements ❑ N/A ❑ Pass ❑ Fail Clay and concrete tile shall have a min. 2-1/2:12 slope Slopes 4:12 and under require double underlayment The City of Wheat Ridge Inspection Check List notes Final Roof Notes Company Name: Com 9, 4,,'4 � Scw, ry Inspector signature: Date of Inspection: -tq'/ City of Wheat Ridge Residential Roofing PERMIT - 201705471 PERMIT NO: 201705471 ISSUED: 08/04/2017 JOB ADDRESS: 3050 Webster ST EXPIRES: 08/04/2018 JOB DESCRIPTION: REVISION: ADDED DECKING TO EXISTING PERMIT Residential Re -roof to install CertainTeed Landmark asphalt shingles with 22 sq. *** CONTACTS *** OWNER (303)875-5186 TENORIO RICK SUB (303)663-5615 Joel/Channa Speckman 080141 All In One Contractors *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 13,608.47 FEES;. Total Valuation 0.00 Use Tax 285.78 Permit Fee 267.70 ** TOTAL ** 553.48 *** 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) 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. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. 1 w City of Wheat Ridge Residential Roofing PERMIT - 201705471 PERMIT NO: 201705471 ISSUED: 08/04/2017 JOB ADDRESS: 3050 Webster ST EXPIRES: 08/04/2018 JOB DESCRIPTION: REVISION: ADDED DECKING TO EXISTING PERMIT Residential Re -roof to install CertainTeed Landmark asphalt shingles with 22 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 perfor n ►a ork to be performe is disclosed in this docu nt and/or its' accompanying approved plans and specifications. Signa ure of OWNER or CONTRACTOR (Circle one) Date I. 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 maybe 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 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 approval of, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Ap r vaI of work is subject to Held inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dan Schultz ,R,)1705-41 / From: no-reply@ci.wheat ridge.co.us Sent: Friday, July 28, 2017 1:30 PM To: CommDev Permits 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 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. 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 l/ 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 Property Owner Email Address 3050 Webster Street Rick Tenorio 303-875-5186 tenoriora@msn.com Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. Attach Copy of Contact Field not completed. CONTRACTOR INFORMATION Contractor Business All In One Name Contractor's License 080141 Number (for the City of Wheat Ridge) Contractor Phone 720-442-9009 Number Contractor Email Address verticalorders@gmail.com Retype Contractor Email verticalorders@gmail.com Address DESCRIPTION OF WORK Are you re -decking the No C� roof? Description of Roofing Certainteed Landmark Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 22 material selected above? Does any portion of the No property include a flat roof? If yes, how many squares Field not completed. on the flat roof? TOTAL SQUARES 22 ✓ (pitched + flat) of all 2 roofing material for this project Provide additional detail House 5/12 Pitch here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract 9778.47 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 Brandon Pask Email not displaying correctly? View it in your browser. 3 City of �W heat j j,dg,e MUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: perm its(a)-ci.wheatridge.co.us FOR OFFICE USE ONLY Date: yj Z�1r� Plan/Permit # -Zc)II�s�� l Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. **" Property Address: 30� 040e>r' 54reel- Property Owner (please print): gicK -retie ,'0 Phone: _30? V; 51B Property Owner Email: 4_G17Ori0Q &0 rnsh . Caln Mailing Address: (if different than property address) Address: Citv. State. Zi Architect/Engineer: Architect/Engineer E-mail: Contractor: Ail i n orne %patse,,rS' Contractors City License #: O90I'll Contractor E-mail Address: OrdeY C�'Iver co G �n��ir C6i✓I Sub Contractors: Electrical W.R.,City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Phone: Phone: 720 YW ! 9'9,oq Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form ❑ COMMERCIAL 9 RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITIONM RESIDENTIAL ROOFING F1RESDENTIAL ADDITION WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ 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 ❑ OTHER (Describe) (For ALL projects, please provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.) S�ex� wj 3/911 C 1)x Sq. Ft./LF 2/ lO q SF Btu's Amps Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ 19M, 75 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. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNE (CONTRACTOR) (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): DATE: ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Building Division Valuation: $ LAM, L 1386 Rating: A+ C ® i 7 t r C t O r v Customer Name: Rick Tenorio 3050 Webster St. Partnered Wilh City, State, Zip Wheat Ridge, CO 80033-8074 Email, Cell Phone: Additional Phone Tenoriora@msn.com 303-875-5186 Insurance Company: Claim t2: Agent Name: Allstate 0455900522 Joev Marlowe so, address of owner I How did you hear about us? ONE STORY ACCESS O Yes []No PITCH 5/12 P1 TEAR OFF and haul away 1 layers of existing shingles. © DECKING - Remove and replace decking, as needed, for $50 per sheet extra. ❑ RE -DECK - Remove and replace all decking UNDERLAYMENT - We will install Synthetic Underlayment SHINGLES - CertainTeed Landmark (Brand & Style) ❑ INSTALL (yr) 3 -Tab (color) INSTALL 50 (yr) Dimensional Resawn Shake (color) RIDGE - [:]3 -Tab Ridge ❑ Matching Hip & Ridge e High Profile Ridge ❑✓ FLASHING - We will replace flashing as needed. 0 VALLEYS & PENETRATIONS - Install ice & water shield. ✓❑ PIPES - Install & paint 1 1 1/2" 1 2" 1 3" _4" lead stacks METAL EDGE ❑ Keep or ✓® Replace all _ Brown (color). VENTILATION Install 1 Cardinal Solar Power Vents 20 Watt Black wind turbines 1 low profiles _ power vents _ LF Ridgevent Brandon Munda E] Detached Garage ❑ Shed ❑ Patio Covering ❑ Other ❑Install squares of ALUM SEAMLESS GUTTER -See Gutter Diagram & Notes ANY CURRENT LEAKS? [:]Yes 2JNo If so please explain below ANY INTERIOR DAMAGE?[] Yes ®No If so please explain below (Please provide photos of leaks & Interior damage) ANY AREAS EXCLUDED FROM WARRANTY? ❑ Yes MNo Please describe Mclean roof, gutters, and jobsite E25 Point Inspection ■❑ Collect Payment Q Haul off excess material 0 Sweep site with magnet 2 Year Workmanship R Other CertainTeed 5 Star SureStart Warranty ROOFING: Remove & Replace(R&R) entire roof, ridge cap, roof vents, exhaust caps, pipe jacks, drip edge, and skylights GUTTERS: R&R 243 linear feet of gutters/downspouts MISCELLANEOU UPGRADES: Synthetic underlayment, solar powered vent Ice & water, 5 star warranty UPGRADE AMT: 0.00 P1 WILL DO JOB FOR INSURANCE PROCEEDS OR a CASH CONTRACT AMOUNT $ Original RCV Amount $ 13,257.23 * 'This may not be final contract price and does not include upgrades or any supplements paid by insurance company. ✓ Does the first insurance check need to be signed by the mortgage company? DYES ❑ NO P1 Already Signed ✓ Homeowner has read and understands the "What to Expect" insert and all pages and terms of this contract? ®YES ®NO Material Placement: Driveway Special Instructions: No smoking, be respectful of residence's privacy Company's Surety and Liability Insurer Information Insurer: Gemini Insurance Company Address: 7233 East Butherus Drive City, State, Zip Code: Scottsdale, AZ 85260-240 Phone Number: (480) 951-0905 ACCEPTANCE OF TERMS tomer's sio ature below signifies acceptance of all terms and co ditions s hints greement ,�j e-- l/!/,NA 7/27/17 7/27/17 custoffr Signa ure Date Project Mahagrer Signature Date Page 1 All in One noted the following items that were not included in your insurer's repair estimate. Gutter guards, modified bitumen COMPLETINGWORK NOT INSURANCE DESCRIPTION OF WORK NOT COMPLETING ITEM #'S_ ACV NOT DEP NOT SECTION Contract start date: 7/27/17 "Estimated Job Completion Date" shall be on or before 180 days after the "Contract Start Date" Line 7 Line 8 3ALANC E T, 1. 1sT INSURANCE CHECK (ACV Less Deductible) 10,341.06 2. INITIAL RECOVERABLE DEPRECIATION 2,416.17 3. NON-RECOVERABLE DEPRECIATION - NOT COMPLETING 4. NON-RECOVERABLE DEPRECIATION -ARE COMPLETING 5. PROPERTY OWNER DEDUCTIBLE 500.00 6. UPGRADES /ADDITIONAL WORK 0.00 7. WORK NOT COMPLETING (ACV Value) ( ) 8. WORK NOT COMPLETING (Depreciation) ( ) 9. TOTAL OWED TO ALL IN ONE*** $ 13,257.23 1sT PAYMENT is due upon roof completion. Amount of 1st PAYMENT $ 10,841.06 $ 500.00 "Out of Pocket Expense" included in 1st PAYMENT FINAL PAYMENT is due upon receipt from insurance or 30 days after job completion, whichever is sooner. Amount of FINAL PAYMENT*** $ 2,416.17 ***I understand all applicable supplements and/or general contractor overhead & profit paid by insurance company will be owed in addition to this amount. Addition I payments sent by insurance for depreciation/s I m nts will also be due upon receipt. Customer Initia s RIGHT OF CANCELLATION PURSUANT TO FEDERAL REGULATION AND COL. REV. STAT. § 5.3-403: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. RIGHT OF CANCELLATION PURSUANT TO COL. REV. ST. § 6-22-104: YOU, THE BUYER, MAY CANCEL THIS AGREEMENT AT ANY TIME WITHIN 72 HOURS AFTER YOU HAVE BEEN NOTIFIED THAT YOUR INSURER HAS DENIED YOUR CLAIM TO PAY FOR THE GOODS AND SERVICES TO BE PROVIDED UNDER THIS AGREEMENT. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Company shall hold in trust any payment from Customer until Company has delivered the materials to your property or has performed a majority of the work on the property. By signing this Agreement you agree that you have also been provided notice of this right to cancel orally in addition to the writing contained herein. ACCEPTANCE OF TERMS %�Ter�ature below signifies acceptance of all terms an"ditions h in t Is greement. `7/27/17 7/27/17 Customer Signature Date Project Mana Date Page 3 r— i CITY OF WHEAT RIDGE L / - Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: -3 c) 7 V L/,L-,e Permit Number:y/'T6 V7 11 F� ❑ No one available for inspection: Time AM/PSI 1 e -Inspection required: Ye No ;- �' When corrections have been made, cfor re -inspection at 303-234-5933 r,� Date:' Inspector: t� 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: Job Address: lei 4Ei3577 R 57` Permit Number: r/, r.; ,, 77 ,444 vftD tars S rte Apia,) 7`" ❑ No one available for inspection: Time f4;r'o PM Re- Inspection required: Yes * When corrections have been made, calf for re- inspection at 303 - 234 - 5933 Date: e Inspect DO NOT REMOVE THIS NOTICE A o CITY OF WHEAT RIDGE ' Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type: Rewf Job Address: s 7 Permit Number: 9"7'7 ❑ No one available for inspection: Time AM /PM Re- inspection required: Yes No When corrections have been made, call for re- inspection at 30.3234 -5933 Date: Y /aG 10 Inspecto DO NOT REMOVE THIS NOTICE ' City of Wheat Ridge Residential Roofing PERMIT - 100977 PERMIT NO:.' 100977` ISSUED: 04/19/2010 JOB ADDRESS: 3050 WEBSTER ST EXPIRES: 30/16/2010 DESCRIPTION.: Reroof20 sqs '***.CONTACTS owner 303/237-0110 Rick Tenorio sub 30.3/500-3191 Giovonny Varts 10-0056 Cornerstone Roofing & Restorat PARCEL INFO ZONE CODE: UA USE: UA SUBDIVISION: 0585 BLOCK/LOT#: 0/ FEE SUMMARY ESTIMATED PROJECT VALUATION: `11,331.00 FEES Permit Fee 1272.10 Total Valuation ` .00 Use Tax 203.96 1"( a @ TOTAL 476.06 Conditions: 6 nails per shingle is required. Ice dam membrane is required from eave edge to 2' inside exterior walls. Board sheathing with any gap greater than 1/211 requires panel sheathing overlay on entire roof. Sheathing inspection is.. required prior to covering..Midroof inspection is not required on permits. purchased after 4/18/10. Contractor shall.. provide' ladder for inspections. Scheduled inspections that cannot .`be performed due to inclement weather must be cancelled prior to 8:30 a.m. on the day of 'inspection ora re inspection fee will be assessed. 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 the Wheat Ridge Building Code (I.B.C). and all other. applicable Wheat Ridge Ordinances, for work under this permit. Plans subject to 'field inspection. ~o - /clrrJ Signature of co ract r/owner date 1. This permit was issued in accordance with the. provisions set forth in your application and is subject to the laws of the State of Colorado and to the Zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable ordinances of the City.`.' 2. This permit 'shall expire. 180 days from the issue date. Requests for an extension must be received.' prior to expiration date An extension may be granted at the discretion of the Building Official. 3. If this permit expires, 'a new permit may be acquired for a fee o£<one-half the amount normally required, provided no changes have been or will be made in the original plansz and specifications and any suspension or. abandonment' has not exceeded one ;(1) year. If changes: have been or if suspension or abandonment: exceeds one (1) year, full fees shall be paid for :a new permit. k. Nol work of any manner shall be done that will change the natural flow of water causing a drainage problem. o. Contractor shall notify the Building Inspector twenty-four (24) :hours in advance for all inspections and shall receive written approval on inspection card before proceeding with successive phases of the job. The'. issuance of a permit. or the approval of :drawings and specifications shall. not be construed to be a permit for, nor an,approv o `any violation of the provisions of the building codes or any other ordinance, law, rule or regulation.: All.. pY n w is subject to field inspections. Signatur of ief Building: Official 'date CNSPE TION REQUEST LINE: (303)234-5933 'BUILDING OFFICE: (303)235-2855 ZEQUESTS MUST BE MADE BY 3PM ANY BUSINESS DAY FOR'. INSPECTION THE FOLLOWING BUSINESS DAY.' APR-19-10 MON 10:55 AM NMBAA FAX NO. 5745832997 P. 01 ♦~A Y City of Wheat idge o per f emt#: e ~ COMMUNITY DEVELot'MENT Building Division 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 " Fax: 303-237-8929 Inspection Line: 303-234-5933 Facsimile Building Permit Application Property Address; 5650 k,)a $ ( p 2 Property Owner (please print) :_R.7G(: vaa✓ e16 Phone: ✓09- ,;2-?7-b/l0 Mailing Address: (if different than property address) Address: Sub Contractors: Cgrnaany Name: License # Expiration Date' Trade/Profession: Approval; Uso of space (description): Description of work- P i ~0)~ Plan Review (gvr (t Vaf + : S § - Y ~ Il Plan Redue at time of submittal): Sq, FUL.Ft added: Squares 2y BTU's Gallons Amps OWNERICONTRACTOR 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 the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work under this permit. Plans subject to field impaction. CIRLGE ONk:: (OWNER) (CONTRACTO or PERSONAL REPRESENTATIVE of VNER) CONTRATOR) I'qq PRINT NAME: .,J___ CAA L't li'~ M---- SIGNATURE: Date: 461 DEPARTMENT USE ONLY ZONING COMMENTS: Zoning: Reviewer. ("WILIC WORKS COMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: OCCUPANCY. Reviewen r1RE DCPARTMENT.: D approved wl comments Cl disapproved rl no review required Bldg valuation: b Credit Card Payment: Use credit card listed on file. Date: Print name- Signature: Contractor LicenseM /Odd5'C, Phone: 30-> $GV> 3/U ) DEPARTMENT OF PLANNING AND DEVELOPMENT BUILDING INSPECTION LINE - 303-234-5933 CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 - (303-235-2855) Building Permit Number Date 9682 10/26/99 Property Owner : Property Address : 3050 WEBSTER STREET Contractor License No. : 20263 Company : Norco Home Improvement Inc. Phone : Phone: 233-5375 WNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Construction Value : $9,600.00 iereby certiy that the setback distances proposed by this permit application are accurete, P2ffT11Y FB2 : $181.25 id do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or rvenants, easements or restrictions of record; that all measurements shown, and allegations Plan Review Fee : $0.00 ade are accurate; that I have read and agree to abide by all conditions printed on this Dplication, and that I assume full responsifor compliance wit he Wheat Ridge Building US2 T8X : $144.00 ode (U.B.C.) and all other applicable Whordinances, f ork under this permi . ~ TOt81 : $32525 DATE IWNER)(CONTRACTOR) SIGNED Use: Description : REPLACEMENT WINDOWS AND TRIM BUILDING DEPARTMENT USE ON LY ZWOO#'4 . . SIC : Sq. Ft. : APprova.l,.... Zoning : W""IMP"O"K OKAY Approval: DM Approval : Occupancy : Walls : Roof : Stories : Residential Units : License No : Plumbing License No : Mechanical License No : Company : Company : Date : Expiration Date : Expiration Date : Approval : Approval : (1) This permit was issued in accortlance with the provisions set foRh in yopur application and is sub'ect to the laws of the State of Coloredo and to the Zoning Regulations and Building Code of Wheat Ridge, Colorado or any other applicable ordinances W t~e Ciry. (2) This permit shall expire if (A) the work authorized is not commencetl within siaty (60) days trom issue date or (B) ihe building authorized is suspentletl or abantlonetl for a period of 120 days. (3) It this permit expires, a new permit may be acquired for a fee of one-half the amount normally requireq provitletl no changes have been or will be made in the original plans and specifcations and any suspension or abandonment has not exceetled one (1) year. IF changes are matle or iF suspension or abandonment exceeds one (7) year, full tees shall be paid for a new pertnit. (4) No work of any manner shall be done ihat will change the natural flow otwater causing a tlrainage problem. (5) Contraclor shall notiry the Building Inspector twenry-four (24) hours in advance for all inspections and shall receive written apProval on inspeclion cartl before proceediing with successive phases otthejo6. (6) The issuance of a pertnit or the approval of drawings antl specifcations shall not be constmetl to be a pertnit for, nor an approval of, any violation of the provisions of the buildin s or ny other ordinance, law, rule or regulahon. ~ Chief Buildin spector DEPARTMENT OF PLANNING AND DEVELOPMENT BUILDING INSPECTION DIVISION - 235-2855 CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE Date : 10/261 ~j -4 t6 a WHEAT RIDGE, CO 80215 APPLICATIo N , Property Owner : Property Address : 3L~Jo Contractor License No. : -14? ° 61~ ,/1Y _ , Building Permit Number : . 4 , Phone : 120 ~B0D ......p.... • ( . riivno. ) NER/CONTRACTOR SIGNATURE OF UNDERST NDING AND AGREEME Construction Value : h n reby certify that the setback distances proposed by this pertnit applieation are aaurete, pgRpit FB2 : do not violate applicable oMinances, rules or regulations of the City of Wheat Ridge or /j/, ZS o enants, easements or restrietions of reeorcl; that all measurcments shown, and allegatlons ia p e are aaurete; that I have read and agree to abide by all cond'Rions printetl on this Use Tax : liwtion, and thai I assume full responsibility tor eomplianee with the Wheat Ridge Building o e(U.B.C.) and all other applicable Whea ~idge oNmances, for rk under this pertnk. TOt21 : ) /~l ER)(CONTRACTOR)SIGNED ~~/l2I A»?/bATE USB~J' escription BUILDING DEPARTMENT USE ONLY SIC : Sq. Ft. : Approvat : Zoning : Approval Approval : Occupancy : Walls : Roof : Stories : Residential Units : ( I a c n a C ;ctrical License No : Plumbing License No : Mechanical License No : impany : Company : Company : piration Date : Expiration Date : Expiration Date : proval : Approval : Approval : 7) This permit was issuetl in axordance wilh the provisbns sM PoM in yo0ur application anE is aubjacl M the laws ot the State ol CobraOO antl ro the Zonirq Z) Thegulatlons antl BuilOirg Code W Wheat RWqq ColanOO or arry oMer applirable oNinances of the Ctty. peimk ahall ezpirc if (A) the work auMOnzeO is not mmmeneeC within aixly (80) days ftam isaue tlete or (B) the building aWwnzed is suspefMeE or abantlonetl for a p8ti0A of 120 tleys. 3) If this pertni[ ezpircs, a nmv permit mey De acquireC for a fee of ono-hett the amount normaly requireE, provitletl no eManpes heve Deen or will De maEe in the original plans ana apecifioa0onn and arry susp8naion or aDantlonment nas not exceeAed one (1) year. tt changes are matle or H suspenaion a abantlanment ezcee0s one (1) year, full teea ahall be paid ior a new permiL o) No vrork ot any manner 9ha11 Oe Oom tlwt will chanpe Cw neWrol Ibw ol water nusing a tlrainage problem. 4 5) ConVactor shall notity the Builtlirp Inapeetor hvmnry-kur (24) houn in aCvance br all inspacXOna antl shall raceive writlen appmval on inspection cer0 DeNie proeeetliing with sucoessive phases of Me p~ b. e) The issuenx pertnk a the app'oval W drarrinqs antl aperJfications shall not he constluM to De a parmtt for, nor an approval of, any vidatbn M the pmviaions W the builEi es o arry other ordinance, law,'ub a repulation. Chief Buildin_ scector ~ n_DEPARTMENT OF PLANNING AND DEVELOPMENT BUILDING INSPECTION DIVISION - 235-2855 CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 Building Permit Number Date 7558 8/3/98 Property Owner : Property Address Contractor License No. Company 3050 Webster Street 19034 APH Service Co.. Inc. Phone: 2336120 Phone:2956622 WNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Construction Value : $3,500.00 iereby certiy that the setback distances proposed by this permit application are accurate, P@ffl'llt Fe@ : $75.50 id do not violate applicable ordinances, rules or regulahons of the City of Wheat Ridge or il t h d ll ti f d h Pl R i F 00 $0 measuremen s s own, an a ega ons rvenants, easements or restrictions o recor ; t at a an ev eW ee : . ade are accurate; that I have read and agree to abide by all conditions printed on this plication, and that I assume full responsibility for compliance with the Wheat Ridge Building Use Tax : $52.50 ode (U.B.C.) and all other applicable Wheat Ridge ordinances, for work under this permit. : Total $128.00 )WNER)(CONTRACTOR) SIGNED DATE Use : Description : 2 ton a/c, 90 k BTU furnace BUILDING DEPARTMENT USE ON LY mumm SIC : Sq. Ft. : Approval: Zoning : Approval: Approval: Occupancy : Walls : Roof : Stories : Residential Units : p License No : Plumbing License No : Mechanical License No : . Company: Company: Date : Expiration Date : Expiration Date : Approval: Approval: (1) This permit wes issued in accordance willt the provisions set forih in yopur application and is subject W the laws of ihe State of Coloredo and lo the 2oning Regulations and Building Code of Wheat Ridge, Colorado or any other applicable ordinances of ihe Ciry. (2) This permit shall ezpire if (A) ihe work authorizetl is not commencetl within sixty (60) days from issue date or (B) the building authorized is suspended or aDantlonetl for a penod of 120 tlays. (3) If this permit expires, a new permit may be acquired for a fee of one-half the amount normally requireU, provitled no changes have been or will be made in Me original plans antl specificatlons and any suspension or abandonment has not exceetled one (1) year. If changes are made or if suspension or abandonment ezceeds one (1) year, full fees shall be paitl for a new petmit. (4) Na work o( any manner shall be done Nat will chan9e the natural flow of water causing a tlrainage problem. (5) Contractor shall noUry the Building Inspector lwenry-four (24) hours in advance for all inspeclions and shall receive written approval on inspectlon card before proceedling with suaessive phases otthe1'ob. (6) The issuance of a permit or the approval of drawin9s and specifcations shall not be construed [o be a pertnit for, nor an approval o( any violation of the provisions ~ of the builtling codes or any other ordinance, law, rule or regulation. Chief Building Inspecto(i ' THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR CALL: 234-5933 24 HOURS PRIOR TO INSPECTION DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : BUILDING INSPECTION DIVISION - 235-2855 CITY OF WHEAT RIDGE Date : 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 Property Owner : GdIA I Phone : Property Address : 3 U 50 ~-1-~ A. ~'{5T Contractor License No. : 3 ti ? L~ ~ Company : Phone : U7 ( 4_ Q) OWNER/CONTR.4CTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Construction Value : I hereby certify that the setback distances proposed by this permd application are accurate, p@fmlt FCB : and do not violate applicable orclinances, rules or regulations of the Ciry of Wheat Ridge or covenants, easements or reslridions of record; that all measurements shown, and allegations made are accurate: thal I have read and ayree lo abide bY all conditions pnnted on this Use Tax : appliwtion, and that I assume full responsibil' for compliance wdh the Wheat Ridge Building Code (U.B.C.) and all other applicable VJheat idge dinances, for work un er this permit. ~ ~ TOt81 :1 TE CrCfi~ tuIr, ~ (OWNER)(CONTRACTOR) SIGNED U52 : U!~ I~ I i~t Description : p C t BUILOING DEPARTMENT USE ONLY ~a '~b SIC : Sq. FL : Approval: Zoning : ~'~II811f';1LCEmmeftE3A Approval: I Approval: Occupancy: Electrical License No Company : Expiration Date : Approval: Walls : Roof Piumbing License No : Company: Expiration Date : Approval: Stories : Residential Units : Mechanical License No : Company: Expiration Date : Approval: (1) This permil was luued in actatlance wiN the qovisions set lorth In yopur applicatlon and is suC ea M Ne laws ol Ne State ol CobraOO anA l0 Me Zonirq RegulaUOns aM BuilEi~ CoEe of Wheat RiOye, Cob2EO a any oNer appiifaCle adinancee of the G~ly. (Y) This pemut s~ail expire d(A) the work auUwnzeE b rwl comrtKncM wMin sizty (60) Eays from Issue Oate or (9) the DuilCinp auUwiized is suspenEeG v abaMOneC Iq a perbd o/710 days. (7) If Uis permil expires, a new pertrut may be ecaWred la a lee N px-latl Ne amounl nonnalty requireA, pfoviCed no Uhangea twve Deen a will Ce maEe in the onqinal Dlans aM apeafiratlons aM any suspension a abandonment tus not e:ceeEeE one (t) year. II chanyes are maEe or if wspensbn a aDanEOnmanl ezceetls are (t) year, lull lees ehall De palC for a new pertnit. No work ol any manner shall be done that vnll Uunqe the natural Ilow of water ausinq a Crolnage pro0lem. (5) CoMrxlot shall ratily the BuilEinq Inscectar nvenry-iour (za) houn in aevance fa an inscectons ana nnan receive wrinen aoo~~ m inspection arO Detore procee0iirp with succeasive phaxs ot Me lob. (8) The iswance o1 a pemul a the epproval o(Erawirps aM spetlficalions shall nol Ce consWe0lo De a permit lor, nor an a00«al ol, airy vlWation ol Na provisbns . W the builCinq Cadea ar am/ oUwr ordinance, Ww• rule a repuWGOn. 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 DEPARTMENT OF COMMUNITY DEVELOPMENT WEST 29tn AvENUE BUILDING INSPECTION DIVISION PERMIT N0. M911116675 i944 ExT. 255 P.o. eoX 638 CITY OF WHEAT RIDGE, COLO. THIS ERMIT VAUD ONl_Y WHEN SIGNED BY THE CHIEF BUIl01Nfi INSPECTOR AND RECEIPTED BEL'JW. C/ G _J r, JOB AD RESS K, 2 'Y' OWNER ' - CONTR I 7 c CTOR ~ ' ~ t: r kn ADDRESS 3C 5c~ tA T C ZIPCODE~ 33 ~ ADDRE ~ S' ~ T+ c C' ~ PHONE ~ - CITY J ZIP CODE ~ ~ONT(iACT PRICE $ i.. ~ ~ C) PHON a- 3J LICENSE NO. 1. TYPE Ground❑ Woll❑ Proiacfin0❑ 0ther SwOFeae 2. MATERIAL Total SQUOn Fad - mit No El f P SI NS . ee . er 3, ILIUMINAT10N Yes❑ No❑ TY7s SET BACK FROM PROPERTY LINE N_ 5_ E_ W Zons_ ApprwW, 2one Inspeetw 4 . rowd ❑ ❑ ❑ Disa pp (Speeit which ia fronl) ❑ 1. TYPE Solid0 Mon TMn BO% ODen0 Less TAOn 80% Open MATERIAL Heiaht ? FE CES . 3. SE7 BACK FROM PROPER7Y LINE N_ S_ E_ W Zone_ Apprwed,Zom InsDeeta rovsd ❑ ❑ Diaa pp (SDSCify whieA if front) ❑ ❑ i. 2(~e rc xj 7a h~rl ~c. • 0 HER a. ~ . RAW SKETCH OR SHOW BELOW,THE FENCE, SIGN, OR OTHER STRUCTURE,GN ~ (SETBACKS OR PROJECTqNS INCLUDED) INSPECTION TICKET REAR PROPERTY LINE JOB -0 - ADDRESS w Z J F ~y~ 1 PERMITB f` J 6-~ S BLDG . o DATE: ¢ a w PERMIT# N BLDG. CONTR. FRONT PROPERTY LINE SUBMNTRACTOR STREET NAME - / A STREETS ES -a O , , DATE INSP. REQ. v $HOW DISTANCES FROM THE MAIN BUII.DING TUADJOINING HOUS DISTANCE TO PROPERTY I,INES, NOT MAXIMUM OR AVERAGE DISTANCE. ~ ' APPLICATION FOR PLUMBING; ELECTRICC TYPE OF INSP. HIS APPLICATION WILL BECOME A PERMIT TO PERFORM THE INDICATED WORN / PERMIT WILL EXPIRE 60 DAYS FROM DATE OF ISSUANCE !F V INSPECTION MADE ELECTRICAL PERMIT PIUMBING PERI ~l REMARKS STATE UCENSE N0. STATE LICENSE N0. or NDERE E B IILEGAL F100R BSM IST UMINUM W WATER CLASET TEMPWASH BOWL SMPS NEW BATH TUB W.R. FORM ~t9 5 CHANM PS SHOWER LICHT SINK HEAtI GARBAGE DISP POWEITS WATER HEATER UTILITY POSER, ETC.) AUTO. WASHER AU7qMATIC SPRINKIER SYSTEM FI%TURES DISH WASHER EIEVATOR WIRING MOTORS 8 CONTROLS FLDUR DRAIN SIGNS URINAL TRANSFORMERS 9 RECTFIERS SEWERS ADDITION TO OLD WORK OTHER RES MOTORS OVER I HP TOTAL FIXTU RE ARKS li - PERMIT FEE 1 ~ VAUp UNL~SjiECEIPTED NOT ~ Y ~O I ca hereby acknowledqe thot this opp tio it eorreet ond undarstand thot I USE TAX co not starf tAis Droled uniil ihia oDDii' $ ea ion is opprovaA. I ehall comply with TOTAL FEE ~?(3 th lawf of the State of Colorado and to - a/ r Ci nd Buildinp i E AP ROV th ona a Zoninp Fequlot ~ ~ C e ofthe Cify of Wheai RidQe. Any se 111 CHIEF BUILDI INSPECTOR,City of Wheat Ridqe vi cau lotion of tne above terms w CALL 237-8944 EXT. 255 im ediate revocation of this Dermit 24 HOURS IN ADVANCE FOR INSPECTIONS c i 1 Date Issu ^ •p Iieant~ SiOnamr• .