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HomeMy WebLinkAbout4000 Yarrow StreetFrom: no-reolvCalci.wheatridae.co.us To: CommDev Permits Subject: Online Form Submittal: PERMIT APPLICATION Air Condiboner/Evaporative Cooler Date: Tuesday, March 15, 2022 9:37:21 AM CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Report any suspicious activities to the IT Division. PERMIT APPLICATION Air Conditioner/Evaporative Cooler This application is exclusively for AIR CONDITIONER OR EVAPORATIVE COOLER. YOU MUST ATTACH THE ELECTRONIC PAYMENT FORM IN ORDER FOR THE PERMIT TO BE PROCESSED. 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. PROPERTY INFORMATION Is this a new install or Replacement of Existing Unit replacement for an existing AC unit? Is this Residential or Residential Commercial? Property Address 4000 Yarrow St Property Owner Name Linda Wolf Property Owner Phone 303-349-0314 Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email caesarrodney@gmail.com Address Attach City of Wheat Wheat Ridge Electronice Payment form docx Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" CONTRACTOR INFORMATION Contractor Business ARS Rescue Rooter Name Contractor's License 018701 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 303-418-6001 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email sewing@ars.com Address Retype Contractor lewing@ars.com Email Address DESCRIPTION OF WORK What type of Air Conditioner replacement unit are you installing? How many tons is the 2 unit? For AC - what is the SEER? For Evaporative Coolers, what is the CFMs? Where is the unit located (for example, rooftop, backyard on ground etc)? Is electrical needed for re -hook? Provide Electrical Contractor's Wheat Ridge License No. 13 Side of house on ground Yes 020349 Project Value (contract 6593.50 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 Lauren Ewing Pe rm it Email not displaying correctly? View it in your browser. i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: YO -5 ReC. Job Address: l/000 &ev0-, IT Permit Number: U I q D ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes (. 0 When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. uslinspection Date: 0' _LInspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Electric PERMIT - 201902244 PERMIT NO: 201902244 ISSUED: 10/22/2019 JOB ADDRESS: 4000 Yarrow St EXPIRES: 10/21/2020 JOB DESCRIPTION: Removing one sub -panel and moving circuits to main panel. *** CONTACTS *** OWNER (303)349-0314 WOLF LINDA SIOUX SUB (720)581-1857 GREG YOUNG 080136 YOUNG ELECTRICAL SERVICES *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 780.00 FEES Total Valuation 0.00 Use Tax 16.38 Permit Fee 36.70 ** TOTAL ** 53.08 *** COMMENTS *** *** CONDITIONS *** Must comply w/ 2012 IRC & 2017 NEC. Subject to field inspection. I, by m i nature, do hereby attest that the work to be performed shall co app�ic le building codes, and all applicable municipal codes, policies and by th egal owner of the property and am authorized to obtain this permit this reit. Yfurther attest.that I am legakly authorized to includ all enf is aisciosea m mply�vith all accompanying approved plans and specifications, cedures, and that I am the legal owner or have been authorized nd perform the work described and approved in conjunction with es named within this document as partes to the work to be and/or its' accompanying approved plans and specifications. Spgr ttf�U ,,OWIxT�R or., -CONTRACTOR (Circle one) � Date It t This perrdlt was issued based 61i'the information provided nth ernit application and accompanying plans and specifications and is subject to the compliance with'those documents, and all plical) a statutes, ordinances, regulations, policies and procedures. This permit shall expire 365 &ys after the date of issua a 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 originalermit 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 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 ant prdmance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of Whcat P, o COMMUNiry D[V1=L0PMLN1 Building & Inspection Services 7500 W. 2911 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 permits(-ci.wheatridge.co.us FOR OFFICE USE ONLY Date: Planmerrnit # Plan Review Fee: Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 3S. Property Owner (please pant): L i',�� I,- (,� Q j�' Phone: i 3-- � _ a t f Property Owner Email: l i Tenant Name (Commercial Projects Only) uW Property Owner Mailing Address: (if different than property address) Address: Arch itect/Engineer2 Architect/Engineer E-mail: Contractor Name: Phone: City of Wheat Ridge Licen e #: 00) 1 Phone: 7,2o' S�` V7, Contractor E-mail Address: CONTACT NAME (please print): Phone: CONTACT EMAIL(p/ease print): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # CotnpMte [:]COMMERCIAL ORESIDENTIAL vrovrcre description oT wom t -or ILLI.. projects, provlae a cletailea oescrlptlon of worK to oe 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. 2 m 6 it t� � U +�� �,{S �n �� Gh�l ►�^Ocf r Sq. FULF BTUs Amp Squares For Solar: Gi�-cc,'ki �0 rnal/I Gallons KW # of Panels Requires Structural Fnr Cnrtr mPrrizkl PmiPr_t-c nniv no-rrrnanru Tv>na- re%nctntrtlnn Tvino- Occupancy Load: Square Footage: Project Value: (Contract value or the cost of all materials and labor included in the entire project) s T78®t-a° 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, casements or restrictions of record; that all measurements shown and allegations made arc 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 pr, ovided Qn the application. CIRCLE ONE: (OWNER) Sionature tfuxt and last name): Printed Name: ZONING COMMMENTS: Reviewer. BUILDING DEPARTMENT COMMENTS: Reviewer PUBLIC WORKS COMMENTS: (A REP)?ESENTATIVE) of (OWN/ER) (CONTRACTOR) DATE:Y �fl j7 DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Reviewer: Building Division Valuation: 4000 Ymeow S INSPECTION 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 Initials Comments Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter lin Nnt Pn11r - - - - - d .--.I ffI vvoI WI I Ila riuVve Inn ecuons Underground/Slab Inspections Date Inspector Initials Comments Electrical Sewer Service Plumbing Do Nnt Cnvar I Inrlcrnrniar%A �r Rough Inspections - - - - D to Inspector Initials — - . I I' HI Vvc11 v1 I ne Hpove inspections Comments heathing d Mid -Roof 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 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 surf that mi inh in¢naMinns oro ---.1-4-A C_ y the Building Division. - -u u ciauuivai ww voltage Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather a A d City of heat Midge j Residential Roofing PERMIT - 201706008 'ERMIT NO: 201706008 ISSUED: 08/12/2017 JOB ADDRESS: 4000 Yarrow ST EXPIRES: 08/12/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration asphalt shingles with ROOF DECKING - 24 sq. k** CONTACTS *** DWNER (303)349-0314 WOLF LINDA SIOUX 3UB (303)295-2220 Tomas Wofram 110052 Core Contractors, Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,500.00 FEES Total Valuation 0.00 Use Tax 157.50 Permit Fee 172.60 ** TOTAL ** 330.10 *** 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. INSPECTION RECORD Inspection online form: http://www.ci.wheatridge.co.us/inspection Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Inspections will not be performed unless this card is posted on the project site Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business day PERMIT:2-t I -1 ADDRESS: ` _ JOB CODE: �c��l�' . Foundation Inspections Date Inspector Initials Comments 102 Caissons / Piers 103 Footing / P.E. Letter 104 Foundation Setback Cert. 105 Stem Walls 106 Foundation wall Insulation Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground / Slab Inspections Date Inspector Initials Comments 201 Electrical / Cable/ Conduit 202 Sewer Underground Int. 203 Sewer Underground Ext. 204 Plumbing Underground Int. 205 Plumbing Underground Ext. 206 Water Underground Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections Rough Inspection Date Inspector Initials Comments 301 Rough Framing 302 Wall Sheathing 303 Roof Sheathing 304 Sheer Inspection 305 Insulation 306 Mid -Roof 307 Metal / Lath / Stucco 308 Rough Electrical Residential 309 Rough Electrical Commercial 310 Electrical Meter Residential —7797/ 311 Electrical Meter Commercial 312 Temp. Const. Meter 313 Rough Plumbing Residential 314 Rough Plumbing Commercial 315 Shower Pan SEE OVER FOR ADDITIONAL INSPECTIONS ADDRESS: Rough Inspection (continued) Date Inspector Initials Comments 316 Rough Mechanical Residential 317 Rough Mechanical Commercial ; �/���ev AF 318 Boiler / Furnace 319 Hot water tank 320 Drywall screw and Nail 321 Moisture board / shower walls 322 Rough Grading 323 Miscellaneous Final Inspections Date Inspector Initials Comments 402 Gas Meter Release 403 Final Electrical Residential ; �/���ev AF 404 Final Electrical Commercial 405 Final Mechanical Residential 406 Final Mechanical Commercial 407 Final Plumbing Residential 408 Final Plumbing Commercial 409 Final Roof 410 Final Window/Door 411 Landscape/Park/Planning* Inspections from these entities shall be requested one week in advance. *For landscaping and parking inspections please call 303-235-2846 **For ROW and drainage inspections please call 303-235-2861 ***For fire inspections please contact the Fire Protection District for your project. 412 Row/Drainage/Public Works** 413 Flood plain Inspection** 414 Fire Insp. / Fire Protection*** 415 Public Works Final** 416 Storm Water Mgmt.** 417 Zoning Final Inspection* 418 Building Final Inspection 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 by the Fire District and i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line 235-2855 Office • (303) 237-8929 Fax �1(303) INSPECTION NOTICE , .;/© LAG Yh 9di AC Lfit�c- Inspection Type: 4/0 Job Address: iYO00 YRVro-1 S7 Permit Number: Zo 1-7 % 55-5 ❑ No one available for inspection: Time Re -Inspection required: Yes QV When corrections have been made, call for re -inspection at 303-234-5933 Date: J Z ���/� Inspector: DO NOT REMOVE THIS NOTICE ❑ No one available for inspection: Time Re -Inspection required: Yes QV When corrections have been made, call for re -inspection at 303-234-5933 Date: J Z ���/� Inspector: DO NOT REMOVE THIS NOTICE - , City of Wheat Ridge Residential Electric PERMIT - 201709355 PERMIT NO: 201709355 ISSUED: 11/30/2017 JOB ADDRESS: 4000 Yarrow ST EXPIRES: 11/30/2018 JOB DESCRIPTION: Permit to upgrade service, mast and grounding from 100amp to 200amp *** CONTACTS *** OWNER (303)349-0314 WOLF LINDA SIOUX SUB (720)581-1857 Greg Young 080136 Young Electrical Services *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 2,600.00 FEES Total Valuation 0.00 Use Tax 54.60 Permit Fee 93.35 ** TOTAL ** 147.95 *** COMMENTS *** *** CONDITIONS *** Must comply w/ 2012 IRC & 2014 NEC. Subject to field inspection. 1, 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. m(" re of O D 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 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 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 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 granfing of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable code or ar�lmance or regulation of this jurisdiction. Approval of work is subject to f any inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of " W heat d ige COMMUNITY 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: permits aaki.wheatridge.co.us FOR OFFICE USE ONLY Date: I q, � Plan/Permit # 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: Proaertv Owner Property Owner Email: Mailing Address: (if different than property address) Address: Phone: City, State, Zip: Architect/Engineer: Arch itectlEngineer E-mail: Phone: Contractor: Q E_l,,. l rV e� LL (_ Contractors City L ense #: C) 3 (c? Phone: Contractor E-mail Address: Sub Contractors: Electrical: W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form ❑ COMMERCIAL `RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESIDENTIAL 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.) ccln serv, (C Sq. FULF Btu's Amps aw Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ C2�ov , 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 1 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: (OWNS{ f) (CONT#4CT0J/ or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): �4�e�/.�'// DATE: z/ J —3c) ) 7 DEPARTMENT USE ONLY ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: Building Division Valuation: $ 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: w6 A112 Job Address: L1000 4l r0 Permit Number: ?-o1 o 6 OG tQ,, ❑ No one available for inspection:__ TimeJs) 30 AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: i /7 Inspector: DO NOT REMOVE THIS NOTICE 41 City of Wheat Ridge ` Residential Roofing PERMIT - 201706008 PERMIT NO: 201706008 ISSUED: 08/12/2017 JOB ADDRESS: 4000 Yarrow ST EXPIRES: 08/12/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration asphalt shingles with ROOF DECKING - 24 sq. *** CONTACTS *** OWNER (303)349-0314 WOLF LINDA SIOUX SUB (303)295-2220 Tomas Wofram 110052 Core Contractors, Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,500.00_ FEES Total Valuation 0.00 Use Tax 157.50 -- Permit Fee 172.60 ** TOTAL ** 330.10 *** 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. PERMIT NO: JOB ADDRESS: JOB DESCRIPTION: City of Wheat Ridge Residential Roofing PERMIT - 201706008 201706008 4000 Yarrow ST ISSUED: 08/12/2017 EXPIRES: 08/12/2018 Residential Re -roof to install Owens Corning Duration asphalt shingles with ROOF DECKING - 24 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 atte t that I am leggally authorized to include al I entities named within this document as partes to the work to be perform�rd thl�n9certormed is disclosed in this document and/omits' a�corppanying approved plans and specifications. Signature of OWNER o�ONTRACTOR (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 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 Budding 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 c2;zz� this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dane Lovett 1766 6�e From: no-reply@ci.wheatri dge.co.us Sent: Tuesday, August 8, 2017 9:24 AM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application ,� 1 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 VV 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 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 4000 Yarrow Street Wheat Ridge CO iK Property Owner Name Linda Wolf !� Property Owner Phone 303-349-0314 Number (enter WITH dashes, eg 303-123-4567) Property Owner Email docs@coredoes.com Address Do you have a signed Yes contract to reroof this property? Applications cannot be submitted without an executed contract attached below. Attach Copy of Executed Wolf Contract.pdf Contract CONTRACTOR INFORMATION Contractor Business Core Contractors Name AV Contractor's License 110052 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 3032952220 Number (enter WITH dashes, eg 303-123-4567) Contractor Address 4049 St. Paul Street (Primary address of your business) Contractor Email Address docs@coredoes.com Retype Contractor Email docs@coredoes.com Address DESCRIPTION OF WORK TOTAL SQUARES of 24 the entire scope of work: Project Value (contra 7,500 value or cost of ALL materials and labor) Are you re -decking the Yes roof? 2 Does the scope of the No project include a flat roof (less than 2:12 pitch)? Does the scope of the Yes project include a pitched roof (2:12 or greater pitch)? How many squares are part of the pitched roof? Describe the roofing materials for the pitched roof: Type of material for the pitched roof: Provide any additional detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) 24 Owens Corning Duration Asphalt House Only SIGNATURE OF UNDERSTANDING AND AGREEMENT 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. I understand that this 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 may not begin on this property until a permit has been issued and posted on the property. Yes Yes Yes 3 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. 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. Name of Applicant Karen Tobin Email not displaying correctly? View it in your browser. 1-1 CONTRACTORS ROOFING SYSTEMS Property Owner Linda Wolf Property Address 4000 Yarrow St Agreement "Doing it right matters" Effective Date 07/26/2017 4501 Logan St, Denver, CO 80216 303.997.1559 City/State Zip Wheat Ridge 80033 Primary Phone number Secondary Phone Number 303.349.0314 Email Address wolf.lindas@gmail.com Terms: By signing this agreement, the property owner authorizes CORE Contractors, Inc. ("CORE") to perform the work and supply the materials as agreed upon by the property owner's insurance carrier. The homeowner agrees to use CORE exclusively, and authorizes CORE to obtain labor and materials in accordance with the scope agreed to by the insurance company and the specifications set out in this agreement to accomplish the replacement or repairs. The initial proposed scope of services is attached to this agreement. This agreement does not obligate the homeowner or CORE in any way, unless the damage is approved by homeowner's insurance carrier. Roofing Scope: The roofing system replacement includes all shingles, underlayment, valley linings, and miscellaneous flashing, per local applicable municipal code. This also includes full clean-up of the property and a 5 year Roof Workmanship Warranty (on full roof replacement only). A one year workmanship warranty is included on all non -roof work Additional Roofing Scope Notes IR Upgrade $729 Additional gutters on rear patio $224 performed by CORE. Due to the nature of repairs related to insurance claims, this contract includes an estimated repair price of the roof system. 12,500 Because the final scope has not been agreed upon with the insurer, this repair price may change. The amount of this contract is for 100% of the replacement cost approved by the insurance company for the work to be completed by CORE. Reaching agreement on the full scope of repairs involves considerable time on CORE's part and we will not proceed with that phase unless you agree to allow us to do the work once the scope is agreed upon. By signing this contract, you authorize CORE to reach an agreement on the scope of repairs on your behalf. CORE agrees to bid the work using the primary insurance industry pricing database (Xactimate) based on the scope of work agreed upon with your insurer. You, the homeowner, recognize CORE Contractors, Inc. as a general contractor and as such shall be entitled to overhead and profit, at customary insurance industry rates (20% on Xactimate line items). Any substantial additions or deductions to the scope of work will be handled on the Customer Verification Form. The property owner, you, must agree that, once a scope of work and project cost is agreed between CORE and the insurance carrier, they are responsible to pay ONLY the deductible amount per their replacement cost insurance policy. Any further changes, in addition to the insurance work, must be requested in writing, by the property owner. If, you, the property owner, plan to use the proceeds of a property and casualty insurance policy issued pursuant to Part 1 of Article 4 of Title 10, C.R.S. to pay for roofing work, pursuant to Section 6-22-105, C.R.S., THE ROOFING CONTRACTOR CANNOT PAY, WAIVE, REBATE, OR PROMISE TO PAY, WAIVE, OR REBATE ALL OR PART OF ANY INSURANCE DEDUCTIBLE APPLICABLE TO THE INSURANCE CLAIM FOR PAYMENT FOR ROOFING WORK ON THE COVERED RESIDENTIAL PROPERTY. PAYMENTS ARE TO BE MADE: HALF (OR FIRST INSURANCE CHECK RECEIVED — ACV CHECK) UPON DELIVERY OF ROOFING MATERIALS, AND FINAL BALANCE UPON COMPLETION OF WORK. THE WORK IS TO BE COMPLETED WITHIN APPROXIMATELY 90 DAYS OF EXECUTED CUSTOMER VERIFICATION FORM. CORE SHALL HOLD IN TRUST ANY PAYMENT FROM THE PROPERTY OWNER UNTIL THE ROOFING CONTRACTOR HAS DELIVERED ROOFING MATERIALS AT THE RESIDENTIAL PROPERTY SITE OR HAS PERFORMED A MAJORITY OF THE ROOFING WORK ON THE RESIDENTIAL PROPERTY. All estimates or contract amounts include a 3.5% discount for cash or check transactions. Property Owner's Initials Right to Cancel You, the homeowner, have the right to rescind this agreement and obtain a full refund of any deposit within 72 hours after entering the agreement. If you plan to use the proceeds of a property and casualty insurance policy to pay for the roofing work, you may rescind this contract within 72 hours after you receive written notice from the insurer that your claim has been denied in whole or in part. Property Owner Linda Wolf Property Owner Signature Date 07/26/2017 Insurance Company State Farm � G RF -D fs'{ E canvas 'A kV k.0 Siibzl;'COJII CORE Contractors, Inc. ("CORE") is authorized to provide you with this NOTICE. You are therefore notified that: (a) ANY PERSON OR COMPANY SUPPLYING LABOR OR MATERIALS FOR THIS IMPROVEMENT TO YOUR PROPERTY MAY FILE A LIEN AGAINST YOUR PROPERTY IF THAT PERSON OR COMPANY IS NOT PAID FOR THE CONTRIBUTIONS. 1. All contracts are subject to approval of our credit department and office without exception. The person executing this contract must obtain the approval from the officer of the CORE Contractors, Inc. for this contract to be effective under any conditions. 2. SHOULD DEFAULT BE MADE IN PAYMENT OF THIS CONTRACT CHARGES SHALL BE ADDED FROM THE DATE THEREOF AT A RATE OF ONE AND ONE HALF (1 ''/z) PERCENT PER MONTH (18% ANNUM) WITH A MINIMUM CHARGE OF $20.00 PER MONTH, AND IF PLACED IN THE HAND OF A COLLECTION AGENCY, ALL COLLECTION, LEGAL, AND FILING FEES SHALL BE PAID BY CUSTOMER ACCEPTING SAID CONTRACT. 3. CORE Contractors, Inc. shall have no responsibility for damages from rain, fire, tornado, windstorm, or other perils, as is normally contemplated to be covered by home owners risk insurance or business risk insurance, or unless a specified written agreement is made therefore prior to commencement of the work. 4. Should legal action be necessary, because of any act that might arise during the course of this agreement; CORE shall be entitled to all costs incurred in connection with such action, including a reasonable attorney's fee. 5. The parties hereto agree that all actions or proceedings arising in connection with this agreement shall be tried and litigated exclusively in the State and Federal courts located in the County of Denver, State of Colorado. 6. Replacement of deteriorated items (such as decking, fascia boards, roof jacks, ventilators, flashing, or other materials) not covered by insurance, discovered during construction and required by governing code or necessary for product warranties are NOT INCLUDED and will be charged as an extra on a time and materials basis unless STATED IN THIS CONTRACT. 7. CORE Contractors, Inc. shall not be liable for failure of performance due to labor controversies, strikes, fires, weather, inability to obtain materials from usual sources, or any other circumstances beyond the control of CORE Contractors, Ins. whether of a similar or dissimilar nature. 8. Subsequent to property owner's insurance carrier approval, if this agreement is terminated by the owner, the owner shall be financially responsible for all work performed based on the following milestones (percentages are additive). a. Consulting Phase: Preparation of CORE Xactimate scope of work and adjuster appointment — 3% of total bid. b. Substantial agreement or scope confirmation with insurer — 5% of total bid. c. Ordering and scheduling of work — 2% of total bid. d. Repair Phase: Any line item of physical work that has been started shall be completed by CORE; if the owner terminates this agreement while physical work is ongoing, they shall be responsible for all costs related to that line item, plus general contractor overhead and profit. 9. In addition, the owner shall be responsible for all other reasonable fees and expenses incurred prior to termination of the agreement, including permit fees, deposits paid by CORE to suppliers and subcontractors, subcontractor fees and expenses, etc. to the extent they are not already included in the line items for work that has been completed. All fees and expenses incurred prior to termination of this agreement shall be paid PO"WE.RF."i BY -^'cai I�&s' Vc_ti1�W )cFiYi`.'asxotl% by the owner within 30 days of invoice date. 10. If material has to be reordered or restocked because of a cancellation by the customer; customer will have to pay the restocking fee assessed to CORE by the supplier. 11. If any provision of this contract should be held to be invalid or unenforceable, the availability and enforce -ability of the remaining provisions of this contract shall not be affected thereby. 12. ANY REPRESENTATIONS, STATEMENTS, OR OTHER COMMUNICATIONS, NOT WRITTEN ON THIS CONTRACT ARE AGREED TO BE IMMATERIAL, are not relied on by either party, and do not survive the execution of this contract. 13. The maximum liability for CORE Contractors, Inc. shall be the original cost of labor and materials for the repair, which the customer agrees shall be the liquidated sum, under any event of default of CORE Contractors, Inc. herein. 14. During the duration of the work, the customer's HOMEOWNER'S INSURANCE will be responsible for any interior damage as long as CORE Contractors, Inc. has taken appropriate action to protect the roof and siding during the repair of the roof. 15. CORE Contractors, Inc. is not responsible for existing construction problems of customer's home. If pointed out and notified to CORE, we will try to assist you in correcting the existing construction problems on a time and material basis. 16. THIS CONTRACT IS COMPOSED OF THIS PAGE AND THE REVERSE SIDE OF THIS PAGE AND SHALL BE CONSIDERED THE ENTIRE CONTRACT BY THE PARTIES. PO114rPFDBY;',canvas WtYK'.7C34<iS7btLS.G(1i� s:ipsi: ! i;�'t� <: ,. 41 City of Wheat Ridge ` Residential Roofing PERMIT - 201706008 PERMIT NO: 201706008 ISSUED: 08/12/2017 JOB ADDRESS: 4000 Yarrow ST EXPIRES: 08/12/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration asphalt shingles with ROOF DECKING - 24 sq. *** CONTACTS *** OWNER (303)349-0314 WOLF LINDA SIOUX SUB (303)295-2220 Tomas Wofram 110052 Core Contractors, Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,500.00_ FEES Total Valuation 0.00 Use Tax 157.50 -- Permit Fee 172.60 ** TOTAL ** 330.10 *** 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. PERMIT NO: JOB ADDRESS: JOB DESCRIPTION: City of Wheat Ridge Residential Roofing PERMIT - 201706008 201706008 4000 Yarrow ST ISSUED: 08/12/2017 EXPIRES: 08/12/2018 Residential Re -roof to install Owens Corning Duration asphalt shingles with ROOF DECKING - 24 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 atte t that I am leggally authorized to include al I entities named within this document as partes to the work to be perform�rd thl�n9certormed is disclosed in this document and/omits' a�corppanying approved plans and specifications. Signature of OWNER o�ONTRACTOR (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 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 Budding 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 c2;zz� this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dane Lovett 1766 6�e From: no-reply@ci.wheatri dge.co.us Sent: Tuesday, August 8, 2017 9:24 AM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application ,� 1 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 VV 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 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 4000 Yarrow Street Wheat Ridge CO iK Property Owner Name Linda Wolf !� Property Owner Phone 303-349-0314 Number (enter WITH dashes, eg 303-123-4567) Property Owner Email docs@coredoes.com Address Do you have a signed Yes contract to reroof this property? Applications cannot be submitted without an executed contract attached below. Attach Copy of Executed Wolf Contract.pdf Contract CONTRACTOR INFORMATION Contractor Business Core Contractors Name AV Contractor's License 110052 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 3032952220 Number (enter WITH dashes, eg 303-123-4567) Contractor Address 4049 St. Paul Street (Primary address of your business) Contractor Email Address docs@coredoes.com Retype Contractor Email docs@coredoes.com Address DESCRIPTION OF WORK TOTAL SQUARES of 24 the entire scope of work: Project Value (contra 7,500 value or cost of ALL materials and labor) Are you re -decking the Yes roof? 2 Does the scope of the No project include a flat roof (less than 2:12 pitch)? Does the scope of the Yes project include a pitched roof (2:12 or greater pitch)? How many squares are part of the pitched roof? Describe the roofing materials for the pitched roof: Type of material for the pitched roof: Provide any additional detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) 24 Owens Corning Duration Asphalt House Only SIGNATURE OF UNDERSTANDING AND AGREEMENT 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. I understand that this 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 may not begin on this property until a permit has been issued and posted on the property. Yes Yes Yes 3 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. 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. Name of Applicant Karen Tobin Email not displaying correctly? View it in your browser. 1-1 CONTRACTORS ROOFING SYSTEMS Property Owner Linda Wolf Property Address 4000 Yarrow St Agreement "Doing it right matters" Effective Date 07/26/2017 4501 Logan St, Denver, CO 80216 303.997.1559 City/State Zip Wheat Ridge 80033 Primary Phone number Secondary Phone Number 303.349.0314 Email Address wolf.lindas@gmail.com Terms: By signing this agreement, the property owner authorizes CORE Contractors, Inc. ("CORE") to perform the work and supply the materials as agreed upon by the property owner's insurance carrier. The homeowner agrees to use CORE exclusively, and authorizes CORE to obtain labor and materials in accordance with the scope agreed to by the insurance company and the specifications set out in this agreement to accomplish the replacement or repairs. The initial proposed scope of services is attached to this agreement. This agreement does not obligate the homeowner or CORE in any way, unless the damage is approved by homeowner's insurance carrier. Roofing Scope: The roofing system replacement includes all shingles, underlayment, valley linings, and miscellaneous flashing, per local applicable municipal code. This also includes full clean-up of the property and a 5 year Roof Workmanship Warranty (on full roof replacement only). A one year workmanship warranty is included on all non -roof work Additional Roofing Scope Notes IR Upgrade $729 Additional gutters on rear patio $224 performed by CORE. Due to the nature of repairs related to insurance claims, this contract includes an estimated repair price of the roof system. 12,500 Because the final scope has not been agreed upon with the insurer, this repair price may change. The amount of this contract is for 100% of the replacement cost approved by the insurance company for the work to be completed by CORE. Reaching agreement on the full scope of repairs involves considerable time on CORE's part and we will not proceed with that phase unless you agree to allow us to do the work once the scope is agreed upon. By signing this contract, you authorize CORE to reach an agreement on the scope of repairs on your behalf. CORE agrees to bid the work using the primary insurance industry pricing database (Xactimate) based on the scope of work agreed upon with your insurer. You, the homeowner, recognize CORE Contractors, Inc. as a general contractor and as such shall be entitled to overhead and profit, at customary insurance industry rates (20% on Xactimate line items). Any substantial additions or deductions to the scope of work will be handled on the Customer Verification Form. The property owner, you, must agree that, once a scope of work and project cost is agreed between CORE and the insurance carrier, they are responsible to pay ONLY the deductible amount per their replacement cost insurance policy. Any further changes, in addition to the insurance work, must be requested in writing, by the property owner. If, you, the property owner, plan to use the proceeds of a property and casualty insurance policy issued pursuant to Part 1 of Article 4 of Title 10, C.R.S. to pay for roofing work, pursuant to Section 6-22-105, C.R.S., THE ROOFING CONTRACTOR CANNOT PAY, WAIVE, REBATE, OR PROMISE TO PAY, WAIVE, OR REBATE ALL OR PART OF ANY INSURANCE DEDUCTIBLE APPLICABLE TO THE INSURANCE CLAIM FOR PAYMENT FOR ROOFING WORK ON THE COVERED RESIDENTIAL PROPERTY. PAYMENTS ARE TO BE MADE: HALF (OR FIRST INSURANCE CHECK RECEIVED — ACV CHECK) UPON DELIVERY OF ROOFING MATERIALS, AND FINAL BALANCE UPON COMPLETION OF WORK. THE WORK IS TO BE COMPLETED WITHIN APPROXIMATELY 90 DAYS OF EXECUTED CUSTOMER VERIFICATION FORM. CORE SHALL HOLD IN TRUST ANY PAYMENT FROM THE PROPERTY OWNER UNTIL THE ROOFING CONTRACTOR HAS DELIVERED ROOFING MATERIALS AT THE RESIDENTIAL PROPERTY SITE OR HAS PERFORMED A MAJORITY OF THE ROOFING WORK ON THE RESIDENTIAL PROPERTY. All estimates or contract amounts include a 3.5% discount for cash or check transactions. Property Owner's Initials Right to Cancel You, the homeowner, have the right to rescind this agreement and obtain a full refund of any deposit within 72 hours after entering the agreement. If you plan to use the proceeds of a property and casualty insurance policy to pay for the roofing work, you may rescind this contract within 72 hours after you receive written notice from the insurer that your claim has been denied in whole or in part. Property Owner Linda Wolf Property Owner Signature Date 07/26/2017 Insurance Company State Farm � G RF -D fs'{ E canvas 'A kV k.0 Siibzl;'COJII CORE Contractors, Inc. ("CORE") is authorized to provide you with this NOTICE. You are therefore notified that: (a) ANY PERSON OR COMPANY SUPPLYING LABOR OR MATERIALS FOR THIS IMPROVEMENT TO YOUR PROPERTY MAY FILE A LIEN AGAINST YOUR PROPERTY IF THAT PERSON OR COMPANY IS NOT PAID FOR THE CONTRIBUTIONS. 1. All contracts are subject to approval of our credit department and office without exception. The person executing this contract must obtain the approval from the officer of the CORE Contractors, Inc. for this contract to be effective under any conditions. 2. SHOULD DEFAULT BE MADE IN PAYMENT OF THIS CONTRACT CHARGES SHALL BE ADDED FROM THE DATE THEREOF AT A RATE OF ONE AND ONE HALF (1 ''/z) PERCENT PER MONTH (18% ANNUM) WITH A MINIMUM CHARGE OF $20.00 PER MONTH, AND IF PLACED IN THE HAND OF A COLLECTION AGENCY, ALL COLLECTION, LEGAL, AND FILING FEES SHALL BE PAID BY CUSTOMER ACCEPTING SAID CONTRACT. 3. CORE Contractors, Inc. shall have no responsibility for damages from rain, fire, tornado, windstorm, or other perils, as is normally contemplated to be covered by home owners risk insurance or business risk insurance, or unless a specified written agreement is made therefore prior to commencement of the work. 4. Should legal action be necessary, because of any act that might arise during the course of this agreement; CORE shall be entitled to all costs incurred in connection with such action, including a reasonable attorney's fee. 5. The parties hereto agree that all actions or proceedings arising in connection with this agreement shall be tried and litigated exclusively in the State and Federal courts located in the County of Denver, State of Colorado. 6. Replacement of deteriorated items (such as decking, fascia boards, roof jacks, ventilators, flashing, or other materials) not covered by insurance, discovered during construction and required by governing code or necessary for product warranties are NOT INCLUDED and will be charged as an extra on a time and materials basis unless STATED IN THIS CONTRACT. 7. CORE Contractors, Inc. shall not be liable for failure of performance due to labor controversies, strikes, fires, weather, inability to obtain materials from usual sources, or any other circumstances beyond the control of CORE Contractors, Ins. whether of a similar or dissimilar nature. 8. Subsequent to property owner's insurance carrier approval, if this agreement is terminated by the owner, the owner shall be financially responsible for all work performed based on the following milestones (percentages are additive). a. Consulting Phase: Preparation of CORE Xactimate scope of work and adjuster appointment — 3% of total bid. b. Substantial agreement or scope confirmation with insurer — 5% of total bid. c. Ordering and scheduling of work — 2% of total bid. d. Repair Phase: Any line item of physical work that has been started shall be completed by CORE; if the owner terminates this agreement while physical work is ongoing, they shall be responsible for all costs related to that line item, plus general contractor overhead and profit. 9. In addition, the owner shall be responsible for all other reasonable fees and expenses incurred prior to termination of the agreement, including permit fees, deposits paid by CORE to suppliers and subcontractors, subcontractor fees and expenses, etc. to the extent they are not already included in the line items for work that has been completed. All fees and expenses incurred prior to termination of this agreement shall be paid PO"WE.RF."i BY -^'cai I�&s' Vc_ti1�W )cFiYi`.'asxotl% by the owner within 30 days of invoice date. 10. If material has to be reordered or restocked because of a cancellation by the customer; customer will have to pay the restocking fee assessed to CORE by the supplier. 11. If any provision of this contract should be held to be invalid or unenforceable, the availability and enforce -ability of the remaining provisions of this contract shall not be affected thereby. 12. ANY REPRESENTATIONS, STATEMENTS, OR OTHER COMMUNICATIONS, NOT WRITTEN ON THIS CONTRACT ARE AGREED TO BE IMMATERIAL, are not relied on by either party, and do not survive the execution of this contract. 13. The maximum liability for CORE Contractors, Inc. shall be the original cost of labor and materials for the repair, which the customer agrees shall be the liquidated sum, under any event of default of CORE Contractors, Inc. herein. 14. During the duration of the work, the customer's HOMEOWNER'S INSURANCE will be responsible for any interior damage as long as CORE Contractors, Inc. has taken appropriate action to protect the roof and siding during the repair of the roof. 15. CORE Contractors, Inc. is not responsible for existing construction problems of customer's home. If pointed out and notified to CORE, we will try to assist you in correcting the existing construction problems on a time and material basis. 16. THIS CONTRACT IS COMPOSED OF THIS PAGE AND THE REVERSE SIDE OF THIS PAGE AND SHALL BE CONSIDERED THE ENTIRE CONTRACT BY THE PARTIES. PO114rPFDBY;',canvas WtYK'.7C34<iS7btLS.G(1i� s:ipsi: ! i;�'t� <: ,. INSPECTION RECORD OccuDancvlTvpe °'INSPECTION LINE: (303) 234 -5933 Inspections will not be made unless this card is posted on the building site Call by 3:00 PM to receive inspection the following business day. 1Y1 17 INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB �7 FOUNDATION INSPECTIONS DATE INSPECTOR INITIALS COMMENTS: Footings /Caissons - Stemwall / (CEG) Concrete Encased Ground Reinforcing or Monolithic Weatherproof/ French Drain - Sewer Service Lines _ Water Service Lines INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. CONCRETE SLAB FLOOR Electrical (Underground) Plumbing (Underground) Heating (Underground) ROUGHS Sheathing Lath / Wall tie - Mid -Roof Electrical Service Rough Electric Rough Plumbing _ Gas Piping INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. Rough Mechanical "NOTE. ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION -------------- - - - - -- -- - OF-- A- CER-T-IFICATE OF-- OCCUR -ANDY —NOR PERMISSION-FOR-0 GGUP,4N . Framing Insulation Drywall Screw TO BE SIGNED FINALS Electrical Plumbing Mechanical Roof Building Final Fire Department R.O.W & Drainage INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. Parking & Landscaping "NOTE. ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION -------------- - - - - -- -- - OF-- A- CER-T-IFICATE OF-- OCCUR -ANDY —NOR PERMISSION-FOR-0 GGUP,4N . OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED PROTECT THIS CARD FROM THE WEATHER ♦ 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: e X;T 1 /o fe;RL u170. 147 Job Address: I /000 ).Mgnw Permit Number: 1la'M ❑ No one available for inspection: Time AM Re- Inspection required: Yes "When corrections have been made, call for re inspection at 303 - Date: Inspecto >� DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Plumbing PERMIT - 110486 PERMIT NO: 110486 ISSUED: 05/02/2011 JOB ADDRESS: 4000 YARROW ST EXPIRES: 05/01/2012 DESCRIPTION: Replace 40 gallon gas water heater * ** CONTACTS * ** owner 303/349 -0314 Linda Wolf sub 303/920 -1102 Tonya /Kevin Lasky 11 -0104 Steadfast Plumbing Inc. ** PARCEL INFO ** ZONE CODE: UA SUBDIVISION: 0331 USE: UA BLOCK /LOT #: 0/ * *FEE SUMMARY ** ESTIMATED PROJECT VALUATION: 825.79 FEES Permit Fee 40.00 Total Valuation .00 Use Tax 14.86 ** TOTAL ** 54.86 Conditions: Work shall comply with 2006 IRC & 2005 NEC. Per IRC Sec. R313, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. Carbon Monoxide detectors are required to be installed within fifteen(15) feet outside the entrance to each sleeping room. Subject to field inspection. 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' acco panying approved plans and specifications. Signature of OWNER I 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 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. Approval of work is subject to field sp on. Signatur ' o ief Building Offical Date INS REQUEST LINE: (303)234 -5933 BUILDING OFFICE: (303)235 -2855 REQUESTS MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of WheatIjAc COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 29" Ave., Wheat Ridge, CO 80033 Office: 303 - 235 - 2855 " Fax: 303 - 237 -8929 Inspection Line: 303 - 234 -5933 Property Owner (plea Date: Plan # Permit # Building Permit Application �000 ynr��� ( �- \ se print) L \� \ V N ("�� V Phone:3L3 3 ' `t_ (� I - O 1 Mailing Address: (if different than property address) Address: City, State, Zip: �\ 1 \ 1 ^ l CD Q 003 Contractors City License #: Phone: 332) -`" a J - �, 0 �uu v.vlluay}urr> Electrical: Plumbing: v echanical: S- ��rnb City License # City License # ty License # DeSCI'IDt1O11 Of WOrrF� $ 99 Contract Value: t�� \V k � ) LU 1����fI Review Fee (due at time of submittal): Squares BTU's 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. CN1S�L�IiIU�A PRINT of (OWNER) (CONTRACTOR) Bldg Valuation: $ 40-41, llt�F ` �v City of Wh6atldge Co UNITY DEvalropmENT SUB - CONTRACTOR AUTHORIZATION FORM Project Address: Permit #: General Contractor: Electrical Contractor Company Name: Phone #: State License #: Master #: Signature of Authorized Agent Date Pl umbing Contractor Company Name: lPu& L� Uy� �1�1 Phone #: 3D3 -ciao —u State License #: t� —� Master #: J gCo as 3 Wheat Ridge License #: Lxt l f I fiat Signature of 0 Agent to I Mechanical Contractor I Company Name: Wheat Ridge License #: Signature of Authorized Agent Phone: Date *This application must be signed by each sub - contractor confirming the same. DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : 10232 BUILDING INSPECTION LINE - 303-234-5933 CITY OF WHEAT RIDGE Date : 3/14/00 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 - (303-235-2855) Property Owner : Property Address : 4000 YARROW ST Phone : 467-6868 Contrector License No. : 17858 Company : Peterson Roofing Phone : 431 9625 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certiy that the setbadc distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules ar 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 (U.B.C.) and all other applicable Wheat Fiidge ordinances, for work under this permR. (OWNER)(CONTRACTOR) SIGNED DATE Description : Install 25 year seal down laminate Construction Value Permit Fee Plan Review Fee Use Tax Total $3,608.00 $97.25 $0.00 $54.12 $151.37 Use: Electrical License No : Company : Plumbing License No : Company: Mechanical License No : Company: Expiration Date : Expiration Date : Expiration Date : Approval: Approval: Approval: (1) This penit was issued in acmrdance with the provisions set forth in yopur application and is sub1'ect to the laws of Me State of Coloratlo antl lo the Zoning Regulations and Building Code of Wheat Ridge, Coloiatlo or arry other applicable ortlinances of the Ciy. (2) This penit shall eupire if (A) Me work authonzed is not commencetl within siaiy (60) days trom issue tlaM or (B) the building authorizetl is suspended or abandoned for a period M 120 tlays. (3) If this penit expires, a new penit may be acquireG for a fee of one-half ihe amount nortnaly requiretl, provided no changes have Eeen or will be made in the original plans and speGficaOOns and any suspension or abandonment has not exceedetl one (i) year. If changes are matle or if suspension or abandonment exceeds one (1) year, tull fees shall be paid for a new pertnit (4) No vrork of any manner shall be done that will change the natwal Bow of water causing a tlrelnage problem. (5) Contractor shall notify the Building Inspeclor twenty-four (24) hours in advance for all inspectlons aM shall receive writlen approval on inspection card before proceediing with successive phases of the'ob. (e) The su of a pertnit or the approval drawings and spacifmtions shall not be construed to be a permit for, nor an approval of, any violation of the provisions of Is di ccdes o!,sry other ordinance, law, rule or regulation. Chief Building 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 qPPLICATIo N Property Owner : W O I Property Address : ~ 7 d40 w Phone :~l_f~~ ContractorLicenseNo.: Comparry : / eki-5,,.. Phone : 7( oX 3 SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this pertnit application are accurete, and do not violate applicable ordinances, rules or regulations of the Ciry of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and allegations made are accurete: that I have read and a9ree to abide by all conditions printetl on this application, and that I assume full responsibility for compliance with the Wheat Ridge Building Code (U.B.C.) and all other applicable Wheat Ridge ordinances, forwork under this pertnit. (OWNER)(CONTRACTOR) SIGNED DATE3'/ y-L)6 Construction Value : 3(0 0 g°- Permit Fee : Use Tax : Total : Use: Description: ~SA-C,tk oLS'_yt- Seul c~~yr I 0.^^,~~t / BUILDING DEPARTMENT USE ONLY OT, SIC : Sq. FL : yApproval : Zoning : Approval , oil Approval : Occupancy : Walls : Roof : Stories : Residential Units : Electrical License No : Company: Plumbing License No : Company: Mechanical License No : Company : Expiration Date : Approval : Expiration Date : Approval: Expiration Date : Approvai: (7) This permit was issueE in accor0ance wiN the provisians set foM in yopur applifation and is suDject ta the laws ot the State ot Colorado and to the Zoning Regulations anC Builtling Cotle o( Wheat RiEqe, Calo2do or any other applira6le oNinances a( Me Ciry. (2) This permit shall expire if (A) the work authanzed is not commenced within siMy (60) days hom issue tlate or (8) the building authonzed is suspenGed or abantloned for a penod of 120 tlays. (3) If this pertnit expires, a new pertnit may be acquired for a fee of one-half the amount rwrtnally required, provitled no Uanges have been or will be matle in the onginal plans antl specifirations antl any suspension or abantlonment has not exceedeO one (1) year. If cfianges are maCe or i/ suspension or aDanOOnment exceetls one (1) year, full fees shall be paid for a new permtt. (4) No work of any manner shall be dane Mat will Uange the natural flax of water ausing a tl2inage problem. (5) ConVaclor shall noti(y the Builtling Inspettor hventy-kur (24) hours in atlvance kr all inspections and shall receive wrdten appmval an inspection rard beMre proceetliing with successive phases of the ob. (e) The issuance of a permk ar Ne approval of d2wings anE specific~atlons shall not he consWeO to Ce a pertnit for, nor an aOProval o(, any violatian af the pmvisions ot the builCing coEes or any other orAinance, law, n,le ar regulatlon. Chief Building Inspector DEPARTMENT OF COMMUNITY DEVELOPMENT ~vipg3#3419 7500 WES7 29tn AvENUE BUILDING INSPECTION DIVISION PERMIT N0. 237-6944 EXT. 255 P.O. BOX 838 CITY OF WHEAT RIDGE, COLO. THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILOING INSPECTOR AND RECEIPTED BEL'JW. APP ICATION FOR MISCELLANEOUS PERMIT p JOB ADDRESS I OQC~ (~A(A h Ii A~) ~ 1 I OWNER`~~a ~i'1/~ CONTRACTOR ~ ~I J I tyl 0 L~~ ADDRESS 4 noo 41 ~ ~Q. 33 iVn ~ .n _ , I '7 /"l 1 ~ - CITV ~ U N 1 i',1..(.~ . ZIP CODE 9i PHONE 4o~ J~O Z C a LICENSE NO. PHONE 4 If 4- LOS,t~ ZIP CODE ~ONTRACT PRICE $ Yi3C3O~-' 1. 7YPE GrounE❑ Wall❑ Proieetinp❑ 01Mr SorDFOCe 2. MATERIAL Total Squon Feat SIGNS 3. ILLUMINATION Yea❑ No❑ Typa Eleef. Permit No. 4. SET BACK FROM PROPERTY LINE N- S_ E_ 1. TYPE SolidU Mon Than 80% OpanL.J Ln FENCES MATERIAL 3. SET BACK FROM PROPERTY LINE (Soecifv whieh it}ront) N_ 5_ E_ ❑ ❑ ❑ INSPECTION TICKET JOB ADDRESS O U~ I. OTHER 2 13. BLDG. PERMITM DATE: -I -7 DRAW SKETCH OFt SHOW BELOW,THE FENCE,SIGN,OR OTHERSTRUCTURE, (SETBACNS OR PROJECTIONS INCIUDEp) STREET NAME SHOW DISTANCES FROM THE MAIN BUILDING TOAWOINING HOUSES, STREETS, DISTANCE TO PROPERTY LINES, NOT MA%IMUM OR AVERAGE DISTANCE. APPLICATION FOR PLUMBING; ELECTRIC THIS APPLICATION WILL BECOME A PERMIT TO PERFORM THEiNqCATEO WOF FERMIT iNILI EXPIRE 60 DAVS FROM DATE OF ISSUANCE !F PERMITk BLDG. CONTR. G ° ~ -L SUBCONTRACTOR DATE INSP. REQ. d -III & TYPE OF INSP. INSPECTION MADE REMARKS W.R. FORM 619 / ELECTRICAL PERMIT STATE LICENSE N0. PLUMBING PEhmi i STATE UCENSE N0. /1Zf J fLC9 MECHANICAL PERMIT ALUMIiaUtaWIREUNDERS2E81LLEGAL PLOOR BSM IST 2ND 3R0 4TH N0. FLE4CkcNOroGoiOil ENeSdor Np. WATER CLASET FORCEO AIR - BTU TEMPORARY METER WASH BOWL HOT WATER - BTU NEW SERVICE AMPS CHANGE SERVICE-AMPS LIGHTIN6 BATH TU8 SHOWER SINK STEAM - BTU AIR CONDITIONING-BTU OTHER HEATING GARBAGE DISP REFRIGERATION SYSTEM PpWER SUB-LIRCUITS UTII.ITY(RANGE,OISPOSER,ETC.) FIXTURES WATER HEATER AUTO. WASHER DISH WASHER Refri aranl Grou Chor ° AUTOMATIL SPRINKLER SYSTEM WtRING MOTOfiS 9 CONTROIS FLDOR DRAIN ELEVATOR SIGNS URINAL TRANSFORMERS 9 RELTFIERS SEWERS ADDITION TO OlD WORK OTHER MOTORS OVER I HP TOTAL FIXTURES REMARKS I hsreby ocknowledqe ihot thia applica- tion ie eorrect ond underatand fhat I ponnot ftarf this projeet unfil this appli- cation ie aDProved. I sholl tomply with the laws of the S1ate of Colorodo and to the ZoninQ ReQulations ond BuildinQ Code offhe Cify of Wheai Ridqe. Any viotofion of the above ferms will cause immsdiate revoeation of tnia permit. M11i<anl~,lf0~n ( C E NOT VALID UNLESS RECEIPTEI PERMIT FE e57 usE rax TOTAL FEE 4 24 APPROVED ~ CHIEF BUILDIN ,City of Wh CALL 237-8944 EXT. 255 24 HOURS IN ADVANCE FOR INSPECTIONS Dafe IssuPd~