HomeMy WebLinkAbout4048 Simms Street4c4e, 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 tha incnprtinn
Oc anc /T• e
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
Initials
Pier
Concrete Encased Ground (CEG)
Foundation/ P.E. Letter
Do Not Pour
Concrete Prinr Tn Annrew.1 rlf Thn Ar,.,.,,, I ----- A.:_ _
Rough Inspections
- ---- --- - - -
Inspector
-1�1'-• •• •w . &O%,Irc nla U%o�I VI '
Underground/Slab Inspections
Date
Comments
Initials
Lath /Wall Tie
Electrical
Sewer Service
Plumbing
ough Mechanical
Rough Inspections
Date
Inspector
Initials
\/vu, w1 1 11C Liu va Ills peupons
Comments
Wall Sheathing
Mid -Roof {,
.
Lath /Wall Tie
Rough Electric '
ough Mechanical
[RoughFraming
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
7
g
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 nccunanry
"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
t
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: �1
Job Address: S
Permit Number:(0
❑ No one available for inspection;. Time r'AM 15M
Re -Inspection required: Yes No
`7_
When corrections have been made, call for re -inspections at 3�03-234-5933
Date: 40' IF / % Inspector:
DO NOT REMOVE THIS NOTICE
A ,� City of Wheat Ridge
Residential Roofing PERMIT - 201705642
PERMIT NO: 201705642 ISSUED: 08/07/2017
JOB ADDRESS: 4048 Simms ST EXPIRES: 08/07/2018
JOB DESCRIPTION: Residential Re -roof to install CertainTeed Presidential T/L asphalt
shingles with 56 sq.
*** CONTACTS ***
OWNER (303)618-2331 T W AND K S DONZE FAMILY TRUST
SUB (303)425-7531 John Borfitz 019983 J & K Roofing Inc.
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 33,829.00
FEES
Total Valuation 0.00
Use Tax 710.41 PAi"
Permit Fee 545.55
** TOTAL ** 1,255.96
*** 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.
41 City of Wheat Ridge
Residential Roofing PERMIT - 201705642
PERMIT NO: 201705642 ISSUED: 08/07/2017
JOB ADDRESS: 4048 Simms ST EXPIRES: 08/07/2018
JOB DESCRIPTION: Residential Re -roof to install CertainTeed Presidential T/L asphalt
shingles with 56 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 ermrt .1 further attest that I am legally authorized to include all entities named within this document as parties to the work to be
perfo d, hat all work to be performed is disclosed his document and/or its' ac ompa�ying approved plans and specifications.
Signature of OWNER or-'ONTRACTOR (Cie) Date /
1. This permit was issued based on the information provided in the permit application and accompanying Flans 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 originalpermitfee.
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 changeof 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, an violation of any provision of any
applicable any ordinance 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.
Dan Schultz
From: no-reply@ci.wheatridge.co.us
Sent: Tuesday, August 1, 2017 10:47 AM
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
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 4048 Simms St
Property Owner Name Terry Donze
Property Owner Phone 303-618-2331
Number
Property Owner Email Field not completed.
Address
U
Do you have a signed
Yes
contract to reroof this
property?
It will need to be
provided at the time of
permit pick-up.
Attached Copy of
donze contract.pdf
Contract
CONTRACTOR INFORMATION
Contractor Business
J & K Roofing
Name
Contractor's License
019983
Number (for the City of
Wheat Ridge)
Contractor Phone
303-425-7531
Number
Contractor Email Address
kathyv@jkroofing.com
Retype Contractor Email
kathyv@jkroofing.com
Address
DESCRIPTION OF WORK
Are you re -decking the
No
roof?
Description of Roofing
CertainTeed Presidential T/L
Material
Select Type of Material:
Asphalt
If "Other" is selected
Field not completed.
above, describe here:
How many squares of the
56
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
56 V
(pitched + flat) of all
FA
roofing material for this
project
Provide additional detail
here on the description of
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
House - 8/12 Pitch - J&K Job #6764
Project Value (contract 33829
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 Kathy Vendegna
Email not displaying correctly? View it in your browser.
3
-' CONTRACT
J&K Roofing
131313 13000 W. 43rd Drive • Golden, CO 80403 t 4-2
Phone: 303-425-7531 Fax: 303-425-1562
www.jkroofing.com
Representative Contact '%,4,o—q 0 '/340 Date —C 20_j_l
Namet�
! ,,rrecyu.0 Phone email'rdoura
Address `� 0v .5; City
Pinnacol Assurance Cincinnati Specialty Underwriters
303-361-4000 303-653-0023
Workers Compensation Insurance General Liability Insurance
Policy #4079290 Policy #CS00061742
LABOR AND MATERIAL SPECIFICATIONS TERMS Extra work ���►l -U-ra L
AND CONDITIONS. PLEASE READ CAREFULLY:
Recover roof with 6AC4,134IZAj Pre T/
Color of shingles�u
Manufacturer's Warranty`L"Vr T�
lTear off
fI` Install Underlaymentso-lb
Double all Eaves
Re -Flash Chimney and/or Skylights
New Valleys1/� 0, _
Replace Ridge4A.-
Ventilation
Galvanized Fasteners—4 J){(- SAAA y�W—
Replace Plumbing Jacks
Paint roof stacks to match
Install.. jln, - Metal Edging
Patio or Flat roof --�-_
Year Warranty on labor
XJ J & K Roofing to furnish all material and labor
Permit: Included _X1..,__ NOT Included
Clean-up debris and haul off all trash from roof
Roll yard with magnetic roller
Gutters cleaned of roofing debris
Decking Repairs $ —9'zs per. ¢.
Hidden La ers (tear off) $—,&[A— per layer
Camerj (Policy Number)
(claim ff) ('//''/`�/1 (Adjustor]
ell —A
{Mortgage Go.; (Mortgage Loan Number)
The property owner is—X is not using proceeds from
property and casualty insurance policy.
1 17
Deductible if applicable $-94_R-q I",
Per Colorado State Law CRS § 6-22-105 which states; 100%
the responsibility of the homeowner to pay this amount. J & K
Roofing will not reimburse or promise to reimburse in whole or
in part any amount of the deductible.
Estimated Start Date__.�o (w�Jt1� Qldir �7 ?
TOTAL ESTIMATE $'
ALL PROPOSALS ARE SUBJECT TO MANAGEMENT APPROVAL
J&K
Hom(
Home
Date_ 17
Date %16-2-9-) 7
Date -� �-rl
Expiration Date &
You have the right to recind this contract and obtain a full refund of any deposit within 72 hours after entering the contract. If you plan to use the
proceeds from a property and casualty insurance policy to pay for the roofing work, you may rescind this contract within 72 hours after receiving
written notice from your insurance carrier that your claim has been denied in whole or in part. However, J&K Roofing is entitled to retain payments or
deposits to compensate for roofing work actually performed in a workmanlike manner consistent with standard roofing practices.
PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION
CITY OF WHEAT RIDGE
Building Inspection Division`~ J
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
J
INSPECTION NOTICE
Inspection Type:
Job Address:
Permit Number:vim? ._
❑ No one available for inspection: Time 5 AMM m
Re -Inspection required: Yep' No - `
When corrections have been made, call for re -inspection at 303-234-5933
Date: '1 Inspector: �&I/ C, lzrf—
DO NOT REMOVE THIS NOTICE
i
Call by r w • • r • business day.
• 4 r
. FRUTMEM
Lath 1 Wall tie
Mid°
Electrical SeMce
Rough Elec
Rough Plumbing
Gas Piping
Rough Mechanical
AB OVE
INSPECTIONS TO BE SIGNED PRIOR TO C
Framing
City felt' Ridge
Insulation
5/11 07-.18 COQ
Drywall Screw
Install 75 yallon h
CDA618084
MOUNT
It
4048 Sim ST
59M
PUPI :2 739
Electrical
Plumbing
PAYMENT RECEIVED
ll
Mechanical
V 9723
AUTH 808281
Roof
1 :
5m AR
05/28/2014 =11 3035341481
From:
M.T rom . fi p ,
� \� � � N \jk..
PAGE m
061111201Z 0738 #Z31 P1002/00Z
« :* «£» «4:
Us* of $ » 4 « w- *»
, £ :2 \: Pa use c card » , »:«« # \>
< s
Print narne:
w
\ �}
INSPECTION RECORD Occupancy/Type
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.
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB
FOUNDATION INSPECTIONS
DATE
INSPECTOR
INITIALS
COMMENTS:
Footings /Caissons
Lath /Wall tie
Stemwall / (CEG) Concrete
Encased Ground
Mid -Roof
-
Reinforcing or Monolithic
2 ��
Electrical Service
Weatherproof / French Drain
Rough Electric
I
Sewer Service Lines
Rough Plumbing
-
Water Service Lines
Gas Piping
INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS
SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
POIIR NO CONORFTF IINTII ARnvF HAS RFFN SIC.NFn
CONCRETE SLAB FLOOR
Electrical (Underground)
Plumbing (Underground)
Heating (Underground)
ROUGHS
fa� � zv � L
Sheathing
Plumbing
Lath /Wall tie
Mechanical
Mid -Roof
a _�
Roof
2 ��
Electrical Service
Building Final
Rough Electric
I
Fire Department -
Rough Plumbing
-
R.O.W & Drainage
Gas Piping
INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS
SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
Parking & Landscaping
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 CERTIFICATE OF OCCUPA NOR PERMISSION FOR OCCUPANCY.
ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING
Framing
Insulation
Drywall Screw
FINALS
Electrical
Plumbing
Mechanical
-
Roof
2 ��
Building Final
I
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 CERTIFICATE OF OCCUPA NOR PERMISSION FOR OCCUPANCY.
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED
PROTECT THIS CARD FROM THE WEATHER
e ` ! d CITY OF WHEAT RIDGE
11 j/ Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office - (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
f
Job Address: tf . Sr S
Permit Number:
h
j;
❑ No one available for inspection: Time AM/PM
Re-Inspection required: Yes No
' When corrections have been made, calf for re-inspection at 303-234-5933
/ j
Date: 11U inspector:
121
/~1 s
fDO NOT REMOVE THIS NOTICE
`a h.. p .. xY n may- yy ...,.. xngp•en "aAw' ... � �.^�
f CITY OF WHEAT RIDGE
Building Inspection Division
I (303) 234 -5933 Inspection line
(303) 235 -2855 Office • (303) 237 -8929 Fax
INSPECTION NOTICE
Inspection Type: 21,
Job Address: _ <j04 4 5f
Permit Number: 05 I
❑ No one available for inspection: Time l02 �, 4_
Re- Inspection required: Ye No
When corrections have been made, call for re inspection at 303 - 234 - 5933
Date: t/ b5 / o Inspector:
i
DO NOT REMOVE THIS NOTICE
4' CITY OF WHEAT RIDGE
Bung Inspection Division
(303) 234-5933 Inspection line
(303)235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: 4-va-
Job Address: 5'r-, °!g S~rsl~mS 5r
Permit Number: e5?7,vli /
.L,
- e('A</ sE'l T, Sf-firvlalf5 7~?A'A/~iTroov..~/G t~atir ; P2 Yv 7,'f,Z
No one available for inspection: Time 3%,7Z1 AM/I
C Re-Inspection required: Yes- No
f
' When corrections have been made, call for re-inspection at 303-234-5933
r"
Date: 7flr"-~ Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address: 9'®V3 _srs~ mat sr
Permit Number: a <v/z~
/ PW4-e 7ae Yc 2rY to SST ~A i G n /2r
pid°r97P?fB2 ~ s.rtsS',Jff_'~s Cl r..~
❑ No one available for inspection: Time r; st AM
Re-Inspection required: No
When corrections have been made, call ffoor/re-Inspection at 303-2345933
Date: ~OJ~~ies Inspector:
DO NOT REMOVE THIS NOTICE
r
e A a CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office - (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: /ih/b/ Ac~1=
Job Address: tfo Y9 .5~.rayn 5 s7-
Permit Number: 09 !/Gl
/~iGG~~~7 8 : 3S
❑ No one available for inspection: Time AM/PM
Re-Inspection required: Yes No
When corrections have been made, call ffoor/re-inspection at 303-234-5933
Date: G Inspector:
DO NOT REMOVE THIS NOTICE
♦ i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: fU's,(ror
Job Address: qeNl n ';"tordit S
Permit Number:
n
❑ No one available for inspection: Time TIS A f M
Re-Inspection required: Yes
' When corrections have been made, call for re-inspection at 303-234-5933
Date: Pi/-t2 Inspector: LiA1,11V D
O NOT REMOVE THIS NOTICE
City of Wheat Ridge
r4000or I Residential Roofing PERMIT - 094161
PERMIT NO: 094161 ISSUED:' 11/18/20.
JOB ADDRESS: 4048 SIMMS ST EXPIRES: 05/17/20.
DESCRIPTION: Reroof 49 sqs
CONTACTS
owner. 303/618-2331 Terry Donze
sub 303/425-7531 John Borfitz 01-9983 J K Roof.
PARCEL INFO
ZONE 'CODE: UA USE: UA
SUBDIVISION:0125.: BLOCK/LOT#: 0/:.
FEE SUMMARY ESTIMATED PROJECT VALUATION:
FEES
Permit Fee 472.30
Total Valuation F'~(L
Use Tax 409.88 -
* * TOTAL
882.18
>f inspection required. Board sheathing spaced more
•equires plywood overlay on entire roof. Ice and
date
3 BUILDING OFFICE:. (303)235-2855
NESS 'DAY FOR 'INSPECTION THE :FOLLOWING' BUSINESS DAY.
of "'"~°rq City of Wheat Ridge Building Division
( 'm 7500 W. 29th Ave„ Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-235-2857
°ocoRaoo Inspection Line: 303-2345933
00- 1(09 0 Building Permit Application
Date:
Plan
Permit #:C/ (
Mom„ harrv i, Qye q 00n-2~
Property Owner (p/ease print): ` o Lt R Sq m m s S-!' Phone:
Mailing Address: (if different than property address)
Address: cJo,t'~
city, State, zip: I A mmi-l-l A n e . 0-0 800 2,3
Contractor License ! a v Phone: S -L- 2 S 7 S3
EMENERM
Electrical City License
Company:
Plumbing City License
Company
Mechanical City License
Company:
Exp. Date: Exp. Date: Exp. Date:
Approval: Approval: Approval:
Use of s ace descri tion): ~~G14' 0 (11 ! construction value: $ 22.`1`71
1 1 !Q- (as calculated per the Building Valuation Data sheet)
~ y~s re.rooP
eer L~ o ee,.l 9r,g S -TL_ ! , *`m a Plan Review (due at time of submittal): $
Sq. Ft./L. Ft added: Squares 4q 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. alaus.subject to field inspection.
CIRLCE ONE: (OWNE (CONTRACTOR) or PERSONAL REPRESENTATIVE of (OWNER) (CONTRATOR)
PRINT NAME: /1"114 U. 0ii-g- SIGNATURE: I.UI d' bck [Date: 11 ' Ig
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DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : 9104
BUILDING INSPECTION LINE - 303-234-5933
CITY OF WHEAT RIDGE Date : 6/24/99
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215 - (303-235-2855)
Property Owner :
Property Address : 4048 SIMMS ST
Contractor License No. : 17152
Phone: 420-7876
Company : Precise Plumbing Phone : 534 0881
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate,
antl 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 acwrate; that I have read and ayree 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 Ridge ordinances, for work under this permit.
(OWNER)(CONTRACTOR) SIGNED DATE
Description : Replace water heater, ready for inspection
Construction Value :
$496.00
Permit Fee :
$23.50
Plan Review Fee :
$0.00
Use Tax :
$0.00
Total:
$23.50
Use:
BUILDING DEPARTMENT USE ONLY
SIC : Sq. Ft. :
Approval:
Zoning :
~ .
Approval:
~
Approval:
Occupancy : Walls : Roof : Stories : Residential Units :
Electrical License No :
Company:
Expiration Date :
Approval:
Plumbing License No :
Company:
Expiration Date :
Approval:
Mechanical License No :
Company :
Expiration Date :
Approval:
(1) This pertnit was issuetl in accordance wi[h the provisions set forth in yopur application antl is subJect to the laws ot the Slate of Colorado and to the Zoning
Regulations and Builtling Code of Wheat Ridqe, Coloratlo or any other appliwble ortlinances of ihe City.
(2) This permit shall expire i! (A) the work authonzed is not commencetl within siMy (60) days trom issue date or (B) Ihe builtling authonzeU is suspendetl or
a6andonetl For a periotl of 120 Aays.
(3) If this permit expires, a new permit may be acquired for a Fee of one-half the amount normally required, provitletl no changes have been or will be made in the
onginal plans and specifications and any suspension or abandonmen[ has not exceeded one (1) year. If changes are matle or if suspension or abandonment
exceeds one (1) year, full fees shall be paid for a new permit.
(4) No work of any manner shall be done that will change the natural flow of water causing a drainage problem.
(5) Contractor shall notify the Builtling Inspeclor hvenry-four (24) hours in advance for all inspections and shall receive wntlen approval on inspection card before
proceediing with successive phases of the job.
(6) The issuance of a permit or the approval ot drewings and specifcalions shall not be constmed to be a permit for, nor an approval of, any violation of ihe provisions
of the-buildin9 mdqs or any other ordinance, law, rule or regulalion.
Chief Building Inspector
DEPARTMENT 01: PLANNING AND DEVELOPMENT Building Permit Number :
BUILDING 1NSPECTION DNISION - 236-28a5
CITY OF WHEAT RIDGE Date :
7500 WEST 29TH AVENUE
WHEA7 RIDGE, CO 80215
Property Owner :A~4,vPG2
30 3
Property Address : 1/o yoP S~ m s„s ,j 8 ao 3 j Phone :,<~o- 7 6
Convactor l.icense No. 7/ f-:2,
ComPan
Y: P. -e cise. li-`,91 .2=71 Phone:S~f~ oSsr/
~ OWNER/CONTR,4CTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
' I hareby certAy tnat the aelback aistanCas ppoosed ey thif ppfmR aDDneation ue scarate.
anE Co not vrolate acPLcabb oromancaa. ruMS a rapmtrons of Ne City of WAeat Ridp. pr .
cownams. easamenb u rosmedons of neony: Mac an msnummey shown. ana aNpauons
rmaa src acwran: mat I have maa uW aprN to aDtlf Oy aY wrqapng; Pmaa an Ihts apppcation. ana mn 1 assurtN !un nspomOYilyfbr opmpymp y,pi Ow yyhom Ridge Buildhig
Cods (U.B.C.) ana an otlw apptipbb Whyt R p~. fCr work; undw thq pa~
(OWNER)(CONTRAC70R) SIGNED -
U
D /
conswcnonvalue: yrs'E -
Permit Fee : 2 1 SD
UseTax:R'a-OjvYS
rotw 3-:;-,o~
escnpdon r-V ,s c e r4eo~i~
~Rtic
Approval :
Zoning :
~JB(~dlflo~lCii3~ibts
Approvai
PObI g
Approval :
Occupancy : Walls
BUILDING DEPARTMENT USE ONLY
Roof : Stories : Residential Units :
Etectncal License No :
Company :
Plumbing License No : Mechanical License No :
Company: Company:
Ecpiretion Date : Expiratlon Date :
Approval : Exp'vadon Date :
ApProval : Approval :
~ : P.ftiis'R54uired=- ~ PIMs Rd4utrod:" :1
~ ~uUi7l~
( t ) This permn waa owea n smomana ..m une pruv,sqns sN bm N yoow aoWUOOn ana u
ReqLwuons ax Bui~anq Coaa of W~aac Rqq@ . Co:aaoo a airy ansr aoouneN oroinanat o~f WNw~tna Iawa U tM Sfato U Cobraao ana m tne Zwivq
(3) Th's pertnrt snLl aapve A!Al
aowonea tor a oerwo of Qo lfla wafk auvqnilp u npl C1mnNncep wpy~ usry (BO) 4iYS hOrn ysw au pt (B) db Ou~NUq auYqnzep q~Wpe1pap p~
mw.
(3) u wa varmrt e:wros. a naw wrmt mav aSoouuw ror a tN W mo-hun tns urount nomuW roawrw. wvNoW ro a
-~Pm Nans &na soealluoons ana any ouswnswn a ae+roanmem naa not exwwn one (1) Y&r. tl n~"~ Own or wiY M eua~ n M~
exaaas ona t 1) yeu. MI haa wtl Ds osa lor a new pertrK, ~qM an mwe p d iwpnyq~ pr uwppm~
(4) No work of arry manner fnan pe Cwfa pyt wM Uanqe ma nawM 110w of waW ou.unq a Erauuqa proOWn.
(5) ConltaROf Snall nppN in! BwlOug InaOlOy (WMry-ipyf (24) n0urs m iOVinGa foI an maplCCpn7 an0 ilytl roe" wriryen mDWOVvI pn mtpKWn Ca/0 DNp~
orxseaimq wnn sucussrve onaaef of tne pp.
(6) TTe uauance of a permtt or Int aDOrovai of arawinqs ana soeolicanpns snan not Oa cpnsweC lo De a pertM Apr. ny in aDProvo10!. iny ndappl pI1M pipryqns
Of I71! DWICin9 cxe3 G iny 0111lf OIOlniitR. 10W. N:t OI!lyW40t1.
Chief Building inspector For Mayor
THIS PERMIT VAUD ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 214-5933 24 HOURS PRIOR TO INSPECTION
, ~ y'- tf t- ( C -7
INSPECTION TICKET
JOB V-~~
ADDRESS
r~4 `5
INSPECTION 71CKET
JOB
ADDRESS
'SS~ .
DATE: ~"1 ~ BLDG. PERMIT# il%'~ ~a tESd b'j
PERMIT#
BLDG. CONTR. `:~A-SUBCONTRACTOR /
2-
DATE INSP. REQ. ~ -
TYPE OF INSP.
LCAe~~
INSPECTION MADE~/_~
v ~
REMARKS
INSPECTION TICKET
JoB y0~4~ S~mnr~5
ADDRESS _
DATE: BLDG. P RMITM
PERMIT#
BLDG. CONTR.l1J U 1 LL..Lj t Z
SUBCONTRACTOR
It5 kA L~ ~ ~lT
DATE INSP. REQ.
43-
TYPEOFINSP. Y~Y
~A~~ 1~'~~CQSQ
INSPECTION MADE
`Z^ C~ .
REMARKS 6
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W.R. FORM 6-18 1
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DATE: BLDG. PERMITM S~ ~
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REMARKS
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7500 WEST 29tn AVENUE DEPARTMENT OF COMMUNITY DEVEIAPMENT
237-6944 ExT. 255 P.O. eoX 638 BUILDING INSPECTION DIVISION PERMIT N0. ME921/5083
CITY OF WHEAT RIDGE, COLO.
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUIL.DING INSPECTOR AND RECEIPTED BELOW.
L/~mS APPLICATION FOR MISCELLANEOUS eEF3ktIT
JOB qDDRESS n ✓ OWNER m~Slgt,1,~5 '
CONTRACTOR 0('7T(r~~ I qDDRESS
ADDRESS PHONE
CITY r ZIP CODE
^------~~-~-~-+~1 ZIP CODE ~I/ ~ONTRACT PRICE $
PHON- E - LICENSE N0. ('7
1. TYPE Ground❑ Wall❑ Proisdinq❑ Othsr SwDFaoo
2. MATERIAL
SIGNS 7ofal Squon Fpt
3. ILLUMINATION Ya❑ No❑ Typa Eleef. permit No.
4. SET BACK FROM PROPERTV LINE N_ S_ E_ W Zons_ Apprwad,2unelncpseta
(Spscifywhichis front) n n n rl
1. TYPE SolidU More Tlron BO% OpenO LOu Thon BO% Open
FENCES MATERIAL Hdphf
3. SET BACK FROM PROPER7Y LINE N__ S_ E_ W Zorn_ qpprowd,Zone Inspepta
c^~ (Spacify whieAia tronf) ❑ ❑ ❑ ❑ Diaapproved
L + i r2~< l1 ~,~Zn m
OTHER 2
3.
DRAW SKETCH OR SHOW BELOW,THE FENCE, SIGN, OR OTHER STRUCTURE,GMNv DISTANCES FROM PROPERTY LINES.
(SETBACNS OR PROJECTpNS INCLUDED)
SPECIFY NORTH
STREET N4ME
SHOW DISTANCES FROM THE MAIN BUILDING TPAOJOINING HOUSES, STREETS, AND PROPERTY LINES; ON IRREGULAR tATS, SHOW LEAST
DISTANCE TO PROPERTY LINES, NOT MAXIMUM OR AVERAGE DISTANCE.
APPLICATION FOR PLUMBING; ELECTRICAL; MECHANICAL PERMIT
THIS APPLICATION WILI BECOME A PERMIT TO PERFORM THE INDICATED WORK pJLY UPON VALIDATION BY THE BUILDING INSPECTION DIVISION.
PERMIT WILL EXPoRE 60 DAVS FROM p4TE OF ISSUANCE !F WORK IS NOT STAR7Fn wIrwroi ~eT riuc
~
ELECTRICAL PERMIT
STATE LICENSE NO.-go-8.1
PLUMBING PERMIT
STATE LICENSE N0.
MECHANICAL PERMIT
ALUMINUM WIRE UNDERSIZE 8 ILLEGAL
FLOOR
BSM
15T
2ND
3RD
4TH
N0.
FI£4C'ucNOnS Gof dlROppy ElaeSola
NO.
WATER CIASET
FORCED AfR - BTU
TEMPORARY METER
WASH BOWL
NpT WATER - BTU
NEW SERVICE AMPS
BATH TUB
STEAM - BTU
CHANGE SERVICE-AMPS
SHOWER
AIR CONDITIONING-BTU
LIGHTIN6
SINK
OTHER
HEATING
GARBAGE DISP
REFRIGERATION SYSTEM
POWER SUB-CIRCUITS
WATER HEATER
Refri aranf Group
UTILITY(RANGE,DISPOSER,ETC)
AUTO. WASHER
Pounds CMr e
FIXTURES
DISH WASHER
AUTOMATIC SPRINKLER SYSTEM
WIRING MOTORS 8 CONTROLS
FLOOR DRAIN
ELEVATOR
SIGNS
URINAI
TRANSfORMERS 9 RECTFIERS
SEWERS
ADDITION TO OLD WORK
OTHER
MOTORS OVER I HP
TOTAL FIXTURES
I hsreby ocknowladpe thot thia aODlico-
tion is eorrect and undarstond thof I
cannof ifo.t this projetf until fhia appli-
eofion is opproved. I eholl tomply with
fhe lows of the Stote of Colorodo ond to
fhe ZoninO ReQUlotiona ond BuilEinq
Code of the City of Wheat RidQe. Any
violotion of ihe above terma will couae
immediafe, revocation ot this permit.
_-A Y✓~
Aeonce.n 3100.'*
PERMIT FEE F_ p{/
USE TAX /y, y Q
TOTAL FEE A 3 ~2 - v G
NOT VAIID UNLESS RECE
LO -
R- 3-5~-
C~ A flWf 9
CHIEF BUILDINB( INSPECTOR,City of Wheat Ridqe
Dote Issued 2-
CALL 237-8944 EXT. 255
24 HOURS IN ADVANCE
FORINSPECTIONS
7500 WEST 29tn AVENUE DEPARTMENT OF COMMUNITY DEVELAPMENT
237-6944 EXT. 255 P.O. eox sse BU
CITY ILDING INSPECTION DIVISION
PERMIT VALID ONIY WHEN SIGNED BY THE CHIEF BUILDIONG IN pEA np ADGE cCOLO._
JOB ADDRESS -5~D yS> S aHPLICATION FOR MI:
CONTRAC7pq
ADDRESS
r c tT
CITY_ C~?/i1~e
PHONE YL~ T--ZIP CODE ~UY03__
LICENSE NO. XJ ;Z `7
1. TYPE GrounE
PERMIT N0. M92#18388
OWNER -J -o m A-Utt i~5~
ADDqESS 6,7 PHONE V '-J -~J( p~
CONTRACT PRICE $ ZIP CODE
-----y O Cj O
2. MATERIAL
SIGNS
W011L--~
Proiecfinpl,]
OIMr
5 a D Fae#
3. ILLUMINATION Yp❑ No❑ Typs
Totol Squore Fast
SET BACK FROM PROPERTY LINE N
Elkt. Per^+it No.
g
(Spseify which ia frpnf) ~
~ E
W
0 ❑
Zon~__ A
OMOVed,Zonslnapeotor
TYPE Soiid[3 Mora 7AOn 80°
~O Opf^0
Diwpprwed
MATERIAL
FENCES
LI u Thon BO%
Opon
4
ET BACK FROM pROPER7Y LINE N
HeWht
~ S
peeify whieA ia fronf)
E
~
- yy
T ❑
Zme p
DOraed,ZoM In~peCta
'aDProved
DRAW SKETCH pR SHOW BEIOW,THE FENCE, SIGN, OR OTHER STRUCTURE,GIWhG DISTANCES FROM pqppEpTy LINES.
(SETBACKS OR PROJECTIONS INCLUDEp)
~
SPEdFV NORTH
STREET NAME
SMOW DISTANCES FROM Tlff MAIN BUILDING TQApJ01NING NOUSES, STREETS, AND PROPERTY LINES; ON IRREGULAR LATS, SYIOW LEAST
DISTANCE TO PROPERTY LINES, NOT MA%IMUM OR AVERAGE DISTANCE.
THIS APpLICAT10N WILL BECOME AP'RM TIp pOR 0~7gEN a
PERMIT WILI EJ(PIRE 60 DAVS F CATED WORK pdLyEUpqNyppq pN BY THE gUILDING INSPECTIpN DIVISION.
ROM DA7E OF ISSUANCE !F WpRK IS NOT STARTED WITHW THAT TIME
ELECTRICAL PERMIT
PlUM81NG PERMIT MECHANICAL PERMIT
STATE LICENSE N0.
STATE IICENSE NO
WASH
DISF
URINAL
I Asreby oCknowisd9e fhot fhia applico-
tion is correct and understond Mof i
tonnof florf fAis projecf until thi, oppli-
cofion ie approveA. I sholl comply wifh
}he lowf of Ihe State of Colorodo ond to
fAs 2oninp Requlotiona and Buildinq
Code of tAe City of Wheai Ridqe. Any
violofion of ihe above terma will cause
immsdiate rovocation o} ihie permil.
1 10<onli 7i0na~er~ j/ ~
/
PERMIT FEE
USE TAX
TOTAL FEE
APPROVED
DISAPPROVED
CHIEF BUILDIP
NOT VAUD UNLE:
a5 - 0-d
;
/
, City of Wheat Ridqe
- ~ I CALL 237-8944 EXT. 255
24 HOURS IN ADVANCE
Date Issued FOR INSPECTIONS
7500 WEST 29th AVENUE DEPARTMENT OF COMMUNITY DEVELOPMENT
2s7-6944 EXr. 255 P.O. Box 638 BUILDING INSPECTION DIVISION PERMIT N0. g92#4677
CITY OF WHEAT RIDGE, COLO.
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND THE MAYOR - CALL 24 HOURS PRIOR TO INSPECTION
TWO SETS OF BUILDING PLANS AND TWO PLOT PLANS MUST ACCOMPANY THIS APPLICATION
BUSINESS NAME ADDRESS
COPY OF pEED AND IMPROVEMENT SURVEY REQUIRED
REAR PROPERTY LINE
~yf
z =
J J
r y
0 o
a
w
o w
N ~
N
FRONT PROPERTY LINE
~
SPECIFY NORTH
STREET NAME (CIRCLE FRONT) N E S W
SHOW DISTANCES FROM THE MAIN BUILDING TO ADJOINING HOUSES, STREETS, AND PROPERTY LINES ON ABOVE SKETCH;
SHOW LEAST DISTANCE TO PROPERTY LINES, NOT MA%IMUM OR AVERAGE DISTANCE.
OWNERS NAM
CONTRACTOR
LOT WIDTH 41:k'63
LIC.NO.ZS 6
PHONE
ZIPCODE S04603
LEGAL DESCFIPTION
METES AND BOUNDS DESCRIPTION ATTACHED
c
ADDRESSYDYe St w.M~2 j SC W ejp Hcq',
i0T N0. y~ BLOCK N0.
SUBDIVISIONMC FILING "
INDICA7E THOSE OF THE FOLLOWING OFF-SITE IMPROVEMENTS NOW EXISTING~ Curb6Gutter_V_~ StreetPovinq 1ti Wi Sewer-k- StamDraimps-.&
HAVE ARRANGEMENTS BEEN MADE TO PROVIDE FOR THOSE NOT NOW EXISTING: YES_NO_
ARE THERE ANY SPECIAL ASSESSMENTS AGAINST THIS PROPERTY; YES_NOK
OCCUPANCV~y+t 6 I 111 1 II EXTERIOR MATERIALS+ WALLS
STORIES I UNITS i REMARKS: ^9OOF S'~sde,
OWNER / CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT pERMIT FEE
I hereby certify thof ihe obave setback distances shown on fhis permit ppplicafion are accurate, and do not violate
applicable ordinances, rules or regulotions of the City of Wheat Rilge or covenanfs, eosemen}s or restricfions of re- U$E TAX ) 7$
cord; that oll measuremenis shown, and allegations mode are accurate; that I have read and agree to abide by all TOTAL FEE $ 6'3
conditions prin}ed on this application, and that I ossume full resDOnsibility }or complionce with fhe Wheot Ridqe
Building Code (U.BC.) and all ofher opplicable Wheat Ridge ordinances, for work undar }his permit. NOT TED
(OWNER) (CONTRACTOR) SIGNED DATE 1~e -9 z- TE25
a
BUILDING D ARTMENT USE ONLY
~S`Q ~FTL rC7OST p ~p Z3c- 7e
BASEMENT-ROUGH ~HE PROPERTY LOCATED AT T!/~h d'W~✓Y~J J~~'.o
BASEMENT-FINISHED IS PRESENTLY ZONED~2
GROUND FLOOR ~ ,c
'-7HE PROPOSE USE ( IS) IS NOT) ALLOWED UNDER THE ZONING ORDIN E,
SECOND FLOOR
GARAGE /ea ~ COMMENTS~ u ~ h
OTHER
OTHER BUILDING COST $ C 11 $41 8 ~
ELECTRICAL PERMIT PLUMBI G PERMIT y MECHANICAL PERMIT
_STATE N0CITY NO STATE NO -2 CITY NO CITY NO /n"_7__
PLANS REVIEWED (_OK)(_NOT OK) I PLANS REVIEWED (-OK)(_NOT OK) PLANS REVIEWED_ (_OK)(_NOT ON)
NO PLANS NEEDED
PLANS NEEDED PRIOR TO ISSUANCE OF
ELECTRICAL PERMIT
PERMIT ISSUED TO =I.PZLC4 laTI
PER REOUEST AS PER PLANS NO_
AS APPROVED AND ON FILE IN MY OFFICE
DO NOT ISSUE PERMIT UNTIL CLEARED BY
CHIEF BUILDING INSPECTOR
NO PLANS NEEDED
PLANS NEEDED PRIOR TO ISSUANCE OF
PLUMBING PERMIT I
PERMIT ISSUED TO S~V ./1
PER REQUEST AS PER PLANS N0.
AS APPROVED AND ON FILE IN MYOFFICE
DO NOT ISSUE PERMIT UNTIL CLEARED BY
CHIEF BUILDINGINSPECTOR
BY
NO PLANS NEEDED
PLANS NEEDED PRIOR TO ISSUANCE OF
MECHANICAL PERMIT
PERMIT ISSUED TO ~ kga
PER REpUEST AS PER PLANS N0.
AS APPROVED AND ON FILE IN MYOFFICE
DO NOT ISSUE PERMIT UNTIL CLEARED Bl'
CHIEF BUILDING INSPECTOR
DATE fl-ftRED _wv
BY
(1) THIS PERMIT WpS ISSLIED iN qCCORD4NCE WITH THE PflOVISIONS SET FORTX IN YOUR APPLIC4TION AND IS SUBJECT Tp THE LAWS OF iHE STATE OF COLORRDO
AND i0 THE ZONING REGULATIONS AND BUILOING CODE OF WHEAT RIDGE, COLOflADO OA ANY OTMER APPLICABLE ORDINANCES OF THE CITY.
(2) THIS PERMIT SMALL E%PIRE IF (A) THE WOqK AUTHORIZED IS NOT COMMENCED WITHIN SIXTY (60) DAYS FROM ISSUE DATE OR (B) THE BUILDING AUTHORRED IS
SUSPENDED OR ABANDONED FOR q>ERIOD OF 120 DAYS.
(3) IF TNIS PENMIT EXPIRES, G NEW PERMIT MAV BE ALOUIRED FOR A FEE OF ONE-NALF THE AMOUNT NORMALLY REOUIqED, PROVIDED NO CHANGES XAVE BEEN OR WILL
BE MADE IN THE ORIGINAL PLANS iND SPECIFIGATIONS AND ANY SUSPENSION OH ABANDONMENT HpS NOT E%CEEDED ONE00YEAR. IF CMANGES 4RE MADE OR IF
SUSVENSION OR ABANDONMENT EXCEEDS ONE (UYEAR, FULI FEES SMALL 8E PAID F A NEW PER4CTD (4) NO WORK OF pNY MANNER SHALL BE UONE THAT WILL OBSTRUCT THE NATURAL F OF WATER G(6) LONTRAC SHq NOTIFY THE BUILDING INSPECTOR TWENTY-FOUfi (24) HOUF ADVANGE FOR LL RECEIVE W pPROVAL
ON INS C ON RO BEFORE P
OCEED G WITH SUCCESSiVE PH4SE5 OF THE J
~ AP
CHIEF BUILDING INSPECTOR DtSOO
FOR
renrrtxuroEn
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DATE: OCTOBER 6, 1992
TO:' PUBLIC WORKS DEPARTMENT
FROM: Building Department
REC CERTIFICATE OF OCCUPANCY
The property at 4043 Simms Street has been
sigaed off by the Building Department and is ready for a CO
inspection.
Once the inspection has been completed, please inform the
buildinq department as to the status.
Thank 'you.
PUBLZG WORKS APPROVAL Q-~
Remar[ca: <f,)r-b c.vt - G
I
..yi~K~tne
~ ~L~,~(•'.''_.y ,fd~ ~ ~/-eW~ G,e~wv~`Cw~ P.a/~~ nmGl ~~0.G0-_. W/
q4vA~ ts~ fM.w Il'2
.
2-
~
DATE: OCTOBER 6, 1992
A CERTIFICATE OF OCCUPANCY HAS BEEN REQUESTED FOR:
4048 Simms Street
PURPOSE OF STRUCTURE: SINGLE FAMILY RESIDENCE
Suilding Dept. Approval:
Remarks:
Zoning Approval:
Remarks:
'oeECTIONS WILL NOT BE MADE UNLESS
i15 caRD IS POSTED oN THE BUILDING SITE
24 HOURS NOTICE REQUIRED FOR INSPECTIONS
WHEAT RIDGE, G_OLORADO
7500 WEST 29th AVENUE
(3~3) 234-5833
INSPECTION RECORD
JOBADDRESS 4048 Sir¢ns Street
BUILDING PERMIT N0. M921118388 DATE ISSUED 8/28192
OWNER Tim Audiss
CONTRACTOR
Don Lutz
TYPE OCCUPANCY
SETBACNS FROM PRGPERTY LINE3: NORTH
SOUTH
EAST
West
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB
I NSPECTION
DATE
I NSPECTOR
Foundations
Footin s
Caissons
Reinforcin or Monolithic
Weather roofin
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
Concrete Slab Floor:
Eiectrical Ground Work
Plumbin Ground Work
Heatin Ground Work
DO NOT POUR FLOOR UNTIL ABOVE HAS BE5N SIGNED
Rou h Electrical
Rou h Plumbin
Air Test Gas Pi in
Rou h Heatin & Ventilation
(above must be signed prior to iraming inspection) /J
Framin
~Z
W
Insulation
Z
Dr wall nailin
Roofin
Refri eration
Eiectrical under round
Final
Electrical Fixtures
Plumbin Fixtures
Heatin & Ventilation
Landsca e 8 Parkin
R.O.W. 8 Draina e
Fire De artment
Job Com leted
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF
OCCUPANCY IS ISSUED
PROTECT THIS CARD FROM THE WEATHER
.
INSPECTIONS WILL NOT BE MADE UNLESS
THIS CARD IS POSTED ON THE BUILDING SITE
24 HOURS NOTICE REQUIRED FOR INSPECTIONS
WHEAT RIDG1=,LC0L0RAD0
7500 WEST 29th AVENUE
INSPECTION RECORD
JOB ADDRESS 4048 Simms Street
BUILDING PERMIT N0. B921i4677 DATE ISSUED 6/26/92 TypE OCCUPANCY
OWNER Jim Audiss
CONTRACTOR Donald Lutz, 7667 Rogers Street, Golden, CO 80403
SETBACKS FROM PROPERTY LINES: NORTH SOUTH EAST West
I NSPECTION
DATE
I NSPECTOR
~
Footin s
Caissons
`
Reinforcin orMonolithic
-
Weather roofin
Electrical Ground Work
Plumbin Ground Work Wcg.
-
" ✓ = '
Heatin Ground Work -Sv" ; r~f
~
Rou h Electrical
Ftou h Plumbin
Air Test Gas Pi in w e ~.~.M.
(
Rou h Heatin & Ventilation ~
..'Lr - ~
Framin
Insulation
Z-~
Dr wall nailin
3
Roofin
°
Refri eration
Electrical under round
Electrical Fixtures d
Plumbin Fixtures
Heatin & Ventilation
91-
Landsca e & Parkin
R.O.W. &Draina e
Fire De artment
Job Com leted
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF
OCCUPANCY IS ISSUED
INSPECTION TICKET
a ~
JOB
ADDRESS qO
DATE: ` -O1 BLDG. PERMIT# ~l6> ~
PERMIT#
~4 ~
BLDG. CONTR.L~~"~
SUBCONTRACTOR
DATE INSP. REQ.
TYPE OF INSP.
INSPECTION MADE
REMARKS
~
INSPECTION TICKET
Joe ~
ADDRESS
DATE: -l - 3 BLDG. PERMITk .SaS3
PEflMITM
BLDG. CONTR.
SUBCONTRACTOR
DATE INSP. REQ. 9 `3
TYPE OF INSP. -'f - 4" ,
INSPECTION MADE a~
REMARKS _ GJ= ~2
W.R. FORM &19
INSPECTION TICKET
JOB
ADORESS ~O'/~q'
DATE: _BLDG. PERMITN L&5j^-
PERMIT#
BLDG. CONTR.
SUBCONTRACTOR
DATE INSP. REQ.
TYPE OF INSP.
INSPECTION MADE ~
REMARKS
W.R. FORM 61g
~
~ q a ~~-q G~.~
ft4 ~ ~
INSPECTION TICKET
JOB
ADDRESS"C"TD ~~YpmS
DATE: BLDG. PERMIN ~
PERMIT#
BLDG. CONTR. <5
SUBCONTRACTOR
DATE INSP. REQ.01 Q /.l/`"L L
TYPE OF INSP.
~
INSPECTION MADE
REMARKS
/
jt6
INSPECTION TICKET
JOB ' ` -
ADDRESS M O CI S-rv~-.,ti.0
C ~lz
DATE: o-~ BLDG. PERMIT# .-6 7
PERMITM
BLDG. CONTR. 1w -u
j
SUBCONTRACTOR
DATE INSP. REQ. 0 -ld
TYPE OF INSP.
INSPECTION MAD~
REMARKS
~
/
16
INSPECTION TICKET
JOB 1~ .
ADDRESS LtG Y Y> dA
DATE: BLDG. PERMIT#
PERMIT#
BLDG. CONTR. q S'~e~<.~-r✓J
SUBCONTRACTOR
DATE INSP. REQ. 6y-lr4
TYPE OF INSP.
INSPECTION MADE
REMARKS D
b
INSPECTION TICKET
JOB f/
ADDRESS
r9 z
DATE: BLDG. PERMIT# u67~'
PERMIT#
BLDG.CONTR
SUBCONTRACTOR
DATE INSP. REQ. 0- l
7YPE OF INSP. ^r
INSPECTION MADE
REMAHKS
c
W.R. FORM 8-19
/
W.R. FORM &19
A~a_& ~YC 7 -7
INSPECTION TICKET
JOB C~ •
ADDRESS VG V I oJl-=~,~-rv~
DATE: BLDG. PERMIT# 41 j7
PERMIT#
BLDG. CONTR. w 2'c V~~
SUBCONTRACTOR
DATE INSP. REQ. 8"/ 8
7YPE OF INSP.
, J~~P
INSPECTION MADE 2,
~
REMARKS O
INSPECTION TICKET
JOB
ADDRESS 7U v ,F
DATE: BLDG. PERMIT# c/G 7)
~r PERMIT#
BLDG. CONTR.
/h •
DATE INSP. REQ. Y"/y
TYPE OF INSP.~-~",- ~
INSPECTION MADE
REMARKS c lz'
W.R. FORM F18
iC6
INSPECTION TICKET
JOB
ADDRESS I f ~1ti
DATE: - °ZG BLDG. PERMIT# PERMIT#
BLDG. CONTR.
SUBCONTRACTOR
DATE INSP. REQ. ~ -
iYPE OF II
INSPECTIO
REMARKS
i~
INSPECTION TICKET
~
JOB
ADDRESS `
"i ~
DATE: BLDG. PERMIT# 77
PERMIT#
BLDG. CONTR. r~Lli~
SUBCONTRACTOR -
5 !N DATE INSP. REQ. 6- J I ~
TYPE OF II
INSPECTIO
fiEMARKS
W.R. FORM 619
!
~
wN; n R,oGt
Ce : 404 8 1gg2
ryNING & ~~ELC?iv cN- f
✓~Lj. l7;
Ty;s J,, L~ i 7~ i 99 z I.D.~ ~l~~2 Z.
GG ~~G~2.~J~~ ~7/f/7~ .S✓t'v~~ OF %~i`C ✓~u.GO/MG
l~~CLl.~luCv'r/~~ia~S "i/"~Lt~c~o.~t>
n,v
T/fc ~~•yo~~-~'o.o~ l~S ~~577~«<'.Tb=»
7"h,'~7-
~
o.v S ~./~"T~ /s Nv7- ociT;S~.IJC nH T~c ✓3u. Gl~~.~iG
s~T%~LIC,C ~E=ST~~~Tia~ss, %/fC /`~~-ST' /1~°rTxlcrrG~ ~'c~2uc'2
3-
~
L/
/
.~i~~'o L~•;- 4~~
5-JJ "Z_
FlPPPOVFD
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Signe - Pian Ch~c.;er
C~lz
RccordcJ at o'cliicr.' M
Rcccptinn Nu.
~
Rceor(Icr.
DEEU OF 1'RUST
'1'lllti Ufsl?I) OI''1'RUS'1', D:ncil Mdx'Ch 5, 1992 . Ixxiwccn
JMIE5 ROBERT AUDISS
lhcgr.mtonccrcin,whoscaddrcssix 9750 WeSt 66th P1aC0
'-vada, Colorado 80004
- *County of Jefferson and Slntc of Colorado,and the
PUI3I.IC 'fRUS'1'C8 of the County or Cily and Counly in which [hc propcrly dcscribcd bclrnv is simated, in the Statc o! Cobrado,
WilnessMh:
Thc graNor lo sccuro a promissory notc or notcs, hcrein:dtcr rcfcrrccl lo in Ihc singular, dated March S, 1992 •
(orfhclolalprincipalsumof Fifty-Five Thousand Two Hundred Seventy-Two & 50/10
dullars, payabic to the ordcrof TRI-STATE BANK
ihe beneficiary herein, whose address is 616 East Speer BIVCl.
Denver, Colorado 80203 akcrthedatethercof,
with interest
in accordance with the terms and tenor of above said Promissor
note with the balance due in full on March 10, 1993.
dces hereby grant and convey un[o said Public Trustee the following described pmperty, siwate in the County
of Jeff2TSOn , State of Colorado, to wit:
PARCEL A:
Lot 40, McLAUGHLIN'S APPLEWOOD SOBDIVISION AMENDED, Except
that part of the East 6.1 Feet thereof which lies immediately
West of and adjacent to Lots 24 and 26, Appleview Subdivision
as conveyed by Quit Claim Deed recorded October 27, 1987 at
Reception no.'s 87131899 and 87131900, County of Jefferson,
State of Colorado.
PARCEL B:
Lot 1, McPHERSON SUBDIVISION, County of Jefferson, State of
Colorado.
also known by street and number as Pareel A: RdW Ground
Parcel B: 9750 West 66th Place
TO IIAVF. AND 70 IIOLD the snme logaher wilh all appunenances, in tmsi nevenheless, Ihet in cau of default in Ihepeymenrof seid note or any patt IAertof or inleast
Ihereon, or in the ~+erfrnmance o( any cmenents hercina0er ut 4xlh. then u~n the hemficiary (aate hnlJer) filin¢ notice oleleclion aml demand for cele, aaid Publk 7}ueke,
afler edverlising naice of xeid sak wcekly, (or nM less than four wxks, in wne newspoper o(grnenl circuluion m eaid coumy, xhall ieell eaiJ properly in Ne mamitt pmvided
bylawineffeclnllhelimeaf0ling suiJnoticeanMdemanJ,et publiceuaionfurcasn,sl anypmperplmeJesignskUinUenoliceofsak.Wto(thepnn~aJSOfa{Jnksaid
Trustee fixll mlain or pay firsuil fees. <harges and coau nd ail naneys edvanced for iue:, msuronce anJ ne.aessmems, rnon nny priorencumbnMe, with iMertN Ihaeon, and
psy Ihe principal anJ imercsl due on SuW mAC, mndering the o.erplus (if eny) umo the gmnmr: anJ a(Ier the eapiralion uf the Iime of rtdemption, saidT'YSlee shsll enecule pnd
deliver lu the purchaur a Jeed b the properly sold. The Ixneficiary may purehave said propeny or any purl Nertuf al such sele.
The gram(tt crnxnanu Ihat ai the time of delivery of these prettnls, he is uiud of wid pmperly in fee simpie, erxl thal said propeny is (rce of eMUmbraMes, exc<pl
liens of record
The gr:imar alsn cuvennm.c Ihal he will keep alI huildings insurcd with o cnmpany appmn•A hy Ihe heneficiary for li¢ anJ ealended crnenge in an amuum eyual 1o the unpaid
Iwlance of said nate with Inss payable m the bencliciary, will delircr a copy of the pulicy to the Mmficiary and wiil pay all Lues end asxeasmrcnts ageinsl said pmptrly snd
anumms due on prior encumFmncex. If grenmr shell fail Iu pny insurunc< premiunu. Iexes or anmumx Jue un prior cwumbranc<, Un heneficier may pry the sume end all
amoums shall Aecome adJilirnial indaMedness Ju< hercunJer, anJ in cam of forcdosurc, he will pay an aumncy's fa of d $ rj Q Q.~Q minimum
olr 5% of the unpaid balance at the time of foreclosur, whichev,
ShoWA the Fc ShL.SYYh@ dnt rP.~Y~~~edk a petly lo ony aclion alfctting Ihis Accd nf Iru~l nr the tillc lo seiJ pmpcrty, the grenlnr agrtes Ihal all coutl cosls anM y Resonable
anumty's fce paid hy Iherebencficiery shell become eddilional inuleMCJnus Jue hemunder. anJ ihe grenmr daes hertby rcleux anJ utiive all cleims in seid pmperty as a
homesleaJ ezemption or oiher exemption now or hertalwr pnrviJed by law.
If aIl rn nny part o( the propeny or an imerest Iherein is wld onransfermd by 1he granlor willrout beneficiary's priur wrilten <onseN, acluding (e) the crcslion of a Ikn or
encumhrance suAnrJinele l016ic UeeJ af'fnisl, (b) the crealiim of a purchett muney security inmrest fur huuseholJ appliances, (c) a trencfer by deviu, descem or by operalion
of law upun the death of a juint tenam or (d) the granl uf any Ieauhuld inkrcst of threc yeurs m less no1 aomaining an oplion lo pu¢hase, 6emficiary may, el beneficiarye
option. Jeclam all the sums secured by this Uced of Trvsl lo be iimneJialety due anJ pwyabie. Beneficiary shnll have xsiveJ such option to accelerale if, prior l01he sale a
IransRt beceficiary atHl lIte perum lu whmn Ure pmperly ix lu be udd M tmnsl<md mxh agreemem in wriling Ihat the credil o( such peraon is salisfxtory to heneficiary and
Ihm the intercet payable on Ihe sums securtJ by Ihis Deed of Tmsl shall be el such vte ax ixneficiary shall «yuesl.
1t is agreed tha[ in case of defnWt in payment of said principel or intercsi or a bmxh nf any uf (he cowennms Iwrcin, then saiJ prim:ipal sum hereby ttemed and inkresuheROn
may a11he oplion o! IM Mneficinry become Jue end payable nl ome, anything in said nMe lo the contrary nawilhstmding and posussion of said qvpeny willlhertupon be
deliv<rtd lo Ihe 6eneficiary, aml on luilure m delirxr euch pussession the Mneficinry shall bc rniitleJ m a receiKr fur seiJ propeny, who may be appoinkd by any caurt of
compctenl jumidicliua .
Whenever uuJ herein the xingular number shall ineWde the plurel, the plural lhe singular, anA the use of any gerMer shall be applicable lo all gadert. Ali of Ihe cmemnfs
hemin shall be binding upon the mspective heirs, pvrswnai mpmsenlalives, xuccexsors anJ as.igne of the panies herelo.
Hxcculcdihe Jay ond year firxl abovc wriflen.
ROBERT AUDISS
S'PATE OF COLORADO 1S
County of 1 $F.
City and Denver
The folegoing instrument was acknowledged before mc this 5t.h day nt Mareh ,1992 .
by JAMES ROBERT'- AUDISS
My commission cxpircs 12-15-94 . H'itness my hand and officiai scal. ///f
L~~~~%7 (-~4 /i70
NoarY 146k _
'If in Dcnvcr, inscrt "City and."
No. 923C. ReV. I-96. Df:F:n OF TRURT (Pohlk 7Fuslee) rith Due on Sde Clvace (D
Bradford Puhlishing, 113: Wazce Si., Ucnvce (Y) N0212 -001) 292-2500- I I-911
~
`.i
ASSIGNMENT OF RENTS
KNOW ALL MEN BY THESE PRESENTS:
WHEREAS, JAMES ROBERT AUDISS
ha S made, executed and delivered to TRI-STATE BANK
(Payee) or order, one promismry no[e(s) in the amoun[ of $ 55 . 272 . 50 , secured by a
Deed of Trust, both bearing even datc herewith, to the Public Trus[ee of the County
of Jef f erson State of Colorado, upon the following described real estate situate in the
County of Jefferson ,StateofColorado,to-wir
PARCEL A:
Lot 40 McLAUGHLIN'S APPLEWOOD SUBDIVISION AMENDED, Except
that part of the East 6.1 feet thereof which lies immediately
West of and adjacent to Lots 24 and 26, Appleview Subdivision
as conveyed by Quit Claim Deed recorded October 27, 1987 at
Reception no.'s 87131899 and 87131900, County of Jefferson,
State of Colorado.
PARCEL B:
Lot 1, McPHERSON SUBDIVISION, County of Jefferson, STate of
Colorado.
PARCEL A: Raw Ground
PARCEL B: 9750 West 66th Place
WHEREAS, the Payee has required as additional security nn assignment of rents, profits and income derived
from the above described real estate in case o( default in the payment of any sums due under the above
described note and Deed of Trust, including payment of taxes and insurance payments, and as further security
for the performance of all of the terms and conditions expressed in the note and Deed of'IFust above described.
NOW, THEREFORE, in consideration of the loan being made and for other good and valuable consideration,
the receipt of which is hereby acknowledged, the undersigned do hereby, in case of default of the payment of
said indebtedness or any part thereof, or failure to comply with any of the terms of the note and Deed of Trust,
assign, transfer and set over unto the said Payee above described, or the holder of said note, all rents, profits
and income derived from the premises above described and from the buildings and improvements thereon,
together with all rights of possession, with full and complete authority and right in the Payee or any subsequent
holder, to demand, collect, receive and receipt for such rents, profits and income, to take possession of the
premises without requiring the appointment of a receiver therefor, to rent and manage the same from time to
time and to apply the proceeds derived therefrom, after payment of all costs of collections and all fees and other
costs, upon the said indebtedness as therein provided until all delinquencies, advances and the indebtedness
sewred by Ihe Deed of Trust and this Assignmen[ are paid in full or until tiUe is obtained through foreclosure or
o[herwise.
A release of the Deed of Trust shall release this Assignmen[ of Ren[s.
Executed this c+th day of March , 19
STATE OF COLORADO
ss.
City a 1~_ Countyof nPn vPr
The foregoing Assignment of Rents was acknowledged before me this S+h day of
March ~19 92yy ,7amac Rnharf AnAicc
My commission expires:
Witness my hand and official seal.
N0. JIO. ASSIGNMi.NT OF RF.NTS
/
, X-~04!
Navy Public
a
RreAlord Puhlishing. 1743 Wavice SL. Drnvcr. f'O 902(t7 (303) 292-2500- 7-91
INSPECTION REPORT
***r*****~****~*******~~~***~****~*****************~**********:**
TYPE OF INSPECTION
LOCATION CU DATE 7-6--y_~_
ADDRESS Sin»7S TIME ,5.;3v
BUILDER
OWNER
CAISSON
TYPE OF SOIL NOTE DEPTH TO WATER
0 TO
TO
TO
TO
TEMP 26S°F
OPEN HOLE
CAISSON
FOOTING
WALL STEEL~ /
OTHER
FOUNDATION /FOOTING REBAR
GRADE STEEL SIZE
FORMS BRACED ~ CLEAN_
" VOID IN PLACE
STEEL TIED ON CHAIRS
" CLEAR
STEEL PR ENG. PLAN
COMMENTS / CORRECTIONS REQUIRED
.
OKAY TO POUR__4,,~n~ REINSPECTION D
I ECTQ DATE
JEHN & ASSOCIATES, INC. PROFESSIONAL ENGINEERS
5695 YUKON STREET, SUITE C, ARVADA, COLORADO 80002
(303) 423 - 6036
INSPECTION REPORT
TYPE OF INSPECTION
LOCATION Wkr~4 J~-d
ADDRESS 4U-q8
BUILDER
OWNER /`~C.~ ~1 • ~s-
TYPE OF
0 TO
TO
TO
TO
DATE 7-
TIME /U: Od
TEMP
OPEN HOLE
CAISSON
FOOTING~
WALL STEEL
OTHER
CAISSON
SOIL NOTE DEPTH TO WATER
COMMENTS / CORRECTIONS REQUIRED
FOUNDATION /FOOTING REBAR
GRADE 6 STEEL SIZE :5-
FORMS BRACEDX, CLEAN>e
i' VOID Irf PLACE
STEEL TIEDX ON CHAIRS
" CLEAR
STEEL PR ENG. PLAN
OKAY TO POURX
J~ A..icAn
INSPECTOR
REINSPECTION
~ y~-
DAT
QUTRED
~
JEHN & ASSOCIATES, INC. PROFESSIONAL ENGINEERS
5695 YUKON STREET, SUITE C, ARVADA, COLORADO 80002
(303) 423 - 6036
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Qlehn $t 2ssociates inc.
5695 YUKON ST. SUITE C, ARVADA, COLORADO 80002
(303) 423-6036
A LEGAL DESCRIPTION
LOT 40
MCLAUGHLIN'S APPLEWOOD SUBDIVISION AMENDED
CITY OF WHEATRIDGE
COUNTY OF JEFFERSON
Q g STATE OF COLORADO
~
FLOOD INFORMATION
SUBJECT PROPERTYDOES NOT .LIE
WITHIN A 100 YEAR FLOOD PLAIN
ACCORDING TO H.U.D./FIRM
COMMUNITY PANEL # 085079-0005 B,
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IMPROVEMENT LOCATION CERTIFICATE
I hereby certi(y thot lhia improvement lowtion cerlffiwte ilos
prepored for and JAMES R. AUDISS
,that It Is not a land
survey plat or lmprovement survey plat, and thot it Is not lo be
rclied upon for tha eslablishment of fence, butlding, of other
fu[ure improvementlinea.
I furthar certlfy ihal the improve nenls on the above described
parcel on th(s dato.. rT'?-O~YL ,19_, except util(ly f.+'N•,•
connections, are entirely wfthin the boundaries of this poreel,
except as shown, thal thare are no encroochmenls upon [he
1 ~
dascribed premises by improvements on ony adjolning premises,
except as indicated, and that there is no opparent evidence or STAMP
sign of any easement crossfng or burdentng any part of said OR ~ e
porcel, except as noted. SEAL Date 1 A ~
5695 YUKON STREET. SUITE C. ARVADA, COLORADO 80002 (303) 423-6036
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DEPARTMENT OF PLANNING & DEVELOPMENT
REQUEST FOR PUHLIC WORKS REVIEW
Date: 6 -ot Case/Building Permit No. 67~
Location: 'q~J c/
Please review the attached materials submitted in application for approval
of a
c}ieck and indicate your decision on those items
below, and please add any other comments which you may have under
number 16.
1.
2.
3.
4
q Boundary Closure:O OK t=1Not OK; refer to Stipulations
C1 Area: Acres
CI Drainage: Square Feet
a. Drainage plan (and report) needed C7
b. Drainage Plan not needed r-I
c. Drainage provisions have been reviewed and are found to
be: C70K d Not OK; refer to Stipulations
o Legal Description: O OK C] Not OK; refer to Stipulations
If not okay, please explain:
5•1~1'Public Zmprovements:
a. Street Paving needed y~
c. Sidewalk needed
e. Storm Sewer needed yy
~
Escrow required, for what improv
6.i=i Development Agreement required
If Yes, for
b. Curb & Gutter needed Y
d. Street Lights needed Y~
f. Escrow required Y If
ements? In what amount?
Y N
7• [--1
All necessary documents have been initiated by Public Works and are
attached hereto:
8. i-:::) Is a traffic impact analysis and report required? y N
9• i= New roadway or alley R.O.W. dedication is recommended:
If yes, what is recommended:
10. O All existing dedicated roadways and alleys meet the standards of
the City:
If no, which do not and what is requested:
11.1~ All existing and proposed dedications have been reviewed and found
to be: q OK L7 Not OK; refer to numbers 8& 9.
12•F-'~'Approval: The Public Works Department has reviewed this request
and hereby gives its approvai, subject to the above and/or attached
stipulations.
- gigln u - _ G ~r2S~
13. ~ The Public Works Department has reviewed this requesteand does not
approve for the reasons stated:
Signature
14. p Stipulations attached: Yes No Date
15. O DEADLINE DATE FOR PUBLIC WORKS DEPARTMENT REPLY:
16.
Summary Comments: c.L= a 4-&-nQ~
pc/reqPWreview
rev.01/89
DEPARTMENT OF COMMUNITY DEVEIAPMENT
7500 WEST 29th AvENUE BUILDING INSPECTION DIVISION PERMIT N0. ME921i5003
237-6944 EXT. 255 P.O. eox 63e CITY OF WHEAT RIDGE, COLO.
THIS PERMIT VALID ONLY WHEN SIGNED BY TNE CHIEF BUILOING INSPECTOR AND RECEIPTED BELOW.
JOB ADDRESS
CONTRACTOR
ADDRESS
GTY~7/'ve'd-al ZIPCODE '~V6V7''
PHONE LICENSE NO.
PERMIT FEE
USE TAX
TOTAL FEE
1. TYPE Ground❑
Woll❑
Proitefinp❑
Othsr SaDFeee
2. MATERIAL
Totol Spuon Fesf
SIGNS
3. ILLUMINATION Yea❑ No❑ Typa
Eleet. Permif No.
4, SET BACK FROM PROPERTY LINE N_
S_ E
- W
Zom_ Approved, ZerN Inapeata
(Soetifv whith ia fron}) ❑
❑
❑ n.
- n~^^^~^°•~
1. TYPE SolidU More Than 80% OpsnU Li b
FENCES MATERIAL INSPECTION TICKET
3 SET BACK FROM PROPER7Y LINE N_ S_ E_
(Spseify whieh ie }ront) ❑ ❑ ❑ JOB
ADDRESS
I.
OTHER Z'
3.
DRAW SKETCH OR SHOW BEIOW,THE FENCE,SIGN,Oft OTHER STRUCTUR(SETBACKS OR PROJECTpNS INCLUDED)
OWNER V"ft ~
ADDi7ESS
PHONE
CONTRAC7 PRICE $
DATE: l'~~ a S BLDG. PERMITB
PERMITB
BLDG. CONTR. ~`s""1 ~
SUBCONTRACTOR
DATE INSP. REQ.(0-
STREET NAME
SHOW DISTANCES FROM THE MAIN BUILDING TOADJOINING HOUSES, STREE
pISTANCE TO PROPERTV LINES, NOT MA%IMUM OR AVERAGE DISTANC
TYPE OF INSP. \V..w4
INSPECTION MADE
REMARKS
APPLiCATION FOR PLUMBING; ELECT W R. FORM 619 y
THIS APPUCATION WILL BECOME A PERMIT TO PERFORM THE INDICATED' ~~^A iION.
Fc.P,RAIT WILL EXPiRE &O DAYS FROM DA'(E OF ISSUANC'✓
ELECTRICAL PERMIT
STATE LICENSE N0.
AIUMIn7Uh1 WIRE t1FIDER SiZE 9 II_LEGAL
PLUMBING
STATE LICENSE N0.
FLOOR BSM I5T 2N0 3R0 4TH NQ FUELCYCMOne GW di RoOOrN EI Sola
Np,
WATER CIASET
FONCED AIR - BTU
TEMPORARY METER
WASH BOWL
IpT WATER - BTU
NEW SERVICE AMPS
BATH TUB
STEAM - BTU
CHANGE SERVICE-AMPS
SHOWER
AIR CONDITIONING-8TU
LIGHTING
SINK
OTHER .
HEATING
GARBAGE DISP
REFRICaERAT10N SYSTEM
POWER SUB-CIRCUITS
UTILITY(RANGE,DISPOSER,ETC.)
FIXTURES
WATER HEATER
AUTO. WASHER
DISN WASMER
Rafri eront Grou
Poundf CMr e
AUTOMATIC SPRINKLER $YSTEM
WIRING MOTORS 9 CONTROLS
FLOOR DRAIN
ELEVATOR
SIGNS
URINAL
TRANSFORMERS 9 RECTFIERS
SEWERS
ADDITION TO OLD WORK
OTHER
MOTORS OVER I HP
TOTAL FIXTURES
I hereby ocknowlsdqe thot this applico-
tion ia eorrecf ond understond ihaf I
cannot sfort tAis projecf until this aD01i-
tation is opproved. I shall comply with
'hs lowt of the State ol Colorado ond to
he Zonina ReQulalions ond Buildinq
ode of fhe City of WAeot Ridpe. Any
olofion of ihe above terma will couse
mediate revoeation of thia permit
'eanb li0nal~i~
A~
CHIEP BUILDI
INSPECTOR,City
ZIP CODE
$
a~~1
Ridqe
Date Issued 6 - IN -3 I--?-
RECEIpTED
CALL 237-8944 EXT. 255
24 HOURS IN ADVANCE
FORINSPECTIONS