HomeMy WebLinkAbout4056 Simms StreetCity of Wheat Ridge
Residential Roofing PERMIT - 201703147
PERMIT NO: 201703147 ISSUED:- 07/03/2017
JOB ADDRESS: 4056 Simms ST EXPIRES: 07/03/2018
JOB DESCRIPTION: Residential Re -roof to install laminated asphalt shingles - 55 sq.
*** CONTACTS ***
OWNER (720)220-6776 SWEENEY CORINE R
SUB (720)999-4882 Robert Anderson 170321 Building Solutions 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: 26,200.00
FEES
Total Valuation 0.00
Use Tax 550.20
permit Fee 465.05
** TOTAL ** 1,015.25
*** 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) requires an approved inspection
prior to installation of ANY roof coverings and is require on the entire roof when spaced
or board sheathing with ANY gap exceeding one half inch exists. 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.
A
7,01 203 l q 7
W S�r��s fit, INSPECTION RECORD Occupant
`
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection
INSPECTION REQUEST LINE: (303) 234-5933
Inspections will not be performed unless this card is posted on the project site.
**Request an inspection before 11:59 p.m. (midnight) to receive an inspection the following business day.**
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections Date Inspector Comments
Initials
Pier
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground/Slab Inspections
Date Inspector Comments
Initials
Electrical
Comments
Sewer Service
Plumbing
Do Not Cover Under round or Below/In-Slab Work Prior To Approval Of The Above Inspections
Rough Inspections
Date
Inspector
Initials
Comments
Wall Sheathing
Mid -Roof
`-f
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 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
lk.vPECTION RECORD
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/forms.aspx?fid=79
INSPECTION REQUEST LIN (303) 234-5933
07.rsInr2 Z� t
GUl
Inspections will not be performed unless this card is posted on the project site.
Call the inspection request line before 11:59 p.m. to receive an inspection the following business day.**
L/0'% J I MA"JAC(or4ust Sign ALL Spaces pertinent to this project
Foundation Inspections Date Inspector
Initials
Comments
Pier
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground/Slab Inspections Date Inspector Comments
Initials
Electrical
Sewer Service
Plumbing
Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections
Rough Inspections Date Inspector Comments
Initials
Wall Sheathing
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 Comments
Initials
Landscaping & Parking / Planning Dept.
ROW & Drainage / Public Works Dept.
Floodplain Inspection (if applicable)
Fire Inspection / Fire Protection Dist.
Final Electrical
Final Plumbing
Final Mechanical
Final Window/Doors
Final Building
I Roof
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.
NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate
of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy.
*For low voltage permits — Please be sure that rough inspections are completed from the Fire District and electrical low voltage
by the Building Division.
Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued
Protect This Card From The Weather
A d City of Wheat Ridge
Resid. Windows/Doors PERMIT - 201702917
PERMIT NO: 201702917 ISSUED: 06/30/2017
JOB ADDRESS: 4056 Simms ST EXPIRES: 06/30/2018
JOB DESCRIPTION: Permit to install 11 windows, 1 kitchen temp, 3 kitchen, 1 spare bedroom, 6
living room windows.
*** CONTACTS ***
OWNER (303)420-6784 SWEENEY CORINE R
SUB (303)945-1519 Matthew Seiler 130206 Renewal by Andersen
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 41,527.00
FEES
Window Replacement 50.00
Total Valuation 0.00
Use Tax 872.07
** TOTAL ** 922.07
*** COMMENTS ***
*** CONDITIONS ***
Windows shall comply with all applicable codes, have a .32 or better U -factor and shall be
safety glazing if within a tub enclosure, less than 18 inches above the floor or within 24
inches of a vertical edge of a door.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
apphca le building codes, and all applicable municipal codes, policies and procedures, and that I am t e 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 ermit. 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.
Signature of OWNER or CONTRACTOR (Circle one) Date
1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the 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. such
6. The issuance or granting of a permit shall not be construed to be a permit for, or roval o v olat' if any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval o r too
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us
between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line.
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PERMIT- � � ADDRESS: L40 Slc Si ofn iS JOB CODE:
INSPECTION RECORD
Inspection online form: http://www.cl.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
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
311 Electrical Meter Commercial
312 Temp. Const. Meter
313 Rough Plumbing Residential
314 Rough Plumbing Commercial
315 Shower Pan
SEE OVER FOR ADDITIONAL INSPECTIONS
Rough Inspection (continued)
Date
Inspector
Initials
Comments
316 Rough Mechanical Residential
317 Rough Mechanical Commercial
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 I Inspector
Initials
Comments
402 Gas Meter Release
403 Final Electrical Residential
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 303-235-2845
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
Electrical low voltage by the Building Division.
V Cs�--' lmn-? '-�- '-J
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:
Permit Number:
❑ No one available for inspection: Time M/PM
Re -Inspection required: Yes &
When corrections have been made, call for re -inspection at 303-2_34-5933
Date:-I//q// 7Inspector: ter
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: H tA�L W I [ IUo l
Job Address: 5u )i m MS
Permit Number: S -O I -10 �-9 I -7
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Yes No
When corrections have been made, call f - e -inspection at 303-234-5933
Datedc)/11—Inspector: 4) c
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
_:�9�Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: 1 T 0
Job Address: MMM
Permit Number: Ul 74) 1 U vl
rl ( 0 -?-C. /� 0
❑ No one available for inspection: Time Y �AM/e ll
Re -Inspection required: Yes
When corrections have been made, call for re -inspection at 303 -234 -
Date: Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
7 ,
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address: b
Permit Number: 2 r, /7]3 /4-17
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Ye No
When corrections have been made, call for re -inspection at 303-234-5933
Date:—117/ Inspector: k X
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Roofing PERMIT - 201703147
PERMIT NO: 201703147 ISSUED: 07/03/2017
JOB ADDRESS: 4056 Simms ST EXPIRES: 07/03/2018
JOB DESCRIPTION: Residential Re -roof to install laminated asphalt shingles - 55 sq.
*** CONTACTS ***
OWNER (720)220-6776 SWEENEY CORINE R
SUB (720)999-4882 Robert Anderson 170321 Building Solutions 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: 26,200.00
FEES
Total Valuation 0.00
Use Tax 550.20
Permit Fee 465.05
** TOTAL ** 1,015.25
*** 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) requires an approved inspection
prior to installation of ANY roof coverings and is require on the entire roof when spaced
or board sheathing with ANY gap exceeding one half inch exists. 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.
City of Wheat Ridge
Residential Roofing PERMIT - 201703147
PERMIT NO: 201703147 ISSUED: 07/03/2017
JOB ADDRESS: 4056 Simms ST EXPIRES: 07/03/2018
JOB DESCRIPTION: Residential Re—roof to install laminated asphalt shingles — 55 sq.
I, by m signature, do hereby attest that the work to be performed shall comply with all accompanyin% 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
perf6n)ied and that a I -work to be..performed is disclosed in this document and/or its' accompanying approved plans and specifications.
M
Signature of OWNER or CONTRACTOR (Circle one) Date
I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Budding
Official and may be subject to a fee equal to one-half of the original permit fee.
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, an violation of any provision of any
applicable cid e any ordman rreguI do 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.
Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us
between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line.
Dan Schultz 26(70�IV
From:
no -reply@ ci.wheatridge.co.us
Sent:
Wednesday, June 21, 2017 3:22 PM
To:
Permits CommDev
Subject:
Online Form Submittal: Residential Roofing Permit Application
2
Categories:
Dane
o
Residential Roofing Permit Application
This application is exclusively for new permits for residential roofs and for licensed
o
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. 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. Permits are currently being
\
processed within 5 business days, subject to change based on volume.
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 1^/`G ValI V Cr
residential roof?
How many dwelling units Single Family Home
are on the property?
PROPERTY INFORMATION
Property Address 4056 Simms St
Property Owner Name Thomas and Corine Sweeney
Property Owner Phone 720-220-6776
Number
Property Owner Email
corinesweeney@mac.com
Address
Do you have a signed
Yes
contract to reroof this
property?
It will need to be
provided at the time of
permit pick-up.
CONTRACTOR INFORMATION
Contractor Name
Building Solutions, Inc
Contractor's License
170321
Number (for the City of
Wheat Ridge)
Contractor Phone
720-999-4882
Number
Contractor Email Address
reconrestorationllc@gmail.com
Retype Contractor Email
reconrestorationllc@gmail.com
Address
DESCRIPTION OF WORK
Are you re-decking the
No /
roof?
Description of Roofing
Asphalt laminated
Material
Select Type of Material:
Asphalt
If "Other" is selected
Field not completed.
above, describe here:
How many squares of the
55
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?
z
TOTAL SQUARES of all
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)
55
House with an 8-10/12 pitch
Project Value (contract $26,200.00
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 Robert Anderson
Email not displaying correctly? View it in your browser.
3
Recon Restoration LLC
Roofing I Construction I Remodeling
6170 Falcon Lane, Morrison, CO 80465 720 -999 -4882
ROOFING AND GUTTER SPECIFICATIONS
Owner:�_�w7ay (2z cl( 'i. lo" Date: f�?.0 l
Address:Lt�,�� ' 5- City: State: Zip: 76>015
Daytime Phone: 7ZC�,J �; ? Evening Phone:
Email Address:v\�i�r_ ;,�as'_.i`x�°,C� Claim #:
Buildings Involved Lbe"!5ei
Tear off Existing Underlaymenty�=�
Drip Edge LF and Color G-zf- Step Flashing LF and
Vents '�' Plumbing Stacks '"1r1� v Y7t%Valleys�
Shingle Brand Shingle Style
Shingle Color d/P,&T Material Placement
DumpsterJ .iA4 ( ,l' Decking Replacement Chimney Flashing
Gutters LF and Location GC/
Downspouts LF and Location
W
Gutter Color ►-^6,z-;?v1-. Downspout Color
Additional Specifications:
OWNER'S SIGNATURE
OWNER'S SIGNATURE
Recon
SIGNA"
Subject to Recon Restoration Management Review
www.reconrestorationllc.com
DATE l0 - )-�J � /7F
DATE
DATE L1 J ✓C IJ %
Recon Restoration LLC
Roofing I Construction I Remodeling
6170 Falcon Lane, Morrison, CO 80465 720 -999 -4882
RESTORATION CONTRACT
Owner:
Address: ^ 5�� �'', �� City:
Daytime Phone:�72e7,' �:< ,.&7 7f Evening
Email Address: l'n:f;.� am"--(?'o
Date:
State: C ) Zip:�::?�E
Claim #:
Owne33
r agrees to pay Recon Restoration, LLC for the work performed as detailed on the attached specifications as follows:
$%(¢ �. plus supplements and permits paid by the owner's insurance company for all work performed.
$ due upon signing this contract.
$> r( due upon first material delivery.
Ba ance due upon final completion of project and funds received from the owner's insurance company.
Upgrades of $0 shall be paid prior to the start of work.
f
Recon Restoration, LLC agrees to perform all work detailed on the following specifications in accordance with applicable building
codes and ordinances for the owner at the said address.
Roof and Gutter Specifications
Window Specifications
General Specifications
By signing below, the right and power to contract for such services is represented by Owner and this becomes a contract be-
tween Owner and Contractor. Owner has read and understands the terms and conditions on the reverse side of this contract.
Owner understand that any person or company has the right to file a lien against your property if not fully paid for materials and
labor supplied for this improvement to your property within 120 days upon the completion of the work. Recon Restoration, LLC
will obtain and furnish lien waivers for each trade upon request. Owner authorizes owner's insurance company to communicate
with Contractor and authorizes owner's insurance company to assign payments directly or jointly to the Owner and Contractor.
Additional Specifications:
OWNER'S SIGNATU
OWNER'S SIGNATU
Recon
SIGNA_
Subject to Recon Restoration Management Review
www.reconrestorationlic.com
DATE
DATE
DATE J ? J u-v�-
City of Wheat Ridge
Resid. Windows/Doors PERMIT - 201702917
PERMIT NO: 201702917 ISSUED: 06/30/2017
JOB ADDRESS: 4056 Simms ST EXPIRES: 06/30/2018
JOB DESCRIPTION: Permit to install 11 windows, 1 kitchen temp, 3 kitchen, 1 spare bedroom, 6
living room windows.
*** CONTACTS ***
OWNER (303)420-6784 SWEENEY CORINE R
SUB (303)945-1519 Matthew Seiler 130206 Renewal by Andersen
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 41,527.00
FEES
Window Replacement 50.00
Total Valuation 0.00
Use Tax 872.07
** TOTAL ** 922.07
*** COMMENTS ***
*** CONDITIONS ***
Windows shall comply with all applicable codes, have a .32 or better U -factor and shall be
safety glazing if within a tub enclosure, less than 18 inches above the floor or within 24
inches of a vertical edge of a door.
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. 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.
Signature of OWNER or CONTRACTOR (Circle one) Date
I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalpermit fee.
1 If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approv#1 of, anyy violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is sub ect to field.ins tion.
xj,,m— I &A4,
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ei.wheatridge.co.us
between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line.
'
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City of
(heat f dg -
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
I FOR OFFICE USE ONLY I
Date: r 11-7
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: 4056 Simms St Wheat Rridge, Co. 80033
Property Owner (please print): Corine Sweeney Phone: 720-220-6776
Property Owner E
Mailing Address: (if different than property address)
Address: Same as Above
City, State, Zip:
Architect/Engineer:
Arch itectlEng in eer E-mail: Phone:
Contractor: Matthew Seiler
Contractors City License #: CL3-130206
Contractor E-mail Address: inseiler@renewalcolorado.com
Sub Contractors:
Electrical:
W.R. City License #
Other City Licensed Sub.
City License #
Plumbing:
W.R. City License #
Phone: 303-945-1519
Other City Licensed Sub:
City License #
Mechanical:
W.R. City License #
Complete all information on BOTH sides of this form
Description of work: (Check all that apply)
❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE
❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING
❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING
❑ RESDENTIAL ADDITION [ WINDOW REPLACEMENT
❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ MECHANICAL SYSTEWAPPLIANCE REPAIR or REPLACEMENT
❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
❑ ELECTRICAL SYSTEWAPPLIANCE 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.)
Sq. FULF
Amps
1- KITCHEN TEMP, 3-KITCHEN,1 -SPARE BEDROOM, 6- LIVING ROOM WINDOWS.
Btu's
Squares
Gallons
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
41, 527.00
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 1 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.
CIRCLE ONE: (OWNER) (CONTRACTOR) o
PRINT NAME: Matthew Seiler
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS`
Reviewer:
(AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
SIGNATURE: ^r DATE:
DEPARTMENT USE ONLY
PROOF OF SUBMISSION FORMS
Fire Department ❑ Received ❑ Not Required
Water District ❑ Received ❑ Not Required
Sanitation District ❑ Received ❑ Not Required
OCCUPANCY CLASSIFICATION:
Building Division Valuation: $,
♦ i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 235-2857 Fax
INSPECTION NOTICE
Inspection Type: p- k""4-_
Job Address: _ Uf' f
r
Permit Number: 0./ fylf b-d'fi tsa r
K~'
❑ No one available for inspection: Time 12; ,r~' Amt;)
Re-Inspection required: Yes A01-1
"When corrections have been made, call r re-ins action at 303-234-5933
Dater - ?t! Inspector: rte., ,71" T
DO NOT REMOVE THIS NOTICE
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City of Wheat Ridge
.rte
Residential Roofing PERMIT - 091226
PERMIT NO: 091226 ISSUED: 08/11/2009
JOB ADDRESS:. 4056 SIMMS ST EXPIRES: 02/07/2010
DESCRIPTION: Reroof 50 sqs.
CONTACTS.***
owner 720/220-6776 Sweeney
sub 303/332-6234 02-1756 New Life Roofing Remodeling
PARCEL INFO
ZONE CODE: UA USE: UA
SUBDIVISION: 0125. BLOCK/LOT#: 0/
e **.FEE SUMMARY ESTIMATED PROJECT VALUATION: ,18,700.00
FEES
Permit Fee. 399.50
Total Valuation .00Qr~]
Use Tax 33660
TOTAL 736.10 Conditions:
I's b nail install ation&mid-roof inspection required. Board sheathing spaced more
than a 1/2 of an inch apart requires plywood overlay on entire roof. Ice and
water shield. required from eave edge to 2' inside exterior walls.
Subject to field inspections.
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
applications and that I assume full responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other
ap e wheat. Ri Ordinances, for work under this permit. Plans subject to field inspection. 61
Sign`aEtlxi e-troro-nttrractor/owner date
This permit was issued in accordance with the provisions set forth in your application and is subject to the. laws of the
State of Colorado and to the zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable
r
`.ordinances of the City.:.
2. This permit shall expire 180 days from the issue date. Requests for an extension must be received. prior to expiration
date. An extension may be granted at the. discretion of the Building Official.
C 3. If this permit expires, a new permit may be acquired for a fee of one-half the amount normally required, provided no
g; changes have been or will be made in the original plans and specifications and. any suspension or abandonment has not
exceeded one (1) year. If changes have been or if suspension or abandonment exceeds one (1): year, full fees shall
a" 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. Building Inspector. twenty-four (24)hours in advance for all inspections and shall receive
rtv '.written approval on inspection card before proceeding with successive phases of the job.
6. The issuance of a permit or the approval of :drawings and specifications. shall' not be 'construed to be apermit for, nor
sf; an approval of, any violation of the.. provisions of the building codes or. any other ordinance, law, rule or regulation.
All plan revie i ject to field inspections.
Signature cf P ?e u~.ld ng Official 'date
INSPECT;ON REQUEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855
e..REQUESTS MUST BE 'MADE BY 3PM.ANY BUSINESS DAY FOR INSPECTION, THE. FOLLOWING BUSINESS DAY.
q~
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oew"E?r~ City of Wheat Ridge Building Division
m 7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 " Fax: 303-235-2857
o Inspection Line: 303-234-5933
OCORP~
Date: M/1 066
Plan
Permit #:Oq/A26,,,
Buiuil"ding` ~Permit Application
Property Address G~~ Z{JLL~ U
Property Owner (please print): :t~ I d 9
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Contractor:
Contractor License
Sub Contractors:
Electrical City License
Company:
Phone:
Phone:
3
Mechanical City License
Company:
Plumbing City License
Company
Exp. Date: Exp. Date: Exp. Date:
Approval: Approval: Approval:
Use of space (description): Construction Value: $ n. C)
Description of work: (as calculated per the Building Val au m Data
X Plan Review (due at time of submittal): $
Sq. Ft./L.Ft added:
BTU's Gallons Amps
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 the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
under this permit. Plans subject to field inspection.
CIRLCE ONE:: (OWN R) ONTRACTOR > or PERSONAL REPRESENTATIVE of (OWNER) (CONTRATOR)
PRINT NAME: SIGNATURES Date:
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City of Wheat Ridgs
~
tia1 EIectric PERiW'IT'F - 080649
PERMTT NO:..480649 . TSSUED: . 06/16/2008 . .
JOS $.DDRESS; 4056 ~S~,~b` ~T . EXPIT2E5:, , . .12/13/2008 . . .
nE5CRTPR`ItiN; Gtitltied solas syateen
* rr,r COTIT't'ACF3 +e ~ w . . . . . . . . . . . . . . . .
owner 303'/431-4:04 Mr. & Mrs. 8weeney '
gc 3b3fI37-7212 Matthew Catyofilles 02-2064 Sa1t Electric LLC
r * :.F7RCEL t~' . ' . . , . .
ZONE CODE:< . , t,7X': . . . . . . USE: UA
susnzv2s16k: Br,ocx/LOZ#: o/ :
~
:r*..FEt E&T26lATEBP&OJECT VALUATION: 33,750.~60 . . . . , FEES . . . . . .
ResideAtial 5a3,aY` . . 500.00 . . . . ' .
Total Va]::uatiari . .00 . TOTAL :t*. . . . 500.00 . . . :
Conditione:
MR . - Fietght escemptpe-r oode . . . . .
JS'- Valuation ok +issees permit feee at stsndard rates subject to field
inspeCtianw4rk 9ha11, eAmply with 2005NEC . ' I hereby cezClEy f,#at EYAe getLppk daetaAeee prppo9ed by thae pexmit application are accurate, and do not violats applicable -
ordinancea, nllqa p;~,~gn3,,,oF th~j {:ity "af Nhlat Riflge or covanante, easemente o; reetrictiona of zecord; tYiaE all .
meaeurement8 ehoan, a a3l~gttaotl9 made ara atcuYate: ehat I haveread and agree toabSde Uy a11condielon9.prinCed on..Thie .
appliCat4on astd,L`31s¢ Y-IE9auine fuSll FeBponBibil}ty.foz compliance wiCh the Wheae Aidc}e euildinJ Code (I.B.C) arid all othez appliceble Npaa¢ Atqg§ OYdynan<ea; focwozk under.ehie permie. Planeautiject to Field lnspection.. Signature ofCOrttsapt;[oWhbr . date . . . . . . . . . . . .
L This peimit x3e="s,Wd.ln acCOxdance wSth-th! prwielone eet:fosthin}rour applleaMon and ia eubjeet Cathe laws of,the
..Stnta^of`Gb12>itddo aaE ta theti3ningRegulgtione and~HUilding Codee ofNheat RSdge, ColoraCO ozany ather applicable 'ardinances~ of tbA CtCy• . . . . . . .
2:: Tdiq pKxmY.t,eh$1} woiz'q 180 daxe framthe leeue date. Ret7ueaCe far anexteneion muet be received priox to.expiration
date. An i%tpnAlmlin9y be gzArited dt the fllecretion of rEe Huilding Oificial.. 3. If thie FfCStnit expizB4,-i new plxmit may be acqulFed for a.fee ofnne-half the amount nomilly requireQ, prov>ded no:- . .
chang4s lwub°Heak+ 4t-fui71 bemade in the oYiginalplane and epecaficatione and anyeuapeneion.or abandonm6nt hae not exceedtdone (13 yaar. Ifchangeahave.been or 16 euepeneion or Abandonment exceeds one (1) year, £ull feee ahall.
be 9a3d fo* &,nta,ps%miC. . . . . . .
a. No wrk oEamp manseF mP+eil Ltdone that will chenge the natusal flow of water caueiag a dralnage pzoblem: . 5.ContraCtor'ghell-ndti£y„tHe Building Inepeetor twenty-four (24) t+evz'e inedvance for-.a11 Snegectione andahall receive writtea agpraYal crn in4pection:cazd beLore ptoceeding with eucceesive phasee of thejob. 6.Tha lesuaac4 of 'e peamSC'or tk8 Sp soval of drawinge andepecificationa ehall not be conetrued to be apezmit for, nos an appzoval of,'any v1bli.Cion ~f ~psovlsione ofthe buildingcodes or any other ordinance; lav, ru1C or regnlatian. .
:All plan sevlaw 3a'eu6$ ~ineplctions. . . . . . . .
Signatureof Chiet 9u11dtt~g fic...l . date
INSPXCTSON~$'~T, St~Sx(303)294-5933BUILDiN(3 OPFICE: (303)235-2855 ~R9QU85Ts~~MUST $8,'M4O3 S'Y 3PM ANSC.H'[fSIE~T~',SS DAY FOR ZNSPECTIdN'ffiE FOLLOWZNG BUSINE3& DAY.
. . . . . ~ . . , s: . . , . _ -
9
OF WHE4l
~ c„ City of Wheat Ridge
°OtoRaa° Residential Roofing PERMIT - 071246
PERMIT NO: 071246 ISSUED: 11/15/2007
JOB ADDRESS: 4056 SIMMS ST EXPIRES: 05/13/2008
DESCRIPTION: T/O; reroof house.
CONTACTS
owner 303/431-1434 Sweeney Residence
PARCEL INFO
ZONE CODE: UA USE: r-3
SUBDIVISION: 0125 BLOCK/LOT#: 0/
FEE SUMMARY ESTIMATED PROJECT VALUATION: 8,850.00
FEES
Permit Fee 217.50
Total Valuation .00
Use Tax 159.30 ma
TOTAL 376.80
Comments:
6 nail installation & mid-roof inspection required.
I hereby cer[ify 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 a11
measurements shown, and allegations made are accurate; that I have read and a9ree m abide by all conditions printed on this
application and that I aseume full responsibility for compliance with the wheat Ridge Building Code (I.B.C) and all other
applicable W~at e Ordinances, for work under this permit. Plans subject to field inspection.
date1/ /s,;LO7
Siqna or/owner
1. This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the
State of Colorado and to the Zoning Regulations and Huilding Codes of Wheat Ridge, Colorado or any othex applicable
ordinances of the City.
2. This permi.t shall expire 180 days from the issue date. Requests for an extension must be received prior to expiration
date. An ex[enaion may be granted at the discretion of Che Huilding Official.
3. If this permit expiree, a new permit may be acquired for a fee of one-half the amount normally required, provided no
changes have been or will be made in the oziginal plans and specifications and any suspension or abandonment has no[
exceeded one (1) year. If changes have been or if suspension or abandonmen[ exceeds one (1) year, full Eees shall
be paid for a new permi[.
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 Building Inspector twenty-four (24) hours in advance for all inspections and shall receive
written approval on inspection card before proceeding with successive phases of the job.
6. The issuance of a permi[ or the approval of drawings and specifications shall not be ronstrued to be a permit for, nor
an approval of, any violation of the provisions of the building codes or any other ordinance, law, rule or regulation.
A11 plan regievAA subject m field inspections.
Signature qg-Nh7XEr Builtling OTL1c1a1
aace
N REQUEST LINS: (303)234-5933 BUILDING OFFICE: (303)235-2655
MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
OFyJHEqr~ City of Wheat Ridge Building Division
~ M 7500 W. 291h Ave., Wheat Ridge, CO 80033
k^-~~==`~ Office: 303-235-2855 ` Fax: 303-235-2857
~ o Inspection Line: 303-234-5933
~GORP~
~
Building Permit Application
Date:
Plan
Permit
Property Address: 4% {vl y►'l S sr
Property Owner (please print):
Contrector:
Phone:
Contractor License k: Phone:
Sub Contractors:
Electrical City License Plumbing City License Mechanical Ciry License
Company: Company Company:
Exp. Date: Exp. Date: Exp. Date:
Approval: Approval: Approval:
Use of space (description): .h'"F c*EFa-A~rt Construction Value: $ nSv
DescriptlOn of wofk: (as calcWatedper the Bu1lding Valuation Data sheet)
Plan Review (due at time o/ submiftal): $
Sq. Ft./LFt added: Squares S() BTU's Gallons Amps
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 restriclions of record; that all measurements shown, and
ailegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full
responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
under this permit. Plans subject to fleld inspection.
CIRLCE ONE:: (OWNER) (CONTRACTOR) or PERSONAL REPRESENTATIVE of (OWNER) (CONTRATOR)
PRINT NAME: SIGNATURE: Date:
DEPARTMENT USE ONLY
ZONING COMMENTS'.
Zoning:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewec
BUILDING DEPARTMENT COMMENTS: OCCUPANCY:
Reviewer.
FIRE DEPARiMENT:: ❑ approved w/ comments ❑ disapproved ❑ no review required Bldg ValUdtion: E
Mailing Address: (if different fhan property address)
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FORM (M) 414-02-1123 PUBLIC SERVICE COMPANY OF COLORADO -~~NO
FL
CITV.TPIYNOFC UNTV W " . ~
ACTIONTAKEN
~ cus„ A R E (PAI"T) 7 e, ~ ❑ NO SHUT OFF
I a 11 ❑ qpPLIANCE OFF
s' IFY ❑ gOTH APPL.B METER OFf
~
~ OWNER! 'r, TENANT ~ AGENT OTHER El METER SHUT OFF
- HAZARD - G Or j
CONDRION TO BE CORRECTED AS SHOWN BELOW CREATES AN IMMEDIATE HIiZAND.THIS EOUIPMENT MUST NOT BE PUT BACK IN
BUI'DING DEPARTMENT FOR CADE,IND PERMIT REQUIHEMENTS PRIONTO FEPFO MINf REP~IpWORKp ~NTAC7YOUR LOCAL
ML
~NAMEANONPEOFAPPLIANGE .
BE COiWECTEO , , i^ - I i .,M1 yJ -i E C.-.y
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TPGGED BY
~CUSTOMERIOCGUP S10114NRE
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~ REVSIIXISMIP OF OCGIIPAM TO COSTOMER
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COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number : 18137
BUILDING INSPECTION LINE -(303-234-5953) Date : 12/13/2004
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
Property Owner: THOMAS SW EENY
Property Address : 4056 SIMMS ST
Contractor License No. : 20569
Phone : 420-6784
Company : Carroll Plumbing & Heating Inc.
Phone :
420-6784
OW NER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Valuation
: $300.00
I hereby certify that the selback distances proposed by this permit appliration are accurate, and
permit Fee
: $30.55
do nol violate applicable ordinances, rules or regulations of lhe City of W heat Ridge or
00
$0
covenants, easements or resVictions of record; that all measurements shown, and allegations
Plan Review Fee
.
:
made are accurete; that I have read and agree to abide by all conditions printed on this
Use Tax
: $3.60
application, and that I assume full responsibility for compliance with the W heat Ridge Buildin9
Code (U.B.C.) and all other applicable W e 'd or
i
'aences, for work under this permit.
Total
: $34.15
DATE
0-
(OWNER)(CONTRACTOR) SIGNED
i
_
_
2co `x ~
Use
:
1I-27C} i5
Description : CAP OFF AND ABANDON 1" NATURAL GAS LINE SUPPLYING BASEMENT APPLIANCES
LOCATED UNDER CONCRETE SLAB
S►`
BUILDING DEPARTMENT USE ONLY
Approval :
Zoning :
Approval :
PuOc V11ork~ Gotg:'
Approval :
Occupancy: Walls
Electrical License No :
Company :
Expiration Date :
Approval :
Roof : Stories
Plumbing License No :20569
Company :Carroll Plumbing & Heating
Inc.
Expiration Date : 1 211 3/2 0 0 5
Approval : OK/KS
SIC : Sq. Ft. :
Residential Units :
Mechanical License No
Company:
Expiration Date :
Approval :
(1) This permit was issued in accordance wilh the provisions set forth in yopur application and is subjecl to the laws of the State of Colorado and to the Zoning
Regulations and Builtling Code of W heat Ridge, Colorado or any other applicable ordinances of the Ciry.
(2) This permit shall expire if (A) the work authorized is not commenced within sixty (80) days from issue dale or (B) the building authorized is suspended or
abandoned for a period of 120 days.
(3) If this parmit expires, a new permit may be acquiretl for a fee of one-half the amount normally required, provided no changes have been or will be made in the
original plans antl specifcations and any suspension or abandonment has not exceeded one (1) year. I( changes are made or if suspension or abandonment
exceeds one (1) year, full (ees shall be paid for a new permit.
(4) No work of any manner shall be done that will change the nalural Oow o( water causing a drainaga problem.
(5) Contractor shall notify the Building Inspector hventy-(our (24) hours in advance for all inspeQions and shall receive written approval on inspection caN before
proceediing with successive pha aptlhe job.
(8) The issuanc ermit e approval o win9s antl specifications shall not be construed to be a permit (or, nor an apProval of, any violation of the
proviss 0ui g c es or ortlinance, law, rule or regulation.
d .
Chief Building Inspector
Please sign Terms and Conditions on reverse side of page.
COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number:
o~ ""E"'y BUILDING INSPECTION LINE - 303-234-5933 Date:
~ g CITY OF WHEAT RIDGE
" 7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
~~~ORP~ APPLICATION
Property Owner. -~j ~J 4_Y,.~
Property Address: 40~TTv 17:MA.y7
Contractor License No.: ~,~F(01 Company: f~ I)
Phone:
Phone:303-
OWNER/CONTRAGTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereDy certify that the setback dislances proposed by ihis pem+it application are
accurate, and do not violate applicable ordinances, rules or regulations of the City of
W heat Ridge or covenants, easements a res4icfion5 of reoord: that all measurements
shown, and allegations made are accurete; that I have read and agree to abide by all
condi6ons printed on this applicaUon and that I assume full responsibiiiry for
compliance wifh the Wheal Ridge Building Code (SLB.C) and all other applicable
Wheat Ridge Ordinances, tor work unde^thi~r~ffiit.
.
(owNIutxcorvrrucTOR)
Description:
Sq.Ft.addetl _
Value:$
Permit Fee:$
Plan Review Fee:$
Use Tax•R
Total:$
'RINTED - >CA~ T v - - ~
6q Q ~~1~'r~ ~a„~L~..~ I""1~.1zA( l o ca-EF~ v,., &`z2 6')'J`2c~~r-
Expiration Date: Expiration Date: Expiration Date:
ApprovaP Approval: Approval:
(1) 7fiis permil was issued in axordance witli the provisions set bM in your appliption and is subjecl to Uv laws of the Stale ot
Colorado and to the Zoning Regulations and Buildinp Codes of W heat RiAge, Colorado w any other applipble ordinances of
the Ciry.
(y) This permif shall expire if (A) the work authorized is nol commenced vrithin sixty (60) days from issue date or (B) the buil0ing
auMOrizeE is suspended a abandoned tor a period of 120 days.
(3) 11 Mis permit ezpiros, a new peimit may be acquired for a fee of one-hal( Me amount rwrtnally required, provi0ed no changes
have been or wi11 be made in the oriyinal plans and spedfications arW any suspenswn or abanAOnment has not exceeded one
(1) year. If chanpes have been a if suspension or abandonment eaceeds one (1) year, lull iees shall be paid For a new pertnit
(4) No work ot anY manner shall be done that wi11 chanye the naWral flow of water rausinp a drainape proWem.
(5) Contractor shall notily the BuiMinp Inspectrn Mrenty-four (24) hours in advance ta all inspections and shall receive written
approval on inspection pM before proceeding with successive Dhases of the job.
(6) The issuance o( a pertnA a the apDmval oi drawinps and specifications shdl not be construed to be a pertnil tor, nw an
approval o(, any violation ot the provisions oi the building codes or any other ordinance, law, rule or regulatbn.
Chief Building Official
ElecVical License No: Plumbing License No: Mechanical License No:
Company: Company: Company: