HomeMy WebLinkAbout4190 Everett Driver 49
City of W151cyj
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COXMIUM-ri Di:vl:tOPMEN7
Building & Inspection Services
7500 W. 2901 Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933 �pR�
Email'. .- - x�Si11-kGi `►t CYL~7-10
FOR OFFICE USE ONLY I
Date: 3 f,)-142 _
Plan/Pennit # aD�� Mti'-�Q
-Plan Reviews Fee N } f -e -V 1'G i o Y\
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address:��`
,,�: Owner (please Prin
o: k&L�'uv1�1 Phone:
Property Owner Email:_ Lkub me—
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address: 'A lq , t_3z . ,
Archite gIneer. \,kk lz i.4rE� 14 j24. -
ArchitectfEnglneer E-mail: 1r�2��/e�rrli►x�Phone:
Contractor Hmme:
City of Wheat Ridge License M Phone::
Contractor E-mail Address:' mow,
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print):`R1 ok,) c.A Phone:_��.
CONTACT EMAIL(p/ease print): `RX,_A& D&rz ZOL123 a
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License f City License #
rA 3
s
7
Complete all highlighted fields.
❑COMMERCIAL ;RRESIDENTIAL
Provide description of work: For ALL projects, 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, 4ape and amount of materials to be used, etc.
rno�e , 5e JAVA t. tt�_�
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12eQx9q C kni 012AI -
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Sq. FULF BTUs 1
Amps Squares For Solar: KW
For Commercial Projects Only: Occupancy Type:
Occupancy load:
—i ICS
�h` i,n � ►t �'
1DQy L,34k i ti
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Frnf=
4 of Panels Requlms Structural
Construct in Type:
Square footage: _
Project Value: (Contract value or the cost of ALmaterials and labor included in the en I pro ct)
Valuation Okay
omMRJCONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) (CONTRAC or A ORIZED RE iESENT f (OWNER) (CONTRACTOR)
Simatury (first and I-11bufth I?ATE:
Printed Name
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
Reviewer. ___ __ . -
BUILDING DEPARTMENT COMMENTS:
Reviewer. _
PUBLIC WORKS COWAENTS:
Reviewer:
CONSTRUCTION TYPE:
Building Division Valuation:
City of
eC�� j�i11 ge
C.C7MMUNt7Y D£VErnnMFr-�-��
Building & Inspection Services
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: )rmits(aki.wheatridge.co.us
FOR OFFICE USE ONLY
Date:
Plan/Permit #
Plan Review Fee:
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property a Address: [ �� �r Plz� kJk"-Ct'_).r(a.1 00033
c
Property Owner (please print): C4<S,4 k�63 Phone: 3�3- !Z 1
Property Owner Email: aym� :Pq /ge,_ LO/V\,-
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address:
Zlo.
Architect/Engineer E-mail: 1Q.�11 [ �12,� gr p h'o0e e7ZO
Contractor Name:
City of Wheat Ridge License #:
9 41 u) erts
Contractor E-mail Address:
For Plan Review Questions & Comments (please print):
Phone: dCJ3q0?,-ff,3?gi
CONTACT NAME (please print): i6CK_ /4- Phone: 3(03`900_-63(c{
CONTACT EMAIL(please print): (44S-bUl(At2.S:4CJW1
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Complete all highlighted fields.
❑COMMERCIAL &RESIDENTIAL
Provide description of work: For ALL projects, 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.
&,Pc(et 1�4� -�- AAS-tetz-
Sq. FULF
BTUs
Gallons
Amps Squares For Solar: KW # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type: A; A
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
Valuation Okay
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) (CONTRA
Signature (first and last name):
Printed Name:
ZONING COMMMENTS:
Reviewer.
BUILDING DEPARTMENT COMMENTS:
Reviewer.
PUBLIC WORKS COMMENTS:
Reviewer:
REPRESENTATIVE) of (OWNER) (C NT CTOR)
DATE: `Y
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Building Division Valuation:
From: no-reolv(alci.wheatridae.m. us
To: CommDev Perm is
Subject: Online Form Submittal: Asbestos Abatement
Date: Wednesday, December 8, 2021 1:29:04 PM
Asbestos Abatement
This application is exclusively for RESIDENTIAL ASBESTOS ABATEMENT
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN
ORDER FOR THE PERMIT TO BE PROCESSED.
Your Permit will be emailed to the email address provided below once it is
processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
Is this application for Yes
residential asbestos
abatement?
Provide copy of Permit Ddf
CDPHE State Permit or
Stamped Approved
CDPHE State Permit
Application
PROPERTY INFORMATION
Property Address 4190 Everett St
Property Owner Name Lisa Kulps
Property Owner Phone 3039297134
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email lakulp@me.com
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
Electronic -Payment -Form. Ddf
CONTRACTOR INFORMATION
Contractor Business
KK Environmental Services, Inc
Name
Wheat Ridge
202240
Contractor's License
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
720-876-0808
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
rwolf@kkes.com
Address
Retype Contractor
rwolf@kkes.com
Email Address
DESCRIPTION OF WORK
State Permit No. or
12/7/21 TS
Application Approval
Date with Initials of
CDPHE Employee
approving application.
Location of Abatement
Entry, Master Bedroom & Bathroom
Square Footage Area
800
of Abatement
Has the abatement
No
been completed
If abatement has been
Field not completed.
completed, upload the
clearance report.
Project Value (contract
9985.00
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 work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal owner of the
property to submit this
application and to
perform the work
described above.
Person Applying for Robert Wolf
Permit
I attest that everything Yes
stated in this
application is true and
correct and that
falsifying information in
this application is an
act of fraud and may
be punishable by fine,
imprisonment, or both.
Email not displaying correctly? View it in your browser.
1* � � i City of Wheat Ridge
�� E -Res. Sewer/Waterline Repair PERMIT - 202100458
PERMIT NO: 202100458 ISSUED: 03/08/2021
JOB ADDRESS: 4190 Everett Dr EXPIRES: 03/08/2022
JOB DESCRIPTION: Sewer line repair in back yard, 45 feet.
*** CONTACTS ***
OWNER ( 3 0 3) 929-7134 KUL P LISA A
SUB (303)981-0079 CARLO SAIS 110007 PAYLESS ROOTER/MATO PLUMBING
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 31600.00
FEES
Total Valuation 0.00
Use Tax 75.60
Permit Fee 109.20
** TOTAL ** 184.80
*** COMMENTS ***
*** CONDITIONS ***
ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive
written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection
by any Sanitation District representative. Inspection and approval of work by any
Sanitation District representative DOES NOT grant authority to cover work without the
approval of the Building Division.
**For trenchless sewer replacements - The contractor will verify proper slope of new sewer
piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed
specifically by the applicable code. The plumbing contractor will provide verification of
proper slope and drainage in writing as a condition of approval of the permitted work.**
Both the front and back of this permit are required to be posted on the job site at all
times. If the complete permit is not present, inspections WILL NOT be performed.
1* � 4 41'
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION:
City of Wheat Ridge
E -Res. Sewer/Waterline Repair PERMIT - 202100458
202100458
ISSUED:
4190 Everett Dr EXPIRES:
Sewer line repair in back yard, 45 feet.
03/08/2021
03/08/2022
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 permrt. I further attest that I am leg ally 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 original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and��procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all requ�ired
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, anviolation of any provision of any
pplicab e code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
03/08/2021
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
From: no-reolv(alci.wheatridae.m. us
To: CommDev Pets
Subject: Online Form Submittal: Sewer or Water Line Repair Permit Application
Date: Monday, March 8, 20212:41: 10 PM
Sewer or Water Line Repair Permit Application
This application is exclusively for SEWER OR WATER LINE REPAIR - IN YARD
Your Permit will be emailed to the email address provided below once it is
processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
Right of Way permits must be applied for with the Public Works Department.
Is this application for Yes
sewer line or water line
repair - in yard only?
PROPERTY INFORMATION
Is this Residential or Residential
Commercial?
Property Address 4190 Everette Dr, Wheat Ridge
Property Owner Name Lisa Kulp
Property Owner Phone 303-929-7134
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email lakulp@me.com
Address
Attach City of Wheat WR 3 08 Ddf
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business Payless Rooter & Mato plumbing LLC
Name
Contractor's License 000572
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
303-981-0079
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
paylessrooterdenver@gmail.com
Address
Retype Contractor
paylessrooterdenver@gmail.com
Email Address
DESCRIPTION OF WORK
Is this a sewer line or
sewer Line
water line repair?
Length of repair
45Ft
Location of repair
Backyard
(backyard, frontyard,
etc)
Provide additional
N/A
details including
installation of clean-
o uts.
Project Value (contract
3600
value or cost of ALL
materials and labor)
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full
Yes
responsibility for
compliance with
applicable City of
Wheat Ridge codes
and ordinances for
work under any permit
issued based on this
application.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal owner of the
property to submit this
application and to
perform the work
described above.
I attest that everything Yes
stated in this
application is true and
correct and that
falsifying information in
this application is an
act of fraud and may
be punishable by fine,
imprisonment, or both.
Person Applying for Carlos sais
Permit
Email not displaying correctly? View it in your browser.
�l�D F✓Grp �� INSPECTION RECORD
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection
INSPECTION REQUEST LINE: (303) 234-5933
Occu anc Type
kwF
Inspections will not be performed unless this card is posted on the project site.
**Request an inspection before 11:59 p.m. (midnight) to receive an inspection the following business day.**
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections Date Inspector Comments
Initials
Pier
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground/Slab Inspections Date Inspector Comments
Initials
Electrical
Sewer Service
Plumbing
Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections
Rough Inspections
Date
Inspector
Initials
Comments
Wall Sheathing
Mid -Roof
r2- -14.
7 PIK
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
.(C1 .
.�/�...w
�
og -
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
City of Wheat Ridge
Residential Roofing PERMIT - 201704402
PERMIT NO: 201704402 ISSUED: 07/19/2017
JOB ADDRESS: 4190 Everett DR EXPIRES: 07/19/2018
JOB DESCRIPTION: Residential Re -roof to install asphalt shingles with 41 sq.
*** CONTACTS ***
OWNER (303)929-7134 KULP LISA A
SUB (720)684-5500 Scott Brasington 170091 GreenPoint Roofing, LLC
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 15,375.00
FEES
Total Valuation 0.00
Use Tax 322.88
Permit Fee 299.40
** TOTAL ** 622.28
*** 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.
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.
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: V_0dc-''
Job Address: 410 r—A r--- -4 T
Permit Number: 1-c)n lc)44c)2
❑ No one available for inspection: Time t4f,_Z_D)AM% M
Re -Inspection required: Yes rNo)
When corrections have been made, call for e -inspection at 303-234-5933
Date: (2 I Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
�/ Building Inspection Division
1 (303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: l I9 R_oorz-
Job Address:
Permit Number:
❑ No one available for inspection: Time F1-7170�APM
Re -Inspection required: Yes No
'When corrections have been made, call fo -inspection at 303-2_ 3433
Date: Inspector: cc O&�
V
DNOT 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: 306-_ %d
Job Address: yl q0 �
Permit Number:
❑ No one available for ins?B_e ' n: Time AM/PM
r
Re -Inspection required• Ye No
When co7113
ions have been made, call for re -inspection at 303-234-5933
Date: 17—inspector: MLV
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
j Residential Roofing PERMIT - 201704402
_R
PERMIT NO: 201704402 ISSUED: 07/19/2017
JOB ADDRESS: 4190 Everett DR EXPIRES: 07/19/2018
JOB DESCRIPTION: Residential Re -roof to install asphalt shingles with 41 sq.
*** CONTACTS ***
OWNER (303)929-7134 KULP LISA A
SUB (720)684-5500 Scott Brasington 170091 GreenPoint Roofing, LLC
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 15,375.00
FEES
Total Valuation 0.00
Use Tax 322.88
Permit Fee 299.40 PARK)
** TOTAL ** 622.28
*** 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.
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.
4( City of Wheat Ridge
Residential Roofing PERMIT - 201704402
PERMIT NO: 201704402 ISSUED: 07/19/2017
JOB ADDRESS: 4190 Everett DR EXPIRES: 07/19/2018
JOB DESCRIPTION: Residential Re—roof to install asphalt shingles with 41 sq.
I, by my signature, do herattest 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�permrt. I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be
performed and that all work t berf hed is disclosed in this document and/or its' accompanying approved plans and specifications.
Z4/,
Signature A—,'�R or CONTRACTOR (Circle one) 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 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 code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official 0 Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Dan Schultz �C �76 446P,
From: no-reply@ci.wheatridge.co.us
Sent: Tuesday, July 11, 2017 4:45 PM
To: Permits CommDev
Subject: Online Form Submittal: Residential Roofing Permit Application
Categories: Danny
G
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 4190 Everett Dr
Property Owner Name Lisa Kulp
Property Owner Phone 303-929-7134
Number
Property Owner Email lakulp@me.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
Contractor's License
Number (for the City of
Wheat Ridge)
Contractor Phone
Number
GreenPoint Roofing
170091
720-684-5500
Contractor Email Address info@greenpointroofing.com
Retype Contractor Email
Address
DESCRIPTION OF WORK
Are you re -decking the
roof?
Description of Roofing
Material
info@greenpointroofing.com
No
Composition asphalt
Select Type of Material: Asphalt
If "Other" is selected Field not completed.
above, describe here:
How many squares of the 41
material selected above?
Does any portion of the
property include a flat
roof?
If yes, how many squares
on the flat roof?
Nov,
Field not completed.
TOTAL SQUARES of all 41
roofing material for this
project
Provide additional detail house, 5/12 pitch - tear off & replace
here on the description of
z
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
Project Value (contract
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 Lisa Underhill
Email not displaying correctly? View it in your browser.
3
1030 Boston Avenue
Longmont, CO 80501
Fax: 720-684-5501
info@greenpointroofing.com
Residential Roof Replacement Contingency Agreement
This agreement is only in effect if the insurance company agrees Any and all supplements approved and paid for by insurance
to a FULL roof replacement. for work performed by GreenPoint Roofing, will be considered
Anythingpart of the claim and due to GreenPoint Roofing. This includes
ess than a full roof replacement and the homeowner is
building code items, and permits that may be required within
under no obligation to use the services of GreenPoint Roofing. your municipality.
The homeowner gives GreenPoint Roofing and its representatives
permission to represent and work on their behalf with the
homeowner's insurance company.
GreenPoint Roofing will furnish all materials and labor in
accordance with the scope of work or estimate provided by the
insurance company.
Homeowner only pays amount allowed and agreed upon
by insurance company as specified by their scope of work /
estimate / loss sheet.
Insuran
Company
Date of Lc
The ONLY cost to the homeowner is their deductible as part
of the policy. Any additional work to be performed above and
beyond the insurance scope of work will be accepted in writing
by the homeowner.
Homeowner agrees to furnish GreenPoint Roofing with all
insurance claim information needed including claim number,
insurance scope of work / estimate / loss sheet. GreenPoint
Roofing will perform all work in a quality manner and adhere
to all local building code requirements. Workmanship and
manufacturer warranties will be delivered upon final payment.
Claim Number Z. .3 2�
Deductible
Date Name
s122� �5 A t�U L -q:>
Email
Cell Phone
14
Phone
Address
Li�q �ve,�--c, '� r N,4,
City
',
State
CO
Zip
U
kuthoriz epresentative of GreenPo t ofmg, Ilc o e Owner Date OO��
�" - r® PREFERRED
HOME 0 oil, ' r : CONTRACTOR ®E�
SERVICES>:»
AUTHORIZED SERVICE PROVIDER ROMIM SYSTEMS
Sq. FULF OWS Gallons
Amps Squares tither
CITY OF WHEAT RIDGE
Building Inspection Division
/0000r (303) 234-5933 Inspection line
(303) 235-2855 Office - (303) 235-2857 Fax
INSPECTION NOTICE
Inspection Type:
Job Address/Permit Number: i/ / E r
A _
❑ No one available for
Re-Inspection required: 'Yes' ; No
*When corre ions have been made,.cai
Date: Inspector: _
/ DO NOT REMOVE
me
at 303-234-5933
1 I 4' CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office - (303) 235-2857 Fax
INSPECTION NOTICE
Inspection Type: F~n~J C, k,
irc5 J
Job Address/Permit Number: -VI A,~3 v?~ e 77'~
❑ No one available for inspection: Time /b '-(c) QM>M
Re-Inspection required: No
When corrections have been made, call for re-inspection at 303-234-5933
Date: 5/D Inspector:
DO NOT REMOVE THIS NOTICE
~►~4'
r4000r,
City of Wheat Ridge
Residential Mechanic PERMIT - 081240
PERMIT NO: 081240 ISSUED: 10/27/2008
JOB ADDRESS: 4190 EVERETT DR EXPIRES: 04/25/2009
DESCRIPTION: Replace 70,000 btu furnace 80%
CONTACTS
owner 303/456-6356 Emily Jay
gc 303/421-3572 William Buras
01-7865 Lakeside Heating & A/C
PARCEL INFO
ZONE CODE: UA
SUBDIVISION: 0281
USE: UA
BLOCK/LOT#: 0/
FEE SUMMARY ESTIMATED PROJECT VALUATION: 2,250.00
FEES
Permit Fee 108.30
Total Valuation .00 i
Use Tax 40.50 ) ~J 1
TOTAL 148.80
Conditions:
Must comply w/ 2003 IRC & 2005 NEC
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
applle/ryabblle Wheat Ridge Ordinances, for work under this permit. Plans }subject to field inspection.
S tureture oa-4y- f contrAtor/owner date
1. This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the
State of Colorado and to the Zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable
ordinances of the City.
2. This permit shall expire 160 days from the issue date. Requests for an extension must be received prior to expiration
date. An extension may be granted at the discretion of the Building Official.
3. If this permit expires, a new permit may be acquired for a fee of one-half the amount normally required, provided no
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
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
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 a permit for, nor
an approval of, any vio at' of the provisions of the building codes or any other ordinance, law, rule or regulation.
All plan review is o field inspections.
Signature of Chief B din Official date
INSPECTION REQ EST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855
REQUESTS MUST BE MADE BY 3.PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
wHeAr Ciry of Wheat Ridge Building Division Date:
Sao ; °c 7500 W. 29" Ave., Wheat Ridge, CO 80033 plan
m Office: 303-235-2855'" Fax: 303-235-2857
Inspection Line: 303-234-5933 Permit#
CO oR 00
/ p Building Permit Application
Property Address:I / D V 2 a'~ !7~ • ' /
~ `lam Phone:3G~' X56 -35
Property Owner (please print): lil
Melling Address: (if different than properly address)
Address:
3.3
City, State, Zip: 14 P
Contractor: 2 1 "nn^~--~ 1
Contractor License v ( Phone: 3,
Sub Contractors: Mechanical City License
Electrical City License Plumbing City License Company:
Company: Company
Exp. Date: Exp. Date:
Exp. Date;
Approval: Approval: Approval:
use of space (description : Construction Value: S p7~✓ lJ • oe>
(as calculated per the Building Valuation Data sheet)
Description of work:1r~~/LL rerse/
~ Plan Review (due at time ofsuomlrtaQ:
w 5
J6,, otlGl
Sq. Ft,/L.Ft added: Squares BTU's Gallons Amps
ACTOR SIGNATURE Op UNDERSTANDING AND AGREEMENT
at the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances,
to of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and
are accurate; that I have read and agree to abide by all conditions printed on this application Ordinances, for
e full
cvah the wheat Ridge Building Code (I.B.C) and all other applicable wheat Ridge CIRLCE ONE:: y(OWNER)
PRINT NAME' (O '
or PERSONAL.
DEPARTMENT USE ONLY
ZONING COMMENTS:
Zoning:
Reviewer.
PUBLIC WORKS COMMENTS:
Reviewer:
(CONTRATOR)
.t1-43, -Date:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
FIRE 05PARTMENT:7 0 approved wi comments 4 disapproved ❑ no review required 61dg Valuation:
OCCUPANCY;
EO/Z0 39Vd EINIiV31-1 3GIS11AVI LE88-697-60E VE:TT 800L/LL/0T