HomeMy WebLinkAbout5395 W. 40th AvenueFrom: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Sewer or Water Line Repair
Date: Friday, March 18, 2022 4:04:11 PM
CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you
recognize the sender and know the content is safe. Report any suspicious activities to the IT Division.
PERMIT APPLICATION Sewer or Water Line Repair
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 5395 WestS 40th Ave
Property Owner Name Shanna wlman
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
720-602-0472
Field not completed.
CC auth form-3--17.Ddf
CONTRACTOR INFORMATION
Contractor Business Afford -A -Rooter
Name
Contractor's License 130129
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone 720-296-7972
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email affordarooter99@gmail.com
Address
Retype Contractor affordarooter99@gmail.com
Email Address
01:K163CiIi1 ffl0N]avOLelS:/
Is this a sewer line or
sewer Line
water line repair?
Length of repair
10 feet
Location of repair
Front yard
(backyard, frontyard,
etc)
Provide additional
clean outs
details including
installation of clean -
outs.
Project Value (contract
1500
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 Robin Fulton
Pe rm it
Email not displaying correctly? View it in your browser.
From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Sewer or Water Line Repair
Date: Monday, March 7, 2022 11:57:29 AM
CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you
recognize the sender and know the content is safe. Report any suspicious activities to the IT Division.
PERMIT APPLICATION Sewer or Water Line Repair
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 5395 w 40th Ave.
Property Owner Name Perter Ergon
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
303-242-9181
perter.ergon@kw.com
City of Wheat Ridae Payment Form - CG.Ddf
CONTRACTOR INFORMATION
Contractor Business Apex Plumbing Inc
Name
Contractor's License 060162
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone 303-215-1348
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email permitting@apexplumbing.com
Address
Retype Contractor permitting@apexplumbing.com
Email Address
01:K163CiIi1 ffl0N]avOLelS:/
Is this a sewer line or
sewer Line
water line repair?
Length of repair
35'
Location of repair
side yard
(backyard, frontyard,
etc)
Provide additional
Repair starts on property and goes to the tap. 35' is what is
details Including
inside the property line. We will install cleanouts.
installation of clean -
outs.
Project Value (contract
5000
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 Charlotte Graham
Pe rm it
Email not displaying correctly? View it in your browser.
City of Wheat Ridge
E -Res. Furnace Replacement PERMIT - 201803024
PERMIT NO: 201803024 ISSUED: 11/16/2018
JOB ADDRESS: 5395 W 40th Ave EXPIRES: 11/16/2019
JOB DESCRIPTION: Replacement of 70K BTUs/80 percent efficient gas furnace in basement and 2
Ton/16 SEER AC unit in backyard.
*** CONTACTS ***
OWNER (720)284-8672 MILIUS JEFFREY A
SUB (303)466-4209 Rosalie Cooper 018111 Cooper Heating & Cooling
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 9,531.00
FEES
'Total Valuation 0.00
Use Tax 200.15
Permit Fee 204.30
** TOTAL ** 404.45
*** COMMENTS ***
*** CONDITIONS ***
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.
Work shall comply with 2012 IRC & 2017 NEC. Per IRC Sec. R314, smoke detectors are required
to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every
level of the structure.
I by my signature, do hereby attest that the work to be performed shall comply with all accompanyingg approved plans and specifications,
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am t7�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
thispennit. I further attest that I amlegally 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 originalermit fee.
3, If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees andprocedures for approval of any new permit. Re -issuance or extension of expired pen -nits 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 granti g of a permit shall not be construed to be a pen -nit for, or an approval of, an violation of any provision of any
apple code or any (Idinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chilf Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Lagenia Reimer V
From: no-reply@ci.wheatridge.co.us
Sent: Friday, November 16, 2018 2:08 PM
To: CommDev Permits
Subject: Online Form Submittal: Residential Furnace/Boiler Replacement Permit Application
Categories: Gina
Residential Furnace/Boiler Replacement Permit Application
This application is exclusively for RESIDENTIAL REPLACEMENT FURNACE or
BOILER - LIKE FOR LIKE ONLY.
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 a Yes
replacement residential
furnace or boiler like for
like?
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-4567)
Property Owner Email
Address
Attach Credit Card
Authorization Form -
**DO NOT ATTACHED
RANDOM FORMS**
5395 W 40th Ave.
Jeff Milius
720-284-8672
jeffrey.milius@colorado.edu
Milius cc authorization. pd
CONTRACTOR INFORMATION
Contractor Business COOPER HEATING
Name
1
4-Np
4q� 3l
Contractor's License 018111
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone 720-361-4245
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address 11780 COLMANS WAY
(Primary address of your
business)
Contractor Email Address kdaniels@coopergreenteam.com
Retype Contractor Email kdaniels@coopergreenteam.com
Address
DESCRIPTION OF WORK
What type of unit is being Furnace
installed?
Number of BTUs 70000
What is the efficiency 80
(%) of the unit?
Is the unit GAS or gas
ELECTRIC?
Where is the furnace or basement
boiler located (for
example, basement,
crawlspace, etc)?
Project Value (contract 4765
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.
2
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.
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 Kathi Daniels
Permit
Email not displaying correctly? View it in your browser.
Lagenia Reimer & l 13 0 5��
From: no-reply@ci.wheatridge.co.us
Sent: Friday, November 16, 2018 2:14 PM
To: CommDev Permits
Subject: Online Form Submittal: Residential Replacement Air Conditioner/Evaporative Cooler
Permit Application
Categories: Gina
Residential Replacement Air Conditioner/Evaporative Cooler Permit
-
Appllcatlon
This application is exclusively for RESIDENTIAL REPLACEMENT AIR
CONDITIONER OR EVAPORATIVE COOLER - LIKE FOR LIKE ONLY.
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN
ORDER FOR THE PERMIT TO BE PROCESSED. �c
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 a Yes
residential replacement
AC or Evaporative Cooler
like for like?
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-4567)
Property Owner Email
Address
Attach Credit Card
Authorization Form -
**DO NOT ATTACH
RANDOM
DOCUMENTS**
5395 W 40th Ave.
Jeff Milius
720-284-8672
jeffrey.milius@colorado.edu
Milius cc authorization. Pd
CONTRACTOR INFORMATION
I
Contractor Business COOPER HEATING
Name
Contractor's License 018111
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone 720-361-4245
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address 11780 COLMANS WAY
(Primary address of your
business)
Contractor Email Address kmckinney@coopergreenteam.com
Retype Contractor Email kmckinney@coopergreenteam.com
Address
DESCRIPTION OF WORK
What type of replacement Replacement Air Conditioner
unit are you installing?
How many tons is the 2
unit?
For AC - what is the 16
SEER?
For Evaporative Coolers,
what is the CFMs?
Where is the unit located backyard
(for example, rooftop,
backyard on ground etc)?
Is electrical needed for re- Yes
hook?
If electrical work is being 018111
performed, you must
provide electrical
contractor's Wheat Ridge
license no. and scope of
work.
Project Value (contract 4766
value or cost of ALL
materials and labor)
z
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 been Yes
authorized by the legal
owner of the property to
submit this application
and to perform the work
described above.
I attest that everything Yes
stated in this application
is true and correct and
that falsifying
information in this
application is an act of
fraud and may be
punishable by fine,
imprisonment, or both.
Person Applying for KATHI Daniels
Permit
Email not displaying correctly? View it in your browser.
3
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
f/
Inspection Type: m
Job Address: ajxe
Permit Number:Q/ %Q 3
❑ No one available for inspection: Time C_
Re -Inspection required: Yes N3
When corrections have been made, call for re -inspection at 303-234-5933
Date: -7.4. /_? Inspector: 1 /
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Roofing PERMIT - 201703332
PERMIT NO:
201703332
ISSUED:
07/06/2017
JOB ADDRESS:
5395 W 40th AVE
EXPIRES:
07/06/2018
JOB DESCRIPTION:
Residential Re -roof to install Dimensional GAF Timberline asphalt shingles
with 24 SQ.
*** CONTACTS ***
OWNER (720)284-8672
MILIUS JEFFREY
A
SUB (303)346-6010
Roy Thomas
090287 Mountain
States Home Improve
*** PARCEL INFO ***
ZONE CODE:
UA / Unassigned
USE:
UA / Unassigned
SUBDIVISION CODE:
2412 / LAKESIDE,
STEWART GARDENS,
OLI BLOCK/LOT*:
0 /
*** FEE SUMMARY ***
ESTIMATED PROJECT VALUATION:
8,000.00
FEES
Total Valuation
0.00
Use Tax
168.00
%.
Permit Fee
172.60
** TOTAL **
340.60
*** 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 - 201703332
PERMIT NO: 201703332 ISSUED: 07/06/2017
JOB ADDRESS: 5395 W 40th AVE EXPIRES: 07/06/2018
JOB DESCRIPTION: Residential Re -roof to install Dimensional GAF Timberline asphalt shingles
with 24 SQ.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this permit. I further attest that I am leggally authorized to include all entities named within this document as parties to the work to be
performed and that all work to be pertorned is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of WNE'IrF or CONTRACTOR (Circle one) Date
I . This pe it 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 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, any violation of any provision of any
applicacode or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
'JAI IrLfw
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.
Kimberly Cook
C17033�Z
From: no-reply@ci.wheat ridge.co.us
Sent: Friday, June 23, 2017 12:29 PM
To: Permits CommDev
Subject: Online Form Submittal: Residential Roofing Permit Application
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. 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
residential roof?
How many dwelling units Single Family Home
are on the property?
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number
Property Owner Email
Address
5395 W 40th Ave
Jeffery Milius
7202848672
Field not completed.
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
Mountain States Home Improvement
090287
3033466010
Contractor Email Address andrew@mountainstatesroofinginc.com
Retype Contractor Email andrew@mountainstatesroofinginc.com
Address
DESCRIPTION OF WORK
Are you re -decking the
roof?
Description of Roofing
Material
Select Type of Material
If "Other" is selected
above, describe here:
No /
Dimensional GAF Timberline
Asphalt
Field not completed.
How many squares of the 24 -'
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 of all 24
roofing material for this
project
2
Provide additional detail
here on the description of
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)
Reroof home, 5/12 pitch, t/o 1 layer to deck
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 Andrew Thomas
Email not displaying correctly? View it in your browser.
3
COLORADO SPRINGS
719-632-7604
PUEBLO
719-543-7124
www.roofingtherockies.com
Corporate Office: 2600 S. Parker Rd., #5-153 Aurora, CO 80014
303-346-6010 • Fax 303-346-6009
WYOMING
307-635-3059
NORTHERN COLORADO
970-373-5838
Proposal Submitted to'
Billing Address:
Da fj
Job Address:
1 ,9 �� C� l
Z
Email:
City, State, R Jip:
I
H me Phone:Work
Phone:
OB DESCRIPTION:
SPECIAL INSTRUCTIONS:
1. Recover roof with: /j
v
NOTE: Replacement of deteriorated decking and facial boards,
otherwise stated in this contract, are not included and will
be charged extra on a "time and materials" basis.
2. Color of shingle:unless
P/
3. Tear off existing roof deck: Layers
4. Base felt:
5. Valley type:
6. Eve metal:
Color:
Map, f C 60
7. Rake Metal:
Color:
8. Vents:
Color:
9. Ice & Water shield:
a 1
10. Pipe Boot Step Flashing
'
11. Furnace Cap
OA 1 0911 �k
12. Company's limited warranty:
LIFETIME
�r
V
13. Clean up and haul -off roofing debris:
YES
14. Roll magnet through yard:
YES
15. Lien waiver provided upon final payment:
YES
Insurance Company:
Sqs. W/W:
Valley:
C �]
Claim No. �✓ o !
'Ridge: Starter:
v
0
SENATE BILL 12-038 SIGNED INTO LAW 6/06/12
PROHIBITS ROOFING CONTRACTORS FROM PAYING, WAIVING, REBATING, OR PROMISING TO PAY, WAIVE, OR REBATE ALL OF PART OF ANY INSURANCE DEDUCTIBLE
APPLICABLE TO AN INSURANCE CLAIM AND TO THE PROPERTY OWNER'S PROPERTY AND CASUALTY INSURER FOR PAYMENT FOR ROOFING WORK ON THE
RESIDENTIAL PROPERTY COVERED BY A PROPERTY AND CASUALTY INSURANCE POLICY.
• Existing Colorado statute related to property insurance fraud (CRS 18.13.119.5) states that paying, waiving or rebating a property owner's insurance
deductible is a Class 2 Misdemeanor.
SB38 - Requires the following information to appear on all contracts
All interior damage to buildings is excluded 45 day after completion date and the owner is notified that any damage to contents will be the responsibility
of the owner and his insurance company. All damage to the building which occurred while roofing was in progress will be covered by the contractor.
r,
Mountain States Roofing, Inc. requires no down payment, however if one is given, Mountain StatesRoofing, Inc. shall hold in trust any payment received from you until Mountain
States Roofing, Inc. has delivered roofing materials at the site or has performed a majority of the roofing work on your property.
Mountain States Roofing, Inc. carries worker's compensation, automobile, and commercial general liability (bodily injury and property damage insurance). A certificate of
insurance identifying our insurance carrier and the types and amounts of coverage and our insurance contact information can be provided to Customer and is incorporated herein by
reference and should be considered as part of this contract.
You have the right to rescind this contract and obtain a full refund of any deposit within 72 hours after entering the contract. If you plan to use the proceeds of a property and casualty
insurance policy to pay for the roofing work, you may rescind this contract within 72 hours after you receive written notice from the property and the casualty insurer that your claim
has been denied in whole or in part. However, Mountain States Roofing, Inc. is entitled to retain payments or deposits to compensate Mountain States Roofing, Inc. for roofing work
actually performed in a workmanlike manner consistent with standard roofing industry practices. Mountain States Roofing, Inc. cannot pay, waive, rebate, or promise to pay, waive or
rebate all or part of any insurance deductible applicable to the insurance claim for payment for roofing work on your property. Mountain States Roofing, Inc. will not begin any work
and/or ordering material until after the 72 hour right of rescission period(s) have expired.
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234 -5933 Inspection line
(303) 235 -2855 Office • (303) 237 -8929 Fax
Inspection Type:
INSPECTION NOTICE
9 0
Job Address: 5- 39 5- W • `/o T
Permit Number: 2 0 /�t O / Ste/
❑ No one available for inspection: Time 0 �K/Vpm
Re- Inspection required: Yes
* When corrections have been made, call for re- inspection at 303 - 234 -5933
Date: 1 ~ �s Inspector:
DO NOT REMOVE T HIS NOTICE
OCT-07-2014 13:24 From:advancedex ter iors
To:3032,352857 page:I/I
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MeChOniC81 CRY License
Company:
F-V,
I a & 11 41 EMMA M
a
Mailing Address: (if different then property,00WOU)
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : 4957
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE Date : 4/25/97
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Property Owner :
Property Address : 5395 40TH AV Phone : 421-2848
Contractor License No. :
Company: Phone:
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certity 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 (U.B.C.) and all oiher applicable Wheat Ridge ordinances, forwork under this permit.
(OWNER)(CONTR4CTOR) SIGNED~ A61.,-/ DATE
Description : REPLACE WATER HEATER
Construction Value :
$125.00
Permit Fee :
$22.00
Plan Review Fee :
$0.00
Use Tax :
$2.50
Total:
$24.50
BUILDING DEPARTMENT USE ONLY
SIC : Sq. Ft. :
Approval :
Zoning :
Approval:
Approval:
Occupancy : Walis : Roof : Stories : Residential Units :
Electrical License No : Plumbing License No : Mechanical License No :
Company : Company : Company :
Expiration Date : Expiration Date : Expiration Date :
Approval : Approval : Approval :
0 imopaoigim
(1) This permit was issued in accortlance with lhe provisions set fotlh in yopur appiica5on and is subject to the laws of the Slate of Colorado and to the Zoning
Regulations and Building Code of Wheat Ritlge, Coloratlo or any other applicable ordinances of the City. (2) This permit shall expire if (A) the work authorized is no[ commenced within sixty (60) days from issue date or (B) the building authorized is suspended or
abandonetl for a periotl of 120 tlays.
(3) If this permit expires, a new permil may be acquired for a fee of one-half the amount normally requiretl, provided no changes have been or wiil be matle in lhe
original plans and specifcations and any suspension or abandonment has not exceeded one (1) year. If changes are made 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 naturai Flow of water causing a drainage problem.
(5) Contracror shall notify the Buiiding Inspector lwenty-four (24) hours in atlvance for all inspections and shall receive written approval on inspection card before
proceediing with successive phases of the job.
(6) The iss ance of a permit or the approval of drawings antl specifcations shalt not be construed to be a permit for, nor an approval of, any violation of the provisions
of Ihe t~ildingcodes or any othgr ordinance, law, mle or regulation.
iilding Inspector
PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO WSPECTION
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number :
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE Date :
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
PropertyOwner:
Property Address : ,S3 q.f W- /-/G 1~71! Phone : 4/2/ ;4
Contractor License No. :
Company : Phone :
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit appliration 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 acwrate; that I have read and agree to abide by all tonditions 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,,eU~ DAT4~- AS'I/
Description :
BUILDING DEPARTMENT USE ONLY
Zoning Comm-: en~~ SIC : Sq. Ft. :
Approval:
Zoning :
auira_in Comm~
Approval :
P~~bli~Woglt~ °Coi~lne'6f5"~
Approval:
Occupancy : Walls : Roof : Stories : Residential Units :
Construction Value :,'2S'-m p
Permit Fee :
Plan Review Fee :
Use Tax :
Total :
Electrical License No : Plumbing License No : Mechanical License No :
Company :
Company :
Company :
Expiration Date :
Approval :
im 13n Re~
Expiration Date :
Approval:
IN
Expiration Date :
Approval:
IN a s Red~i~d
(1) This pemit was issued in accortlance with the provisions set forth in yopur application and is su6jed to lhe laws of the State of Colorado and to the Zoning
Regulations antl Building Code ot WTeal Ritlge, Colo2tlo or any other applicable ordinances of the Ciry.
(2) This pemit shall expire R(A) ihe work authonzetl is not commenced within sixty (60) days from issue date or (e) Ne building authorized is suspended or
abandoned for a periotl of 720 days.
(7) If this pertnit ezpires, a new pemit may be acquiretl tor a fee of one-hall lhe amount normally required, provitled no changes have been or will be made in the
onginal plans antl speufications and any suspension or abandonment has not exceeded one (1) year. It changes are made or if suspension or abandonmenl
exceeds one (1) year, full fees shall be paitl lor a new pertnit.
(4) No work o( any manner shall be tlone that will change the natural Ilow of water wusinya tlrainage problem.
(5) Contractor shall notiry the Building Inspeclor Nrenry-lour (24) hours in atlvance for all inspecfions and shall receive written approval on inspection card before
proceediing with successive phases of the ~ob. (6) The issuance of a pemit or the approval o~tlrawings and specifications shall not be construed to be a permit lor, nor an approval of, any violation of the pmvisions
of the building codes or any other ordinance, law, rule or regulation.
Chief Building Inspector
For Mayor
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
DEPARTMENT OF PLANNING AND DEVELOPMENT
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Building Permit Number
Date
5059
5/9/97
Property Owner :
Property Address : 5395 40TH AV
Contractor License No. : 19467
Company : A Alpine Aire Heating & Cooling, Inc.
Phone: 421-2848
Phone:2524108
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 re nd agre to abide by all cond" s printed on this
application, and that I assume resppa$ibility or co nce th Wheat Ridge Building
Code (U.B.C.) and all other ~ plicable ~~(h~atR~ gNo inance , f r wor under this permit. ~
Description :
Construction Value : $1,495.00
Permit Fee : $49.50
Plan Review Fee : $0.00
Use Tax : $17.94
Total: $67.44
BUILDING DEPARTMENT USE ONLY
R - EM SIC : Sq. Ft. :
Approval:
Zoning :
TWIRM"9~~~
Approval:
Ftln~~"~
Approval:
Occupancy : Walls : Roof : Stories : Residential Units ;
Electrical License No : Plumbing License No : Mechanical License No :
Company: Company: Company:
Expiration Date : Expiration Date : Expiration Date :
Approval: Approval: Approval:
~ AW-M F~"r` k 04 m , N ffl~~
(7) This permit was issued in accordance with the provisions set forth in yopur application and is subject to the laws of the State of Colorado and to the Zoning Regulations and Building Cotle of Wheat Ridge, Cobrado or any other applicable ordinances of the Ciry. (2) This permit shall expire if (A) lhe work authorized is not commenced within sixty (60) days from issue date or (B) the building authorized is suspended or
abandoned for a periotl of 120 days.
(3) If this permit expires, a new permit may be acquired for a fee of one-half the amoun[ normally required, provided no changes have been or will be matle in the
original plans and specifcations and any suspension or abandonment has not exceeded one (1) yeac If changes are made or if suspension or abandonment
exceeds one (7) year, full fees shali be paid for a new permit . (4) No work of any manner shall be done that will change the na[ural Flow of wa[er causing a drainage problem. (5) Contractor shall notify the Building Inspector lwenty-four (24) hours in advance for all inspections and shall receive written approval on inspection card before
proceediing with successive phases of the job. '
(6) Th issuance of a permit or the approval of drawings antl specifcations shail not be construed to be a permi[ for, nor an approval of, any violation of the provisions
of build' g cotles or other ordiryI~1 nce, lawQ, mle or regWation.
nA
ilding inspector
PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
DEPARTMENT OF PLANNING AND DEVELOPMENT
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Building Permit Number:
Date :~/s~9
Property Owner :'T, 00 U<A~
Property Address : GcJ -
Contractor License No. :
Company : l9%ze
1/4All Oif ,
OWNER/CONTR,4CTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certiy that the setback distances proposed by this pertnit application are accurate,
and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or
covenants, easements or restrictions rd; that all measurements shown, and allegations
made are accurate; that I have and agre abide by all conditinns printed on this
application, and that I assu full responsibility fo compliance with the Wheat Ridge Building
Code (U.B.C.) and all ot r applicab"heat RA rrdinaNCes, forywork under this permrt.
Description :
~
Approval :
Zoning :
Phone : 7al- ,6
Pnone 2-
Permit Pee : 49 :5~0
Use Tax : / 7 •9 G
Total : 6
Construction Value :
BUILDING DEPARTMENT USE ONLY
Approval :
F~lpli~nYY~t~6fiiTt~IKt,s~
3
Approval:
Occupancy : Walls : Roof : Stories : Residential Units :
Electrical License No : Plumbing License No Mechanical License No :/5~CoVl
Company : Company : Company :A A~~~ ~
dfg-l Z_ay~
Expiration Date : Expiration Date : Expiration Date :
,'vpprovai: Approval: Approval:
~ - Pfans Requfie¢_.;° _j ~ PlIms Required ~-P
(1) This permrt was issuetl in accortlance with the provisions set forth in yopur apPlication antl is subjed to the laws oFlhe State of Coloratlo antl to ihe Zoning
Regulations antl Building Cotle ot Wheat Ridge, Coloratlo or any other applicable ordinances of the City.
(2) This permrt shall expire i( (A) Ihe work authonzed is not commencetl wilhin sixry (60) days from issue tlate or (8) lhe builtlin9 authonzed is suspendetl or
a6andonetl for a periotl of 120 tlays .
(3) If ihis permit expires, a new pertnit may be acquiretl for a fee of one-halflf the amount nortnally required, provitled no changes have been or wiil he made in the
onginal plans antl specifications and any suspension or a6andonment has not exceetletl one (1) year, if changes are matle or if suspension or abantlonment
exceetls one (1) year, full fees shall be paitl for a new permit.
(4) No work oF any manner shall be tlone ihai wili change [he naNrel Flow of watet causing a tlramage problem. -
(5) Contractor shall notify the Building Inspector twenry-four (24) hours in atlvance for all inspecuons antl shall receive written approval on inspection card he(ore
.
proceetliing with successive phases of the job.
(6) The issuance of a permit or the approval of tlrawings antl specifcations shall not be consVUea to be a permit for, nor an approval of, any vioiation of the provisions
of Ihe building cotles or any other ortlinance, law. rule or reguiation.
Chief Building Inspector
For Mayor
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
I,