HomeMy WebLinkAbout7145 W 48th Avenuezm17o6S"M
INSPECTION
RECORD
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection
INSPECTION REQUEST LINE: (303) 234-5933
Cancellations must be submitted via the online form before 8 a.m. the day of the inspection
Occupancy/Type
r
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
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.
Mid -Roof
`r c
z
Floodplain Inspection (if applicable)
Lath / Wall Tie
Fire Inspection / Fire Protection Dist.
Rough Electric
Final Electrical
Rough Plumbing/Gas Line
Final Plumbing
Rough Mechanical
Final Mechanical
AI
Rough Framing
Roof
Rough Grading
Final Window/Doors
Insulation
Final Building
Drywall Screw/ Nail
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.
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
AI
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
�' City of Wheat Ridge 11,186
,186
Residential Roofing PERMIT - 201706583
PERMIT NO: 201706583 ISSUED: 08/25/2017
JOB ADDRESS: 7145 W 48th AVE EXPIRES: 08/25/2018
JOB DESCRIPTION: Residential Re -roof to install asphalt shingles - 20 sq
*** CONTACTS ***
OWNER (303)838-7917 BALLIETT W ANN
SUB (720)643-5033 David Scheck 170158 Watershed Roofing & Restoratn
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: R-3 / Residential
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,140.00
FEES
Total Valuation 0.00
Use Tax 107.94
Permit Fee 140.90
** TOTAL ** 248.84
*** COMMENTS ***
*** CONDITIONS ***
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) is required on the entire roof
when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and
mid -roofs may be called in at the same time, one hundred percent of the sheathing must be
complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required
to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield
is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturer installation instructions,
whichever is more stringent. In order to pass a final inspection of elastomeric or similar
type roof coverings, a letter of inspection and approval from the manufacturer technical
representative stating that "the application of the roof at (project address) has been
applied in accordance with the installation instruction for (roof material brand name)
roof covering" is required to be on site at the time of final inspection.
Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd
party inspection report will be collected at final roof inspection performed by City of
Wheat Ridge. If report is not available the final inspection will not be completed.
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: 4c, RU
Job Address: i 4X -4,i
Aitzo-
Permit Number: 2CA-706,_z�--`S
a PCO 1)(ZOV
❑ No one available for inspection: Time
Re-Inspection required: Yes C��
When corrections have been made, call for re -inspection at 303-234-5933
Date: (�l fr Inspector: Gtr
DO NOT REMOVE THIS NOTICE
,, � A s City of Wheat Ridge
Residential Roofing PERMIT - 201706583
PERMIT NO: 201706583 ISSUED: 08/25/2017
JOB ADDRESS: 7145 W 48th AVE EXPIRES: 08/25/2018
JOB DESCRIPTION: Residential Re -roof to install asphalt shingles - 20 sq
*** CONTACTS ***
OWNER (303)838-7917 BALLIETT W ANN
SUB (720)643-5033 David Scheck 170158 Watershed Roofing & Restoratn
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: R-3 / Residential
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,140.00
FEES
Total Valuation 0.00
Use Tax 107.94 c
Permit Fee 140.90
** TOTAL ** 248.84
*** COMMENTS ***
*** CONDITIONS ***
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) is required on the entire roof
when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and
mid -roofs may be called in at the same time, one hundred percent of the sheathing must be
complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required
to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield
is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturer installation instructions,
whichever is more stringent. In order to pass a final inspection of elastomeric or similar
type roof coverings, a letter of inspection and approval from the manufacturer technical
representative stating that "the application of the roof at (project address) has been
applied in accordance with the installation instruction for (roof material brand name)
roof covering" is required to be on site at the time of final inspection.
Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd
party inspection report will be collected at final roof inspection performed by City of
Wheat Ridge. If report is not available the final inspection will not be completed.
�.
City of Wheat Ridge
V,
Residential Roofing PERMIT - 201706583
PERMIT NO: 201706583 ISSUED:
JOB ADDRESS: 7145 W 48th AVE EXPIRES:
JOB DESCRIPTION: Residential Re -roof to install asphalt shingles
08/25/2017
08/25/2018
20 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 pro and am authorized to o. ain this permit and perform the work described and approved in conjunction with
this permit. I furthe t m legally authori 'nclude all entities named within this document as parties to the work to be
performed and t _w.orr be perform d is ,ose'd in this document and/or its' accompanying approved plans and specifications.
G � �
.40
Sig r OWNER r TO (Circle o e) Date
is p mit waation provided in the permit application and accompanying plans and specifications and is
subject omp ' those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall e 5 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to t e 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 originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or 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.
Sign�buildifi� Date
REQUESTS MUST BE MADE BY 11:59Pt Y BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Dane Lovett
From: no-reply@ci.wheatridge.co.us
Sent: Wednesday, August 23, 2017 9:08 AM
To: CommDev Permits
Subject: Online Form Submittal: Residential Roofing Permit Application
Follow Up Flag: Follow up
Flag Status: Completed
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 'bL
Property Address 7145 W 48th Ave
Property Owner Name Ann Balliet
Property Owner Phone 303-838-7917
Number (enter WITH
dashes, eg 303-123-4567)
`I► 1 �l
Property Owner Email Field not completed
Address
Do you have a signed Yes
contract to reroof this
property?
Applications cannot be
submitted without an
executed contract
attached below.
Attach Copy of Executed 17-180.pdf
Contract
CONTRACTOR INFORMATION
Contractor Business
Watershed Roofing and Restoration
Name
DIL
Contractor's License
170158
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone
303-489-4198
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address
1360 S Wadsworth Blvd Ste 116
(Primary address of your
business)
Contractor Email Address
maria@watershedroofs.com
Retype Contractor Email
maria@watershedroofs.com
Address
DESCRIPTION OF WORK
TOTAL SQUARES of 20
the entire scope of work:
Project Value (contract
value or cost of ALL 0
materials and labor)
Are you re -decking the No
roof?
10
Does the scope of the No
project include a flat roof
(less than 2:12 pitch)?
Does the scope of the
project include a pitched
roof (2:12 or greater
pitch)?
How many squares are
part of the pitched roof?
Describe the roofing
materials for the pitched
roof:
Type of material for the
pitched roof:
Provide any additional
detail here on the
description of work. (Is
this for a house or
garage? What is the roof
pitch? Etc)
Yes
�i1
Atlas Pristine
Asphalt
tear off one layer, re roof with Atlas shingle on 5/12 pitch house
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full
responsibility for
compliance with
applicable City of Wheat
Ridge codes and
ordinances for work
under any permit
issued based on this
application.
I understand that this
application is NOT a
permit. I understand I will
be contacted by the City
to pay for and pick up the
permit for this property.
I understand that work
may not begin on this
property until a permit
has been issued and
posted on the property.
Yes
Yes
Yes
11
I certify that I have been Yes
authorized by the legal
owner of the property to
submit this application
and to perform the work
described above.
I attest that everything Yes
stated in this application
is true and correct and
that falsifying
information in this
application is an act of
fraud and may be
punishable by fine,
imprisonment, or both.
Name of Applicant Maria Leyba
Email not displaying correctly? View it in your browser.
12
WATER51
ROOFING AND RESTORATION
1360 S. Wadsworth Blvd. #116, Lakewood, CO 80232
Phone: 720-643-5033 / Fax: 720-643-5034
Proposal Date: 2 , ; _,3 , ?-- C
This proposal may be withdrawn by Watershed Roofing &
Restoration if not accepted within 30 days from above date.
Watershed Roofing shall hold in trust any payment received from you until Watershed has
delivered materials at the site or has performed a majority of roofing work on your property.
PROPOSAL FOR: L� CBy: Watershed Roofing & Restoration
Name: Watershed Rep -e ' +-'(ZE7
Job Address: I' '� ` Cell Phone: _:�r e 2; -7 q-7 4. 4,10
City, State, Zip: ,C -G �,y�'c 00 9:�rl -a-. Insurance Company:
Phone:
Mailing Address:
City, State, Zip: .
Email Address: .
yfear Off
_ ,inspect Decking: Deteriorated existing decking replaced at cost of
$ Per Sq. Ft. Property owner will be notified if any damaged
w�od is found during tear off.
Ff /Install ice shield on eaves and in valley(s)
i' I tall drip edge /C� Color
j�tall underlayment �
VIncv�arer roof with fin— ! emanufacturer warranty.
le Manufacturer— Color
�6il every shingle
Install%'✓��✓_ ridge style
%mall pipe jacks J Lead ''acks J Detach/Reset Swamp cooler
t- tep flash sidewalls rXStep flash chimney _J Step flash skylight
4,6ean up and haul of roofing debris J Clean out gutters
° Magnetic sweep of surrounding area
J/Gtershed Roofing will provide General Liability insurance of at
legit $1,000,000 & Workers Compensation of at least $100,000
.SII required Permits furnished by Watershed Roofing & Restoration
�e be reimbursedby Insurance Company/Homeowner
/ytlatershed Roofing &Restoration 5 -year warranty on labor
1 Current VentilatioRecommended
Adjustor Information:
Claim Number: S -"V )/
Date of Adjuster Meeting: :' Z a,j
-,,Gutters:
Color: L''�d'�- Style:
J Windows
C lor:
ing
Color:
J Deck
Color:
J Painting
Color:
All per insurance scope and price.
:J Additional work not covered:
f
Style
Style:
Style:
Style:
Deductible collected at time of material delivery
$ initial total claim amount as of
Price is subject to supplements/adjustments approved by insurance company.
Work to be completed within 21 days of final insurance approval & mortgage
endorsement.
t
Date of Acceptance Watershed Roofing & Restoration Representative Property Owner Signature
Property Owner is. / is not _intending to make payment from the proceeds of a property & casualty insurance policy. If yes, homeowner must read and sign below.
INSURANCE ALLOWA E AGREEMENT:
I / We agree to retain Watershed Roofing and Restoration (contractor) to repair/replace the damaged or entire portion of the property described on this contract contingent upon the
contractor obtaining my insurance company's approval and payment to have said work completed. It is agreed that the contractor is empowered to contact my insurance carrier and to
meet with their representative in order to negotiate the amount of damage, the cost of the repair or replacement of the damage to the above property. Upon insurance carrier agreement
with the contractor and the down payment being made the work will be scheduled and may begin on a first in first out basis.
Checks shall be made payable to Watershed Roofing and Restoration.
In the event that the insurance carrier fails to negotiate in a fair and reasonable manner, the contractor shall not be held liable and this agreement shall be void. The contractor will
release the complete file to the Commissioner of Insurance at the customer's request. Insured out of pocket expense will not exceed the insured (purchaser) policy deductible for the
work agreed upon between the insurance carrier and the contractor. Insured also agrees to provide all the necessary documentation for the claim (including documentation to facili-
tate payment from insurance carrier and/or mortgage holder). The contractor reserves the right to file for supplemental claims due to material and/or labor increases due to a storm
environment or to insurances adjuster's mistakes, errors, or omissions.
Insurance Co pony r Claim Number
Owner
Date
Co-owner
I/We agree that by signing above we agree to all of the conditions on both the front and back of this agreement.
Date
i CITYF,OF WHEAT RIDGE
_��9rBuilding Inspection Division -
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
. INSPECTION NOTICE
Inspection Type: 0j 'J
Job Address: -7114-5- w t4,9 44 A �e
Permit Number: -Do 17 o G -5—,q 3
0 0 4` ri
❑ No one available for inspection: Time If 1-5 &PM
Re -Inspection required: Yes (9
When corrections have been made, call for re -inspection at 303-234-5933
Date: q r- Inspector: Tb
DO NOT REMOVE THIS NOTICE
DEPARTNIENT OF COMMUNITY DEVELOPMENT
7500WEST29thAVENUE BUILDING INSPECTION DIVISION PERMIT N0. D9P93#3526
234-5933 P.O. BOx838 CITY OF WHEAT RIDGE, COLO.
THIS PERMIT VALID ONLY WHEN S16NED BY THE CHIEF BUILDING WSPECTOR ANC RECEIPTED BELOW
nvai iCATION FOR MISCELLANEOUS PERMIT
JOB ADDRESS ~ ~
CONTRACTOR
ADDRESS 1~~7/Jf
CITY ~~2 ~ ZIP CODE
PHONE _ y~~ G%ZCJ~ _ LICENSE NO.
OWNER
ADDRESS ~VSW~ yg'l- pJ
PHONE ZIP CODE
CONTRA/CT ICE $ 3 fD
DATE / - /
1. TYPE GroundU
WoIIIJ
Proieannp,:
2. MATERIAL
SIGNS
❑
3. ILLUMINATION Yea❑ No
TY7a
4. SET BACK FROM PROPERTY LINE N
S-- E
W_
❑ ~
(SOacify whith ia front)
❑
❑
I. TYPE SolidO Mon Than 80% ODanD
Less Thon
MATERIAL
FENCES
3 SET BACK FROM PROPERTY LINE N
S__ E
_ W-
(Spscify whith ia tront)
❑
❑
El E:
I.
OTHER
2
PERMIT FEE
3.
BLDG. CONTR.
DRAW SNETCH OR SHOW BELOW,THE FENCE,SIGN,OR OTHER STRUCTURE, GIVINu
~ Cfs19'--~ (SETBACKS Oft PROJECTIONS INCLUDED) SUBCONTRACTOR
DATE INSP. REQ. /G - I /
TYPE OF IN P:"r-
INSPECT~~ A E c 0 PA
REMARKS L~f-~ ~t ~
G
STREET N4ME W.R. FORM 679
SHOW DISTANCE$ FROM THE MAIN BUILDING TQADJOINING HOUSES,STREETS,AND
OISTANCE TO PROPERTY lINE5,N0T MAXIMUM OR AVERAGE DISTANCE.
~
ppPLICATION FOR PLUMBING; ELECTRICAL
THIS APPLICATION WILL BECOME A PERMIT TO PERFORM THE INDICATED WORK ONLY UPON VALIDATION BY TME BUILD{NG INSPECTION DIVISION.
nE ien nnvc tipnM 7HF nATE OF ISSUANCE IF WORK IS NOT STARTED WITHIN THAT TIME.
MECHANICAL PERMIT
PLUMBING PERMIT
ELECTRICAL PERMIT
STATE UCENSE N0.
STATE LICENSE N0.
4TH
FLOOR BSM I ST 2N0 3R0
EUCirrJ~QwGo{dl E Sdor
N0. R1
ALUMINUTA WIRE UNDER $IZE 8 ILLEGAL
TU
FORCED AIR B
NO
.
WATER CLASET
- BTU
HOT WATER
TEMPORARY METER
WASH BOWL
STEAM BTU
NEW SERVICE - AMPS
BATH TUB
pIR CONDITIONING-BTU
CHANGE SERVICE - AMPS
SHOWER
OTMER
LIGHTIN6
SINN
REFRIGERATION SYSTEM
HEATING
GARBAGE DISP
Refri srant Grou
POWER SUB CIFCUITS
-
WATER HEATER
pqumds pqr e
UTIUTY (RANGE, DISPo5ER, ETC )
AUTO. WASHER
R
pUTOMATIC SPRINKLER SYSTEM
FIXTURE$
DISH WASHE
ELEVATOR
WIRING MOTOFtS B CONTROLS
F~.~ ~Q~N
SIGNS
URINAL
4f
TRANSFORMERS 9 RECTFIERS
SEWERS
ADDITION TO OlD WORK
OTHER
MOTORS OVER I HP
TOTAL FIXTURES
REMARKS
I hereby ocknowledpe that thie aDGlic0-
tl0n If COrfQtt afld understand thot I
cannof ftart this Drojbct until thie ap0li-
cotion it o00roved. 1 shall comply wifh
ths lows of the State of Colorado ond fo
1M Zoninp ReOulntiona ond BuddinQ
Code ofthe City o1 Wheat Ridpe. Any
violOtion of ihe above terme will couse
immediate revocation o~+is ~mit
USE TAX
TOTAL FEE
CHIEF BUILDINI~ INSPECTOR,City
ptryer 5 a D Fi ~
~
INSPECTION TICKET
JOB
DDRESS ~"k(5 ~ ~E6~g~L
DATE: BLDG.` ERM TN -f-T`6
PERMITN
NO~~
4, U
$ .~C7
Ridqe
Date Issued
-8 y ~
06
CALL 234-5933
24 HOURS IN ADVANCE
FOR INSPECTIONS
~OplieanU Siynarvr
L
Ki1ding Permit
CTTY OF WHEAT RIDGE
asoo wac29TH nveoue
vvheaaiagc, co aooas
303-235-2855
u'^~y uEVA~mdpe
Residential Plumbing
Permit Number
19134
8/23/2005
Inspectiorr Llne
303•234-5933
7145
wayne ballitt
48th av
unit:
(303) 418-6000
ma;r;nstall new clean ouu hvo clean outs.
Unksd,
Occupancy: r-3
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Page I of 1
P
, - Building Permit ~ Perm;`Number
~ 19134
CTTY OF WHEAT RIDGE 8/23/2005
7500 west 29TH a.enue
wheasrid8e; co e0033 inspection Llne
303-235-2855 Cuy+~r'~ta~e ~ M z34-5333
Residential Plumbing
PROPERTY 714$ 48t11 8V UDIt: owNER: wayne ballitt (303) 418-6000
Daedption . . . .
Sewer line repair install new clean outs two clean outs.
Authorized By guilding Approval
Authorized On
Zoning
8/23/2005 Approved By croo[
Tuesday, August 23, 2005 Page 1 of 1
COMMUNIN DEVELOPMENT DEPARTMENT Building Permit Number:
of w"E^T BUILDING INSPECTION LtNE - 303-234-5933 Date:
ti Po, CITY OF WHEAT RIDGE
" 7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
`°~~R^°° APPLICATION
Property Owner:
Property Address: 1kyS Phone:
Contractor License No.: Ip p101
Company: A/LS I ILQSCVE &+e/Z Pbone: 3o3 'q I$'-G000
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Suildina Dept. Valuation Figure:
I hereby certify that the setback distances proposed by fhis pemit applicaGon are
accu2le, and do not violale applicable ordinances, rvles or regulaGons of Ne City of
Wheat Ridge orcovenants, easements or resVictions of record; ihalall measurements
shown, and allegations made are accurate: that I have read and agree to abide by all
conditions printed on this application and that I assume full responsibility for
compliance with the Wheat Ritlge BuilCing Code (I.B.C) and all otherapplicable Wheat
Ridge Ordinances, for work under this pertniL Plans subjec[ to field inspection.
(OWNERNCONTRACTOR):SIGNE0DATE. 8/23105
`1
(OWNER)(GONTMCTOR):PRINTEO~ ~ IC ~/~D'YM DATE 8/L3l~
Value:$
Permit Fee:$
Plan Review Fee:$
Use Tax $
Total:$
Use of Space (description): SEWeO /lQpAi2 PtJ tL351AlL tba~'~s VAIJ Description of work:
Sq.Ft.added
Expiration Date: Expiration Date: Expiration Date:
Approval• Approval: Approval:
(1) This permit was issued in accordance with ihe provisions set forth in your appliqtlon and is subject to the laws of the State of
Colorado and W the Zoning RagulaGons and Building Codes of Wheat Ridge, Colorado or any other applipble ordinances oi
me Ciry.
(2) This pemit shall expire if (A) ihe xrork authorized is not commenced within sixry (90) days from issue dale or (B) the building
authorized is suspended or abandoned tor a period of 180 days.
(3) If ihis pemit expires, a new pemit may be acquired for a fee ot one-half the amount normally required, provided no changes
have been orwill 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 suspansion or abandonment excceds one (1) year, Tull fees shall be paid for a new pemit
(4) No work o( any manner shall be done that will change the natural flow of water causing a drainage Droblem.
(5) Contractor shall no6fy the Building Inspector lwenry-tour (24) hours in advance for all inspections and shail receive written
approvai on inspectlon prd before proceadinp with successive phases of the job.
(6) The issuance of a pemit or ihe approval of drawings and spedfications shall not be consVUeO W be a pemit for, nor an
approvalof,a violationofJpe'jirovisionsofthebuildingcodesoranyotherordinance,law,rulearaguladon.AllpWnreWew
is subiptM fleld Ins oittlon;- ~J
Chief tl ing Official
Electrical License No: Plumbing License No: Mechanical License No:
Company: Company: Company: