Loading...
HomeMy WebLinkAbout6330 W 46th Avenue6 6 4 tA Aw,, Cq;, G) I -/ o 4o 4 -2,_ INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Occupancy/Type 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 Initials Comments Electrical Comments 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 3 � 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 27 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 r A i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: ❑ No one available for inspectionn;:Time /e -d" AM/PM Re -Inspection required: Yes When correct' ns ave been made, caYfor re -inspection at 303-234-5933 � / Date: Inspector: M­7_7� O NOT REMOVE THIS NOTICE A ,r City of Wheat Ridge Residential Roofing PERMIT - 201704042 PERMIT NO: 201704042 ISSUED: 07/14/2017 JOB ADDRESS: 6330 W 46th AVE EXPIRES: 07/14/2018 JOB DESCRIPTION: Residential Re -roof to install Malarkey Laminate asphalt shingles with 35 sq. (27 sq. pitched, 8 sq. flat) *** CONTACTS *** OWNER (303)423-4590 BLANCHARD ZACHARY J SUB (303)789-1107 Steve Kuhlman 021574 COLORADO PREMIER ROOFING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 14,500.00 FEES Total Valuation 0.00 PAID Use Tax 304.50 Permit Fee 283.55--- (,__---------- ** TOTAL ** 588.05 *** 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. A City of Wheat Ridge��� Residential Roofing PERMIT - 201704042 PERMIT NO: 201704042 ISSUED: 07/14/2017 JOB ADDRESS: 6330 W 46th AVE EXPIRES: 07/14/2018 JOB DESCRIPTION: Residential Re—roof to install Malarkey Laminate asphalt shingles with 35 sq. (27 sq. pitched, 8 sq. flat) 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 per . I fu her attest that I am legally authorized to include all entities named within this document as parties to the work to be perfo �d an 1 wop'kKt b erformed is disclosed in this document and/or its' comp.Vying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date I. This permit was issued based on the information provided in thepermit 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 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 androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable c r any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dane Lovett I �_ � / t7o /0 VI: _- I?- - From: no-reply@ci.wheatridge.co.us Sent: Wednesday, July 5, 2017 9:39 AM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Gina 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 Property Owner Name Property Owner Phone Number Property Owner Email Address 6330 W. 46th Ave. Jay Blanchard 303-423-4590 loriandjay2009@gmail.com .1 -A� - C),S- 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 Colorado Premier Roofing Contractor's License 021574 Number (for the City of Wheat Ridge) Contractor Phone 303-789-1107 Number Contractor Email Address coloradopremier@hotmail.com Retype Contractor Email coloradopremier@hotmail.com Address DESCRIPTION OF WORK Are you re -decking the No roof? Description of Roofing Malarkey Laminate shingles Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 27 material selected above? Does any portion of the Yes property include a flat roof? If yes, how many squares 8 on the flat roof? TOTAL SQUARES of all 35 roofing material for this proj ect Provide additional detail House, garage flat here on the description of z work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract14500.00 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that this Yes application is NOT a permit. I understand I will be contacted by the City to pay for and pick up the permit for this property. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have been Yes authorized by the legal owner of the property to submit this application and to perform the work described above. Name of Applicant Beth Shull Email not displaying correctly? View it in your browser. 3 RESIDENTIAL k6, A0.01 do Premier 11652 W. Hampden Place Roofing Lakewood, Colorado 80227 Office... 303.789.1107 Owner's Name: Owner's Address: Fax ...... 303.789.1106 Zachary or Lori Blanchard 6330 W. 46th Ave. coloradopremier@hotmail.com Owner's City: Owner's Zip Code: Owner's Phone: Owner's Work Phone: www.coloradopremierroofing.com Wheat Ridge 80033 303-423-4590 Project Name & Address: Email: 6330 W. 46th Ave. Wheat Ridge, CO 80033 Loriandjay2009@gmaii.com I/WE, the Owner(s) of the premises described above authorize Colorado Premier Roofing, hereinafter referred to as "Contractor", to furnish all materials and labor necessary to roof and/or improve these premises according to the following terms, specifications and provisions: PROPERTY OWNER IS INTENDING TO MAKE PAYMENT FROM THE PROCEEDS OF A PROPERTY AND CASUALTY INSURANCE POLICY. INITIALS a. Scope of Roofing Services and Materials to be Provided: Per The Hartford Insurance Company -Claim # PP0017366513 Main House Remove existing shingles, felt and all roof related items per insurance claim Install felt Owens Corning Tru Definition Storm Class4 Impact Resistive shingles and all roof related items perinsurance claim Modified Roof R& R modified bitumen per insurance claim Gutters R & R gutters/downspouts per insurance claim ShingleColor: Approximate Sum does NOT include supplements thatmay be billed to your insurance company forpaymentto : Colorado Premier Roofing Supplements to include but not limited to: Building Code requirements, Permit Fee b. Description of any areas that will NOT be worked on: Windows/screens painting latticework paint fencing vinyl storage shed fascia evaporative cooler This list of specifications may be continued on subsequent pages (see page number below). c. Approximate Costs of the Services for Damage Known at This Time: Contract r will perform the above, (subject to any additions and/or deductions pursuant to authorized change orders), for the Approximate Sum of $ (10 . Down Payment (if any) $1 000.00 INSURANCE: THIS AGREEMENT IS NULL AND VOID AND DOES NOT OBLIGATE ANY PARTY TO IT SHOULD THE INSURANCE COMPANY REFUSE COVERAGE UNDER THIS CLAIM OR SHOULD THE COVERAGE OFFERED BE INSUFFICIENT FOR CONTRACTOR TO PROPERLY DO THE WORK. THE ONLY COST TO THE PROPERTY OWNER IS THEIR DEDUCTIBLE, PLUS ANY UPGRADES CHOSEN OR ANY NON COVERED ITEMS THAT MUST BE REPLACED TO COMPLETE THE REPAIRS. THE CONTRACT BALANCE (ACTUAL CASH VALUE OF THE WORK) IS PAID BY YOUR INSURANCE COMPANY PER FINAL LOSS INVOICE. ALL PROCEEDS FROM THE INSURANCE COMPANY INCLUDING, BUT NOT LIMITED TO, PROCEEDS FOR SUPPLEMENTAL CLAIMS MADE BY CONTRACTOR ON BEHALF OF OWNER, PROCEEDS FOR PROFIT & OVERHEAD, AND PROCEEDS FOR RECOVERABLE DEPRECIATION, ARE GIVEN IN PAYMENT FOR THE WORK OF CONTRACTOR AND OWNER AGREES TO TIMELY, (WITHIN 24 HOURS OF RECEIPT BY OWNER), REMIT ALL SUCH PROCEEDS TO CONTRACTOR. PER COLORADO SB38, CONTRACTOR SHALL HOLD IN TRUST ANY PAYMENT FROM THE PROPERTY OWNER UNTIL CONTRACTOR HAS DELIVERED ROOFING MATERIALS AT THE RESIDENTIAL PROPERTY SITE OR HAS PERFORMED A MAJORITY OF THE ROOFING WORK ON THE RESIDENTIAL PROPERTY. d. Approximate Dates of Service: Substantial commencement of work shall mean either the physical delivery of materials onto the premises or the performance of any labor and shall be subject to any permissible delays as per provision (5) on the reverse side. Approximate Start Date: June 7, 2017 Approximate Completion Date: June 9, 2017 e. Acceptance: This contract is approved and accepted. I (we) understand there are no oral agreements or understandings between the parties of this agreement. The written terms, provisions, plans (if any) and specifications in this contract is the entire agreement between the parties. Changes in this agreement shall be done by written change order only and with the express approval of both parties. Changes may incur additional charges. Additional Provisions Of This Contract Are On The Reverse Side And May Be Continued On Subsequent Pages (see page number below). Read "Arbitration of Disputes" provision on page two (2), provision 12 and the NOTICE following this provision. if you agree to arbitration, initial on the line below th OTICE where indicated. Also, initial in the same place on EACH COPY of this contract. CANCELLATION POLICY: eel U Your right to cancel this contract is limited to the following: approved and accepted (owner) date You, the Buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See the attached Notice of Cancellation form for approved and accepted (owner) an explanation of this right. Steve Kuhlman NOTE: This contract may be withdrawn or renegotiated after 3 approved (contractor) date days from if not approved and signed by BOTH parties. Form RC31-C Copyright © 1996-2012 ACT Contractors Forms (800) 820-5656 www.calform.com Page ONE of 2 Total Pages 3011ON SIHI gAOW3bl ION 00 :ao�oadsul ££6S-t,EZ-£OE;e uoijoadsui-aa aoj ileo `spew uaaq aney s�oljoaJjoo uaym, t,-oN- s@A :paainbaa uoiloodsul-aa W& ' awl :uoiloodsui aol apepene auo ON r :aagwnN }ivaaad :ssaippd gof T r-� :edA1 uoil3odsul 331ION N01103dSNI xeJ 6068 -LE, (EOE) • aglgo 5s8a-sCj (EOE) aull uolloadsul CMS -M (£OE) uoisinia mpedsul Buipjin8 3JQIa 1V3HM =10 Alli � � � A ,r City of Wheat Ridge Residential Roofing PERMIT - 201704042 PERMIT NO: 201704042 ISSUED: 07/14/2017 JOB ADDRESS: 6330 W 46th AVE EXPIRES: 07/14/2018 JOB DESCRIPTION: Residential Re -roof to install Malarkey Laminate asphalt shingles with 35 sq. (27 sq. pitched, 8 sq. flat) *** CONTACTS *** OWNER (303)423-4590 BLANCHARD ZACHARY J SUB (303)789-1107 Steve Kuhlman 021574 COLORADO PREMIER ROOFING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 14,500.00 FEES Total Valuation 0.00 PAID Use Tax 304.50 Permit Fee 283.55--- (,__---------- ** TOTAL ** 588.05 *** 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. A City of Wheat Ridge��� Residential Roofing PERMIT - 201704042 PERMIT NO: 201704042 ISSUED: 07/14/2017 JOB ADDRESS: 6330 W 46th AVE EXPIRES: 07/14/2018 JOB DESCRIPTION: Residential Re—roof to install Malarkey Laminate asphalt shingles with 35 sq. (27 sq. pitched, 8 sq. flat) 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 per . I fu her attest that I am legally authorized to include all entities named within this document as parties to the work to be perfo �d an 1 wop'kKt b erformed is disclosed in this document and/or its' comp.Vying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date I. This permit was issued based on the information provided in thepermit 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 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 androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable c r any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dane Lovett I �_ � / t7o /0 VI: _- I?- - From: no-reply@ci.wheatridge.co.us Sent: Wednesday, July 5, 2017 9:39 AM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Gina 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 Property Owner Name Property Owner Phone Number Property Owner Email Address 6330 W. 46th Ave. Jay Blanchard 303-423-4590 loriandjay2009@gmail.com .1 -A� - C),S- 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 Colorado Premier Roofing Contractor's License 021574 Number (for the City of Wheat Ridge) Contractor Phone 303-789-1107 Number Contractor Email Address coloradopremier@hotmail.com Retype Contractor Email coloradopremier@hotmail.com Address DESCRIPTION OF WORK Are you re -decking the No roof? Description of Roofing Malarkey Laminate shingles Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 27 material selected above? Does any portion of the Yes property include a flat roof? If yes, how many squares 8 on the flat roof? TOTAL SQUARES of all 35 roofing material for this proj ect Provide additional detail House, garage flat here on the description of z work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract14500.00 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that this Yes application is NOT a permit. I understand I will be contacted by the City to pay for and pick up the permit for this property. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have been Yes authorized by the legal owner of the property to submit this application and to perform the work described above. Name of Applicant Beth Shull Email not displaying correctly? View it in your browser. 3 RESIDENTIAL k6, A0.01 do Premier 11652 W. Hampden Place Roofing Lakewood, Colorado 80227 Office... 303.789.1107 Owner's Name: Owner's Address: Fax ...... 303.789.1106 Zachary or Lori Blanchard 6330 W. 46th Ave. coloradopremier@hotmail.com Owner's City: Owner's Zip Code: Owner's Phone: Owner's Work Phone: www.coloradopremierroofing.com Wheat Ridge 80033 303-423-4590 Project Name & Address: Email: 6330 W. 46th Ave. Wheat Ridge, CO 80033 Loriandjay2009@gmaii.com I/WE, the Owner(s) of the premises described above authorize Colorado Premier Roofing, hereinafter referred to as "Contractor", to furnish all materials and labor necessary to roof and/or improve these premises according to the following terms, specifications and provisions: PROPERTY OWNER IS INTENDING TO MAKE PAYMENT FROM THE PROCEEDS OF A PROPERTY AND CASUALTY INSURANCE POLICY. INITIALS a. Scope of Roofing Services and Materials to be Provided: Per The Hartford Insurance Company -Claim # PP0017366513 Main House Remove existing shingles, felt and all roof related items per insurance claim Install felt Owens Corning Tru Definition Storm Class4 Impact Resistive shingles and all roof related items perinsurance claim Modified Roof R& R modified bitumen per insurance claim Gutters R & R gutters/downspouts per insurance claim ShingleColor: Approximate Sum does NOT include supplements thatmay be billed to your insurance company forpaymentto : Colorado Premier Roofing Supplements to include but not limited to: Building Code requirements, Permit Fee b. Description of any areas that will NOT be worked on: Windows/screens painting latticework paint fencing vinyl storage shed fascia evaporative cooler This list of specifications may be continued on subsequent pages (see page number below). c. Approximate Costs of the Services for Damage Known at This Time: Contract r will perform the above, (subject to any additions and/or deductions pursuant to authorized change orders), for the Approximate Sum of $ (10 . Down Payment (if any) $1 000.00 INSURANCE: THIS AGREEMENT IS NULL AND VOID AND DOES NOT OBLIGATE ANY PARTY TO IT SHOULD THE INSURANCE COMPANY REFUSE COVERAGE UNDER THIS CLAIM OR SHOULD THE COVERAGE OFFERED BE INSUFFICIENT FOR CONTRACTOR TO PROPERLY DO THE WORK. THE ONLY COST TO THE PROPERTY OWNER IS THEIR DEDUCTIBLE, PLUS ANY UPGRADES CHOSEN OR ANY NON COVERED ITEMS THAT MUST BE REPLACED TO COMPLETE THE REPAIRS. THE CONTRACT BALANCE (ACTUAL CASH VALUE OF THE WORK) IS PAID BY YOUR INSURANCE COMPANY PER FINAL LOSS INVOICE. ALL PROCEEDS FROM THE INSURANCE COMPANY INCLUDING, BUT NOT LIMITED TO, PROCEEDS FOR SUPPLEMENTAL CLAIMS MADE BY CONTRACTOR ON BEHALF OF OWNER, PROCEEDS FOR PROFIT & OVERHEAD, AND PROCEEDS FOR RECOVERABLE DEPRECIATION, ARE GIVEN IN PAYMENT FOR THE WORK OF CONTRACTOR AND OWNER AGREES TO TIMELY, (WITHIN 24 HOURS OF RECEIPT BY OWNER), REMIT ALL SUCH PROCEEDS TO CONTRACTOR. PER COLORADO SB38, CONTRACTOR SHALL HOLD IN TRUST ANY PAYMENT FROM THE PROPERTY OWNER UNTIL CONTRACTOR HAS DELIVERED ROOFING MATERIALS AT THE RESIDENTIAL PROPERTY SITE OR HAS PERFORMED A MAJORITY OF THE ROOFING WORK ON THE RESIDENTIAL PROPERTY. d. Approximate Dates of Service: Substantial commencement of work shall mean either the physical delivery of materials onto the premises or the performance of any labor and shall be subject to any permissible delays as per provision (5) on the reverse side. Approximate Start Date: June 7, 2017 Approximate Completion Date: June 9, 2017 e. Acceptance: This contract is approved and accepted. I (we) understand there are no oral agreements or understandings between the parties of this agreement. The written terms, provisions, plans (if any) and specifications in this contract is the entire agreement between the parties. Changes in this agreement shall be done by written change order only and with the express approval of both parties. Changes may incur additional charges. Additional Provisions Of This Contract Are On The Reverse Side And May Be Continued On Subsequent Pages (see page number below). Read "Arbitration of Disputes" provision on page two (2), provision 12 and the NOTICE following this provision. if you agree to arbitration, initial on the line below th OTICE where indicated. Also, initial in the same place on EACH COPY of this contract. CANCELLATION POLICY: eel U Your right to cancel this contract is limited to the following: approved and accepted (owner) date You, the Buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See the attached Notice of Cancellation form for approved and accepted (owner) an explanation of this right. Steve Kuhlman NOTE: This contract may be withdrawn or renegotiated after 3 approved (contractor) date days from if not approved and signed by BOTH parties. Form RC31-C Copyright © 1996-2012 ACT Contractors Forms (800) 820-5656 www.calform.com Page ONE of 2 Total Pages BROKE -3 OP ID: PB ACOR® CERTIFICATE OF LIABILITY INSURANCE ATE (MM/DD/YYYY) r07/06/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Madison Insurance Group 600 S. Cherry Street, #900(A/C,No Denver, CO 80246 Craig Allegrezza, Inc CONTANAME: Paula Blohm PHONE FAX Ext): 303-322-0800 ,C, No): 303-322-0874 E-MAIL blohm madisoninsurance.net ADDRESS: pblohm@madisoninsurance.net 101GLOO18773-03 05/31/2017 AFFORDING COVERAGE NAIC If INSURER A: Colony Insurance Company 39993 DAMAGE TO RENTED 100000 PREMISES Ea occurrence $ INSURED Broken Arrow Enterprises, LLC INSURER B: Auto Owners Insurance 18988 Colorado Premier Roofing 11652 W. Hampden PI INSURER C: Pinnacol Assurance Company 41190 GENERAL AGGREGATE $ 2,000,000 Lakewood, CO 80227 INSURER D: INSURER E: AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON-OWNED X FX HIRED AUTOS AUTOS INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Al OCCUR 101GLOO18773-03 05/31/2017 05/31/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100000 PREMISES Ea occurrence $ MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY E PRO- JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON-OWNED X FX HIRED AUTOS AUTOS 4971070200 01/22/2017 01/22/2018 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILYINJURY(Perperson) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE NOT WITH MADISON EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A 4174333 06/01/2017 06/01/2018 PEROTH- STATUTE X ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) t, r -m I trIt,A l C ACORD 25 (2014/01) CITWHE1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Wheat Ridge ACCORDANCE WITH THE POLICY PROVISIONS. 7500 W. 29th Ave Wheat Ridge, CO 80033 AUTHORIZED REPRESENTATIVE qr_A�� bw� © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ♦ i CITY OF WHEAT RIDGE Bung Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: w!sL /?00,-- Job Address: X33 o /Jos y6 "/✓e Permit Number: 0`?,2556 qi 9I i i I ❑ No one available for inspection: Time AM/PM Re-Inspection required: Yes No ' When corrections have been made, call for re-inspection at 303-234-5933 i f Date: /0Inspector: DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE 1 Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE y!A / 12,, o / rrA ❑ No one available for inspection: Time AM/PM Re-Inspection required: Yes No When corrections have been made, call for re-inspection at 303-234-5933 Date: /b -5-- oz:~, Inspector: YY~ DO NOT REMOVE THIS NOTICE Inspection Type: /)/4 17oo Job Address: 63.>~ Ajaes /rd ~/Vve Permit Number: ®92.54(, " 1 City of Wheat Ridge row 0 Residential Roofing PERMIT - 092556 PERMIT NO: -092556' :ISSUED:- 09/18/2009 JOB ADDRESS:. 6330 W.46TH AVE -'EXPIRES: 03/17/2010 DESCRIPTION: Reroof 27 sqs ***'CONTACTS owner 303/818-9848 Jay Blanchard sub 281/391-8555 Greg Arnim 09-0264 Remedy Roofing, Inc. k* PARCEL`. INFO " ZONE CODE: UA 'USE: UA >UBDIVISION: 0378 BLOCK/LOT#: 0/ k* FEE SUMMARY ESTIMATED PROJECT VALUATION: 11,525.00 FEES Permit Fee ( 272.10 ~Total Valuation .00 .~J!3?L'LJ~~~` Use Tax 207.45 j **TOTAL 479.55 'onditions:: 5 nail installation& mid-roof inspection required. Board sheathing spaced more ,han'.:a 1/2 of an inch apart requires plywood overlay on entire roof. Ice and water shield required from'eave edge to 21 inside exterior walls. >ubject to field inspection.` I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the City of :Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I,assume full responsibility for compliance with. the Wheat. Ridge;:Building Code ,(I.B.C) and all other applicable Wheat Ridge ordinances, for work under this permit. Plans subject to field inspection. Ga:A ml-o, Sign ure of contractor/owner :date This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the State of Colorado and to the Zoning Regulations and. Building Codes of Wheat Ridge,:.Colorado or any. other applicable ordinances of the city. This permit shall expire 180 days from the issue date. Requests for an extension must be received prior to expiration date. An extension may be granted at the discretion of the Building Official. If this permit expires,a new permit may be acquired fora 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 anew permit. Nowork of any manner shall be done that will change thee. natural flow of water causing a drainage problem. Contractor shall notify the Building Inspector twenty-four (24) hours in advance for all inspections and shall receive written approval on inspection card before proceedmq with successive chases of the loh. xii: plan review is s eject to field: inspections. I _ ignature ofJ uildmg Official date NSPECT R 1 QEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855 EQUESTS`MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING 'BUSINESS DAY. ~oF W"s?TRa City of Wheat Ridge Building Division Date: m 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Plan 0.....,.._ -o Inspection Line: 303-234-5933 Permit ~LORA~ ~ Building Permit Application Property Address; b ® J b V.( c Property Owner (please print): i / fVchrgral Phone: 3o-3 81s 9 118 Mailing Address: (if different than property address) Address: 6 3~ O `n/ q w 13 V City, State, Zip: Wh r?y f~I JA P Lo Contractor: Lfine~ y ~op~ n Contractor License Phone: Sub C6ntr4ctors`: Electrical City License Company: Plumbing City License Company Mechanical City License Company: Exp. Date: Exp. Date: Exp. Date: Approval: Approval: Approval: Use of space (description): Construction Value: , S`~2~ Description of wOrk:: (as calculated per the BU%tdnhVatoatiOn Data sheet) Plan Review (due at time of submittal): $ Sq. Ft./L.Ft added: Squares ~ BTU's Gallons Amps OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work under this permit. Plans subje o ie spection. CIRLCE ONE:: pp(OWNER) tCoNNTRAcTIR) or PERSONAL REPRESENTATIVE of (OW/N~ E_R) (CONTRATOR) PRINT NAME: SIGNATURE: " "rd Ul''~ Date: ati'ied,] Bldg Valuation: $ 1 DEPARTMENT OF COMMUNITY DEVELOPMENT 7500 WEST 29th AVENUE BUILDING INSPECTION DIVISION PERMIT N0. M93#18709 234•5933 P.O. BoXe38 CITY OF WHEAT RIDGE, C0L0. THIS PERMIT VAUD ONIY WHEN SIGNED BY THE CHIEF BUILDING INSPECTORANCRECEIPTEDBELOW. APPUCATION FOR MISCELLANEOUS RMIT JOB ADDRESS OWNER CONTRACTOR ADDRESS _ CITY PHONE - ZIP CODE LICENSE NO. ADDRESS v (F' ~"S. 142 W+ PHONE kS 21PCODE CONTRACT PLR~IC~E ~$-~~Od DATE 1. TYPE Ground ❑ Woll❑ Proisclinp❑ Othar S or D Foet 2. MATERIAL Totol Squon F»t SIGNS 3. ILLUMINATION Yes❑ No❑ Typs E4ct. Parmit No. 4 SET BACK FROM PROPERTV LINE N (Specity whian ie Iront) _ ❑ S_ E ❑ _ W ❑ ❑ Zons_ ADDrrn'ed,Zan IneWetor DisoDWmsd c 1. TYPE Sglid More Thon 80% ODen❑ Lest TAOn BO% Open ~ MATERIAL HsiipM ~ FENCES 3. SET BACK FROM PROPERTY LINE N (Specify which it tront) _ ❑ S_ E ❑ _ W ❑ ❑ Zono_ ApprwW,Zons Inspaetor DiaoODroved I . Z OTHER 3. DRAW SKETCH OR SHOW BELOW, THE FENCE,SIGN,OR OTHER STRUCTURE,GIViNG ,7ISTANCES FROM PROPERTV LINES. (SETBACKS OR PROJECTIONS INCLUDED) = I J SPECIFV NORTN 6 INSPECTION TICKET STREET NAME SHOW DISTANLES FROM THE MAIN BUILDING TUADJOINING HOUSES, STREETS,AND DISTANCE TO PROPERTV IINES,NOT MAXIMUM OR AVERAGE DISTANCE. APPLICATION FOR PLUMBING; ELECTRICAL; THIS APPLICATION WILL BECOME A PERMIT TO PERFORM THE INDICATED WORK ONL PERMIT WILL EXPIRE 180 DAYS FROM THE DATE OF ISSUANCE IF N ELECTRICAL PERMIT STATE LICENSE N0. PLUMBING PERMIT S7ATE LICENSE NO ALUMINUM WIRE UNDERSIZE B ILIEGAL FLOOR BSM IST 2ND N0. WATER CIASET TEMPORARY METER WASH BOWL NEW SERVICE - AMPS BATH TUB CHANGE SERVICE-QMPS SHOWER LIGHTING SINK HEATING GARBAGE DISP POWER SUB-CIFCUITS WATER HEATER UTILITY (RANGE, DISPoSER, ETC AUTO. WASHER FIXTURES DISH WASHER WIRING MOTOFtS 9 CONTROLS FLOOR DRAIN SIGNS URINAL TRANSFORMERS 9 RECTFIERS SEWERS ADOITION TO OLD WORN OTHER MOTORS OVER I HP TOTAL FI%TURES I hsreby acknowledqe thol this opDlico- fion ia correat ond undersiand thot I tonnot stort Ihis projett unlil thi3 aDDli- cation is apOroveC. I shall comply wiih IAe lows of 1he S1o1e ot Colorado and ro the Zoninp Repulofi0ns and Bwldinp Code ofthe Ci1y of Wheoi RidQe. Any violotion of the obove terme will couse immediote revocation of tn;s permlt JOB ADDRESS DATE: BLDG. PERMITS I~ BLDG. ~ PERMITN SUBCONTRACTOR DATE INSP. REQ. i, TYPE OF INSP. INSPECTION MADE L~ Z Z g3 REMARKS W.R. FORM 619 / PERMIT FEE ~ NOT VALID UWlESS RECEIPTED pE S7 cL USE TAX TOTAL FEE $ APPROVEO [d- DISAPPROVED CHIEF BUILDI INSPECTOR,Cifyof Wheat Ridqe CALL 2345933 L~ ) 24 HOURS IN ADVANCE Da18 ISSUBd 3 FOR INSPECTIONS 6T liean~-sio+^tw. /f INSPECTION RECORD Occupancy/Type IV - INSPECTION LINE: (303) 234 -5933 Inspections will not be made unless this card is posted on the building site Call by 3:00 PM to receive inspection the following business day. oh, (k). O ` t1D r INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB FOUNDATION INSPECTIONS DATE ` .INSPECTOR INITIALS COMMENTS Footings /Caissons .. : Plumbing Stemwall / (CEG) Concrete, Encased Ground �- /✓ — 9E en l 3 m � Q� n[ %E.f Reinforcing or Monolithic L GC Y A, Weatherproof / French Drain Roof N— Sewer Service Lines... Building Final Water Service Lines Fire Department VVRIYV VVIVVRCIC V VVC II ' CONCRETE SLAB FLOOR Electrical (Underground) Plumbing (Underground) Heating (Underground) nh NnT Pll11R PI hl1R I INTII 6R(1 \/F 1 P.FFN CI(:NFO ROUGHS Sheathing Electrical Lath /Wall tie .. : Plumbing Mid -Roof �- /✓ — 9E en l 3 m � Q� n[ %E.f Electrical Service L GC Y A, Rough Electric Roof N— Rough Plumbing Building Final Gas Piping Fire Department Rough Mechanical .' y OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED PROTECT THIS CARD FROM THE WEATHER FINALS Electrical .. : Plumbing Mechanical �' Roof N— Building Final Fire Department .' R.O.W & Drainage INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. Parking & Landscaping * ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A " CERTIFICATE OF OCCUPANCY IS ISSUED.. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION t OF A C ERTIF1 ATE QF CCUPANCY NOR PERMISSION FOR OCCUPANCY. y OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED PROTECT THIS CARD FROM THE WEATHER