HomeMy WebLinkAbout7130 W. 42nd Avenue41 City of Wheat Ridge
Residential Roofing PERMIT - 201704529
}ERMIT NO:
201704529
ISSUED:
07/20/2017
JOB ADDRESS:
7130 W 42nd AVE
EXPIRES:
07/20/2018
JOB DESCRIPTION:
Residential Re -roof to install
IKO Cambridge asphalt shingles with 33 sq.
*** CONTACTS ***
OWNER (303)249-7452
PAILING COURTNEY
SUB (303)679-8509
Mark Schymanski
160210 Genesis
Construction Inc.
*** PARCEL INFO ***
ZONE CODE:
UA / Unassigned
USE:
UA / Unassigned
SUBDIVISION CODE:
2405 / BARTHS, COULEHAN
GRANGE,
WHEAT BLOCK/LOT#:
0 /
*** FEE SUMMARY ***
ESTIMATED PROJECT VALUATION:
9,900.00
FEES
Total Valuation
0.00
Use Tax
207.90
Permit Fee
204.30
** TOTAL **
412.20
*** 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.
INSPECTION RECORD Occupancy/Type
al L
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection
INSPECTION REQUEST LINE: (303) 234-5933
Inspections will not be performed unless this card is posted on the project site.
**Request an inspection before 11:59 p.m. (midnight) to receive an inspection the following business day.**
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections Date Inspector Comments
Initials
Pier
Concrete Encased Ground (CEG)
FniinriMinn / P _ I Ptter
n.. 41..E n....r r.,ra+rn4n Dries Tn Annrnvni (V Thp Ahnvp Insnections
Underground/Slab Inspections
Date Inspector Comments
Initials
Electrical
- - -
Comments
Sewer Service
Plumbing
r%_ wl_a rw-mm~4 nr KAlf%1A111n.\151n VVnrK rrinr In Annu"VAI lJl 1IIC MUVVC 1110LJgUV�lv11.7
LO v 1.W vv.
Rough Inspections
Date
Inspector
Initials
- - -
Comments
Wall Sheathing
Mid -Roof
�"
Lath / Wall Tie
Rough Electric'
Rough Plumbing/Gas Line
Rough Mechanical
Rough Framing
Rough Grading
Insulation
Drywall Screw / Nail
Final Inspections
Date Inspector
CommentsInitials
Landscaping & Parking / Planning Dept.
Inspections from these entities should be requested
one week in advance. For landscaping and parking
inspections call 303-235-2846. For ROW and drainage
inspections call 303-235-2861. For fire inspections
contact the Fire Protection District for your project.
ROW & Drainage / Public Works Dept.
Floodplain Inspection (if applicable)
Fire Inspection / Fire Protection Dist.
Final Electrical
Final Plumbing
Final Mechanical
Roof
Final Window/Doors
Final Building
NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate
of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy.
wFor low voltage permits — mease De sure uiai III iaNcUuvi1a 01c UU.HPicicv
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
w
Residential Roofing PERMIT - 201704529
PERMIT NO:
201704529
ISSUED:
07/20/2017
JOB ADDRESS:
7130 W 42nd AVE
EXPIRES:
07/20/2018
JOB DESCRIPTION:
Residential Re -roof to install
IKO Cambridge asphalt shingles with 33 sq.
*** CONTACTS ***
OWNER (303)249-7452
PAILING COURTNEY
SUB (303)679-8509
Mark Schymanski
160210 Genesis
Construction Inc.
*** PARCEL INFO ***
ZONE CODE:
UA / Unassigned
USE:
UA / Unassigned
SUBDIVISION CODE:
2405 / BARTHS, COULEHAN GRANGE,
WHEAT BLOCK/LOT#:
0 /
*** FEE SUMMARY ***
ESTIMATED PROJECT VALUATION:
9,900.00
FEES
Total Valuation
0.00
Use Tax
207.90
Permit Fee
204.30
P A
* * TOTAL * *
412.20
*** 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.
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION:.
City of Wheat Ridge
Residential Roofing PERMIT - 201704529
201704529
7130 W 42nd AVE
ISSUED: 07/20/2017
EXPIRES: 07/20/2018
Residential Re—roof to install IKO Cambridge asphalt shingles with 33 sq.
I, by my signature, do hereby attest that the work to be pE
applicable building codes, and all applicable municipal c
by the legal owner of the property and am authorized to c
this permit. I further attest that I am legally authorized to
performed and that all work to be performed is disclosed
comply with all accompanying approved plans and specifications,
and procedures, and that I am the legal owner or have been authorized
nit and perform the work described and approved in conjunction with
tities named within this document as parties to the work to be
ent and/or its' accompanying approved plans and specifications.
-7/31/ t2
Signature of OWNER or CONTRACTOR (Circle one) Date
1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalpermit fee.
3. If this permit expires, anew permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applicable cod �ordinance f- or reWlati his 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.
GENESIS
TOTAL. EXTERIORS
1250 Bergen Parkway Suite B-110
Evergreen, CO 80439
303.679.8509 1 www.genesistotalexteriors.com
Insurance Company:
Q
Policy Number:
Claim Number:
2
Adjuster:
Phone:
eoH
8 _ Z
Adjuster Meeting:
INSURANCE RESTORATION AGREEMENT
Owner: �� Phone: 503 8 _e7
Address: 50 Alt Phone:
City:�. State: Zip.33 Email: &U—46m
30X
Owner authorizes Genesis to contact Owner's insurance company regarding damage to the Property and understands that Contractor will
assist Owner in obtaining additional funds to properly restore Owner's property. Owner authorizes Owner's insurance company to discuss
matters directly with Contractor. Owner agrees to provide Contractor with any and all insurance information including claim number,
insurance loss sheets, and revised loss sheets provided to Owner by insurance company. Owner agrees that Contractor shall perform work
prescribed by the insurance company's adjuster report, which Includes the estimate of repairs as set forth in the insurer's claim file, plus
any upgrades selected by Owner.
Owner is obligated to pay only the deductible required by Owner's insurance carrier; additional decking (if required); plus any upgrades
requested by the Owner not included in the insurance loss data sheet. SB38 prohibits any roofing contractor from paying, waiving, or
rebating an insurance deductible for a property owner. This agreement automatically terminates and the Owner owes nothing In the
event that the insurance company does not authorize full roof replacement. With written notification, you may CANCEL this transaction,
without any Penalty or Obligation, within 72 Hours from the below date.
Genesis Total Exteriors agrees to furnish all materials aniiJabor necessary to perform the roof replacement and/or other work of this
contract for the approximate cost of $ or the Replacement Cost Value (RCV) set forth by the Owner's insurance company
also called the "Contract Price". The approximate cost is based on damages know as of the date of this contract. Genesis Total Exteriors is a
general contractor and thus is entitled to Overhead and Profit on all projects requiring more than just roof replacement.
Scope of Work:�All Insurance Approved Work Roof ❑ Siding/FasciaAGutters WPaint ❑ Windows CAdditional Work
Deductible Initials Materials to Be Used �1e
Additional`
Instructions: i'(,/ _
, �(s�
*See contract addendum, install verification form for additional details
Payment in the amount of first insurance draft, or equal amount, is due to Contractor before delivery of materials or start of work. Upon
receipt of deposit payment contractor agrees to apply for permitting, purchase material, and schedule roof install within 2 to 4 weeks.
Contractor shall hold in trust any payment from the property owner until the Contractor has delivered roofing materials to the jobsite or
has performed the majority of roofing work on the property. Final payment due upon substantial completion of work and receipt of invoice.
Owner has carefully read and understands the terms and conditions of the contract, including the second page, this is a contract and
not a proposal. Aside from listed upgrades the summary of work to be performed is described and embodied in the insurance loss sheet(s)
provided by Owner's insurer, in addition to the summary of work the data sheets are also the basis on which the price will be calculated,
these amounts will constitute the Price for the work; this includes updates to the loss sheet in the way of supplements. Owner specifically
understands that if this contract is cancelled before commencement of work, Owner agrees to pay Contractor 25% of the total sum of the
work authorized by Owner's insurance company as reasonable compensation for the time expended in obtaining insurance proceeds for
improvement of the Owner's property.
6-44Jh�4J12Lt 2-01'+
Property Owner Auth rized frenesis Representative Date
TERMS AND CONDITIONS
CHANGE ORDER: Any alteration or deviation from contract specifications will require the execution of a Chang Order. It is agreed that all terms
and conditions of this Contract shall apply equally to additional work added to this Contract in the form of a Change Order. No repair work or
alterations shall be done, except as specified and expressly agreed to by Contractor and Owner in writing. Work required under a Change Order
will not begin until full payment of the Change Order is made by Owner. Further, if Contractor encounters any unforeseen conditions during the
course of the Work, they shall promptly notify Owner. Changes to the Work, if any, Shall be made by Change Order.
OWNER RESPONSIBILITIES: Unless otherwise specified, Contractor's price is based upon Owner's representation that there are no conditions
preventing Contractor from proceeding with the usual installation procedures for the materials required under the Contract. Owner represents
that personal effects, personal property and plants will be relocated or trimmed prior to the beginning of work so that Contractor has free access
to free portions of the premises where work is to be done. Owner authorizes Contractor to use Owner's electricity for work to be completed under
this contract. Owner further understands that as a precautionary measure all pictures and wall accessories that are not securely fastened should
be removed until all work has been completed. Owner shall carry premises liability Insurance. If necessary for the work, Owner shall secure
permission to work on or over adjoining property at no cost to Contractor. Owner agrees to be responsible and to hold Contractor harmless and
accepted any risks resulting from access through adjacent properties. Owner grants to Contractor and its employees the right to perform
contracted services during daylight hours from Monday thru Saturday between 7 a.m., and 9 p.m., unless otherwise specified by Owner.
NON -RESPONSIBILITY: Contractor shall not be responsible for any damage occasioned by the Owner or their agents, rain, windstorm, Acts of God
or other causes beyond the control of Contractor. Contractor is not liable for any act of negligence or misuse by the Owner or any other party.
Contractor shall not be responsible for damage to existing shrubs, lawns, trees, clothes lines, personal property, telephone and electric lines,
doorbells, cable -TV or light fixtures unless otherwise specified in the contract. Contractor Is not responsible for delays caused by strikes, weather,
accidents, or other events beyond Contractor's control. Except through negligence, Contractor is not liable for damages to interior fixtures,
drywall, plaster wall construction, decorations, or to other parts of premises or its contents. Contractor shall have no responsibility for correcting
any existing defects which may be recognized during the course of the work of hidden or latent conditions of the property. Contractor is not
responsible for work done by others, existing structural defects, materials furnished by Owner, dry rot, or existing code violations.
PAYMENTS: Contractor shall be entitled to prompt payment In accordance with this agreement. If, after Contractor has declared the work to be
satisfactorily performed but Owner claims that work still remains to be done, Owner agrees to make prompt payment of the Contractor amount,
less only an amount needed to complete the work claimed yet to be done. Upon completion of the remaining work, Contractor must immediately
be paid the remaining balance due. Nonetheless, Contractor shall hat the right to stop work and keep the job idle if any payment in accordance
with the agreement are not made. In the event Owner does not pay Contractor according to the terms of this agreement, Contractor may add a
monthly service charge of 2% (Annual Rate of 24%), or in accordance with the prevailing rate allowable by law, to the balance owed.
DISPUTES: It is specifically understood and agreed between the parties hereto that an event of a dispute over any of the terms, conditions or
clauses contained herein the Colorado District Courts shall have full and exclusive jurisdiction over the matter. Owner agrees that if Contractor
shall prevail in an action against Owner, Owner shall be responsible for any collection costs and attorney fees Incurred by Contractor. Owner
warrants that this contract is signed without any reliance upon any representation or promises by Contractor, or its agents except as is specifically
written in this contract, ant that no such promises or representations have been offered as inducement for signing.
LIQUIDATED DAMAGES: In the event Owner cancels or refused to perform under this agreement before commencement of work, Owner agrees
that Contractor may retain 25% of the total sum of the work authorized by Owner's insurance company as a reasonable amount of liquidated
damages for breach of this agreement. Owner understands that his amount Is a reasonable measure of actual damages suffered by Contractor for
such cancellation. In the event that a court of competent jurisdiction deems this amount unreasonable, Owner agrees that the Contractor is
entitled to the unpaid contract price less the amount it would have cost to complete the work under this agreement. In the event of any breach of
this agreement, Owner agrees to pay for any reasonable attorney's fees, legal expenses and costs of collection which may result.
MATERIALS AND SUBCONTRACTORS: All products are warranted upon delivery or installation against defects in material and workmanship and no
other warranties or guaranties, expressed or implied are authorized unless in accordance with a standard written manufacturer's warranty held by
purchaser. Materials listed above that are special ordered or custom made for the work under this agreement cannot be changed, cancelled,
modified or discharged on whole or in part by the Owner once orders for such materials are placed. Owner agrees to be responsible for any costs
associated with the return or re -ordering of such event. Any materials not used in the performance of this Agreement remain the property of
Contractor, whether or not delivered to the job site. Contractor reserves the right to choose and direct its own subcontractors and suppliers.
"Genesis Total Exteriors is licensed and insured, our General Liability Provider is AmTrust, Insurance Policy # NA103383704 and can be
reached at 877.528.7878.
Initials
Dan Schultz
765e45-�9
From: no-reply@ci.wheatridge.co.us
Sent: Wednesday, July 12, 2017 10:31 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
7130 W. 42nd Ave
Jason Pailing
303-249-7452
tim@genesis-constructioninc.com
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
Genesis Construction Inc
160210
3036798509
Contractor Email Address tim@genesis-constructioninc.com
Retype Contractor Email tim@genesis-constructioninc.com
Address
DESCRIPTION OF WORK
Are you re -decking the No
roof?
Description of Roofing IKO Cambridge IR
Material
Select Type of Material: Asphalt
If "Other" is selected Field not completed.
above, describe here:
How many squares of the 33
material selected above?
Does any portion of the
property include a flat
roof?
If yes, how many squares
on the flat roof?
No
Field not completed.
TOTAL SQUARES of all 33 ✓
roofing material for this
project
Provide additional detail 5/12 pitch remove all layers. Install asphalt shingle
here on the description of
z
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
Project Value (contrac 9900
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 Tim Little
Email not displaying correctly? View it in your browser.
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: `1/30 <<J
Permit Number:
❑ No one available for inspection: Time AN PM
Re -Inspection required: Yes NO
When corrections have been made, call for re -inspection at 303-234-5933
Date: '' Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: JI,lr `)
Job Address: '� T, {.� `-, %C, �c
Permit Number: 2
❑ No one available for inspection: Time
Re -Inspection required: Yes r' N
When corrections have been made, call for re -inspection at 303-234-5933
Date: Inspector:
®O NOT REMOVE THIS NOTICE
: -
COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number': 78565
BUILDING INSPECTION LINE -(303-234-5933) Date : 4/7/2005
CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 -(303235-2855)
Property Owner. JANE ANDERSON
Property Address : 7130 W 42ND AVE Phone : 420-5726
Contractor License No. : 18362
Company : Creative Wiring Phone : 758 2632
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Valuation : $1,200.00
..Iherebycertirythatthese[tiack.distancesproposedbythispermitapplicationareaccurate;and PefmitFOB: $58.34 -do not violate applicable ordinances, mlesor regulations of the City of Wheat Ridge or . cbvenants, easements or restrictions of record; that all measurements sFiown, and allegations PIBp R2VIeW F26 : ~$0.00
. made are accurate; tfiat I have read and agree to abide by all conditions printed on this application, and that 1 assume full responsibility for compliance with the Wheat Ridge Building
USB T8X : ~21:60 `Code (I.BIC.) and all other applicatile Wheat Ridge ordinances, for work under this permit. .(OWNER)(CONTRACTOR)SIGNED` DATE TO181: $79{94
= Use :
Description : 125 AMP SERVICE CHANGE
BUILDING DEPARTMENT USE ONLY
SIC : Sq. Ft. :
Approval :
Zoning :
000l~~!?9~~.rnen.x '
Approval
:
o~`s~o~
APProJal: Occupancy : Walis : Roof : Stories Residential Units
Electrical License No 18362 ' Plumbing License No : Mechanical License No :
Company: Creative Wiring Company:' Company;
Expiration Date : 2/28/2005
Approval : Expirationbate : Expiration Date :
Approval: Approval:
(1) This permitwas issued in accordance with the provisions set forth in yopur application and is subject to ihe laws of the State.of Colorado and to the Zoning
Regulations and Building Code of Wheat Ridge; Colorado or:any other applicable ordinances of the City. . • ~ - ,.(2) ~This permit shalfexpire if (A) the work aufhorized is not commenced wdhin sixty (60) days from issue date or (B) the bmldingauthorized is suspended or .
abandoned for a period of 180 days.
(3) if this permit expires, a new permit may be acquired for a fee of one half the amount nortnally reqmred, provided no changes have been orwill be made m the
original plans znd specifiwtions.and any suspension or abandonmenFhas nofezceeded one (1) Yeac If changes are made or if suspension or abandonment ezceeds one (7) year, full fees shall be paidfor a new permd . . .(4) No work of any manner shall be done that will change ihe naturel flow ofwater causing a drainage pmblem. .
(5) Coniractor shall noliythe 8uildin Ins__p~ec~t~enty-four (24) houre in advance for all mspechons and shall receive written approval on inspection card before
proceedim ccess asesof '
(6) The i a a p ' orttie app wings and specifications shall not be construedio be a permit for, nor an approval of, any violanon of ihe ~ P. i' i~es o
roother ordinance, law, rule or regulation
Chief Building Inspector
Please sign Terms and Conditions on reverse side'of page. ;
COMMUNI7Y DEVELOPMEN7 DEPARTMENT Building Permit Number:
oF~'"~ry BUILDING iNSPECTION LINE - 303-234-5933 Date:
~ CITY OF WHEAT RIDGE
° 7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-2352855) APPLICATION
Property Owner: ~MJ-0,~U„
Property Address: G~ Z k~ Q UE Phone: ? LI Z &
Contractor License No.:
Company: U , r\' 1'j Phone: 3-'7$~l-7 b?7
OWNER/CONTRACTOk SIGNATURE OF UNDERSTANOING AND AGREEMENT
i hereby certify that the setback dstances proposed by this permR application are
accurate, and do not violate applicable or6nances, rules or regWations of the City of
YVheat Ridge or covenants, easemen4s or r dions of record; that all
measuremenls shown, and alleg ade ar rate~ hat I have read antl
agree to abide by all condkion pri on thi appii tio nd that I assume full
responsibility !w compliance~~l~h t'eat "dqe ild' U.B.C) and all
omer appicable wheat Ridg Orpi ~pces, i wdrk is permit.
(OWNER)(COHiRACTOR):PRINTEO DATE
Description: (ZSANp
Sq. FL added
Construction Value:$ t2c^Ip,cx?
Permit Fee:$ Sg
Plan Review Fee:$
11S!~Tax•$
Totai:$
ExpiraGon Date: ExpiraGon Date: Expiration Date:
Aoproval: Approval: Approval:
(1) 7his permit was issued in accordance with the provisiors set torth in yaa application ana is subjed to the iaws otMe State of
. Cobrado and to the Zoning Regulatioru and Buildirg Codes W Wheat Ridge, Cdorado or any other applicable ordinances of
the City.
(2) This pemdt shall expire if (A) Ihe wak authorized is rat commenced within sixty (60) days trom issue date a(8) the building
au[ha¢ea is suspended or abandoneC for a period of 120 days. .
(3) 1f this perrtul expires, a rrew permit may be acquired ta a fee of one-hatf Me amount nortnally required, provided rw changes
have been w wiil be made in the original plam and speaficatiws and any suspension or abandonmerd has rat euceeded one
(1)year.ltchanpeshavebeenwifsuspensimaabandommerdexceedsore(1)year.fullfeesshailbepaAtorarrewpermil.
(4) No wak of any marner shell be dorre that.will change ttie natural flow of water causing a drainage problem
(5) Cartractor shall rwUly the Building Inspedor Mren[y-taa (24) hows in advance tor all inspediau arM shall reoeive written
appmval on inspedion card before proceeding with successive phases of the pb.
(6) 7he issuance of a pertrul w the approval of drawings and specifications shall rwt be construed to be a pemii[ for, rwr an
approval of, any violation of the povisions of tlie building codes a any other ordinance, law, rule or regulation.
Chief Buiiding Officiai
ElecNcal license No: Plumbing License No: Mechaniql License No:
Company: Company: Company: