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Home My WebLink About7170 W. 42nd Avenue4D_�'�I�'iNSPECTION2..v 17n5�s� 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 Occu anc /T e 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 Annroval Of The AhovP InsnPr_finnc Underground/Slab Inspections Date Inspector Comments Initials Electrical Comments Sewer Service Plumbing uo Not Cover Underaround or Below/in-Slab Work Prior To Annroval Of The Above Inspections Rough Inspections Date Inspector Initials Comments ?dill Sheathing Mid -Roof!•%% j 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 2 0 'R 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 *** 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 1)e 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 elast.omeric 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 Residential Roofing PERMIT - 201705357 PERMIT NO: 201705357 ISSUED: 08/03/2017 JOB ADDRESS: 7170 W 42nd AVE EXPIRES: 08/03/2018 JOB DESCRIPTION: Residential Re -roof and Re -deck to install Owens Corning asphalt shingles with 23 sq. *** CONTACTS *** OWNER REVOLVE CONSTRUCTION SUB (720)231-4156 Jared Phifer 150033 Revolve Construction *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,600.00 FEES Total Valuation 0.00 Use Tax 180.60 Permit Fee 188.45 Investigative Fees 140.90 ** TOTAL ** 509.95 *** 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 1)e 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 elast.omeric 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 Residential Roofing PERMIT - 201700752 PERVITT NO: 201700752 ISSUED: 05/1-9/2017 JOB ADDRESS: 7150 w 42nd AVE EXPIRES: 05/19/2018 JOB DESCRIPTION: Reroof with asphalt shingle GAF Armorshield Ii IRU - 20 squares CONTACTS OWNER (303)421-6351 PARRISH PETER T SUB (720)542-8715 Garrett Lister PARCEL INFO ZONE CODE: UA / Unassigned USE: UA Unassigned SUBDIVISION CODE: 2405 BARTHS, CGULEHAN GRANGE, WHEAT BLOCK/LOT#; 0 FEE SUMARY ESTIMATED PROJECT VALUATION: 8,000.00 FEES Total Valuation 0.00 Use Tax 144.00 Permit Fee 172.60 * * 1\0 TAL * * 316.60 cc A *** COMMENTS ** CONDITIONS Effective December 1, 2014, asphalt shingle installations require an approved inspection, midroot conducted when 25-75 percent of the roof covering is installed, prior to 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 exc'eedirig &1/2 -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 feel above the roof cave and secured in place is required to be provided for all roof `nspec� tiOns. Roof ventilation is required to comply with applicable codes and/or manufactureraiFrIls installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection ani approval from the :Manufacturer's technical representative stating that "the application of the roof at (Project address) has been appliedn accordance rdance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. City of Wheat Ridge Residential Roofing PERMIT - 201700752 PERMIT NO: 201700752 ISSUED: 05/19/2017 JOB ADDRESS. 7150 w 42nd AVE EXPIRES; 05/19/2018 JOB DESCRIPTTON: Reroof with asphalt shingle OAF Armorshield IT IRU - 20 squares I b f m sigaiature, do hereby attest that the work to be performed shall comply with all accompanym . approvedspecifications, &e le;al owner or have been authorized policies and procedures,and the plans and specif it and performthe work described and approved in conjunction with 8 owner fe'Zitlies named within this document as parties to the work to be "'Phe 1�gt de al is permit. �y perfoprmed'n s document and/or its` accompanying approved plans and specifications. Signatur8of OWNER or CONTRACTOR (Circle one) Date I. This permit was issued based on the information provided in the permit application and accornfanying Flans and specifications and is subject to the compliance with those documents, and all applicable statutes. ordinances re icies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. f 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 ati procedures for approval of any new permit. Re -issuance or extension of expired p&m its is at the sole discretion of the Chief Building 091eial and is not guaranteed. 4. No work, of an manner shall be performed that shall results in a change of the natural flow of water without prior and s ecific approval - The pen -nit ho der shall notify the Building and Inspection Services Division in accordance with established policy of all re 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 gy-Iting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or fthis jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MST BE MADE By 11:59pg .arty BUSINESS DAy FOR INSPECTION THE FOLLOWING BUSINESS I)AY. Inspection time requests Nvill be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.lis between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. City of Wheat Ridge Residential Roofing PERMIT - 201705357 PERMIT NO: 201705357 ISSUED: 08/03/2017 JOB ADDRESS: 7170 W 42nd AVE EXPIRES: 08/03/2018 JOB DESCRIPTION: Residential Re -roof and Re -deck to install Owens Corning asphalt shingles with 23 sq. *** CONTACTS *** OWNER REVOLVE CONSTRUCTION SUB (720)231-4156 Jared Phifer 150033 Revolve Construction *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATI 8,600.00 FEES Total Valuation 0.00 Use Tax 180.60 Permit Fee 188.45 Investigative Fees 140.90 �f ** TOTAL ** 509.95 * * * 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 Residential Roofing PERMIT - 201705357 PERMIT NO: 201705357 ISSUED: 08/03/2017 JOB ADDRESS: 7170 W 42nd AVE EXPIRES: 08/03/2018 JOB DESCRIPTION: Residential Re -roof and Re -deck to install Owens Corning asphalt shingles with 23 sq. I, by my signature, do hereby atthat the work to be performed shall comply with all accompanying approved plans and specifications; apphcabble building codes, and all applicable municipal codes, policies and procedures, and that [ 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 ermrt. I fwther attest that I am legally authorized to include alI entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date I . This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original ?ermrt 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, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval o, "'14 is subject to Field inspection. y Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/01/2017 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 have ADDITIONAL INSURED provisions or 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). A CONTAPRODUCER NAME: Stephen Test Stephen A. Test Insurance Agency 425 S CHERRY ST STE 105 PHONE (303)745-0404 FAX A/C No(720)306-3198 E-MAIL stephen.a.test@gmail.com ADDRESS: P @gmail.com INSURERS AFFORDING COVERAGE NAIC # 02/26/2018 INSURER A: INTERNATIONAL INS CO OF HANNOVER SE 112082 GLENDALE CO 80246-1228 INSURED INSURER B INSURER C: Revolve Construction, Inc INSURER D: 5168 Parfet St INSURER E Unit I INSURER F Wheat Ridge CO 80033 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. INTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM IDD/YYYY POLICY ID IMMDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR IG011004350-00 02/26/2017 02/26/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- JECT [::] LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED Y AUTOS ONLAUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY L COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ BODILY INJURY Per accident) $ PROPERTY DAMAGE $ Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A I PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Revolve Construction Inc ACCORDANCE WITH THE POLICY PROVISIONS. 5168 Parfet St AUTHORIZED REPRESENTATIVE Unit I Wheat Ridge CO 80033: @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD City of �W heat die MUNITy DEVELOPMENT Building & Inspection Services Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: perm itsCabci.wheatridge.co.us FOR OFFICE USE ONLY Date: Plan/Permit # Ic I I kc),5,�; S] Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: -31-40 W (A 2.4 &Qe- 1V, C' e Property Owner (please print): ,o Ah�� o��k Phone: 72o -77%- -7,5Z-? Property Owner Email: 1oa rin o k. 6U1 eyyLotl L Cowl Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer: Architect/Engineer E-mail: Contractor: 1�12va �v Z b./' Phone: Contractors City License #: 4 r2'00 3,3 Phone: 7Z0 - 7_3A -`AI S5/ Contractor E-mail Address: 3kce_� �P_ re-yo�JeCovn5 uruA1 � •Low\ Sub Contractors: Electrical: W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form ❑ COMMERCIAL ❑ RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION [RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ OTHER (Describe) (For ALL projects, please provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.) Sq. Ft./LF Amps Btu's Squares 2� Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. 1, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) ! w Signature (first and last name): ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: ARTMENT USE ONLY DATE: !J l 7 / 7 OCCUPANCY CLASSIFICATION: Building Division Valuation: $ Dan Schultz �D(/7D53S7 From: no- reply@ci.wheatri dge.co.us Sent: Wednesday, July 26, 2017 8:58 PM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Danny, STOP WORK ORDER 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? w6!, How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address 7170 W 42nd Ave. Wheat Ridge Co. 80033 Property Owner Name Revolve Con. Property Owner Phone 000-000-0000 Number Property Owner Email Field not completed. Address 4, _-6, cl 73 lnic -mDes SAC)_ Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. Attach Copy of Contact Field not completed CONTRACTOR INFORMATION Contractor Business Name Contractor's License Number (for the City of Wheat Ridge) Contractor Phone Number Eber Dominguez Construction 100344 7202763614 Contractor Email Address dominguez_eber@yahoo.com Retype Contractor Email Address DESCRIPTION OF WORK Are you re -decking the roof? Description of Roofing Material Select Type of Material: If "Other" is selected above, describe here: How many squares of the material selected above? Does any portion of the property include a flat roof? If yes, how many squares on the flat roof? TOTAL SQUARES (pitched + flat) of all dominguez_eber@yahoo.com No Owens Corning Asphalt Field not completed. 23 No Field not completed. 23 ✓ 2 roofing material for this project Provide additional detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract value or cost of ALL materials and labor) Single Family, 4:12 -5a7�s77:>1 t 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 Anna Dominguez Email not displaying correctly? View it in your browser. 3 PERMIT NO: JOB ADDRESS: JOB DESCRIPTION: City of Wheat Ridge Residential Roofing PERMIT - 201705357 201705357 ISSUED: 08/03/2017 7170 W 42nd AVE EXPIRES: 08/03/2018 Residential Re -roof and Re -deck to install Owens Corning asphalt shingles with 23 sq. **REVISION**Added flat roof portion of roof to permit; 2.5 squares; Added valuation: $1,500.00 *** CONTACTS *** OWNER REVOLVE CONSTRUCTION SUB (720)231-4156 Jared Phifer 150033 Revolve Construction *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: OA / Unassigned *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,100.00 Total Valuation FEES0.00 Use Tax 212.10 Permit Fee 220.15 Investigative Fees 140.90 ** TOTAL ** 573.15 *** 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� A �e PERMIT NO: JOB ADDRESS: JOB DESCRIPTION: City of Wheat Ridge Residential Roofing PERMIT - 201705357 201705357 ISSUED: 08/03/2017 7170 W 42nd AVE EXPIRES: 08/03/2018 Residential Re -roof and Re -deck to install Owens Corning asphalt shingles with 23 sq. **REVISION**Added flat roof portion of roof to permit; 2.5 squares; Added valuation: $1,500.00 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 ate 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 ermtt. I further attest that I am ley to t1�clucle all entities named within this document as parties to the work'to be perfo�rtted-arfdfhat all work toc ose 'n this document and/or its' accompanying approved plans and specifications. 'LJLG".� Signature of ER(* CONTRACTOR_(Circle one) Date I. This permit was issue on the ' eitfiation provided in the permit application and accompanying plans and specifications and is subject to the compliance wit t ose documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This.permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Isuance of a new permit shall be subject to the standard requirements, fees andprocedures for approval of any new permit. Re -issuance or extension of expired 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, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Officra1� 'l„a F ” REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY PA INSPECTION THE FOLLOWING BUSINESS DAY. - City of ' Wheat �idge COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: perm its(ki.wheatridge.coms FOR OFFICE USE ONLY Date: Add to Permit #01 � 0 IV C j DD�- Com/ Building Permit Revision/Amendment Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: Property Owner (please print): Phone: Property Owner Email: Mailing Address: (if different than property address) Address: City, State, Zip: Contact Person: -�AV-CZ V--tA"vz Phone: (7)6) /'" x to f Contractor: Contractors City License #: ) Phone: jai I— H I SC yc jbt Contractor E-mail Address: Please Note: Additional valuation must include all general and subcontracted work to be performed related to the revisions and/or amendments declared in the description of work and which were not included in the original permit valuation. If revisions or amendments increase the original valuation, additional fees will be due at the time of approval. Depending on the scope of work, additional plan review fees may be due upon approval ($60.00 an hour — 2 hour minimum). Description of revised/amended work: tA- %=,F ol, Z CaV62C,v> Tp,,TW5. Sq. Ft./LF Amps Btu's Gallons Squares Other Additional Project Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above) OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) PRINT NAME:. SIGNATURES _ : ; ��•'' DATE: ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: PROOF OF SUBMISSION FORMS Fire Department ❑ Received ❑ Not Required Water District ❑ Received Sanitation District 0 Received DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: ❑ Not Required ❑ Not Required Building Division Valuation: $ v i CITY OF WHEAT RIDGE =. V, t Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 2= t Job Address: 95/lo �� iV Permit Number: Irl 3 5- L) ❑ No one available for inspection: Timer-) i AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: fid/t r�// rte' 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 ICE Inspection Type: Job Address: -.'577 7 </T 7 7 2v Permit Number: 1 ' ; 'i r n c; , L,-.- /.,' • -i c . J ❑ No one available for inspection: TimeO i �/PM Re -Inspection required;'` Yes ,No S When corrections have been made, call for re -inspection at 303-234-5933 t Date: �� l� Inspecto�/ I DO NOT REMOVE THIS NOTICE t i CITY OF WHEAT RIDGE 3 Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTIOU—NOTICE Inspection Type: Job Address: Permit Number: ✓ [:f `%/ fJ r nCC 5 c i C ( rCr."=� ❑ No one available for inspection: Time ` AM/PM Re -inspection required: "17 k�io When corrections have been made, call for re -inspection at 303-234-5933 Date: J r� inspector:) r DO NOT REMOVE THIS NOTICE 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: 17 V,` Job Address: 7/7G L,,- L,Z Permit Number: ?r,f 7, y � r7 U, ;,- 6 ❑ No one available for inspection: Time % `�� AM/PM Re -Inspection required: Yes : No i When corrections have been made, call for re -inspection at 303-234-5933 Date: Cl r Inspector: DO NOT REMOVE THIS NOTICE A s_ CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPEC/'TIO��N NOTICE A�. Inspection Type: � r Job Address: fff /-7U Permit Number: v 5 3 i 7 ❑ No one available for inspection: Time {I� AM&M Re -Inspection required: ,Yes` No i,Vhen corrections have been made, call for re -inspection at 303-234-5933 Date: Inspector: rL fart DO NOT REMOVE THIS NOTICE 44, CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: PE Job Address: %!7 y w y2 G U _ Permit Number: ❑ No one available for inspection: Time /ff Re -Inspection required: Yes .No When corrections have been made, call for re -inspection at 303-234-5933 Date: /I`7 Inspector: ` DO NOT REMOVE THIS NOTICE City of Wheat Ridge 06A Residential Roofing PERMIT - 201705357 PERMIT NO: 201705357 ISSUED: 08/03/2017 JOB ADDRESS: 7170 W 42nd AVE EXPIRES: 08/03/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning asphalt shingles with 23 sq. *** CONTACTS *** OWNER REVOLVE CONSTRUCTION SUB (720)276-3614 Eber Dominguez 100344 Eber Dominguez *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATI 5 Q0 FEES Total Valuation 0.00 Use Tax 124.13 Permit Fee 140.90 Investigative Fees 140.90 ** TOTAL ** 405.93 *** 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. �v i CITY OF WHEAT RIDGE 4 �(303) Building Inspection Division _:�(303) 234-5933 Inspection line 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: ✓e- Permit Number: Ll No one available for inspection: Time � a t /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 r0 41 CITY 'OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 0) O 1 Job Address: ""� ! 7 0 W 'q _L L - Permit Number: �L 0 I C O 17 ;t (�i � aJ a l 1� a 6-f' A P /� 0 Y,1 Q i A011 9 nv V A NU PeK m 1, f i Ae-1-\ 6 n, $ , �-'E ❑ No one available for inspection: Time/ Re -Inspection required: Yes No *When corrections have been made, call for re -inspection at 303-234-5933 Date: a ' a 1-7 Inspector:. I DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE �(303) Building Inspection Division (303) 234-5933 Inspection line 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: M I n Job Address: j I ::7 o W �j CYC Permit Number: ,.a cz) ] ❑ No one available for inspection: Time 10,' �Opm Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 r Date:j 1 Inspect DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Roofing PERMIT - 201601727 PERMIT NO: 201601727 ISSUED: JOB ADDRESS: 7170 W 42nd AVE EXPIRES: JOB DESCRIPTION: Tear off and re -roof 37 squares *** CONTACTS *** OWNER (303)274-2700 SOLOMON BEVERLY A GC (303)804-0303 Tom Brown 11/01/2016 11/01/2017 070055 North West Roofing *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: / SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,175.00 FEES PAID Total Valuation 0.00 Use Tax 183.15 _ Permit Fee 220.15 ** TOTAL ** 403.30 *** 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 Alh-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 manufacturera€l"s 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's technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. City of Wheat Ridge Residential Roofing PERMIT - 201601727 PERMIT NO: 201601727 ISSUED: JOB ADDRESS: 7170 W 42nd AVE EXPIRES: JOB DESCRIPTION: Tear off and re -roof 37 squares 11/01/2016 11/01/2017 I, by my si mature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable wilding codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 5 days after the date of issuance regardless of activity. Requests for extension must be ade in writing and received prior to the date o36m f expiration. An extension of no more than 180.days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this pen -nit 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 pen -nits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a 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 r granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicabl c e or.;any o nance Aregulation of this jurisdiction. Approval of work is subject to field inspection. �'°` I I) I I/ In Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. 4ZJ`'l 91P l�cI-7a� Occ INSPECTION RECORD upancv/Ivae 3 75ej INSPECTION REQUEST LINE: (303) 234-5933 Inspections will not be performed unless this card is posted on the project site. Call the inspection request line before 11:59 p.m. 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 Ins Underground/Slab Inspections Date Inspector Comments Initials Electrical Sewer Service Plumbing Do Not Cover Underaround or Below/In-Slab Work Prior To AI Rough Inspections Date Inspector Initials Comments Wall Sheathing Mid -Roof Lath / Wall Tie Rough Electric ` Rough Plumbing/Gas Line Rough Mechanical Rough Framing 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. Insulation Fire Inspection / Fire Protection Dist. 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. City of Wheat Ridye 11/61/2016 12:27 CDBA Tear off and re -roof CDA013524 AMOUNT BPSP 7176 W 42nd AVE 463.30 ADPL/PERMIT NO: 201601727 PAYMENT RECEIVED AMOUNT VS / 1695 403.36 AUTH CODE: 023609 TOTAL 403.30 ---------------------------------------- Final Inspections Date Inspector Initials Comments Final Electrical Final Plumbing Final Mechanical Roof Final Window / Doors Final Building 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. Fire Inspection / Fire Protection Dist. 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 rare uistrici dlJU Cltll 11 Hol IUw vvnayc by the Building Division. "For Inspection Time Window Requests —Please email insptimerequest(c ci wheatridge.co.us by 8:00 A.M. the day of the inspection with the property address in the subject line of the email. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather Nov/01/2016 11 ,55,56 AM Northwest Roofing 8888465545 1/2 '•- City of Date:_j0PrWh6atF4'd COMMU�iiTy DEVEIAPMENT Permit #k Building Division aD*0l W 7500 W. 29" Ave., Wheat Ridge, CO 80033 Once: 303-235-2855 " Pax: 303-237-8929 Inspection Line: 303-234-5933 Facsimile Building Permit Application Property Address:Phtane; Property Owner (please print): �es►lS��`1rvv.nc� Malting Address: (d different than property, addre Address; 11 I F�, c,- , . , n r1�r _ •r~� \ City, State, zip: I ()kV c Contractor: Contractor License —iJ Q-0 Phone: Slid Colltr Ctors: Co-Iny Name: Cleanse #• Ion Qt: Tad® n: a); Use Of space (description): Description of work: Plan Review (due at true Of submlttel):16- Sq. Ft./L.Ft added:S uarea BTU's _ Gallons Amps OWNERICONTRACTOR SIGNATURE OF UNDERSTANDING ANO AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate 8171310131a 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 reed and agree to oblde by all conditions printed on this application and that !assume full responsibility for compliance with the Wheat Rldgga Building Codes (I.B.C) and all other applicable Wheat Ridge Ordinences, for work under this permit Plans subject to field Inspeation. CIRLCE ONE:: (OWNER) �)NRACTO or PERSONAL REPRESENTATIVE of (OWNER) (CONTRATOR) .. PRINY NAME: SIGNATUR°� _ Date; `y► DEPARTMENT USE ONLY zorriHincoMM�rre: �ottln�: Review+ar PUBLIC WORK$ COMMENTB: Reviewer: RUILMNC DEOARTM ZNT COMtMEMT OCCUPANCY: Revlewter. Bid Valuation: $ FIRE DEPARTf� ENT.". a sppraved w1 comments 0 disapproved 0 na review required Credit Card P yment: Use credit card listed on tile. Date: .�. Print name: Ra M Signature: DEPARTMENT OF COMMUNITY DEVELOPMENT 7500 WEST 29tn AVENUE BUILDING INSPECTION DIVISION PERMIT NO.M91/~17038 237•6944 ExT. 255 P.O. eoX 638 CITY OF WHEAT RIDGE, COLO. THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND RECEIPTED BEL'JW. JOB ADDRESS }(CONTRACTOR iq' ~ e- .yADDRESS CITY PHONE OWNER . ADDRESS 7170 ' W' y2h'd /I "t PHONE If23 ZIP CODE Z_ ' ZIPCODE CONTRACT PRICE $ 17 vV• " DATE 7 - S- 9/' I, TYPE GrounCLJ WoIILJ ProitatinpLJ Ofher Sor DFoce 2. MATERIAL Total Squars Feat SiGNS 3. ILLUMINATION Yea❑ No❑ Typs Elaef. Psrmit No. 4 SET BACK FROM PROPERTV LINE N_ S_ E- W Zone_ ApDrovsd, 2one Inspeetor (Soecifv whieh is front) ❑ ❑ ❑ ❑ Dieaoorwed I. TYPE SolidU Mora Than BO% MATERIAL FENCES 3. SET BACN FROM PROPERTY LINE (Specify whieh is tront) 1. V'e4V101/L old ~ OTHER 2 a. Lest Than 80% Hsipht N_ S_ E_ W Zma_ Apprwed,Zons Inspaeta ❑ ❑ ❑ ❑ DieaDProved e- 'F- h o u s c, DRAW.SKETCH OR SHOW BEIOW,THE FENCE,SIGN,OR OTHER STRUCTURE,GIViNG DISTANCES FROM PROPERTY LINES. (SETBACKS OR PROJECTIONS INCLUDED) ' i ~ J y r f z SPECIfY NORTH ~ H LICENSE N0. STREET NAME SHOW DISTANCES FROM THE MAIN BUILDIN6 TOADJOINING HOUSES, STREETS, AND PROPERTY LINES;ON IRREGULAR 10T5, SHOW LEAST DISTANCE TO PROPERTY LINES,NOT MAXIMUM OR AVERAGE DISTANCE. APPLICATION FOR PLUMBING; ELECTRICAL; MECHANICAL PERMIT THIS APPLICATION WILL BECOME A PERMITTO PERFORM THE INDICATED WORK ONLY UPON VALIDATION BYTHE BUIIDING INSPECTION DIVISION. PERMIT WILI EXPIRE 180 DAYS FROM THE DATE OF ISSUANCE IF WORK IS NOTSTAfiTED WITHIN THAT TIME. ELECTRICAL PERMIT STATE IICENSE N0. PLUMBING PERMIT STATE LICENSE N0. MECHANICAL PERMIT ALUMINUMWIREUNDERSIZE81l.lEGAL FLOOR BSM IST 2ND 3RD 4TH N0. FIffLCircbOneGoShcPropane ElxSolar NO. WATER CIASET FORCED AIR - BTU TEMPORARY METER WASH 80WL HOT WATER - BTU NEW SERVICE AMPS BATH TUB STEAM - BTU CHANGE SERVICE-AMPS SHOWER AIR CONDITIONING-9TU LIGHTING SINK OTHER HEATING GARBAGE DISP REFRIGERATION SYSTEM POWER SUB-CIFCUITS WATER HEATER Refri erant fnoup UTILITY(RANGE,DISPOSER,ETC) AUTO. WASHER pounds CAor e FIXTURES DISH WASHER AUTOMATIC SPRINKLER SYSTEM WIRING MOTORS B: CONTROLS FLOOR DRAIN ELEVATOR SIGNS URINAL - TRANSFORMERS d RECTFIERS SEWERS ADDITION TO OlD WORK OTHER MOTORS OVER I HP TOTAI FIXTURES I hereby acknowledqe that this aOPlica- fion is eorreci and understond ihat I connof ttort this projeet until ihis oDGli- eotion is approved. I shall comply wiih tAS lows ot Ihe State o( Colorado and fo }hs ZoninQ Repulations and Buildinq Code of the Cify of Wheat Ridqe. Any violofion of ihe above terme will cause immediate revocafion of this permit 400fieanb SiOnaluu PERMIT FEE 3 oo NPT `/AUD U LESS ~CEIPTEP 4ft9 `a _x.r USE TAx p-o TOTAL FEE $ (o APPROVED CHIEF BUILDIN INSPECTOR,City of Wheat Ridqe CALL 237$944 EXT. 255 " 24 HOURS IN ADVANCE ~ Date Issued FORINSPECTIONS ~ ~