HomeMy WebLinkAbout3395 Zephyr Courti CITY.OF WHEAT RIDGE
.Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: 1D
Job Address:
Permit Number:ti`:"`1
❑ No one available for inspection,: Tim AM/FM
Re -Inspection required: Ye o
When corrections have been made, call for re -inspection at 303-234-5933
Date: 1-113 Inspector:
DO NOT REMOVE THIS NOTICE
n.
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: Ce w rt e SV
JobAddress:
Permit Number:
❑ No one available for inspection: Time 6PM
Re -Inspection required: Yes
When corrections have been made, call for re -inspection at 303-234-5933
Date&! V 1 9 -Inspector: �dr1� Lov
DO NOT REMOVE THIS NOTICE
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION
City of Wheat Ridge
Residential Roofing PERMIT - 201802609
201802609 ISSUED: 09/25/2018
3395 Zephyr Ct EXPIRES: 09/25/2019
Reroof OC Duration Teak asphalt shingles; 4/12 pitch; 39 squares
*** CONTACTS ***
OWNER (303)237-7201 LOMBARDI DOLORES E
SUB (303)255-9066 Demetrius Slayton 170488 Perfection Plus Roofing Co.
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,023.00
FEES
Total Valuation 0.00
Use Tax 210.48
Permit Fee 220.15
** TOTAL ** 430.63
*** COMMENTS ***
** CONDITIONS ***
Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be
required for both the midroof and final inspections. The 3rd party inspection report AND
THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat
Ridge. The report MUST BE SIGNED by the Homeowner.
REGARDING ROOF VENTILATION: Roof ventilation shall comply with IBC Sec. 1203.2 or IRC Sec.
R806. The installation of ridge venting requires the installation or existence of soffit
venting. For calculation purposes, one hat or turtle vent equal to one-half of one square
foot of opening.
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.
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION
City of Wheat Ridge
Residential Roofing PERMIT - 201802609
201802609
3395 Zephyr Ct
ISSUED: 09/25/2018
EXPIRES: 09/25/2019
Reroof OC Duration Teak asphalt shingles; 4/12 pitch; 39 squares
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 pr perty and m authorized to obtain this permit and perform the work described and approved in conjunction with
this permit. I further attest t at I am le ly authorized to include all entities n ed within this document as parties to the work to be
performed and that work o be perf0 y is disclosed in this document ar d% r its' accompanying approved plans and specifications.
Signature of OWNER or �ONTRAOIPOR—(Circle one) Date U L I v
1. 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 original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees 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 code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief lguMif g lcial',f "I Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City Of
0W heat j�igge
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: permits(aD-ci.wheatridge.co.us
FOR OFFICE USE ONLY
Date: q / as 1 U
Plan/Permit # ) vn
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: 1 +'
Propertv Owner
Property Owner Email:
Tenant (Commercial Projects Only)
Phone:
Property Owner Mailing Address: (if different than property address)
_ - --'?�
Address: =
1
Citv, State, Zip: 3
Arch itect/Eng1neer E-mail: Phone:
i
Contractor Name: �) din 1�(� �� ^� ff) P(\f
City of Wheat Ridge License #: Phon
Contractor E-mail Address: I U
For Plan Review Questions & Comments (please print):
}}
CONTACT NAME (please print): U 1 M ^� J
CONTACT EMAIL(p/ease print): Kt'
Sub Contractors (Must provide Wheat Ridge License No.):
Electrical: Plumbing:
W.R. City License # W.R. City License #
JJ
966
Phone.
Other City Licensed Sub: Other City Licensed Sub:
City License'# City License #
Mechanical:
W.R. City License #
r
❑COMMERCIAL []RESIDENTIAL
Description of work: For ALL projects, 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.
9 "N
Sq. FULF
Amps
BTUs
Squares
Gallons
Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load:
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. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER)
Signature (first and last name):
Printed Name: • (rt t t
ZONING COMMMENTS:
Reviewer.
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
REPRESENTATIVE) of (OWNER)(CONTRAC
DATE: ~I y r
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
31 �sas�=loaa30'
Building Division Valuation: 4 A --s
tb . City of Wheat Ridge
r>
Resid. Windows/Doors PERMIT - 201801752
PERMIT NO: 201801752 ISSUED: 06/18/2018
JOB ADDRESS: 3395 Zephyr CT EXPIRES: 06/18/2019
JOB DESCRIPTION: Replacing 8 windows like for like. U factor will be .30 or better.
*** CONTACTS ***
OWNER (303)237-7201 LOMBARDI DOLORES E
SUB (303)945-1519 Matthew Seiler 130206 Renewal by Andersen
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 25,280.00
FEES
Window Replacement 50.00
Total Valuation 0.00
Use Tax 530.88
** TOTAL ** 580.88
*** COMMENTS ***
*** CONDITIONS ***
Windows shall comply with all applicable codes, have a .32 or better U -factor and shall be
safety glazing if within a tub enclosure, less than 18 inches above the floor or within 24
inches of a vertical edge of a door.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanyingg approved plans and specifications,
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am t7�e legal owner or have been authorized
by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this ermit. I further 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 York 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 thepermit 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 tee.
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 f a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applicaode or any o mance 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.
City of
WhEatl�gc
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
FOR OFFICE USE ONLY
Date:
I U)/
Plan/Permit #
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: 3395 Zephyr Ct
Property Owner (please print): Dolores Lombardi Phone: 303-237-7201
Property Owner Email:
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Arch itectIEngineer:
Architect/Engineer E-mail:
Contractor: Matthew Seiler
Contractors City License #: CL3-130206
Contractor E-mail Address: mseiler@renewalcolorado.com
Sub Contractors:
Electrical:
W.R. City License #
Other City Licensed Sub:
City License #
Plumbing:
W. R. City License #
Phone:
Phone: 303-945 1519
Other City Licensed Sub:
City License #
Mechanical:
W.R. City License #
Complete all information on BOTH sides of this form
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. FtJLF
Amps
Replacing 8 windows like for like. U factor will be .30 or better.
Btu's
Squares
Gallons
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$ 25,280
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
1 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 t 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 1 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) 'o{f,(OWNER) (CONTRACTOR)
PRINT NAME: Matthew Seiler SIGNATURE: Fix �r]ir DATE:
—r --
ZONING COMMMENTS
Reviewer,
BUILDING DEPARTMENT COMMENTS`
Reviewer:
PUBLIC WORKS COMMENTS
Reviewer
PROOF OF SUBMISSION FORMS
Fire Department ❑ Received ❑ Not Required
Water District ❑ Received ❑ Not Required
Sanitation District ❑ Received ❑ Not Required
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION'
Building Division Valuation: $
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i
i CITY OF WHEAT RIDGE
r-j Bung Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: PM
Job Address: 534 74,y C .
Permit Number: 1 yQ f n
e -Fj
❑ No one available for inspection: Time AM &
Re-Inspection required: Yes
"When corrections have been made, call for e-.nspection att303t234v933
Date: Inspector: err P ~,.It
DO NOT REMOVE THIS NOTICE
INSPECTIOW RECORD Occupancy[Type
'VANSPECTION 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.
INSPECTOVMUST SIGN ALL SPACES PERTAINING To THIS JOB
FOUNDATION INSPECTIONS
DATE
INSPECTOR
INITIALS
COMMENTS:
Footings/Caissons
Mechanical
Roof
Sternwall / (CEG) Concrete
Encased Ground
Building Final
Reinforcing or Monolithic
0 0 0 V
. ;rain e
INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS
OLLLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
Weatherproof / French nmin
* NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A
CERTIFICATE OF OCCUPANCY ISISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTEAUTHORIZATION
OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY.
Sewer Service Lines
Water Ser
CONCRETE SLAB FLOOR
Electrical (Underground)
Plumbing (Underground)
Heating (Underground)
POUR No CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGHS
Sheathing
Lath / Wall tie
Mid-Roof
Electrical Service
Rough Electric
Rough Plumbing
Gas Piping
Rough Mechanical
Framing
Insulation
Drywall Screw
FINALS
Electrical
Plumbing
Mechanical
Roof
Building Final
F De p a,, m TIT
rim
rim
m
0 0 0 V
. ;rain e
INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS
OLLLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
Parking & Landscaping
* NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A
CERTIFICATE OF OCCUPANCY ISISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTEAUTHORIZATION
OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY.
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED
PROTECT THIS CARD FROM THE WEATHER
♦ i CITY OF WHEAT RIDGE
Building Inspection Division
r (303) 234-5933 Inspection line -
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
r
Inspection Type: M k
Job Address: ~ ~ p L9
Permit Number: n9
i
F:
r>
❑ No one available for inspection: Time r~' 1 AM V6
Re-Inspection required: Yes No
"When corrections have been made, call for re-inspection at 303-2342933
i
Date: Inspector: r`_ ~
DO NOT REMOVE THIS NOTICE
♦ i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 h spection line
(303) 235-2855 Office- 929,Fae
INSPECTION NOTICE
Inspection Type:
Job Address:,
Permit Number:)1 i
A /7
❑ No one available for inspection: Timeja' 2~ An .M
Re-Inspection required: No
When corrections have been made, call for re-inspection at 303-234-5933
((rY Date: `1t Inspector:
t.
t ~
DO NOT REMOVE THIS NOTICE
' A City of Wheat Ridge
l Residential Roofing PERMIT - 093891
PERMIT NO: 093891 :ISSUED( 11/06/2009
JOB ADDRESS:: 3395 ZEPHYR CT EXPIRES: 05/05/2010
DESCRIPTION: Reroof 40 sqs
CONTACTS
owner 303/424-4612 Dolores Lombardi
sub 303/773-7128 Case Arkell 09-0372 Legacy Extriors LLC of Colorad
PARCEL INFO
ZONE CODE: UA USE: UA
SUBDIVISION:2 0568 BLOCK/LOT#: 0/
FEE SUMMARY ESTIMATED PROJECT VALUATION: '.12,000.00
FEES
Permit Fee 272.10n-~'Mnr
Total Valuation ,00
P
Use Tax 216.00"
TOTAL 488.10
Conditions:
6 nail installation & mid roof inspection required. Board sheathing spaced more
thanra 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.'
***Contractor/Property owner shall rprovide 'iadder(s) secured in place for
inpsections.
Subject 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'Rid rdina es, for work under this permit. Plans subject to field inspection.
Big ure contractor/owner date
1. 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.
2 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.
3 If this permit expires, :a new permit may be acquired for a 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 f(1) year. If changes have been or if suspension or abandonment `exceeds one (1) year,'. full feesshall
be paid for atnew permit.
4. No work of any manner shall be done that will. change the natural flow of water causing a drainage problem.
5. Contractor shall notify the Building Inspector twenty-four (24) hours in advance for all inspections and shall receive <
written approval on inspection card before proceeding with successive phases of the job.
6. The issuance of a permit'. or the approval of drawings and specifications shallnot. hP conatrnPd to hP a nP+ mit Fnr nnr
(303)235-2855
S THE FOLLOWING BUSINESS DAY.
Nab
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C: I City of
j X r + Date:
~ct7x>- MUNI3YDEVELOPMENT - Permit#.~a 'q'
I iin-<-
Building Division
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855' Fax: 303-237-8929
Inspection Line: 303-234-5933
Facsimile Building Permit Application
(ar'2,
Property Address: 53 7C Pr F~1~ f
Property Owner (please print): r/oLa CL C~ Lo ~Ayt~ r Phone:'3o3 - ~(2~ f -x(6(2
Mailing Address: (if different than property address)
Address: City State Zip: WttYi CL D6( L Co
Contractor: L a~ c. - 97,,c "G_a , ,n- 5 a -K Lc> t- z- C-
-Contractor License#: 6iQ63-7 2-- Phone: 303- 773-7/2
Sub Contractors:
Company Name: License # Expiration Date: Trade/Profession: Approval:
Use of space (description):
Des((c~triptiorn of work1 - I2-6nO
` 'LIG 12oDt2 7-)0.> cr / S+4'Z t~r
~f tti Q34./1_t.~-sL jar) ~ S/12( r~ „z~ / Plan Review (due at fime ofsubmittalJ: $
Sq. Ft.IL.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 regulatws 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 (LB.C) and all other applicable Wheat Ridge Ordinances, for work
under this permit. Plans subject t ection.
CIRLCEONE:: (OWNER) o PERSONAL REPRESENTATIVE of (OWNER) (CONTRATOR)
PRINT NAME: Cl-, SIGNATURE: - Date:
DEPARTMENT USE ONLY
ZONING COMMENTS
. Zoning:
Reviewer. - - -
PUBUCwORKSCOMMENTS: -
Reviewer.
BUItD1NG DEPARTMENT COMMENTS: - OCCUPANCY:
Reviewer.
- FIRE DEPARTMENT:: 0 appioved wl comments 0 disapproved 0 no review required Bldg Valuation: $
Credit Card Payment: Use credit card listed on file. Date:
Printname:` Signature:
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