HomeMy WebLinkAbout4735 Newland Streeti CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICI
Inspection Type:
.;i
Job Address:
Permit Number:C��-.�C�
❑ No one available for inspection: Timdc `" z M/I?M
Re -Inspection required: Yep: No
When corrections have been made, sc le fa�cre-inspection online at:
http✓/Www.ci.wheatridge.co.uslinspedf� �''�
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i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: 0
Job Address:
Permit Number:
❑ No one available for inspection: Time6 �7_ / M
Re -Inspection required: Yes No� -
When corrections have been made, schedule for re-inspec' n-o"ge at:
http✓/www.ci.wheatridge.co.u�nspeofion�* � t `N
City of Wheat Ridge
E -Res. Electrical Service PERMIT - 202000220
PERMIT NO: 202000220 ISSUED: 01/31/2020
JOB ADDRESS: 4735 Newland St EXPIRES: 01/30/2021
JOB DESCRIPTION: Electrical upgrade of 200 AMPs in house.
*** CONTACTS ***
OWNER (720)499-5683 KIMMAIRD TYLER
SUB (720)788-2310 AARON DOLCE 190345 MIDWAY ELECTRIC 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: 3,000.00
FEES
Total Valuation 0.00
Use Tax 63.00
Permit Fee 93.35
** TOTAL ** 156.35
*** COMMENTS ***
*** CONDITIONS ***
Both the front and back of this permit are required to be posted on the job site at all
times. If the complete permit is not present, inspections WILL NOT be performed.
Work shall comply with 2012 IRC & 2017 NEC. Smoke alarms shall comply with 2012 IRC Section
134. INTERIOR ALTERATIONS, REPAIRS, FUEL -FIRED APPLIANCE REPLACEMENTS, OR ADDITIONS, ANY OF
WHICH REQUIRE A BUILDING PERMIT, OCCURS OR WHERE ONE OR MORE ROOMS LAWFULLY USED FOR
SLEEPING PURPOSES ARE ADDED SHALL HAVE AN OPERATIONAL CARBON MONOXIDE ALARM INSTALLED
WITHIN FIFTEEN FEET OF THE ENTRANCE TO EACH ROOM LAWFULLY USED FOR SLEEPING PURPOSES
City of Wheat Ridge
E -Res. Electrical Service PERMIT - 202000220
PERMIT NO: 202000220 ISSUED:
JOB ADDRESS: 4735 Newland St EXPIRES
JOB DESCRIPTION: Electrical upgrade of 200 AMPS in house.
01/31/2020
01/30/2021
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
thispernit. I further attest that I a n legally authorized to include all entities named within this document as partes 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 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, any violation of any provision of any
apftltcable code or aqy ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of What Ridge
01/31/2020 09:15 CD8B
Electrical upgrade o
CDDU22459 AMOUNT
APPL/P[RM{T NO; 202000220
PAMENTRUTIVE-1.1 AMOUNT
FP / 9778 156.35
AUTH CODE! 70484671
TOTAL 156.35
_____________________
Dina Kemp
From: no-reply@ci.wheatridge.co.us
Sent: Friday, January 31, 2020 8:24 AM
To: CommDev Permits
Subject: Online Form Submittal: Residential Electrical Service Change/Upgrade Permit
Application
Categories: Dina
Residential Electrical Service Change/Upgrade Permit Application
This application is exclusively for RESIDENTIAL ELECTRICAL SERVICE CHANGE
OR UPGRADE (200 amps or less).
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN
ORDER FOR THE PERMIT TO BE PROCESSED.
Your Permit will be emailed to the email address provided below once it is
processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
Is this application for Yes
electrical service change
or upgrade - 200 amps or
less?
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-4567)
Attach Credit Card
Authorization Form -
**DO NOT ATTACH
RANDOM
DOCUMENTS
4735 Newland Street
Tyler Kinnaird
720-499-5683
Scan 20200131.pdf
CONTRACTOR INFORMATION
Contractor Business Midway Electric INC
Name
1
Contractor's License 190345
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone 7207882310
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Email Address contact@midwaycoelectric.com
Retype Contractor Email
Address
DESCRIPTION OF WORK
Is this an electrical
service upgrade or
change?
Number of Amps
Location of
upgrade/change (garage,
house, etc)
contact@midwaycoelectric.com
Upgrade
'rye
house
Provide additional details, n/a
if needed.
Project Value (contract 3000.00
value or cost of ALL
materials and labor)
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full
responsibility for
compliance with
applicable City of Wheat
Ridge codes and
ordinances for work
under any permit
issued based on this
application.
I understand that work
may not begin on this
property until a permit
has been issued and
posted on the property.
Yes
Yes
z
I certify that I have been Yes
authorized by the legal
owner of the property to
submit this application
and to perform the work
described above.
I attest that everything Yes
stated in this application
is true and correct and
that falsifying
information in this
application is an act of
fraud and may be
punishable by fine,
imprisonment, or both.
Person Applying for Aaron Dolce
Permit
Email not displaying correctly? View it in your browser.
The City of Wheat Ridge,1
Third Party Form Check List --.-
Property Address 4735 Newland St, Wheatridge, CO 80033
Permit Number 201705- cy
Permit Issued Date 7/28/2017
Owner Information
Property Owner Information Courtney Christensen
Property Owner Address 4735 Newland St Wheatridge: CO
Inspector Information
Inspection Company Safe uilt
Inspector Name w
Inspector Contact info.
Inspector Statement and Acknowledgement
* I hearby acknowledge the roof I am inspecting is 6/12 or over. All roofs
that are under 6/12 must be inspected by the City of Wheat Ridge Buiding Dept.
* I hearby acknowledge the roofing system for the referenced building has been inspected
and found to be in compliance with the minimum requirements of the 2012 IRC and 2012
IBC as well as all City of Wheat Ridge Policies and Procedure and Manufacturer's
recommendations and sp ons.
Inspector: Date: fg
Property Owner Statement of Acknowledgement
*1 hearby acknowledge that I am the owner of the building referenced above and I give
my consent for the listed third -party inspection company to perform my roof inspection
in lieu of the City of Wheat Ridge Building Division inspection.
Propery Owner/Agent: Date: 1/23/2018
This original document and permit card, as well as the roofing check list, must be submitted tc
the Chief Building Official within seven days of the final inspection.
Drop off in person
Permit counter 2nd floor
7500 W. 29th Ave
Wheat Ridge CO 80033
Draft Date: 7/26/17
Cve i%cC. 1()
� �
6r\t f -e -,VL Y 0C } IniPlease add note to reverse side
The City of Wheat Ridge
Third Party Form Check List
Please add note to reverse side
The City of Wheat Ridge
Inspection Check List notes
Mid -Roof
Roof inspection
❑ N/A
W Pass
❑ Fail
❑ N/A
V&Pass
❑ Fail
Structural roof components
❑ N/A
Pass
❑ Fail
Verify that no more than 2 layers of shingles exist
❑ N/APass
EJFail
Flashing for roof and walls
Pass
❑ Fail
If new sheathing is installed verify that it is listed in the
permit description (Valuation must be adjusted)
❑ N/A
Pass
F]Fail
Verify sheathing nail pattern (See Policy & Procedures)
❑ N/A
Pass
❑ Fail
Crickets and saddles where needed
❑ N/A
Pass
❑ Fail
Verify B vent must have boot same gauge as pipe
❑ N/A
Pass
❑ Fail
Verify vent caps
N/A
Pass
❑ Fail
Verify no flashings are damaged or rusted
❑ N/A
Pass
❑ Fail
Step flashing shall be min. of 4x4 piece per shingle
XN/A
❑ Pass
❑ Fail
Verify scuppers allow for proper drainage
❑ N/A
Pass
❑ Fail
Ice and water shield 2' in heated wall spaces
❑ N/A
&Pass
❑ Fail
Underlayments must follow 2012 IRC / 2012 IBC
❑ N/A
R Pass
❑ Fail
Verify roof slope for proper drainage
❑ N/A
Pass
❑ Fail
Dripedge shall have min of 2" overlap
❑ N/A
9 Pass
❑ Fail
Dripedge should extend down min 2" past roof deck
17 N/A
' 4 Pass
❑ Fail
Dripedge shall be mechanicaly fastened 12" OC
[ N/A
❑ Pass
❑ Fail
90 LB roll roofing shall not be applied to roof slopes
less than 2:12 slope: Exception, detached garages,
patios, carports, open on three sides with min. slope of
1:12
❑ N/A
Pass
❑ Fail
Modified Bitumen, EPDM, TPO min slope 1/4:12 slope
❑ N/A
,� Pass
❑ Fail
Above roof insulation R-25
bJfN/A
❑ Pass
❑ Fail
Below roof residential R-38
U N/A
❑ Pass
❑ Fail
Below roof commercial R-32
❑ N/A
Pass
❑ Fail
Modified Bitumen, EPDM, TPO min slope 1/4:12 slope
must be installed in accordance with the manufacturers
specifications- Must have manufactures letter of
warranty with the address on the letter for final inspection
Metal Roof Shingles
Requirements
❑ Pass
❑ Fail
Metal roof shingles shall not be installed on slope less
tkN/A
3:12
N/A
❑ Pass
❑ Fail
Metal valley flashing shall be the same material as roof
N/A
❑ Pass
❑ Fail
Metal valley flashing shall extend a min of 8" from the
centerline with a min. of 3/4 " high splash diverter
rib built-in at the flow line with sections overlapping a
a min. of 4"
Tile Roofs Requirements
❑ Pass
❑ Fail
Clay and concrete tile shall have a min. 2-1/2:12 slope
/AN/A
Slopes 4:12 and under require double underlayment
The City of Wheat Ridge
Inspection Check List notes
Mid -Roof
Notes
j P_Pok-
Company Name:
Inspector signature:
Date of Inspection: /V ( E
The City of Wheat Ridge
1 a
Third Party Form Check List
Property Address 4735 Newland St, Wheatridge, CO 80033
Permit Number --Z8--�(
Permit Issued Date 7/28/2017
Owner Information
Property Owner Information Courtney Christensen
Property Owner Address 4735 Newland St, Wheatridge, CO
Inspector Information
Inspection Company Safebuit
Inspector Name
Inspector Contact info. ;)-7
Inspector Statement and Acknowledaement
* I hearby acknowledge the roof I am inspecting is 6/12 or over. All roofs
that are under 6/12 must be inspected by the City of Wheat Ridge Buiding Dept.
* 1 hearby acknowledge the roofing system for the referenced building has been inspected
and found to be in compliance with the minimum requirements of the 2012 IRC and 2012
IBC as well as all City of Wheat Ridge Policies and Procedure and Manufacturer's
recommendations and tions.
Inspector: Date: f
Property Owner Statement of Acknowledgement
*1 hearby acknowledge that I am the owner of the building referenced above and I give
my consent for the listed third -party inspection company to perform my roof inspection
in lieu of the City of Wheat Ridge Building Division inspection.
Propery Owner/Agent: 6e � Date: 2/15/2018
This original document and permit card, as well as the roofing check list, must be submitted to
the Chief Building Official within seven days of the final inspection.
Drop off in person
Permit counter 2nd floor
7500 W. 29th Ave
Wheat Ridge CO 80033
Draft Date: 7/26/17
Please add note to reverse side
The City of Wheat Ridge
Third Party Form Check List
Please add note to reverse side
The City of Wheat Ridge
Inspection Check List notes
Final Roof
Roof Inspection
❑ N/A
ig Pass
❑ Fail
❑ N/A
Pass
❑ Fail
Structural roof components
❑ N/A
Pass
❑ Fail
Verify that no more than 2 layers of shingles exist
❑ N/A
Pass
❑ Fail
Flashing for roof and walls
Pass
❑ Fail
If new sheathing is installed verify that it is listed in the
permit description (Valuation must be adjusted)
N/A
Q Pass
❑ Fail
Verify sheathing nail pattern (See Policy & Procedures)
❑ N/A
Pass
❑ Fail
Crickets and saddles where needed
❑ N/A
Pass
❑Fail
Verify B vent must have boot same gauge as pipe
❑ N/A
Pass
❑ Fail
Verify vent caps
❑ N/A
�4 Pass
❑ Fail
Verify no flashings are damaged or rusted
❑ N/A
0 Pass
❑ Fail
Step flashing shall be min. of 4x4 piece per shingle
J�_4N/A
❑ Pass
❑ Fail
Verify scuppers allow for proper drainage
❑ N/A
0 Pass
❑ Fail
Ice and water shield 2' in heated wall spaces
❑ N/A
�q Pass
❑ Fail
Underlayments must follow 2012 IRC / 2012 IBC
❑ N/A
9 Pass
❑ Fail
Verify roof slope for proper drainage
❑ N/A
K Pass
❑ Fail
Dripedge shall have min of 2" overlap
❑ N/A
a Pass
❑ Fail
Dripedge should extend down min 2" past roof deck
❑ N/A
Pass
❑ Fail
Dripedge shall be mechanicaly fastened 12" OC
ZJ-N/A
❑ Pass
❑ Fail
90 LB roll roofing shall not be applied to roof slopes
less than 2:12 slope; Exception: detached garages,
patios, carports, open on three sides with min. slope of
1:12
❑ N/A
X—Pass
❑ Fail
Modified Bitumen, EPDM, TPO min slope 1/4:12 slope
❑ N/A
�4 Pass
❑ Fail
Above roof insulation R-25
,jam N/A
❑ Pass
❑ Fail
Below roof residential R-38
ES -N/A
❑ Pass
❑ Fail
Below roof commercial R-32
❑ N/A
3Q Pass
❑ Fail
Modified Bitumen, EPDM, TPO min slope 1/4:12 slope
must be installed in accordance with the manufacturers
specifications - Must have manufactures letter of
warranty with the address on the letter for final inspection
Metal Roof Shingles
Requirements
6 -N/A
❑ Pass
❑ Fail
Metal roof shingles shall not be installed on slope less
3:12
N/A
❑ Pass
❑ Fail
Metal valley flashing shall be the same material as roof
RN/A
❑ Pass
❑ Fail
Metal valley flashing shall extend a min of 8" from the
centerline with a min. of 3/4 " high splash diverter
rib built-in at the flow line with sections overlapping a
a min. of 4"
Tile Roofs Requirements
N/A
���V `"`7_
El Pass
❑ Fail
Clay and concrete tile shall have a min. 2-1/2:12 slope
Slopes 4:12 and under require double underlayment
The City of Wheat Ridge
Inspection Check List notes
Final Roof
Notes
Company Name:
Inspector signature:
Date of Inspection:
INSPECTION RECORD
Inspection online form: http://www.ci.wheatridge.co.us/inspection
Cancellations must be submitted via the online form before 8 a.m. the day of the inspection
Inspections will not be performed unless this card is posted on the project site
Request an inspection before MIDNIGHT (11:59 PM) to recei a an inspection the following business day
PERMIT:.L, ADDRESS: JOB CODE: ar-
Foundation Inspections
Date
Inspector
Initials
Comments
102 Caissons / Piers
103 Footing / P.E. Letter
104 Foundation Setback Cert.
105 Stem Walls
106 Foundation wall Insulation
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground / Slab Inspections
Date
Inspector
Initials
Comments
201 Electrical / Cable/ Conduit
202 Sewer Underground Int.
203 Sewer Underground Ext.
204 Plumbing Underground Int.
205 Plumbing Underground Ext.
206 Water Underground
t -
, -- LC -S, T'
Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections
Rough Inspection
Date
Inspector
Initials
Comments
301 Rough Framing
302 Wall Sheathing
303 Roof Sheathing
304 Sheer Inspection
305 Insulation
306 Mid -Roof
t -
, -- LC -S, T'
307 Metal / Lath / Stucco
308 Rough Electrical Residential
309 Rough Electrical Commercial
310 Electrical Meter Residential
311 Electrical Meter Commercial
312 Temp. Const. Meter
313 Rough Plumbing Residential
314 Rough Plumbing Commercial
315 Shower Pan
SEE OVER FOR ADDITIONAL INSPECTIONS
A
PERMIT:.-, 6, ( ) C_ , C dv , ADDRESS: � aL, lUi �-J/&--/-�I JOB CODE:
Rough Inspection (continued)
Date
Inspector
Initials
Comments
316 Rough Mechanical Residential
317 Rough Mechanical Commercial
318 Boiler / Furnace
319 Hot water tank
320 Drywall screw and Nail
321 Moisture board / shower walls
322 Rough Grading
323 Miscellaneous
Final Inspections
Date
Inspector
Initials
Comments
402 Gas Meter Release
403 Final Electrical Residential
404 Final Electrical Commercial
405 Final Mechanical Residential
406 Final Mechanical Commercial
407 Final Plumbing Residential
408 Final Plumbing Commercial
409 Final Roof
410 Final Window/Door
411 Landscape/Park/Planning*
Inspections from these entities shall be requested
one week in advance.
*For landscaping and parking inspections please
call 303-235-2846
**For ROW and drainage inspections please call
303-235-2861
***For fire inspections please contact the Fire
Protection District for your project.
412 Row/Drainage/Public Works**
413 Flood plain Inspection**
414 Fire Insp. / Fire Protection***
415 Public Works Final**
416 Storm Water Mgmt.**
417 Zoning Final Inspection*
418 Building Final Inspection
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 by the Fire District and
Electrical low voltage by the Building Division.
A City of Wheat Ridge
Residential Roofing PERMIT - 201705026
PERMIT NO: 201705026 ISSUED: 07/28/2017
JOB ADDRESS: 4735 Newland ST EXPIRES: 07/28/2018
JOB DESCRIPTION: Residential Re -roof to install GAF ArmorShield II asphalt shingles with
ROOF DECKING - 17 sq.
*** CONTACTS ***
OWNER (720)252-4105 CHRISTENSEN COURTNEY
SUB (303)772-5700 David Prestwich 160236 Stone Creek Roofing & Exterior
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,052.55
FEES
Total Valuation 0.00
Use Tax 211.10
Permit Fee 220.15
Misc. Fee 25.00
** TOTAL ** 456.25
*** 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 - 201705026
PERMIT NO: 201705026 ISSUED: 07/28/2017
JOB ADDRESS: 4735 Newland ST EXPIRES: 07/28/2018
JOB DESCRIPTION: Residential Re -roof to install GAF ArmorShield II asphalt shingles with
ROOF DECKING - 17 sq.
I, by int ire, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this permit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be
perform and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signat re 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 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 and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
A 41 City of Wheat Ridge
Residential Roofing PERMIT - 201705026
PERMIT NO: 201705026 ISSUED: 07/28/2017
JOB ADDRESS: 4735 Newland ST EXPIRES: 07/28/2018
JOB DESCRIPTION: Residential Re -roof to install GAF ArmorShield II asphalt shingles with
ROOF DECKING - 17 sq.
*** CONTACTS ***
OWNER (720)252-4105 CHRISTENSEN COURTNEY
SUB (303)772-5700 David Prestwich 160236 Stone Creek Roofing & Exterior
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,052.55
FEES
Total Valuation 0.00 r ^�
Use Tax 211.10 PA&AL
Permit Fee 220.15
** TOTAL ** 431.25
*** 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.
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION:
City of Wheat Ridge
Residential Roofing PERMIT - 201705026
201705026 ISSUED: 07/28/2017
4735 Newland ST EXPIRES: 07/28/2018
Residential Re -roof to install GAF ArmorShield II asphalt shingles with
ROOF DECKING - 17 sq.
I, by my signature, do herattest that the work to be performed shall comply with all accompanying approved plans and specifications=
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this 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 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 Flans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees 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
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
applic ode or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
'r,AR trL.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Dan Schultz
From:
no-reply@ci.wheatridge.co.us
Sent:
Thursday, July 20, 2017 9:25 AM
To:
CommDev Permits
Subject:
Online Form Submittal: Residential Roofing Permit Application _
Categories: Danny
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�P,
residential roof? '7�G1
How many dwelling units Single Family Home �� '"" `gl -/ l
are on the property?
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number
Property Owner Email
Address
4735 Newland Street
Cortney Christensen
7202524105
jordan@stonecreekroofing.com
<9 4 3 ( - -2_��_
Do you have a signed No
contract to reroof this
property?
It will need to be
provided at the time of
permit pick-up.
CONTRACTOR INFORMATION
Contractor Business
Name
Contractor's License
Number (for the City of
Wheat Ridge)
Contractor Phone
Number
Stone Creek Roofing & Exteriors
160236
3037725700
Contractor Email Address danielle@stonecreekroofing.com
Retype Contractor Email danielle@stonecreekroofing.com
Address
DESCRIPTION OF WORK
Are you re -decking the (:!es
roof?
Description of Roofing GAF Armorshield II
Material
Select Type of Material: Asphalt
If "Other" is selected Field not completed.
above, describe here:
How many squares of the 17
material selected above? /
Does any portion of the No ✓
property include a flat
roof?
If yes, how many squares Field not completed.
on the flat roof? /
TOTAL SQUARES 17 V
(pitched + flat) of all
roofing material for this
project
2
Provide additional detail Replace entire roof on dwelling per contract specifications and
here on the description of building code. Predominant Pitch =7/12
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
Project Value (contract 10052.55
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 Danielle Martin
Email not displaying correctly? View it in your browser.
3
"J� -mm"
STONE CREEK
ROOFING & EXTERIORS
We treat your home like it's our own:"
stonecreekroofing.com
1567 Skyway Drive, Unit A
Longmont, CO 80504
303-772-5700 Office
303-265-9479 Fax
Pr perty Owner.,
Date:
PropertyAddre r
Insurannc�e'Car ier & t1aim A
City, St tel Jp:
Z�C]-C.
Pr ' tManager:
PM's Phone #.
Main Phone:
Alierhate Phone:
Proj ctManager's Email.•
Property Owner's Email:
PM's Supervisor:
Supervisor's Phone A
Work to be completed as follows:
Wermit Furnished, Jurisdiction:
r off #J—layers of composition layers o edar
eWnspect Decking ❑ Install Decking
1pffistall Drip Edge, Color_ , L
cO Eaves akes
I stall Ice & Water Shield
alleys Eaves
[Install 304 Felt. I
ffnstall Synthetic Underlayment
"ingle Manufacturer �;'� � F
>&hingle Type
Ahingle Color
,,,�7TRidge CapL
❑Manufacturer's Warranty
Special
Work:
dosed Valleys ❑ Open Valleys
El Remove Satellite ❑ Reinstall Satellite
,,Wnstall Rubber Pipe Jacks ❑ Install Furnace Caps
--, ?stall Turtle Vents, Color 2n, ,., }r)
Paint Pipe Jacks & Turtle Vents to match
(4ep Flash Sidewalls, Color ro L,)
�,Aep Flash Chimney
Parp and cover property and and as needed
Olean Up & Remove Trash CI Out Gutters
Sweep Yard with Magnet
I work to be completed per applicable building codes
Wone Creek Roofing Five Year Labor Warranty
alone Creek Roofing $1,000,000 Liability Insurance
Work to be completed according to the above specifications in the amount of: $�� .� 5 **
Stone Creek Roofing & Exteriors shall hold in trust any payment received from you until Stone Creek
Roofing & Exteriors has delivered roofing materials to the site or has performed a mcdor•ity of the roofing
work on your property.
"In addition to the above amounts, any and all supplements billed on behalf of Stone Creek Roofing &
Exteriors, and approved by the Insurance Carrier, will become part of the contract and will be paid to
Stone Creek Roofing & Exteriors in addition to contract amount stated above. Code requirements: all
work will be done according to applicable building codes. All work completed as required by applicable
building codes will be billed to Insurance Carrier. Any costs associated with building code requirements
not covered by the Insurance Carrier will be the responsibility oft operty Owner.
PO Initials: Date: -215 SCRE Initials: Date:
Page 1 of 3
• C�Ap roximate date(s) for contracted work to be completed:
Note: the listed dates of service are approximate and not a guarantee and may be amended based
on weat er, material availability, property owner's request for delay, or other unforeseen delays.
• Stone Creek Roofing & Exteriors liability insurance held by: Western Pacific Insurance, 10397 W
Centennial Rd, Littleton, CO 80127. Insurance agent is L.A. Rowe, 829 Main Street, Longmont, CO 80501,
phone 303-684-9034.
• Property Owner is � is not intending to make payment from the proceeds of a property
and casualty "nsurance policy.
proceeds f
nce
•as p dare to be used to pay for the contracted work, Stone Creek Roofing &Exteriors
cannot pay, waive, or rebate all or part of the insurance deductible applicable to the insurance claim for
7w7k�ompleted.
• _Property Owner has the right to rescind this contract and obtain a full refund of any deposit within 72
hours after entering into the contract. Refund of any deposits or payments following rescission of this
contract will be made within 10 days of rescission. If you plan to use the proceeds of a property and
casualty insurance policy to pay for the roofing work, you may rescind this contract within 72 hours after
you receive written notice from the property and casualty insurer that your claim has been denied in whole
or in part. However, Stone Creek Roofing & Exteriors is entitled to retain payments or deposits to
compensate Stone Creek Roofing & Exteriors for roofing work actually performed in a workmanlike manner
consistent with standard roofing industry practices. Stone Creek Roofing & Exteriors is also entitled to
compensation for costs incurred for any custom or non -returnable materials that may have been ordered
prior to any contract rescission.
Down Payment: $ 2 0 —Date:
SCBE Initial•
I (We) agree, by signing below, to all the contract conditions on all pages ofthis Vreetnent.
1567 Skyway Drive, Unit A
STONE CREEK
Longmont, CO 80504
ROOFING & EXTERIORS
BBB
303-772-5700 Office
303-265-9479 Fax
We treat your home like it's our own."
stonecreekroofing.Com
• C�Ap roximate date(s) for contracted work to be completed:
Note: the listed dates of service are approximate and not a guarantee and may be amended based
on weat er, material availability, property owner's request for delay, or other unforeseen delays.
• Stone Creek Roofing & Exteriors liability insurance held by: Western Pacific Insurance, 10397 W
Centennial Rd, Littleton, CO 80127. Insurance agent is L.A. Rowe, 829 Main Street, Longmont, CO 80501,
phone 303-684-9034.
• Property Owner is � is not intending to make payment from the proceeds of a property
and casualty "nsurance policy.
proceeds f
nce
•as p dare to be used to pay for the contracted work, Stone Creek Roofing &Exteriors
cannot pay, waive, or rebate all or part of the insurance deductible applicable to the insurance claim for
7w7k�ompleted.
• _Property Owner has the right to rescind this contract and obtain a full refund of any deposit within 72
hours after entering into the contract. Refund of any deposits or payments following rescission of this
contract will be made within 10 days of rescission. If you plan to use the proceeds of a property and
casualty insurance policy to pay for the roofing work, you may rescind this contract within 72 hours after
you receive written notice from the property and casualty insurer that your claim has been denied in whole
or in part. However, Stone Creek Roofing & Exteriors is entitled to retain payments or deposits to
compensate Stone Creek Roofing & Exteriors for roofing work actually performed in a workmanlike manner
consistent with standard roofing industry practices. Stone Creek Roofing & Exteriors is also entitled to
compensation for costs incurred for any custom or non -returnable materials that may have been ordered
prior to any contract rescission.
Down Payment: $ 2 0 —Date:
SCBE Initial•
I (We) agree, by signing below, to all the contract conditions on all pages ofthis Vreetnent.
W
AJ66
STONE CREEK
ROOFING & EXTERIORSBBB
We treat your home like it's our own.'"
'�` a
stonecreekroofing.com
1567 Skyway Drive, Unit A
Longmont, CO 80504
303-772-5700 Office
303-265-9479 Fax
1. All Contracts are subject to approval by Stone Creek Roofing & Exteriors management.
2. Contract price is valid for sixty (60) days.
3. Stone Creek Roofing & Exteriors reserves the right to perform specified work in accordance
with generally accepted roofing and construction guidelines, while adhering to local codes in
effect at the time of contract.
4. All checks must be made payable to: Stone Creek Roofing & Exteriors.
5. All excess materials remain the property of Stone Creek Roofing & Exteriors.
6. Property owner is responsible for Home Owner's Association approval of roofing products
and colors.
7. For the purposes of this contract, completion of work is defined as installation of roofing
materials completed in accordance with this agreement.
8. Property owner acknowledges Stone Creek Roofing & Exteriors as a general contractor, and
as such Stone Creek Roofing & Exteriors will be entitled to ten percent (10%) overhead, and
ten percent (10%) profit, if approved by the insurance company, as part of the claim.
9. An account is defined as past due when 30 days have elapsed from the date of completion
of work. Past due accounts will earn interest at a rate of ten percent (10%) per month. In
addition, if Stone Creek Roofing & Exteriors is required to turn the matter over to an attorney
for collection, the property owner also agrees to pay all costs incurred, including attorney's
fees.
10. Should default of payment occur on this contract, Stone Creek Roofing & Exteriors reserves
the right to place a mechanic's lien on contract property.
11. Stone Creek Roofing & Exteriors shall not be held liable for failure of performance due to
labor controversies, strike, fire, hail, weather, inability to obtain material from usual source, or
any other circumstance beyond the control of Stone Creek Roofing & Exteriors.
12. Our standard workmanship warranty for roofing is five (5) years, and one (1) year for all other
work, however, the company will provide a service call for roof inspection, as long as
property owner still owns the property.
13. Stone Creek Roofing & Exteriors is not responsible for any leaks or water damage below the
roof line caused by excessive wind, ice, or hail during the period of the warranty.
14. A property owner has the right to rescind this contract pursuant to SB38 Section 6-22-104 of
Article 22, Title 6, Colorado Revised Statutes.
15. Stone Creek Roofing & Exteriors will not be held responsible for slight scratching or denting
of gutters, droplets of oil in the driveway, cracks in concrete, or damage to plants and trees.
Furthermore, Stone Creek Roofing & Exteriors will not be held responsible for exterior
damages such as deteriorated: crown molding, stucco, solar panels, evaporative coolers,
siding, existing skylights, or interior damage such as falling dust and debris, cracked plaster,
sheet rock or nail pops, as a result of normal re -roofing.
16. Replacement or repair of the deteriorated decking, fascia boards, swamp cooler, ventilators,
chimneys, counter flashing, or any other work completed for the property owner not explicitly
stated in this contract, are not included in quoted price and will be charged as extra on a time
and material basis.
PO Initials:l� Date:Wt SCRE Initials: Date:
Page 3 of 3
♦ i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 inspection line
(303) 235-2855 Office • (303) 235-2857 Fax
INSPECTION NOTICE
Inspection Type: dp1F .W , 9 yAZ
Job Address: 1/735 AYgoalAy,,> s
Permit Number: C~~~~ea
❑ No one available for inspection: Time ~b AM/PM
Re-Inspection required: Yes 4902
"When corrections have been made, call for re-inspection at 303-234-5933
Date: t Inspector
DO NOT REMOVE THIS NOTICE
♦ i CITY OF WHEAT RIDGE
r Building Inspection Division
1 (303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 235-2857 Fax
INSPECTION NOTICE
Inspection Type: MA- e✓ s' Irif. ,x N~'e/
Job Address: Z735'
Permit Number: c.;
P[
❑ No one available for inspection: Time I AM/PM
Re-Inspection required: es No
"When corrections have been made, call for re-inspection at 303-234-5933
Date: t w/ _r Inspect
l
DO NOT REMOVE THIS NOTICE
~iC~ ~~1 G ~ ~c~l
elfle,,, n
Office: 303-235-2855 x Fax: 303-235-ZB5I
Inspection Line: 303-234-5933
Building Permit Application
,00A s= y-736 1\7ew 1at,-:-cJ. s7-
Property Owner (please print):
Mailing Address: (if different than property address)
rrau a.
Permit#: Z~1C
Phone: 5/3 G-
Address:
City, State, Zip:
Contractor license Phone: 3 90 / -fiV45P 7
Electrical City License Plumbing City License Mechanical City License
Company:(?~Nq(tl:~hf Adedr& Company Company:
Exp. Date:
Exp. Date:
Exp. Date:
Approval:
Approval:
Approval:
Use of s ace descdption): i )15~Yi r<~
N ~f~/Z b~t!
Construction Value: $ 7 5 7?~ 06
n~d
T
tas calculated tier the Building Valuation Data sixeet)
3'
f~
Plan Review (due at time of submrttatJ: $
C rcui
vr ur,.~ca~~
Sq. FtA-.Ft added: Squares BTU's Gallons Amps
OWNERfCONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby ce(rfity that the setback distances proposed by this permit application are accurate, and do not violate applicable erdinances.
rules or "ulaffons of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shovm, and
allegations; made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full
responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
under this permit. Plans subject to field inspection.
CIRLCEOME: (OWNER) CONTRACTOR aERSONAL RE. ES of WN R) (CONTRATOR)
PRINTNAw:'r Yf%JWCdP SIGNATURE: Date:
I'd ILSISES60S 1H9I-13-1QNH3 wui Erg 6002 90 Jdu
41
CITY OF WHEAT RIDGE
, Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office ' (303) 235-2857 Fax
INSPECTION NOTICE 4ti
llGTiG./Gi~-~~~
Inspection Type:
Job Address/Permit Number:
❑ No one available for inspection: #'irne T _ AM/PM
Re-Inspection required: Yes
When corrections have been made`, call for re-insi2ection at 303-2345933
Date:ZZA~ Inspector:
DO NOT REMOV
" 1 City of Wheat Ridge
]~r
Residential Electric PERMIT - 081378
PERMIT NO: 081378 ISSUED: 11/26/2008
JOB ADDRESS: 4735 NEWLAND ST EXPIRES: 05/25/2009
DESCRIPTION: 125 amp overhead service change
CONTACTS
owner 303/432-9456 David Christen
sub 303/935-5495 Beverly Gorshern 01-9569 Candlelight Electric
PARCEL INFO
ZONE CODE: UA USE: UA
SUBDIVISION: 0369 BLOCK/LOT#: 0/
FEE SUMMARY ESTIMATED PROJECT VALUATION: 3,234.00
FEES
Permit Fee 126.50
Total Valuation .00
Use Tax 58.21 V`f
TOTAL 184.71
Conditions:
Must comply w/ 2003 IRC & 2005 NEC.
Subject to field inspections.
I hereby ce tify that the setback distances proposed by this permit application are accurate, and do not violate applicable
ordinanc ules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all
measur ant shown, and allegat' made e accurate; that I have read and agree to abide by all conditions printed on this
appliAtIA/ i and that I ume ul re on bility for compliance with the Wheat Ridge Building Code (I.B.C) and all other
a _ Is Wheat dg di nce r rk under this permit. Plans subject to field inspection.
od'
/12
Signature of contr ctor/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 (1) year. If changes have been or if suspension or abandonment exceeds one (1) year, full fees shall
be paid for a new 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 shall not be construed to be a permit for, nor
an approval of, any violation of the provisions of the building codes or any other ordinance, law, rule or regulation.
All plan review is subject to field inspections.
Signature of Chief Build icial date
`INSPECTION REQUE LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855
REQUESTS MUST B MADE BY RPM PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY..
l ~ 'cam
Office: 303-235-2855 x Fax: 303-23b-Zbbf ~•°•r
W'-040RX99
Inspection Line: 303-234-5933 Permif
Building Permit Application
I
0000
! w*i: y 735" A26 W la tid 57-
Property
caner (please print): Phone: 31 32'~7y~lt
Mailing Ad
dress: (if different than property address)
Address:
City, State,
Zip:
Contracto
LicenseM Phone:3 35-5 14
Electrical C
ity License* Plumbing City License A. Mechanical City License
Company.
Company Company:
Exp. Date:
Exp. Date: Exp. Date:
Approval:
Approval: Approval:
Use spac
description): Construction Value: $ 3a3~1 oD
e
- ° asp N9P duCrheac~ (as calculated per the Building Valuation Data sheet)
SINlJG YLfGTGr Plan Review (due at lime of submttlal): $
j rx/'✓/CL
.G ~•1Lt/JFji_
Sq. Ft.k.Ft a
ded: Squares BTU's Gallons Amps
OWNER/C
NTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby ce
City that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances,
rules or reg
latims of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and
allegations
ade are accurate: that 1 have read and agree to abide by all conditions printed on this application and that I assume full
responatbiii
for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
under this p
rmit° Plans subject to field inspection.
CIRLCEO
E:: (OWNER) ONTRAC or
P
E
(
O3W1-fNER (CON TOR)
RSONAL REPRES TATIVEoof
PRINT NA
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p
E: ~crinaryge r66df0& sIGNATLRE: ,t t.ulVJ`7 j~ s.+ Date: ~~O
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