HomeMy WebLinkAbout4665 Pierce StreetOFWHE'?T~i City of Wheat Ridge Building Division
m 7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-235-2857
c o Inspection Line: 303-234-5933
O<ORP~
Building Permit Application
Date: 07-/231D
Plan
Permit
Property Address: 14Cy~ PM0 C1 YCO Y `3 /J/
Property Owner (please print): MO-A>f~ I.OJ~~S r Phone: ~ Z7 r) i/- ZbO~
Mailing Address: (if different than property address)
Address:
State,
Contractor: (JU1l/!/Llr i~ 24~ :Nc,
Contractor License Phone: 7 0
Sub Contractors:
Electrical City License
Company:
Exp. Date:
Plumbing City License
Company
Exp. Date:
Mechanical City License
Company:
Exp. Date:
Use of space (description):
Description of work:
O ,C , pt 3~ Y/z //o A//i -
Sq. Ft./L.Ft added: Squares
20
Construction Value: $ ~(rJ
(as calculated per the Building Valuation Data sheet)
Plan Review (due at time of submittal): $
BTU's Gallons Amps
OWNERICONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances,
rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and
allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full
responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
under this permit. Plans subject to field inspection. 1. A
CIRLCE ONE:: (OWNER) (CONTRACTOR) or PI
`L~r/Nl
PRINT NAME:
(CONTRATOR)
d-] Bldg Valuation: $