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Home My WebLink About4730 Upham StreetCity of Wheat Ridge Residential Roofing PERMIT - 201704769 PERMIT NO: 201704769 ISSUED: 07/25/2017 JOB ADDRESS: 4730 Upham ST EXPIRES: 07/25/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Armorshield asphalt shingles with 26sq replace roof on the main house. pitch 4/12 *** CONTACTS *** OWNER (720)998-3271 CURTIS WILLETT SUB (720)708-4126 Terry Marks 130138 Home Guard Services LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,682.00 FEES Total Valuation 0.00 Use Tax 140.32 Permit Fee 156.75 Misc. Fee 25.00 ** TOTAL ** 322.07 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt single installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A _l.addel 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. L IV INSPECTION RECORD I� INSPECTION O LINE 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 Occupancy/Type 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 Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Sewer Service Plumbing Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall A id -Roof `6 �� ath / Wall ' EE� ric * Rough Plumbing/Gas Line Rough Mechanical Rough Framing Vw- 1 -0000 Rough Grading Nalor_ Insulation d1or 100F, 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 �5 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 City of Wheat Ridge Residential Roofing PERMIT - 201704769 PERMIT NO: 201704769 ISSUED: 07/25/2017 JOB ADDRESS: 4730 Upham ST EXPIRES: 07/25/2018 J0'3 DESCRIPTION: Residential Re -roof to install GAF Armorshield asphalt shingles with 26sq replace roof on the main house. pitch 4/12 *** CONTACTS *** OWNER (720)998-3271 CURTIS WILLETT SUB (720)708-4126 Terry Marks 130138 Home Guard Services LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,682.00 FEES Total Valuation 0.00 Use Tax 140.32 Permit Fee 156.75 ** TOTAL ** 297.07 * * * COMMENTS * * * *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. lot S� INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Occupancy/Type 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 Wall Sheathing Concrete Encased Ground (CEG) Sewer Service Foundation / P.E. Letter Mid -Roof Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Wall Sheathing 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. Sewer Service Mid -Roof Plumbing Fire Inspection / Fire Protection Dist. Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing 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. Mid -Roof Fire Inspection / Fire Protection Dist. Lath / Wall Tie Final Plumbing Rough Electric' Final Mechanical Rough Plumbing/Gas Line Roof Rough Mechanical Final Building Rough Framing 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. 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 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 A City of Wheat Ridge Residential Roofing PERMIT - 201704769 PERMIT NO: 201704769 ISSUED: 07/25/2017 JOB ADDRESS: 4730 Upham ST EXPIRES: 07/25/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Armorshield asphalt shingles with 26sq replace roof on the main house. pitch 4/12 *** CONTACTS *** OWNER (720)998-3271 CURTIS WILLETT SUB (720)708-4126 Terry Marks 130138 Home Guard Services LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,682.00 FEES_- Total Valuation 0.00 .. Use Tax 140.32 Permit Fee 156.75`�-^- ** TOTAL ** 297.07 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. City of Wheat Ridge ` Residential Roofing PERMIT - 201704769 PERMIT NO: 201704769 ISSUED: 07/25/2017 JOB ADDRESS: 4730 Upham ST EXPIRES: 07/25/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Armorshield asphalt shingles with 26sq replace roof on the main house. pitch 4/12 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 this permit. I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be perfo d and that all to be p ormed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature -0,f 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_pennit 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 . applicabl r any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. I�A_44 Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dan Schultz 77� 7 1, From: no -reply@ ci.wheatridge.co.us Sent: Monday, July 17, 2017 1:57 PM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Gina Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received and due to the volume of requests, time to process varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes residential roof? How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number 4730 Upham St. Curtis Willett 720-998-3271 Property Owner Email Field not completed./6 , O 7 Address a rr//;j�V Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. CONTRACTOR INFORMATION Contractor Name Homeguard Roofing Contractor's License 130138 Number (for the City of Wheat Ridge) Contractor Phone 720-708-4126 Number Contractor Email Address fernl@homeguardroof.com Retype Contractor Email fernl@homeguardroof.com Address DESCRIPTION OF WORK Are you re -decking the No roof? Description of Roofing GAF Armorshield Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 26 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 of all 26 roofing material for this proj ect Provide additional detail Replace roof on the main house. Pitch 4/12 here on the description of 2 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) 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 Fern Lytwyn Email not displaying correctly? View it in your browser. 3 SURETY AND LIABILITY INSURER INFORMATION Colony insurance- Policy Number QTE21366 014 Co Stash GIA Risk Management, 13031423-0162, ext, 136 HOMEGUARD 0513 W, 52nd Avenue Suits 106 Arvada, CO 80002 Office720.708.4126 Fax, 720.921.8658 MagterElite ROOFING & RESTORATION info@HlomeGuardRool.carn HomeGuardRoof.com BEI " A ......USTOMER I.... _JzNFORMAITION IRK Name: Deb Green Address, 4730 Upham St. City, Wheat Ridge. CO zip. 80033 Project Address: [if different from above) Home#-, Celt#�, 720-998-3271 Erai(� ciarillett0ariffam.com Insurance Company; Aineftan Family Clan No: 00-315-100863 — Deductible; Sates Representathret Name: Scott Barbich Phone,,, 720-955-2730 Project Manager: Nam- Scott Barbich 720-955-2730 EW,OQFING SYSTEM: SCOPE ORRESTORAT ON SERVICES TO BEPR6 ED STRUCTURESINCLUDED ®Main 177IDeiacheciGa.-age Manufacturer: GAF Type,. 50 yr ArmorShield 11 Color. TBD Ridge Material, 9eai•a Ridge UnderLayment: Synthetic Leek Barrie- 0 Eaves F—i k:alley it Per Code N Penetrations Drip Edge 10 Eaves Rakes n Color R,,ashing [:1 Sidevval: ❑ Chimney Venittaticu) [I Turtle 171 Ridge [I Edge E3 Other Plumbing Bouts Is N Paint All Root Accessories NRemove trash from roof gutters & yard a Roil :awn & drive with magnetic sweeper M Furnish permit [:1 Miscellaneous; SERVICE AGREEMENTS GAF ROOFING SYSTEMS i U, � 50 -year SO -year manufacturer warranty manufacturer warranty K�_11-fTE-1 STANDARD 25- ear service policy 10 -year service policy M-Y.a 10-yar triainurad,iriir warranty manufadanrwarramy "ear l—atpoiicy 2 -year N 41 wiork""Itip "runtyo?, rorated ........... ROOF SYSTEM Material, - Material - Manufacture Standard Manufacture Standard Workmanship 5 yrs Workmanship 2 yrs LOW SLOPE AREAS Material Type Out-of-pocket upgrade costs Manufacturer-- Color— Custo'ner Initials .. ....... . A P ST Tal :SERVICES TO BE PROV113ED oi All additional areas of construction wilt be repaired or replaced with high grade materials of like kind and quality SERVICE AGREEMENT SGuiters Mater at �PAaL utast RPaint/Stairr 05iding C10ndows, []Intersor E]Skyt.,ght ElOtries" Ora Standard Notes: "Scope of Restoration Services Provided shall include any additional supplements and sermces approved by Customer's insurance company and accepted by Company. This Agreement does NOT clitgate the Customer nor Company in any way unless the insurance riairrini approved fat repairs or reptaceinent to the above mentioned/written scope of restoration services to be provided by Customer's insurance camilany and excepted by Company.. Customer's sionalure'beilow, signifies acceptance of all terms and conditions of this Agreement, including alt terms on the reverse side hereat. Customer's total out of packet expenses are not to exceed Insurance deductible plus upgrades for non -insurance items. Customer Payment is due upon completion of each trade. Company and its authorized representatives are NOT acting as public insurance adjusters. Att work is installed per the manufarturer's imlattahori instructions & the local building codes. Agreed Price: Par Insurance shall be the total amourm due to Company under this Agreement, which is subject to any additmns and/or deductions pursuant to outhonzed insurance suppiemeritr or as set fort; on the reverse side hereof. Total estimated cost of any non -insurance upgrades shaft be:, Approximate perforin fice o Substantial conimencenrent of virork shall mean either the physical dalg5y of maleriats onto the premises or the a 'abor and shall be any pe^miss 's as per provision 141 on the reverse side, App ate: — Approximate Completion Date: - Tt3----- By signing this Agreement you agree that you have also been provided notice of this right to cancel orally in addition to the writing contained herein. This cantract is'subject to Company management review & apprivat. I accept the above terms of this contract and authorize Company to proceed. rk C_ Q3 5/23/17 Date Approved and Aoreple 011ie P, roved at rcceo Omar' Approved and Accepted (CustomeO Date 1 have received the 'Things to Remember"' document InitialS, RIGHT OF CANCELLATION PURSUANT TO FEDERAL REGULATION AND COL. REV. STAT. 6 5-3-403: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. RIGHT OF CANCELLATION PURSUANT TO COL. REV. ST. -b-22-104: YOU, THE BUYER, MAY CANCEL THIS AGREEMENT AT ANY TIME WITHIN 72 HOURS AFTER YOU HAVE BEEN NOTIFIED THAT YOUR INSURER HAS DENIED YOUR CLAIM TO PAY FOR THE GOODS AND SERVICES TO BE PROVIDED UNDER THIS AGREEMENT. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Company shat) hold iin trust any payment from customer until Company has delivered the materials to your property or has performed a majority of the work on the property, 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: /V, Job Address: `"� 6 L"f l,n, 1 Permit Number: ter -,-a F t LlNo one available for inspection: Time ) AM1VI Re -Inspection required: Yes N When corrections have been made, call for re -inspection at 303-234-5933 Date: L- Inspector: ; -, 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: Job Address: Permit Number: I f,- 4, ❑ No one available for inspection: Time t mlpm Re -Inspection required: Yes- _ NO When corrections have been made, call for re -inspection at 303 -234 - Date:— Inspector: DO NOT REMOVE THIS NOTICE 301ION S/HI 3AOn3d ION 00 1 1, 001 :aoloedsul 6El-E0E ui -ai'jol live `epvw ueeq envy suoljoeuoo ueyM sok :paambaa uolloodsul-aa V yvnyy )L ;) auai uuo aol elgellene auo ON 11 )20 :aagwnN Mwaad 710 0 0 /) :ssaippV qoP J-LQ :auA.L uol;aadsul 30110N N01103dSNl Xvzf 6e68-L£0 (COO) • eog{O 358e -5£Z (£OE) � euii uoi;aedsul EE69-tiEZ (006) /J uolslnlU uogoodsul 6ulplln8 -/JJ 39a1d 1V3HM =10 A110 r ♦ A i CITY OF WHEAT RIDGE Building Inspection Division r (303) 234 -5933 Inspection line l /(303) 235 -2855 Office • (303) 237 -8929 Fax INSPECTION NOTICE f-; Inspection Type: Job Address: - 7 � 41 Permit Number: C )9r!) 6 ❑ No one available for inspection: Time 1. AM% M Re- inspection required: Yes o When corrections have been made, call for re inspection at 303 - 234 - 5933 Date: / ° / l Inspector P) .r DO NOT REMOVE THIS NOTICE I n- ♦ 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: i�1f1' Frf Job Address: 1 !7�/ 0 Permit Number: 6q ❑ No one available for inspection: Time Re- Inspection required: Yes * When corrections have been made, call f or re- inspection at f3 3 � l 03- 234 - 5933 Date: 9� 31 -r?q Inspector: DO NOT REMOVE THIS NOTICE ♦ 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: ~f 4F~r'Ad`PPr Job Address: 117;L', jinlnma 0 Permit Number: ez-,0_eg oL.V-eEae ILK ❑ No one available for inspection: Time O h Re-Inspection required: Yes 6 When corrections have been made, call forge-inspection at 303-234-5933 Date: 9.3-667 Inspector: r, IP DO NOT REMOVE THIS NOTICE of ""qT~ city of wheat Klage tsuuaing uivislon 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-235-2857 c o Inspection Line: 303-234-5933 O<ORPO Building Permit Application I Property Address: Ji 73D U f) k ~ Date: 101 Plan Permit#: Property Owner (please print): 11--c- b I-A (.r f-f e Mailing Address: (if different than property address) Phone: 3--7/ t0 - License 01993 g Phone: 31 7Y?- Contractors: Sub Electrical City License Plumbing City License Mechanical City License Company: Company Company: Exp. Date: Exp. Date: Exp. Date: Approval: Approval: Approval: Use of space (description): Construction Value: $ Od Description of work: T>~r" / ,yr„ a r (as calculated per the Building Valuation Data sheet) Plan Review (due at time of submittal): $ ~~'~r- 3 0 ~l fit. Sq. Ft./L.Ft added: Squares 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. CIRLCE ONE:: (OWNER) (CONTRACTOR) or PERSONAL REPRESENTATIVE of 2(OWNER) (CONTRATOR) 7/4-1 PRINT NAME: Lair.a G &e Son SIGNATURE: 1ENy~~*"" l~ a-Aa'~ Date: DEPARTMENT USE ONLY ZONINGCOMMENTS: - zoning: Reviewer PUBLIC WORKS COMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: FIRE DEPARTMENT:: ❑ approved w/ comments ❑ disapproved ❑ no review required OCCUPANCY:- i Bldg Valuation: $ `L.?(//. i Contractor: ~nf~iS7a r~ 1qOO1i,7et_ %,2c .