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Home My WebLink About4125 Newland StreetCITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: .� J A-+, Job Address; 0 ` L Permit Number: & ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes' f When corrections have been made, schedule for re -inspection online at: http✓/www.ci.wheatridge.co.usli*--p-osCion ._-~''— \ Daft °:' IrAspect ®� i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Permit Number: ❑ No one available for inspection: Time "TYV A 1PM Re -Inspection required: Yes 60) When corrections have been made, schedule for re -inspection online at: http://www. ci. wheatridge.co. us/inspection Date: k/0 _q—00Mnspector: - DO NOT REMOVE THIS NOTICE City of Wheat Ridge "g E -Res. A/C Replacement PERMIT - 202001984 PERMIT NO: 202001984 ISSUED: 10/05/2020 JOB ADDRESS: 4125 Newland St EXPIRES: 10/05/2021 JOB DESCRIPTION: Replacing 2 ton, 13 seer A/C in backyard. *** CONTACTS *** OWNER (802)318-7191 JAHN JANET ANNE SUB (303)466-4209 ROSALIE COOPER 018111 COOPER HEATING & COOLING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,118.00 FEES A/C Replacement 183.54 Total Valuation 0.00 Use Tax 86.48 ** TOTAL ** 270.02 *** 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 2018 IRC & 2020 NEC. Smoke alarms shall comply with 2018 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 shall have an operational carbon monoxide alarm installed within fifteen feet of the entrance to each room lawfully used for sleeping purposes. � A o City of Wheat Ridge E -Res. A/C Replacement PERMIT - 202001984 PERMIT NO: 202001984 ISSUED: 10/05/2020 JOB ADDRESS: 4125 Newland St EXPIRES: 10/05/2021 JOB DESCRIPTION: Replacing 2 ton, 13 seer A/C in backyard. 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 ermrt. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 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 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 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 of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any ap4**� code or a4yprdinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Cfiief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dina Kemp From: no -reply@ ci.wheatridge.co.us Sent: Friday, October 2, 2020 12:38 PM To: CommDev Permits Subject: Online Form Submittal: Air Conditioner/Evaporative Cooler Permit Application Categories: Dina Air Conditioner/Evaporative Cooler Permit Application This application is exclusively for AIR CONDITIONER OR EVAPORATIVE COOLER. YOU MUST ATTACH THE ELECTRONIC PAYMENT 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. PROPERTY INFORMATION Is this a new install or replacement for an existing AC unit? Is this Residential or Commercial? Property Address Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123-4567) Property Owner Email Address Attach City of Wheat Ridge Electronic Payment Form - **DO NOT ATTACH A PICTURE OF A CREDIT CARD** Replacement of Existing Unit Residential 4125 Newland St. Janet Jahn 802-318-7191 jjinnorthpole@gmail.com Jahn cc auth.pdf CONTRACTOR INFORMATION I Contractor Business Cooper Heating Name Contractor's License 018111 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 303-466-4209 Number (enter WITH dashes, eg 303-123-4567) Contractor Email Address kdaniels@coopergreenteam.com Retype Contractor Email kdaniels@coopergreenteam.com Address DESCRIPTION OF WORK What type of replacement Air Conditioner unit are you installing? How many tons is the 2 unit? For AC - what is the 13 SEER? For Evaporative Coolers, what is the CFMs? Where is the unit located backyard (for example, rooftop, backyard on ground etc)? Is electrical needed for re- Yes hook? Provide Electrical 018111 Contractor's Wheat Ridge License No. Project Value (contract 4118 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 2 Ridge codes and ordinances for work under any permit issued based on this application. 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. 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 Kathi Daniels Permit Email not displaying correctly? View it in your browser. City of Wheat Ridge Residential Roofing PERMIT - 201703469 PERMIT NO: 201703469 ISSUED: 07/07/2017 JOB ADDRESS: 4125 Newland ST EXPIRES: 07/07/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning- Oakridge asphalt shingles with 18sq House, 1 Story, 5/12 pitch, 1 layer *** CONTACTS *** OWNER (720)697-7777 JAHN JANET ANNE SUB (303)776-5263 James Hooven 140187 Northern Lights Exteriors *** PARCEL INFO *** ZONE CODE; UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,000.00 FEES Total Valuation 0.00 Use Tax 105.00 Permit Fee 125.05 ** TOTAL ** 230.05 *** 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. TI N RECORD Occupancy,Typc INSPEC O INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 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 UT I ne Aaove inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Sewer Service " Plumbing Lath / Wall Tie Do Not Cover Underaround or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing Mid -Roof r� " Lath / Wall Tie Rough Electric' Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw / Nail Final Inspections Date Inspector Initials Comments Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical Roof 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 Uistrict 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 a, Residential Roofing PERMIT - 201703469 PERMIT NO: 201703469 ISSUED: 07/07/2.017 JOB ADDRESS: 4125 Newland ST EXPIRES: 07/07/2018 JOB DESCRIPTION: Residential Re -.roof to install Owens Corning- Oakridge asphalt shingles with 18sq House, 1 Story, 5/12 pitch, 1 layer *** CONTACTS *** OWNER (720)697-7777 JAHN JANET ANNE SUB (303)776-5263 James Hooven 140187 Northern Lights Exteriors *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,000.00 FEES Total Valuation 0.00 Use Tax 105.00 E. Permit Fee 125.05 "" t ** TOTAL ** 230.05 1 *** 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. r City of Wheat Ridge Residential Roofing PERMIT - 201703469 PERMIT NO: 201703469 ISSUED: 07/07/2017 JOB ADDRESS: 4125 Newland ST EXPIRES: 07/07/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning- Oakridge asphalt shingles with 18sq House, 1 Story, 5/12 pitch, 1 layer 1, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable huilding 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 thispermit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all work to be perfo tsclosed ' ocument and/or ' s' ac mpanying approved plans and specifications. 2a Signat e of O r CONTRACTOR irc Date 1. Th . rmit was issued based on the information provided i the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all a icable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of is ce regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extensi n 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 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 applic eeo�r�an,�y ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. /fir`- / • Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. Dan Schultz From: no-reply@ci.wheatri dge.co.us Sent: Monday, June 26, 2017 10:14 AM 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. 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. Permits are currently being processed within 5 business days, subject to change based on volume. 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? J 1 � p - 7/Sh 7 J PROPERTY INFORMATION 'i``` -'"t' J 7"� Property Address 4125 Newland Street Wheat Ridge CO 80033 Property Owner Name Janet Jahn Property Owner Phone 720-697-7777 Number Property Owner Email Field not completed. Address 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 Northern Lights Exteriors Contractor's License 140187 Number (for the City of Wheat Ridge) Contractor Phone 303-776-5263 Number Contractor Email Address Kristen@NorthernLightsExteriors.com Retype Contractor Email Kristen@NorthernLightsExteriors.com Address DESCRIPTION OF WORK Are you re-decking the No roof? Description of Roofing Owens Corning - Oakridge Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 18 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? 6 TOTAL SQUARES of all roofing material for this project Provide additional detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract value or cost of ALL materials and labor) 18 House, 1 Story, 5/12 pitch, 1 layer 5000 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 Kristen Cherry Email not displaying correctly? View it in your browser. 3 NAME: ADDRESS: I 12a- /vt,.L Av4- PHONE 1: %ZO - �5%- %%'7 % SPECIFICATIONS ❑ GRADE OF SHINGLE: Ddu-slo�g I ❑ STYLE OF SHINGLE: LJ COLOR OF SHINGLE: ❑ RIDGE MATERIAL: A--rjo 11 ❑ VALLEY: oma+ w c. ki e � � ❑ VENTS: t� vis POWER VENT: YID ❑ PLUMBING STACKS:- L3METAL EDGING:_ 2, x L f" �rL•..a�w. �I „� ❑ TEAR OFF: � NO 1411 LAYERS ❑ FELT: —-1a / ICE & WATER: v�- r �� ❑ AITCH: S' Z STORIES: I MOVE TRA H FROM ROOF, GUTTERS AND YARD ROTECT LANDSCAPING WHERE APPLICABLE LN/PjI'DL YARD AND DRIVEWAY WITH MAGNETIC ROLLER FURNISH PERMIT SPECIAL ATTENTION AREAS TYPE O. SKYLIGHTS Y 60 GUTTER DAMAGE ® N SIDING DAMAGE Y (�l SCREEN DAMAGE Y (�l SHUTTER DAMAGE N DECK DAMAGE 81 N -a COVER POOL Y DRIVEWAY PASSAGE ® N EMERGENCY REPAIR Y -0 CHIMNEY: LEAKS: INSURANCE COMPANY: CLAIM NUMBER: MORTGAGE COMPANY: ACCT: PHONE # ADDRESS: CITY/STATE: ZIP: FIELD SUPERVISOR: MANAGEMENT APPROVAL: NORTHERN LIGHTS EXTERIORS, LLC 11375 WELD COUNTY ROAD 23 FT. LUPTON, CO 80621 OFFICE: 303-776-5263 FAX: 303-774-1206 DATE: S J10 /---7 _ CITY/STATE �A4 a, 4e.1-0 L PHONE 2 SPECIAL INSTRUCTIONS n �m�lerr�. a �, nmr i'v�Ju�cs+c� Sc vao �.•� ,a ow„ -J r --7v04 fb a J I DELIVERY INSTRUCTIONS COMPANY'S LIMITED WARRANTY FNS - 4 -t --'O Tvue-Years on Replacement & @Tm Year on Repairs Warranty Certificate & Waiver Issued Upon Final Payment General Contractor: Homeowner acknowledges NL EXTERIORS as a general contractor and as such will be entitled to to % overhead and /,o % profit as allowed by insurance industry standards. Insurance/mortgage Company Note: I hereby authorize the insurance and/or mortgage company below to make any checks payable jointly with Northern Lights Exteriors. Terms: This agreement does not obligate the homeowner or NL EXTERIORS in any way unless it is approved by the insurance company and accepted by NL EXTERIORS. When "price agreeable" is determined it shall become the final contract price of $ Pae t ^Svc -mac c. 5(.q and the homeowner authorizes labor and material I accordance with the "price agreement" and the specifications set out herein and on the reverse side hereof to accomplish the replacement or repair. Acce y Homeowner on: Date: / /6 / 1 B Pay e t Method: PAY UPON COMPLETION OF EACH TRADE By: A i CITY OF WHEAT RIDGE _��9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE /i -- Inspection Type: _ Job Address:: - Permit Number: 20/7 a 61 6' ❑ No one available for inspection: -Time f > `L' AM/PM Re -Inspection required: Yes; No,_/ f When corrections have been made, `call for re -inspection at'303-234-5933 Date: f j Inspector: 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: goF Job Address: `i l7 f tri�� Permit Number: `70 4�1 ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: r Lk, Inspector: DO NOT REMOVE THIS NOTICE wominny 014668250 ANDUNT 1 78.098 btu f 11992 VI fIVFD AMOUNT TOTAL ~___= . "OlIg s F Facsimile Building Permit Application ♦ ♦ CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 235 -2857 Fax INSPECTION NOTICE Inspection Type: Job Address: �11�.5 rl �d> 1��.� sT Permit Number: L> 2ZQ -2 1 ,? ❑ No one available for inspection: Time 5!.'YO AM /PM Re- Inspection required: es No * When corrections have been made, call for re- inspection at 303- 234 -5933 Date: /7 Inspector: �7_" ✓ DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: A o o F fl~l~z Job Address: 4125 1V,r1dLxa6 9Y- Permit Number: CJV00S r7e~/~~r<rE~ f No one available for inspection: Time AM/PM Re-Inspection required: Yes No When corrections have been made, call for re-inspection at 303-234-5933 Date: Inspector: 'El DO NOT REMOVE THIS NOTICE {Y BLOCK/LOT#:. 0/ FWHEgi. o R, City of Wheat Ridge Building Division Date: o- ~ P 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855' Fax: 303-235-2857 Plan o Inspection Line: 303-234-5933 °LORPO Permit #:011(60 Building Permit Application Property Address`. W05 A)&t,)>LeallY S-f Property owner (p/ease print): 8IGjnio Phone: 3o3Li67- 1/ZZ7 Mailing Address: (if different than property address) Address: State, Contractor: 0701 /7a{>fp (Ems(` S Contractor License Phone:3o3 3 66 -1.xyy Sub Contractors: Electrical City License Company: Plumbing City License Mechanical City License Company Company: Exp. Date: Exp. Date: Exp. Date: - Approval: Approval: Approval: Use of space (description): Construction Value: $ 3 AOe) Description of work: 7CL,-- ( Q~~ U5 f0 (as calculated per the Building Valuation Data sheet) Plan Review (due at time of submittal): $ ~e =r,sf~t( l~Y~ oc 36~~ AC, De~icr Sq. Ft./L.Ft added: Squares /011, 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 REPRESENT TIVE of(OWNER) (CONTRATOR) q PRINT NAME: A1hcks ZmenGo SIGNATURE: Date: Z~('-Q 07/29/09 15:02:45 City of Wheat Ridge Page 1 bp340-iq ESTIMATE OF VALUATIONS AND FEES mmackey THE FOLLOWING INFORMATION ARE ESTIMATES ONLY AND NOT ACTUAL VALUES. CODE-- DESCRIPTION--- -----VALUATION --------FEE ---USE TAX prm Permit Fee 1,250.00 62.31 0.00 totva Total Valuati 1,250.00 0.00 0.00 use Use Tax 1,250.00 0.00 22.50 TOTAL VALUATION: 1,250.00 FEES VALUATION: 1,250.00 PERMIT FEE: 62.31 USE TAX: 22.50 OTHER FEES: .00 TOTAL FEES: 84.81