HomeMy WebLinkAbout3380 Yarrow StreetFrom: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Sewer or Water Line Repair
Date: Thursday, April 14, 2022 9:32:37 AM
CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you
recognize the sender and know the content is safe. Report any suspicious activities to the IT Division.
PERMIT APPLICATION Sewer or Water Line Repair
This application is exclusively for SEWER OR WATER LINE REPAIR -IN YARD
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.
Right of Way permits must be applied for with the Public Works Department.
Is this application for Yes
sewer line or water line
repair - in yard only?
PROPERTY INFORMATION
Is this Residential or Residential
Commercial?
Property Address 3380 YARROW ST
Property Owner Name PATRICIA JOHNSON
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"
303-403-4022
Field not completed.
Electron ic-Payment-Form. Cdf
CONTRACTOR INFORMATION
Contractor Business TRENCH RIGHT
Name
Contractor's License 130022
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone 303-287-9009
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email OFFICE@TRENCHRIGHT.COM
Address
Retype Contractor OFFICE@TRENCHRIGHT.COM
Email Address
01:K163CiIi1 ffl0N]&TO(6]S:/
Is this a sewer line or
Sewer Line
water line repair?
Length of repair
10'
Location of repair
FRONT YARD
(backyard, frontyard,
etc)
Provide additional
INSTALL CLEANOUTS
details including
installation of clean -
outs.
Project Value (contract
5000
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 work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been 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 WILLIAM LOHMAN
Pe rm it
Email not displaying correctly? View it in your browser.
�� -2,� 1 --1 C) I s pj
INSPECTION RECORD
INSPECTION ONLINE 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 Comments
Initials
Wall Sheathing
Mid -Roof
Lath / Wall Tie
Rough Electric
Rough Plumbing/Gas Line
Rough Mechanical
Rough Framing
UW1
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
'Lj7.
Wo—TC
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 - 201701584
PERMIT NO: 201701584 ISSUED: 06/06/2017
JOB ADDRESS: 3380 Yarrow ST EXPIRES: 06/06/2018
JOB DESCRIPTION: Complete reroof, asphalt shingles, certainteed landmark - 46 squares
*** CONTACTS ***
OWNER (303)287-1562 FRANK STITES REVOCABLE TRUST
SUB (303)734-0956 Guy W. Thacker 022126 Sunny Contractors & Roofing
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 13,000.00
FEES
Total Valuation 0.00 r
Use Tax 273.00
Permit Fee 251.85 l•� ///
Misc. Fee �� ^
* * TOTAL
*** 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 k/2 -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 manufacturera€lms 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's technical representative stating that "the application of the roof at
(project address) has been applied in accordance with the installation instruction for
(roof material brand name) roof covering" is required to be on site at the time of final
inspection.
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION
City of Wheat Ridge
Residential Roofing PERMIT - 201701584
201701584 ISSUED: 06/06/2017
3380 Yarrow ST EXPIRES: 06/06/2018
Complete reroof, asphalt shingles, certainteed landmark - 46 squares
I, by n signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
apphca le 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 authorised to include alI entities named within this document as parties to the work to be
performedA that all world 0 be pe rmed is disclosed in this document anc�lor its' accompanying approved plans and specifications.
Signature of OWNEVor COIv'TRA&OR (Circle one) 6�te
1, This permit was issued based on the information provided in the permit application and accompanyingplans 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 maybe 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 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
applicable code or any ordinance or regafa4n of this jurisdiction. Approval of work is subject to field inspection.
welf
Signature of Chief Building Official Date v
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
} i
City of
(j C
�F�Wh6atl�,
MUNITY DEVELOPMENT
7500 W 29th Avenue, Wheat Ridge, CO 80033
P: 303.235.2855 F: 303-237-8929
Email: contractors(cD-ci.wheatridge.co.us
LICENSE (Office Use):
❑ NEW
❑ RENEWAL
Lic # lion O
Exp:
APPLICATION FOR BUILDING CONTRACTORS LICENSE
The undersigned affirms that he/she is knowledgeable of the ordinances and regulations of the City of Wheat
Ridge relative to building & construction within the City and shall at all times perform in compliance with same
as a contractor under the class of license hereby applied for:
Lic. Class/Description Fee Lic. Class/Description Fee
() Class 1 — Unlimited $150.00 () Class 8 — Plumbing $100.00
Testing or verification of tested license required Provide copies of Masters License
and State Contractors License
() Class 2 — Limited $125.00
Testing or verification of tested license required () Class 9 — Mechanical $100.00
Testing or verification of tested license req.
Class 3 — Residential $100.00
Testing or verification of tested license required () Class 10 — Electrical No fee
*DO NOT USE THIS FORM
Class 4 — Subcontractors $75.00
All subcontractors or trades not authorized
under other license classes
Type:
Class 5 — Homeowner No Fee
Testing may be required
() Class 6 — Structure Moving $75.00
() Class 7 — Demolition $75.00
( ) Class 11 —Sign $75.00
Class 12 — Fire Protection $75.00
Class 13 — Lawn Sprinkler $75.00
Class 14 — Roofing $75.00
Testing or verification of tested license req.
Class 15 — Electrical Signal $75.00
(Systems < than 50 volts)
BUSINESS NAME ril/'iYlt?Y>' If corporation, provide EIN
OWNER(S) NAME(S)
ADDRESS z-$Zg SR6- 'G(Vd, CITY
PHONE FAX
EMAIL
REFERENCES (3 other Municipal/County Licenses — provide copies):
** Provide copies of licenses
** Provide copy of General liability and
Worker's Compensation insurance with City
of Wheat Ridge listed as certificate holder.
(See Insurance requirements on page 4.)
STATE ZIP
CELL
*Complete all information on all pages. Sign and date application on Page 5
Lic
Lic
Lic
V- C't's5-<-S
f
A �(-i
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COMPANY OFFICER INFORMATION SHEET
Name(s) of owner(s)
Home Address
Phone number:
Signature:
Name(s) of owner(s)
Home Address
Phone number:
Signature:
Name(s) of owner(s)
Home Address _
Phone number:
Signature:
IM00M000MM000000aaaa9aa000MMMM0M0e0MM0ff000M00M0Ea0M000M0M00M0000aa0aM00M0000MMaM0M
Person(s) able to pull permits:
Name:
Home Address
Phone number:
Signature:
Name:
Home Address
Phone number:
Signature:
Name:
Home Address_
Phone number:
Signature:
Name:
Home Address_
Phone number:
Signature:
*Complete all information on all pages. Sign and date application on Page 5.
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r�
Residential Roofing PERMIT - 201708017
PERMIT NO: 201708017 ISSUED: 10/05/2017
JOB ADDRESS: 3280 Yarrow ST EXPIRES: 10/05/2018
JOB DESCRIPTION: Residential Re -roof to install Tamko asphalt shingles - 50 sq Pitch =
4/12
*** CONTACTS ***
OWNER (303)704-0999 JANICE M DEIBERT TRUST DTD 7/2
SUB (720)402-8039 Tracy Schram 170242 Arvada Roofing & Home Improvmn
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 25,000.00
FEES
Total Valuation 0.00
Use Tax 525.00
Permit Fee 442.05
** TOTAL ** 967.05
*** COMMENTS ***
*** CONDITIONS ***
Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be
required for both the midroof and final inspections. The 3rd party inspection report AND
THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat
Ridge. The report MUST BE SIGNED by the Homeowner.
REGARDING ROOF VENTILATION: Roof ventilation shall comply with IBC Sec. 1203.2 or IRC Sec.
R806. The installation of ridge venting requires the installation or existence of soffit
venting. For calculation purposes, one hat or turtle vent equal to one-half of one square
foot of opening.
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) is required on the entire roof
when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and
mid -roofs may be called in at the same time, one hundred percent of the sheathing must be
complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required
to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield
is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturer installation instructions,
whichever is more stringent. In order to pass a final inspection of elastomeric or similar
type roof coverings, a letter of inspection and approval from the manufacturer technical
representative stating that "the application of the roof at (project address) has been
applied in accordance with the installation instruction for (roof material brand name) roof
covering" is required to be on site at the time of final inspection.
Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be
required, the 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped
off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the
Homeowner.
w
City of Wheat Ridge
3 4
Residential Roofing PERMIT - 201708017
PERMIT NO: 201708017 ISSUED: 10/05/2017
JOB ADDRESS: 3280 Yarrow ST EXPIRES: 10/05/2018
JOB DESCRIPTION: Residential Re -roof to install Tamko asphalt shingles - 50 sq 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 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.
h
Sigruiflu're of OWNER or CONTRACTOR (Circle one) Date
I . 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 maybe 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 Off tial 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 o rmit shall wt con rue to be a permit for, or an approval of, an violation of any provision of any
applicable code or any a ulati ' ri action. 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.
7Dane Lovett 0 00 0 1
From: no-reply@ci.wheatridge.co.us
Sent:
To:
Monday, October 2, 2017 10:07 AM
CommDev Permits
Subject: Online Form Submittal: Residential Roofing Permit Application
Follow Up Flag: Follow up
Flag Status: Completed
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.
-fi
�r
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, 3- or 4- Units
are on the property?
PROPERTY INFORMATION
Property Address 3280 Yarrow St.
Property Owner Name Janice Deibert
Property Owner Phone 303-704-0999
Number (enter WITH
dashes, eg 303-123-4567)
25
r.
v
r;
R
C
�a
\
a
s.
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, 3- or 4- Units
are on the property?
PROPERTY INFORMATION
Property Address 3280 Yarrow St.
Property Owner Name Janice Deibert
Property Owner Phone 303-704-0999
Number (enter WITH
dashes, eg 303-123-4567)
25
Property Owner Email Field not completed.
Address
Do you have a signed Yes
contract to reroof this
property?
Applications cannot be
submitted without an
executed contract
attached below.
Attach Copy of Executed IMG 0069.JPG
Contract
CONTRACTOR INFORMATION
Contractor Business
Name
Contractor's License
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address
(Primary address of your
business)
Arvada Roofing & Home Improvement
170242
303-918-5812
5255 Marshall St.
Contractor Email Address tracy@arvadaroofing.com
Retype Contractor Email tracy@arvadaroofing.com
Address
DESCRIPTION OF WORK
TOTAL SQUARES of 50
the entire scope of work:
Project Value (contract 25000
value or cost of ALL
materials and labor)
Are you re -decking the
roof?
Is the permit for a flat
roof, pitched roof, or
No
Pitched roof (2:12 pitch or greater)
26
both? (check all that
apply)
What is the specific pitch
4/12
of the PITCHED roof?
How many squares are
50
part of the PITCHED
roof?
Describe the roofing
Tamko Heritage
materials for the
PITCHED roof:
Type of material for the
Asphalt
PITCHED roof:
Provide any additional
color is rustic evergreen
detail here on the
description of work. (Is
this for a house or
garage? Etc)
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
27
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.
Name of Applicant Tracy Schram
Email not displaying correctly? View it in your browser.
28
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: M 1, O
Job Address: -3 ? to I/ /2 f b L. b
Permit Number: )G/,70
1�1bV) 1/
❑ No one available for inspection: Time a O c) AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: �� �7 Inspector:
_741wj_.1_
DO NOT REMOVE THIS NOTICE 'a
City of Wheat Ridge
�y
Residential Roofing PERMIT - 201701584
PERMIT NO: 201701584 ISSUED: 06/06/2017
JOB ADDRESS: 3380 Yarrow ST EXPIRES: 06/06/2018
JOB DESCRIPTION: Complete reroof, asphalt shingles, certainteed landmark - 46 squares
*** CONTACTS ***
OWNER (303)287-1562 FRANK STITES REVOCABLE TRUST
SUB (303)734-0956 Guy W. Thacker 022126 Sunny Contractors & Roofing
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 13,000.00
FEES
Total Valuation 0.00,:
Use Tax 273.00
Permit Fee 251.85 --
** TOTAL ** 524.85 - _.-
*** 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 A/2 -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 manufacturera€ms 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's technical representative stating that "the application of the roof at
(project address) has been applied in accordance with the installation instruction for
(roof material brand name) roof covering" is required to be on site at the time of final
inspection.
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION:
City of Wheat Ridge
Residential Roofing PERMIT - 201701584
201701584 ISSUED: 06/06/2017
3380 Yarrow ST EXPIRES: 06/06/2018
Complete reroof, asphalt shingles, certainteed landmark - 46 squares
1, by in 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 legally authorized to include all entities named within this document as parties to the work to be
performed and that all work to be erformed is disclosed in this document and/or its' accompanying approved plans and specifications.
(3xt4c - C6 - .
Signature o)OWNER or CONTRACTOR (Circle one) Date
I . This periritt 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. pen -nit 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-,L4all not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division., a
6. The issuance or ' ip pe e construed to be a permit for, or an approval of, any violation of any provision of any
applicable code brr ance or egu a io f this jurisdiction. Approval of work is subject to field inspection.
Signatui6lof 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.
I FOR OFFICE USE ONLY I
j.
City off. fk� Date:
W h ai �.... c
£7 4t 7Nrry DUNFLOPMENT Plan/Permit# �
Building & Inspection Services Division
7500 W. 29" Ave., Wheat Ridge, CO 80033 Plan Review Fee:
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: perm itstc'D.ci.wheatridae.co.us
Building Permit Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address:
Property Owner (please print): �U�C��n S�—'1 �- �,s Phone: E5 10
Property Owner Email: ��`1 AF-- S N q 9
Mailing Address: (if different than property address)
Address: Q Hi,
Architect/Engineers bA \ -:a
Architect/Engineer E-mail: N I+ Phone: S�A
Contractors City License #: C) a a 1 C-:)� In
Contractor E-mail Address: ������� (Z 1�1' u,\\ V ul —�f ���C� D c---, Vv\
Sub Contractors: +�
Electrical:
W.R. City License #
Other City Licensed Sub:
City License #
Plumbing:
W.R. City License #
Other City Licensed Sub:
City License #
Mechanical:
W.R. City License #
Complete all information on BOTH sides of this form
❑ COMMERCIAL ❑ RESIDENTIAL
Description of work: (Check all that apply)
❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE
❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING
❑ COMMERCIAL ADDITION RESIDENTIAL ROOFING
❑ RESDENTIAL ADDITION WINDOW REPLACEMENT
❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ OTHER (Describe)
(For ALL projects, please provide a detailed description of work to be performed, including current use of areas,
proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and
amount of materials to be used, etc.)
Sq. Ft./LF Lp Btu's
Amps
Squares
Gallons
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE. (OWNER) (CONTRACTOR) or (ASU• THORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Electronic Signature (first and last name): �� G �(� DATE: O
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
Building Division Valuation: $
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: /`11?D _
Job Address: -3 �� y/9e2. �L c7«/ -5 1
Permit Number: l 0/2c?/5-L4/
�I`No one available for inspection: Time /0__S6 AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re-insp ti � at 303-234-5933
Date:CJ / -/� Inspector: �,j
DO NOT REMOVE THIS NOTICE
µ1.
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: "'D F
Job Address: yak e o w
Permit Number: D/ "7 O / -s '� y
IV b
re /l
m i -� r
Ikg D ►u t
1i
�c6
ClJSt'Pc
%,ejt,) m
r �. n a I� � Sr 64 a N r
❑ 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
�r
Date: C Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
_1�9rBuilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: C)r-
Job Address: zof 0
Permit Number: 3;j-?cS A& JW 3 r
LlNo one available for inspection: Time Z� /PM
Re -Inspection required: Yes ON
When corrections have been made, call for re -inspection at 303-234-5933
Date: Inspector:
DO NOT REMOVE THIS NOTICE
' CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234 -5933 Inspection line
(303) 235 -2855 Office - (303) 235 -2857 Fax
INSPECTION NOTICE
Inspection Type: &14
Job Address /Permit Number: *;M) c 3 r>f. b
❑ No one available for inspection: Time ;y AM/ M
Re- Inspection required: 'Yes No 1
When corrections have been made, call for r - inspection at 303 - 234 -5933
Date: f
Inspector:,
DO NOT REMOVE THIS HIS NOTICE
♦ i CITY OF WHEAT RIDGE
r Building Inspection Division
f (303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 235-2857 Fax
INSPECTION ~j~^NOTICE
Inspection Type: 1` CJ i t lkJA I,
Job Address: 333,C) Yk A \0101 4 i S t
Permit Number: 09 lb-
❑ No one available for inspection: Time AM/PM
Re-Inspection required: Yes No
When corrections have been made, call ./e-irl "Lction of 303-234-5933
Date: Inspector: 1
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 `! o Ro O�:_
Job Address: 3 ? h 0 Y , .CJ 57
Permit Number: on � (rte
❑ 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: _ 1� ` c % Inspector: Zf�r'
DO NOT REMOVE THIS NOTICE
oe W"E?T~ 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
OCORPO
Building Permit Application
Property Address: =;3'00
`(Arr
ow
gy033
Property owner (please print):
L.fjl S
~r~
Phone:
h x~ 3b3 2~~
~
7
2 53
Mailing Address: (if different than property address)
Address:
City,
Contractor:
Date: ' :e1 e~ 9
Plan
Permit CW ?&zY
Contractor License Phone: -1,()'~ ° ~Gf c/ CJ
Sub Contractors:
Electrical City License
Company:
Plumbing City License
Company
Mechanical City License
Company:
Exp. Date: Exp. Date: Exp. Date:
Approval: Approval: Approval:
Use of space (description): Construction Value: $ !R/ <0C!)
Description of work: (as calculated per the Building Valuation Data sheet)
" ""'ev`e' (U 'bo -L Plan Review (due at time of submittal): $
Gc,~w r 145
T/ e l /z 30'~
Sq. Ft./~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 REPRESENT E of (OWNER) (CONTRATOR)
PRINT NAME: eDo j 6vt ( Dm SIGNATURE: Date:
] Bldg Valuation: $
♦ 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: ew.
Job Address: = ~filf?ow
Permit Number:
14p P,Jtlcc 2
❑ No one available for inspection: Time a ~c AM/PM
Re-Inspection required: Yes ~
'When corrections have been made, call for re-inspection at 303-234-5933
i Date: Inspector:
DO NOT REMOVE THIS NOTICE
OF WHEgT~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<ORA~
tinngppPermit Application
Property Address: ~JO/%tff~U
Property Owner (please print): 60
(g!/
Mailing Address: (if different than property address)
Address:
State, Zip:
Contractor:
Contractor License 0~)- I "JO J Phone:
Sub Contractors:
Electrical City License
Company:
Plumbing City License
Company
Exp. Date:
Exp. Date:
Approval:
Use of space (description): f5~°5/ 12a(if)/yt ~l
Description of work:
Sq. Ft./L.Ft added: Squares BTU's
I
Date:
Plan
Permit cc/ 6,;00
Phone:
Mechanical City License
Company:
Exp. Date:
Approval:
Construction Value: $ l rs~I
(as calculated Per the Building aluation Data sheet)
Plan Review (due at time of submittal): $
2 _ to 1W_ _C/
i
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) r PERSONAL REPRE T TI I of (OWNER} (C NTRATOR)
PRINT NAME: SIGNATURE: at
D'EPgRT.IVIENT USE'ONLY
ZONINGCOMMENTS
Zoning: - -
Reviewer -
PUBLIC WORKS COMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:. -
FIRE. DEPARTMENT:: ❑ approved w/ comments ❑ dlsapproved ❑~-no.revlewh
ed Bidg Valuation:
OCCUPANCY:.
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