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HomeMy WebLinkAbout3802 Simms CourtCity of Wheat Ridge E -Res. Water Heater Replemnt PERMIT - 201801293 PERMIT NO: 201801293 ISSUED: 05/04/2018 JOB ADDRESS: 3802 Simms CT EXPIRES: 05/04/2019 JOB DESCRIPTION: Remove and install one 40K / 40gallon gas water heater. *** CONTACTS *** OWNER (720)261-9043 GEORGE CUMMINGS SUB (972)655-8080 Svetlin Tchakarov 130133 Prospect Plumbing, LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 1,015.00 FEES Hot Water Heater 40.00 Total Valuation 0.00 Use Tax 21.32 ** TOTAL ** 61.32 *** COMMENTS *** *** CONDITIONS *** Both the front and back of this permit are required to be posted on the job site at all times. If the complete permit is not present, inspections WILL NOT be performed. Work shall comply with 2012 IRC & 2014 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. 1, by my signature, do hereby attest that the work to be performed shall comply with al] accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this ermit. I further attes} that I am le ally authorized to include all entities named within this document as parties to the work toe performed and that all work to be perrmesdisclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the 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 regulation of this jurisdiction. Approval of work is subject to field inspection. 5rgnature�ditlig"Otticial Date REQUESTS MUST BE E BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. PERMIT:201 801293 ADDRESS: 3802 Simms Ct JOB CODE: RPS Rough Inspection (continued) Date Inspector Initials Comments 316 Rough Mechanical Residential Commercial 318 Boiler / Furnace 319 Hot water tank 320 Drywall screw and Nail 321 Moisture board / shower walls 322 Rough Grading 323 Miscellaneous Final Inspections Date Inspector Initials Comments 401 Gasline 402 Gas Meter Release 403 Final Electrical Residential 404 Final Electrical Commercial 405 Final Mechanical Residential 406 Final Mechanical Commercial 407 Final Plumbing Residential 408 Final Plumbing Commercial 409 Final Roof 410 Final Window/Door 411 Landscape/Park/Planning* Inspections from these entities shall be requested one week in advance. *For landscaping and parking inspections please call 303-235-2846 "For ROW and drainage inspections please call 303-235-2861 ***For fire inspections please contact the Fire Protection District for your project. 412 Row/Drainage/Public Works** 413 Flood plain Inspection** 414 Fire Insp. / Fire Protection*** 415 Public Works Final** 416 Storm Water Mgmt.** 417 Zoning Final Inspection* 418 Building Final Inspection Note: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building Inspection does not constitute authorization of occupancy. For Low Voltage permits please be sure that rough inspections are completed by the Fire District and Electrical low voltage by the Building Division. City of Wheat c e COKMUNrry DEVEUOPMENT Building & Inspection Services Division 7500 W. 291' Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(aa ci.wheatridge co us FOR OFFICE USE ONLY Date: PlaNPprmit # Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Pro J�U petty Address: � h11'a, Owner G(C,rae t S�-Ua3-3 Phone: 3517 Property Owner Email: 4 Tenant (Commercial Projects Only) Property Owner Mailing Address. (if different than property address) Address: — S w vl1 City, State, Zip: W � �( Q��1, (0 Architect/Engineer E-mail: Contractor: (" Yo5io TictriiL �`, Z City of Wheat Ridge License #: 130 J Contractor E-mail Address: nY 1 s� For Pian Review Questions & Comments (please print): CONTACT NAME (please print): -2-h �SltliA,s CONTACT EMAIL(p/ease print): Sub Contractors (Must provide Wheat Ridge License No.): Electrical: Plumbing: W.R. City License # W.R. City License # Other City Licensed Sub: City License # Phone: Other City Licensed Sub: City License # 3qq oogl Mechanical: W.R. City License # ❑COMMERCIALRESIDENTIAL DeSCriation of For ALL projects,provide a de 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 almpunt.of materials to be used, etc. 0Iit WaR-+{r�zv �zPluCe�v�r+� `ion Commercial Projects Only: Occupancy Type: Construction Type: Sq. FULF BTUs Gallons Amps Squares Project Value: (Contract value or the cost of PU materials and labor inciuded in the entire project) u1 OM'NERICONTRACTOR 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 1 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) (CO �TRACor (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) (Am! jand last: name): A' n rb V DATE: Printed Name: CiEPARTMENT.P$E ONLY UPANCY may/ gy1/gN #%EUt8bah3r 3., >r CONSTRUCTtow TYPE.- i x- apt SUtLDIMG DEPARTMENT Cf3M`VEUTS: � c" ` 'r � � 1� PUBLIC UUORKS Co;MMENTS Rex4 wer: Building Division Valuation: The City of Wheat Ridge Third Party Form Check List Property Address &Q �.,.� Permit Number Permit Issued Date Owner Information Property Owner Information Property Owner Address Inspector Information Inspection Company Guy Inspector Name Mania" P.O. Box 263 Inspector Contact info. JAN Ur'Mpr.0080118 - Cdt 720.Y 3.8280 Ema6: �uyymanioz�ginal.can Inspector Statement and Acknowledgement I hearty acknowledge the roof I am inspecting is 6112 or over. All roofs that are under 6/12 must be inspected by the City of Wheat Ridge Buiding Dept. x I hearty acknowledge the roofing system for the referenced building has been inspected and found to be in compliance with the minimum requirements of the 2012 IRC and 2012 IBC as well as all C Wheat Ridge Pglicies and Procedure and Manufacturer's Inspector: Date: Page 1 of 2 RI hearby acknowledge that I am the owner of the building referenced above and I give my consent for the listed third -party inspection company to perform my roof inspection in lieu of the City of Wheat/!ding /vision inspection. Propery Owner/Agent: Date: This original document and permit card, as well the roofing check list, must be submitted tc the Chief Building Official 1within sevendaysof tthefinal insp�ectfon Drop off in person RECEIVED Permit counter 2nd floor 'AN 0 9 7500 W. 29th Ave 01 Wheat Ridge CO 80033 Per Draft Date: 7/26/17 f The City of Wheat Ridge Inspection Checklist Notes The City of Wheat Ridge Inspection Checklist Notes M14AL Page 2 of 2 Roof InsDection F.11 YA Structural roof components E] u.,.4 [71 Fail EJ rav Verify that no more than 2 layers of shingles exist Flashing for roof and %valls; (� V— I -as, E] Fail If new sheathing is installed verif y that it is listed in the permit description (Valuation must be adjusted) Verify sheathing nail pattern. (See Policy & Procedures) El E-1 Crickets and saddles where needed F-1 wA E] Fa.4 Verify B vent must have boot same gauge as pipe El WA EJ Verify vent caps 0 WA Vertfy no flashings are damaged or rusted 0 El Fief Step flashing shall be min. of 4x4 piece per shingle L" F -I rail Verify scuppers allow for proper drainage El miA El Fail Ice anti water shield 2' in heated wall spaces f__1 WA F-1 rao Underlayments must follow 2012 IRC 12012 UBQ El E-] r-.ij Verify roof slope for proper drainage e, i 1 XM5— EJ wA L -i r Dripedge shatl have min of 2" overlap El rail Drkpedge should extend down min 2='pastroof deck r 'A na Dripedge shat) be rnechanicaly fastened 12" OC 90 LB roll roofing shall not be applied to roof slopes less than 2:12 slope: Exception, detached garages, patios, carports, open on three sides Mthmin. slope of M Favi Modified Bitumen, EPDM, TPO min slope 1f4:12 slope E. rafr Above roof insulation R-25 Law­% r 53 El Below roof residential R-38 LI -14/A M r-aii Below roof commercial R-32 r=Fail Modiffied Bitumen, EPDNI, TPO min slope 1!4-12 scope must be installed in accordance wM the manufacturers specifications- Must have manufactures letter of warranty with the address on the letter for final inspection Mel Roof Shin les Rectuirements L L Metal roof shingles shall not be installed on slope less 312 11 Metal valley flashing shall be the same material as roof Metal valley flashing shall extend a min of 8" front the centerline with a min- of 314 " high splash diverter rib built-in at the Row line with sections overlapping a. mini_ 'o 4" :m le RoofsRe�iremnt El �4"A rod concrete file shall have a min. 2-1f2:12 slope Slopes 4:12 and under require double underlayment Company Name: JBA SULTI G Company Name: JBA C SULTWG Inspector Signatur Inspector Signature: Date of MID -ROOF Insp cti n: le Date of FINAL Inspection: INSPECTION RECORD Inspection online form: http://www.ci.wheatridge.co.us/inspection Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Inspections will not be performed unless this card is posted on the project site Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business day PERMIT: ADDRESS: JOB CODE: 47 Foundation Inspections Date Inspector Initials Comments 102 Caissons / Piers 103 Footing / P.E. Letter 104 Foundation Setback Cert. 105 Stem Walls 106 Foundation wall Insulation Do Not Pour concrete Prior To Approval Of The Above Inspections Underground / Slab Inspections Date Inspector Initials Comments 201 Electrical / Cable/ Conduit 202 Sewer Underground Int. 203 Sewer Underground Ext. 204 Plumbing Underground Int. 205 Plumbing Underground Ext. 206 Water Underground 1 Z uo Not cover underground or Below / In-51ab Work Prior To Approval Of The Above Inspections Rough Inspection Date Inspector Initials Comments 301 Rough Framing 302 Wall Sheathing 303 Roof Sheathing 304 Sheer Inspection 305 Insulation 306 Mid -Roof 1 Z 307 Metal / Lath / Stucco 308 Rough Electrical Residential 309 Rough Electrical Commercial 310 Electrical Meter Residential 311 Electrical Meter Commercial 312 Temp. Const. Meter 313 Rough Plumbing Residential 314 Rough Plumbing Commercial 315 Shower Pan CCC r'%\/CE) CrlM nnn1T1nk1A1 INI[�r1 r/�TIr111[+ PERMIT: ADDRESS: JOB CODE: Rough Inspection (continued) Date Inspector Initials Comments 316 Rough Mechanical Residential 317 Rough Mechanical Commercial L 318 Boiler / Furnace 319 Hot water tank 320 Drywall screw and Nail 321 Moisture board / shower walls 322 Rough Grading 323 Miscellaneous ( (o Final Inspections Date Inspector Initials Comments 402 Gas Meter Release 403 Final Electrical Residential L 404 Final Electrical Commercial 405 Final Mechanical Residential 406 Final Mechanical Commercial 407 Final Plumbing Residential 408 Final Plumbing Commercial 409 Final Roof ( (o 410 Final Window/Door 411 Landscape/Park/Planning* Inspections from these entities shall be requested one week in advance. *For landscaping and parking inspections please call 303-235-2846 **For ROW and drainage inspections please call 303-235-2861 ***For fire inspections please contact the Fire Protection District for your project. 412 Row/Drainage/Public Works** 413 Flood plain Inspection** 414 Fire Insp. / Fire Protection*** 415 Public Works Final** 416 Storm Water Mgmt.** 417 Zoning Final Inspection* 418 Building Final Inspection Note: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building Inspection does not constitute authorization of occupancy. For Low Voltage permits please be sure that rough inspections are completed by the Fire District and Electrical low voltage by the Building Division. ► ' , City of Wheat Ridge �( Residential Roofing PERMIT - 201708669 PERMIT NO: 201708669 ISSUED: 10/27/2017 JOB ADDRESS: 3802 Simms CT EXPIRES: 10/27/2018 JOB DESCRIPTION: Residential Re -roof to install OC asphalt shingles - 36 sq Pitch = 8/12 (3rd party inspector required) *** CONTACTS *** OWNER (720)261-9043 HEENEY PATRICIA M SUB (970)223-2455 John Anderson 170116 Severe Weather Rfg & Restor *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 9,252.00 FEES Total Valuation 0.00 Use Tax 194.29 Permit Fee 204.30 ** TOTAL ** 398.59 *** 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. ► A , City of Wheat Ridge Residential Roofing PERMIT - 201708669 PERMIT NO: 201708669 ISSUED: 10/27/2017 JOB ADDRESS: 3802 Simms CT EXPIRES: 10/27/2018 JOB DESCRIPTION: Residential Re -roof to install OC asphalt shingles - 36 sq Pitch = 8/12 (3rd party inspector required) 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 1 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 wor to e performed 's disclosed in this document and/or i ' acco panying approved plans and specifications. ` � Dy Signature of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing, and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the 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, an violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. 011�­b Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. �( Dane Lovett 2 (��7 6 From: no-reply@ci.wheatridge.co.us Sent: Thursday, October 26, 2017 11:54 AM To: 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. 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 IUZ Property Address ---3-202 Simms Ct Property Owner Name Patricia Heeney Property Owner Phone 7202619043 Number (enter WITH dashes, eg 303-123-4567) 5 Property Owner Email home@severeweatherroofing.com 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 Heeney Contract.pdf Contract CONTRACTOR INFORMATION Contractor Business Severe Weather Roofing & Restoration, LLC Name Contractor's License 170116 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 9702232455 Number (enter WITH dashes, eg 303-123-4567) Contractor Address 3307 S College Ave #220 (Primary address of your business) Contractor Email Address carly@severeweatherroofing.com Retype Contractor Email carly@severeweatherroofing.com Address DESCRIPTION OF WORK TOTAL SQUARES of 36 the entire scope of work: Project Value (contract 360b value or cost of ALL materials and labor) Are you re -decking the No roof? Is the permit for a flat Pitched roof (2:12 pitch or greater) roof, pitched roof, or 6 both? (check all that apply) What is the specific pitch of the PITCHED roof? How many squares are part of the PITCHED roof? Describe the roofing materials for the PITCHED roof: Type of material for the PITCHED roof: Provide any additional detail here on the description of work. (Is this for a house or garage? Etc) 6/12 and 8/12 36,z Owens Corning Duration Storm Onxy Black. 10 skylights, 11 turtle vents, 2 bathroom vents, ice/water shield Asphalt Main Dwelling and Front Porch 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. 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 Carly Fronsee Email not displaying correctly? View it in your browser. SEVERE WEATHER ROOFING, LLC 3307 S. College Avenue, #220, Fort Collins, CO 80525 Phone: 970-223-2455 Email: home@severeweatherroofing.com CONTRACT Ownert � Owner's Insurance Company VAs-�a'UA (0 L5_o/\J) Color: Address Adjuster/Claim # ILL� go -e 1 City, State, Zip Representative 33 1<eN -' Contact No. Email -�a0-2(� - 9 O 3 *A-dls0--n 0 ROOF SPECIFICATIONS SIDING Tear Off: Yes No / # layers roofing Install Underlayment: 151b 49Synthetic Install: OvJQABrand shingles /tyle: SSC<rvv�_ Year: Color: #SQs: Ice/Water hield: a ft. from eaves & _2 ft. from valley Install New Drip Edge:__g X,@ Color: yjw, fie. Install Lead Jacks 1.5" A,� 2"M 3" AnIA 4" 5" Vents: �.o (� Color: 13 — Valley: Open Closed Type: Ridge: 7:J AQ Ridge vent: Y N LF Roof Pitch: /12 #Stories Open Soffit: Yes No Vaulted Ceilings: Yes No Redeck: Yes No Damaged Wood: Plywood@80/sheet 1X@7.00 / LF GUTTERS & DOWNSPOUTS 0 PER INSURANCE SCOPE Remove & Replace LF 5" Gutters kA \ LF 2x3 Downspouts Remove & Replace LF 6" Gutters LF 3x4 Downspouts Color: Qi� �- , Install Leaf Screens: Yes No Special I�nsttr juctions: Iao Ii 1 coaly/�s J Brand: # SQs Style: Color: Housewrap/Insulation: Replacement Elevations: Front Rear Left Right Replace Wood Fascia: LF x Fascia: Color: Wrap: Color: Soffit: Color: ADDITIONAL SPECIFICATIONS Placement of Materials: Emergency Repairs: Existing Interior Damage: Roll yard & driveway with magnetic nail sweeper Clean-up & haul away work debris APPROXIMATE DATES OF SERVICE: PAYMENT SCHEDULE: Agreement Amount: $ 1 Roofing: $ t 6 7 Gutters: $ Other: 'T OtK $ LD 119 8 Supplements: $ Overhead & Profit: $ TOTAL AGREEMENT AMOUNT$ T J A�> ALL PAYMENTS SHALL BE MADE PAYABLE T SEVERE WEATHER ROOFING, LLC. SEVERE WEATHER ROOFING, LLC, SHALL HOLD IN TRUST ANY PAYMENT FROM A All material is guaranteed to be as specified, with any applicable manufacturer's warranties. All work to be completed in a workman- like manner according to standard practices, with a 10 vear warranty (Slell!uI JaUMO) :1aealuoa slg4 04ui paleJodJoaul AlssaJdxa aJe q:)lgM pue Molaq glJ0J las SUOlslnoJd leuoilip aql of lDa[gns pup 2AMO Aq pal aJJe AgaJaq aJe pup AJ0IJeJSQ2S aJe SUOIIIpUOJ PUP SU0I42DIJ!D@ds 'saolJd anoge aql ! / •IuawaaJ6e slgl ul pa:PalJaJ slsoa aql anoge pup JanO a6Jeq:) eJlxa up awooaq 11 !m pup 'sJapJo a6uegO ualllJM uodn Aluo palnz)axa aq IIIM S4SOD Jo sa6ewep Jeu011lppe 6UTAj0nul suolleDIJtads anoge woJ3 A1213d021d lVI1N3UIS3i1 3H1 NO SH210M SNI30021 3H1 Uollelnap Jo uolleJalle Jaglo AuV •IOeJIuoO slgl 40 awll aql le Isixa of d0 AIIIIOCVW V U3WI104113d SVH i10 31IS A1213d021d UMOUN Sa6eUJ2P uodn paseq aJe slsoO pup suoileDiJID@ds IIV •(joaJagl lVI1N3UIS311 3H1 1V SlVIS31VW DNIc10021 03ll3AI13a suolllpuoo pup swJal aql of lOa[gns '6uluJoD-su@mo Aq papiAoJd CHu vf%I nWU 1 Mn -1 nTHC 7T F iun ]33i. Mr. -SKT i A6?#`TC SJ2@A 9 pup SIMS Aq papinoJd AjU2JJeM JeaA z) dlgsuew�JoM uo PROPERTY OWNER'S RIGHTS AND RESPONSIBILITIES 1. This contract is between the property owner(s) ["Owner"] and SWR ["SWR"] only, and Owner represents that he/she owns the property on which the work is to be performed. SWR will work in good faith with Owner's insurer as needed for any insurance claim Qrl—tf relating to replacement or repair of the items reflected in scope of work set forth above, but the insurer is not a party to this contract. To aid in this process, Owner must promptly provide SWR with all necessary insurance information relating to repair or replacement of the roof and other relevant portions of the premises, including copies of all insurance estimates and supplements thereto. 2. Cancellation: Under Colorado law, Owner may rescind this contract as follows: a) For any reason, within seventy-two (72) hours after entering it. No materials or products will be delivered to the property ID until this rescission period has expired; or b) Within seventy-two (72) hours after Owner receives written notice from his/her insurer that a claim for payment for roofing work on the property is denied in whole or in part. This right of rescission does not apply when the insurer denies, in whole or in part, a claim related to a request for supplemental roofing services, if the damage requiring the supplemental roofing services could not have been reasonably foreseen as a necessary and related roofing service at the time of the initial roofing inspection or the execution of the initial roofing contract. Owner is still legally obligated to pay for any work actually performed on the premises by SWR and/or its subcontractors, as well as for any materials involved in said work, in the event the insurer fails or refuses to make payment. Owner is also legally obligated to pay for any upgrades or additional work requested by Owner and not approved by the insurer. c) To be effective, Owner must give written notice of cancellation under (a) or (b) above either postmarked or delivered in person to the address for SWR listed at the top of this contract within the prescribed 72 -hour period. 3. Prior to roof installation, it is the sole responsibility of Owner to remove any breakable/valuable objects from the landscaping, as well as pictures and valuables that may hang on interior walls, ceilings, mantles or shelves. It is an expected part of such work that noise and vibrations throughout the structure will occur and cause items to crack and/or fall. SWR will not assume any liability for these types of expected damages. 4. Owner is responsible for obtaining any necessary reviews and approvals of roofing or siding materials and colors from the governing homeowner's association or other entity. )0 5. If work to be performed under this contract is being paid for in whole or in part by Owner's insurance, Owner is responsible to obtain the release of such funds from the owner's mortgage company and/or insurance company. Owner is responsible for payment of all amounts due upon immediate receipt of said funds, but no later than 30 days from substantial completion of the project, with all payments made payable to Severe Weather Roofing, LLC. In the event there is a pending municipal inspection, Owner has the right to withhold 2% of the total job cost until inspection has passed. All amounts 30 days past due shall bear interest at the rate of 1.5% per month, compounded monthly, until paid in full. (owner initials) SWR'S RIGHTS AND RESPONSIBILITIES 1 1. Under Colorado law, SWR cannot pay, waive, rebate, or promise to pay, waive, or rebate all or part of any insurance deductible applicable to any insurance claim for payment for roofing work on residential property. SWR shall maintain general commercial liability insurance covering its operations under this contract. At the time of the execution of this agreement, said coverage is provided by: l'1/ 5g -v4 / 3. SWR has the right to subcontract any part of, or all of, the work herein. 4. SWR shall not be liable for failure of performance due to labor controversies, strike, fire, hail, weather, inability to obtain material from usual sources, or any other circumstances beyond its control. 5. SWR shall not be liable for problems due to improper ventilation, pre-existing structural problems, or the appearance of the roof due to irregularities in the underlying roofing system. SWR will inform Owner of any dry -rot or other sub -roof deterioration which is concealed and is discovered during the course of the work. SWR is not responsible to repair any such discovered deterioration and any work done by WR to remedy such issues will only be done as extra work on a written change order. SWR also is not responsible for any mold or asbestos abatement, removal, or encapsulation, or any removal of lead paint, unless expressly stated herein. 6. SWR will use reasonable care in the work to be performed under this agreement, and Owner understands some minor �nj damage to the premises may occur due to the heavy nature of the work. SWR is not responsible for scratching and denting of gutters, ll�� oil droplets in the driveway, cracks in concrete or damage to plants or trees. Furthermore; SWR will not be responsible for exterior damages such as broken or fallen crown molding or stucco, solar panels, cooling units, skylights, and other similar objects. SWR also is not responsible for damage to unforeseen concealed items such as cables, wires, water pipes, electric lines, and other items. 7. Upon completion of the work, SWR will make diligent efforts to remove all project debris and excess project materials; said excess materials are the sole property of SWR. SWR will leave the premises in a broom clean condition and will make a magnetic sweep of the eve line and surrounding walkways. However, SWR does not guarantee the removal of all nails from the project area, and SWR shall not be responsible for any debris consisting of dirt, dust, asphalt or small bits of materials that settle into attics, garage areas or any other surrounding areas. Said debris is unavoidable and an expected result of this type of work. . In the event of Owner's default under this contract, Owner shall be responsible to SWR for payment of all attorney's fees and costs incurred by SWR in enforcing the terms of this agreement. SWR also reserves the right to place a mechanic's lien on the property as allowed by Colorado law. owner initials) GENERAL PROVISIONSKiF7 If any provision of this contract shall be held invalid or unenforceable, the remainder of this contract shall not be affected %i. h therebv and shall continue to be valid and shall be enforced to the fullest extent under Colorado law. /,.r r a City of Wheat Ridge Residential Roofing PERMIT - 201705565 PERMIT NO: 201705565 ISSUED: 08/07/2017 JOB ADDRESS: 3802 Simms CT EXPIRES: 08/07/2018 JOB DESCRIPTION: Residential Re-roof to install Owens Corning asphalt shingles - 34 sq *** CONTACTS *** OWNER (720)261-9043 OLSON FRED J SUB (303)981-1265 Jon Lowrie 100243 Monarch Construction & Roofing *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,737.00 FEES Total Valuation 0.00Ck Use Tax 183.48 Permit Fee 188.45 ** TOTAL ** 371.93 --- *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) is required on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and mid -roofs may be called in at the same time, one hundred percent of the sheathing must be complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. 4 City of Wheat Ridge r .- Residential Roofing PERMIT - 201705565 PERMIT NO: 201705565 ISSUED: 08/07/2017 JOB ADDRESS: 3802 Simms CT EXPIRES: 08/07/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning asphalt shingles - 34 sq 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 roperty and am authorized to obtain this permit and perform the work described and approved in conjunction with this,permit. I further attesrthat 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 jitts`'accompanying approved plans and specifications. O 4Z� C� I Signature of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in thepermit application and accompanying Flaps and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees 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 amanner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit ho lnyder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable pQc1�or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. W wrt— IatA Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Tgp 1`fp of roofing contractors � �{� PHU>,>;IYdli'161 itF6 KAX(9dl}AFd.6hi1 }.v�,.. jy, .jz :bE+v .�.� ! WS `ydS �) §g.'}jl,, pss}6 g$#' FdiAii.ypNA64ri4'PIP4N41{F-tiVM "„t; � �y �M"#AIK I i Al L3 LABS 1\(, ll. K1q'if'.MtINAPCI(0.AUF1tiGtOM w.+,nw3.. _ TAY- .,• •• t;.• ... Customer Name Trisha Olsen Address 3802 Simms Ct Wheat Ridgf) CO 80033 ..�-a..-..-..n.• _ _... _.. _........--=2-.-r,,-.—n�,,h-:.�---•-.ate..-.�,--�._...•-�—�._• .:,,:. , Rhona 7202619043 All. Lhpng Emailrrtolson33Cagmaii,c4m _,.__.... Insuranoo l5ompany Shelter Insurance clpirn tE 05 / I ?-607734-0 In4.Rolioy # Monarch' cnatnletian 3 [3Sofny LLQ will of .t3te,fcc t t , i; uuLt 4 as Monarch. The scope of worh and mptadals ideritiNad below are :hc ogpe o v�rk �%;or ilpndad by Monarch Cgnstrpr dpn $ Pooling; @donatPh is not abligg*o t, ppif r o an'r Ra$ of the srgope Qf Work that Is not apprgvvd by the inaurance company unless you authanzl; the work and a0rae to pay for this Witunal W1,111 Ty'e_ Miration Int %C Yoar off ail existing layers (I.._layera) i ,rear off ,r;e IWer of W,000 §t a,ko sh1nQips it ,3h 0a wing (7115' OS3} sheds of Os3 are included eduh ad01 to shat hitt' tt� 463 per �"oet npfall, New Urdgriayment _,5'h. __ 'C b. .X Synth. "'�• _Install Pre-Psnintsd brietal$ to code 3rCvtn Chprr sal Tan ray 1w.hitp 4tc4 tr +� t .._._. r_„ irit, Valley(*) will tae chased with Ice & water shleld ( 1 Val oy(§) will be op, in X Ridge (s) to be cater-coordin ited with Shingle Ridge(5) to be High-Proft;a and coipr-eoaflinatad With $1111191P X Install new pipe jacks X Replace vents as negded X Re -cash chimney($) and all wail abutment as ne0ed install Ridge Vent 36 -LF _ Install Ice &t Water shield per code, $s well as all vents and skylight$ nstail 4-5 nalia per shingle as required by city co,inty Bodes. Satellite/ Dish Alignment (ea,in customer will need to a rite f the proyj* to fe align dish after roof Installation) tnt _. _x Final Inapecticne will he cornpleted as eltyfpounties aligws; I have road the hack of cgntract # 2 X 57year workmanship warranty on roofing all ether mnstru0pri trades will r@ii@ivo a 1 yr. workmt ,,hip war rarity Extended Warranty Per S0. _ ._. <. circle: Qwatts Corning Platinum GAF Other: X Monarch Wn5trWioii a Roofing will provide general Ii olll y {nsuranuf , Qra, r; (A s E 0.000 evreral aggr lyte X Perform madnetir, stvaE t of drvgway and yard for rerngyal of any ria.05 X Relgove al' lra5n F, -,j debris k9rn Work. listed (,Utters 3nS _LF SiZo;v inGh or 5 inch Goic.r Repla Ciu c SQ-Fenype i X 'nsurance urd4 includeortpay e Gorrpah Ye- _� No (If yes P16440 G 3m5ipta 14e gird patty authonzatipn term} Int t €p@ci@i Instructions The apprftxintal, coat Otto, an'i§ b0>:Etii Q;1,t r'04s 4o9Wr, t Sj3 s Sgplir t js ar;ta S de's c air:?d by �._.�... inBurarrge. Mo isr„ h trip pr°oim ,hP §cgpv S {i -tx 8pp o� d by qny r u pn e W� p y Np i will @t W'rn' rt t3 i 9 ".i rlt# Ow, rot n b Eppd ar ��@nrk t. e ud c pans P„V s.,+nar:;f o0eq whicr, buy mGteas.@ �nPJdl dollar en 40n4 that nal a ,a ip Paying out SNpPiat ant / 91frrg biiir- to n „� .,iA B e appmvd by the nsc lr� company tdr pddii rat a oik of In{,ra3sF<6 in C'e$t5 pcGOnts 57 read eftltis cantrap. Thr; final soaps end pAQ G9r d Rfl 2atvtaan the lu n 0r� „C , � $(la kv QoA' h ahall bggome the final NIAI-614t 6 ci for til. aUprgutd csope. ;ustr3!her will qy roto nhltbts tp Roy for any awgradBR; dadoctjola, or o0ditt9nal year& authorized 4y Via sttatonter tact she ln@uran4a company dptah)in46 ie not c,)vri' 4 wrifhin ittg Roopy 0909_rraao pr' 40vd ay yzo Wur'd F pa i ny- - AAproximats Nacefi of 5ervtas _ __ naso datya cf sa[v:oe A S guh psR iQ chaaaa d�9 tr unuiiii j1 delays in tsanspc 4aGon of materisla, payment del5ys, tn$ttran0e app:6vai, 4 ii+;Esq'#@ ti?sr ¢slay , VY 6ny ot5 +cguca# World rsg hove osrt,rotaf Mori.arah, Mpnarch will provide comowir940P to cti0p, iw to show tantotiva dates. Notim if the property owner plans to use proceeds of a propgl y and pasualty Insuranoe pgi�qy 11y§uod porsn,ant to poft i of otic -IQ 4:10, G.R S., to pay tortno rpofing . ork, puraudnt to a00p t 6-22-105, the roofing contr#§tgr Panne! pay. vast rpow, or promise to Pay Ware, of rgbat§ all or pad f any ;upuur n a dadyGfible app'y_uQla b the insurfinep claim for f ny tient on the covereQ resdantial prgrvrfy, I(,”) hereby Quthgwe S iq,1o;Qt the insurance gumpany 6 lin homers to include I.h, gsr„g Qf Pdonarph 0on§1 t;Vigrf & Rocina i.I,G ap co-payo@ go any sokireduent leas draft or r;,gks star Way's date es indiQatad FWve. f (via) at;thpri?e any is:gal ieprasgn 40411.- aof M n . _, k cn3tr ci z +no a:n nMmraq na4ey a y to cgroplL•te aqE funct:c;y pEo'd aS relative to the claim numbar refarsa(Ad aboya. I two) further 4019r a+ Monor,.h to N .c: pK :in all W& tliokt or r-hatra rin myaur rte °if and behalf of hicnare+•. 5rJ'C,'1 09 PqR yy I('.itl�i5 tet4.,nrr',n Gtin� uC�JUn �ho✓1•P�tly ch21i h5+iL t,ratn o -'"!k p� -� �r9.-±Y•3k _ _ . - ._.. .-'.:art ji JS �: k;� ��if-r¢1tI�Ne:+?5 ,}FB -d t!sG d,?f-try';ty e m�7ctity of Lir, ru�ar tF^. .�Grtir�:t7 ! ."f22, agrps t.y to ani the uer: rt;G ry di !_ r. Pow & 4P:gpI( Dan Schultz -2z� �o 5V From: no-reply@ci.wheatridge.co.us Sent: Monday, July 31, 2017 1:54 PM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Dane 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 Property Owner Email Address 3802 simms ct t trisha olsen 7202619043 Field not completed. �371,�3 Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. Attached Copy of Field not completed. Contract CONTRACTOR INFORMATION Contractor Business monarch construction Name Contractor's License 100243))L, Number (for the City of Wheat Ridge) Contractor Phone 3039811265 Number Contractor Email Address permits@monarchroofs.com Retype Contractor Email permits@monarchroofs.com Address DESCRIPTION OF WORK Are you re -decking the Noz roof? Description of Roofing owens corning Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 34 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 34 (pitched + flat) of all z roofing material for this project Provide additional detail house here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract ?3t'li1-- value or cost of ALL ('173 , materials and labor) ij V li 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 brie lowrie Email not displaying correctly? View it in your browser. 3 ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 235 -2857 Fax INSPECTION NOTICE Inspection Type: 4 i4o Pl"Ic' Job Address: 3"r92 ex° Permit Number: 42o 72° �z�+n�rL'rar >.r E' ❑ No one available for inspection: Time rs.' AM /PM [g, Re- Inspection required: Yes Glo When corrections have been made, call for re- inspection at 303 - 234 -5933 Date: 7 Inspector: DO NOT REMOVE THIS NOTICE r; ♦ i CITY OF WHEAT RIDGE Bung Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: w r in e Job Address: -3 Y i 3 Permit Number: ci l; 4 ❑ 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: DO NOT REMOVE THIS NOTICE r-; ISSUED:'. 08/04/2009 "EXPIRES: 01/31/2010 r Tamkoshingles 521.96` oFw"EATS City of Wheat Ridge Building Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 v m Office: 303-235-2855 " Fax: 303-235-2857 c o Inspection Line: 303-234-5933 OCORP~ Date: O Plan Permit M/ Building Permit Application Property Address: S~(r" Property owner (please print): Frey 0~; rQ n. Phone: ZD~ fi(n) ~o4Z Mailing Address: (if different than property address) Address: State, Contractor: Sl(tv~ ~,e~ A Contractor License ! Phone: - 2 - (Do Sub Contractors: 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: $ 1ZA o Description of work: (as calculated per the Building Valuation Data sheet) R-R-_ Cif Lio Sp V'I i (KO 1~~ ~r I Plan Review (due at time of submittal): $ Sq. Ft./L.Ft added: Squarest 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 (OWNER) (CONTRATOR) PRINT NAME: SIGNATURE: Date: '1 `4 61, Bldg Valuation: $