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: $