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Home My WebLink About4120 Carr StreetCity of Wheat Ridge Residential Sewer Repair PERMIT - 201902712 PERMIT NO: 201902712 ISSUED: 12/27/2019 JOB ADDRESS: 4120 Carr St EXPIRES: 12/26/2020 JOB DESCRIPTION: Sewer repair 30 feet in front yard, new clean outs installed. *** CONTACTS *** OWNER (303)456-5545 MUHS JOHN W SUB (720)296-7972 TREVOR HARVEY 130129 AFFORD A ROOTER *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA j Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,800.00 FEES Total Valuation 0.00 Use Tax 100.80 Permit Fee 125.05 Same Day Inspection 120.00 ** TOTAL ** 345.85 *** COMMENTS *** *** CONDITIONS *** ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection by any Sanitation District representative. Inspection and approval of work by any Sanitation District representative DOES NOT grant authority to cover work without the approval of the Building Division. **For trenchless sewer replacements - The contractor will verify proper slope of new sewer piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed specifically by the applicable code. The plumbing contractor will provide verification of proper slope and drainage in writing as a condition of approval of the permitted work.** r City of Wheat Ridge w Residential Sewer Repair PERMIT - 201902712 PERMIT NO: 201902712 ISSUED: 12/27/2019 JOB ADDRESS: 4120 Carr St EXPIRES: 12/26/2020 JOB DESCRIPTION: Sewer repair 30 feet in front yard, new clean outs installed. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications; applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all entities named within this document as partes to the work to be perform -ame�nd,�//that all work to be perform/ ii disclosed in this document and/or/its' acc% pan g pgr ved 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 Flans 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 and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any prdinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chkf Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dina Kemp From: no-reply@ci.wheatridge.co.us Sent: Friday, December 27, 2019 11:51 AM To: CommDev Permits Subject: Online Form Submittal: Residential Sewer or Water Line Repair Permit Application Categories: Dina Residential Sewer or Water Line Repair Permit Application This application is exclusively for RESIDENTIAL SEWER OR WATER LINE REPAIR - IN YARD ONLY - NO RIGHT OF WAY WORK. YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN ORDER FOR THE PERMIT TO BE PROCESSED. Your Permit will be emailed to the email address provided below once it is processed. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. Is this application for Yes residential sewer line or water line repair - in yard only? PROPERTY INFORMATION Property Address 4120 Carr Street Property Owner Name John Muhs Property Owner Phone 303-456-5545 Number (enter WITH dashes, eg 303-123-4567) Property Owner Email Unknown Address Attach Credit Card C.pdf Authorization Form - **DO NOT ATTACH RANDOM DOCUMENTS** CONTRACTOR INFORMATION Contractor Business AFFORD -A -ROOTER Plumbing Name Contractor's License 459 Number (This is a 5 or 6 digit number for the City C of Wheat Ridge) Contractor Phone 720-296-7972 Number (enter WITH dashes, eg 303-123-4567) Contractor Email Address affordarooter99@gmail.com Retype Contractor Email Address DESCRIPTION OF WORK Is this a sewer line or water line repair? Length of repair affordarooter99@gmail.com Sewer Line Location of repair frontyard (backyard, frontyard, etc) Provide additional details including installation of clean -outs. Project Value (contract value or cost of ALL materials and labor) new clean outs installed FA, SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit 2 has been issued and posted on the property. I certify that I have been Yes authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying for Sue Wells Permit Email not displaying correctly? View it in your browser. i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Zk6, Job Address: _TTla,._-`' Permit Number: C 2� ❑ No one available for inspection:® e Re -Inspection required: Yes, When corrections have been made, schedule for re -inspection online at: http://www.ci. wheatridge.co. uslinspection Date: �f i-` "Z --i - `t- 1 Inspector: ---�- DO NOT REMOVE THIS NOTICE 4"2-D Com, `01 � i�N INSPEC IRECORD INSPECTION REQUEST LINE: (303) 234-5933 Occu anc /T , Inspections will not be performed unless this card is posted on the project site. Call the inspection request line before 11:59 p.m. to receive an inspection the following hncinPco A— I l— *� Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Pier Initials Comments Concrete Encased Ground (CEG) Foundation / P.E. Letter Do Not Pour Concrete Prior To Approval Of The Above Inspeci Underground/Slab Inspections Date Inspector Electrical Initials Comments Sewer Service Plumbing Do Not Cover Unde Rough Inspections Wall Sheathing Mid -Roof Lath / Wall Tie Rough Electric " Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw/ Nail Final Inspections and or Below/In-Slab Work Prior To :J:Date: Inspector Initials Landscaping & Parking / Planning Dept. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical Roof Final Window/Doors Final Building Date Inspector Initials ns oval Of The Above In Comments Comments Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before Of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of Occupancy. 'For low voltage permits — Please be sure that rough inspections are completed from th:3, ire District and g a Certificate �y the Building Division.p y" electrical low voltage "For Inspection Time Window— Please email insptimerequest@ci.wheatridge.co.us b 8:00 A.M. the mornin of the /n i h the property a ress i ,object line of the email. Time window is based on the inspector's route. section Occupancy Is Not Permitted Until A Certificate of Occupanc Is I Protect This Card From The Weather y sued ions City of Wheat Ridge Residential Roofing PERMIT - 201700722 ISSUED: 05/18/2017 RMIT N0: 201700722 EXPIRES: 05/18/2018 B ADDRESS: 4120 Carr ST place roof; no decking; replace with laminated 30 year comp OC 113 DESCRIPTION: Remove and re - 28 squares F* CONTACTS *** aNER (303)456-5545 MUHS JOHN W 140116 MadSky Roofing & Restoration JB (855)623-7597 Chris Nussbeck ** PARCEL INFO *** USE: UA / Unassigned Unassigned 0 ONE CODE: UA / / UBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: ESTIMATED PROJECT VALUATION: 9,750.00 ** FEE SUMMARY *** FEES 0.00 'otal Valuation 175.50 Jse Tax 204.30 ?ermit Fee 379,80 ** TOTAL ** *** COMMENTS *** *** CONDITIONS *** ire an approved midroof 2014, asphalt shingle installations require installed, prior to final Effective December 1, ercent of the roof covering roved inspection inspection, conducted when 25-75 p requires an app approval. Installation of roof sheathing (new or overlay) on the entire prior to installation of ANY roof coverings andchsexigStsreAsphalt shingles oare requiredto p exceeding or board sheathing with ANY gap ed. A ladder extending 3 feet above the roof eave required. Eave and rake be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shieldis metal is req uir b and secured in place is required to e codesprovided and/ofor inspections. all roof manufacturera€�msinstallationentilation is required to comply with applicable instructions, whichever is more stringent. In order to pass a final inspection the imilar type roof coverings, a letter of inspection elastomeric or sthe application the roof at manufacturer's technical representative stating that (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. City of Wheat Ridge Residential Roofing PERMIT - 201700722 PERMIT NO: 201700722 ISSUED: 05/18/2017 JOB ADDRESS: 4120 Carr ST EXPIRES: 05/18/2018 JOB DESCRIPTION: Remove and replace roof; no decking; replace with laminated 30 year comp OC - 28 squares *** CONTACTS *** OWNER (303)456-5545 MUHS JOHN W SUB (855)623-7597 Chris Nussbeck 140116 MadSky Roofing & Restoration *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 9,750.00 FEES Total Valuation 0.00 Use Tax 175.50 //��►►�� ] tt Permit Fee 204.30 ** TOTAL ** 379.80 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding k/2 -inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufactureraoms installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer's technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. City of Wheat Ridge Residential Roofing PERMIT - 201700722 PERMIT NO: 201700722 ISSUED: 05/18/2017 JOB ADDRESS: 4120 Carr ST EXPIRES: 05/18/2018 JOB DESCRIPTION: Remove and replace roof; no decking; replace with laminated 30 year comp OC - 28 squares I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable wilding codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this'permit. her est that I am legally authorized to include all entities named within this document as parties to the work to be pertorme nd ha I to be performed is disclosed 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 originalermit fee. 3. if this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4, No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief BuiTi3ing Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us between 7:30am and S:OOam he Q ring g t ►e in§.pextwn..Please put the address of the inspection in the subject line. City of WheatR COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(a)_ci.wheatridge.co.us FOR OFFICE USE ONLY Date: �0 Plan/Permit # 1 n � 00 I �1 Plan Review Fee: v l Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: H 1 a 0 Property Owner (please print): J f\ 6Q�s Phone: Property Owner Email:_ �� . �t c- a �,�{� Co m Loan . r\x.A Mailing Address: (if different than property address) Address City, State, Zip: Arch itect/Engineer: Architect/Engineer E-mail: Contractor: I' X Gd S Contractors City License #: Phone: Phone:_(a'L( () . L( ( Contractor E-mail Address: C. p i � e(' t� r? ` (---)K T . Cw-) Sub Contractors: Electrical W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form ❑ COMMERCIAL RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ OTHER (Describe) (For ALL projects, please provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.)�� car o& 9-elmt,Vq. an 3o", r Comp OC— Sq. Ft.ILF Btu's Amps Gallons Squares a A Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) Q.I- S-70 -,Z 0 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (C TRACTO or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Electronic Signature (first and last name): DATE: (� ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Q Building Division Valuation: $ I- lq e i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office - (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: M 'I Job Address: e tL "f Permit Number: - t -? o C) ) ❑ No one available for inspection: Time G' A`M/P 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 fG CITY OF WHEAT RIDGE ..�.Z . . Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: R G r Job Address: 14 1),0 C F>•i' t S1 Permit Number: 6 �7 - -1 ❑ No one available for inspection: Time f ®.'r0 AM/PM Re -Inspection required: Yes No *When corrections have been made, call for re -inspection at 303-234-5933 Date:' !f I Inspector: ' DO NOT REMOVE �HS NOTICE ♦~~41 CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 0//ice ' (303) 235-2857 Fax INSPECTION NOTICE Inspection Type:n Job Address/Permit Number: Ur2~ / l? 6a2,~71~ ,-rc~~-rte-,. i v~ E F' H it ❑ No one available for inspection: Time I. P AM/ M _Re-Inspection required: Yes. When corrections have been made, call f, insgecn at 303-234-5933 I k= Date:-fZ~f'G? Inspector: r, l cr'' " DO NOT REMOVE THIS NOTICE V, CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office ' (303) 235-2857 Fax INSPECTION NOTICE ❑ No one available for inspection: Time Re-Inspection required: Yes No AM/PM When corrections have been made, call for re-inspection at 303-234-5933 i r Date: DO NOT REMOVE THIS NOTICE Inspection Type: J' 1:2, Job Address/Permit Number: {^`~~i 1 f 73 r " 4' City of Wheat Ridge r Residential Roofing PERMIT.: - 090839 PERMIT NO: 090839 - - ISSUED: 07/13/2009- JOB ADDRESS: 4120 CARR ST :EXPIRES: 01/09/2010. DESCRIPTION:T/O reroof 29 sqs with. TAMKO laminated shingles z CONTACTS owner 720/299-9337 John Muhs sub 303/984-0481 Joe H. Wicker 01-9890 Andy Bob's Roofing / Gutters , s * * PARCEL: INFO * * ZONE. CODE: UA -USE: - UA- SUBDIVISION: 0327. BLOCK/LOT#: 0/-. a FEE SUMMARY ESTIMATED PROJECT VALUATION: 5,133.00 as FEES - Permit Fee 162.90 Total Valuation .00 Use Tax 92.39 %~FfCJU} ~f.. * ' * : TOTAL. 255.29 ffl Conditions: 3 6 nail installation & mid-roof inspection required. Board sheeting spaced more thana 1/4 of an inch apart requires plywood overlay on entire roof. Ice and ;y water sheild:required from eave edge to 2' inside exterior walls. Subject to field inspections. M I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable A ! - 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. applicat' andtha I assume u11 responsibility fox compliance with the Wheat Ridge Building Code (I.B.C) and all other applic 1 9)2 at ge G di ork under this permit. Plans subject to field inspection. cis y3 Signat e of contractor/owner date 1. This permit was issued in accordance with the provisions set forth in your:. application and is subject tothe..laws of the k'. State of Colorado and to the Zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable ordinances. of the City. 2:' This permit shall expire. 180 days from the issue date. Requests for an extension must be received prior to expiration date. An extension maybe granted at the discretion of the Building Official. 3. If. this permit expires, a new permit may be acquired for a fee of one-half the amount normally required, provided no changes have been or. will be made in the original plans and specifications and any suspension or abandonment has not <p exceeded one'. (1) year. -If changes. have been or if suspension or abandonment exceeds one (1) year, full fees shall ; be. paid for a.. new permit. 4. NO work of any manner shall be done that will . change the natural flow of water causing a drainage problem. 5. -Contractor shall notify the Building Inspector twenty-four (24) hours in advance for all . inspections and shall: receive written approval on inspection card before proceeding with successive phases of the . job, 6. The issuance of a permit or the approval of drawings and ` specifications shall not be construed to be a permit for, nor n an approval of, any violation of the provisions of the building codes or any other ordinance, law,. rule or regulation. All plan review 1 s t to field inspections. ~p Signature of Chi ding. Official date INSPECTION EQUEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855 REQUESTS MUST BE MADE BY 3PMANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. ~a ,I a City of Wheat Ridge Building Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-235-2857 Inspection Line: 303-234-5933 Building Permit Application Date: Q~ ~g Plan Permit . Property Address. 'Vl,O 61a..r ~S+. CV17~G~ Ilir~C.C~ t tJ oos,5 Property Owner (please print): b70~ n //!LEFTS Phone: 2,?®-,2w-&V Mailing Address: (if different than property address) Address: City, State, Contractor: Contractor License OI l ? Phone: --1303 1? gZ/- Dyg/ 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): / 5915. Construction Value: $ Description of' work: (as calculated per the Building Valuation Data sheet) Ile) foL 'L .-1,.c GieGv- wAin Plan Review (due at time of submittal):$ ia-mie® ti{za~re~zties onwnal sitiru~i s Wyr. Sq. Ft./L.Ft added: Squares BTU's Gallons Amps OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with 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: