HomeMy WebLinkAbout4223 Owens Streete W"EqT City of Wheat Ridge Building Division
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m 7500 W. 29th Ave., Wheat Ridge, CO 80033
- - Office: 303-235-2855 * Fax: 303-235-2857
c o Inspection Line: 303-234-5933
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Property Address; L}~dJ OVWA5 5 IA
Property Owner (please print) (~a r~,I f~P,vtc ► F Phone: 33
Mailing Address: (if different than property address)
Address: 14993
City, State, Zip: >tia6a f Qlt4mv, 00 RM'~?
Contractor: A91914?1it f1 lbtlnr "fA iVIC %CL 'CIA(
Building Permit Application
Date: 94,
Plan
Permit #:0
Contractor License i26931 v J Phone: .303-q S Sq 81&
Sub` Contractors:
Electrical City License
Company:
Plumbing City License
Company
Mechanical City License
Company:
Exp. Date: Exp. Date: Exp. Date:
Approval: Approval: Approval:
Use of space (description): Construction Value: $ ,3556
Descriptio m of work: (as calculated per the Building Valuation Data sheet)
000 RMP. und-eryana -seruiLe Ch&kqe, Plan Review (due at time of submittal): $
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.: WNER) (CONTRACTOR) or PERSONAL REPRE NTATIVE of (OWNE ( ONTRATOR)
PRINT NAME: 1) nA,4 SIGNATURE: Date: v rJ~
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