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HomeMy WebLinkAbout4640 Reed StreetCity of Wheat Ridge E -Res. Window Replacement PERMIT - 202002609 PERMIT NO: 202002609 ISSUED: 12/16/2020 JOB ADDRESS: 4640 Reed St EXPIRES: 12/16/2021 JOB DESCRIPTION: Replacing 4 windows in sun room. U -value is .27 *** CONTACTS *** OWNER (720)232-0372 ZARAT E ANTONIO SUB (303)371-3750 GRAYDON BEVIS 020762 PELLA WINDOWS & DOORS INC. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 71324.00 FEES Window Replacement 50.00 Total Valuation 0.00 Use Tax 153.80 ** TOTAL ** 203.80 *** 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 2018 IRC & 2020 NEC. Smoke alarms shall comply with 2018 IRC Section 134. Interior alterations, repairs, fuel -fired appliance replacements, or additions, any of which require a building permit, occurs or where one or more rooms lawfully used for sleeping purposes shall have an operational carbon monoxide alarm installed within fifteen feet of the entrance to each room lawfully used for sleeping purposes. 1* � 4 41' PERMIT NO: JOB ADDRESS: JOB DESCRIPTION: City of Wheat Ridge E -Res. Window Replacement PERMIT - 202002609 202002609 4640 Reed St ISSUED: 12/16/2020 EXPIRES: 12/16/2021 Replacing 4 windows in sun room. U -value is .27 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 permrt. I further attest that I am leg ally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. 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 original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees 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 requ�ired 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, anviolation 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 Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. From: no-reolv(alci.wheatridae.m. us To: CommDev Perm is Subject: Online Form Submittal: Residential Window/Door Replacement Permit Application Date: Tuesday, December 15, 2020 3:50:14 PM Residential Window/Door Replacement Permit Application This application is exclusively for RESIDENTIAL REPLACEMENT WINDOWS and DOORS - LIKE FOR LIKE ONLY. YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM AND WINDOW/DOOR CUTSHEET (SPEC SHEET) 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 replacement window(s) and/or door(s) like for like? PROPERTY INFORMATION Property Address 4640 Reed St Property Owner Name Antonio Zarate Property Owner Phone Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email Address Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" 720-232-0372 Field not completed. CONTRACTOR INFORMATION Contractor Business Pella Windows & Doors of Colorado Name Contractor's License 020762 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone Number (enter WITH dashes, eg 303-123- 4567) Contractor Email Address Retype Contractor Email Address DESCRIPTION OF WORK What is being replaced Number of window and/or doors being replaced Location of window(s)/door(s) being replaced (for example, master bedroom, kitchen, bathroom, etc): What is the u -value of the window(s)/door(s)? City of Wheat Ridge requires the u -value to be .30 or better on windows.. Attach copy of window/door cut sheets showing sizes and u - value Project Value (contract value or cost of ALL materials and labor) 11#18a1:0011-18Gz 1-PSI@pellacolorado.com 1-PSI@pellacolorado.com NVA Morel, 0 Sunroom 0.27 715BCCO78F Zarate OOC. Ddf 7324 SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have Yes been authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying for LeeAnn Swearengen Permit Email not displaying correctly? View it in your browser. 0is �o61 1W SA, INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Occupancy/Tyne Inspections will not be performed unless this card is posted on the project site. **Request an inspection before 11:59 p.m. (midnight) to receive an inspection the following business day.** Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Comments Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Comments Sewer Service 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. Plumbing Do Not Cover Underground or Below/In-Slab Work Prior To AoDroval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. ROW & Drainage / Public Works Dept. Mid -Roof Fire Inspection / Fire Protection Dist. Lath / Wall Tie Final Plumbing Rough Electric " Final Mechanical Rough Plumbing/Gas Line Roof Z vl Rough Mechanical Final Building Rough Framing 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. Rough Grading Insulation Drywall Screw/ Nail Final Inspections Date Inspector Initials Comments Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical Roof Z vl Final Window/Doors Final Building NOTE. All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy. For iow voltage permits — Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather City of Wheat Ridge Residential Roofing PERMIT - 201706175 PERMIT NO: 201706175 ISSUED: 08/16/2017 JOB ADDRESS: 4640 Reed ST EXPIRES: 08/16/2018 JOB DESCRIPTION: Residential Re -roof to install OC Duration asphalt shingles - 28 sq (24 sq pitched / 4 sq flat) *** CONTACTS *** OWNER (720)232-0372 ZARATE ANTONIO SUB (303)728-9402 Mark Janney, Tom Ross 170025 Concise Construction *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,300.00 FEES Total Valuation 0.00 Use Tax 216.30 Permit Fee 220.15 ** TOTAL ** 436.45 *** 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. City of Wheat Ridge � s Residential Roofing PERMIT - 201706175 PERMIT NO: 201706175 ISSUED: 08/16/2017 JOB ADDRESS: 4640 Reed ST EXPIRES: 08/16/2018 JOB DESCRIPTION: Residential Re -roof to install OC Duration asphalt shingles - 28 sq (24 sq pitched / 4 sq flat) *** CONTACTS *** OWNER (720)232-0372 ZARATE ANTONIO SUB (303)728-9402 Mark Janney, Tom Ross 170025 Concise Construction *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,300.00 FEES Total Valuation 0.00 Use Tax 216.30 Permit Fee 220.15 ** TOTAL ** 436.45 *** 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. ®t ' 41 City of Wheat Ridge ., V- ® Residential Roofing PERMIT - 201706175 PERMIT NO: 201706175 ISSUED: 08/16/2017 JOB ADDRESS: 4640 Reed ST EXPIRES: 08/16/2018 JOB DESCRIPTION: Residential Re—roof to install OC Duration asphalt shingles — 28 sq (24 sq pitched / 4 sq flat) 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 thisYer mitand performthe work descibed andapproved in conjunction with this permit.IfuherattestthatIamegallyauthorzdtoinclude aentitiesnamewithin this document as partestotheworktobe perormed anItfiat all work to e performed disclosed in this doment and/or its' accompapying�pproved plans and specifications. Signatuf�of R o ON O (Circle one) Date 1. This pe as issued base a information provided in the permit application and accompanying plans and specifications and is subject a compliance ose documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 3 -eaft after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original ermit 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 Off-cial 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 orrdmancce or regulation of this jurisdiction. Approval of work is subject to field inspection. � Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. 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 PL Property Address 4640 reed st Property Owner Name Antonio Zarate 81 201706 (75 - Dan Schultz From: no-reply@ci.wheatridge.co.us Sent: Monday, August 14, 2017 10:32 AM To: CommDev Permits (� Subject: Online Form Submittal: Residential Roofing Permit Application cam' Follow Up Flag: Follow up Flag Status: Completed 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 PL Property Address 4640 reed st Property Owner Name Antonio Zarate 81 Property Owner Phone 720-232-0372 Number (enter WITH dashes, eg 303-123-4567) Property Owner Email Field not completed. Address Do you have a signed Yes contract to reroof this property? Applications cannot be submitted without an executed contract attached below. Attach Copy of Executed ZarateContract.pdf Contract CONTRACTOR INFORMATION Contractor Business Concise construction Name Contractor's License 170025 Number (This is a 5 or 6 __ digit number for the City of Wheat Ridge) Contractor Phone Number (enter WITH dashes, eg 303-123-4567) Contractor Address (Primary address of your business) 720-728-9016 2750 S Wadsworth Blvd Unit D-100 Contractor Email Address permits@conciseconstruction.com Retype Contractor Email permits@conciseconstruction.com Address DESCRIPTION OF WORK TOTAL SQUARES of 28 the entire scope of work: Project Value (contract10300 value or cost of ALL __ materials and labor) 82 Are you re -decking the roof? Does the scope of the project include a flat roof (less than 2:12 pitch)? How many squares are part of the flat roof? Describe the roofing material for the flat roof: Type of material for the flat roof: Does the scope of the project include a pitched roof (2:12 or greater pitch)? 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? What is the roof pitch? Etc) No/ Yes/ ALI standard white mod bit Rolled Yes 24 OC Duration Tru Def Asphalt Complete house re roof with a 4/12 pitch 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. 83 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 Mark Janney Email not displaying correctly? View it in your browser. 84 zmw*mw*�� CONCIsc CONSTRUCTION 2750 S. Wadsworth Blvd. Suite D-100 Denver, CO 80227 303-728-9402 Web: conciseconstruction.com Email: info@conciseconstruction.com -( _- I IJ - 1 -7 -- Dale Cucto„er %,40 Reel 5-1 Address Wham- �, � �o 0o3F, Gcy. State. Zip Home Number Work Number 770 -7-32 - o37Z Cell Number Email SCOPE OF WORKAS APPROVED BY INSURANCE CARRIER PREFERRED CONTRACTOR ACCREDITED BUSINESS • Protect landscaping, clean site daily Obtain building permit as required • Tear off all layers down to the decking Adhere to all local building codes in effect • Install Synthetic Felt Roll lawn and driveway with magnetic sweeper • Install new plumbing boots Provide liability insurance of $1,000,000.00 • Install new pre -painted drip edge & Maintain workman's comp. insurance on all crews • Install new shingles, 6 nails per shingle • CONCISE CONST. 5 Year Installation Guarantee • Re -flash all wall abutments and chimneys as needed • Manufacturer's Warrant�� IIr lI years. • Install ice and water shield in all valleys Material drop location � Roof _ Driveway ❑ ROOF ONLY K ROOF AND GUTTERS Shingle Mfr/Stylet �� DEF Shingle Color _H � S k&Drip Color Vl1 ^` Gutter Color 1 Ji 1G ki4P. WI&Y' Gutter LF Downspout Qty. LF CLIENT RESPONSIBILITY [/We understand that it is our responsibility to make sure that our choice of shingle/color meets HOA approval. I/We have been shown shingle samples and have agreed to the above shingle and color. I/We understand that we owe our deductible for an insurance claim being addressed. Client Initials Approximate cost of services (Estimated RCV) $ 12-- IW • 2-'5- The S The above items (estimated cost and dates of services) are general estimates on damages known at the time of this contract being entered. All work completed will be performed for the RCV total plus any agreed supplements provided by your insurance carrier. Start and completion dates are subject to change based on availability of first check, weather and availability of materials. Estimated Start Date Za 17- Estimated Completion Date 7— 30— 1!_T Deductible Amount $ 2& 141.00 Customer agrees to provide a DEPOSIT in the amount of 00 . DO upon Delivery of Materials PROPERTYOWNER DATE COMPANYREPRESENTA DATE Scanned by CamScanner Concise Construction, LLC (hereafter referred to as "Concise Co." or "CCL') will perform roof replacement and exterior repairs to the Premises for the Client as approved and specified by Client's insurance company (collectively, the "Scope of Work") for the replacement cost value (RCV) of the insurance claim. The only out of pocket cost to the Client is their deductible, any non-recoverable depreciation, where applicable, as well as any agreed costs for upgrades or additional work authorized by the Client in writing. Supplemental claims and/or overhead and profit billed by CCI, on behalf of the Client and approved by the Client's insurance company for additional work, or increases in costs in addition to this contract, shall also be deemed a part of this contract as if contained herein. This contract will become binding upon execution and CCL shall receive all insurance proceeds, including the deductible. CCL will not charge the client for the ACV (Actual Cash Value) amounts for line items not addressed by CCL. Client agrees to provide CCL with all insurance communications, both written and verbal, and to authorize CCL to negotiate with the insurance company on Client's behalf to secure the funds necessary to complete the contracted Scope of Work. CCL shall hold in trust any payment received from the Client until CCL has delivered roofing materials at the Premises or has performed a majority of the roofing work on the Premises. 1. All proposals are subject to approval of CCL management. 2. CCL will perform the Scope of Work in accordance with generally accepted roofing and construction guidelines, adhering to local codes effect at the time of construction. 3. CCL's standard payment terms are as follows: 50% when materials are delivered and 50% when work is completed. Endorse and/or make all checks payable to Concise Construction, LLC. Any joint checks issued by Client's insurance company shall be immediately endorsed and tendered by Client to CCL. 4. You have the right to rescind this contract and obtain a full refund of any deposit within seventy- two (72) hours after entering the contract. If you plan to use the proceeds of a property and casualty insurance policy to pay for the roofing work, you may also rescind this contract with in seventy-two (72) hours after you receive written notice from the property and casualty insurer that your claim has been denied in whole or in part. However, CCL is entitled to retain payments or deposits to compensate CCL for roofing work actually performed in a workmanlike manner consistent with standard roofing industry practices. CCL cannot pay, waive, rebate, or promise to pay, rebate all or part of any insurance deductible applicable to the insurance claim for payment for roofing work on your property. S. To rescind, send by certified mail or personally deliver a signed and dated copy of the cancelled contract within seventy-two (72) hours of contract signing, or seventy-two (72) hours of written notice of denial of claim from the insurance carrier to the CCL address on this contract. Client may also email a signed and dated copy of the cancelled contract to info(@conciseconstruction.com. 6. All excess materials will remain the property of Concise Constructions, LLC. 7. Client is responsible for timely securing all required Homeowner's Association approvals of the roofing products and color(s). 8. CCL shall not be liable for failure of performance due to labor controversies, strike, fire, hail, weather, acts of God, inability to obtain material from usual sources, or any other circumstances beyond CCL's control. 9. CCL shall not be responsible for any leaks or water damage below the roof line, or any damage caused by excessive wind, ice, or hail during the period of the warranty. 10. Replacement of code required materials/upgrades not covered in Client's insurance policy will be additionally charged to Client on a labor and material basis. 11. CCL will not be held responsible for slight scratching or denting of gutters, oil droplets in the driveway, hairline fractures in concrete, or damage to plants or shrubbery. Furthermore, CCL will not be held responsible for exterior damages such as broken or fallen crown molding or fascia, or interior damages such as cracked plaster/sheet rock or nail pops. 12. CCL's liability insurer is Blue Sky Insurance Services, 9090 Ridgeline Blvd. Highlands Ranch, CO 80129. Contact: Bill Vaughan, 303-647-5477. Scanned by CamScanner ti.'rhis Contract and all attachill(`Ilts hereto repl'esellt the entire cO11U'.1CC betwCen parties, and supersede all prior written or Oral coil tracts heIWeen IIIc talc.IIt'111(1 C(:1,. 14. This contract cannot he cllallged, modified or terminated by any other contract unless the same is in writing and signed by the party ag jillst wllOIll elilol'(:((Relit of the chailge, modification or termination is solight. 15 -This contract shall he binding upon the partes and theh' respective successors, heirs, legal representatives and permitted assigns. 16. if any one or more of the provisions Contained in this contract shall for any reason he held invalid, illegal or unenforceable in any respect, such invalidity, illegality, or unenforceability, shall not affect any of the other provisions hereof, and this contract shall be construed as if such invalid, illegal or unenforceable provision had (lever been contained herein. 17. An account is past dile wilen more than thirty (:30) (lays have passed after the roofing work was completed. Iran account is past title by sixty (60) days, a latae charge of $120.00 will occur. If an account goes into collections, Client shall pay CCL interest at twenty-one (21%) percent per annum for all past dile accounts. 1l Clieilt does not pay all sums when due under this contract to CCL, thele Client agrees to pay all costs and fees incurred by CCL for its collection, including reasonable attorney fees and costs. Accounts are, considered due ante all work agreed upon in this contract is complete and the customer has received final payment from his/her insurance carrier, even if final inspections from the city or county have not yet taken place. CCL further guarantees that all Nvork will pass final inspections. CCL reserves the right to place a mechanic's lien on Client's property for any default in the timely payment of amounts due under this contract. Client shall pay CCL interest at twenty-one (21/0) percent per annum for all accounts ninety (90) days past due. 18. The parties avaive the right to a jury trial in any action or proceeding, based upon or related to, any aspect of the transaction in connection with this contract, or any document executed or delivered in connection with such transaction. 19. Venue for any legal action brought pursuant to or involving this contract, shall be in the City/County of Denver, State of Colorado, or any other location mutually agreeable to the parties. 20. All attachments to this contract shall be part of this contract and are incorporated herein by this reference. 21. It is the Client's sole responsibility to provide a safe -keeping area for all pets. CCL shall not responsible for gates left open during or after its work. Scanned by CarnScanner CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: ❑ No one available for inspection: Time — AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-2_ 34.5833 7% Date: / -d < —Inspector: ®O NOT REMOVE THIS MoT/CE City of Wheat Ridge � s Residential Roofing PERMIT - 201706175 PERMIT NO: 201706175 ISSUED: 08/16/2017 JOB ADDRESS: 4640 Reed ST EXPIRES: 08/16/2018 JOB DESCRIPTION: Residential Re -roof to install OC Duration asphalt shingles - 28 sq (24 sq pitched / 4 sq flat) *** CONTACTS *** OWNER (720)232-0372 ZARATE ANTONIO SUB (303)728-9402 Mark Janney, Tom Ross 170025 Concise Construction *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,300.00 FEES Total Valuation 0.00 Use Tax 216.30 Permit Fee 220.15 ** TOTAL ** 436.45 *** 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. ®t ' 41 City of Wheat Ridge ., V- ® Residential Roofing PERMIT - 201706175 PERMIT NO: 201706175 ISSUED: 08/16/2017 JOB ADDRESS: 4640 Reed ST EXPIRES: 08/16/2018 JOB DESCRIPTION: Residential Re—roof to install OC Duration asphalt shingles — 28 sq (24 sq pitched / 4 sq flat) 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 thisYer mitand performthe work descibed andapproved in conjunction with this permit.IfuherattestthatIamegallyauthorzdtoinclude aentitiesnamewithin this document as partestotheworktobe perormed anItfiat all work to e performed disclosed in this doment and/or its' accompapying�pproved plans and specifications. Signatuf�of R o ON O (Circle one) Date 1. This pe as issued base a information provided in the permit application and accompanying plans and specifications and is subject a compliance ose documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 3 -eaft after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original ermit 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 Off-cial 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 orrdmancce or regulation of this jurisdiction. Approval of work is subject to field inspection. � Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. 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 PL Property Address 4640 reed st Property Owner Name Antonio Zarate 81 201706 (75 - Dan Schultz From: no-reply@ci.wheatridge.co.us Sent: Monday, August 14, 2017 10:32 AM To: CommDev Permits (� Subject: Online Form Submittal: Residential Roofing Permit Application cam' Follow Up Flag: Follow up Flag Status: Completed 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 PL Property Address 4640 reed st Property Owner Name Antonio Zarate 81 Property Owner Phone 720-232-0372 Number (enter WITH dashes, eg 303-123-4567) Property Owner Email Field not completed. Address Do you have a signed Yes contract to reroof this property? Applications cannot be submitted without an executed contract attached below. Attach Copy of Executed ZarateContract.pdf Contract CONTRACTOR INFORMATION Contractor Business Concise construction Name Contractor's License 170025 Number (This is a 5 or 6 __ digit number for the City of Wheat Ridge) Contractor Phone Number (enter WITH dashes, eg 303-123-4567) Contractor Address (Primary address of your business) 720-728-9016 2750 S Wadsworth Blvd Unit D-100 Contractor Email Address permits@conciseconstruction.com Retype Contractor Email permits@conciseconstruction.com Address DESCRIPTION OF WORK TOTAL SQUARES of 28 the entire scope of work: Project Value (contract10300 value or cost of ALL __ materials and labor) 82 Are you re -decking the roof? Does the scope of the project include a flat roof (less than 2:12 pitch)? How many squares are part of the flat roof? Describe the roofing material for the flat roof: Type of material for the flat roof: Does the scope of the project include a pitched roof (2:12 or greater pitch)? 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? What is the roof pitch? Etc) No/ Yes/ ALI standard white mod bit Rolled Yes 24 OC Duration Tru Def Asphalt Complete house re roof with a 4/12 pitch 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. 83 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 Mark Janney Email not displaying correctly? View it in your browser. 84 zmw*mw*�� CONCIsc CONSTRUCTION 2750 S. Wadsworth Blvd. Suite D-100 Denver, CO 80227 303-728-9402 Web: conciseconstruction.com Email: info@conciseconstruction.com -( _- I IJ - 1 -7 -- Dale Cucto„er %,40 Reel 5-1 Address Wham- �, � �o 0o3F, Gcy. State. Zip Home Number Work Number 770 -7-32 - o37Z Cell Number Email SCOPE OF WORKAS APPROVED BY INSURANCE CARRIER PREFERRED CONTRACTOR ACCREDITED BUSINESS • Protect landscaping, clean site daily Obtain building permit as required • Tear off all layers down to the decking Adhere to all local building codes in effect • Install Synthetic Felt Roll lawn and driveway with magnetic sweeper • Install new plumbing boots Provide liability insurance of $1,000,000.00 • Install new pre -painted drip edge & Maintain workman's comp. insurance on all crews • Install new shingles, 6 nails per shingle • CONCISE CONST. 5 Year Installation Guarantee • Re -flash all wall abutments and chimneys as needed • Manufacturer's Warrant�� IIr lI years. • Install ice and water shield in all valleys Material drop location � Roof _ Driveway ❑ ROOF ONLY K ROOF AND GUTTERS Shingle Mfr/Stylet �� DEF Shingle Color _H � S k&Drip Color Vl1 ^` Gutter Color 1 Ji 1G ki4P. WI&Y' Gutter LF Downspout Qty. LF CLIENT RESPONSIBILITY [/We understand that it is our responsibility to make sure that our choice of shingle/color meets HOA approval. I/We have been shown shingle samples and have agreed to the above shingle and color. I/We understand that we owe our deductible for an insurance claim being addressed. Client Initials Approximate cost of services (Estimated RCV) $ 12-- IW • 2-'5- The S The above items (estimated cost and dates of services) are general estimates on damages known at the time of this contract being entered. All work completed will be performed for the RCV total plus any agreed supplements provided by your insurance carrier. Start and completion dates are subject to change based on availability of first check, weather and availability of materials. Estimated Start Date Za 17- Estimated Completion Date 7— 30— 1!_T Deductible Amount $ 2& 141.00 Customer agrees to provide a DEPOSIT in the amount of 00 . DO upon Delivery of Materials PROPERTYOWNER DATE COMPANYREPRESENTA DATE Scanned by CamScanner Concise Construction, LLC (hereafter referred to as "Concise Co." or "CCL') will perform roof replacement and exterior repairs to the Premises for the Client as approved and specified by Client's insurance company (collectively, the "Scope of Work") for the replacement cost value (RCV) of the insurance claim. The only out of pocket cost to the Client is their deductible, any non-recoverable depreciation, where applicable, as well as any agreed costs for upgrades or additional work authorized by the Client in writing. Supplemental claims and/or overhead and profit billed by CCI, on behalf of the Client and approved by the Client's insurance company for additional work, or increases in costs in addition to this contract, shall also be deemed a part of this contract as if contained herein. This contract will become binding upon execution and CCL shall receive all insurance proceeds, including the deductible. CCL will not charge the client for the ACV (Actual Cash Value) amounts for line items not addressed by CCL. Client agrees to provide CCL with all insurance communications, both written and verbal, and to authorize CCL to negotiate with the insurance company on Client's behalf to secure the funds necessary to complete the contracted Scope of Work. CCL shall hold in trust any payment received from the Client until CCL has delivered roofing materials at the Premises or has performed a majority of the roofing work on the Premises. 1. All proposals are subject to approval of CCL management. 2. CCL will perform the Scope of Work in accordance with generally accepted roofing and construction guidelines, adhering to local codes effect at the time of construction. 3. CCL's standard payment terms are as follows: 50% when materials are delivered and 50% when work is completed. Endorse and/or make all checks payable to Concise Construction, LLC. Any joint checks issued by Client's insurance company shall be immediately endorsed and tendered by Client to CCL. 4. You have the right to rescind this contract and obtain a full refund of any deposit within seventy- two (72) hours after entering the contract. If you plan to use the proceeds of a property and casualty insurance policy to pay for the roofing work, you may also rescind this contract with in seventy-two (72) hours after you receive written notice from the property and casualty insurer that your claim has been denied in whole or in part. However, CCL is entitled to retain payments or deposits to compensate CCL for roofing work actually performed in a workmanlike manner consistent with standard roofing industry practices. CCL cannot pay, waive, rebate, or promise to pay, rebate all or part of any insurance deductible applicable to the insurance claim for payment for roofing work on your property. S. To rescind, send by certified mail or personally deliver a signed and dated copy of the cancelled contract within seventy-two (72) hours of contract signing, or seventy-two (72) hours of written notice of denial of claim from the insurance carrier to the CCL address on this contract. Client may also email a signed and dated copy of the cancelled contract to info(@conciseconstruction.com. 6. All excess materials will remain the property of Concise Constructions, LLC. 7. Client is responsible for timely securing all required Homeowner's Association approvals of the roofing products and color(s). 8. CCL shall not be liable for failure of performance due to labor controversies, strike, fire, hail, weather, acts of God, inability to obtain material from usual sources, or any other circumstances beyond CCL's control. 9. CCL shall not be responsible for any leaks or water damage below the roof line, or any damage caused by excessive wind, ice, or hail during the period of the warranty. 10. Replacement of code required materials/upgrades not covered in Client's insurance policy will be additionally charged to Client on a labor and material basis. 11. CCL will not be held responsible for slight scratching or denting of gutters, oil droplets in the driveway, hairline fractures in concrete, or damage to plants or shrubbery. Furthermore, CCL will not be held responsible for exterior damages such as broken or fallen crown molding or fascia, or interior damages such as cracked plaster/sheet rock or nail pops. 12. CCL's liability insurer is Blue Sky Insurance Services, 9090 Ridgeline Blvd. Highlands Ranch, CO 80129. Contact: Bill Vaughan, 303-647-5477. Scanned by CamScanner ti.'rhis Contract and all attachill(`Ilts hereto repl'esellt the entire cO11U'.1CC betwCen parties, and supersede all prior written or Oral coil tracts heIWeen IIIc talc.IIt'111(1 C(:1,. 14. This contract cannot he cllallged, modified or terminated by any other contract unless the same is in writing and signed by the party ag jillst wllOIll elilol'(:((Relit of the chailge, modification or termination is solight. 15 -This contract shall he binding upon the partes and theh' respective successors, heirs, legal representatives and permitted assigns. 16. if any one or more of the provisions Contained in this contract shall for any reason he held invalid, illegal or unenforceable in any respect, such invalidity, illegality, or unenforceability, shall not affect any of the other provisions hereof, and this contract shall be construed as if such invalid, illegal or unenforceable provision had (lever been contained herein. 17. An account is past dile wilen more than thirty (:30) (lays have passed after the roofing work was completed. Iran account is past title by sixty (60) days, a latae charge of $120.00 will occur. If an account goes into collections, Client shall pay CCL interest at twenty-one (21%) percent per annum for all past dile accounts. 1l Clieilt does not pay all sums when due under this contract to CCL, thele Client agrees to pay all costs and fees incurred by CCL for its collection, including reasonable attorney fees and costs. Accounts are, considered due ante all work agreed upon in this contract is complete and the customer has received final payment from his/her insurance carrier, even if final inspections from the city or county have not yet taken place. CCL further guarantees that all Nvork will pass final inspections. CCL reserves the right to place a mechanic's lien on Client's property for any default in the timely payment of amounts due under this contract. Client shall pay CCL interest at twenty-one (21/0) percent per annum for all accounts ninety (90) days past due. 18. The parties avaive the right to a jury trial in any action or proceeding, based upon or related to, any aspect of the transaction in connection with this contract, or any document executed or delivered in connection with such transaction. 19. Venue for any legal action brought pursuant to or involving this contract, shall be in the City/County of Denver, State of Colorado, or any other location mutually agreeable to the parties. 20. All attachments to this contract shall be part of this contract and are incorporated herein by this reference. 21. It is the Client's sole responsibility to provide a safe -keeping area for all pets. CCL shall not responsible for gates left open during or after its work. Scanned by CarnScanner CITY OF WHEAT RIDGE Building Inspection Division � (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: /(�/t k;ecrf c.4 Permit Number: r� /-,)0 67 ❑ No one available for inspection: Time ' AM/PM Re -Inspection required: Yes Flo When corrections have been made, call for re -inspection at 303-234-5933 Dater =' Inspector: DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: 6 Job Address: if m L J C!: 1f.$l Permit Number: ❑ No one available for inspection: Time AM Re-Inspection required: Yes l / "When corrections have been made, can for re-inspection at 303-23,4-5933 Date: Inspector:, 1 D2 K. DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: PI)O Job Address: 616,' ~ RoLo) Permit Number: MCP/~;?D ,J7 r r r'~ h kor- rn rr rt o r-6 a No one available for inspection: Time (f /PM Re-Inspection required: es No 'When corrections have been made, call 101 re-inspection at 303-234-5933 ff Date: ~J~' ? F)l Inspector: - Ola ~ Lw- DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office - (303) 235 -2857 Fax INSPECTION NOTICE Inspection Type: thts, . P" M Job Address /Permit Number: rqwrp ❑ No one available for inspection: Time 2 AfvTMJ Re- Inspection required: Yes No E: When corrections have been made, call for r -ins paction at 303 - 234 -5933 Date ! fspector: (/P V DO NOT REMOVE THIS NOTICE { oFw"Eqr~ City of Wheat Ridge Building Division m 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855' Fax: 303-235-2857 0 o Inspection Line: 303-234-5933 OCORP~ Building Permit Application Property Address: U k 'ESP 57T Property Owner (please print): ZIAL1,: ^r l0 or,csyT Phone:3 ° 3 4,6 0 e9 Mailing Address: (if different than property address) Address: State, Contractor: P V2_ X 721 04?5~ Contractor License Phone:,3f3 -1-4 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: $ Description of work: 1 yq (as calculated per the Building Valuation Data sheet) ,.Pitts m try " a 4 Plan Review (due at time of submittal): $ ` <S~AL L NA' ar ?)py/Z ~llrt~~f~uKat <_,_0 5i/a Sq. Ft./L.Ft added: Squares , BTU's Gallons Amps OWNERICONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work under this permit. Plans subject to field inspection. CIRLCE ONE:: (OWNER) ONTRACTO or PERSONAL REPRESeE lATIV~E off((OW~NEERR.). (CONTRATOR) PRINT NAME: /~dg2t!,s'~ la0 ac- SIGNATURE: ` U"''' - Date:' 43a o