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Home My WebLink About3130-3140 Gray StreetFrom: no-reolvCalci.wheatridae.co.us To: CommDev Permits Subject: Online Form Submittal: PERMIT APPLICATION Water Heater Replacement Date: Monday, March 28, 2022 3:01:21 PM CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Report any suspicious activities to the IT Division. PERMIT APPLICATION Water Heater Replacement This application is exclusively for RESIDENTIAL REPLACEMENT WATER HEATERS - LIKE FOR LIKE ONLY. 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. Do Not use this form if the Water Heater is changing locations or if this is a conversion to a Tankless Water Heater. Please use the General Permit Application for a more comprehensive review. Is this application for a Yes replacement water heater like for like? PROPERTY INFORMATION Property Address 3130 Gray Street Wheat Ridge, CO 80214 Property Owner Name Brian Rice Property Owner Phone 303-475-9796 Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email Address (Leave blank if not known) Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A brianj rice@com cast. net PICTURE OF A CREDIT CARD" CONTRACTOR INFORMATION Contractor Business Blue Sky Plumbing & Heating Name Contractor's License 017835 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 303-407-7967 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email randyp@blueskyplumbing.com Address Retype Contractor randyp@blueskyplumbing.com Email Address DESCRIPTION OF WORK Number of gallons 40 Is the water heater GAS GAS or ELECTRIC? If GAS, enter # of 40,000 BTUs. If electric, enter n/a Where is the water crawl space heater located (for example, basement, crawlspace, etc)? Project Value (contract 1550.00 value or cost of ALL materials and labor) 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 randyp@blueskyplumbing.com Pe rm it Email not displaying correctly? View it in your browser. From: no-reolvCalci.wheatridae.co.us To: CommDev Permits Subject: Online Form Submittal: PERMIT APPLICATION Furnace/Boiler Replacement Date: Monday, March 28, 2022 2:56:33 PM CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Report any suspicious activities to the IT Division. PERMIT APPLICATION Furnace/Boiler Replacement This application is exclusively for RESIDENTIAL REPLACEMENT FURNACE or BOILER - LIKE FOR LIKE ONLY. 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 a Yes replacement residential furnace or boiler like for like? PROPERTY INFORMATION Is this Residential or Residential Commercial? Property Address 3130 Gray Street Wheat Ridge, CO 80214 Property Owner Name Brian Rice Property Owner Phone 303-475-9796 Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email brianjrice@comcast.net Address Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" Wheat Ridae Payment Form 2022.Odf CONTRACTOR INFORMATION Contractor Business Blue Sky Plumbing & Heating Name Contractor's License 017835 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 303-407-7967 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email randyp@blueskyplumbing.com Address Retype Contractor randyp@blueskyplumbing.com Email Address DESCRIPTION OF WORK What type of unit is Furnace being installed? Number of BTUs 60,000 What is the efficiency 96% (%) of the unit? Is the unit GAS or GAS ELECTRIC? Where is the furnace or crawl Space boiler located (for example, basement, crawlspace, etc)? Project Value (contract 5774.00 value or cost of ALL materials and labor) 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 Randy Palato Pe rm it Email not displaying correctly? View it in your browser. From: no-reolv(alci.wheatridae.m. us To: CommDev Perm is Subject: Online Form Submittal: Water Heater Replacement Permit Application Date: Thursday, December 16, 20218:35:27 AM Water Heater Replacement Permit Application This application is exclusively for RESIDENTIAL REPLACEMENT WATER HEATERS - LIKE FOR LIKE ONLY. 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 a Yes replacement water heater like for like? PROPERTY INFORMATION Property Address 3140 Gray Street Property Owner Name Brian Rice Property Owner Phone 303-475-9796 Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email Address (Leave blank if not known) Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" Brianjrice@comcast.net CONTRACTOR INFORMATION Contractor Business Colorado Delta Mechanical Name Contractor's License 080021 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 Number of gallons E:I.'3:r-SON AN91? copermits@deltamechanical.com copermits@deltamechanical.com IN Is the water heater Gas GAS or ELECTRIC? If GAS, enter # of 40000 BTUs. If electric, enter n/a Where is the water crawlspace heater located (for example, basement, crawlspace, etc)? Project Value (contract 2760 value or cost of ALL materials and labor) 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 Kayla McCallie Permit Email not displaying correctly? View it in your browser. 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 :r ADDRESS: JOB CODE: 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 C�' Do Not Cover Underground or Below / In -Slab 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 C�' 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 SEE OVER FOR ADDITIONAL INSPECTIONS PERMIT:�� 7� I ( ADDRESS: �`'� C�-fi JOB CODE:I`V Rough Inspection (continued) Date Inspector Initials Comments 316 Rough Mechanical Residential 317 Rough Mechanical 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 l . ) 411 Landscape/Park/Planning* Inspections from these entities sha be req ted 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. The City of Wheat Ridge 7500 W. 29th Avenue, Wheat Ridge, CO 80033 Third Party Form Check List Property Address 3110 Axn6A ger Permit Number ?moo 1044 1 Permit Issued Date -11 l Cl /1'1 Owner Information Property Owner Information -Cyte.r %V Son Property Owner Address 7-07-0 C,ADLW trV "V_9fAU44 Inspector Information Inspection Company CV0UzC\ Ja& Inspector Name Vow -y- %<n3QTn%n Inspector Contact info. 0110 - 11,L - Z3 q 9 Inspector Statement and Acknowledgement * I hearby acknowledge the roof I am inspecting is 6/12 or over. All roofs that are under 6/12 must be inspected by the City of Wheat Ridge Buiding Dept. * I hearby 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 City of Wheat Ridge Policies and Procedure and Manufacturer's recommendations and specifications.` ,Z) 4' ' 7 Inspector: y�,ej- Date: Property Owner Statement of Acknowledgement *1 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 Ridge Buil ing Division inspection. Propery Owner/Agent: Date: This original document and permit card, as well as the roofing check list, must be submitted tc the Chief Building Official within seven days of the final inspection. Drop off in person Permit counter 2nd floor 7500 W. 29th Ave Wheat Ridge CO 80033 Draft Date: 7/26/17 Please add note to reverse side The City of Wheat Ridge Inspection Check List notes Mid-Roof Roof Inspection�� ❑ N/A ❑ Pass ❑ Fail ❑ N/A V1 Pass ❑ Fail Structural roof components N/A 1E Pass ❑ Fail Verify that no more than 2 layers of shingles exist N/A ❑ Pass ❑ Fail Flashing for roof and walls Pass ❑ Fail If new sheathing is installed verify that it is listed in the permit description (Valuation must be adjusted) ❑ N/A [ Pass ❑ Fail Verify sheathing nail pattern (See Policy & Procedures) 14 N/A ❑ Pass ❑ Fail Crickets and saddles where needed ❑ N/A Pass ❑ Fail Verify B vent must have boot same gauge as pipe ❑ N/A Pass ❑ Fail Verify vent caps N/A ❑ Pass ❑ Fail Verify no flashings are damaged or rusted N/A ❑ Pass ❑ Fail Step flashing shall be min. of 4x4 piece per shingle N/A ❑ Pass ❑ Fail Verify scuppers allow for proper drainage ❑ N/A X Pass ❑ Fail Ice and water shield 2' in heated wall spaces ❑ N/A 54 Pass ❑ Fail Underlayments must follow 2012 IRC / 2012 IBC ❑ N/A Pass ❑ Fail Verify roof slope for proper drainage ❑ N/A Pass ❑ Fail Dripedge shall have min of 2" overlap ❑ N/A Pass ❑ Fail Dripedge should extend down min 2" past roof deck ❑ N/A Pass ❑ Fail Dripedge shall be mechanicaly fastened 12" OC N/A ❑ Pass ❑ Fail 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 with min. slope of 1:12 N/A ❑ Pass ❑ Fail Modified Bitumen, EPDM, TPO min slope 1/4:12 slope N/A ❑ Pass ❑ Fail Above roof insulation R-25 N/A ❑ Pass ❑ Fail Below roof residential R-38 N/A ❑ Pass ❑ Fail Below roof commercial R-32 N/A ❑ Pass ❑ Fail Modified Bitumen, EPDM, TPO min slope 1/4:12 slope must be installed in accordance with the manufacturers specifications- Must have manufactures letter of warranty with the address on the letter for final inspection Metal Roof Shingles Requirements ❑ N/A ❑ Pass ❑ Fail Metal roof shingles shall not be installed on slope less 3:12 ❑ N/A ❑ Pass ❑ Fail Metal valley flashing shall be the same material as roof ❑ N/A ❑ Pass ❑ Fail Metal valley flashing shall extend a min of 8" from the centerline with a min. of 3/4 " high splash diverter rib built-in at the flow line with sections overlapping a a min. of 4" Tile Roofs Requirements ❑ N/A ❑ Pass ❑ Fail Clay and concrete the shall have a min. 2-1/2:12 slope Slopes 4:12 and under require double underlayment Company Name: Inspector signature: Date of Inspection: The City of Wheat Ridge Inspection Check List notes Mid -Roof Notes n 1E L -3)A I Mark Benjamin PE PHI -D&E Inc. dba Crown Jade (com) Design and Engineering PO 17, Ft. Collins CO 80522 970-472-2394 �e�,D0L,fi..q 333 0 CJ .ao. The City of Wheat Ridge Inspection Check List notes Final Roof (� Roof Inspection ❑ N/A ❑ Pass ❑ Fail ❑ N/A Pass ❑ Fail Structural roof components ❑ N/A Pass ❑ Fail Verify that no more than 2 layers of shingles exist N/A ❑ Pass ❑ Fail Flashing for roof and walls Pass ❑ Fail If new sheathing is installed verify that it is listed in the permit description (Valuation must be adjusted) ❑ N/A Pass ❑ Fail Verify sheathing nail pattern (See Policy & Procedures) ;] N/A LP ElPass ❑ Fail Crickets and saddles where needed ❑ N/A Pass ❑ Fail Verify B vent must have boot same gauge as pipe ❑ N/A Pass ❑ Fail Verify vent caps N/A ❑ Pass ❑ Fail Verify no flashings are damaged or rusted N/A ❑ Pass ❑ Fail Step flashing shall be min. of 44 piece per shingle N/A ❑ Pass ❑ Fail Verify scuppers allow for proper drainage ❑ N/A Pass ❑ Fail Ice and water shield 2' in heated wall spaces ❑ N/A Pass ❑ Fail Underlayments must follow 2012 IRC / 2012 IBC ❑ N/A [ Pass ❑ Fail Verify roof slope for proper drainage ❑ N/A Pass ❑ Fail Dripedge shall have min of 2" overlap ❑ N/A Pass ❑ Fail Dripedge should extend down min 2" past roof deck ❑ N/A ® Pass ❑ Fail Dripedge shall be mechanicaly fastened 12" OC [�] N/A ❑ Pass ❑ Fail 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 with min. slope of 1:12 N/A ❑ Pass ❑ Fail Modified Bitumen, EPDM, TPO min slope 1/4:12 slope N/A ❑ Pass ❑ Fail Above roof insulation R-25 N/A ❑ Pass ❑ Fail Below roof residential R-38 (� N/A ❑ Pass ❑ Fail Below roof commercial R-32 PO N/A E] Pass ❑ Fail Modified Bitumen, EPDM, TPO min slope 1/4:12 slope must be installed in accordance with the manufacturer's specifications - Must have manufacturer's letter of warranty with the address on the letter for final inspection Metal Roof Shingles Requirements ❑ N/A ❑ Pass ❑ Fail Metal roof shingles shall not be installed on slope less 3:12 ❑ N/A ❑ Pass ❑ Fail Metal valley flashing shall be the same material as roof ❑ N/A ❑ Pass ❑ Fail Metal valley flashing shall extend a min of 8" from the centerline with a min. of 3/4 " high splash diverter rib built-in at the flow line with sections overlapping a a min. of 4" Tile Roofs Requirements ❑ N/A ❑ Pass ❑ Fail Clay and concrete tile shall have a min. 2-1/2:12 slope Slopes 4:12 and under require double underlayment Company Name: Inspector signature: Date of Inspection: The City of Wheat Ridge Inspection Check List notes Final Roof Notes Zn S 1 1 \7 Mark Benjamin PE PHI -D&E Inc. dba Crown Jade (.com) Design and Engineering PO 17, Ft. Collins CO 80522 970-472-2394 LJ. vc�JJaQ � s A d City of Wheat Ridge Residential Roofing PERMIT - 201704411 PERMIT NO: 201704411 ISSUED: 07/19/2017 JOB ADDRESS: 3130 Gray ST EXPIRES: 07/19/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning asphalt shingles - 18 sq *** CONTACTS *** OWNER (701)770-7010 PERSON TYLER SUB (303)981-1265 Jon Lowrie . 100243 Monarch Construction & Roofing *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 11,500.00 FEES Total Valuation 0.00 Use Tax 241.50 Permit Fee 236.00 ** TOTAL ** 477.50 *** 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 one half 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 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. 'V �, A ,r City of Wheat Ridge `r Residential Roofing PERMIT - 201704411 PERMIT NO: 201704411 ISSUED: 07/19/2017 JOB ADDRESS: 3130 Gray ST EXPIRES: 07/19/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning asphalt shingles - 18 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 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 vrk to be performed is disclosed in this document an or its' accompanying approved plans and specifications. Signature o OWNER ter---e6NTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in thepermit 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 maybe 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 Oficial 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 in pections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services 6. The issuince ongran4ug a peri t all not be construed to be a permit for, or an approval of, any violation of any provision of any app cy`any o ulation 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. Dan Schultz ?tJ � 70 � q From: no-reply@ci.wheatridge.co.us Sent: Tuesday, July 11, 2017 11:12 AM To: Permits CommDev 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 3130 gray st tyler persson 7017707010 Property Owner Email Field not completed. Address 2", S PXt I, rtij c-, Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. CONTRACTOR INFORMATION Contractor Name Contractor's License Number (for the City of Wheat Ridge) Contractor Phone Number monarch construction 100243 3039811265 Contractor Email Address blowrie@monarchroofs.com Retype Contractor Email Address DESCRIPTION OF WORK Are you re -decking the roof? Description of Roofing Material Select Type of Material: If "Other" is selected above, describe here: How many squares of the material selected above? Does any portion of the property include a flat roof? blowrie@monarchroofs.com No owens corning Asphalt Field not completed. 18 No If yes, how many squares Field not completed. on the flat roof? TOTAL SQUARES of all 18 roofing material for this project Provide additional detail reroof house here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract11500 value or cost of ALL materials and labor) 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 CES IANEWOOD. CO 80328 PHONE:13031981-126S FM:r303141-1 V.40 W.MAlr.: MONARDAR CIICO@D0.81 GMTEAII LOnf.OM MONARCH `l+' ^ RCf °§ WWW.MONApCNROOFlNO.COM (.111 K,1-111`., && K-11.111. Customer Name Tyler Persson Top 1% of roofing contractors I F r -r LJ JA !BBB. � Address 3130 Gray St Wheatridge CO 80214 Phone 7017707010 Email tpersson29 gmail.com Insurance Company Ins.Policy # Alt Phone Claim # Monarch Construction & Roofing, LLC will be referred to in this contract as Monarch. The scope of work and materials identified below are the scope of work recommended by Monarch Construction & Roofing; Monarch is not obligated to perform any part of the scope of work that is not approved by the insurance company unless you authorize the work and agree to pay for this additional work. Shingle Manufacturer OC Type: Storm ColorOnyx Black Int. X Tear off all existing layers (2 layers) ❑ Tear off one layer of wood shake shingles X Install Decking (7/16" OSB) 2 sheets of OSB are included, each additional sheet will be $65 per sheet Install New Undedayment _151b. _301b. X Synth. —FP X Install Pre -Painted metals to code Brown Charcoal Tan Gray White Other Black Int. — X Valley(s) will be closed with ice & water shield 7 Valley(s) will be open X Ridge (s) to be color -coordinated with shingle _ Ridge(s) to be Nigh-Proffle and color -coordinated with shingle X Install new pipe jacks X Replace vents as needed X Re -flash chimney(s) and all wall abutment as needed _ Install Ridge Vent _LF X Install Ice & Water shield per code, as well as all vents and skylights X Install 4-6 nails per shingle as required by city/county codes. _ Satellite/ Dish Alignment (each customer will need to contact the provider to re -align dish after roof installation) X Final Inspections will be completed as city/counties allows, I have read the back of contract # 23 X 5 -year workmanship warranty on roofing, all other construction trades will receive a 1 yr. workmanship warranty _ Extended Warranty Per Sq. $ Circle: Owens Corning Platinum GAF X Monarch Construction & Roofing will provide general liability insurance coverage of $2,000,000 general aggregate X Perform magnetic sweep of driveway and yard for removal of any nails X Remove all trash and debris from work listed X Gutters LF Size: 5 -inch or 6 -inch Color: Int — X Replace Gutter Screens Type: Int. Int.m— Other: X Insurance funds include Mortgage Company _ Yes _ No (If yes please complete the third party authorization form) Special Instructions Int TP The approximate cost of the services based on damages known at the time this contract is entered is $ determined by insurance. Monarch will perform the scope of work approved by the insurance company. Monarch will supplement for items priced low, not included or items needed to pass city/county codes, which may increase initial dollar amount that insurance is paying out. Supplemental claims billed by Monarch that are approved by the insurance company for additional work or increases in costs become a part of this contract The final scope and price agreed on between the insurance company and Monarch shall become the final contract price for the insurance approved scope. Customer will be responsible to pay for any upgrades; deductible, non-recoverable deprecation or additional work authorized by the customer that the insurance company determines is not covered within the scope of coverage provided by your insurance policy. Approximate Dates of Service: these dates of service are subject to change due to unusual delays in transportation of materials, payment delays, insurance approval, ordinary weather delays, or by any other causes beyond reasonable control of Monarch. Monarch will provide communication to customer to show tentative dates. Notice: If the property owner plans to use proceeds of a property and casualty insurance policy issued pursuant to part 1 of article 4:10, C.R.S., to pay for the roofing work, pursuant to section 6-22-105, the roofing contractor cannot pay, waive, rebate, or promise to pay, waive, or rebate all or part of any insurance deductible applicable to the insurance claim for payment on the covered residential proper. I(we) hereby authorize & instruct the insurance company & lien holders to include the name of Monarch Construction & Roofing LLC as co -payee on any subsequent loss draft or checks after today's date as indicated above. I (we) authorize any legal representative and/or agent of Monarch Construction to obtain information necessary to complete any funding process relative to the claim number referenced above. I (we) further authorize Monarch to pick up in person any loss drafts or checks on my/our behalf and behalf of Monarch. Deposit Amount: $ Date: 6/29/2017 2:27:05 PM Rep. InitialsJ�—! IL Monarch Construction &Roofing LLC shall hold in trust any payment from the property owner until Monarch Construction & Roofing LLC has delivered roofing materials at the residential property site or has performed a majority of the roofing work on the property. I (we) agree, by signing below, to all the contract conditions, both front and back of this agreement. Dam of Acceptance:6/29/2017 2:27:39 Customer Signatura(s): ;C;� Customer Signature: Monarch Representative: Evan Kelley LLOOGAN. .> City of Wheat Ridge Residential Mechanic PERMIT - 201702022 PERMIT NO: 201702022 ISSUED: 06/15/2017 JOB ADDRESS: 3140 Gray ST EXPIRES: 06/15/2018 JOB DESCRIPTION: Repair gas line from gas leak in crawlspace *** CONTACTS *** OWNER (303)249-6236 FONLANE SARAH & BOB OHLINGER SUB (303)233-7007 Torrey Cosgrove 017885 Lakewood Plumbing LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 600.00 FEES Total Valuation 0.00 Use Tax 12.60 Permit Fee 29.90 ** TOTAL ** 42.50 *** COMMENTS *** *** CONDITIONS *** 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. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanyingg approved plans and specifications, nd applicable building codes, and all applicable municipal codes, policies and procedures, athat I am %e legal owner or have been authorized by the legal owner of the property and am authorized to obtain thispermit and perform the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include alt entities named within this document as parties to the work to be per formfdFand that all worts to be_perrmed 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 thepermit 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 andprocedures 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 Building 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 insptimerequestgci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. City Of ��,,,,�Wheatl e MUN17Y DEVELOPMENT Building $ Inspection Services Division 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Request Line: 303-234-5933 Pe WQrty Address; PropY 4in+ sr (please print): �Vlail,ng AtJrlr+ss (if City, State, Zip: Date: —'-- Plan # Permit #0V AN VM Building Permit Application 1® c�inkr,��to�: ' t 'L;� E ,ry Contractors City License #: �_ S� Phone: Electrical: Plumbing: Mechanical: City License # City License # City License # ��SCT1 �IO�q�97NYjT('` (Fu d scribe wor}c to be p formed Attach additional sheet if necessary) ff . i Review Fee (due at time of submittal): Squares BU's Gallons Amps Sq Ft. � Fheroby R/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT her certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, gulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and ns made are accurate; that I have read and agree to abide by all conditions printed on this application and that 1 assume full bility for compliance wi _l cable City of Wheat Ridge codes and ordinances for work under any permit issued based on cation; that I am ih egal owner or have been authorized by the legal owner of the property to perform the described work lso authorized b e legalowner of any entity included on this application to list that entityyon this application. ItQtl d(7nlrll.�c OR Bldg Valuation: $ 1* � A 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: e /$1 Z — Job Address: 313 D , le 14 K S7 Permit Number: 20/ 60 / -76 Z 0b /00, c,rre-- 5- , W ;/l .n e.-, f No one available for inspection: Time ' 10AM/PM /'Re -Inspection required: Y No *When corrections have beelrmade, call for re -inspection at 303-234-5933 Date Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE ��9rBuilding Inspection Division (303) 234-5933 Inspection line (303)235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: '�_ M - L'1�' '�-f ' �-9 f ��, Job Address: 3 l N 0 C tZi4 V 5r Permit Number: 206 0 / -793 C 1j 0 it El No one available for inspection: Time ?G 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 I, by my si gnat redo reby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable 'ding des, and. II applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorr_cd by the le owne f the rty and am authorized to obtain this permit and perform the work described and approved in conjunction with t I pen t. I f er at a n le��all a r+zed to include all entities named within this document as pames to the work to be pe red that or e�1r3is disclosed in this document and/or its' accompanying approved plans and specifications. Sl"gnaturezff OWNER or CONTRACTOR (Circle one) Date I, Thispermit was issued based on the information provided in the permit application and accompanying }dans 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 tlle Chief Building Official and may be subject to a fee equal to one-half of the originalermit fee. 3. If this pen -nit 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 noltbe construed to be a permit for, or an approval of, any violation of any provision of any applicable codeorany 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. Inspection time requests will be accepted by email only. Please email requests to insptime(T-ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. City of Wheat Ridge Residential Electric PERMIT - 201601782 PERMIT NO: 201601782 ISSUED: 11/10/2016 JOB ADDRESS: 3130 Gray ST EXPIRES: 11/10/2017 JOB DESCRIPTION: Service change to 125 amp *** CONTACTS *** OWNER (720)775-8916 180 INVESTMENTS GRAY LLC GC (720)422-9060 Lou Santanostasi 021892 Platinum Electric Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: / SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 1,700.00 FEES Total Valuation 0.00 Use Tax 30.60 PAID, Permit Fee 67.30 ** TOTAL ** 97.90 *** COMMENTS *** *** CONDITIONS *** Must comply w/ 2012 IRC & 2014 NEC. Subject to field inspection. I, by my si gnat redo reby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable 'ding des, and. II applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorr_cd by the le owne f the rty and am authorized to obtain this permit and perform the work described and approved in conjunction with t I pen t. I f er at a n le��all a r+zed to include all entities named within this document as pames to the work to be pe red that or e�1r3is disclosed in this document and/or its' accompanying approved plans and specifications. Sl"gnaturezff OWNER or CONTRACTOR (Circle one) Date I, Thispermit was issued based on the information provided in the permit application and accompanying }dans 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 tlle Chief Building Official and may be subject to a fee equal to one-half of the originalermit fee. 3. If this pen -nit 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 noltbe construed to be a permit for, or an approval of, any violation of any provision of any applicable codeorany 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. Inspection time requests will be accepted by email only. Please email requests to insptime(T-ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. City of W heat l�, COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 29" Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: perm its(oki.wheatridge.co.us FOR OFFICE USE ONLY Date: 6 l Plan/Permit # OLV I Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 3 l 3 r ",i �% Property Owner (please print): Phone: rp Property Owner Email: Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer: Architect/Engineer E-mail: 7 Contractor: Contractors City License #: Contractor E-mail Address: Sub Contractors: Electrical: W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Phone: Phone: % 22 �? 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 9 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.) Sq. FULF Btu's Amps ) Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) 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. CIRCLE ONE: (OWNS (CONTRACTOR r (AUTHORIZED REPRE ENTATIVE) of (OWNER) (CONTRACTOR) PRINT NAME: 4y5�9��/US�/"�S/ SIGNATURE- DATE: ✓ lC� �� ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: PROOF OF SUBMISSION FORMS Fire Department ❑ Received ❑ Not Required Water District ❑ Received ❑ Not Required Sanitation District ❑ Received ❑ Not Required DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: TYPE OF CONSTRUCTION: SPRINKLERED: OCCUPANT LOAD: Building Division Valuation: $ I, by my signature, do eby attest t the work to be performed shall comply with all accompanying approved plans and specifications, applicable buildi od ,and plicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal 011 er o e pr a am authorized to obtain this permit and perform the work described and approved in conjunction with this ermityl"furt attes authorized to include all entities named within this document as parties to the work to be perfoiigd a E ormed is disclosed in this document and/or its' accompanying approved plans and specifications. 'Signature or OWNER or CONTRACTOR (Circle one) Date I. 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 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 ra ting 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 r y ordinan(( or�re�guetion of this jurisdiction. Approval of work is subject to field inspection. I I II cl l/0 Signature of Chief Building Official Date I REQUESTS MUST BE MADE BY 11:59PH ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptime@ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. City of Wheat Ridge Residential Electric PERMIT - 201601783 PERMIT NO: 201601783 ISSUED: 11/10/2016 JOB ADDRESS: 3140 Gray ST EXPIRES: 11/10/2017 JOB DESCRIPTION: Service change to 125 amp *** CONTACTS *** OWNER OWNER/OCCUPANT GC (720)422-9060 Lou Santanostasi 021892 Platinum Electric Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: / SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 1,700.00 FEES Total Valuation Use Tax 0.0 30.660 PAID Permit Fee 67.30 ** TOTAL ** 97.90 *** COMMENTS *** *** CONDITIONS *** Must comply w/ 2012 IRC & 2014 NEC. Subject to field inspection. I, by my signature, do eby attest t the work to be performed shall comply with all accompanying approved plans and specifications, applicable buildi od ,and plicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal 011 er o e pr a am authorized to obtain this permit and perform the work described and approved in conjunction with this ermityl"furt attes authorized to include all entities named within this document as parties to the work to be perfoiigd a E ormed is disclosed in this document and/or its' accompanying approved plans and specifications. 'Signature or OWNER or CONTRACTOR (Circle one) Date I. 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 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 ra ting 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 r y ordinan(( or�re�guetion of this jurisdiction. Approval of work is subject to field inspection. I I II cl l/0 Signature of Chief Building Official Date I REQUESTS MUST BE MADE BY 11:59PH ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptime@ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. City of Wheat , dge COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 29`h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: perm its(a-)ci.wheatridge.co.us FOR OFFICE USE ONLY Date: I Plan/Permit # j,,u I �o) Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: Property Owner (please print): Phone: Property Owner Email: Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer: Architect/Engineer E-mail: Contractor: '!�_L'c`e'77?i' rz� Contractors City License #: Contractor E-mail Address: Sub Contractors: Electrical: W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Phone: Phone: 7,2J 6z 0 7� s'Z 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 >ff ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESIDENTIAL 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.) Sq. Ft./LF FC, To Btu's Amps )7 Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) l 7o 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. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) PRINTNAME: ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: PROOF OF SUBMISSION FORMS Fire Department ❑ Received ❑ Not Required Water District ❑ Received ❑ Not Required Sanitation District ❑ Received ❑ Not Required DEPARTMENT USE ONLY DATE:`, lG�6 OCCUPANCY CLASSIFICATION: TYPE OF CONSTRUCTION: SPRINKLERED: OCCUPANT LOAD: Building Division Valuation: $ A i CITY OF WHEAT RIDGE ��9rBuilding Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: l� J. Job Address: ; 1 r c.., ��- Permit Number:.nL�' Q) 3 J Q A f QV)�I T (1 ❑ No one available for inspection: Time10i 3 ci �1�71yPM Re -Inspection required: Yes No *When corrections have been made, call for re -inspection at 303-234-5933 Date: %OIL/ f G Inspector: 2L DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax �2 INSPECTION NOTICE Inspection Type: • O. f. Job Address: 3 1 3 y G r o Permit Number: i 5 0/ 3- y ❑ 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:I C Inspector_ DO NOT REMOVE THIS NOTICE City of Wheat Ridge 114'emorandum FROM: Melissa Mackey, Building Division I '' SUBJECT: Refund for Permit DATE: May 18th, 2016 Reason: Received written request from contractor (attached) requesting that permit #201501394 for 3130 Gray St. be cancelled due to non-payment. Please refund: Contractors License$ ( Total: $53.50 TO: A.M. Electrical Enterprises 7140 W, Colorado Dr. Lakewood, CO 80232 City of Wheat Ridge Municipal Building 7500 W 29" Ave. Wheat Ridge, CO 80033-8001 P: 301235.2855 F: 3012378929 I IF=$ # "To"i Company Name/Name (to whom check should be made out to): Address: Zip: Pho=-NO—AZ Fax: Email: Permit #:_2LA5Lj2_q_q_ Permit Address:_3A Ic ft Printed Name: signature: ?ate. �Date: For office use only This request has been: Approved Denied Refund Arnount: $ Approved b Date: aim City of Wheat Ridge Memorandum TO: Accounting Department FROM: Melissa Mackey, Building Division ` kiak � SUBJECT: Refund for Permit DATE: May 18th, 2016 Reason* Received written request from contractor (attached) requesting that permit #201501395 for 3140 Gray St. be cancelled due to non-payment, Please refund: Contractors License$ ( TO: A.M. Electrical Enterprises 7140 W. Colorado Dr. Lakewood, CO 80232 1=6 aw#Tml a Complete this application in its entirety, attach all copies of pennits, permit cards (if issued) and receipts that were received at the time of permit issuance. Requests for more than 80 percent of the amount paid will not be approved without prior approval from the Building Official. The refund application must be received by the Wheat Ridge Building Division no later than 180 days after permit issuance. Applications received after 180 f- UI=Nr#MMLjQjj "M I Company Name/Name (to whom check should be made out �*ts Address: City. State: Zip:-- S01 2 Phone:_2,Ea�:�� Fax: Pertnit Permit Address:��- �- �c-' Reason for request: For of use only 5 This request has been: 'Approved Denied Refund Amount: '"D Approved b� Date:_ FOR OFFICE USE ONLY City of tate: mi C�O. tt art D 'i� wp Pdent#'errrrlt# "jg Building & Inspection Services Division 7500 W. 2e Ave., Whet Ridge, CO 80033 Purr Review Office. 303-235-2555 * 'ex; 303-237-8929 Inspection Line; 303-2345933 Building er ` it AppliCation Mailing Address: (if different than property address) Address: City, State, Zi ArghttectlEwfam- Arch tecfEhqi er E-mail'. Phone* Contractor: C - fit L G Contractors City License #.- 5 12 " t Phone:, . Contractor E-mail Address: � Sub Contractors: Electrical: Plumbing: Mechanical: WR City License # WR City License# W,R. City Ucense Other City Licensed Sub: Other City Licensed Sub. City License # City License # Complete all information on BOTH sides of this for It, tAe d: ... r R Yt A 11 aY XF ' pM A : Y AY AR i • • ♦ !Y t ilY • j i s A Alk Mt A '.AF i Y tlw t M AW Y t Sq. FULF Stu's Gallons Amps 1, a,' "� Squares tither FOR OFFICE USE ONLY City of Date: _��rWh6atPjdge CXOMXAMOUMTY DEvELopmENT plan1permit # )101 ) Building & Inspection Services Division 7500 W. 2e Ave., Wheat Ridge, CO 80033 Plan Review Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line.- 303-234-5933 Building Permit Application OropertyAddress:_3 I Lit) Property Owner Email: Im Mailing Address: (if different than property address) Address: City, State, Zip: Flu Contractor: j� , vvx , C, Contracfor s,'City License M Phone 3L 'V2 tG —0 Contractor E-mail Address: Sub Contractors-, Electrical: Plumbing: Mechanical: W,R. City License # W,k City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all information on BOTH sides of this form W f Check all that .rr 1. � F P • } M M p iP � iIW ♦ t • � �,. AiF N A Alr F i �N � M 1w '. � Sq. FULF Btu's Gallons Amps VI vI,e � Squares Other FOR OFFICE USE ONLY City of Dom. .. �COMMUNiTy DEVUOPhl!�.NT� bat CC) Building & Inspection Services Division 7500 WN 2e Ave., Wheat Ridge, CO 80 033 Plan Reviewv Office. 3033-235-2855 * e: 3033-237-8929 Inspection Line; 303-234-5933 BuildingPermit` Application Property Address:Aj 4 Pry Owner (please print): °` � � '° � �, Pit . 2,10-7E57 - Property Owner ll Mailing Address: (if different than property address) Address: City, State, i h Arch t Engin r E-mail: Phone.. . 2q -_L Contractors City License *- Contractor fit Address: Sulo Contractors.- Electrical: ontra tors.- Electri l: Plumbing: Mechanical: W.R. City License # W.R.City License # W.R. City License # Other City Licensed Serb; Other City Licensed Sub: City License # City License # Complete all information on BOTH sides of this form • � .lei +! _ �� ,� eY A 1 M ilf 1 s ! A...• ♦ IMS � 1 Iffawls a IM r •" amount oTmatenais to oe usea, atc.) Sq. FULF Btu's Gallons Amps Squares Other