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4516 Field Street
FOR OFFICE USE ONLY City of Date., s_ 0::;0 COMMUNiTy DEVILOPIMPENTjg # Building & Inspection Services Division '2— 500 W. 29th Ave., Wheat Ridge, CO 80033 Plea Review Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Building r it Application Pleasecorriplate all highliahted arose on bath sides of this form. fricaiinplete, applications may not be Processed. Property Address: F �1 f, La f) rc it (pleaseprint}: Phone: -- -- Property Owner mail: Mailing +d+ r°+ : (if different than property address) Address. City, State, Zip. Arch t+ rigineerE-mail: Phone: ContractE-mailAddress: Sub contractors: Electrical: Plumbing: Mechanical: aR. City License # WR City License # W.R. City License Other City Licensed Sub: Other City Lien Scab: City License # City License Complete all information on BOTH sides of this form #±»?2*2»« »<w*«» (Check all that :#ply NEW COMMERCIAL STRUCTURE $ELECTRICAL SERVICE UPGRADE NEW RESIDENTIAL % �RUCTUR $ COMMERCIAL ROOFING COMMERCIAL , /■\ \RESIDENTIAL ROOFIN RESDENTIAL ADDITION $ WINDOW RE w w COMMERCIALACCESSORY STRUCTURE «%&,\> deck, RESIDENTIAL ACCESSORY S°® ^ ' \ (Garage, shed, deck, 33� MECHANICAL SYSw a ,P REPAIR or REPLACEMENT PLUMBING ::...wNC REPAIR or REPLACMENT -©»L SYSTEM/APPLIANCE REPAIR or REPLACEMENT #< »#!«»! .F!%F y \ » . & . \\ ..: ©«». 2 <Gallons Amps . \\ 2�: .: . . »mSquares Other: . .. .. ..