HomeMy WebLinkAbout4721 Cody StreetFrom: no-reolv(alci.wheatridae.m. us
To: CommDev Pets
Subject: Online Form Submittal: Furnace/Boiler Replacement Permit Application
Date: Monday, April 19, 20213:28:37 PM
Furnace/Boiler Replacement Permit Application
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 4721 Cody street
Property Owner Name
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"
Jonathan Morman
720-400-0140
fixitgroup@s1 permits. com
CONTRACTOR INFORMATION
Contractor Business Fix -It Group LLC
Name
Contractor's License 180142
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
720-795-3146
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
fixitgroup@s1 permits. com
Address
Retype Contractor
fixitgroup@s1 permits. com
Email Address
DESCRIPTION OF WORK
What type of unit is
Furnace
being installed?
Number of BTUs
60K
What is the efficiency
80%
(°%) of the unit?
Is the unit GAS or
gas
ELECTRIC?
Where is the furnace or
interior
boiler located (for
example, basement,
crawlspace, etc)?
Project Value (contract
$4,200
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 Kevin Ritter
Permit
Email not displaying correctly? View it in your browser.
City of Wheat Ridge
E -Res. Furnace Replacement PERMIT - 202100623
PERMIT NO: 202100623 ISSUED: 04/20/2021
JOB ADDRESS: 4721 Cody St EXPIRES: 04/20/2022
JOB DESCRIPTION: Replace furnace in basement, 60K, 80% efficiency
*** CONTACTS ***
OWNER (720)400-0140 MORMAN JONATHAN L
SUB (303)578-3957 GAYLE FRUENDT 180142 FIX -IT GROUP, LLC
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2002 / KI PL ING , 1-70 & CLEARCREEK ARE BLOCK/ LOT# : 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 41200.00
FEES
Furnace Replacement 40.00
Total Valuation 0.00
Use Tax 88.20
** TOTAL ** 128.20
*** 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. Furnace Replacement PERMIT - 202100623
202100623
4721 Cody St
Replace furnace in basement, 60K,
ISSUED: 04/20/2021
EXPIRES: 04/20/2022
80% efficiency
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
pplicab e code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
04/20/2021
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
-117Z
i�W"i/Lo o�cup cv`. �e
NPECTION R
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection
INSPECTION REQUEST LINE: (303) 234-5933
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
"oncrete Encased Ground (CEG)
Foundation / P.E. Letter
uo root rour l.Oncrete rnor I o Ap roval UT I ne Above Inspections
Underground/Slab Inspections Date Inspector Comments
Initials
Electrical
fewer Service
'lumbing
Do Not Cover Underaround or Below/In-Slab Work Prior To Annrnvnl [)f Tho Ahrnvn Incnne-frons
I
Rough Inspections
Date
Inspector
Initials
Comments
-Vheathing�
!lid -Roof
ath /Wall Tie
'ough Electric "
Rough Plumbing/Gas Line
?ough Mechanical
Rough Framing
Rough Grading
Insulation
drywall Screw/ Nail
�:inalInspections
Date Inspector
Initials
Comments
andscaping & 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.
tOW & Drainage / Public Works Dept.
Floodplain Inspection (if applicable)
moire Inspection / Fire Protection Dist.
aminal Electrical
sinal Plumbing
sinal Mechanical
Roof
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 low 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 - 201703986
PERMIT NO:
201703986
ISSUED:
07/14/2017
JOB ADDRESS:
4721 Cody ST
EXPIRES:
07/14/2018
JOB DESCRIPTION:
Residential Re -roof to
install Owens Corning Duration
asphalt shingles with
20 Sq
House Roof Only 5/12
Pitch
*** CONTACTS ***
OWNER (720)400-0140
KHAITTHA SAENCHA
SUB (303)459-7889
Quality Construction
110245 Quality
Construction
*** PARCEL INFO ***
ZONE CODE:
UA / Unassigned
USE:
UA / Unassigned
SUBDIVISION CODE:
2002 / KIPLING, I-70
& CLEARCREEK
ARE BLOCK/LOT#:
0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION:
6,000.00
FEES
Total Valuation
0.00
Use Tax
126.00
Permit Fee
140.90
** TOTAL **
266.90
*** 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.
13
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: OF
Job Address: `1-72 ud 4
Permit Number:
❑ No one available for inspection: Time { 0/13M
Re -Inspection required: Yes
01
When corrections have been made, call for re -inspection at 303-234-5933
Date: ( f Inspector: !
DO NOT REMOVE THIS NOTICE
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: Z v 17 3 i R,
& _6" t 0 // L,,` L,7 ,J I�
❑ No one available for inspection: Time A—` I P(I/PM
e Inspection required: es No
when corrections have been made, call for re -inspection at 303 -234 -
Date: Inspector:
DO NOT REMOVE THIS NOTICE
i 91 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: _� 7O
f,
•F
j V nqq,�
❑ No one available for inspection: Time
Re -Inspection required: YesgI
When C
Gor
rections have been made, call for re -inspection at 303-234-5933
Date: o , l 5' 1 7 Inspector:?I—
DO NOT REMOVE THIS NOTICE
Ai
CITY OF WHEAT RIDGE
Buildingxlnspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: M i P
Job Address: 4– o2 i c -op � `sr
Permit Number: 2 b 1:1 () 3 9 LP
A -.
❑ No one available for inspection: Time �' + Aw�M
Re -Inspection require Yes No
When corrections have been made, call for re -inspection at 303-234-5933
11
Date: i Inspector:
DO NOT REMOVE THIS NOTICE
4 City of Wheat Ridge
j Residential Roofing PERMIT - 201703986
PERMIT NO: 201703986 ISSUED: 07/14/2017
JOB ADDRESS: 4721 Cody ST EXPIRES: 07/14/2018
JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration asphalt shingles with
20 Sq
House Roof Only 5/12 Pitch
**REVISION**Added redecking; Added valuation: $2,100.00
*** CONTACTS ***
OWNER (720)400-0140 KHAITTHA SAENCHA
SUB (303)459-7889 Quality Construction 110245 Quality Construction
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2002 / KIPLING, I-70 & CLEARCREEK ARE BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,100.00
FEES
Total Valuation 0.00
Use Tax 170.10
Permit Fee 188.45
** TOTAL ** 358.55
*** 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.
City of Wheat Ridge
Residential Roofing PERMIT - 201703986
PERMIT NO: 201703986 ISSUED: 07/14/2017
JOB ADDRESS: 4721 Cody ST EXPIRES: 07/14/2018
JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration asphalt shingles with
20 Sq
House Roof Only 5/12 Pitch
**REVISION**Added redecking; Added valuation: $2,100.00
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 tfhe legal owner or have been authorized
by the legal owner of the property and am authorized to _btam this permit and perform the work described and approved in conjunction with
this ermit. I further attest hat I am le alit -attth�izaa to include all entities named wit n this document as parties to the work to be
performed and th k a oil disclosed in this document and/o lits'raompany' g approved plans and specifications.
ature 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 originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a 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
applica�le`ctsde or any ordinance or regulation of this jurisdiction. Approval of work is subject to Held inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
Wheat A,e
COMMUNITY DEVELOPMENT
Building & Inspection Services Division
7500 W. 291h Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: perm its(@ci.wheatridge.co.us
I FOR OFFICE USE ONLY I
Date:
Add to Permit #
Building Permit Revis on/Amendment Application
Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *"*
Property Address:
AV -T-
Property Owner (please print): /� !� t L� /� �o�ne
Property Owner Email:
Mailing Address: (if different than property address)
Address
, State, Zip:
Submitting Company/:
Contact Person: Phone:
Contractor: � �� l�— � a �-� ( � � S T `�' l.c� C� -�-6)
Contractors City License #: 1 r 1 _I S Phone:
Contractor E-mail Address:
Please Note: Additional valuation must include all general and subcontracted work to be performed
related to the revisions and/or amendments declared in the description of work and which were not
included in the original permit valuation.
If revisions or amendments increase the original valuation, additional fees will be due at the time of
approval. Depending on the scope of work, additional plan review fees may be due upon approval
($60.00 an hour — 2 hour minimum).
Description of revised/amended work:
Sq. Ft./LF
Amps
Btu's
Squares
J'e,cl<� e /,-
Gallons
Other
Additional Project Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above)
OWNEWCONTRACTOR 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 ain also authorized by the legal owner of any
entity included on this application to list that entity on this application.
CIRCLE ONE: (OWNER) (CONT CTOR) or (AUTHORIZED REPR NTATIVE) of (OWNER) (CONTR TOR)
PRLNT NAME: �� / SIGNATUR DATE: /
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
Reviewer
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
PROOF OF SUBMISSION FORMS
Fire Department ❑ Received
Water District ❑ Received
Sanitation District ❑ Received
❑ Not Required
❑ Not Required
❑ Not Required Building Division Valuation: $
y. City of Wheat Ridge
Residential Roofing PERMIT - 201703986
PERMIT NO: 201703986 ISSUED: 07/14/2017
JOB ADDRESS: 4721 Cody ST EXPIRES: 07/14/2018
JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration asphalt shingles with
20 Sq
House Roof Only 5/12 Pitch
*** CONTACTS ***
OWNER (720)400-0140 KHAITTHA SAENCHA
SUB (303)459-7889 Quality Construction 1102.45 Quality Construction
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2002 / KIPLING, I-70 & CLEARCREEK ARE BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,000.00
FEES
Total Valuation 0.00"Al"
Use Tax 126.00
Permit Fee 140.90
** TOTAL ** 266.90
*** 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.
City of Wheat Ridge
Residential Roofing PERMIT - 201703986
PERMIT NO: 201703986 ISSUED: 07/14/2017
JOB ADDRESS: 4721 Cody ST EXPIRES: 07/14/2018
JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration asphalt shingles with
20 Sq
House Roof Only 5/12 Pitch
I, b m si nature, do her Z
st that the work to be performed, shall comply with all accompanying approvefi plans and specifications,
app rl cable wilding codes, anc,applicable municj-eapohcies and procedures, and that Lam the legal owner or have been authorized
by the legal owner of the pr and am kvYize t_o obtain this permit and perform the work/described ayd approved in conjunction with
thispermit. I further attes _-t I am a to include all entities named within this ocumen as�parties to the work to be
Per
and that all rk to b r sclosed in this document and/or its' accomp,yinkao roved plaids and specifications.
Signaturk6f OWNER or CONTRACTOR (Circle one) Date
I . This permit was issued based on the information provided in the permit application and accompariving 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 originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4' No work of any manner shall be performed that shall results in a 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 -or y ordinance or r ulat' rt o 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.
Dane Lovett
10.f q sqk
From: no-reply@ci.wheatridge.co.us
Sent: Wednesday, July 5, 2017 11:25 AM
To: Permits CommDev
Subject: Online Form Submittal: Residential Roofing Permit Application
Categories: Gina`
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
4721 Cody St. Wheat Ridge, CO 80033
Khaittha Saencha
720-400-0140
Property Owner Email N/A ,
Address q ��) ^ �( 1
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
Quality Construction
110245
303-459-7889
Contractor Email Address claims@truequalityconstruction.com
Retype Contractor Email claims@truequalityconstruction.com
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:
M
OwensCorning Duration
Asphalt
Field not completed.
How many squares of the 20
material selected above?
Does any portion of the
property include a flat
roof?
If yes, how many squares
on the flat roof?
No
Field not completed.
TOTAL SQUARES of all 20
roofing material for this
proj ect
Provide additional detail House Roof Only 5:12 Pitch
here on the description of
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
Project Value (contract 6000
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 Robert Saitta
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3
Policy #: GLOO18071-02
QUALITY
Construction
BBB.
5895 E. Evans Ave., Denver, CO 80222
Phone: 303-459-7889 — 303459-2245
Expires: 05/24/2017 Limit: $2,000,000
Fully Insured
Licensed
Carrier: Accord
Customer:
Insurance Provider: _\
Address: O
Phone #:
00
Policy #: Claim #:
Phone #:
Project Manes er:
Date: - S�_
Phone #:
Shingle Manufacturer U 1P1
Tear off ._ layers of composition shingles
l [ 1 Install Decking (7/16"ASB)
\[ j Install new felt
Install new shingles
41113tall pre -painted eave metal to code -Color
Valleys) will be closed
Ridge(s) to be color -coordinated
I1[ Ridges(s) will be"High Profile Ridge" color -coordinator shingles
nstall new pipe jacks
eplace vents as needed
Re -flash chimneys and all abutment as needed and if possible (stucco or siding
maybe a deterrent)
[ l Install In. fL of series ridge vent
Approximate Date of Roof Completion -'-I — [ I"t- Start:
Approximate Dollars 3� '3
Yr. _-S( ) Color
NN,`[Q _QST Sr In. ft, ice and waterTlield to code
)Install i -e nails per shingle �k
[ 1 Clean our gutters
15 -year workmanship warranty
1 Quality Construction will provide general liability insurance
coverage of at least $2,000,000
�l Make a magnetic sweep of driveway and yard for removal of any nails
Remove all debris resulting from above work
( l Special Instructions
[ )Tear off one layer of wood shingles
11 I/2CDX
[ 1 Valleys(s) will be open
If initialed by buyer, then the contract price is contingent upon insurance approval; and buyer is only responsible for his/her deductible. When the insurance carrier
agrees to pay the claim for damage to the property, then the buyer agrees to allow Quality Construction, Inc, to perform all repairs prescribed by insurance company's adjuster
report. By reference, said adjusterls report and estimate becomes and hen is a part of this contract.
1. This agreement is subject to final approval by Quality Construction, Inc. and it the entire agreement of the parties and no other terms will be recognized.
2. Stating that the roofing contractor stall hold in trust any payment from the property owner until the roofing contractor has delivered materials or has performed a majority of the work.
3. Any supplemental payment fmm the buyerl; insurance company is due to Quality Construction, Inc. inclWing Cootractors Overhead and Profit. The payw4t schedule shall be. 5o% Depoir,
and the final 501A due at the completion of each trade.
4. Labor warranty does not toter damage caused by natural disasters: lighting, gak force wind, hurricane tornado, hailstorm, and impact of foreign objects or other damages due to
settlement, distortion, or failure of the roof deck, walls or foundation of a building.
S. Quality Construction, Inc. is not responsible to provide any materials or to perform asy work otter than what is described above.
6. 1.5%men thly will be added in daily increments to the balance of any and all unpaid portions of the o wunut, eommeocing upon completion date reception of remaining insurance proceeds.
7. Qua] ityConstnetion, Inc. wilIperform all work according tolocal building codes speciNat ion
8. If this contract is catcalled by the buyer later than three (3) days from signing, the buyer sham pay to Quality Construction, Inc an amount equivalent to thirty percent (30%) of Approved
Replacement CostValue, as liquidation damages, and Quality Construction, Inc Agrees to accept such as reasonable and just compensation for said cancellation and Consequential loss of
Profits.
9. Contract may be rescinded within 72 hours atter the property owner receives written notice that the Insurance claim has been denied
10. Buyer shall provide an electricity necessary to complete the above scope of work.
Il. Quality Construction, Inc. shall not be liable for any structural movement, settfirig, cracks in drym] 1, driveways or dents in grittOrs created during coma] construction procedures.
12. Befort any warramN written or otherwise, 6 to be considered valid, the Contract must be paid in full. la the event of a problem, due to Workmanship, Quality Construction, Inc must be
notified in writing within 10 business days of discovery of said problem. Quality Com truction, Inc. must be allowed to impact and correct the problem before anyone else, and will Or be
held responsible for any problems &rising from long-term exposure to water.
13. Each trade represented will be payable in full at completion of said trade.
14. If customer fails to pay for services performed by Quality Construction, Ine. then the Customer 4 responsible to pay an legal Costs and fees acquired by Quality Construction, Inc in pursuing
payment.
15. Final payment shall not be held while waiting for city or county inspection.
16. Quality Construction reserves the right to reject work at any time. If Quality Construction rejects a portion of the contract, the homeowner will be reimbursed for work not completed.
17. Quality cons tructionreserves the fight t ordu excess msterisls, All excess materials are properly of Quality Construction,
18. The Contractor cannot pay, waive r to an insurance deductible.
All ch cede payable to Quali n tion, Inc `rt'���✓ 1.
Owner: ry �- Consultant:
Date: to ` 5 ^ 1:7 Approved By:
Mountain Insurance Brokers - 3705 Kipling Street, Suite 104 -Wheat Ridge, CO 80033
ccs
Inspections will not e perfortned unless this card is posted
projectCall the inspection request line before 11: 59 pm. to receive an inspection the following business day.
Inspector Must Sign ALL Spaces pertinent to this
Foundation Inspections
wl I o uu w INTI I� N
Monolithic Reinforcement
Co ne r a t Wiirtc« « w Ground
FootJnQJStemwaI1 P.E. e-
Underground/Slab InspectionsM-
Mechanical
�IIIMi ILII ..�' .'�
The
Rough
Drywall
e Iql IIII I PI III II II
Inspector rnl,
Final Inspections
Initials
Final Electrical��
Final Plumbing
Final M
Final Building / Frame
- ! . , . � ♦ „.. , w . •
Drainage
{•
To: Page 2 of 4 2016-05-31 20:17:00 (GMT) 13034240495 From: Jesse Lanyon
City of WWI
CoMMU'N-ITY OrVVLOPMENT
Building A 1011 :ti Services Division
7500 M29M :
I Ave,, Wheat Ridge, CO 80033 Plan Review Fee:
Office:.30-235-2855," Fax. -303237-8929
grasp tion Line. 303-234.,5933
Emait.
SMIlding Permit Application
4721 Cody St
P
V, k", l, Jon Morman 720-400-0140
Se
.Address:
9!Y-1 �Slalel
BluePlumbing& Heating
17835 ,----'30 1-2161
AO sara@blueskyplumbinq.com
Complete altinformation on BOTH sides of this or
To: Page 3 of 4 2016-05-31 20-117:00 (GMT) 13034240495 From Jesse Lany'a
.s#
ftes GOOOPS
OWNERICONTRACTOR SIGNATUWOF UNDER -----
'N3 "7I° .NMP. + REEME;;N
1,eetti tat ilt set e#istattcs trrtapn.gcd by thispe at applicatia are aeca i%areat vieriarta trrgtacirie rrz atistaartas, rtti or
rre laticr s'ttft� .ii iri" est e r,ctr ceaveriatsts, tr its jarrestrictiun$ afrec0tti; that all nwAsuperiumts st own att t.atic a#s"atns t
nad it
a CCW1 ; ttt t iaaV�e.r ti d agree to ahi � y i Conditions printed on 016, application that I assme iii � sihi��fits pian
With oppfiorjetity of Wheat tgc ccodens and ordtlwxcs for.work un*r any pmt its baste! :on is'se� phemion, tit i Xtra tae legal ca r er
or ha ee s stt s t� y i le i owner f th .pr+ t p� r tho work a am a. O authorized rized by` w igat a erf any
tit itte tilts a n this appbca iion tea Hsi That entity On ttais rappti trt3gm 2, the. applicant ftrr thiq budding prrtlxtst a plicatiotr, rovatmt.the
trttthliihaa s ondw upplicabom
v
r
ICOR OFFICE USE ONLY
City of Dates:
Ci{tt3N'1 LOivttl�3i
planIpwMits'. .'
Building & inspection Services Division
7500 W, 29th Ave., Wheat Ridge, CO 8 033 Flan Rev
iew Fee:
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Building er it Application
Please complete all highlighted s on both $1d0$ of NS f0rM. incomplete ft t s may not be processed.
*#z0r^�o �k �n'�q l� *��
t ,
Mailing Address (if different than property address
Address:
City,
tete;'
r h tectfE ngin a er E-mail: Phone:
Contractor: ?Z0
Contractors City Ueense, #: �q7
Contractor E-mail Address: L"4 0 o'
Stab Contract
Electrical: Plumbing: Mechanical:
W.k City License # W.k City License #W.R. City License #
Other City Licensed Seib: Other City LicensedSub:
City License # City License #
Complete all information on BOTH sides of this for
�; � Ami A.. •.•A � � �
A
M A A•• A !M W� $ PM * s i A
i.1 INNovi M�
amount of materials to be used, etc.
oma.
Sq. FULF Btu's Gallons
Amps Square$ Other
FOIR OFFICE USE ONLY
City of Date:
0;0rWh6atR,�g1e
COMMUNiTy DEVU011MENT PlanlPennit#
'17 ?
Building & Inspection Services Division q
1"]
'-
7500 W, 291h Ave., Wheat Ridge, CO 80033 Plan Review Fee:
3ffice: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Building permit Application
Please complete all highlighted areas on both sides of this form. Incomplete al:Wllcatloos may not be processed.
__� a, I
Propettv Address:
troperty Owner (please print): 4-1
T-
/v
Property Owner Email: I
Mailing Address: (if different than property address)
Address:
Cit y, State, Zip:
ArchitectlEngineer E-mail.- Phone:
Contractor:
Contractors Coy, License Phone - 1
Contractorf-mall Address: r\ A- 18t/T a
Sub Contract
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W,k City License #
Other City Licensed Sub: Other City Licensed Sub:
City License# City License #
Complete all information on BOTH sides of this form
NEW COMMERCIAL
A MR • ELECTRICAL
MP k
SERVICE
UPGRADE
NEW RESIDENTIAL
t w M COMMERCIAL R#
COMMERCIAL
t tCyO RESIDENTIAL
R! t ADDITION WINDOW RAt
COMMERCIAL
Rk
t..• • i
E (Garage, shed, deck, etc.)
RESIDENTIAL
t kMR STRUCTURE
RMR « shed, deck,
MECHANICAL
t t MF iA REPAIR
M • tW or
REPLACEMENT
M iP i.
PLUMBING
M..r sysTtM/APPLIANCE
REPAIR
r t o • 1R t
CMENT
ELECTRICAL SYSTEM/fPLIANT! REPAIR or REPLACEMENT
OTHER (Describe)
f
Sq. FULF u Stu' Gallons
Amps Squares ,, Other