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HomeMy WebLinkAbout6150 W. 46th AvenueCity of Wheat Ridge Homeowner Mechanical PERMIT - 201800538 PERMIT NO: 201800538 ISSUED: 02/27/2018 JOB ADDRESS: 6150 W 46th AVE EXPIRES: 02/27/2019 JOB DESCRIPTION: Replace water heater, 50 gallon electric. Replace kitchen cabinets and counter tops and new tile floor. Install Tyvek house wrap, vinyl siding, soffit fascia. *** CONTACTS *** OWNER (610)369-1235 COZZONE ANTHONY T *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,751.21 FEES Hot Water Heater 40.00 Total Valuation 0.00 Use Tax 141.78 Permit Fee 156.75 ** TOTAL ** 338.53 *** 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 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 le 6wner of the property and am authorized to obtain this p rmit and perform the work described and approved in conjunction with this�pe t. I further attest that I am le ally authorized to include all e title named within this document as parties to the work to be ,13�rfor ed and that all work be performed is disclosed in this docum n and/or its' accompanying approved plans and specifications. r S ature Ir of OWNE CONTRACTOR (Circle one) Date I. This permit was iss ed 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 Budding 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 ermit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable code any ordma ce 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. City of' Wh6at Pid 'Rorm, , MMUNrry DEVELOPMENT Building & Inspection Services Division 7500 9Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits0ci.wheatridgq.co.us FOR FOR 0,FFICE USE ONLY '0 —1 Dal�� k7;?�� pian1pennif # Plan Review Fee: ' Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. "* Property Address* 6150 w 46th ave Wheat Ridge CO 80033 Property Owner (please print): Anthony Cozzone Phone: 610 639 1 235 Property Owner Email: atcozzone@_)gmail.com Mailing Address: (if different than property address) City, State, Zip: Arch itect/Eng i neer E-mail: Phone: Contractor: Contractors City License #: Phone: Contractor E-mail Address: Sub Contractors: W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Other City Licensed'Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form (4350.00) ❑ COMMERCIAL ❑ RESIDENTIAL Description of work: (Check all that apply) NEW COMMERCIAL STRUCTURE ❑ 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.) ❑ CHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT LUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT PJ ECTRICAL SYSTEM/APPLII NCE REPAIR or EPI ACEMENT OTHER (Describe) (For ALL projects, please provide a detailed/de6cription 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.) ,q`,o swe4,,— %3�.�.arc carr �..��</'�c�.�%r', �..-.�.�//�yr�,� �rrs .rr�,s�� %i•�y�.�'/�'/-"�'i Squares M Gallons 50 I Project Value: (Contract value or the cast of all materials and labor included in the entire project) OW NEW'C ONTRACTOR SIGNATURE OF CNMRST.ANDING AND .AGR, MIEN # I hereby certify that the setback distances proposed by this pennit application are accurate and do not violate applicable ordinances, rule or regulations of the City of'Whcat Ridge or covenants, eaascinents or restriction, of'record; that all mcasurements shown and allegations made atr accurtatc° that I have read and agree to abide by all conditions printed on this application and that I assurne full responsibility for compliance with applicable City of Wheat Midge codes and ordinances for work tender ,any pennit issued based on this application; that I ani the legal owner or have been authorized by the legal o ner of the property it) perfonn the described work and ant also authorized by the legal owner of any cntity included on dais application to list that ctatity on this application. CIRCLE O. E: ((Jli:ii'I"RJ (COAYRACTOR) gr of (011,i'ER) (CONTRACTOR) PRt':y" T NAME: Anthony Cozzone SIGNA ZONING COMMMENTS, Reviewer BUILDING DEPARTMENT COMMENTS Reviewer PUBLIC WORKS COMMENT S Reviewer PROOF OF SUBMISSION FORMS Fire Department 0 Received D Not Required Water District ❑ Received ❑ Not Required Sanitation District 0 Received ❑ Not Required Y DATE.';?1� OCC UPANCY CLASSIFICATION. ...._.____�.. TYPE OF CONSTRUCTION — SPR INKLEREt3 W OCCUPAN- LOAC3 Building Division Valuation: $ City of Wh6a-t id COMMUNiTY DEVELOPMENT Official Certification of Property Owner Permit THIS IS TO CERTIFY that I, the property owner, by my signature, attest that I currently reside at the project property, or intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers, or, if hiring sub -contractors, list them on the permit. Consultations and inspections will only be performed with the homeowner of record present at the project property. Property Owner(s): Project Property: ACI S'—O ejf if rized signatur' Applicant State of Colorado } County of �T ss .V— The fore oing instrument was acknowledged by me this —dL day of 201?'by TAMARA D ODEAN NOTARY PUBLIC STATE OF COLORADO NOTARY ID 20164015481 MY COMMISSION EXPIRES APRIL 22, 2020 �6Otl — My Commission Expires Notary Public i CITY OF WHEAT RIDGE Bra"ilding Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: S W O Job Address: 6 07-z ty c/ Permit Number: St G Aj a r- k- (1, i P i Coit a ❑ No one available for inspection: Time 1�= 01 AMA&M Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234- Date:--,9 03-234-Date:-,9 �;) i ) l8 Inspector: -T-,f> DO NOT REMOVE THIS NOTICE City of Wheat Ridge s �r Homeowner Roof PERMIT - 201708013 PERMIT NO: 201708013 ISSUED: 10/04/2017 JOB ADDRESS: 6150 W 46th AVE EXPIRES: 10/04/2018 JOB DESCRIPTION: Permit for a Homeowner reroof: Remove existing roofing materials to decking and install 30# base and modified roof system. Install HP 4 1/2 coping to perimeter of roof. Install new vent collars and flash and counter flash chimney. total roof: 15 squares flat roof. *** CONTACTS *** OWNER (720)327-0472 COZZONE ANTHONY T *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,000.00 FEES Total Valuation 0.00 Use Tax 105.00 Permit Fee 125.05 ** TOTAL ** 230.05 *** COMMENTS *** *** CONDITIONS *** I, the property owner, by my signature, attest that I currently reside at the project property, intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers. Consultations and inspections will only be performed with the homeowner of record present. Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be required for both the midroof and final inspections. The 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the Homeowner. REGARDING ROOF VENTILATION: Roof ventilation shall comply with IBC Sec. 1203.2 or IRC Sec. R806. The installation of ridge venting requires the installation or existence of soffit venting. For calculation purposes, one hat or turtle vent equal to one-half of one square foot of opening. Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) is required on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and mid -roofs may be called in at the same time, one hundred percent of the sheathing must be complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be required, the 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the Homeowner. 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 ali applicable municipal codes, policies and procedures, and that 1 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 rther attest that I am le ally authorized to include all entities named within this document as parties to the work to be perform c�d gall work to��, performedsd�sclosed in this document apd/or its' accompanying�pproved plans and specifications. Signature o OWNER or NTR R (Circle one) Date 1. This permit was issued sed on the-, information provided in the permit application and accompanying )tans 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 androcedures 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 no uAranteed. 4. No work of any manner shall be per f med 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 mit an approval of, any violation of any provision of any applicable code or any ordinance or regulation.' llri� diction. r 1 0 ork 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. City of W heat Idge COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(aki.wheatridge.co.us FOR OFFICE USE ONLY Date: t�l�(�)� Plan/Permit # 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: ,5� ��� ��•19-7/3i'lr Property OwneY (please print): ,�s o� �g Phone;,/ d l -7, Property Owner Emailf— 9- �l" o �. Z o�L �4J e:f j,, Mailing Address: (if different than property address) Address City, State, Zip: Architect/Engineer: Architect/Engineer E-mail: 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: Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form ❑ COMMERCIAL K RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION N-PESIDENTIAL 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.) j y� x``30 +A 0� • ����r s •�, ..��-s7�// Sq. Ft./LF Amps Btu's Gallons Squares '7 // C 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. 1, the applicant for this building permit application, warrant the tq thfulness of the information provided on the application. CIRCLE ONE (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name) :k—b`�0` ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Building Division Valuation: $ City of Wheat i c COMMUNITY DEVELOPMENT Official Certification of Property Owner Permit THIS IS TO CERTIFY that I, the property owner, by my signature, attest that I currently reside at the project property, or intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers, or, if hiring sub -contractors, list them on the permit. Consultations and inspections will only be performed with the homeowner of record present at the project property. Property Owner(s): s Project Property:�.�® Notarized signatyoof App State of Colorado } County of Jo- Ssv4o^ } ss 441-1 The fore oing instrument was acknowledged by me this day of QC t 20_11 by C F ARA D ODEAN TARY PUBLIC OF COLORADO RY ID 20164015481 ON EXPIRES APRIL 22, 2020 gym--- My Commission Expires 12Q_Az) Notary Public City of Wheat Ridge Homeowner Roof PERMIT - 201708013 PERMIT NO: 201708013 4 ISSUED: 10/04/2017 JOB ADDRESS: 6150 W 46th AVE EXPIRES: 10/04/2018 JOB DESCRIPTION: Permit for a Homeowner reroof: Remove existing roofing materials to decking and install 30# base and modified roof system. Install HP 4 1/2 coping to perimeter of roof. Install new vent collars and flash and counter flash chimney. total roof: 15 squares flat roof. **REVISION**Garage roof: Tear off existing modified roof membrane; install metal edge, #30 base sheet and modified roofing, 7 squares; Added valuation $1,799.00 *** CONTACTS *** OWNER (720)327-0472 COZZONE ANTHONY T *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 % *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,799.00 FEES Total Valuation 0.00 Use Tax 142.78 Permit Fee 156.75 ** TOTAL ** 299.53 *** COMMENTS *** *** CONDITIONS *** I, the property owner, by my signature, attest that I currently reside at the project property, intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers. Consultations and inspections will only be performed with the homeowner of record present. Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be required for both the midroof and final inspections. The 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the Homeowner. REGARDING ROOF VENTILATION: Roof ventilation shall comply with IBC Sec. 1203.2 or IRC Sec. R806. The installation of ridge venting requires the installation or existence of soffit venting. For calculation purposes, one hat or turtle vent equal to one-half of one square foot of opening. Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) is required on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and mid -roofs may be called in at the same time, one hundred percent of the sheathing must be complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be required, the 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the Homeowner. 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 ermrt, I further attest that I am letrally authorized to include all entities named within this document as parties to the work to be per an that all worko be performed is disclosed in this document and/or jts' accompanying approved plans and specifications. ignature c �WNERr %CONTRACTOR (Circle one) Date This permit was iss ed 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. 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. ` 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 Official and is not guaranteed. 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. 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, 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 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. City of WheatR Ae COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(o)-ci.wheatridge.co.us I FOR OFFICE USE ONLY Date: Plan/Permit #'a o I _j 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: Z/�o Owner Property Owner Email: Mailing Address: (if different than property address) Address City, State, Zip: Architect/Engineer: Architect/Engineer E-mail: 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 # Ik Phone: Phone: Other City Licensed Sub: City License # Phone:��0.391a3s 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 ❑ 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 b used, etc.) r/!•f Sq. FULF Amps Btu's 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. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): ��/ DATE: �* 7 ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: / -� q q Building Division Valuation: $ City of Wjh6atPs.,.�dge COMMUNITY DEVELOPMENT Official Certification of Property Owner for Trade Specific Permit THIS IS TO CERTIFY that I, the property owner, by my signature, attest that I currently reside at the project property, or intend to reside at the property for a period of one year after completion of the project, and am personally, performing all work, without the assistance of hired or professional workers, or, if hiring sub -contractors, list them on the permit. Consultations and inspections will only be performed with the homeowner of record present at the project property. Property Owner(s):_l`-,'i�� �o Ny Ci Z Project Property: sl_� Notarized signaturq�`bfApplicant State of Colorado } Countyof ss The foregoing instrument was acknowledged by me this � day of aLe-, 20_L2 by G, ?-z or'. TAMARA D ODEAN NOTARY PUBLIC STATE OF COLORADO NOTARY ID 20164015481 MY COMMISSION EXPIRES APRIL 22, 2020 0. - -� ah— My Commission Expires Ltj a2J20 -2e Notary Public T t N* i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line_:�9r; (303) 235-2855 Office • (303) 237-8929 Fak INSPECTION NOTICE, Inspection Type:��l Job Address: Sy© iA Permit Number: c-)1,70.! p / -7 ❑ No one available forJinspection: Time 7 AM/PM Re -Inspection required: Yes -nNoo When corrections have been made, tocall for re -in ep't' n at 303-234-5933 -- �' Date: Inspecr: / *> 1 "` DO NOT REMOVE THIS NOTICE FOR OFFICE USE ONLY City Of Gate: Wh6atj?, Building & inspection Services Division c � 7500 W. 29'x' Ave., Wheat Ridge, CO 80033 Plan Review Fee. Office: 303-235-2355 * Fax: 303-237-3929 Inspection Line. 303-2345933 Building er it Application ** Please complete all highlighted areas on both sides of this form. Incomplete ap li flon may not be processed. *** Property Address. 3-3 p Property Owner Mailing Address. (if different than property address) Address: City, State, Zip: 1pq Contractor: 5z ('t ag- -L "j �.O- Contractors City License Contractor E-mailAddress: Stab Contractors: Electrical: Plurnbing; Mechanical: W.K City License # WA. City License# W,R. City License #r Cather City Licensed Serb, ether City Licensed Sub: City License # City License Complete all information can BOTH sides of this furan ec ear arac&ag rc�oa'a �Li 6JCT 4fn'SrCS44p R'�tita �:.tj 995 . FULFr stns ��