HomeMy WebLinkAbout8300 W. 38th Avenue - 2016ll
`i_ CITY OF WHEAT RIDGE I � AM
Building Inspection Division
(303) 234-5933 Inspection line /
(303) 235-2855 Office • (303) 237-8929 Fax %J
INSPECTION NOTICE
Inspection Type: E F I
Job Address: 3yO W ?j$ /-)VIE
Permit Number: Z01Q 1 H
No 1,-4 n PoV,,/,pM
y i h FLO-or ry- l y., (C�1
Lq,4. Ly6.�Nu4. E: L q . r L LIA
❑ No one available for ins tion: Time LW AM/PM
Re -Inspection required: Q No
When corrections have been made, call for re -inspection at 303-234-
M77iDate: 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: E Fi
Job Address: a3 4 V
Permit Number: Zol 6d / y 6�
❑ No one available for inspection: Time
AM/PM
Re -Inspection required: Yes �No/
When corrections have been made, call for re -inspection at 303-34_Sg33
Date: % %i
Inspector:
DO NOT REMOVE THIS NOT/CE
k) 3 �90) 60 lvoq
INSPECTION RECORD
INSPECTION REQUEST LINE: (303) 234-5933
Occupancy/Type
Inspections will not be performed unless this card is posted on the project site.
Call the inspection request line before 11:59 p.m. to receive an inspection the following business day.**
Inspector Must Sign ALL Spaces pertinent to this project
Wall Sheathing
Foundation Inspections Date
Inspector Comments
Initials
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.
Pier
Plumbing
Concrete Encased Ground (CEG)
Lath / Wall Tie
Foundation / P.E. Letter
Rough Electric
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground/Slab Inspections
Date Inspector
Initials
Comments
Electrical
Wall Sheathing
Sewer Service
Inspections from these entities should be requested
one week in advance. For landscaping and parking
inspections call 303-235-2846. For ROW and drainage
inspections call 303-235-2861. For fire inspections
contact the Fire Protection District for your project.
Mid -Roof
Plumbing
Fire Inspection / Fire Protection Dist.
Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections
Rough Inspections
Date
Inspector
Initials
Comments
Wall Sheathing
Inspections from these entities should be requested
one week in advance. For landscaping and parking
inspections call 303-235-2846. For ROW and drainage
inspections call 303-235-2861. For fire inspections
contact the Fire Protection District for your project.
Mid -Roof
Fire Inspection / Fire Protection Dist.
Lath / Wall Tie
Final Electrical
Final Plumbing
Rough Electric
Final Mechanical
Rough Plumbing/Gas Line
�
Rough Mechanical
Roof
Rough Framing
Insulation
Drywall Screw/ Nail
Final Inspections
Date
Inspector
Initials
Comments
Landscaping & Parking / Planning Dept.
Inspections from these entities should be requested
one week in advance. For landscaping and parking
inspections call 303-235-2846. For ROW and drainage
inspections call 303-235-2861. For fire inspections
contact the Fire Protection District for your project.
ROW & Drainage / Public Works Dept.
Fire Inspection / Fire Protection Dist.
Final Electrical
Final Plumbing
Wn
Final 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.
**For Inspection Time Window Requests — Please email insptimerequest(@ci.wheatridpe.co.us by 8:00 A.M. the day of the
inspection with the property address in the subject line of the email.
Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued
Protect This Card From The Weather
City of Wheat Ridge
Commercial Electric PERMIT - 201601464
PERMIT NO: 201601464 ISSUED: 10/04/2016
JOB ADDRESS: 8300 W 38th AVE EXPIRES: 10/04/2017
JOB DESCRIPTION: Switchgear replacement; south wing & radiation oncology
*** CONTACTS ***
OWNER (303)813-5056 SCL LUTHERAN MEDICAL CENTER
GC (303)295-2511 M.A. Mortenson, Jr 018817 M. A. Mortenson Company
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned
SUBDIVISION CODE: UA / Unassigned
*** FEE SUMMARY ***
Total Valuation
Plan Review Fee
Use Tax
Permit Fee
** TOTAL **
*** COMMENTS ***
USE: /
BLOCK/LOT#: 0 /
ESTIMATED PROJECT VALUATION
FEES
0.00
1,683.34
5,868.00
2,589.75
10,141.09
326,000.00
*** CONDITIONS ***
Work must comply with the 2014 NEC, 2012 IBC and other applicable codes and ordinances.
Bork i5 ubjecL to field inspection.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanyin�ee
approved plans and specifications,
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am hgaloner orhave been authorized
by the legal owner of the property and am authorized to obtain this permit and perform the work descibed 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 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 ior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Bw
prlding
Official and may be subject to a fee equal to one-half of the original permrt 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 Chef 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. Tile 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 gr 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 o or any or ' ance o regulation of this jurisdiction. Approval of work is subject to field inspection.
/( /2--116
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE (Ail_ Ac
Inspection Type: 6 F 1 Floor( 3d-1-1
Job Address: 9300 c -J 38'x' 4 ter'
Permit Number: 2 0 16 G Il b c/
L1690 1-/411 Ude
Vlat C Lfil�
qc-'-c
DP311 9�c- F&&h
_34A 3 Ca L.
❑ No one available for inspection: Time
Re -inspection required: Yes I
When corrections have been made, call for re -inspection at 303-234-5933
Date: % 12 S // 7 Inspector: 6A
DO NOT REMOVE THIS NOTICE
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:
Job Address: OQ h
Permit Number: L
❑ No one available for inspection: Time dw
Re -Inspection required: Yes ()o
When corrections have been made, call for re -inspection at 303-23
Date:T
Inspector: k/- !
r,
DO NOT REMOVE THIS NOTICE
City Of
W heat idJg
COMMUNITY DEVELOPMENT
City of Wheat Ridge Municipal Building 7500 W. 29`h Ave. Wheat Ridge, CO
80033-8001 P: 303.235.2855 F: 303.237.8929
Permit
Extension
Request
Form
Permits 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 may 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.
Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not
guaranteed. Please complete this form in its entirety and submit to the Building Division at
permits a,ci.wheatridge.co.us or fax to 303-237-8929.
Party requesting permit extension: C,6ASIZ.L, c-M�L
Permit # o2&1561313 Property Address: 0ZQZ) pi, 2507 - �h rel CSC 3
r
Phone # 724" &70' Email Address: S/ervR, S4ztCIJ9:-r14) Mari er- tSQ ✓t-, C��h
Reason for extension request:
iz-cl - Cal lwev�_ 4 16e Cwh'04
sd�)C <-- 7�'W, 4 -Ile k" le- ""_k -I'kA � k;tVe
be - l« -744' /a"q(, Ul,
Number of days requested: /?p
Printed Name: S/Ele64 577h'f'FeQ. Signature: - Date: 4/,;Z///7
For office use only
This request has ben: XApproved -1 Denied Extended until: 0 I
t
Approved by: " l Date: 31 a)_/ 1 �
NNwiv.ci.wheatridge.co.us
City of
�Wheatrl,iclge
COMMUNiTy DEVELOPMENT
City of Wheat Ridge Municipal Building 7500 W. 291h Ave. Wheat Ridge, CO 80033-8001 P: 303.235.2855 F: 303.237.8929
Permit Extension Request Form
Permits 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 may 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.
Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not
guaranteed. Please complete this form in its entirety and submit to the Building Division at
permitskci.wheatridge.co.us or fax to 303-237-8929.
Party requesting permit extension: SEX" <27*vF��,� /ytpJ2 b" -1S6 L C A-4 P c�'7o �L
Permit# 261500828 Property Address: W. 3�7�0f rC w`%�'�"'ei� t?v i 33
Phone # 7-ZO . 676 Email Address: Ccm
Reason for extension request: '0`i� c-�vr� �°' '� 7� �"`�1� C 7
_V -X/ 5-�i�i-L as % SO4A- /Se) 2215-d13 �3
Number of days requested: /90
Printed Name: SAIFAr�'- Signature: Date: 3 22
l/ U
For office use only ¢
This request has been:. A owed Denied Extended until: 0 I
Approved by:"-.- Date:
www.ci.w heutridge.co. us
i CITY OF WHEAT RIDGE
Building Inspection Division
r(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: E /z I
Job Address: 3°®
Permit Number: ( G i' -i&
❑ No one available for inspection: Time/ LZ CAI M
Re -Inspection required: Yes L/Noc/
When corrections have been made, call for re -inspection at 303-234-5933
Date: Z�- i7 Inspector:j
DO NOT REMOVE THIS NOTICE
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: (/J S
Job Address:
Permit Number: 12-V I S DO q S
i, f-
r CUP^ q r0G
❑ No one available for inspection: Time `t� A M`
Re -Inspection required: Yes No
When corrections have been made, call four re -inspection at 303-234-5933
Date: 23 -17 Inspector: (!),<<<(�
DO NOT REMOVE THIS NOTICE
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: H 1 J
Job Address: ' 3 00 kA) 2
Permit Number: of j- o )'R('
Cij kit lk x.i -)t
❑ 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
Inspector:
DO NOT REMOVE THIS NOTICE
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: F- l2 . "r_ IJ N-5
Job Address: R) w 2a� *), I�Vt
Permit Number: Qct ) S- (DQ) �5 `1 K
42 42 P -312"A
❑ No one available for inspection: Timeq`. i S /PM
Re -Inspection required: Yes No
*When corrections have been made; call -f r re -inspection at 303-234-5933
f
Date: ) Inspector. ��, , �..�Qi`�
DO NOT REMOVE THIS NOTICE
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CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: / ` I
Job Address: 830,0 t --J. ,/
Permit Number: / 1 36 �57
{)
e f : 0-r-110
❑ No one available for inspection: TimeAI f/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Dater ` Inspector: 6"�,&-, f "
_DO NOT REMOVE THIS NOTICE
>CITY OF WHEAT RIDGE
j Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type;
Job Address:
Permit Number: 1
�. ' C
G6:,,j1 k- tf ft7t\
r•.
❑ No one available for inspection: Time Mgr, 0 /PM
Re-Inspection required: Yes No
When corrections have been made, c for re-inspection. at 303-234-5933
Date: 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: i @
Job Address: 6300 t,/ 36 A V&: -
Permit
& -Permit Number: 20l moo
Mara (
❑ No one available for inspection: Timet 2y M/PM
Re -Inspection required: Yes No
When corrections have been made, call forre-inspection at 303-234-5933
P �
Date: I p
Ins ector: '
DO NOT REMOVE THIS NOTICE
e ®� CITY OF-WHEAT-RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: - LL/�
Job Address:
Permit Number: I 1
ef
❑ No one available for inspection: Time :3 (AIVPM
Re-Inspection required:Ye No
*When corrections have been made, call for re-inspection at 303-234-5933
Date: Inspect : '#
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:
Job Address: 3 O 0 W
Permit Number: a V / (,, 0 09 4
1 1)) S-
❑ No one available for inspection: Time AM PM
Re -Inspection required:es)' o
When corrections have been made, cal or re -inspection at 303-234-5933
Date: I 0 / G Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
�9rVr Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: V1 ) 5
Job Address: U-) AV,2
Permit Number: Cil 6 0 _32N 8
1" 1 I `' - !,c 00-014 T_'_5
❑ No one available for inspection: Timeln 9 (AM/PM
Re -Inspection required: Yes No
*When corrections have been made, cell for re -inspection at 303-234-5933
Date: // Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
��9rV, Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: t , 1
Job Address: 300 w- 3 8 7� AJC
Permit Number: - 0160130 S
CT-) of
P i
U
❑ No one available for inspection: Time S AM/P
Re -Inspection required: Yes (6
*When corrections have been made, call for re -inspection at 303-234-5933
Date: 716�" 16 Inspector: il*/ ( /
DO NOT REMOVE THIS NOTICE
City of
whe-",atP -Ye
CONANIUNITY DEVE1,01"MENT
FOR OFFICE USE ONLY
Date:
Plan/Pennit #
Plan Review Fee.,
# # # #
it ��i ME ii 11
P*00#4104#0* 8300 W 38th Ave
anne.l,ut,z@sclhs.net
Architecture
Contractor: M.A. Mort enson
Contractors City License #: 018 8 f'T" Phone: 720-259-4879
Contractor E-mail Address
Sub Contractors:
Electrical: Sturgeon Electric Plumbing* Apollo Mechanical Mechanical: Apollo Mechanical
WR City License # 018567 W,R. City License # W,R, City License #
Other City Licensed Sub: Arapahoe Fire
City License #
R COMMERCIAL [I RESIDENTIAL
NEW COMMERCIAL STRUCTURE El ELECTRICAL SERVICE UPGRADE
NEW RESIDENTIAL STRUCTURE EICOMMERCIAL ROOFING
COMMERCIAL ADDITION [I RESIDENTIAL ROOFING
RESDENTIAL ADDITION E]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 k. •• REPAIR or REPLACEMENT
OTHER (Describe) Replacement of existing CT Machine
Replacement of existing CT Machine. Remove the
new Machine. A new humidifier will be installed
electrical upgrades and moving of plumbing lines
existing CT machine and replace wit
as well. There will. be some
for new humidifier.
Amps Squares Other
(Contract value or the cost of all materials and labor included in the entire project)
$ 158, 000,
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
truthfulness of the information provided on the application,
CIRCLEONE: (01VIVER) (CONTRACTOR) gr (AUITIIORIZL DRf'PRESF-NTATIIT) of (OPVVER) (COTRACTOR)
Elelotroille Signa—fitre (first and last name):
Building Division Valuation:
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:
Job Address: 63oo L✓ -3S 1 rr Ave -
Permit
VePermit Number:
❑ No one available for inspection: Time I I.' 3CJ Alyl M
Re -Inspection required: Yes CNo
*When corrections have been made, call for re -inspection at 303-234-5933
Date: Inspector:
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Commercial Electric PERMIT - 201601464
PERMIT NO: 201601464 ISSUED: 10/04/2016
JOB ADDRESS: 8300 W 38th AVE EXPIRES: 10/04/2017
JOB DESCRIPTION: Switchgear replacement; south wing & radiation oncology
*** CONTACTS ***
OWNER (303)813-5056 SCL LUTHERAN MEDICAL CENTER
GC (303)295-2511 M.A. Mortenson, Jr 018817 M. A. MortPnsnn (mmnanw
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: /
SUBDIVISION CODE: UA / Unassigned BLOCK/LOT#: 0
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: FEES 3 000.00
Total Valuation FEE
0.00
Plan Review Fee 1,683.34
Use Tax 5,868.00
Permit Fee 2,589.75
** TOTAL ** 10,141.09
*** COMMENTS ***
*** CONDITIONS ***
Work must comply with the 2014 NEC, 2012 IBC and other applicable codes and ordinances.
Work is ubject to field inspection.
I, by in signature, do hereby attest that the work to be performed shall comply with all accompanyingg approved plans and specifications,
applicable building codes, and all a a"
codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the rope and am authorize to obtain this permit and perform the work described and approved in conjunction with
this permit. I f es at I am legally authori d to include all entities named within this document as parties to the work to be
P er orme that or t be performed i closed in this document and/or its' accompanying approved plans and specifications.
Signature of 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 trust 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 �ranting fa ermit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applicable co i ce or r 7 ation 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
W heatj,
COMMUNITY DEVELOPMENT
FOR OFFICE USE ONLY
Date:
Plan/Permit # II
Building & Inspection Services Division /A6 j k, D' y 'r
7500 W. 29th Ave., Wheat Ridge, CO 80033 PAID Plan Review Fee:
Office: 303-235-2855 * Fax: 303-237-8929 Qj� Aa /3 V- 3 3
Inspection Line: 303-234-5933 PAID
Email: permitscD_ci.wheatrid_qe.co.us
Building Permit Application 3
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address: 8 3dU w 9!e� s % S�' ' 'N ),.^ 'X,
4�1 N .c`rZ
Property Owner (please print): SL L. L. u' c\_—r r--7_zc c Phone:
Property Owner Email: G�- � S G�� S • tie_ -
Mailing Address: (if different than property address)
Address: �c:'CD LVJ CD rL-t--\Z!,U gU v� . 5 v = : e� 4 3U U
City, State, Zip: QjP-oc_-�
Architect/Engineer: t�'`L- ��t\' �- Z'rz 61
Architect/Engineer E-mail: ��' �al\��\�c.rz� -C C/-"' Phone: ---> C) scu F - 0 -) Lr 1
Contractor: j-'1 �-_' "(:ate' & N s v >J
Contractors City License #: 0\ a g N Phone: 7 w- 2 s S- L I e-) G
Contractor E-mail Address:
Sub Contractors:
Electrical: 51 0 Z-
W.R. City License # 01
Other City Licensed Sub:
City License #
C-yGr\. 00 )_�Or\e- --,0/1 . LU/—
Plumbing: Mechanical:
W.R. City License # W.R. City License #
Other City Licensed Sub:
City License #
Complete all information on BOTH sides of this form
N / N
COMMERCIAL ❑ RESIDENTIAL
Description of work: (Check all that apply)
❑ NEW COMMERCIAL STRUCTURE '6, 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. FLlLF
Amps
�� ��� � � ,� S �- �.�•� ate.
Btu's Gallons
Squares
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$ 3Z(=" V-,
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
1 hereby certify that the setback distances proposed by this pen -nit 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 perforin 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) RACTOR) r (AUTHORIZED REPRESENTATIV ER) (CQNTRACTOR)
PRINT NAME: �w SIGNATU J DATE: Ci'7, 2 Z - t
DEPARTMENT USE ONLY
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
)� 0. dwCAyr► ,lit K ,r �,; ,.,�, i' u r 11 2c,)'( NCC / 2-e. j ; ,3 i
PUBLIC WORKS COMMENTS:
Reviewer:
PROOF OF SUBMISSION FORMS
Fire Department ❑ Received ❑ Not Required
Water District ❑ Received ❑ Not Required
Sanitation District ❑ Received ❑ Not Required
OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION:
SPRINKLERED:
OCCUPANT LOAD:
Building Division Valuation: $
City of
W heat l is e,
CITY OF WHEAT RIDGE BUILDING AND INSPECTION SERVICES DIVISION
7500 W 29th Ave Wheat Ridge, CO 80033-8001 p. 303.235.2855..j. 303.237.8929
Proof of Submission for Permitting/Plan Review
A copy of this form must be completed by each agency indicated on the Permit Submittal Checklist for the project
type and be attached to the Building Permit Application at the time of submission. Applications presented for
submission without a completed Proof of Submission form from a required agency will not be accepted or
processed.
Date:
Project Address: U 4J38VN �-\ ve ^ L.)C , 9-, p b Z , L C
Name of Firm/Individual submitting documents: c� 0
Project Type/Description: SG.; �. \` e
6`4-1 O �LA 2 -
Signature of Firm Representative or Individual:
DO NOT WRITE BELOW THIS POINT - FOR AGENCY USE ONLY
1, % , am a duly authorized representative of the agency indicated below
and do, by my signature below, hereby acknowledge receipt of documents necessary for review and approval of
the project indicated above.
Agency represented: (Please check one)
cv' West Metro Fire Protection
o Arvada Fire Protection
o Wheat Ridge Water District
o Consolidated Mutual Water District
o Valley Water District
o Denver Water
Agency Notes:
Signature:
Representative)
o Wheat Ridge Sanitation District
o Clear Creek Sanitation District
o Fruitdale Sanitation District
o Westridge Sanitation District
o Other
'7-,:22 - /�)
i CITY OF WHEAT RIDGE
Vr Building Inspection Division
?�;Ir(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: 'P pz 1" • _
Job Address:
Permit Number: s 01 (C)
ME -n yy-_-q>P_n P R6'Ppo/y'z:?)0 J
❑ No one available for inspection: Time/PM
Re -Inspection required: Yes No
*When corrections have been made, call for re -inspection at 303-234-5933
;i�
Date:Cj Inspect DO NOT 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
INSPECTION NOTICE
Inspection Type:
�g r Mje►
Job Address: 8 300 W . 3 8 4 VL-
Permit
LPermit Number. -_
2 o / 6 GO
L/if c
iea t L, I -"--
/I
v.
/I'H �� G Cr
❑ No one available for inspection: Time /0-`(57 /Q/PM
Re -Inspection required: Ye No
*When corrections have bee ade, call for re -inspection at 303-234-5933
Date: Inspector:��,z6z�
DO NOT REMOVE THIS NOTICE
41 CITY OF WHEAT RIDGE
�A Building Inspection Division
t234 5933Inspection
Inspection(303) 235-2855 Office - (303) 237-8929 Fax
Type:
r•••
Permiter:�►
No one available for inspection Time .. ,____ AM/&,)',
Re -inspection required; ices
When corrections have been made, call for re -inspection st 303-234-5933
Date: lraretcsr: ..=Ierl�
DO NOT REMOVE THIS NOTICE
City o
c-`
it)N I FY 1-XVfA0V,,kAUN I
FOR OFFICE USE ONLY
Date:
Plan1permit # f
Plan Rev - iew Fee ly
I!! i � I I I I 11 mliqlgil 111
PAID
tZIMM =1771
PropertyAOdress: 8300 West 38th Avenue
SCL Health - Lutheran Medical Ce ph .303-425-8685
r6 one.
PropertOwner Eirlail* anne.lutz@sclhs.net
Address: 500 Eldorado Blvd, Suite 4300
A 4; hitecture
v c
ng ne r rz -1 mhagan@hlarch.com (303) 298-4746
Archii6ditt I e
Contractor: M. A. Mortensen
Contractors City License #: 013817 Phone: 720-259-4879
Contractor E-mail Address: ryan. may@ mortenson, corn
nl=�ffl
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
018567
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Complete all information on BOTH sides of this form
NEW COMMERCIAL
. A «" • ELECTRICAL
: A MYVICE UPGRADE
PLUMBINGNEW RESIDENTIAL STRUCTURE 0 COMMERCIAL ROOFING
COMMERCIAL ADDITION 0 RESIDENTIAL ROOFING
RESDENTIAL ADDITION 0 WINDOW REPLACEMENT
COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
REPAIR
t M 11F or r► y« A
CMENT
ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
OTHER (Describel Renovation of existing space to install a Cl'smutator
Minor remodeling of an existing space to house a new CT Simulator. Construction will include
minor selective demolition of existing ceiling, raised floor and some interior partitions. Wall framing
of a new control room and installing two new doors. Mechanical and electrical rough in for the new
equipment. New Casework, Ceilings, flooring and paint.
Sq. t,/LF 602 SF Btu's
tTatlaras
Amps squares Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
ONA'NER/CUNTRAC""TOR SIGNATURE, +IJ7]% Ci;VDERS"i".#NliING AND AGREEMENT
1 hereby certify that tic 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 c:o v nants, casements or restrictions of regard, that all measurements shown and allegations made are
accurate; that 1 have read and agree e: to abide by all conditions printed on this application and that I assume hall responsibility for compliance
with applicable C:'i�y of Wheat Rick codes and ordinances for work under any permit issued based on this; application -,that I .I'm the legal owner
or have been authorized by the: legal owner of the property, to perform tire; described work and am also authorized by the legal owner ofany
entity included can this application to list that entity on this application. 1 the applicant for this building permit application, warrant the
truthfulness of the information provided on the. application,
CIRCLE ONE: ((7tVIVER CIN?"R CT or (AUi'HORIZED REP 1VE) of (OWNER) (COINITRACTOR)
rst and last na e _ A - Dei7'E: 6,Z4"1
1 understand that checking this hos;, that I .acknoaa=ledl e that this constitutes a legal sigmature. W „
BuildingDivision
h, 6,a, t Ii~
c;Erry oF" WHEATRIDGE BUB -DING AND INSPEt 110N SERVICES DIVISION
7500 W 29th Ave Wheat Ridge, CO 80033-8001 p, 303.235.2855. f: 303.237.8929
Proof of Submission for Permitting/Plan Review
A copy of this farm must be completed by each agency indicated on the Permit Submittal Checklist for the project
type and be attached to the Building Permit Application at the time of submission. Applications presented for
submission without a completed Proof of Submission form from a required agency will not be accepted or
processed.
Date:
Project Address; : 1�ox'kw : C') t,
Name of Firm/individual submitting documents:+ "► "'
Project Type/Description:
Signature of Firm Representative or individual:
DO NOT WRITE BELOW THIS POINT - FOR AGENCY USE ONLY
i
am a dui authorized representative of the agency indicated below
an�d�o-,y� signature be bw, hereby acknowledge receipt of documents necessary for review and approval of
the project indicated above.
Agency represented: (Please check ane)
`West Metro Fire Protection
o Wheat Ridge Sanitation District
o' Arvada Fire Protection
dear geek Sanitation District
* Wheat Ridge Water District
o Fruitdale Sanitation District
* Consolidated Mutual Water District
o Westridge Sanitation District
Malley Water District
o tither
o Denver Water
Agency Dotes:
Signatur :
Hate: ��2JI
-&
t envy Repr an ative)
w
M
ON
I
0
im
MEDICAL GAS SYSTEMS JOBSITE VISIT & INSTALLER AFFIDAVIT FORM PER NFPA: M41999 02002
■ 20052012
Facility:
Address:
Job Description: Mt mc
Contractor. bate:
of Medical Air Testing & Services, Inc. has tested the following equipment for proper operation per NFPA 99
Oxygen Outlets
WAGD Inlets
Vacuum Pump System
Vacuum Inlets
Area Alarm Panels
Air Compressor System
Medical Air Outlets
Master Alarm Panels
Proportioning System
Nitrogen Cutlets
Zone Values
Dental Vacuum Pump
Nitrous Oxide Cutlets
Manifolds
Dental Air Compressor
Carbon Dioxide Cutlets
Bulk Gas Systems
Other:
Comments;
Re Ail I I v * .
�1Z
FOR OFFICE USE ONLY
Ci[ of'
DaW
'.
ge
PraniPernBt #
Building & Inspection Services Division ) L'-' �
7500 W, 29th Ave,, Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-3929 Purr Review Pee.
Inspection Imine: 303-234-5933
BuildingPermitApplication� -AI-D.
• « ,, ease p
Address:
s : •
Plumbing: VNVC> e- t -
City License.
informationon • fid....
R
Mechanical: I -P co 4—j— C"4
WR, City License #
.rr
COMMERCIALNEW COMMERCIAL STRUCTURE El ELECTRICAL SERVICE UPGRADE
NEW RESIDENTIAL STRUCTURE 0 COMMERCIAL ROOFING
COMMERCIAL ADDITION [I RESIDENTIAL ROOFING
RESDENTIAL ADDITION 0 WINDOW REPLACEMENT
ACCESSORY
Y1lw MM M
RESIDENTIAL
D1. 1w STRUCTURE (Garage, shed, deck, etc,)
MECHANICAL
1 : 1 M1R L1 REPAIR
s ! 1w' or
REPLACEMENT
e ie 1
PLUMBING SYSTEM/APPLIANCE
f•1 w• 1R or
REPLACMENT
ELECTRICAL
1 1 • • 1, REPAIR
Y M1 1XM REPLACEMENT
II ♦ 1
#THER (Describe)
„„ k. -'O> .. x x
t,%0 PC" T
= AJ ^ 4-4- -=> "' .
a �. 1
« µ
Sq. FULF Eau's Gallons
Amus Squares Other
TYPE
IRE DEPARTMENT USE ONLY
FOR OFFICE USE ONLY
City
of
tete.
W h 6 at, Rj, Si g, e-
t r i UNI DWELOPMENT %n1pot it# z .� t .
Building & Inspection Services Division
7500 W.29 t Ave., Wheat Ridge„ CO 80033 #sten Review Feer
Office: 303-235.2855 * Fax: 303-237"-8929
Inspection Lime: 303-234-5933
Building Permit Application
Pleese complete all hightighte4, auras on both slags of thi's icy Inc apoloattoos may' t be Wooessed.
Property Address.- a l q 003
Property Owner (please print): PhO"e: 101 , I `.
Property Owner'Email t N g .
Mailing Address: (if different than property address)
Address.
Complete a all informations on BOTH sides of this form
W r (Check all thatapply)
NEW COMMERCIAL AL STRUCTURE Q ELECTRICAL SERVICE UPGRADE
NEW RESIDENTIAL STRUCTURE El COMMERCIAL ROOFING
j COMMERCIAL ADDITION RESIDENTIAL ROOFING
RESDENTEAL ADDITION H WINDOW REPLACEMENT
COMMERCIAL ACCESSORY STRUCTURE (garage, shed, deck, etc.)
E 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)
r
t,47-
Sq.
r
Sq. FOLF NIA Stu's Gallons
Amps Squares Other