HomeMy WebLinkAbout4780 Upham StreetCity of _
C;OA SAUNiTy DEVELOPMENT q
Building & Inspection Services
7500 W. 291" Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
inspection Line: 303-234-5933
Email: permitsa-ci.wheatridge.co.us
FOR OFFICE USE ONLY
Date; 5/Wa
Plan/Permit #
r v
'Plan Review Fee:
Building Permit Application
***
Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address:. .moi-: d . v . Q � �E- C',
Propel 'y Owner (please print}: E_
VC-C,C 0, c2k - Phone:
Property Owner Email: f,C-0 en
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address:
Com, State, Zip:
Architect/Engineer E-mail:
Phone:
Contractor NameL C_
City of Wheat Ridge License #: Phone: - BZ_8
Contractor E-mail Address: YNNpoc Akx7\t z � 1 , • Co �M
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print):.-- _ Phone:
CONTACT EMAIL(please print):-
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License #" City License #
Complete all highlighted fields.
❑COMMERCIAL ®RESIDENTIAL
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, squarefootage, existing condition and
proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.
Al–e.\c z- C
v�� mom `
Sq. FULF FT til_ `_--_ - - - — - - - - - Gallons
Amps — -w Squares, _ For Solar: — Kw _ of Panels Requires; 8tructurel
For Commercial Projects Only: Occupancy 'Type: Constructloi
Occupancy Load: Square Footage
Project Value: (Contract value or the cost of aillj„materials and labor included in the en i project)
# 2 , 2®d
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 sho«n 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 ofthe information provided on the application.
CIRCLE ONE: (OWNER) CONTRACTO or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last npme): DATE: a®Z�
Printed Naane:
DEPARTMENT USE ONLY
ZONING COMMM&tdt'S:
BUILDING DEPARTMENT COMMENTS'.
Reviewer.
PUBLIC WORKS COMMENTS:
OCCUPANCY gtASSIFICATION
CONSTRUCTION TYPE:
Reviewer:
Building Division valuation:
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION
City of Wheat Ridge
Homeowner Roof PERMIT - 201702597
201702597
4780 Upham ST
Reroof 30 squares
*** CONTACTS ***
OWNER (720)212-6405 GARCIA ELEAZAR JR
ISSUED: 06/27/2017
EXPIRES: 06/27/2018
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,000.00
FEES
Total Valuation 0.00
Use Tax 168.00''
Permit Fee 172.60
** TOTAL ** 340.60
*** 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.
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 k/2 -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&ems 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's 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.
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION
City of Wheat Ridge
Homeowner Roof PERMIT - 201702597
201702597
4780 Upham ST
Reroof 30 squares
ISSUED: 06/27/2017
EXPIRES: 06/27/2018
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 tie 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�ppermrt. I.further attest that I am le ally authorized to include alt entities named within this document as parties to the work to be
perfonne�l and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signatitwof OWNER or CONTRACTOR `(Circle one) Date
I . This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This.permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made -be granted at the discretion of the Chief Budding
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 pen -nit 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 pen -nit 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 �e onstrued to be a permit for, or an approval of, any violation of any provision of any
applicable code or &c�y ordmance`iela o this jurisdiction. Approval of work is subject to field inspection.
Xl���tr._ �1
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FORINSPECTION THE FOLLOWING BUSINESS DAY.
Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us
between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line.
City of
�W heat Rjige
MLJNiTy 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: permits(a)-ci.wheatridge.co.us
I FOR OFFICE USE ONLY I
Date:
Plan/Permit # X)
� a 5
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: q 7 cO C P "i m `'j 1- wLzi f-
Property Owner (please print): lF e Ct '?- E, V- 6 C t^ -,r0, � 12 Phone: 7 ?o- 7— (Z- (P'-/o57-
Property
'-/oy
Property Owner Email:
LIN
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Arch itect/Enaineer:
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 X RESIDENTIAL
Description of work: (Check all that apply)
❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE
❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING
❑ COMMERCIAL ADDITION N RESIDENTIAL ROOFING
❑ RESIDENTIAL ADDITION 5Q WINDOW REPLACEMENT
❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ OTHER (Describe)
(For ALL projects, please provide a detailed description of work to be performed, including current use of areas,
proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and
amount of materials to be used, etc.)
Sq. Ft./LF
Amps
Btu's
Gallons
Squares `l U Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$x,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: OWNER (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last name): DATE:(o-27-
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
Building Division Valuation: $
C't f
iyo
Wheat Psjd e
P
COMMUNITY DEVELOENT
M
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? r�<c
State of Colorado }
County of ^E' eJ'ssc\ I ss
4k -
The foregoing instrument was acknowledged by me this )7" day of 20 17 by
1E(_eA:�gr G,.rc,A
TAMARA D ODEAN
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20164015481
MY COMMISSION EXPIRES APRIL 22, 2020
1 Ub--- My Commission Expires q /22/2026
Notary Public
3-3
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(.Dona m+ at.+ua iIwo I:a,t, its produ,I, rnnr,1d+li!ati4m,. to wanann , thu r ,weriwnt, anw t he relicil upon by Owner ti; an) othrr
fe.,ny anal (anon+( he attributed it) Dino -I a,t Funhernt+uc, nu per,on ma) .hangs tit nutdity am w rn, to rvuufiuun, of This No -Millar Iinru
\\.rrrant). unit- in wrtnng aml +rfncd h) tins aulhorwed u1newillalltc nl the ()anon .uxl h\ a Hoot 14st niiuct tit ht thr IAut. 1 aht (Jualn\
\„ur:uuc Manager
SI)\iF til %TF:S !X) NOTALLOW LIMITATIONS ON Ito%% LONG AN IMPLIED \\ \RR \NTY I \SI:N, S(I NI ('11 \ i.INII IA -
I ION Ni%N '%Ayi WP1.1" 1'O YOI+. T"HIS Il:\RR;\N'i'1' G11 F:S l Ol' SPF:('Itl(' I •F[;%I RIGHTS, AND %01 %1\% \LNO IME
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Or}11•.R Ri(;lf rs T'HAT' i ARl' FROM S'I'.II'E II) STATE. it any pnrti,ion to uxhtidu:d It'tnl hetxm n 1maln] of uncnim—"tile unJer
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and form, will bo unalle,led.
DURO-LAST', INC.
525 Boric\ Dri\c
Sagina", A11 U601
Name of Building
Addrr s of Itulkling
(9t). Stale & Zip of tiuiMirrg
Building Dt^ lgnatlon
j%ZAZ,
Y Z,9/7
IUfecilte Date
tirrial No.
NIGEL WESY
OUALI YY ASSURANCE TECH REP
sip
naturr of I)uro-Last ()A 'I'tvh Rep nr (1,\ Atunnger
Signature of Ownrr
(Ntour Iprinted)
6(7.
� L11�1.s
Signature of ('ontratNor
Contractor iprinledl
11 '�'
Sitiquare F'lartage
z��
ti'arrant) No.
Duro-Last Duro-Fleece Pius
Supreme 15 -Year NDL 4t2!15
Ni
�
r
."
i iIIS NO-DOI 1. \R LiMIT I1 \RRAN1'l
AND ME RF:SPONS11flu r1ES AND RENIEDILS S I A I t l)
IIF Ri•:IN M.
iAPRF.SSIA \(;REED 1'0 111 0A% \I K kND Dl'RO-LAST AND C'ONSTI'1'U IF *1 t!E SOLE: 11 %RR \N
1*1 %till RUNIF:
DIF -S OF TIII OI►NF.R FOR ANN
\I Ll GED DETECTOR FAiLURE OF THE DURO-LAST S1STF:Ni, \\I11•:LIIF:K
\IF'\iltR:1NF.. A['('F:SSORIF:S.OR (
ON UR \(' FOR IiORKNIANSHiP.
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1 HF: RFTAIR.OR R III \( I NII N 1 PROVIDED HERE -A% IN F \( i I til\ I \til) IN LIFT" OF ALL 0UIER Ri.MEDIFS. ALL
r. t I MIS FON NI 1,1 i(;F N) F. AND FOR I-AIIA RF OF ESSF.Nl1.\1. PURPOSE ARE FXPREssIA \\ %IN FI).
Iti I I VAI I I \ND f Nt LI ILLI 1,
0%% %1 It AND Dl RO-LAS-1 60111 A('KNONI.F:IM:t. %ND utRIA I N \1 Illy %O•DOI.I.AR IJNiIT \\ARRANTi C0%I•:RS
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(.Dona m+ at.+ua iIwo I:a,t, its produ,I, rnnr,1d+li!ati4m,. to wanann , thu r ,weriwnt, anw t he relicil upon by Owner ti; an) othrr
fe.,ny anal (anon+( he attributed it) Dino -I a,t Funhernt+uc, nu per,on ma) .hangs tit nutdity am w rn, to rvuufiuun, of This No -Millar Iinru
\\.rrrant). unit- in wrtnng aml +rfncd h) tins aulhorwed u1newillalltc nl the ()anon .uxl h\ a Hoot 14st niiuct tit ht thr IAut. 1 aht (Jualn\
\„ur:uuc Manager
SI)\iF til %TF:S !X) NOTALLOW LIMITATIONS ON Ito%% LONG AN IMPLIED \\ \RR \NTY I \SI:N, S(I NI ('11 \ i.INII IA -
I ION Ni%N '%Ayi WP1.1" 1'O YOI+. T"HIS Il:\RR;\N'i'1' G11 F:S l Ol' SPF:('Itl(' I •F[;%I RIGHTS, AND %01 %1\% \LNO IME
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and form, will bo unalle,led.
DURO-LAST', INC.
525 Boric\ Dri\c
Sagina", A11 U601
Name of Building
Addrr s of Itulkling
(9t). Stale & Zip of tiuiMirrg
Building Dt^ lgnatlon
j%ZAZ,
Y Z,9/7
IUfecilte Date
tirrial No.
NIGEL WESY
OUALI YY ASSURANCE TECH REP
sip
naturr of I)uro-Last ()A 'I'tvh Rep nr (1,\ Atunnger
Signature of Ownrr
(Ntour Iprinted)
6(7.
� L11�1.s
Signature of ('ontratNor
Contractor iprinledl
11 '�'
Sitiquare F'lartage
z��
ti'arrant) No.
Duro-Last Duro-Fleece Pius
Supreme 15 -Year NDL 4t2!15
DUKO-LAST
SUl'REl'►RF
15 -Year N D L
Warranty
Warranty No.
I.'i'F.RNIS and CONDITION'S
In
)u+ I asC . In. ("lluro 1 a,t") cu,mt, the \,t Rolla, I mum (""NDA ") \\'arrant} to tie owner I 'Owner'"1 set a budding containing a
Duro-Last Rotrling System t'"Duro-Last 5vstcm 'l m,f.dled by it Drift) Last amlhonzcd fit alerrConmact r f "Cor tractor" i. subject int
the tondiiwn, .tnd lunnenons cowaued harm
Dun+ last's obligation during the I , through file I i sear ,hall be In rcpaur any leak no rise Dum l.a,l Systcrn taklwd hs any dele,I in
a component of life Duro Last Svstem or by rhe wofkm.m,hip set the Contnictor, but only as the woiknuamhil+ retain, to till installs
I on of the I)Lao last Systems itself and nut :n, it fel:rc, f,iutter -Roil, Iwitorrted,nI any Duro I a,C nhingauon imlgtles.at Dun, 1 ast',
diwrown, either the relate of ieplan•mcnl of pan tit all of the Duo+ 1 ant Sy,a m and also ,n, lutie, lite furnishing of cost ,,t talon to
rt•lam life Dunrl_ast System pool ldcd rlrc lottowtng conditions are nisi
A.Ihro I,.r,l acrd Cont):wwi hat,• been paid in Full tut lite Duro I ,.,t Sy,tein. at, uisl.,llation and any outstanding utoice, issued
by Duro-Last that arise after the installation.
R ala• Durn-Lost System his Ness approved by Dull, I .a,1 fi/lott un• w,14•, n,=m by .lit .nuhorlicii Ditto I.a,l (shiahly As,uransr
Iethmeal Representative ("Dur, I as QA Tach Rcl, i Ihr No-D,,Ildl 1 mull \\.trraofy has been stgneal by% a Dun; last QA
Ie.h Rep of Quality Assurm,c Managel', anti Ile corlt.elut Undlfrm, Ilial lhr Dul„ I .til Stem was installed in .wandantc
"fill Duro L ast,%,llecnbcanom, .oaf "rillen installation icquurmcut
C. I lie I )wnct has nullhell Ilia,, 1 ao ttohm 7 days of lite di,t(rvcry of any Icak, lallill.. tit Other aHcged Dllril last Sy,tein
dctctl Owncr must notal) Dun: -Last by Calling the [bun Last Quaid% \—utance I)c1satlnicnt at 1 Kir, 2K4 9.134, by
c mating ws0dur/-lau.com, or by ceniftcd mad. Irtum receipt requested;
D.The t )caner allows Duro-hist'., QA Tech Reps s). and/or Dam I a,t ComritnmaJ access t.. the o,,,, In.fuding, it nctr,sar%, the
wnlor al and replacement by Owlu r at I )tater'. expense any and all oh,trucfions, awfullmg flat runt limited to ftodiop gardens.
earth. sod, pater,. ballast, deck,. paint aaid walking surlace malcnal,, photovoltaic syslcm. and olhei inrrhurdrm and
E. Dirt, I al authunies the repair and. al Dulls I ist's Ilpnon, either Dunt -Lasts QA Tech Reps, 1. nn an aulhorved Conlraetln
make, flee repair
11. I 1\111 AHONS and FWIA SIGNS
A. this No-Dollaa I not Nin:nuy docs ma applt to a Dun, I list Sy% sterni Installed on 11 single lamily ic,uk-me
R.Ihmrl,a,l shall nor tie liable for damages arising born deleet in the design of ,:un,tnlc nun of the budding tit tool a—cnrhly
mor shall Duro Last he liable for any other products asldc from the Duro i ase Sy,lem
C.Dunrl.ast is nut liable fill any Duro Lau System defect ser failure noir fere ,uh,cklocul danmges arising from Acts set (itul or
cause\ outside Durw-last's romml Including. but not Itrltitcif b,
11 Damage caused hs Ines lightning. hum: due, gale, hail. tornado. Iltrol, carlhquake animals. inset,. or
2) Damage caused by iccalent. %andah,m. nmentional iwt, negligence ser failure 1'. use « aumahly cur. whether un tiro
part of the (lure[ of ala diva. in
-t) Damage c.afwd by airy unauthorurd mtahfitanon to the Dtno Last Sy,lcin irkhidmg. ben not limned to_ damage
tauscd by unauthorized components used am mstalltitin tri wpan by additional equipment In structures added is) or
male 1a part til life ted• by traffic• in by Okmi al, not nnrmilh Inwad set nature of rbc lake: or
41 Inlerioa tundrnsatitut andro r misisture emenng the Duto Last ~},tern Ihlouch wall,. copings, structurd dcfccis, HVAC
sy,(rnls. or any pall of tiro building stmclulr, including from adlatent buildings
D. Dum la,f dues not warrant the watertightne,, of metal products that aac haaled ounidc of dw termination of the that, -I ast
membrane.
F. Duro Last does not warrant against colon change and -in pattern change and,oi print change in the Dino 1 a,I System
F. Duro 1 i,t ,hall hate cru liabilily under any theory til law lin any Haim., repairs. ser tutee damage, relating: Is, life piesente til
ashe,tus set lent t aloe,. turns. mold,. fungi. bacteria. spines, mycofuxms, or the Ido in set ria die i)in,, I aft Syslcm or in the
buildme r+f in rbc au „r wafci ,ening the building
G. IItIs \o IAdlar I.onII \larrant\ pasty, tri tenure O,A net, ,,f the building for Ihr full 15 }cal, hricof
H. I lo, No Dollar Lunt Warrant mu,t he signed by a Duro 1 a,t QA Tcch Rep set Quality Msurancc \1.m..gcr. ('otelagc under
the Icrms of this No Dollar I rant Narianty began, tin rte F11c,lir Date M i tic, tltc Dae is detcmuned by Dvto Last
1 adur• of the Owner to Conua,loi to sign this tin -11.11.11 1 inlil lik afranty d.w, mol alta fife Hffcciive Date.
1. Iht, \o Dollar Lmnat Warrant shall he gotcincd b\ the Iuw, set flit! State (it \fichigalt ttnhoul regard w printiplc, set tunUwl,
.i law Duro-larsl ain't ()wncf hcicby agree that the 01,1111 Cslut" bol tin• t timuy ,,1 signed%%. State or \b, hlgan.,n ate l filled
State, I cdcial Disuwa t',nao fill the la,ern D„tn,i of \I1,111 v.111 ui Hast Ity,11.111 haft'. the exclu,nc tunsdKilon to
determine anv and all da,pulr,. or ,Linins relating b+ flit, No D"Illn l mill Nan:mm .mai do herchy submit IhernwI%c, tit the
sole peruinal lurisdit mon of those Court,
J. \r, claim. suis, in ones proceeding arising out ,,I or related to lite Duro Last pro ducts of these term,, nitluthng ttithow
limitation this Nit Dollar Limit WanamP. may he hioughr by de Ownct set ancone else after one ( I i }car Inrn flit- tisk it
as, roe,
K.Dur, I,,,1 does not waive any nghls under this No Dollar Lunn N:arrarlt by retrain iv from excr,Ismg it, right in full in one
of 111,11e mstantc,
ON ER: (,ON, i7NUED ON BACK
A i CITY OF WHEAT RIDGE
_:�9rBuilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: _L� 0
Job Address: // % 49'0 J PlVltf`ll S T`
Permit Number: Z 0 5"-
❑ 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
ff,
Date: Inspector: < "
DO NOT REMOVE THIS NOTICE
City of
Wh6atIR,jgic
''....775:14 "" is" «1f
Inspecton303-234-5933
iffa"t—Al"r1 •
! " 0 0 •
*oWIN iii,
DO* L, — 2 - - I Lo
2-0
=!!! wilpoillip
Address:
Contrattor
WR Oki Lkeimse 9
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, ate.)
RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
PLUMBING SYSTEMIAPPLIANCE REPAIR or REPLACMENT
ELECTRICAL SYSTEMIAPPLIANCE REPAIR or REPLACEMENT
OTHER (Describe)
41
C1
0
Sq. FtJLF Btu's Gallons
Amps Squares —'Z, other
F���i"V-8111W- (Contract value or the cost of &LImaterials and labor included in the entire project)
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
regulatiols Of Lke City of Wkeet'?idge or covm.-Aft, +r of rtwl; thvA, ?11 mv—st-&—camts vxowx 21,00 alleg2tiozs M24C al
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance