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Home My WebLink About4335 Gray Street9 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: Q0 cl ` Job Address: `-/ 3 3 s Permit Number: P 0 1 `7 07 j 1 Li 7T_ --A I t 1- i r� c� o� < < c,. CL r - o <Yl L C it -�-O C j �4 Ot j . ❑ No one available for inspection: Time 10 - 0 3 cmffim Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: ► a 1 s r -7 Inspector: -T--b DO NOT REMOVE THIS NOTICE . , City of Wheat Ridge "r Residential Roofing PERMIT - 201708143 PERMIT NO: 201708143 ISSUED: 10/10/2017 JOB ADDRESS: 4335 Gray ST EXPIRES: 10/10/2018 JOB DESCRIPTION: Residential Re -roof to install OC asphalt shingles - 23 sq Pitch = 5/12 *** CONTACTS *** OWNER (719)594-6382 JORGENSEN MARY SUB (303)763-9114 Scott Riopelle 019938 Interstate Roofing Incorporate *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,911.00 FEES Total Valuation 0.00 Use Tax 124.13 Permit Fee 140.90 ** TOTAL ** 265.03 *** COMMENTS *** *** CONDITIONS *** 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. City of Wheat Ridge Residential Roofing PERMIT - 201708143 PERMIT NO: 201708143 ISSUED: 10/10/2017 JOB ADDRESS: 4335 Gray ST EXPIRES: 10/10/2018 JOB DESCRIPTION: Residential Re -roof to install OC asphalt shingles - 23 sq Pitch = 5/12 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 permit. I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be perfo ed and that all work to be ed is disc se m t is document an�d+/dor 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 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 not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof 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 it shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable code or any or in or r, r reguullat €4his j isd' tion. 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 From: no-reply@ci.wheatridge.co.us Sent: Friday, October 6, 2017 1:25 PM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Follow Up Flag: Follow up ct Flag Status: Completed Residential Roofing Permit Application _4J 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 (enter WITH dashes, eg 303-123-4567) 4335 Gray St /%7 Mary Jorgensen 719-594-6382 45 Property Owner Email Address Do you have a signed contract to reroof this property? Applications cannot be submitted without an executed contract attached below. Attach Copy of Executed Contract jwiles@interstateroof.com Yes contract.pdf CONTRACTOR INFORMATION Contractor Business Interstate Roofing Name Contractor's License 011938 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 303-763-9114 Number (enter WITH dashes, eg 303-123-4567) Contractor Address 1000 W 47th Ave (Primary address of your business) Contractor Email Address jwiles@interstateroof.com Retype Contractor Email jwiles@interstateroof.com Address DESCRIPTION OF WORK TOTAL SQUARES of 23 the entire scope of work: Project Value (contract value or cost of ALL materials and labor) Are you re -decking the roof? Is the permit for a flat roof, pitched roof, or 52901 ---- No Pitched roof (2:12 pitch or greater) 46 both? (check all that apply) What is the specific pitch 5:12 of the PITCHED roof? How many squares are 23, part of the PITCHED roof? Describe the roofing O/C Duration materials for the PITCHED roof: Type of material for the Asphalt PITCHED roof: Provide any additional house detail here on the description of work. (Is this for a house or garage? Etc) 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 47 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. Name of Applicant John Quante Email not displaying correctly? View it in your browser. 48 referralisiTNT0comERSTATE ROOFING Submitted To Mary Louise Jorgensen Date Email Phone 719-594-6382 Alt. Phone 6/30/2017 Street 4335 Gray Street City Wheat Ridge State CO ZIP 80212 Insurance Company Travelers Claim# SNY3605001 H Policy# Scope of Work and Materials to be Provided. The scope of work and matenais identified be'ow are the scope of work recommended by Interstate Roofing Inc.: however, Interstate Roofing is not obligated to perform any part of the scope of work that is not approved by the insurance# unless you authorize the work and agree to pay for this additional work. \ RATI v � Tear off ALL layers of composition shingles * ❑Tear off one layer o1 wood shingles /❑riri Install Decking (7116" OSB) v*MATERAIL DEPOSIT $1 (DUE UPON DELIVERY OF MATERIAL) C9 Install new felt. PER INSURANCE SCOPE r? 1 t j"' ?i 1 UPON EACH TRADE COMPLETION. BALANCE OF ACV IS DUE FOR THAT TRADE �j Install pre -painted eave metal to code - Color BROWN CHARCOAL TAN GRAY WHITE INIT ❑ Valley(s) will be closed ❑ Valleys will be open Ridge(s) to be color -coordinated It F N-014 AZ N C_—/2 ❑ Ridge(s) will be "High Profile Ridge" color -coordinated shingles i4 /L L D0 Su'(L.! ; /j -J S �1 install new pipejacks R CV r—ff) (t ! % U / L L ® Replace Vents as needed - THE NUMBER OF ROOF VENTS TO MEET SHINGLE MANUFACTURER WARRANTY REQUIREMENTS 'n yy- S v- �v 671 ❑ Re -flash chimneys and all wall abutment as needed and d possible (stucco or siding may be a deterrent) „ J L ❑ Install In. ft. of series ridge vent ��0� C CO ri c ® Install Yes inft. of ice & water shield to Code AS REQUIRED BY BUILDING CODESAi- • Install 6 nails per shingleClean out gutters 5 year workmanship warranty® interstate Roofing, Inc will provide general liability insurance coverage of $2,000,000, general agMake a magnetic sweep of driveway and yard for removal of any nails � I Remove all debris resulting from above work J- ✓0 4 S 0-L" J/ ® Special instructions ' INTERSTATE ROOFING WILL COMPLETE A♦-Ei4ef2fE. LISTED IN THE INSU ANCE ESTIMATE, FOR THE REPLACEMENT COST VALUE OF THE FINAL INSURANCE ESTIMATE, UNLESS NOTED OTHERWISE ON THIS AGREEMENT THE HOMEOWNER IS RESPONSIBLE FOR JUST THE DEDUCTIBLE. - BALANCE OF CONTRACT AMOUNT IS DUE WHEN THE HOMEOWNER HAS RECEIVED FINAL PAYMENT FROM THI - GENERAL CONTRACTOR OVERHEAD AND PROFIT (O&P) IS INCLUDED. $ 17,109.98 (RCS) CLOS PER FEE The approximate costs of the services based on damages known at the time this contract is entered s Plus APaaoveo sUcaLEMEnre Interstate Roofing, Inc., however, will perform the scope of work approved by the insurance company for the amount of the insurance approved proceeds. with no additional costs to you except for your deductible. The final scope and price agreed on between the insurance company and Interstate Roofing, Inc. shall become the final contract price for the insurance approved scope. You will be responsible to pay for any upgrades or additional work authorized by you that the insurance company determines is not covered within the scope of coverage provided by your insurance policy. Supplemental claims billed by Interstate Roofing. Inc that are approved by the insurance company for additional work or increases in Cos15 become a pan of this contract. Approximate Dates of Service: 14 to 60 days after signature date These dates of service are subject to change due to unusual delays in transportation of materials, ordinary weather delays, or by any other causes beyond the reasonable control of Contractor Notice: If the property owner pians to use the proceeds of a property and causualty insurance policy Issued pursuant to part 1 of article 4 of title 10. C.R S.. to pay for the roofing work, pursuant to section 6.22-105, the roofing contractor cannot pay, waive, rebate, or promise to pay, waive, or rebate all or part of any insurance deductible applicable to the insurance claim for payment for work on the covered residential property, Payment for roof work to be made to interstate Roofing. For all other claim work, payment to be made to the general contractor. Boaz Construction. Terms: who manages all other claim work. Total payment amounts should equal contract agreement price. after adjustments for supplements and permit fee. I (We) hereby authorize & instruct the insurance company & all lien holders to include the name of Interstate Roofing, Inc. as co -payee on any subsequent loss drafts or checks after today's date as indicated above. I (We) also authorize any legal representative and/or agent of interstate Roofing, Inc. to obtain information necessary to complete any funding process relative to the claim number referenced above. I (we) further authorize Interstate Roofing, Inc. to pick up in person any loss drafts or checks on myour behalf and behalf of Interstate Roofing. Deposit Amount: $14,664.11 (ACV payment) Date: Ren initials' Interstate Roofing shall hold in trust any payment from the property owner until Interstate Roofing has delivered roofing materials at the residential property site or has preformed a majority of the roofing work on the property, 1 (We) agree, by signing below, to all the contract conditions, both front & back of this agreement Note: This agreement is fully voided if the insurance company denies the claim. Date of Aeceptanc 3D - f'7 Client Signature(s)� Representative r1 LL'C< �JCIt- Corporate Neadquortas oredc Spnngs VRlce Fort Collins Office Cheyenne Office Steck Ins. Agency 1050 'W 47th Ave. 325 Tia Juane Street a 970 492.7722 F 970 682 1018 '010 S Greeley H,ghway 9600 E Araoahoe Rc ,205 Denver. CO 80211 Colorado Springs. CO 80909 Toil Free 877.898.8144 Cheyenne, WY 8021' Englewood. Co 80112.3726 P 303 763 9114 F. 303.7 37 P G7 471 9752 F 719.597 x444 www interstaleroof co, P 307,634 2553 (303) 397-7820 www. interstate r¢of t;om info@interstateroof.com 4 33 5 6C 2)+ f N ECTI UiV RECORD Kk-�r 2bS INSPECTION REQUEST LINE: (303) 234933 Date inspector Initials 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 thefollowing business day.** inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Comments Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter 13n Nnt Pour Concrete Prior To Aonroval Of The Abolfe lnspecTions UndergroundISiab Inspections Date inspector Initials Comments Electrical Sewer Service Plumbing Do Not Cover Una Rough Inspections Wall Sheathing Mid -Roof Lath /Wall Tie Rough Electric' Rough Plumbing/Gas Line Rough Mechanical Rough Framing Insulation Drywall Screw / Nail Final Inspections Final Electrical Final Plumbing Final Mechanical Roof Final Window / Doors Final Buildina or Belowiin-Slab Work Prior To Date IInspector Date inspector Initials Of i ne Above ms Comments City of Uheat Ridge 11/15/266 83:0 CH14 Reroof 26 sotiares - CDD913946 AMOUNT EPSP 4335 Gray ST 307.22 APDL/PER111T NO: 281601684 PAYHENT RECEIUEE AC / 2,t78 AUTH CODE: 861686 --------------------- TOTAL Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking ROW & Drainage / Public Works Dept. inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections Fire Inspection / Fire Protection Dist. contact the Fire Protection District for your project. AilouNi 3R7. P NOTE. All items must be completed and approved by Planning, Public Works, Fine 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 insotimereoueslOci wheatridae.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 41 CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax Inspection Type: Job Address: { 335 �' e Y S r - Permit Number: 2 o/ INSPECTION NOTICE OF - od F.11111 L ❑ No one available for inspection: Time 10 AM M_'�1 Re -Inspection required: Yes o, t *When corrections have been made, call for re -inspection at 303-234-5933 Date Inspector: �Ia�t�f1� DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE ��9rBuilding Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax Inspection Type: INSPECTION NOTICE M )b Job Address: L4 3 3 c r^ c- ti '�:4, Permit Number: QQI (p IT— El No one available for inspection Time 70-J7 AM PM Re -Inspection required: Yes No * When corrections have been made, or re -inspection at 303-234-5933 Date: Inspector. tL11 - DO NOT REMOVE THIS NOTICE 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: Z21 i 0 Job Address: !�4 3S (—,IQ c/ 57- Permit 7Permit Number: ,QcYh ❑ No one available for inspection: Time 'I i / 6PM Re -Inspection required: Yes No *When corrections have been made, call for re -inspection at 303-234-5933 Date: Inspector: t�( DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Roofing PERMIT - 201601804 PERMIT NO: 201601804 ISSUED: 11/15/2016 JOB ADDRESS: 4335 Gray ST EXPIRES: 11/15/2017 JOB DESCRIPTION: Reroof 26 squares - OC Duration material - Pitch 4 1/2 *** CONTACTS *** OWNER DIETZ MARY LOUISE GC (303)763-9114 Scott Riopelle 019938 Interstate Roofing Incorporate *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: / SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,479.00 Total Valuation FEES 0.00 PAID Use Tax 134.62 Permit Fee 172.60 ** TOTAL ** 307.22 *** 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 kh-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 manufacturera€r"s 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. w City of Wheat Ridge J0009r Residential Roofing PERMIT - 201601804 PERMIT NO: 201601804 ISSUED: 11/15/2016 JOB ADDRESS: 4335 Gray ST EXPIRES: 11/15/2017 JOB DESCRIPTION: Reroof 26 squares - OC Duration material - Pitch 4 1/2 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 permit. I further attest that I am legally authorized to include all entities named within this document as paes 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. Thispermit 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 changeof 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 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. Inspection time requests will be accepted by email only. Please email requests to insptimeCci.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. � Occunancy/Typ335 tN P)E " RECORD e Mif INSPECTION REQUEST LINE: (303) 234.5933 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 Foundation Inspections Date Inspector Comments Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Sewer Service Plumbing Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Wall Sheathing Mid -Roof Lath /Wall Tie Rough Electric' Rough Plumbing/Gas Line Rough Mechanical Rough Framing Insulation Drywall Screw / Nail Final Inspections Date Inspector Initials Final Electrical Final Plumbing Final Mechanical Roof Final Window / Doors Final Building Comments City of Wheat Ridge 11/15l2b16 09:4b CDH Reroof 26 squares - CDB013946 AMOUNT EPSP 4335 Gra ST 307.22 APPL/PERIIIT NO: 201601804 PAYMENT RECEIVED AMOUNT MC / 2378 307.22 RUTH CODE: 081606 TOTAL 307.22 ---------- ------------------------------ Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking ROW & Drainage / Public Works Dept. inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections Fire Inspection / Fire Protection Dist. contact the Fire Protection District for your project. 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 insl)timerequest(cDci.wheatridge.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 _ qgc ��WheatI MUNITY DEVELOPMENT Building 8 inspection Services Division 7500 W. 29`" Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 ' Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(c)ci.wheatridge.co.us FOR OFFICE USE ONLY Date: Plan/Permit # �nl�l�ol� 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: Y3-�!5 Q S 4 - � Property Owner Property Owner Email: Mailing Address: (if different than property address) Address: City, State, Zip: aC Phone) I`1 Architect/Engineer Architect/Engineer E-mail: Phone: Contractor: Contractors City License #: 1, - 1 �) Phone: Contractor E-mail Address: Sub Contractors: Electrical: 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 ❑ COMMERCIAL RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING COMMERCIAL ADDITION RESIDENTIAL ROOFING HRESDENTIAL 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 SY )T�jvl/APPL,,ANC REPAIR or REPLACEMENT OTHER Describe iC..I� VA - (For A L projects, please provide a detaile 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.) �k a4 Z 60, PJcL L4 )ro,,., Sq. FILILF Amps Btu's Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) I—) 'Al ` O) --- 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 arc 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. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Electronic SiEnature (first and last name): ZONING COMMMENTS: Reviewer. BUILDING DEPARTMENT COMMENTS: Reviewer. DEPARTMENT USE ONLY DATE: OCCUPANCY CLASSIFICATION: Building Division Valuation: $