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3875 Brentwood Street
City of Wheat Ridge r �- �d Residential Roofing PERMIT - 201700952 PERMIT NO: 201700952 ISSUED: 05/30/2017 JOB ADDRESS: 3875 Brentwood ST EXPIRES: 05/30/2018 JOB DESCRIPTION: Replace roof with Owens Corning Duration Onyx Black asphalt shingles - 28 squares *** CONTACTS *** OWNER (917)805-8944 EISENGER JANA SUB (303)808-0687 Andrew Ubben & Lindsey Parker 170184 Black Bear Roofing *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 13,545.00 FEES Total Valuation 0.00 Use Tax 243.81 Permit Fee 267.70 ** TOTAL ** 511.51 *** 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 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 manufacturera ms 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. lT)tili'4 C�qINSPECTION RECORDr j s INSPECTION REQUEST LINE: (303) 234-5933 Occu anc� 'Tore 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 Initials Comments Mid -Roof Pier Fire Inspection / Fire Protection Dist. Lath / Wall Tie Concrete Encased Ground (CEG) Final Plumbing Rough Electric Foundation / P.E. Letter Final Mechanical Rough Plumbing/Gas Line 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 -� 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. ROW & Drainage / Public Works Dept. Mid -Roof 5 3t h Fire Inspection / Fire Protection Dist. Lath / Wall Tie Final Plumbing Rough Electric Final Mechanical Rough Plumbing/Gas Line Roof a /7 Rough Mechanical Final Building Rough Framing 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. Rough Grading 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. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical Roof a /7 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 — Please email insptimerequest@Ci.Wheatridge.CO.US by 8:00 A.M. the morning of the inspection with the property address in the subject line of the email. Time window is based on the inspector's route. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather City of Wheat Ridge Residential Mechanic PERMIT - 201700675 PERMIT NO; 201700675 ISSUED: 05/15/2017 JOB ADDRESS: 3875 Brentwood ST EXPIRES: 05/3,5/202-8 JOB DESCRIPTION: Replace existing w/Lennox 80% afue 90K BTU furnace CONTACTS OWNER (720)318-5015 DOJA PROPERTIES SUB (303)431-8015 Edward Terranova 019402 Aaark Heating & Air Conditioni PARCEL INFO ZONE CODE: UA / Unassigned USE: UA I Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#.- 0 'I - FEE SUMMARY ESTIMATED PROJECT VALUATION: 4,500.00 FEES Furnace Replacement 40.00 Total valuation 0.00 r X14 N Use Tax 81.00 TOTAL 121.00 -,rn *** COY14ENTS *** CONDITIONS Work shall comply with 2012 1RC & 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. Both the front and back of this permit are required to be posted on the job site at all times- If the complete permit is not present, inspections WILL NOT be performed. b, s!'a re d o hereby t es' that specifications, oileraca Ie , din�co,esanail applicable been authorized zedbYthe legal 0wrer0fthe 0pe4a conjunction with this erIttesthat1amapprcxved lans and Legally aithclrized to include all entities named within this docurrieiit as artes to the work o be pe�rmed and that all work to be pe cations, Signature of O'WWER or CONTRACTOR {Circle one) Date 1. This permit was issued based on the information provided in theennit 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. Re nests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days madeNe granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original t f6c, 3. If this permit expires. a new permit may be reiuired to be obtaffied. Fsermance of a new permit shall be subject to the standard requirements, fees and rocedures for approval of any new permit, Re -issuance or extension of expired permits is at the sole discretion of the Chief Building 041pCial and is not guaranteed. 4 No work of an manner shall be perfo-rined that shall results in a change of ftienatural flow of water without prior and s ecific approval. n 5: The petit holder shall notify the Building and Inspection Services Division in accordance with established policy of aT retred inspections and shall not proceed or conceal work Without written approval of such work from the Building and Inspection ervices Division. 6, The issuance orgian g of aperinit shall fiat be construed to be apermit for, or an approval of, an violation of any provision of any n rdinance or regulation of this jurisdiction. Approval of work is subject to field inspection. applicable code 11IN!o lwy Signature of Chief Building Official Date REQUMTS XUBT BE MADE By 11.59PM MY BUSTINESS DAY FOR INSPECTIOW TIM FOLLOV11MGmm:r=53 - f rm. Inspection time requests will be accepted by email only. Please email requests to ins ptimerequestg,,cl.wheati-idgeco.us between 7:30am and 9:00am, the morning of the mipection. Please put th4e address of the mspeztion in the subject line. 06,01, I~)<D0G-1: 3M tHLJ-,�d 2rINSPECTION RECORD V(rL--A11W `"(dr 6k , INSPECTION REQUEST LINE: (303) 234-5933 Occupancylrype 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 Comments Sewer Service Fire Inspection / Fire Protection Dist. Plumbing Do Not Cover Under round or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing Fire Inspection / Fire Protection Dist. Final Electrical Mid -Roof Final Mechanical Lath / Wall Tie Final Window/Doors Rough Electric Final Building Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw / Nail Final Inspections Date Inspector Initials Inspections froi one week in adi inspections call inspections call contact the Fire I wr your project. Landscaping & Parking / Planning Dept. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing 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 — Please email nsptimerequest@o.whea ridges C.=.: by 8:00 A.M. the morning of the inspection with the property address in the subject line of the em ` ". Window is based on the inspector's route. Occupancy Is Not Permitted 4' ;ate of Occupancy Is Issued Protect This , ' Veather s - A4' CITY OF WHEAT RID68 Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: p F Job Address: 3 7 �� K r tiq C? �7 Permit Number: / 4 Q 9 S`; , GV\ %i T V (� /til p l777 - U G ❑ No one available for inspection: Time / l `_/ AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: - Inspector: r DO NOT REMOVE THIS NOTICE /A � CITY OF WHEAT RIDGE of r Building Inspection Division ' (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 0 � t Job Address: 3 7�" '13 ry % 00 D Permit Number: G 1 `� 0 ( `7 L/ C_/ ._i --7 El -s h h e le . ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corr ctions have been made, call for -inspection 1.303-234-5933 �7/ Date: 7 Inspector: DO NOT REMOVE T/418 NOTICE City of Wheat Ridge Residential Roofing PERMIT - 201700952 PERMIT NO: 201700952 ISSUED: 05/30/2017 JOB ADDRESS: 3875 Brentwood ST EXPIRES: 05/30/2018 JOB DESCRIPTION: Replace roof with Owens Corning Duration Onyx Black asphalt shingles - 28 squares *** CONTACTS *** OWNER (917)805-8944 EISENGER JANA SUB (303)808-0687 Andrew Ubben & Lindsey Parker 170184 Black Bear Roofing *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 13,545.00 FEES Total Valuation 0.00 Use Tax 243.81 Permit Fee 267.70 ** TOTAL ** 511.51 -- *** 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 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&4Frms 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. City of Wheat Ridge Residential Roofing PERMIT - 201700952 PERMIT NO: 201700952 ISSUED: 05/30/2017 JOB ADDRESS: 3875 Brentwood ST EXPIRES: 05/30/2018 JOB DESCRIPTION: Replace roof with Owens Corning Duration Onyx Black asphalt shingles - 28 squares 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 perm){. I further attest that I am le ally authorized to include alI entities named within this document as parties to the work to be perforrlid th�ll work to bye perormed is disclosed in this document and/or its' accompanying approved plans and specifications. 'Signaturrf Pr.EJ or CONTRACTOR (Circle one) Date Q, I . This er� t was 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 Building Official and may be subject to a fee equal to one-half of the originalermit 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 andicrocedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Budding 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 o,;or ting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable c ny ordince ano regulato of this jurisdiction. Approval of work is subject to Iield inspection. r 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 insptimerequestgci.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 h6at - COMMUNITY DEVELO PMFNT Building & 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: permitsaaci.wheatridge.co.us FOR OFFICE USE ONLY Date: 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: --7, ?7 Ss L I; C Property Owner (please print): Jana Eisenger Phone: 917-805-8944 Property Owner Email: Jana.eisinger@gmail.com Mailing Address: (if different than property address) Address City, State, Zip: Arch itect/Enaineer: Architect/Engineer E-mail: Contractor: Black Bear Roofing and Exteriors LLC Contractors City License #: 170184 Contractor E-mail Add ress:andrew@blackbearroofi Sub Contractors: Electrical W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Phone: Phone: 303-808-0687 com 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 ❑ 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. FtALF Amps Owens Corning Duration Onyx Black Residential ReRoof Asphalt Shingles Btu's Gallons Squares 28 Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ 13545.00 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. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Electronic Si nature (first and last name): � DATE: May 26, 2017 ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Building Division Valuation: $ 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: ';)' 3i S 8 eCAn ST Permit Number: -0,D) 1 00 615 2 ❑ No one available for inspection: Time t� . _2AM M Re -Inspection required: Yer No i *When corrections have been mad call for re -inspection at 303-234-5933 Date: -Inspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Mechanic PERMIT - 201700675 PERMIT NO: 201700675 ISSUED: 05/15/2017 JOB ADDRESS: 3875 Brentwood ST EXPIRES: 05/15/2018 JOB DESCRIPTION: Replace existing w/Lennox 80% afue 90K BTU furnace *** CONTACTS *** OWNER (720)318-5015 DOJA PROPERTIES SUB (303)431-8015 Edward Terranova 019402 Aaark Heating & Air Conditioni *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,500.00 FEES Furnace Replacement 40.00 Total Valuation 0.00 Use Tax 81.00 ** TOTAL ** 121.00 *** 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. Both the front and back of this permit are required to be posted on the job site at all times. If the complete permit is not present, inspections WILL NOT be performed. I, by my signature, do he attest that the work to be performed shall comply with all accompanyingg approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am t11e legal owner or have been authorized by �ermItIrthera e legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with thisfuttest that I am le ally authorized to include alperrmed and that all work to be perormed is disclosed 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 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 change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or an _ rdinance or regulation of this jurisdiction. Approval of work is subject to field inspection. _ U 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 insptimerequestgci.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. (�375 �`2rINSPECTION RECORD �y� VqL__f�,,W -l�F-64t 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 Foundation Inspections Date Inspector Comments Initials Pier & Drainage / Public Works Dept. Concrete Encased Ground (CEG) Plumbing Foundation / P.E. Letter Litt' of Wheat I?131qu 0_,/ =;2;@17 lcs= 6 ?:i)ri wrL CDA014K2 AP,GiJ;T f spl 3875 B r,uwc at lc .?E u11iui /NP14TT Mi -t. i6isirikl.7= Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Wall Sheathing Sewer Service & Drainage / Public Works Dept. Mid -Roof Plumbing Floodplain Inspection (if applicable) Litt' of Wheat I?131qu 0_,/ =;2;@17 lcs= 6 ?:i)ri wrL CDA014K2 AP,GiJ;T f spl 3875 B r,uwc at lc .?E u11iui /NP14TT Mi -t. i6isirikl.7= Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing & Drainage / Public Works Dept. Mid -Roof Floodplain Inspection (if applicable) Litt' of Wheat I?131qu 0_,/ =;2;@17 lcs= 6 ?:i)ri wrL CDA014K2 AP,GiJ;T f spl 3875 B r,uwc at lc .?E u11iui /NP14TT Mi -t. i6isirikl.7= Lath / Wall Tie Fire Inspection / Fire Protection Dist. Rough Electric " Final Electrical Rough Plumbing/Gas Line Final Plumbing Rough Mechanical Rough Framing Rough Grading Roof Insulation Final Window/Doors Drywall Screw/ Nail Final Inspections Date Inspector Initials kif,yT h;.r4t; All DUN a Inspections froi Y'S J 951 121. OP N'TH OH: l:� 11UROW one week in adi Thi t inspections call ;-------------------------------------- inspections call contact the Fire I your project. Landscaping & Parking / Planning Dept. & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing 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 — Please email insptimerequeSt@ci.Wheatridge.CO.US by 8:00 A.M. the morning of the inspection with the property address in the subject line of the email. Time window is based on the inspector's route. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather �- City of "Wheatldge COMMUNITY DEVELOPMENT Building B 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: permitsO-ci.wheatridge.co.us I FOR OFFICE USE ONLY I Date: f _ Plan/Permit # 901 ) 00 / Plan Review Fee: Building Permit Application ' Please complete all highlighted areas on both sides of this form. incomplete applications may not be processed. I Property Address: 3EUn n 13V,E tV 1 r V CC C) Property Owner (please print): �)D-YA rDIMpE�'r[ �'� Phone•Cz N -(- J-1; Property Owner Email: Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer E-mail: Contractors City License #: Sub Contractors: Electrical: W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Phone: Phone: -�uQ :z ) 1 —,R -Ac if Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form UK ❑ 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 (GareWe,sk►ed, d -dc.) MECHANICAL SYSTEWAPPLIANCE REPAIR o REPLACEMENT PLUMBING SYSTEM/APPLIANCE REPAIR or REPLAC� M N ELECTRICAL SYSTEWAPPLIANCE 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.) P�-P-plc� �us'nr,c:� �I I._2�nr�ox `�D%oo�u��f0K13TU �J �Urr�C2, Sq. FULF Amps Btu's Gallons Squares Other Project Value: (Contract value or the cost of all materials and labor included In the entire project) .I C f1 CO OWNERICONTRACTOR 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 oa the application CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Electronic Signature (first and bast name): DATE: DEPARTMENT USE ONLY ZONING COMMMENTS OCCUPANCY CLASSIFICATION: Reviewer: BUILDING DEPARTMENT COMMENTS. Reviewer. Building Division Valuation: $ I'* ► d 41CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: CJ �- Job Address: 3 "?` C {� �,� �C.' C-.�) Permit Number: P a- 0 /9 J ( Z) h' 1n�y, C ❑ No one available for inspection: Time ` 3 AIV/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 .In.1. rifll —]Flll4'�ln n'6 /5 0 -CrAWCJI •, �I INSPECTION RECORD I� r INSPECTION REQUEST LINE: (303) 234-5933 Occunanc /i e. Electrical 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 Comments Sewer Service Plumbing 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. 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 Rough Electric Final Plumbing • 3 -i1 Rough Plumbing/Gas Line Final Mechanical Rough Mechanical Roof Rough Framing Final Window/Doors Insulation Final Building Drywall Screw/ Nail 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. 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 • 3 -i1 Tzf—" 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(cDci.wheatridcle.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 44, CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: L) Job Address: �_ 7e TS9-?-ti-4 wofl Permit Number: '`x s2 12 it (a 4/ 3 G, ❑ No one available for inspection: Time ,/) : vy AM/PM Re -Inspection required: Yes No When corrections have been made, call for re-inspectfo -'at 303-234-5933 Date: Inspector: t . DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Plumbing PERMIT - 201700436 PERMIT NO: 201700436 ISSUED: 03/30/2017 JOB ADDRESS: 3875 Brentwood ST EXPIRES: 03/30/2018 JOB DESCRIPTION: 10 ft spot repair in yard only on 4 in. sewer service line. Will be in stalling double sweep clean outs *** CONTACTS *** OWNER GOLDSTEIN SETH I SUB (303)519-0240 R. Andrew Russell 120161 The Elite Pipe MD *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 2,800.00 FEES Total Valuation 0.00 PA Use Tax 50.40 0 Irl Permit Fee 93.35 ** TOTAL ** 143.75Q *** COMMENTS *** *** CONDITIONS *** ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection by any Sanitation District representative. Inspection and approval of work by any Sanitation District representative DOES NOT grant authority to cover work without the approval of the Building Division. **For trenchless sewer replacements - The contractor will verify proper slope of new sewer piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed specifically by the applicable code. The plumbing contractor will provide verification of proper slope and drainage in writing as a condition of approval of the permitted work.** City of Wheat Ridge Residential Plumbing PERMIT - 201700436 PERMIT NO: 201700436 ISSUED: 03/30/2017 JOB ADDRESS: 3875 Brentwood ST EXPIRES: 03/30/2018 JOB DESCRIPTION: 10 ft spot repair in yard only on 4 in, sewer service line. Will be in stalling double sweep clean outs I, by rn signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable Id n 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 ermit. I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be performed an hat be performed is disclosed in this document and/or its' accompanying approved plans and specifications. 3,5-, Signat�of OW ER or CONTRACTOR (Circle one) Date 1. kbis permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4, No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any applicable code or any f ordinance or regulation of this jurisdiction. Approval of work is subject to _y violation inspection. Signature of Chief Building Official 10 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 insptimerequestgei.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 Wheat j�idgC 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 FOR OFFICE USE ONLY Date: 3/ 30 l _ PlawPermit # + 0 1 — OM 1 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: 3,67S- Al. 8n.%4 j 5k Property Ower (please print): Dc,ILa S�� Phone- -5!r -,io> Property Owner Email: Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Enain2gr: Architect/Engineer E-mail: Contractor: -1-gE E L.z7e P-zpc ,t,,,, 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 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 LECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ OTHER (Describe) (Far 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.) /O' Spoi- IZtv,,er ,,,, yA(-c1 CrAly on //a dLGa-of 15CfUf)r-L 1",...-. w -C W'11 tic ,k�4all� �ov1�Lc vtv«� CLcA+A CJ-�s to A -((Ow 'uk-�J-r--C- Accc5S. Sq. FtAF Amps Btu's Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ arsoc). 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. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) PRINT NAME: 5S,5r lam/ SIGNATURE: ZONING COMMMENTS: Reviewer. BUILDING DEPARTMENT COMMENTS: Reviewer. PUBLIC WORKS COMMENTS: Reviewer: PROOF OF SUBMISSION FORMS Fire Department ❑ Received ❑ Not Required Water District ❑ Received ❑ Not Required Sanitation District ❑ Received ❑ Not Required USE ONLY DATE: 3 - 3 y "/ 7 OCCUPANCY CLASSIFICATION: Building Division Valuation: $ i CITY OF WHEAT RIDGE -.A Building Inspection Division / (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE r' 1 Inspection Type: Job Address:8�5 �iz�Ni r��oa� 5T Permit Number: 2-0170013 �'01�I/V4 06l ❑ No one available for inspection: Time Re -Inspection required: Yes (`No When corrections have been made, call for re -inspection at 303-234-5933 Date: 2__1_'1_7 Inspector: "&,-7 It C"aI DO NOT REMOVE THIS NOTICE i '% a -I . I INS EI TION RECORD INSPECTION REQUEST LINE: (303) 234-5933 occupanC /� 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 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. Concrete Encased Ground (CEG) Foundation / P.E. Letter Fire Inspection / Fire Protection Dist. 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 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 ,A Fire Inspection / Fire Protection Dist. Lath / Wall Tie Final Electrical Rough Electric Final Plumbing Rough Plumbing/Gas Line Final Mechanical Rough Mechanical Roof Rough Framing Final Window/Doors Insulation Final Building Drywall Screw/ Nail 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. 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 Final Mechanical Roof elc 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 emai)int sptimereauest(d)ci.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. 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: 40-7-w e) , Pe6—,, t.Number: Z D t / 0,0 t 17 ,I ❑ No one available for inspection: Time AMM 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 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: `57 Permit Number: r 1 t ❑ No one available for inspection: Time CAM)APM Re -Inspection required: Yes No 4 When corrections have been made, cafi for re -inspection at 363-234-5933 Dater - Inspector: Insp �7 $i t - r DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE ?;17(.303) Building Inspection Division (303) 234-5933 Inspection line 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Q _ Job Address: + w o o A� Permit Number: D o/ 7 6 0/ 3 V U i J PC, c � , G nJ (_0 ") o r U ki S I h (_G N p; %; c P') _r> . ❑ No one available for inspection: Time 0 AM/PM Re -Inspection required: Yes No When corrections have been made, call for re-inspectio t 303-234-5933 4 Date: a -3 Inspector: I DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division 1 (303) 234-5933 Inspection line (303) 235-2855 Office - (303) 237-8929 Fax INSPECTION NOTICE Inspection Type. 1 Job Address: Permit Number: VCS ❑ No one available for inspection: Time A n 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 4 City of Wheat Ridge Residential Roofing PERMIT - 201700138 PERMIT NO: 201700138 ISSUED: 01/31/2017 JOB ADDRESS: 3875 Brentwood ST EXPIRES: 01/31/2018 JOB DESCRIPTION: 21 squares; 5/12 pitch, one layer tear -off 30 year Tamco dimensional *** CONTACTS *** OWNER GOLDSTEIN SETH I SUB (303)669-9344 Silvestre Cuellar 060076 C -S Roofing *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,397.00 FEES N Total Valuation 0.00 Use Tax 97.15 Permit Fee 140.90 ** TOTAL ** 238.05 *** 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 A/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 manufacturera€ms 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. "V. il 14,E City of Wheat Ridge V_ Residential Roofing PERMIT - 201700138 PERMIT NO: 201700138 ISSUED: 01/31/2017 JOB ADDRESS: 3875 Brentwood ST EXPIRES: 01/31/2018 JOB DESCRIPTION: 21 squares; 5/12 pitch, one layer tear -off 30 year Tamco dimensional 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 thisermit. I further attes that I am legally authorized to include all entities named within this document as parties to the work to be performe d !Pat al r to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Si ature f OWNER or CONTRACTOR (Circle one) Date 1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpermit fee. 3, If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4, No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. �13� 11� 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 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 Wheaticlge COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(oki.wheatridge.coms 1 FOR OFFICE USE ONLY Date: Plan/Permit # �IIMIM 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: �; E_ 7 �— 1' Owner (please print): /G u Property Owner Email: --------- -- Mailing Address: (if different than property address) Address: City, State, Zi Arch itect/Enaineer: Phone Architect/Engineer E-mail: Phone: n� Contractor: Contractors City License #: Phone:4� G Contractor E-mail Address: �' f rir ���� (% / 16�_Z o l l . 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 ❑ 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. FULF Btu's Amps Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) $�v--_.- 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. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Electronic Signature (first and last name): �L�// �i��i�� DATE: j ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Building Division Valuation: $ City of Wh6atlk gle �COMMUNtTy DEVELOPMFNT 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: r)ermits(cDci.wheatridge.co.us imsum Date: Plan/Permit # W013� Plan Review Fee: *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 3FL- Property Owner (please print): Phone: 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 # � vchl', � I Plumbing: W.R. City License # Phone•: Phone•: 30 Other City Licensed Sub: City License # V03-3 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 STRUCTUREELECTRICAL SERVICE UPGRADE ElNEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING FI COMMERCIAL ADDITION n 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. Ft./LF Btu's Gallons Amps goX Squares Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) 00 $ .004 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. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) J °� Electronic Signature (first and last name): DATE: _1 ► J Building Division Valuation: $