HomeMy WebLinkAbout4090 Zephyr Drivei CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: �'� f
Job Address:►o o Zai, `(P
Permit Number: 2 O -�L 1,-l3
❑ 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 -
Date:— S '� /c'6 Inspector:
DO NOT REMOVE THIS NOTICE
5
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: 4 O--7 F- • P, R
Job Address: H 09,::) _�� �F be
c _
Permit Number: c) 1 O 4 t 4 3
i �7-�� � ►_�C-�� ter' �e� � � 3 a�
❑ No one available for inspection: Time , 5 a, /PM
r
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303 -234 -
Date: da3) 1 '3 Inspector. n_,: ) q_ �_=
DO NOT REMOVE THIS NOTICE
, _4 City of Wheat Ridge
Residential Plumbing PERMIT - 201707143
PERMIT NO: 201707143 ISSUED: 09/12/2017
JOB ADDRESS: 4090 Zephyr DR EXPIRES: 09/12/2018
JOB DESCRIPTION: residential plumbing replacing current boiler with triangle tube solo 110
86,000BTUs
*** CONTACTS ***
OWNER (303)420-3890 SHAW CAROL B AND BART
SUB (303)421-2161 Stephen Lanyon 017835 Blue Sky Plumbing
*** 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: 9,108.00
FEES
Boiler Replacement 40.00 ilk
Total Valuation 0.00
Use Tax 191.27
** TOTAL ** 231.27
*** COMMENTS ***
*** CONDITIONS ***
All work shall comply 2012 International Codes, 2014 NEC (if applicable), and ordinances
adopted by the City of Wheat Ridge. Work is subject to field inspections.
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 thispermit 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 parties to the work to be
performed and that work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signa e 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 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 shaU not be construed to be a permit for, or an approval of, an violation of any provision of any
applic de or any ce or eg ation of this jurisdiction. Approval of work is subject to field inspection.
*Ao
ll a niv, -
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
J��rWh6atl dbe
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(o-)ci.wheatridge.co.us
FOR OFFICE USE 0;%Y
Date: O/
Plan/Permit # XD ] %6
qM5_
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:
Property Owner (please print): t ����� �� Phone: 363::q2c) 5b
Property Owner Email:
Mailing Address: (if different than property address)
Address
State. Zip:
Architect/Engineer:
Architect/Engineer E-mail: Phone:
Contractor:
Contractors City License #: Phone:
Contractor E-mail Address: (. � b ncq C Lm
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.)
❑ R SIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
NQECHANICAL 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.)
9--e-Q \a c.t v1% c j Ic r -e- vi � bo ive f �r k dn9 Ce. T(A ;-e Sc>1 o ( V®
Sq. FULF
Amps
Btu's e L/ C) C) V Gallons
Squares
Other
Projectt Value: (Contract value or the cost of all materials and labor included in the entire project)
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information provided e application.
CIRCLE ONE: (OWNER) ((CO TRACT ) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Electronic Signature (first and last name): DATE: q A-0
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
Building Division Valuation: $
A i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: -510 Hrlro
Job Address:'
b P
Permit Number: (7L -9 -109 -
CID (41
,f..,
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Yes No
*Wher
Date
A 1( City of Wheat Ridge
r -
Residential Electric PERMIT - 201707608
PERMIT NO: 201707608 ISSUED: 09/22/2017
JOB ADDRESS: 4090 Zephyr DR EXPIRES: 09/22/2018
JOB DESCRIPTION: Residential Electrical Service upgrade to 200 amps
*** CONTACTS ***
OWNER (303)420-3890 SHAW CAROL B AND BART
SUB (303)288-7988 Martin Black 130207 Mighty Bee Electric LLC
*** 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: 1,999.00
FEES
Total Valuation 0.00
Use Tax 41.98
Permit Fee 77.50
** TOTAL ** 119.48
*** COMMENTS ***
*** CONDITIONS ***
Must comply w/ 2012 IRC & 2014 NEC. Subject to field inspection.
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 thispermit 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 parties to the work to be
performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received 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 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 an 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, an violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official mftw Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
Y f Wheatfk
MUNITy 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: perm its(a)ci.wheatridge.co.us
FOR OFFICE USE ONLY I
Date: 9
Plan/Permit #50
/
Plan Review
Building Permit Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address: ZO
Property Owner (please print): Phone: -3103 -9 2-0
Property Owner Email:
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Architect/Engineer:
Architect/Engineer E-mail:
Contractor:
Phone:
Contractors City License #: Phone: 9 7TS'S'
Contractor E-mail Address:—
Sub Contractors:
Electrical:
W.R. City License # % ZD z.0`7
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 2—a -a Squares
Gallons
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
>ig91C'
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the infonnation provided on the application.
CIRCLE ONE: (OWNER) C�OyNTRA�� or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last name)://z+CdGG.�C/ /� DATE: 7i
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
Building Division Valuation: $
c� 17 0-3
aoqo -zh1/ f Pf. INSPECTION RECORD
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection
INSPECTION REQUEST LINE: (303) 234-5933
OccupancyType
Inspections will not be performed unless this card is posted on the project site.
**Request an inspection before 11:59 P.M. (midnight) to receive an inspection the following business day.**
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections Date
Inspector Comments
Initials
Pier
Electrical
Concrete Encased Ground (CEG)
Sewer Service
Foundation / P.E. Letter
Plumbing
Underground/Slab Inspections
Date Inspector Comments
Inspector
Initials
Initials
Electrical
Sewer Service
Plumbing
Rough Inspections
Date
Inspector
Initials
vI ■11�i /16/vYG �11.7F.JCGl1�i1�5
Comments
Wall Sheathing
Mid -Roof
Lath / Wall Tie
Rough Electric
Rough Plumbing/Gas Line
Rough Mechanical
Rough Framing
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
( ,
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.
*Fnr Inw unl4tano nor—i+. _ D1-_ Lel.. .. tl..
• -- -- ---- ---_._- .....-r---�.•��,�..�......���t �o U nviii LI i nc �i uiclanu uiwancal low voltage
by the Building Division.
Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued
Protect This Card From The Weather
CITY OF WHEAT RIDGE
__:��Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: //? b
Job Address: `-/G l U Z-, �
Permit Number: -7 v 3' L t
❑ No one available for inspection: Time f AM/PM
Re -Inspection required: Yes No
''When corrections have been made, cal or re -inspection at 303-234-5933
Date: Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
_:�9rBuilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
4/1 Inspection Type: - �0
Job Address: r 7 A
Permit Number: 7 u/ -r(,,3 &U
J No one available for inspection: Time AM/P..M
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303 -234 -
Date: ' /, Inspector: K
f(
DO NOT REMOVE THIS NOTICE
.r City of Wheat Ridge
tet, Residential Roofing PERMIT - 201703184
PERMIT NO: 201703184 ISSUED: 07/03/2017
JOB ADDRESS: 4090 Zephyr DR EXPIRES: 07/03/2018
JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration asphalt shingles with
29 sq. (26 sq. pitched, 3 sq. flat)
*** CONTACTS ***
OWNER 303-420-3890 SHAW CAROL
SUB (303)295-2220 Tomas Wofram 110052 Core Contractors, Inc.
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: UA / Unassigned BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,453.00
FEES
Total Valuation 0.00
Use Tax 156.51
Permit Fee 172.60
** TOTAL ** 329.11
*** 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 one half 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
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.
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION
City of Wheat Ridge
Residential Roofing PERMIT - 201703184
201703184
4090 Zephyr DR
Residential Re—roof to install Owens
29 sq. (26 sq. pitched, 3 sq. flat)
ISSUED: 07/03/2017
EXPIRES: 07/03/2018
Corning Duration asphalt shingles with
I, by m 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 to 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 parties to the work to be
performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER of 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, po icies 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 ally 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 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.
Dan Schultz 2C)17031,
From: no-reply@ci.wheatridge.co.us
Sent: Wednesday, June 21, 2017 9:01 AM
To: Permits CommDev
Subject: Online Form Submittal: Residential Roofing Permit Application
Categories: Danny
Residential Roofing Permit Application
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. 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. Permits are currently being
processed within 5 business days, subject to change based on volume.
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
4090 Zephyr Dr
Carol Shaw
303-420-3890
Property Owner Email
Field not completed.
Address
Do you have a signed
Yes
contract to reroof this
property?
It will need to be
provided at the time of
permit pick-up.
CONTRACTOR INFORMATION
Contractor Name
Core Contractors, Inc.
Contractor's License
110052
Number (for the City of
Wheat Ridge)
Contractor Phone
303-295-2220
Number
Contractor Email Address
docs@coredoes.com
Retype Contractor Email
docs@coredoes.com
Address
DESCRIPTION OF WORK
Are you re -decking the
No
roof?
Description of Roofing
Owens Corning Duration
Material
Select Type of Material:
Asphalt, Other (specify below)
If "Other" is selected
Modified Bitumen
above, describe here:
How many squares of the
26
material selected above?
Does any portion of the
f
Yes U✓"
property include a flat
root?
If yes, how many squares
3
on the flat roof?
01
TOTAL SQUARES of all 29
roofing material for this
project
Provide additional detail Remove & replace asphalt shingles on main house and
here on the description of attached garage (4/12 pitch). Apply modified bitumen to patio
work. (Is this for a house and porch (1/12 pitch).
or garage? What is the
roof pitch? Etc)
Project Value (contract
value or cost of ALL
materials and labor)
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
submit this application
and to perform the work
described above.
Name of Applicant Tomas Wolfram
Email not displaying correctly? View it in your browser.
3
CORE
CONTRACTORS
Colorado Owned
And Operated
Since 2001
Property Owner:
Property Addres!
City/State:
Home Phone:
CORE CONTRACTORS, Inc.
Genera( Contracting and Insurance Restoration
4501 Logan Street, Denver, Colorado 80216
Phone: 303-295-2220 / Fax: 303 477-5557
"Doing it right matters"
r-1 AGREEMENT
Effective Date:
Rated
BBB A+
Licensed and Insured
Westfleid Insurance
Company
800-766-9133
TERMS: By signing this agreement, the Property Owner authorizes CORE CONTRACTORS, INC ("CORE") to perform the
work and supply the materials as agreed upon by Property Owner's insurance carrier. Homeowner agrees to use CORE
exclusively, and authorizes CORE to obtain labor and materials in accordance with the scope agreed to by the
insurance company and the specifications set out in this Agreement to accomplish the replacement or repairs. The
initial proposed scope of services is attached to this agreement. This agreement does not obligate the homeowner or
CORE in any way, unless the damage is approved by homeowner's insurance carrier.
Roofing Scope:
The roofing system replacement includes all shingles,
undertayment, valley Linings and miscellaneous flashings, per local
applicable municipal code. This also includes full ctean-up of the
property. A 5 year Roof Workmanship Warranty included on full roof
replacement only. A one year workmanship warranty included all
non -roof replacements. Roof repairs are excluded.
Additional Roofing scope notes:
Due to the nature of repair related to insurance claims, this contract includes an estimated repair price of the roof
system, approximately$ t6i _� 0 . Because the final scope has not been agreed upon with the insurer, this repair
price might change. The am6unt of this contract is for 100Y6 of the replacement cost approved by the insurance
coml?an for work to be completed by CORE. Reaching agreement on the full scope of repairs involves considerable
time on CORE's part; we will not proceed with that phase unless you agree to allow us to do the work once the scope is
agreed upon. By signing this contract, you authorize CORE to reach agreement on the scope of repairs on your behalf.
CORE agrees to bid the work using the primary insurance industry pricing database (Xactimate) based on the scope of
work agreed upon with your insurer. You, the homeowner, recognize CORE CONTRACTORS, Inc. as a general contractor
and as such shall be entitled to overhead and profit, at customary insurance industry rates (20% on Xactimate line
items). Any substantial additions or deductions to the scope of work will be handled on the Customer Verification
Form. Property Owner agrees that if a scope of work and project cost is agreed between CORE and the insurance
carrier, that they are responsible to pay ONLY the deductible amount per their replacement cost insurance policy. Any
further changes, in addition to the insurance work, must be requested in writing, by Property Owner.
If, you, the Property Owner, plan to use the proceeds of a property and casualty insurance policy issued pursuant to
Part I of Article 4 of Title 10, C.R.S. to pay for roofing work, pursuant to Section 6-22-105, C.R.S., 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 ROOFING WORK ON THE
COVERED RESIDENTIAL PROPERTY. Property Owner's Initials0_-.L_
PAYMENTS ARE TO BE MADE: 1/2 (OR FIRST INSURANCE CHECK RECEIVED - ACV CHECK) UPON DELIVERY OF ROOFING
MATERIALS, AND BALANCE UPON COMPLETION OF WORK. WORK TO BE COMPLETED WITHIN APPROXIMATELY 90 DAYS OF
EXECUTED CUSTOMER VERIFICATION FORM. CORE SHALL HOLD IN TRUST ANY PAYMENT FROM THE PROPERTY OWNER
UNTIL THE ROOFING CONTRACTOR HAS DELIVERED ROOFING MATERIALS AT THE RESIDENTIAL PROPERTY SITE OR HAS
PERFORMED A MAJORITY OF THE ROOFING WORK ON THE RESIDENTIAL PROPERTY.
RIGHT TO CANCEL
You, the homeowner, have the right to rescind this Agreement and obtain a full refund of any deposit within 72 hours
after entering the Agreement. If you plan to use the proceeds of a property and casualty insurance policy to pay for the
roofing work, you may rescind this contract within 72 hours after you receive written notice from the insurer that your
claim has been denied in whole or in part.
Property Owner:
Date: Insurance Company:
Core Representative: e: �/Claim #:
.0 6
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