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Home My WebLink About4212 Owens StreetCity of Wheat Ridge Resid. Windows/Doors PERMIT - 201704251 PERMIT NO: 201704251 ISSUED: 07/18/2017 JOB ADDRESS: 4212 Owens ST EXPIRES: 07/18/2018 JOB DESCRIPTION: replacing 1 door u factor will be .30 or better. *** CONTACTS *** OWNER (303)477-4057 FERRIER NANCY L SUB (303)945-1519 Matthew Seiler 130206 Renewal by Andersen *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2951 / KIPLING HEIGHTS BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,317.00 FEES Window Replacement 50.00 Total Valuation 0.00 Use Tax 132.66 ** TOTAL ** 182.66 *** COMMENTS *** *** CONDITIONS *** Windows shall comply with all applicable codes, have a .32 or better U -factor and shall be safety glazing if within a tub enclosure, less than 18 inches above the floor or within 24 inches of a vertical edge of a door. 1, 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. l further attest that I am le ally authorized to include all entities named within this document as parties to the work to be performed and that ail 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 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 Offcial 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. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Occupancy/Type 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 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 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. *For low voltage permits — Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather INSPECTION RECORD Inspection online form: http://www-ci.wheatridge.co.us/inspection card is posted on the project site Cancellations must be submitted via the online fors before 8 a.m. the day of the inspection Inspections will not be performed unless t ection before MIDNIGHT (11:59 PM) to receive an inspection the following business day Request an rasp I� JOB CODE: 9 PERMIT:(-�41�7 �ADDRESS: 4-0 R Foundation Inspections Inspector Date Initials 102 Caissons / Piers 103 Footing / P.E. Letter 104 Foundation Setback Cert. 105 Stem Walls 106 Foundation wall Insulation Do Not Pour Concrete Prior To Approval Of The Above Inspections Inspector Underground 1 Slab Insp ections Date Initials 2 . 202 Se' erground Int. 203 :rground Ext. Comments Comments 204 F underground Int. 2051 g Underground Ext. 20�� rground Approval of The Above Inspections Do Not Cover Underground or Below I In -Slab Work Prior To App Rough Inspection 301 Rough Framing 302 Wall Sheathing 303 Roof Sheathing 304 Sheer n,pection 305 Ins, 30h Mid of 307 Metal ! n / Stucco 308 Rougi E. Xtrical Residential 309 Rough Electrical Commercial 310 Electrical Meter Residential 311 Electrical Meter Commercial 312 Temp. Const. Meter 313 Rough Plumbing Residential 314 Rough Plumbing Commercial 315 Shower Pan Date Insp tce or I Comments Initials i�E t:.; VER :" Z fir,° PERMIT: gppRESS: Rough Inspection (continued) 316 Rough Mechanical Residential 317 Rough Mechanical Commercial 318 Boiler / Furnace 319 Hot water tank 320 Drywall screw andgowerwalls 321 Moisture board /s 322 Rough Grading 323 Miscellaneous Final Inspections 402 Gas Meter Release 403 Final Electrical Residential 404 Final Electrical Commercial 405 Final Mechanical Residential 406 Final Mechanical Commercial 407 Final Plumbing Residential 408 Final Plumbing Commercial 409 Final Roof 410 Final Window/Door 411 Landscape/Park/Planning* 412 Row/Drainage/Public Works** 413 Flood plain Inspection** 414 Fire Insp. / Fire Protection*** 315 Public Works Final** 116 Storm Water M ,17 Zoning Final Inspection* 18 Building Final Inspection Date IInspector Initials Date IInspector Initials JOB CODE: Comments Comments Inspections from these entities shall be requested one week in advance. *For landscaping and parking inspections please call 303-235-2846 **For ROW and drainage inspections please call 303-235-2861 ***For fire inspections please contact the Fire Protection District for your project. Note: All items must be completed and approved by Planning, Public Works, Fire an before a Certificate of Occupancy is issued. Approval of the Final Building Inspection d Building constitute authorization of occupancy. p does not For Low Voltage permits please be sure that rough inspections are completed by the Fire District and Electrical low voltage by the Building Division. X. i CITY OF WHEAT RIDGE Building Inspection Division �(303) (303) 234-5933 Inspection line 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: t/0�% Job Address: y �_i g ,.,e n 5 .5/, - Permit rPermit Number: 20 /7,29 60,6 ❑ No one available for inspection - Time 1 6L�(,/ AM/PM Re -Inspection required: Yes No When correct'on7ve been made, call for re -inspection at 303 -234 -Date: %�% Inspector: /�rT// DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE �'(303) Building Inspection Division (303) 234-5933 Inspection line 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: ?;,0%, w I D Job Address: 212. WIC s Permit Number: ( (� 6N - u�yi f_: ❑ No one available for inspectio • ime Z -q M Re -Inspection required: YesNo When corrections have been made, call for re -i 1 pection 303-`234- 933 Date: I �� l I Inspector: DO NOT REMOVE THIS NOTICE ► 'Ir City of Wheat Ridge Residential Roofing PERMIT - 201708606 PERMIT NO: 201708606 ISSUED: 10/25/2017 JOB ADDRESS: 4212 Owens ST EXPIRES: 10/25/2018 JOB DESCRIPTION: Residential Re -roof to install Timberline asphalt shingles - 55 sq Pitch = 4/12 *** CONTACTS *** OWNER (720)863-6526 FERRIER NANCY L SUB (720)283-7997 WAIVER 022104 Hart Roofing Inc *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2951 / KIPLING HEIGHTS BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 19,000.00 FEES Total Valuation 0.00 Use Tax 399.00 Permit Fee 346.95 ** TOTAL ** 745.95 *** 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 - 201708606 PERMIT NO: 201708606 ISSUED: 10/25/2017 JOB ADDRESS: 4212 Owens ST EXPIRES: 10/25/2018 JOB DESCRIPTION: Residential Re -roof to install Timberline asphalt shingles - 55 sq Pitch = 4/12 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 legally authorized to include ali entities named within this document as partes 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 maybe 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 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, 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 V Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dane Lovett �� 17� 0 From: no-reply@ci.wheatridge.co.us Sent: Wednesday, October 25, 2017 9:58 AM fi To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Follow Up Flag: Follow up Flag Status: Completed (s 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 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 3- or 4- Units are on the property? PROPERTY INFORMATION Property Address 4212 OWENS ST Property Owner Name OWENS PARK HOA Property Owner Phone 720-863-6526 Number (enter WITH dashes, eg 303-123-4567) 29 Property Owner Email BRUCE@HARTRFG.COM Address Do you have a signed Yes contract to reroof this property? Applications cannot be submitted without an executed contract attached below. Attach Copy of Executed Contract Hart Roofing.pdf Contract CONTRACTOR INFORMATION Contractor Business HART ROOFING INC Name A , ; Contractor's License 022104 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 720-723-1011 Number (enter WITH dashes, eg 303-123-4567) Contractor Address 2171 S TRENTON WAY # 217 (Primary address of your business) Contractor Email Address BRUCE@HARTRFG.COM Retype Contractor Email BRUCE@HARTRFG.COM Address DESCRIPTION OF WORK TOTAL SQUARES of 55 the entire scope of work: Project Value (contract 19000 1 value or cost of ALL materials and labor) Are you re -decking the No ; roof? Is the permit for a flat Pitched roof (2:12 pitch or greater) roof, pitched roof, or 30 both? (check all that apply) What is the specific pitch 4 of the PITCHED roof? How many squares are 55 part of the PITCHED roof? Describe the roofing TIMBERLINE materials for the PITCHED roof: Type of material for the Asphalt PITCHED roof: Provide any additional TOWNHOMES 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 31 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 Bruce Farmer Email not displaying correctly? View it in your browser. 32 Roo&ng Denver Since 1996 2171 S. Trenton WayHART R ��G Tei {720) 283-7997 Suite 217 Fax (303) 325-7.427 Denver, CO 892 1� y YOUR TOTAL ROOFING SOURCE 1i ��j / wt i REPRESENTATIVE t��V ��-f7 DAT -- 17 Hart Roofing, Inc. agrees to furor h ail materials and labor necessary for the work (specified below) on premises located at,'Tl- yt; NAME OJ t Cif HOME PHONEWORK PHONE -1-2C)- ADDRESS 0,7- +� i/We the Owner(s) agree to pave .-)&- KSu-ZIkC ' • SPECIAL as ot_ subject Roof work to be completed of final insurance approval endorsement' . Property Owner Is/is not intending to make payment from the proceeds of a property.,and casualty Insuranc INSURANCE ALLOWANCE At EEMENT If so, homeowner must read and sign below. 1/We agree to retain Hart Roofing (contractor) to repair/replace the damaged or entire portion of the property described on this contract contingent upon the contractor obtair company's approval and payment to have said work completed. It Is agreed that the contractor is empowered to contact my insurance carrier and to meet with their represenu negotiate the amount of damage, the cost of the repair or replacement of the damage to the above property. Upon the Insurance carrier agreement with the contractor and tb being made the work will, be scheduled and may begin on a first in flrst out basis. All checks shall be made payable to Hart Roofing. In the event that the Insurance carrier falls to negotiate in a fair and reasonable manner, the contractor shall not be held liable and this agreement will be void.The contractor u complete file to the Commissioner of insurance at the customer's request. insured out of pocket expense will not exceed the Insured (purchaser) policy deductible for the work between the Insurance carrier and the contractor. Insured also agrees to provide all the necessary documentation for the claim (including documentation to facilitate payment i carrier and or mortgage holder).The contractor reserves the right to file for supplemental claims due to material and/or labor increases due to a storm environment or to Insura mistakes, errors or omissions. Hart Roofing shall hold in trust any payment received from you until Hart Roofing has delivered roofing material at the site or has performed malorlty of the roofing work on yo! Acceptance of Contract The above prices, specifications, and conditions are satisfactory and are hereby accept will be mad as outs! d Above. i 1t4 1i'Gli (insurance (olky No Signature >Q�t (Claim tN0.) 4za 47 f•4 t fC yV'l}vpc ►�tA�f i{ pf) RAD> --i (04 Signature (Mortgage Co.) (Mo�$gu" V1 t a) f;u wo You gre authorized to do the work as specified. Date Date If roof. This is z be lmount. is price is ,nts. In 21 days nortgage policy. g my insurance re in order to Iowa payment release the reed upon minsurance e adjuster's property S & CONDITIONS Recover roof with dit�y��(Jl7IkP.rotect landscape ❑Cover Pool_ P -Tear off er 8-Elean-up and haul off trash from roof {ee Shield (,lir- Ca ❑ Flat Roof ❑ Decking J'Felt k -Any siding repair to ailovq installation of new step flashing will ❑ Color of Shingle i be done at a rate of $__ __per hour, per worker, plus materia 'p- Style of Shingle !e, ::I�D ❑ Type ofValleyl!"r over and above original §ld orice. -� LLam�,, �nstall�..x G--- � �iffe al edge Permit SI Steep T Story 11 Offset �astenersJ77— - Hart Roofing, Inc -to furnish all material and labor ❑ Ridge TypetG �k oaf Stacks 1.5"3" Hart Roofing, Inc. to furnish own insurance 4" 5" _ X HVAC Caps 3'+ (.(� 6++ $•�� "aterial WarrantyVPv Gr � Labor warranty a- -Skylight ❑ TurbineVents Ar 1st payment of 6aiabowill be due upon completion ❑ Roof Louvers Roller Magnet Yard contingent upon any city or county inspections. Initials ❑ Placement of materia) -�/deductlble Siding Specifications Gutter Specification — ❑ Aluminum ❑ Vinyl srzEA-S" $ sim: O 05 O D4 STYLE: DL O SL O BB cotoR: -a , Q I collected. . f SPECIAL as ot_ subject Roof work to be completed of final insurance approval endorsement' . Property Owner Is/is not intending to make payment from the proceeds of a property.,and casualty Insuranc INSURANCE ALLOWANCE At EEMENT If so, homeowner must read and sign below. 1/We agree to retain Hart Roofing (contractor) to repair/replace the damaged or entire portion of the property described on this contract contingent upon the contractor obtair company's approval and payment to have said work completed. It Is agreed that the contractor is empowered to contact my insurance carrier and to meet with their represenu negotiate the amount of damage, the cost of the repair or replacement of the damage to the above property. Upon the Insurance carrier agreement with the contractor and tb being made the work will, be scheduled and may begin on a first in flrst out basis. All checks shall be made payable to Hart Roofing. In the event that the Insurance carrier falls to negotiate in a fair and reasonable manner, the contractor shall not be held liable and this agreement will be void.The contractor u complete file to the Commissioner of insurance at the customer's request. insured out of pocket expense will not exceed the Insured (purchaser) policy deductible for the work between the Insurance carrier and the contractor. Insured also agrees to provide all the necessary documentation for the claim (including documentation to facilitate payment i carrier and or mortgage holder).The contractor reserves the right to file for supplemental claims due to material and/or labor increases due to a storm environment or to Insura mistakes, errors or omissions. Hart Roofing shall hold in trust any payment received from you until Hart Roofing has delivered roofing material at the site or has performed malorlty of the roofing work on yo! Acceptance of Contract The above prices, specifications, and conditions are satisfactory and are hereby accept will be mad as outs! d Above. i 1t4 1i'Gli (insurance (olky No Signature >Q�t (Claim tN0.) 4za 47 f•4 t fC yV'l}vpc ►�tA�f i{ pf) RAD> --i (04 Signature (Mortgage Co.) (Mo�$gu" V1 t a) f;u wo You gre authorized to do the work as specified. Date Date If roof. This is z be lmount. is price is ,nts. In 21 days nortgage policy. g my insurance re in order to Iowa payment release the reed upon minsurance e adjuster's property 2 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: r— VI/ Job Address: �Z Z U,tis�,j S Permit Number: 2 7LU2 ❑ No one available for inspection: Time j L) ,'I b &, /PM s Re -Inspection required: Yes (No } When corrections have been made, call for re -inspection at 303-234-5933 Date: r �� Inspector: f(I DO NOT REMOVE THIS NOTICE Iv.City of Wheat Ridge Resid. Windows/Doors PERMIT - 201704251 �r PERMIT NO: 201704251 ISSUED: 07/18/2017 JOB ADDRESS: 4212 Owens ST EXPIRES: 07/18/2018 JOB DESCRIPTION: replacing 1 door u factor will be .30 or better. *** CONTACTS *** OWNER (303)477-4057 FERRIER NANCY L SUB (303)945-1519 Matthew Seiler 130206 Renewal by Andersen *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2951 / KIPLING HEIGHTS BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,317.00 FEES Window Replacement 50.00 Total Valuation 0.00 Use Tax 132.66 ** TOTAL ** 182.66 *** COMMENTS *** *** CONDITIONS *** Windows shall comply with all applicable codes, have a .32 or better U -factor and shall be safety glazing if within a tub enclosure, less than 18 inches above the floor or within 24 inches of a vertical edge of a door. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applica le 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 prope and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I leggally authorized tonclude all entities named within this document as parties to the work to be performed and that all work�01)e ertormed 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 thepermit 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 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 perfornwd sults in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building an ion Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work out written approval of such work from the Building and Inspection Services Div1sio 6. The i ua��ytin04offs rmit shal not be c � 'strued to be a permit for or an approval of, any violation of any provision of any applica e o u tion of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of' W heat jidgc - COMMUNiT-y DEVELOI'MENT Building & Inspection Services Division 7500 W. 29'h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 ' Fax: 303-237-8929 Inspection Line: 303-234-5933 FOR OFFICE USE ONLY Date: ,.sj f /7 Plan/Permit # Plan Review Fee: Building Permit Application PRA I D Please complete all highlighted areas on both sides of this form. incomplete applications may -not -be -processed—)" Property Address: 4212 OWENS ST. WHEATRIDGE, CO 80033 Property Owner (please print): NANCY FERRIER Phone: 303/477-4057 Property Owner Email: Mailing Address: (if different than property address) Address: SAME AS ABOVE State, Zip: Architect/Engineer: Architect/Engineer E-mail: Contractor: Matthew Seiler Contractors City License #: CL3-130206 Contractor E-mail Address: rnseiler@renewalcolorado.corn Sub Contractors: Electrical: W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Phone: Phone: 303-445-1514 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 [3 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) 1 - nnnR- U-FACTQR WILL RE 30 OR BETTER (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 Amps Btu's Squares Gallons Other Project Value: (Contract vvalue t ost of all materials and labor included in the entire project) OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT 1 hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations ofthe 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 1 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) ar (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) PRINT NAME: Matthew Seiler ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer. PUBLIC WORKS COMMENTS: Reviewer, SIGNATURE: _ DATE: PROOF OF SUBMISSION FORMS Fire Department ❑ Received ❑ Not Required Water District ❑ Received ❑ Not Required Sanitation District ❑ Received ❑ Not Required DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Building Division Valuation: $ 1 „3 x b M 3 E _o C a s df!l67d 'o O z z ma7aJ naars� o 0 r 3 O Q � Y Q 3 d f > a � H � n � a w o x M z s X d a Q x x z� x � 3 � noa v V � r�a4� G M ¢ N O N ailu r fi w/w C U z F Q PIPWIa z W/W TPV0 n N M L" N 4 lqo 0 C x-¢I � m o� a M U T U G d z O = Y a z `m c m 3 O c `o 0 ik 3 Ow 0 6 •- 6 J O o x ¢ N a D 0 l N ° o �;0 v cY o -o �- o = 0 -O O O Ga U o 7 Q 5 W a� 0 N z w vii p 0 3 a Z U V W Q -a od — N t} O L a >c O > p g .M -0 T N 'd Y t E- to mz ° O aN 3 Z M Q Q ur k d1 0 ? 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