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Home My WebLink About3980 Cody StreetFrom: no-reolv(alci.wheatridae.m. us To: CommDev Pets Subject: Online Form Submittal: Sewer or Water Line Repair Permit Application Date: Monday, January 10, 2022 8:36:38 AM Sewer or Water Line Repair Permit Application This application is exclusively for SEWER OR WATER LINE REPAIR - IN YARD Your Permit will be emailed to the email address provided below once it is processed. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. Right of Way permits must be applied for with the Public Works Department. Is this application for Yes sewer line or water line repair - in yard only? PROPERTY INFORMATION Is this Residential or Residential Commercial? Property Address 3980 Cody St Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123- 4567) Ike Nelson t<i8ic1rc 16-M Property Owner Email Field not completed. Address Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" CONTRACTOR INFORMATION Contractor Business Name Contractor's License Number (This is a 5 or Pipeline Solutions LLC ipillVil 6 digit number for the City of Wheat Ridge) Contractor Phone 3038105321 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email denpermits@gmail.com Address Retype Contractor denpermits@gmail.com Email Address DESCRIPTION OF WORK Is this a sewer line or sewer Line water line repair? Length of repair 10' repair Location of repair front yard (backyard, frontyard, etc) Provide additional set of cleanouts details including installation of clean- o uts. Project Value (contract 2200 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 work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have Yes been authorized by the legal owner of the property to 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. Person Applying for Jose Guerrero Permit Email not displaying correctly? View it in your browser. 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: AM PCIF Job Address: &Q GODk_I Permit Number: �Z00064-o� ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, call for re-inspec io 303-234-5933 Date: f (3U / Inspector:_�/ / IT DO NOT REMOVE THIS NOTICE A i City of Wheat Ridge Residential Roofing PERMIT - 201705405 PERMIT NO: 201705405 ISSUED: 08/03/2017 JOB ADDRESS: 3980 Cody ST EXPIRES: 08/03/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration Storm asphalt shingles with 24 sq. *** CONTACTS *** OWNER (720)935-6231 NELSON IKE SUB (303)761-6400 J. Bretz 018118 Excel Roofing, Inc. *** 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: 7,723.81 FEES Total Valuation 0.00 Use Tax 162.20 Permit Fee 172.60 ** TOTAL ** 334.80 *** 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) 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. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. A i City of Wheat Ridge ®r'6 Residential Roofing PERMIT - 201705405 PERMIT NO: 201705405 ISSUED: 08/03/2017 JOB ADDRESS: 3980 Cody ST EXPIRES: 08/03/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration Storm asphalt shingles with 24 sq. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all entities named within this document as 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. pU fe;Nc tL.� �i�yr/1 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 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 applic ode or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Caa� Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dan Schultz c:;�017613—V�l From: no-reply@ci.wheatridge.co.us Sent: Wednesday, July 26, 2017 2:15 PM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Gina 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 Single Family Home are on the property? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number Property Owner Email Address 3980 Cody St Ike Nelson 720-935-6231 Field not completed. Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. Attach Copy of Contact Field not completed CONTRACTOR INFORMATION Contractor Business Excel Roofing Name Contractor's License 018118 Number (for the City of Wheat Ridge) Contractor Phone 303-761-6400 Number Contractor Email Address excel@excel roof ing. com Retype Contractor Email excel@excelroofing.com Address DESCRIPTION OF WORK Are you re -decking the No roof? Description of Roofing Remove existing roof and replace with Owens Corning Storm Material shingles. Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 24 material selected above? Does any portion of the No property include a flat roof? If yes, how many squares Field not completed. on the flat roof? TOTAL SQUARES 24 (pitched + flat) of all i roofing material for this project Provide additional detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract value or cost of ALL materials and labor) House=22 squares Shed=2 squares Pitch=5/12 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 James Bretz Email not displaying correctly? View it in your browser. 3 Jul 12 1709:29p Kevin McCarthy 720-870-7682 p.1 Excel Roo,fng We're on Top of It Copy of Ike Nelson EXCEL ROOFING.COM ON 4510 S FEDERAL BLVD ENGLEWOOD CO 80110 303-761.6400 Proposal/Contract zil5z fxcelRooffng.com Date: 7/7/2017 Proposal submitted to: Ike Nelson Address: 3980 Cody St Wheat Ridge, CO 80030 Phone # (730) 935-6231 Email: ike50@mac.com Job style 0 We hereby propose to furnish materials and labor necessary for the completion of: I. Installation of the; Owens Corning Duration Storm .mited Life - Class`s 4 Impact rated asphalt roof installed per manufactures recommendation. Inttu t... Color: T -1f4 -V V0C) ? A. Provide Workman's Comp and Liability Insurance. {Acor s 303-762-1717) and Pinnacol ins. B. Obtain building permit from city or county. (cost not included) C. Provide Carbon Monom. de Alarm at start of project. D. Remove all layers of existing roofing, currently has: E. Inspect Roof decking; $ 55 per sheet to replace if needed. F. Ensure that all eaves and gables have metal drip edge. G. Install New shingle underla}nnent(s) that meet or exceed code: H. Ensure all HVAC vents are properly flashed & painted. Install & paint new neoprene flashing on all plumbing vent pipes. I. Install asphalt shingles to manufacturer's recommendations with VA inch galvanized nails, 6 nails per shingle. J. Attic ventilation: Excel Roofing recommends; K. Install matching ridge shingles. L. Final inspection with Project Manager at completion of project and call for final permit inspection. H. Workmanship is guaranteed for Five (5) years. Free transfer to new owner. IIT. Excel Roofing will clean up, use nail magnet and haul all debris at completion of project. IIII. Excel Roofing will wash the roof at completion of project. Excel Project Manager: Kevin McCarthy Email: Kevin@exce€roofing.com Phone #: 303-356-4125 ExcelRoofing.com copy of Ike Nelson Exce! F, oof%ng We're on Top of it Pages 1 of 3 Jul 12 17 09:30p Kevin McCarthy 720-870-7682 p.2 Excel Roofing Copy of Ike Nelson ExcelRoofng.corn We're on Top of it A. Additional items: Complete painting and window screen repairs as described by the Adjustor $ 657.97 B. We will bill Horace Mann for the emergency repairs $350.00 as a supplement to the claim. C. We can repair your ceiling if you would like. Any and all Unforeseen Code Upgrades, Supplemental items and permit fee will be billed to the insurance company, if it is an insurance claim and the policy allows. N. Home and Roof Options: Costfor removal and replacement of Roof, including all labor and materials. $ 7,723.81 Replace 89 Feet 5" gutter 9 Feet of D/S Color: White $ 583.61 Cost to upgrade to a Limited Life Class 4 Impact rated shingle. Free Cost for additional attic ventilation; $ - Cost to replace flat roof area with: Modified Bituman N/A $ - Cost to add 0 inches of blown insulation on top of existing attic insulation $ - Cost for any additional items noted on the 2nd page of the contract. $ 6657.97 Payment Options: *Please initial next to the payment option of choice* A: Payment using Financing: *Payment plan options, HVAC* Amo mt to be financed $ 9,503.31 *Please note that Excel does not make any additional money on these tees and loans* Dealcr # 11543 ph # 866-393-0("33 12 Month 01/o Deferred Interest 60 Months 7.99% interest 120 Months 7.99% interest ($791.94) ($192.65) ($115.25) Initial; Initials Initials 8: Payment Using Credit Card: Cost of Project if paid by credit card. Price reflects the 3% convenience fee $ 9,234.33 Initials C: Payment by cash, check or secured fu - $ 8,965.39 Initials plus permittee EAcel Project Manager: Kevin McCarthy Email: Kevin@exceiroofing.com Phone #: 303-356-4125 ExcelRoofing.com Copy of Ike Nelson Excel Roofing Ale're on Top of it Pages 2 q'(3 Jul 12 17 09:30p Kevin McCarthy 720-870-7682 p.3 excel Roo; ng Copy of Ike Nelson Erce(Rooing.com vVe're on Top of R Terms: 100% Payment due upon completion of each phase of work Total Cost does not include City/County Permit fee. According to Colorado law if the services provided are paid through an insurance claim it is illegal for a Contractor to pay the homeowner's deductible in whole or part, also any deposit paid by the Homeowner must be held in trust. The homeowner may cancel this contract at any time prior to construction. If the material has been delivered or the permit has been purchased then the homeowner shall be obligated to pay the delivery and permit costs. The homeowner may also cancel this contract if they are notified that their claim is denied in whole or part. All work to be completed per standard industry practices according to specifications submitted. The homeowner agrees that if any additional work is required to complete the above specifications involving extra cost they will pay these additional charges. All agreements are contingent upon strikes, accidents, or delays beyond our control. Owner agrees to carry regular homeowners insurance. Excel Roofing will not be held liable for any structural movement, settling, cracks in drywall, damage to driveway, or any damage to siding due to the roofing or loading process. Finance charges of 1 % percent per month will be added to any Unpaid balance. In the event collection action is taken to recover payment under this agreement, Excel Roofing, Inc., should be entitled to reasonable collection and attorney fees and costs incurred in such action. Excel Roofing's liability insurer is Cincinnati Insurance Company, 6200 S. Gilmore Road, Fairfield, OH 45014- 5141. This proposal may be withdrawn by Excel if not accepted within _7_days. The approximate start date shall be within_60_days of acceptance of this proposal. Kevin McCarthy Project Manager Date: 7/7/2017 Cell Phone # 303-356-4125 303-761-6442 Fax Acceptance of Contract The above price, specifications and conditions are satisfactory and are hereby accepted. Excel Roofing, Inc is hereby authorized to do the work as specified. and payment: will be made to Excel Roofing, Inc., as outlined above-Ael:5-oflPrintedName l �'Title Signa ExcelRoofing.com Copy of Ike Nelson 7-7-17 1xcA; RooF,ng We're on Top of It Pages 3 cf 3 i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax t IN PECTION NOTICE Inspection Type: A00 Job Address: co/-)/ S =_ Permit Number: ❑ No one available for ins ction: Time 114 AM/PM Re -Inspection required: . N p q e o When corrections have been made, call for re-insp, c ' n at 303-234-5933 Date: ` Z / Inspector: DO NOT REMOVE THIS NOTICE A i"CITY OF WHEAT RIDGE _:�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: _ Job Address: ❑ No one available for inspection ime�!/! 1 AM/PM r Re -Inspection required: YesNo When corrections have been made, call for re-insp do t 303-234-5933 d Date: Z` �� Inspector: DO NOT REMOVE IS NOTICE City of Wheat Ridge j Residential Roofing PERMIT - 201705405 PERMIT NO: 201705405 ISSUED: 08/03/2017 JOB ADDRESS: 3980 Cody ST EXPIRES: 08/03/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration Storm asphalt shingles with 24 sq. ****revision add redecking****** *** CONTACTS *** OWNER (720)935-6231 NELSON IKE SUB (303)761-6400 J. Bretz 018118 Excel Roofing, Inc. *** 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: 10,375.18 FEES Total Valuation 0.00 Use Tax 217,88 Permit Fee 220.15 ** TOTAL ** 438.03 *** 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) 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. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. City of Wheat Ridge Residential Roofing PERMIT - 201705405 PERMIT NO: 201705405 ISSUED: 08/03/2017 JOB ADDRESS: 3980 Cody ST EXPIRES: 08/03/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration Storm asphalt shingles with 24 sq. ****revision add redecking****** 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_perrp,tt. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be pertfgrmyed and that 0 work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. ,;-- I / -- Signature -,- 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 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 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 ranting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable co a pan�y��or�d,,�nance�x regulaQio 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. of ,"Soo oU1 �, 2� .jt�di FOR OFFI cl i ce 29th Aeoti0 % Date: l nSpecti 303 � S Ve"' whn Secy, - Ffiail e°ne. 3855 *P. iogf vi'/, ! 0 nits ci 0� at 9 303 23 89�� 33 �% P/an/Pem�it ff y US P/Vase caplet P/an Review Fee: propem'�4 a all h f04/1, ed e4,'a�h proper aareS�' araah�th9 p�,r�it pr�Pe yo��er�A/�a S�d� °fth�s fo Aald/%Cc�t%O/� may not bi . nY owoer�� ' •sear/r7f); 'n'' /hcamp/ete applications gddr ISO s• Jv ess. �f d/der E: e�ffr, � pha`n a State 2i .Arppevol aadr�, ssJ ArohtectF �owneer ,Contr$ctor r -ontractors , ,,; 'tractor , C�tY License � mat l Admire # l CiCense phpn'@: ins P/vhbt ea SUb W R city�tcen se � Me�hani oth CO�pIE,t cty zi.'t'CiwR Cts ��/erase � ail ih forget, ease �ce rased sib: �p 010 ❑ 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.) osp I Sq. Ft./LF Amps Btu's Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) $- - - -- - - ---- -- ------ 0 ) ( S- 5� 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 1 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 provideo4m�the application. CIRCLE ONE (OWNER) of (OWNER) (CONTRACTOR) Electronic Signature (first and last name): ZONING COMiMMENTS. Reviewer: BUILDING DEPARTMENT OO WENTS: Reviewer. DEPARTMENT USE ONLY DATE: "t s I OCCUPANCY CLASWtCATION Building Division Valuation: $