HomeMy WebLinkAbout5330 Holland StreetCity of Wheat Ridge
Community Development Department
Memorandum
TO: Accounting Department
FROM: Kim Cook, Building Division
SUBJECT: Refund for Permit
DATE: February 11, 2018
Reason: Customer cancelled work request prior to start of work. Contractor
requested to have permit #201706691, for 10070 W. 44th Avenue closed out.
Please refund: Contractors License$ (acct 01-510-00-513)
80% permit fee: $ 264.88 (acct 01-510-00-516)
0% plan review $ (acct 01-550-05-551)
100 % use tax: $ 378.00 (acct 01-500-02-505)
Total: $ 642.88
TO:
D -Roc Renovations
5330 Holland Street
Arvada, CO 80002
Thank You!
Permit Technician
City of
O,/� Wheat midge
MUNI ll D[ VI -LOP --NT
City of Wheat Ridge Municipal Building 7500 W. 29"' Ave.
H
Wheat Ridge, CO 80033-8001 P: 303.235.2855 F: 303.237.8929
Refund Application
Complete this application in its entirety, attach all copies of permits, permit cards (if issued) and receipts that
were received at the time of permit issuance. Requests for more than 80 percent of the amount paid will not be
approved without prior approval from the Building Official. The refund application must be received by the
Wheat Ridge Building Division no later than 180 days after permit issuance. Applications received after 180
days of permit issuance will not be approved. You can mail or hand -deliver all required documents to: City of
Wheat Ridge, Attn: Building Division, 7500 W. 29th Ave., Wheat Ridge, CO 80033.
Company Name/Name (to whom check should be made out to): —D — —Z0L�p
Address: �J 3 y
City: kA(Ly V;),-- Z> kP,- State: CQ Zip: B(J--)u Z
Phone: 3()3S U zS--zN Fax:
Permit#: 4
Email o�c�t o . )� LL�K e -r4 70 <1 0 C•ti..,a [ c . 66r
Permit Address: k u u q --u bJ 44 —,'-'T p,-\1 L—
Reason for request: Vol C–1 Cco�TLWrL i br, I. E0 - ----"-3 ?—
Printed Nam bL- Signatur Date: 2
For office use only
This request has been: Approved ❑ Denied Refund Amount: $ & z R
Approved by-'� �— Date: A1S' 9-// e
www.ci.wheatridge.co.us