HomeMy WebLinkAbout3226 Pierson StreetCity of
�"
`1Vheat ,dge
MUNITY DEVELOPMENT
City of Wheat Ridge Municipal Building 7500 W. 29t1 Ave.
F: 303.237.8929
August 12, 2019
Owner/Occupant
3226 Pierson Street
Wheat Ridge, CO 80033
Wheat Ridge, CO 80033-8001 P: 303.235.2855
RE: Previously permitted project plans available for retrieval — Permit 201803081 (Detached
Garage)
Owner/Occupant,
This letter is being sent to you because a project for which a permit was issued by the City of
Wheat Ridge Building Division and plans and/or other documents were required was recently
completed and approved. In accordance with the Building Division's document retention policy,
the associated plans and/or other documents are scheduled for disposal.
We are writing to offer you an opportunity to retrieve those approved plans and/or documents
prior to their disposal by the Building Division. The plans and/or documents are available for
retrieval for a period of 20 working days (4 weeks) from the date of this letter — September 9th
— and must be retrieved in person at the Building Division offices. This letter must be
presented at the time of retrieval of the plans and/or documents. Plans and/or documents
available for retrieval CANNOT be mailed and plans and/or documents will NOT be available
for retrieval after the expiration of the retrieval period.
You may retrieve plans and/or documents between the hours of 7:30 a.m. and 3:30 p.m., Monday
through Friday, at the Building Division offices located at 7500 W. 29`h Avenue in Wheat Ridge.
Cordially,
Kimberly Cook
Permit Technician
7500 W. 29th Avenue
Wheat Ridge, Colorado 80033
Office Phone: 303-235-2873
Fax: 303-237-8929
www.ci.wheatridge.co.0
City of
COW heat j�ids�e
MMUNITY DEVELOPMENT
www.ci.wheatridge.co.us
® � ® s_ CITY OF WHEAT RIDGE
_1�9�Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: \0'- , \ &N —, C, �'< r, 4
Job Address: 2 2 t n P -t 5 �► -,
Permit Number: c�C3 CDC>� 1
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: `-i d c� °± t ` Inspector: "
DO NOT REMOVE THIS NOTICE
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:
Job Address:���"� -�
Permit Number: C!.-::> I \�_
❑ No one available for inspection: Time
Re -Inspection required: Yes No
When corrections have been madecaM for re-ins�lectign at 303-234-5933
Date: Inspe , o �--�---
DO NOT REMOVE THIS NOTICE
i CITY OFWHEATRIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office - (303) 237-8929 Fax
INSPECTION'hOTICE
Inspection Type:
r
Job Address: S
Permit Number: 0 I g O-_3 n 4R
❑ No one available for inspection: Time /QQFPv/PM
Re -Inspection require Ye No
:
When corrections have been made, call' or re-inspectio 03-234-5933
Date: Inspector:
r
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE ' z'
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: q0q- pr'�cj t gDU_F
Job Address: �?�t t'/;ate Sy .
Permit Number:,-,) 010030 j
t /7, l R,60-� ulV_ v 4
❑ No one available for inspection: Time jiq5- PM
Re -Inspection required: Yes 6'
When corrections have been made, call for re -inspection at 303-234-5933
Date: -Y / (- // i I Inspector: ] n E: [ 0vt r
DO NOT REMOVE THIS NOTICE
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,�d1__0U-r
Job Address: b ! ' �C'f1 ST
Permit Number: X11 �� 0
A P
❑ No one available for inspection: Time Z a = AM&
Re -Inspection required: Yeso
When corrections have been made, ca for re -inspection at 303-234-5933
Date: r� ���` P Inspector: D41'�'
DO NOT REMOVE THIS NOTICE
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: 3 3 2 ( :011-e, so,,
Job Address:
Permit Number: `t� U
l tnC:E ��� ✓� t Irr 1-'
❑ No one available for inspection: Time 1 a \":�_ AM/PM
Re -Inspection required: es No
When corrections have been made, call for re -inspection at 303-234-
Date:.
03-234-
Date: � ' 2 ' Inspector: t '
DO NOT REMOVE THIS NOTICE
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:
Job Address: ^%7 -Z U P
Permit Number: cf' r'' 7 0 3 t
A V
F
c
❑ No one available for inspection: Time i'it� AM/PM
Re -Inspection required: Yes /No
When corrections have been made, call for re -inspection at 303 -234 -
Date: Inspector: 17,
DO NOT REMOVE THIS NOTICE
41 CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office & (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: n yn I r!,�
3
Job Address:
Permit Number:
j
ci
J No one available for inspection: Time AM/PM
Re -inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
-L Le If Inspector: _,� 1 -1
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE 11
Inspection Type: C ! ' . )ec - Cr b e n `t 4
Job Address: 3 0? (v f -es's v n
Permit Number: o I S Q 3 a 1
❑ No one available for inspection: Time (AM PM
Re -Inspection required: -'Yes,-N6
When corrections have been made, call fo inspection at 303-234-5933
Date:. i inspect
DO NOT REMOVE THIS NOTICE
l
�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: ZO C -6C 016 (--6
Job Address: p I►,50)V ST
Permit Number: '%o 190 2S:7?/ �
❑ No one available for inspection: Time--
.�DAM1PM
Re -Inspection required: Yes (No�
When corrections have been made, call fpr re -inspection at 303-2 - 933
Date: j� " Co lnspecto,
DO NOT REMO THIS NOTICE
*** CONDITIONS ***
**No additional buildings may be constructed on this property due to the 25% lot coverage
maximum allowance**
Landscaping removed or damaged during construction must be replaced prior to final
inspection.
Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all
applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections.
City of Wheat Ridge
Residential Detached Garage
PERMIT - 201803081
PERMIT NO:
201803081
ISSUED: 12/07/2018
JOB ADDRESS:
3226 Pierson St
EXPIRES: 12/07/2019
JOB DESCRIPTION:
Residential detached garage in backyard with monolithic foundation, 8X8
steel garage door, 12.5 ft x 35
ft; 437.5 sq ft total; no electrical
*** CONTACTS ***
OWNER (303)868-3097 MELODY/MIKE RIVERA
SUB (303)489-3376
Rich Cordova
180360 Rich Cordova
SUB (720)298-5113 Anthony H. Chavez
021086 Edison Electical Contractors
*** PARCEL INFO ***
ZONE CODE:
UA / Unassigned
USE: UA / Unassigned
SUBDIVISION CODE:
2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 16,387.00
FEES
Total Valuation
0.00
Plan Review Fee
204.91
Use Tax
344.13
Permit Fee
315.25
** TOTAL **
864.29
*** COMMENTS ***
*** CONDITIONS ***
**No additional buildings may be constructed on this property due to the 25% lot coverage
maximum allowance**
Landscaping removed or damaged during construction must be replaced prior to final
inspection.
Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all
applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections.
�. City of Wheat Ridge
Residential Detached Garage PERMIT - 201803081
PERMIT NO: 201803081 ISSUED: 12/07/2018
JOB ADDRESS: 3226 Pierson St EXPIRES: 12/07/2019
JOB DESCRIPTION: Residential detached garage in backyard with monolithic foundation, 8X8
steel garage door, 12.5 ft x 35 ft; 437.5 sq ft total; no electrical
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications2
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 le ally authorized to inc a I entities named within this document as partes to the work to be
performed and that all work to be ormed is disclosed i is d cument and/or its' accompanying approved plans rid specifications.
Signature of OWNER or C TRACTOR (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 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 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 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.
City of
W heat Ijdge
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)
Email: permits(cDci.wheatridge.co.us
Building Permit Revision/Amendment Application
I FOR OFFICE USE ONLY I
Date:
Add to Permit #%1
* Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *
Property Address: 3 2
t z"� S�-
Property Owner (please print): M F,_�,_00 `� � iM I )<�--t �4 \V Phone: � G 2 56 9 3 d 9
Property Owner Email:
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Contact Person: C,�` -c�Z�� n Phone:
Contractor:
tom- cam. � s �e C_
Contractors City License #: 0 k' Phone: �� 3
E-mail
t-+- Q54D , Cs -0 ' —_
Please Note: Additional valuation must include all general and subcontracted work to be performed
related to the revisions and/or amendments declared in the description of work and which were not
included in the original permit valuation.
If revisions or amendments increase the original valuation, additional fees will be due at the time of
approval. Depending on the scope of work, additional plan review fees may be due upon approval
($60.00 an hour— 2 hour minimum).
Description of revised/amended work:
Sq. Ft/LF
Amps
Btu's
Squares
Gallons
Other
Additional Project Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above)
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 (A
PRINT NAME: I,,`
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
SIGNATURE:
ATIV,0 of (OWNER) (CONTRACTOR)
DEPARTMENT USE ONLY
PROOF OF SUBMISSION FORMS
Fire Department ❑ Received ❑ Not Required
Water District ❑ Received ❑ Not Required
Sanitation District ❑ Received ❑ Not Required
DATE: ) 2- /'f"
OCCUPANCY CLASSIFICATION:
Building Division Valuation: $
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:��=--�Sr� c
Job Address:?_ ?
Permit Number: C) 4
r20vf.0
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Yes No
When corrections have been made, call 'tor re -inspection at 303 -234 -
Date: `' Inspector:
3
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
_��9�Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office a (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address: D U k 0
Permit Number: P t 0f
9
rd
❑ No one available for inspection: Time 0106 AM/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
City of Wheat Ridge
Residential Detached Garage PERMIT - 201803081
PERMIT NO: 201803081 ISSUED: 12/07/2018
JOB ADDRESS: 3226 Pierson St EXPIRES: 12/07/2019
JOB DESCRIPTION: Residential detached garage in backyard with monolithic foundation, 2X4
wall. 8X10 steel garage, 437.5 square feet; no electrical
*** CONTACTS ***
OWNER (303)868-3097 MELODY/MIKE RIVERA
SUB (303)489-3376 Rich Cordova 180360 Rich Cordova
SUB (720)298-5113 Anthony H. Chavez 021086 Edison Electical Contractors
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 16,387.00
FEES
Total Valuation 0.00
Plan Review Fee 204.91
Use Tax 344.13
Permit Fee 315.25
** TOTAL ** 864.29
*** COMMENTS ***
*** CONDITIONS ***
**No additional buildings may be constructed on this property due to the 250 lot coverage
maximum allowance**
Landscaping removed or damaged during construction must be replaced prior to final
inspection.
Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all
applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections.
City of Wheat Ridge
Residential Detached Garage PERMIT - 201803081
PERMIT NO: 201803081 ISSUED: 12/07/2018
JOB ADDRESS: 3226 Pierson St EXPIRES: 12/07/2019
JOB DESCRIPTION: Residential detached garage in backyard with monolithic foundation, 2X4
wall. 8X10 steel garage, 437.5 square feet; no electrical
1, by m signature, do hereby attest that t e work to b erforined shall comply with all accompanying approved plans and specifications,
applicable building codes, and all applic le music' al code , policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the pr erty and m authori to obt in this permit and perform the work described and approved in conjunction with
this ennit. I further at t t I am Bgally a ish i ized to i chide all entities named within this document as parties to the work to be
performed and tha wor to be rtormed is isclosed ' this document and/or its' accompanying approvedns and specifications.
[-2—/2—/7
Signature of OW R or CONTRACTORS (Circle one) Date
I. This permit was issued based on the information provided in the permit application and accompanying pplans 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 penmrt 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 rocedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Oficial 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
apple code or an f iirdinance 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.
is
_`- City of
��Wheat j ge
COMMUNITY DEVEI.OPMI:NT
Building & Inspection Services Division
7500 W. 2911 Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits( )-ci.wheatridge.co.us
I FOR OFFICE USE ONLY I
Date:
Add to Permit #
(T� 6!
Building Permit Revision/Amendment Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. I
Property Address:
2e
Property Owner (please print): `TCI V i`C &Ct YGt Phone:
Property Owner Email:��iC^ 1 ke�l � �YZC`1 ��1UYY12�141 �&r- s- ccCry'1
Mailing Address: (if different than property address)
LCI
��.
Address: V�1�� , �iw YQ_ C'1('Q_')
City, State, Zip: 60A%k Cl
Submitting Company; ` Y C,�_aC p CALCCLn 11 c
Contact Person: - el' i Phone: le __W- l�
Contractor: �Cz V ()yco-�.�
Contractors City License #: � O T�� Phone: 363 ,
Contractor E-mail Address: �on �_[C4 `� ��r � 0I ` y� bdl1Cb `J . wm
Please Note: Additional valuation must include all general and subcontracted work to be performed
related to the revisions and/or amendments declared in the description of work and which were not
included in the original permit valuation.
If revisions or amendments increase the original valuation, additional fees will be due at the time of
approval. Depending on the scope of work, additional plan review fees may be due upon approval
($60.00 an hour — 2 hour minimum).
Description of revised/amended work:�r?.,�Q��
a QI� C�I �rnp. C�r�►'tQ.,r Cs��
Md- —rem p Otc �ti c, SRrv� c2�
Sq. Ft./LF
Amps
Btu's
Squares
Gallons
Other
Additional Project Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above)
$ 1500 .
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 applic-4tior►----___
CIRCLE ONE: (OWNER) (CONTRACTOR) or HORIZED REPRESENTATI \
( ER) CONTRACTOR)
PRINT NAME: Q 1 %t YC1'�� SIGNAi�kg-
TURE: \V� DATE: d I
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
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
Building Division Valuation: $
Q City of
Wh6,atP,,,j,1..C19e
COMMUNITY DEVELOPMT
SUB -CONTRACTOR AUTHORIZATION FORM
This form must be signed by each sub -contractor.
This form will not be accepted with missing information.
Subcontractor's City of Wheat Ridge License number must be provided in the applicable space.
Subcontractor's insurance and license must be up to date prior to permit issuance.
Project Address: 3'Z -7 -f- "PNPr.s-..j ':;A-- Permit #Z_ -:;_A101 go 30k/
General Contractor:
Electrical Sub -Contractor I
Company Name:,��,�:c�„%>/f Phone #:
State License #: .S"��� Master #:
Wheat Ridge License #:-0-2109* (required field)
Signature of Authorized Agent Date
Company Name: Phone #:
State License #: Master #:
Wheat Ridge License #: (required field)
Signature of Authorized Agent Date
Company Name: Phone:
Wheat Ridge License #: (required Geld)
Signature of Authorized Agent Date
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:
Job Address:
Permit Number: D U k 7 U U�
C.% Cri`
❑ 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: ? ' Inspector:
r
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Detached Garage PERMIT - 201803081
PERMIT NO: 201803081 ISSUED: 12/07/2018
JOB ADDRESS: 3226 Pierson St EXPIRES: 12/07/2019
JOB DESCRIPTION: Residential detached garage in backyard with monolithic foundation, 2X4
wall. 8X10 steel garage, 437.5 square feet; no electrical
*** CONTACTS ***
OWNER (303)868-3097 MELODY/MIKE RIVERA
SUB (303)489-3376 Rich Cordova 180360 Rich Cordova
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY ***
Total Valuation
Plan Review Fee
Use Tax
Permit Fee
** TOTAL **
*** COMMENTS ***
ESTIMATED PROJECT VALUATION
FEES
0.00
204.91
344.13
315.25
864.29
16,387.00
*** CONDITIONS ***
**No additional buildings may be constructed on this property due to the 25% lot coverage
maximum allowance**
Landscaping removed or damaged during construction must be replaced prior to final
inspection.
Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all
applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections.
City of Wheat Ridge
Residential Detached Garage PERMIT - 201803081
PERMIT NO: 201803081 ISSUED: 12/07/2018
JOB ADDRESS: 3226 Pierson St EXPIRES: 12/07/2019
JOB DESCRIPTION: Residential detached garage in backyard with monolithic foundation, 2X4
wall. 8X10 steel garage, 437.5 square feet; no electrical
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 municippal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the property and a thorized to obtain this permit and perform the work described and approved in conjunction with
this�permit. I furth ttest that I am le ally authorized to include all entities named within this document as parties to the work to be
performed a at I work o be pe ormed 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 originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of anew
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, an violation of any provision of any
applicable code or rany ordinan+pr regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Buildirr� Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
Wheat_idge
COMMUNITY DEVELOPMENT ,, _ I ` E D
Building & Inspection Services NOV
7500 W. 291h Ave., Wheat Ridge, CO 80033 l
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933 Pe
Email: permits Oki.wheatridge.co.us
I FOR OFFICE USE ONLY
Date:
Plan/Permit #
/g6� r
Plan Reviewe: �'
1r�
Building Permit Application
Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address: 32-7--(z, - y , e >>-\—
Property Owner (please print): I Yy\\)-c6Q_ 01\ 0- � Phone:
Property Owner Email: \ v-* -C---v , C -L;' -,
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address: R Lr_ s, ,J 54
City, State, Zip: l� �2-� D 6 ,
Architect/Engineer:
Architect/Engineer E-mail: Phone:
Contractor Name: 7 Lc\ -k c \j t -C" 6 4 ia, C'o'4
City of Wheat Ridge License #: G G Phone: j'- 2 5f 9 13 -7 oo
Contractor E-mail Address:�2-t 3 Y,i�izc� . G v•v�
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): Phone: 3;=-:3
CONTACT EMAIL(please print): f - ( C.QC_0<.)`2'k--
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Complete all highlighted fields, if applicable.
❑COMMERCIAL
[RESIDENTIAL
Provide description of work: For ALL projects, 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.
y('.v t-► c0 k • � kr,- t,ti f.! .A h T enc -mss L rte' v .1—L S7 C Ste- �v v� LT
Sq. FULF
"f3.7 , �;-
BTUs
i&i4* 49 %-J CA
Gallons
Amps Squares For Solar: KW # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$ -7VQ-0 ,
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 on the application.
CIRCLE ONE: (OWNER)ONTRACTOR (AUTH ZED SENTATIVE) of (OWNER) ••i�(CONTRACTOR)
Signature (first and last name): DATE:
Printed Name: 0,---r— /V%-
DEPARTMENT USE ONLY
ZONING COMMMENTS: 424� V A'?9f&-Qa IsklkbA Vst W ti -A- eK . OCCUPANCY CLASSIFICATION:
?1-0" Com- wu �) d'
V6
CONSTRUCTION TYPE:
Reviewer:
BUILDING DEP ENT COMME S: U l
Reviewer: I I �• (�� ���
lIJZg fit$
PUBLIC WORKS COMMENTS:
Reviewer:
Building Division Valuation: l b 1 3 D
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: Ll l� - R,,4,,11 i'mq P.'" l
Job Address: 2216 ` e/-Sri,n L1,
Permit Number: Z01602.021
/7y [/ n ; r
❑ No one available for inspection: Time ASC ay M/PM
Re -Inspection required: Yes
When corrections have been made, call for re -inspection at 303-234-5933
Dater l / 2-611 � Inspector: 9✓e, L I ct
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Demolition PERMIT - 201802871
PERMIT NO: 201802871 ISSUED: 10/26/2018
JOB ADDRESS: 3226 Pierson St EXPIRES: 10/26/2019
JOB DESCRIPTION: Demo existing structure in order to build new structure 343 sq ft.
Demo brickwalls, no electrical, tile roof, and some wood.
State of Colorado CDPHE Permit approved 10/25/18 .
*** CONTACTS ***
OWNER (303)868-3097 MELODY/MIKE RIVERA
SUB (303)489-3376 Rich Cordova 180360 Rich Cordova
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 1,000.00
Total Valuation
Demolition Fee
** TOTAL **
*** COMMENTS ***
FEES
0.00
50.00
50.00
*** CONDITIONS ***
Work shall comply with 2012 IRC & 2017 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.
I, by my sitrnature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
applicable wilding 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 uthorized to include a]I entities named within this document as parties to the work to be
performed angjheVall work to be er o lis 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 Budding
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 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 granti g of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applicabi5 code or any dinance 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.
City of
Wheat ,ge
COMMUNITY DEVELOPMENT
Building & Inspection Services
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permitsgci.wheatridge.co.us
FOR OFFICE USE ONLY
Date:
Plan/Permit # n/50Z l
Plan Review Fee. '
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address:
0
Property Owner (please print): M ot_�-V `t' (Yl V_� Phone:
Property Owner Email: -'1h e- 1` V e"'F�' C-0
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address: IS
City, State, Zip:
Architect/Engineer E-mail:
Phone:
Contractor Name: \ 1 (021 -o' -Jr -s- N , P— kON (�'Fl ' a CIO rv' S
City of Wheat Ridge License M L' Phone: _ � ci
Contractor E-mail Address: V- f C g,;- dk�o Z-1 3 ry A �o -..--
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): LC9-Ckd a Phone: �� 4f3 c� 3T3 7/
CONTACT EMAIL(please print):
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Complete all highlighted fields, if applicable.
❑COMMERCIAL
RESIDENTIAL
Provide description of work: For ALL projects, 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 lefficiency, type and amount of materials to be used, etc.
Q
p
Sq. FULF W3 BTUs
Gallons
Amps Squares For Solar: KW # of Panels Requires structural
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$ #P1kGzk-�
OVI'NER/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 or this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) ( or THORIZ D PR ENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last name): DATE: —
Printed Name:
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Building Division Valuation:
Colorado Department
of Public Health
and Environment
DEMOLITION NOTIFICATION APPLICATION FORM
APPLICATION FEE MUST ACCOMPANY THIS FORM
INCOMPLETE APPLICATIONS WILL BE RETURNED
(Notice will be mailed to the demolition contractor unless specified otherwise)
Fee: $50 + $5 per 1000 ft2 of area to be demolished = $ .1
(See instruction #1 on reverse side)
Submit form to:
Permit Coordinator
Colorado Dept. of Public
Health and Environment
APCD4E-B1
4300 Cherry Creek Drive
South
Denver, CO 80246-1530
Phone: 303-692-3100
Fax: 303-782-0278
Asbestos@state-co.us
* Regulated asbestos -containing materials means (a) friable asbestos -containing material, (b) Category l nonfriable ACM that has become `;able, (c)
,motet 3r -v ' nonfriable ACM that will be or has been subjected to sanding, grindinguttng, or abrading or (d) Category 11 nonfriable ACM that has a high `.
probability of becoming or has become crumbled, pulverized, or reduced to powder by the forces expected to act on the material in the course of r ev) J1j
uosfti m' or rano Z U01_- operations regulated by this regulation. Note: Asbestos-cogta3ining sheetvinyt_and linoleum must be properly
abated/removed prior to demolition.00r 12 So
r APCs
Foan: DNA08 - Rm 01/30/08 Irltt T2r•?(�-
Company Name:
Building Name:
Street: _
Square footage of footprint of facility or portion of facility to be demolished
c'
+O+
City
State:
Zip Code:
Street
C
u)
Telephone #
/
Fax #
City
Gounry
Zip Code: _
P / ?
( - ) -
( )
C
Q
�,
L �.'C- j S
Project Manager
Cell Phone #
Propos Date --
Pfopdsed Completion Date
I certify that the Certified Asbestos Building Inspector has informed me
Method/M of -Demolition:
E
p
about any remaining asbestos -containing materials in the facility to be
01
,
E
d
demolist
ElBurning ElImplosion [IMoving 0 Other, specify:
Signature'Print
Name:[JWrecking
t
Burning requires additional authorization —Please call (303) 692-3100 and ask
Landfill Receiving Building Debris:
1 ` i
('t30 S
to speak to the Open Burning Permit Coordinator
General Abatement Contractor (GAC)Owner'sName:
i0
y
CDPHE Asbestos Permit#
Total Asbestos Removed
Street:
♦�,
Quantity of
Date Removal Completed
Telephone #
City
State: Zip Code:,
m
fC
C
Q C
/
V
m
Type(s) of Asbestos -Containing Material Removed:
Contact's Name: J
Telephone #
With my signature below, I certify that I possess current AHERA accreditation and state of Colorado certification as
`o
an Asbestos Building Inspector. I also certify that I have thoroughly inspected the facility to be demolished, as listed
in the Demolition Site block above, sampled all suspect materials, had all samples analyzed for the presence of
C,
asbestos by a NVLAP-accredited laboratory, and have determined that no Regulated ACM exists anywhere in the
=
facility." I also certify that 1 have informed the owner/operator of the facility or the demolition contractor that any
N o
asbestos -containing material allowed to stay in the facility must remain non -friable during demolition. Specify type(s)
Nm'
of ACM remaining, below: (check appropriate box(es)):
N C
❑ Vinyl asbestos floor the (VAT) El VAT mastic ❑Tar/asphalt impregnated roofing El Asphaltic pipe coatings
U
❑ Spray -applied tar coatings ❑ Caulking ❑ Glazing ❑ Other, specify:
4)
SignatuBlue Ink)
Printed Name:
LAS J. ?"kv 0- Yf + N C� A I_
V
Date of Final Inspection
-20113
CO Cert #
Expiration Date
Zi 2otcl
Telephone # Cell Phone #
(?2o )aQL-`)2-16 '
I verify that all refrigerants from air conditioning/refrigeration appliances have been properly recovered in accordance with AQCC Regulation No.
15 (for information on CFC requirements call 692-3100). 1 further verify that all luminous exit signs (containing radioactive material) have been
0
disposed of in accordance with 6 CCR 1007-1 subpart 3.6.4.3 (for information on luminous exit sign requirements call 303-692-3320).
CHECK THE APPROPRIATE BOX:
m O V
E]Building Owner
Contractor
❑ Other
Date:
Signature: 1 ) Print Name:,
THIS Box Is FOR CDPHE USF -ONLY:
Postmark or Hand Delivery Date: t !
Approved By:
Code: [].-initial-310 ❑ transfer -380
Form of Payment & #: . �, `Uv `
Permit #:
Record #
Date Issued:
* Regulated asbestos -containing materials means (a) friable asbestos -containing material, (b) Category l nonfriable ACM that has become `;able, (c)
,motet 3r -v ' nonfriable ACM that will be or has been subjected to sanding, grindinguttng, or abrading or (d) Category 11 nonfriable ACM that has a high `.
probability of becoming or has become crumbled, pulverized, or reduced to powder by the forces expected to act on the material in the course of r ev) J1j
uosfti m' or rano Z U01_- operations regulated by this regulation. Note: Asbestos-cogta3ining sheetvinyt_and linoleum must be properly
abated/removed prior to demolition.00r 12 So
r APCs
Foan: DNA08 - Rm 01/30/08 Irltt T2r•?(�-
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i CITY OF WHEAT RIDGE
��P�Building Inspection Division
(303) 234-5933 Inspection line
'(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: 1-j o 3 - F -('nn ( ,pec e5
Job Address: P r e f -Go,, s' -r
Permit Number: 'a o) f3 D a 3/ fi
❑ No one available for inspection: Time M/PM
Re -Inspection required: Ye
When corrections have been made, ('al 'fob re -inspection at 303-234-5933
®� City of Wheat Ridge
Residential Electric PERMIT - 201802315
PERMIT NO: 201802315 ISSUED: 08/21/2018
JOB ADDRESS: 3226 Pierson St EXPIRES: 08/21/2019
JOB DESCRIPTION: Change out the old 200 AMP and replacing with a new 200 AMP Eaton Panel.
*** CONTACTS ***
OWNER (3 03) 903 -5653 GENDERS LINDA M
SUB (303)204-4117 Ryan Recktenwald 150214 First Light Electric LLC
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 2,250.00
FEES
Total Valuation 0.00
Use Tax 47.25
Permit Fee 93.35
** TOTAL ** 140.60
*** COMMENTS ***
*** CONDITIONS ***
Must comply w/ 2012 IRC & 2017 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 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 nd 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
I. This permit was issued based on the information provided in the permit application and accompanying Flans 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 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 i nce or granti of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any
app a co a or an dinance 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.
City of
W heat
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(a)-ci.wheatridge.co.us
I FOR OFFICE USE ONLY
Date:
Plan/Permit # V
�
` / W (),-93
P
Ian Rev►ew Fee:
Building Permit Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications
may not be processed. ***
Property Address: j ,( % S
Property Owner (please print): / ;,� ��` (7 c') A- Phone: -36 3 - %0 '3 - 5 >US 5
Property Owner Email: LL
Tenant (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address: ,� ,A (G, P , L i 5 un
Zip: til/ ke,,f K. d c�_G co
Arch itect/Eng 1 neer E-mail:
Contractor Name. F1'/ 5 i F (e J( L
Phone:
City of Wheat Ridge License M I L ( Phone: 3 0.3 � U Y - y -7
Contractor E-mail Address: r d 5 >! L,` �, .� C 1 P d A C v 1C> ,� o� r, cc �, L o;�►
For Plan Review Questions & Comments (please print): Q
CONTACT NAME (please print): i2 `, �,� 1� e G ' i vi w !d' Phone: 3D ` ay 11-y / O
CONTACT EMAIL(p/ease print):
Sub Contractors (Must provide Wheat Ridge License No.):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
❑ COMMERCIAL
RESIDENTIAL
Description of work: For ALL projects, 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.
A ✓t !1 I ✓'l G� G V � I � 1 CCJ � � � V V t,.� �„� � �i' G� t? �Cti � � � C � � ' C
y e I d (z I e -i// O(U CA r.---1 �a,tel
Sq. FULF
BTUs
Amps -� U 0 Squares
Gallons
Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load:
Project Value:
_(Contract value or the cost of all materials and labor included in the entire project)
O"ER/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)
Signature (first and last name):
Printed Name:
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
ra
or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
--- - DATE:
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
CONSIRUGtION TYPE:
Building Division Valuation: