HomeMy WebLinkAbout11630 W 32nd AvenueFrom: no-reolv(alci.wheatridae.m. us
To: CommDev Pets
Subject: Online Form Submittal: Sewer or Water Line Repair Permit Application
Date: Thursday, November 11, 202112:24:26 PM
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 11630 West 32nd Avenue, Wheat Ridge, C080033
Property Owner Name Bill Petropulos
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email Wmgpetro@comcast.net
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
AAA SERVICE PLUMBING LLC
6 digit number for the
City of Wheat Ridge)
Contractor Phone
303-313-3333
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
EMMA@AAATODAY.COM
Address
Retype Contractor
EMMA@AAATODAY.COM
Email Address
DESCRIPTION OF WORK
Is this a sewer line or
sewer Line
water line repair?
Length of repair
10,
Location of repair
Front Yard
(backyard, frontyard,
etc)
Provide additional
1Oft spot repair in cement driveway & cement patch. Traffic rated
details Including
cleanout caps will be needed.
installation of clean-
o uts.
Project Value (contract
7000
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 Emma Duggan
Permit
Email not displaying correctly? View it in your browser.
4'
-Ai
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTI
Inspection Type: '
Job Address:
Permit Number:
CE
❑ No one available for inspection: TimeOA.IVJI M
Re -Inspection requireds, No
When corrections have been made, �chedule for re -inspection online at:
http✓/www.ci.wheatridge.co.us inspeWtion
r -t
D r' Ins ctor: a
DO NOT REI 6m THIS NOTICE
City of Wheat Ridge
Residential Electric PERMIT - 202001783
PERMIT NO: 202001783 ISSUED: 09/04/2020
JOB ADDRESS: 11630 W 32nd Ave EXPIRES: 09/04/2021
JOB DESCRIPTION: Service upgrade - 200 amps
*** CONTACTS ***
OWNER (720)300-6484 STANLEY WILLIAM A / STANLEY CO
SUB (719)520-9999 RICK GASKINS 180076 TELLER PARK ELECTRIC
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2404 / APPLEWOOD KNOLLS, PARAMOUNT HE 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/ 2018 IRC & 2020 NEC. Subject to field inspection.
I, by n 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 1 am legally authorized to include alI entities named within this document as parties to the work to be
performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
1. This permit was issued based on the information provided in the permit application and accompanying )Tans 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.
If this pennit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any
applicable codS.Kany ordinancf 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.