HomeMy WebLinkAbout13051 W 40th AvenueFrom: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Electrical Service Change/Upgrade/Electrical Work
Date: Tuesday, May 10, 2022 10:26:16 AM
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PERMIT APPLICATION Electrical Service
Change/Upgrade/Electrical Work
This application is exclusively for RESIDENTIAL ELECTRICAL SERVICE
CHANGE OR UPGRADE (200 amps or less).
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN
ORDER FOR THE PERMIT TO BE PROCESSED.
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.
Is this application for
No
electrical service
change or upgrade -
200 amps or less?
PROPERTY INFORMATION
Is this Residential or
Commercial
Commercial?
Property Address
13051 W. 40th Ave. Wheat Ridge CO, 80033
Property Owner Name
Sisters of Charity of Levenworth
Property Owner Phone
303-813-5130
Number (enter WITH
dashes, eg 303-123-
4567)
Attach City of Wheat
Electronic Payment Form.Ddf
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business Encore Electric
Name
Contractor's License 070211
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone 7203333285
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
mike.tyson@encoreelectric.com
Address
Retype Contractor
mike.tyson@encoreelectric.com
Email Address
DESCRIPTION OF WORK
Scope of Work
Parking Garage Temporary Power
Location of work
Garage
(garage, house, etc)
Provide additional
N/A
details, if needed.
Project Value (contract
$5000
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 Michael Tyson
Pe rm it
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City of
Wheat idge
COMMUN ITY DEVELOPMENT
City of Wheat Ridge Municipal Building 7500 W. 29th Ave. Wheat Ridge, CO 80033-8001 P: 303.235.2846 F: 303.235.2857
March 3, 2022
OFFICIAL ADDRESS NOTIFICATION
NOTIFICATION is hereby given that the following address has been assigned to the property/properties as
indicated below:
NEW ADDRESS: 13051 West 40' Avenue
NOTES: This is a courtesy notification. Addressing only for the parking garage for SCL Hospital at Clear
Creek Crossing.
AUTHORIZED BY:DATE:_2 2
DISTRIBUTION:
1. Property Owner
2. Applicant
3. Xcel Energy, gM.d.motsingeraa,xcelenergy com
4. Jeffcom: cadupdatesCajeffcom9l Lor
5. Fire Dept: planreview(a),westmetrofire.org
6. Wheat Ridge Building Division
7. Log File
NOTE: Please notify all other parties concerned.
ADDRESS MAP UPDATED BY:
www.ci.wheatridge.co.us
DATE:
Vicinity Map
SCL HEALTH LUTHERAN MEDICAL CENTER AT CLEAR CREEK CROSSING
A SPECIFIC DEVELOPMENT PLAN IN THE CITY OF WHEAT RIDGE, CID ►—
BLOCK 1, LOT!, SCL HEALTH LUTHERAN MEDICAL CENTER AT CLEAR CREEK CROSSING
SITUATED IN SECTICt,IS 19.20,29,& 30, TOWNSHIP 3 SOUTH, RANGE % WEST OF THE &XTH PRINCIPAL MERIDIAN
CITY OF WHEAT R DGE, COUNTY OF EFFERSON- STATE OF COLORAD•C ,
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Existing Address (to remain):
W. 40th Ave.
13155
(main hospital building)
- New address:
13051 W. 40th
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garage)
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