HomeMy WebLinkAbout5500 W. 29th AvenueFrom: no-reolv(alci.wheatridae.m. us
To: CommDev Perm is
Subject: Online Form Submittal: Roofing Permit Application
Date: Monday, November 8, 20212:24:20 PM
Roofing Permit Application
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
REROOFING UNTIL PERMIT HAS BEEN ISSUED.
Is this property Commercial
Commercial or
Residential?
PROPERTY INFORMATION
Property Address 5500 W 29th Ave
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Address
Galen Jurasek
Field not completed.
Do you have a signed Yes
contract to reroof this
property?
CONTRACTOR INFORMATION
Contractor Business Lujan Investment Group
Name
Contractor's License
Number
Contractor Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
Address
210127
11#18bb611
lujaninvestmentgroup@gmail.com
Retype Contractor lujaninvestmentgroup@gmail.com
Email Address
Attach City of Wheat Wheatridae Payment Form ndf
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
DESCRIPTION OF WORK
TOTAL SQUARES of
35
the entire scope of
wo rk:
Project Value (contract
14,000
value or cost of ALL
materials and labor)
Are you re -decking the
No
roof?
Is the permit for a flat
Flat roof (less than 2:12 pitch)
roof, pitched roof, or
both? (check all that
apply)
What is the pitch of the
2:12
FLAT roof?
How many squares are
35
part of the FLAT roof?
Describe the roofing
TPO
material for the FLAT
roof:
Type of material for the
TPO/EPDM
FLAT roof:
Provide any additional
Mr. Lucky's sandwiches business will be re roofed with TPO
detail here on the
description of work. (Is
this for a house or
garage? Etc)
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 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 Alexis Lujan
Permit
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