HomeMy WebLinkAbout4901 Garrison Street #204CFrom: no-reolv(alci.wheatridae.m. us
To: CommDev Pets
Subject: Online Form Submittal: Furnace/Boiler Replacement Permit Application
Date: Tuesday, November 9, 2021 10:33:28 AM
Furnace/Boiler Replacement Permit Application
This application is exclusively for RESIDENTIAL REPLACEMENT FURNACE or
BOILER - LIKE FOR LIKE ONLY.
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 a Yes
replacement residential
furnace or boiler like for
like?
PROPERTY INFORMATION
Is this Residential or Residential
Commercial?
Property Address 4901 Garrison St #204
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
Associated Brokers
303-564-8121
Field not completed.
CONTRACTOR INFORMATION
Contractor Business Lakewood Plumbing & Heating LLC
Name
Contractor's License 017885
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
303-233-7007
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
office@lakewoodplumbing.com
Address
Retype Contractor
office@lakewoodplumbing.com
Email Address
DESCRIPTION OF WORK
What type of unit is
Furnace
being installed?
Number of BTUs
45000
What is the efficiency
80
(%) of the unit?
Is the unit GAS or
gas
ELECTRIC?
Where is the furnace or
mechanical
boiler located (for
example, basement,
crawlspace, etc)?
Project Value (contract
2950
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 lynnettesalter@yahoo.com
Permit
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