HomeMy WebLinkAbout4315 Balsam St - Gas Pipe Revision Application_Page_1From: no -reply@ ci.wheatridge.co.us < no- reply@ ci.wheatridge.co.us>
Sent: Tuesday, April 26, 2022 12:22 PM
To: CommDev Permits <Permits@ci.wheatridge.co.us>
Subject: Online Form Submittal: REVISION APPLICATION Revisions to Permit
CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you
recognize the sender and know the content is safe. Report any suspicious activities to the IT Division.
REVISION APPLICATION Revisions to Permit
Permit Number assigned to 202200408
project
PROPERTY INFORMATION
Permit Number
Property Address
202200408
C[Cib7:�a1CF7ii1E.9iiS7i
Property Owner Name Andrew Benavides
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-4567)
Property Owner Email
Address
720-894-5016
and rewbenavidesOl ive. com
CONTRACTOR INFORMATION
CONTACT INFORMATION
Submitting General
Contractor or Architect Triple JP LLC
Contractor's License 210336
Contract Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Contact Email Address
720-530-7701
john@jplegacycompanies.com
Retype Contact Email john@jplegacycompanies.com
Address
Check the appropriate
boxes if the following
work is involved in the
project.
Plumbing Contractor
Name
Plumbing Contractor
License Number (This
is a 5 or 6 digit number
for the City of Wheat
Ridge)
Are there any
ADDITIONAL Sub
Contractors associated
with this project?
DESCRIPTION OF WORK
Detailed Revised Scope of
Work- Provide a detailed
description of the change
in scope of work including
mechanical, electrical,
plumbing work occurring,
adding/removing walls, etc
Plumbing
JDM Plumbing LLC
210411
QG7
Add : put existing gas pipe on air test for a meter release order
Engineer Letter (if Field not completed.
applicable)
Additional Documents on
Letter Size
Are plans or documents
locked for editing?
Field not completed.
0q re,
Construction Plans scanned Field not completed.
on 11"x17" or larger
Additional Project Value
Only add what the revised
scope of work is valued at.
Attach City of Wheat Ridge
Electronic Payment Form -
I understand that work may
not begin on this property
until a permit has been
issued and posted on the
property.
I certify that I have been
authorized by the legal
owner of the property to
submit this application and
to perform the work
described above.
500.00
Wheat Ridge electronic payment form. pd
Yes
Yes
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 byfine,
imprisonment, or both.
Person Submitting Revision Lore Genender
Email not displaying correctly? View it in your browser.