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*SAME DAY PERMIT*
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This application is exclusively for Same Day Permits submitted on Thursdays and
Fridays(except holidays) between 9am-11am.
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.
PROPERTY INFORMATION
Is the property Residential or
Commercial?*
O Commercial
® Residential
Property Address*
3950 Dover St.
Select Language
Property Owner Name*
Cody Hart and Lauren Antonoff
Property Owner Phone Number (enter WITH dashes, eg 303-123-4567)*
303-548-0257
Property Owner Email Address
cody.l.hart@gmail.com � 1
Attach City of Wheat Ridge Electronic Payment Form - **DO NOT ATTACH A
PICTURE OF A CREDIT CARD***
Choose File ; Electronic Payment Form.jpg J-e.e a 7ya c' -le k woe" .
Your application cannot be processed if the City of Wheat Ridge electronic
payment form is not attached. There is specific information on the form that is
needed to run the payment.
The form is located here: Electronic Payment Form Be sure to save to your
computer before attaching to this application.
APPLICANT INFORMATION
Applicant Name*
Cody Hart and Lauren Antonoff I
What is your role in the project?*
0 Property Owner
❑ General Contractor
❑ Architect
❑ Other
Select Language �/�
Are you performing the work yourself, live in the home and will be living in the
home 1 year after completion?
Q Yes
Q No
Homeowners can act as General Contractor - but must provide a notarized
affidavit meeting the following requirements
1. Address on application is primary residence and not a rental property
2. Plan to live in the property one year after completion of project
3. Hired professionals will be listed on permit
4. Performing all work without the help of hired professionals, if so, must be listed
on permit.
Attach Notarized Homeowner Authorization Form*
Choose File I Official Certification of Property Owner Permit.pdf J_'0_C at/Az-.44-
7490em -
If you do not have the notarized form, stop application and apply when you have
the form ready to attach to this application. It is a required document. The form can
be located here: Homeowner Authorization Form
Contact Phone Number (enter WITH dashes, eg 303-123-4567)*
303-525-6221
Provide contact for questions or comments
Contact Email Address*
donhartl@gmail.com
CHECK FOR TYPOS! Your permit will be emailed back to this address.
Retype Contact Email Address*
donhartl@gmail.com
CHECK FOR TYPOS! Your permit will be emailed back to this address.
Check the appropriate boxes if the following work is involved in the project.
Mechanical ® Electrical rj Plumbing
Select Language \,e
Mechanical Contractor Name*
Eastside Heating and Air Conditioning
Enter "Owner" If work is being performed by the Home Owner.
Mechanical Contractor License Number (This is a 5 or 6 digit number for the City of
Wheat Ridge)
020801
Electrical Contractor Name*
Stubblefield Electric
Enter "Owner" If work is being performed by the Home Owner.
Electrical Contractor License Number (This is a 5 or 6 digit number for the City of
Wheat Ridge)
150292
Plumbing Contractor Name*
AKins's Plumbing LLC
Enter "Owner" If work is being performed by the Home Owner.
Plumbing Contractor License Number (This is a 5 or 6 digit number for the City of
Wheat Ridge)
190353
Are there any ADDITIONAL Sub Contractors associated with this project?
0 Yes #Xde.-
® No ,ry D — C C7/°op—
DESCRIPTION OF WORK
Select Language �/
Choose the type of permit you are applying for. If it is not listed then it is not
eligible for a Same Day Permit.*
O Basement Finish (non-structural)
O Window replacements like for like, meeting .30 U- factor min
O Emergency escape windows basement foundation cut only with
stamped engineered drawings
Interior remodels without structural or if structural stamped
engineered plans/ details
❑ Minor exterior modifications (Generator)
O Bathroom remodels nonstructural or if structural stamped engineered
plans/ details
O Tankless water heater with isometric gas pipe drawing / calculations
and specs for whole system
❑ Fire pit / BBQ / fireplace insert with gas pipe isometric drawings /
calculations and specs for whole system
O Simple single level decks w / complete plans, site plan, ICC handouts
or engineered drawing (if using engineered AYC girder or other
engineered products stamped engineered plans required)
O Patio covers, pergola or car ports with complete plans, ICC handouts
or stamped engineered drawings
❑ Storage Sheds include complete drawings, specs or stamped
engineered drawings
O Detached garages / accessory structure complete drawings, ICC
handouts or stamped engineered drawings
❑ Signs (wall and monument)
O Zoning Permits (painted signs, trash enclosures)
Detailed Scope of Work - Provide a detailed description of
work including mechanical, electrical, plumbing work
occurring, adding/removing walls, etc.*
Square footage of scope of work*
352 square feet
Location of work (backyard, on roof, etc)*
Kitchen and bathrooms
Detailed Scope of Work:
- Kitchen remodel: Remove existing appliances, countertops, cabinetry, soffit,
flooring, and a section of a non -load-bearing wall (structural engineer's report
attached). Home contains no asbestos (report attached). Add drywall where wall
was removed. Install new flooring, cabinets, countertops, and appliances.
Footprint is relatively similar but plumbing and some electrical will be slightly
moved. Can lights installed in ceiling. Hood vent ducting will be moved
approximately 4' from existing location.
- Remodel two side-by-side bathrooms on the main floor and turn into one full
bathroom and a half bathroom (powder room): Demo old tub, shower, sinks,
vanities, toilets, and flooring and replace with new. Remove a load-bearing wall
and install a header (see attached structural engineer's report for specs). Remove
two non -load-bearing walls. Add walls to enclose the powder room and a toilet
room within the larger bathroom. Update and re-route plumbing to accommodate
new placement of toilets, bathtub, shower, and sinks. Relocate electrical switches
and outlets. Relocate one vent fan and add two additional vent fans.
- Basement bathroom to be remodeled: Footprint will not change. Demo old
shower, sink, vanity, toilet, and flooring and replace with new.
- 1/2" plumbing supply to be upgraded to 3/4" PEX.
Project Value (contract value or cost of
ALL materials and labor)*
$29,500
Upload Engineer letter e 1/
ep-
Choose File I Structural ... eport.pdf
Upload Asbestos Report if triggler level
is met per CDPHE regulation.
Choose File Asbestos ...eport.pdf 1L
If removing more than the trigger level
(32 sq ft), attach a copy of the asbestos
report.
Upload Documents
Choose File -1 Existing K ... r Plan.pdf
Upload Additional Drawings
Choose File Proposed ... Plan.pdf
Upload Additional Drawings
Choose File J Existing B ... r Plan.pdf
Upload Additional Drawings
Choose File ] Proposed ... Plan.pdf
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full responsibility for compliance with applicable City of Wheat Ridge
codes and ordinances for work under any permit
issued based on this application.*
® Yes
I understand that work may not begin on this property until a permit has been
issued and posted on the property.*
12 Yes
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.*
' Yes
I attest that everything 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.*
Yes Select Language �/
Person Applying for Permit *
Cody Hart
Must be a person's name, not the name of the company or the
application will be rejected. Must be listed as a person able to pull
permits for the licensed contractor.
r� •air �.
Privacy Terms
Receive an email copy of this form.
Email address
160- nhartl @gmail.com
This field is not part of the form
submission.
Submit
* indicates a required field
Select Language �/