HomeMy WebLinkAbout202201372 - 3351 Kipling St - Application_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION General
Date: Tuesday, June 21, 2022 12:39:26 PM
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PERMIT APPLICATION General
This application is exclusively for Scopes of Work that do not already have a
specific form.
YOU MUST ATTACH AN ELECTRONIC PAYMENT FORM IN ORDER FOR THE
PERMIT TO BE PROCESSED.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
PROPERTY INFORMATION
Is the property Residential
Residential or
Commercial?
Property Address 3351 Kipling St
Property Owner Name Daniel Frayre
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"
CONTACT INFORMATION
Submitting General
Contractor or Architect
Contractor's License
303-434-4818
drfcc4@comcast.net
Champion Window Co of Denver
020146
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contract Phone
720-974-1403
Number (enter WITH
dashes, eg 303-123-
4567)
Contact Email Address
shemans@getchampion.com
Retype Contact Email
shemans@getchampion.com
Address
Check the appropriate
Field not completed.
boxes if the following
work is involved in the
project.
Are there any
No
ADDITIONAL Sub
Contractors associated
with this project?
DESCRIPTION OF WORK
Detailed Scope of
Enlarge window opening to install a 72x80 sliding glass patio
Work - Provide a
door. Homeowner to provide deck landing and move RF cable.
detailed description of
work including
mechanical, electrical,
plumbing work
occurring,
adding/removing walls,
etc.
Square footage of
40
scope of work
Location of work
Back yard
(backyard, on roof, etc)
Project Value (contract
6500.00
value or cost of ALL
materials and labor)
Upload Engineer letter
Fravre ndf
Upload Asbestos
Field not completed.
Report if triggler level is
met per CDPHE
regulation.
Upload Drawings Fravre 1.odf
Upload Additional Field not completed.
Drawings
Upload Additional Field not completed.
Drawings
Upload Additional Field not completed.
Drawings
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 Steve Hemans
Pe rm it
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