HomeMy WebLinkAbout202201481 - 4629 Otis St - Application_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION General
Date: Wednesday, June 29, 2022 5:34:24 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 Commercial
Residential or
Commercial?
Property Address 4629 Otis Street, Unit 4645, Wheat Ridge, CO 80033
Property Owner Name 4629-4353 Otis St, LLC
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
303-902-3000
lombardi8l@gmail.com
Property Doctors, Inc.
190177
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contract Phone
303-456-0911
Number (enter WITH
dashes, eg 303-123-
4567)
Contact Email Address
office@propertydrs.com
Retype Contact Email
office@propertydrs.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
UNIT 4645: Asbestos abatement on ACM approved by CDPHE
Work - Provide a
on 6/23/22: Full gut due to fire. Removing all ACM drywall walls
detailed description of
and ceilings.
work including
mechanical, electrical,
plumbing work
occurring,
adding/removing walls,
etc.
Square footage of
2620
scope of work
Location of work
Interior
(backyard, on roof, etc)
Project Value (contract
22,379.00
value or cost of ALL
materials and labor)
Upload Engineer letter
4629-4653 Otis St Wheat Ridae 80033 ndf
Upload Asbestos
Asbestos Report - Otis ndf
Report if triggler level is
met per CDPHE
regulation.
Upload Drawings Asbestos Reoort - Otisl.odf
Upload Additional Unit 4645 -Sketch ndf
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 Nancy Rees
Pe rm it
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