HomeMy WebLinkAbout202201503 - 7609 W 47th Ave - Application_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Asbestos Abatement
Date: Wednesday, July 6, 2022 10:20:30 AM
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.
PERMIT APPLICATION Asbestos Abatement
This application is exclusively for ASBESTOS ABATEMENT
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 project Residential
Residential or
Commercial?
Provide copy of
CDPHE State Permit or
Stamped Approved
CDPHE State Permit
Application
7609 W 47th Ave- aOOroved Oermit.Odf
PROPERTY INFORMATION
Property Address 7609 W. 47th Ave Wheat Ridge, Co 80033
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Shea Whitham
�y�:a��rcrcl
Property Owner Email 14etymology@gmail.com
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
Wheat Ridae Payment Form.Ddf
From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Asbestos Abatement
Date: Wednesday, July 6, 2022 10:20:30 AM
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.
PERMIT APPLICATION Asbestos Abatement
This application is exclusively for ASBESTOS ABATEMENT
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 project Residential
Residential or
Commercial?
Provide copy of
CDPHE State Permit or
Stamped Approved
CDPHE State Permit
Application
7609 W 47th Ave- aOOroved Oermit.Odf
PROPERTY INFORMATION
Property Address 7609 W. 47th Ave Wheat Ridge, Co 80033
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Shea Whitham
�y�:a��rcrcl
Property Owner Email 14etymology@gmail.com
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
Wheat Ridae Payment Form.Ddf
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business
Asbestos Abatement Inc.
Name
Wheat Ridge
190058
Contractor's License
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
3037284513
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
admin@asbestosfree.com
Address
Retype Contractor
admin@asbestosfree.com
Email Address
DESCRIPTION OF WORK
State Permit No. or
SEK
Application Approval
Date with Initials of
CDPHE Employee
approving application.
Location of Abatement
7609 W 47th Ave
Square Footage Area
262SF
of Abatement
Has the abatement
No
been completed
If abatement has been
Field not completed.
completed, upload the
clearance report.
Project Value (contract
3385.90
value or cost of ALL
materials and labor)
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full Yes
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business
Asbestos Abatement Inc.
Name
Wheat Ridge
190058
Contractor's License
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
3037284513
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
admin@asbestosfree.com
Address
Retype Contractor
admin@asbestosfree.com
Email Address
DESCRIPTION OF WORK
State Permit No. or
SEK
Application Approval
Date with Initials of
CDPHE Employee
approving application.
Location of Abatement
7609 W 47th Ave
Square Footage Area
262SF
of Abatement
Has the abatement
No
been completed
If abatement has been
Field not completed.
completed, upload the
clearance report.
Project Value (contract
3385.90
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.
Person Applying for Shannon Stickley
Pe rm it
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.
Email not displaying correctly? View it in your browser.
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.
Person Applying for Shannon Stickley
Pe rm it
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.
Email not displaying correctly? View it in your browser.