HomeMy WebLinkAbout202201603 - 3520 Chase St - App_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Air Condiboner/Evaporative Cooler
Date: Friday, July 15, 2022 11:21:28 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 Air Conditioner/Evaporative Cooler
This application is exclusively for AIR CONDITIONER OR EVAPORATIVE
COOLER.
YOU MUST ATTACH THE ELECTRONIC PAYMENT 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 this a new install or
replacement for an
existing AC unit?
Is this Residential or
Commercial?
New Unit Installation
Residential
Property Address 3520 Chase St
Property Owner Name Kevin Gomez
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
7206935596
Property Owner Email kagomez21@yahoo.com
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business
Name
Contractor's License
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
Address
The Cooler Company
[0li[cI:Y:
3034225308
morgan@thecoolercompany.com
Retype Contractor morgan@thecoolercompany.com
Email Address
DESCRIPTION OF WORK
What type of Evaporative Cooler
replacement unit are
you installing?
How many tons is the
unit?
For AC - what is the
SEER?
For Evaporative
Coolers, what is the
CFMs?
Where is the unit
located (for example,
rooftop, backyard on
ground etc)?
0
fil+'17
BACKSIDE OF ROOFTOP
Is electrical needed for Yes
re -hook?
Provide Electrical 021365
Contractor's Wheat
Ridge License No.
Project Value (contract 6000
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.
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 Brandt
Pe rm it
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From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION General
Date: Tuesday, July 12, 2022 11:17:06 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 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 4340 Teller Street
Property Owner Name Neil Behnke
Property Owner Phone 3039035266
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email Field not completed
Address
Attach City of Wheat CCF 000120 Ddf
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTACT INFORMATION
Submitting General Jim Needham Plumbing
Contractor or Architect
Contractor's License 190362
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contract Phone 3036744411
Number (enter WITH
dashes, eg 303-123-
4567)
Contact Email Address tori@calljimnow.com
Retype Contact Email tori@calljimnow.com
Address
Check the appropriate Plumbing
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)
Jim Needham Plumbing
190362
Are there any Field not completed.
ADDITIONAL Sub
Contractors associated
with this project?
DESCRIPTION OF WORK
Detailed Scope of
Work - Provide a
detailed description of
work including
mechanical, electrical,
plumbing work
occurring,
adding/removing walls,
etc.
swaping like for like unit, gas line untouched
Square footage of 0
scope of work
Location of work Crawlspace
(backyard, on roof, etc)
Project Value (contract
6016
value or cost of ALL
materials and labor)
Upload Engineer letter
Field not completed.
Upload Asbestos
Field not completed.
Report if triggler level is
met per CDPHE
regulation.
Upload Drawings
specs 1. Do
Upload Additional
specs iDo
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 Tori Crawford
Pe rm it
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