HomeMy WebLinkAbout202201619 - 5536 W 27th Ave - Application_Page_1City of
Cats mux Ty DEVELOPMFNT
Building & Inspection Servian
7500 W. 29'h Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax. 303-237-8929
Inspection Line: 303-234-5933
Email: aermits0ci.wheatridge.co.us
FOR OFFICE USE ONLY
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P:t# 902'a-bl
Plan Review Fee: JND , 6D
Building Permit Application
'* Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed.
Property Address: Y S t� t 1'ejae Co.
Property owner (please print}: phone: 36 3 -5w
Property Owner Email:
Tenant Name (Commercial. Projects Only).
Property Owner Mailing Address: (f diiferrent than property address)
Address:
City, State, Zap:... T
ArchitectlEngineer E-mails I Phone.,
Contractor Name: _a - Ug -a hi' I M ;l e- a ►1•.S
City of Wheat Ridge License #. Li 0 1,2S S Phone..& g - 51q- 3 4 9D
Contractor E-mail Address: --F uc,,,� Mg) _ ot - (r.J , [ . co rvt
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): i -)nr_A.. Phone: 3- J J L4 3 :T5 d
CONTACT EMA1L(please print): �i_� ,,� alxa
r ,e . rz � ti �YtR,r�- C a,ti
L�
Sub Contractors (Mast provide Wheat Ridge License No Si Signed Subcontractor Authorization forrn):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License# W.R. City License #
Other City Licensed Sub: Other City Ucensed Sub:
City License # City License #
Complete all highlighted fields, if applicable.
❑COMMERCIAL [] RESIDENTIAL.
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, square footage, existing condition and
proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.
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, �a-
Iilc I s tS, �0"t -(�fovK IA'U%A e k0 "Ki}t( PJT
Sq. FULF
Amps Squares
BTUs
For Solar: Kw
Gallons
_s of Panels iiequkn Structural
For Commercial Projects Only; Occupancy Type: Construction Type:
Occupancy Load; Square Footage:
Project Value. (Contract value or the cost of pj materials and labor included in the entire project)
S
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
"regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that 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; that I am theiclo owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information pmvi ed on theR-(A
n.
CIRCLE ONE: (OWNER) (CO CUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Sismature (rfst tnd last aame)s DATE: j
Printed Name• Z E A .^ C' .e Q 'L. Z
ZONING COtAMMENTS:
Reviewer.
BUILDING DEPARTMENT COMMENTS:
Reviewer
PUSUC VVDRKS COMMENTS:
Reviewer.
DEPART l USE
OCCUPANCY CLASSIFICATION:
CONSTRUCTiON'TYPE.
Building Division Valuation: