HomeMy WebLinkAbout202201746 - 4490 Upham St - Application_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Roofing
Date: Tuesday, August 2, 2022 1:22:09 PM
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PERMIT APPLICATION Roofing
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
REROOFING UNTIL PERMIT HAS BEEN ISSUED.
Is this property Residential
Commercial or
Residential?
How many dwelling
units are on the
property?
Single Family Home
PROPERTY INFORMATION
Property Address 4490 Upham St
Property Owner Name Adelio Lombadri
Property Owner Phone 303-513-1400
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Address
Do you have a signed
contract to reroof this
property?
Field not completed.
Yes
CONTRACTOR INFORMATION
Contractor Business Gold Star Premium Roofing
Name
Contractor's License 170225
Number
Contractor Phone 303-593-2761
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email jspearsgspr@gmail.com
Address
Retype Contractor jspearsgspr@gmail.com
Email Address
Attach City of Wheat doc02130020220802133509 ndf
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
DESCRIPTION OF WORK
TOTAL SQUARES of 28.66
the entire scope of
work:
Project Value (contract 12,000.00
value or cost of ALL
materials and labor)
Are you re -decking the No
roof?
Is the permit for a flat
roof, pitched roof, or
both? (check all that
apply)
What is the specific
pitch of the PITCHED
roof?
How many squares are
part of the PITCHED
roof?
Describe the roofing
materials for the
PITCHED roof:
Pitched roof (2:12 pitch or greater)
4/12
:..
IKO Cambridge
Type of material for the Asphalt
PITCHED roof:
Provide any additional Roofing main house and garage
detail here on the
description of work. (Is
this for a house or
garage? Etc)
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 this Yes
application is NOT a
permit. I understand I
will be contacted by the
City to pay for and pick
up the permit for this
property.
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.
Caine Knapp
Person Applying for
Pe rm it
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