HomeMy WebLinkAbout4340 Iris St - 202201831_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Electrical Service Change/Upgrade/Electrical Work
Date: Thursday, August 11, 2022 11:05:59 AM
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PERMIT APPLICATION Electrical Service
Change/Upgrade/Electrical Work
This application is exclusively for RESIDENTIAL ELECTRICAL SERVICE
CHANGE OR UPGRADE (200 amps or less).
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 application for
Yes
electrical service
change or upgrade -
200 amps or less?
PROPERTY INFORMATION
Is this Residential or
Residential
Commercial?
Property Address
4340 Iris st
Property Owner Name
Erin Rabe
Property Owner Phone
8562969947
Number (enter WITH
dashes, eg 303-123-
4567)
Attach City of Wheat
20220811 095103.ina
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business Erin Rabe
Name
Contractor's License 123456
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone 856-296-9947
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
erin.rabe@gmail.com
Address
Retype Contractor
erin.rabe@gmail.com
Email Address
DESCRIPTION OF WORK
Is this an electrical
Upgrade, Change
service upgrade or
change?
Number of Amps
100
Location of work
house
(garage, house, etc)
Provide additional
emergency disconnect living without power, xcel can not give a
details, if needed.
straight answer
Project Value (contract
1850
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 Erin Rabe
Pe rm it
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