HomeMy WebLinkAbout5100.5 Vivian StreetFrom: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION General
Date: Thursday, June 9, 2022 3:22:04 PM
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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 Commercial
Residential or
Commercial?
Property Address 5100.5 Vivian St.
Property Owner Name Comcast
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTACT INFORMATION
Submitting General
Contractor or Architect
Contractor's License
720-435-5091
N/A
3-tec Inc.
021309
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contract Phone 303-981-2480
Number (enter WITH
dashes, eg 303-123-
4567)
Contact Email Address caseyj@b-tec-inc.com
Retype Contact Email caseyj@b-tec-inc.com
Address
Check the appropriate Electrical
boxes if the following
work is involved in the
project.
Electrical Contractor B -Tec Inc.
Name
Electrical Contractor 021309
License Number (This
is a 5 or 6 digit number
for the City of Wheat
Ridge)
Are there any
No
ADDITIONAL Sub
Contractors associated
with this project?
DESCRIPTION OF WORK
Detailed Scope of
Installing a new 60 -amp electrical service to feed new Comcast
Work - Provide a
power supply cabinet
detailed description of
work including
mechanical, electrical,
plumbing work
occurring,
adding/removing walls,
etc.
Square footage of
5
scope of work
Location of work
ROW
(backyard, on roof, etc)
Project Value (contract
value or cost of ALL
materials and labor)
Upload Engineer letter
Upload Asbestos
Report if triggler level is
met per CDPHE
regulation.
Upload Drawings
Upload Additional
Drawings
Upload Additional
Drawings
•18
CS OneLine. odf
Field not completed.
Ridae at Ward Station PS Mark-uo JB433673 SR225222.odf
Ridae at Ward GIS. ndf
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 Casey Judish
Pe rm it
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