HomeMy WebLinkAbout202201348 - 12081 W 32nd Dr_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Furnace/Boiler Replacement
Date: Thursday, June 16, 2022 3:14:08 PM
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PERMIT APPLICATION Furnace/Boiler Replacement
This application is exclusively for RESIDENTIAL REPLACEMENT FURNACE or
BOILER - LIKE FOR LIKE ONLY.
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 a
Yes
replacement residential
furnace or boiler like for
like?
PROPERTY INFORMATION
Is this Residential or
Residential
Commercial?
Property Address
12081 W 32nd Dr
Property Owner Name
Andy Geurts
Property Owner Phone
608-284-0405
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Field not completed.
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
wheat ridae aoolication.odf
CONTRACTOR INFORMATION
Contractor Business
AppleAire
Name
Contractor's License
022239
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
3037332813
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
info@appleaireinc.com
Address
Retype Contractor
info@appleaireinc.com
Email Address
DESCRIPTION OF WORK
What type of unit is
Furnace
being installed?
Number of BTUs
60000
What is the efficiency
80
(%) of the unit?
Is the unit GAS or
Gas
ELECTRIC?
Where is the furnace or
closet
boiler located (for
example, basement,
crawlspace, etc)?
Project Value (contract
15000
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 Noelle Hardin
Pe rm it
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