HomeMy WebLinkAbout202201396 - 3526 Newland St - App_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Water Heater Replacement
Date: Wednesday, June 22, 2022 4:15:58 PM
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PERMIT APPLICATION Water Heater Replacement
This application is exclusively for RESIDENTIAL REPLACEMENT WATER
HEATERS - 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.
Do Not use this form if the Water Heater is changing locations or if this is a
conversion to a Tankless Water Heater. Please use the General Permit
Application for a more comprehensive review.
Is this application for a Yes
replacement water
heater like for like?
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Property Address 3526 Newland St.
Property Owner Name Mary Dominguez
Property Owner Phone 979-777-5993
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email tonya.steadfastplumbing@gmail.com
Address (Leave blank if
not known)
Attach City of Wheat vvneat triage Llectronlc payment nat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business
Steadfast Plumbing Inc
Name
Contractor's License
110104
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
3039201102
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
tonya.steadfastplumbing@gmail.com
Address
Retype Contractor
tonya.steadfastplumbing@gmail.com
Email Address
DESCRIPTION OF WORK
Number of gallons
38
Is the water heater
gas
GAS or ELECTRIC?
If GAS, enter # of
40000
BTUs. If electric, enter
n/a
Where is the water garage
heater located (for
example, basement,
crawlspace, etc)?
Project Value (contract 2164.73
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 Tonya Lasky
Pe rm it
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