HomeMy WebLinkAbout202201411 - 3591 Allison St - Application_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Residential Interior Remodel
Date: Friday, June 24, 2022 10:09:18 AM
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PERMIT APPLICATION Residential Interior Remodel
This application is exclusively for Residential Interior Remodels and other scopes
of work which do not have a specific form already available.
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.
PROPERTY INFORMATION
Property Address 3591 Allison St
Property Owner Name William & Allison Jones
Property Owner Phone 9708199968
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email Allison.Finn@gmail.com
Address
Attach City of Wheat Electronic Payment Form New (2) 202202021540092706 ndf
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
APPLICANT INFORMATION
Applicant Name Allison L Jones
What is your role in the Property owner
project?
City Of
�. Wheat F�idge
COMMtJNn-y DEVELOPMENT
Building & Inspection Services
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection, Line_ 303-234-5933
E 1' it CN h t d ' 1..
FOR OFFICE USE ONLY
Date: 1;Lq /X2
Plan/Permit # r'10n; o I q
Plan Review Fee: 4 APV 5. j�1
mai . E eFm a ci.w ea ge.co.us
Building: Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed.
Property Address: .12 J. ± ..?>►� VV;1�t rfti+:
Properly Owner (please print): kkt - MNE, 0z7 tv Phone: -2--p_: 1 ` q,&r4
Property Owner Email: bp] ' a ftN• LAM -
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address: 2 23 V� vt 6k) Wtc
City, State, Zip' . A hElI tou IVA' • ' ?irt'f i . n o
Architect/Engineer E-mail:
Contractor Name:
City of Wheat Ridge License #:
Contractor E-mail Address:
Phone:
Phone:
For Plan Review Questions & Co//mppm��ents (please print): a
CONTACT NAME (please print): li�� P^ LO Phone: � C Gge
CONTACT EMAIL(please print): (yL-bDSW a N A7�
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
5V$%IAMb �12PJ22 V1b14 U.Q'AtV,
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Are you performing the Yes
work yourself, live in
the home and will be
living in the home 1
year after completion?
Attach Notarized
Homeowner
Authorization Form
Contact Phone Number
(enter WITH dashes,
eg 303-123-4567)
Contact Email Address
for Plan Review
Comments
=81-3 IF'T'10I1-1:1
alIison.finn@gmail.com
Retype Contractor alIison.finn@gmail.com
Email Address
DESCRIPTION OF WORK
Detailed Scope of
Work - In the space
below (not as an
attachment), Provide a
detailed description of
work including
mechanical, electrical,
plumbing work
occurring,
adding/removing walls,
etc
I, the applicant,
understand my
application will be
rejected if I do not
include a Detailed
Scope of Work.
New tile floor and backsplash at kitchen and two bathrooms, new
appliances in kitchen, remove decorative soffit above old kitchen
cabinets (not structural).
I have entered a detailed scope of work.
Location of Work Kitchen, Upstairs Bathroom, Downstairs Bathroom
Square Footage Area
of Work Being
Performed
360
Asbestos R_•• •- •s Inspect on R -•••3591•n St Wheat C••- CO
Complete all highlighted fields, if applicable.
❑COMMERCIALESIDENTIAL
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, square footage, existing condition and
proposed new condition, appliance size and efficiency, type and amount of materials to a used, etc.
U Pwmb fi � (i &Votf-'1 ► SE%�t`> >S i� lT l�! 11►1 '�6 (,!
6 �'LurlL�tUG. XD Wr iuu vp �VW t
WN UJ1iJAfWG1 IJ& - j)19DR— 46E-=tV0.{ 400VV`'i Mow h MeA) WkL,rz A
tnL 611l� l2.'b�S1Y1. Oa)Um-r rwVe05 Fee... 6)31lt.Wr& 4- DgtttPj, yr ttt6F,.
Sq. FULF i l ` BTUs
Gallons
Amps . Squares For Solar: KW # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: Square Footage: _
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
rr', ,VCV ----E loo, uto ttntkie
ONVNERICONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: OWNE
Signature (first an last name):.
Printed Name. I IL
(CO�O�)- Or��RIZED REPRESENTATIVE)
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer.
PUBLIC WORKS COMMENTS:
Reviewer:
DEPARTMENT USE ONLY
of (OW ) (CONTRACTOR)
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Building Division Valuation:
Upload letter size Floor Plans.odf
documents here
Construction Plans Field not completed.
scanned on 11'x17" or
larger
Project Value (contract 8000
value or cost of ALL
materials and labor)
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full
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
may not begin on this
property until a permit
has been issued and
posted on the property.
Yes
Yes
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.
Person Applying for Allison Jones
Pe rm it
I attest that everything
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.
Yes
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