HomeMy WebLinkAbout202201425 - 3720 Holland St - Application_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Air Condiboner/Evaporative Cooler
Date: Friday, June 24, 2022 9:52:27 AM
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PERMIT APPLICATION Air Conditioner/Evaporative Cooler
This application is exclusively for AIR CONDITIONER OR EVAPORATIVE
COOLER.
YOU MUST ATTACH THE ELECTRONIC PAYMENT 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
Is this a new install or
replacement for an
existing AC unit?
Is this Residential or
Commercial?
New Unit Installation
Residential
Property Address 3720 Holland Street
Property Owner Name Anlexandrea Westlund
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
402-499-0628
Property Owner Email alexandrea.westlund@gmail.com
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business Simply Mechanical
Name
Contractor's License 210478
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone 720-231-0671
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email cassidy@simplymechanicalco.com
Address
Retype Contractor cassidy@simplymechanicalco.com
Email Address
DESCRIPTION OF WORK
What type of Air Conditioner
replacement unit are
you installing?
How many tons is the 3
unit?
For AC - what is the 16
SEER?
For Evaporative
Coolers, what is the
CFMs?
Where is the unit on the ground, SE corner
located (for example,
rooftop, backyard on
ground etc)?
Is electrical needed for No
re -hook?
Project Value (contract 8185
value or cost of ALL
materials and labor)
Yes
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 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 Stephen Martin
Pe rm it
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