HomeMy WebLinkAbout202201460 - 4430 Dover St - App_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Furnace/Boiler Replacement
Date: Wednesday, June 29, 2022 3:45:13 PM
CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you
recognize the sender and know the content is safe. Report any suspicious activities to the IT Division.
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 4430 Dover St
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Dave Bomhoff
303-550-5147
Property Owner Email davebom7448@aol.com
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
Wheat Ridae Electronice Payment form.docx
CONTRACTOR INFORMATION
Contractor Business
ARS Rescue Rooter
Name
Contractor's License
018701
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
303-418-6001
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
sewing@ars.com
Address
Retype Contractor
lewing@ars.com
Email Address
DESCRIPTION OF WORK
What type of unit is
Furnace
being installed?
Number of BTUs
75
What is the efficiency
80
(%) of the unit?
Is the unit GAS or
Gas
ELECTRIC?
Where is the furnace or
basement
boiler located (for
example, basement,
crawlspace, etc)?
Project Value (contract
7800
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 Lauren Ewing
Pe rm it
Email not displaying correctly? View it in your browser.