HomeMy WebLinkAbout202201464 - 3201 Vance St - Application_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Furnace/Boiler Replacement
Date: Wednesday, June 29, 2022 2:53:35 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 3201 Vance Street, Wheat Ridge, CO 80033
Property Owner Name Felipe Quiroz
Property Owner Phone 303-909-1307
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email fquiroz@casacolorado.com
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
Payment Form 6-24-22.Odf
CONTRACTOR INFORMATION
Contractor Business
K&L Mechanical
Name
Contractor's License
100278
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
720-281-5428
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
Imconstructionllc@outlook.com
Address
Retype Contractor
Imconstructionllc@outlook.com
Email Address
DESCRIPTION OF WORK
What type of unit is
Furnace
being installed?
Number of BTUs
65000
What is the efficiency
96%
(%) of the unit?
Is the unit GAS or
Gas
ELECTRIC?
Where is the furnace or
crawl space
boiler located (for
example, basement,
crawlspace, etc)?
Project Value (contract
80000
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 Felipe Quiroz
Pe rm it
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