HomeMy WebLinkAbout202201465 - 7075 W 43rd Pl - AppFOR OFFICE USE ONLY
City of
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Building s Inspection Services Pc+h*'}
7500 W. 292 Ave., Wheat
:303Ridge, G080033 f4en Reree Fs: �l�C.�
InspeOficection
Une: 303 •Fax: 303-23T-8929 .l
Email;
line: 303-234dg33
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Email: oennitsfdci wheaMtlae co us
Building Permit Application
Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed.
Property Address: W Y>d
Property Owner (please pnnif: rM a /♦ 4er c a n Phone:
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than propertyaddress)
Architect/Engineer E -mall:
Contractor Name: A(i((ed power So P v i c os
City of Wheat Ridge License M lr` D1W!�'Phone: 3 /PF
Contractor E-mailE-ail Address: a I eK Q �S 5) o oh -took r cow
For Plan Review Questions S Comments (please print):
CONTACT NAME (please print): 1�(QX J�IdPZ Pimm`-7/J2/Zy%S--o
CONTACT EMAIL(please print): 00i'l2ok,co�
Sub Contractors (Must provide Wheat Ridge License No S Signed Subcontractor Authorization form):
Elec l: Plumbing: McOanical:
W.R. City License# I p0(Ll 1 W.R. City Lwas# W. R. City License#
Other CRY Licemed Sub: Other City Licensed Sub:
City License# City License#
Complete all highlighted fields, if applicable.
[-]COMMERCIAL
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 be used, etc.
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Sq. FLILF BTUs Gellons
Amps IDD Squares For Solar. lov dr %_Mwk.asm ml
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: _ Square Footage:
Pralect Vearc (Codrant value or the coat of gtlmaterials aid Wilbur inducted in the Soft Naled)
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OW NERICON'IRACiOR SIGNATURE OF UNDP,RSTANDWG ANO AGMEo4M T
I hereby racily that the eedmck diaMoaa propmed by bit parent appliutioo ere arcatme and do not vvolele awficable admanre0. rales or
,egulm ars of the City of when Wolge or covmmnm. aumerda orreor iodone ofterord; that ell meevuremara shown and allegations made are
accmere; dut I have and aM agree to abide by all conditions printed on the Whatton and the i assume bull respolubJity for romphourre
carry included oil they applicmim to list one ounny on thio npplleatlon 1, the applicant tor tart bmWmg pMnrl ap "hails wmra,t me
a ithbulnaa of We information pmvidvd on that applicmiot,
CRCAEeNE: lefin iRI (CON)RACgeal or (AOTd0RIZSDMf"S1bM'ATT461 of (OWNER) (CONTRACTOR)
rlendoOATS: ✓< 30 2t
Prided Nana: TeX U.. IraeL
DEPARTMENT USE ONLY
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