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HomeMy WebLinkAbout202201503 - 7609 W 47th Ave - Application_Page_1From: no-reolvCalci.wheatridae.co.us To: CommDev Permits Subject: Online Form Submittal: PERMIT APPLICATION Asbestos Abatement Date: Wednesday, July 6, 2022 10:20:30 AM 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 Asbestos Abatement This application is exclusively for ASBESTOS ABATEMENT 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 project Residential Residential or Commercial? Provide copy of CDPHE State Permit or Stamped Approved CDPHE State Permit Application 7609 W 47th Ave- aOOroved Oermit.Odf PROPERTY INFORMATION Property Address 7609 W. 47th Ave Wheat Ridge, Co 80033 Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123- 4567) Shea Whitham �y�:a��rcrcl Property Owner Email 14etymology@gmail.com Address Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A Wheat Ridae Payment Form.Ddf From: no-reolvCalci.wheatridae.co.us To: CommDev Permits Subject: Online Form Submittal: PERMIT APPLICATION Asbestos Abatement Date: Wednesday, July 6, 2022 10:20:30 AM 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 Asbestos Abatement This application is exclusively for ASBESTOS ABATEMENT 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 project Residential Residential or Commercial? Provide copy of CDPHE State Permit or Stamped Approved CDPHE State Permit Application 7609 W 47th Ave- aOOroved Oermit.Odf PROPERTY INFORMATION Property Address 7609 W. 47th Ave Wheat Ridge, Co 80033 Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123- 4567) Shea Whitham �y�:a��rcrcl Property Owner Email 14etymology@gmail.com Address Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A Wheat Ridae Payment Form.Ddf CREDIT CARD" CONTRACTOR INFORMATION Contractor Business Asbestos Abatement Inc. Name Wheat Ridge 190058 Contractor's License Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 3037284513 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email admin@asbestosfree.com Address Retype Contractor admin@asbestosfree.com Email Address DESCRIPTION OF WORK State Permit No. or SEK Application Approval Date with Initials of CDPHE Employee approving application. Location of Abatement 7609 W 47th Ave Square Footage Area 262SF of Abatement Has the abatement No been completed If abatement has been Field not completed. completed, upload the clearance report. Project Value (contract 3385.90 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes CREDIT CARD" CONTRACTOR INFORMATION Contractor Business Asbestos Abatement Inc. Name Wheat Ridge 190058 Contractor's License Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 3037284513 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email admin@asbestosfree.com Address Retype Contractor admin@asbestosfree.com Email Address DESCRIPTION OF WORK State Permit No. or SEK Application Approval Date with Initials of CDPHE Employee approving application. Location of Abatement 7609 W 47th Ave Square Footage Area 262SF of Abatement Has the abatement No been completed If abatement has been Field not completed. completed, upload the clearance report. Project Value (contract 3385.90 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. Person Applying for Shannon Stickley Pe rm it 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. Email not displaying correctly? View it in your browser. 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. Person Applying for Shannon Stickley Pe rm it 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. Email not displaying correctly? View it in your browser.