HomeMy WebLinkAbout202201554 - 2633 Teller St_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Water Heater Replacement
Date: Wednesday, July 13, 2022 9:56:30 AM
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PERMIT APPLICATION Water Heater Replacement
This application is exclusively for RESIDENTIAL REPLACEMENT WATER
HEATERS - 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.
Do Not use this form if the Water Heater is changing locations or if this is a
conversion to a Tankless Water Heater. Please use the General Permit
Application for a more comprehensive review.
Is this application for a Yes
replacement water
heater like for like?
PROPERTY INFORMATION
Property Address 2633 Teller St
Property Owner Name Nicholas Shaneyfelt
Property Owner Phone 303-974-0116
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email Field not completed.
Address (Leave blank if
not known)
Attach City of Wheat 2633 Teller St - Credit Card Authorization Form ndf
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business
Coffman & Company Heating and AC LLC
Name
Contractor's License
18464
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
303-366-1112
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
pschmidt@coffmanco.com
Address
Retype Contractor
pschmidt@coffmanco.com
Email Address
DESCRIPTION OF WORK
Number of gallons
40
Is the water heater
gas
GAS or ELECTRIC?
If GAS, enter # of
40,000
BTUs. If electric, enter
n/a
Where is the water basement
heater located (for
example, basement,
crawlspace, etc)?
Project Value (contract 2495
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 Patricia J Schmidt
Pe rm it
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