HomeMy WebLinkAbout202201561 - 3565 Kline St - Application_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Asbestos Abatement
Date: Monday, July 11, 2022 2:11:03 PM
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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
3565 Kline St Wheat Ridae 80033 app (1).Ddf
CDPHE State Permit or
Stamped Approved
CDPHE State Permit
Application
PROPERTY INFORMATION
Property Address
3565 Kline St, Wheat Ridge, CO. 80033
Property Owner Name
Patricia Neville
Property Owner Phone
720-323-6689
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
carolynmarie1019@gmail.com
Address
Attach City of Wheat
Electronic -Payment -Permit Eco-Friendly-Biz.Ddf
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
%R40111 AT30ork
Contractor Business
Eco -Friendly -Biz
Name
457
Wheat Ridge
210486
Contractor's License
Yes
Number (This is a 5 or
6 digit number for the
Final Air Clearance Report 3565 Kline St Wheat ridge CO 80033
City of Wheat Ridge)
(1) Ddf
Contractor Phone
7205190951
Number (enter WITH
11,100.00
dashes, eg 303-123-
4567)
Contractor Email
martin@eco-friendly-biz.com
Address
Retype Contractor
martin@eco-friendly-biz.com
Email Address
91:K163ziIi11010N]avOLel S:1
State Permit No. or 22JE1514N
Application Approval
Date with Initials of
CDPHE Employee
approving application.
Location of Abatement
kitchen, laundry, bathroom, and bedroom
Square Footage Area
457
of Abatement
Has the abatement
Yes
been completed
If abatement has been
Final Air Clearance Report 3565 Kline St Wheat ridge CO 80033
completed, upload the
(1) Ddf
clearance report.
Project Value (contract
11,100.00
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 Martin Ramirez
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.
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