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HomeMy WebLinkAbout202201620 - 5554 W 27th Ave - Application_Page_1W City of mmumiTy DEvELopmjENT Building & inspection Services 7500 W. 291' Ave., Wheat lodge, CO 8W33 Office: 303-235-2855 * Fax 303-237-8929 Inspection Line: 303-234-5933 Email: germits&i.wheatridoe.coms R FOR OFFICE USE ONLY PAvn#%nnft# loan ©160 Plan Review Fee: �W $1 i� (� r b o Building Permit Application ' * Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address. 5SS14 e-0 �- Property Owner (please prim): C�c� f (cec�v�.lQr� Phone: 3-'5-00 - I SP (Z - Property z Property Owner Email: Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: 'SS Ll Zl �v e City, State, Zip: ,,.1k�0.� ArchitectlEngineer E-mail: Phone: Contractor:Name: I &AA, 6 C a-" ' S City of Wheat Ridge License # 1401 Phone, 363 S ! ( - 3 7$0 Contractor E-mail Address: lv'������ Z• °' w�ca - CGS For Plan Review Questions & Comments (please print) CONTACT NAME (please JL.v ut✓A CONTACT EMAI L(please print): � I V� A c wive Z- 0 ()?7 wta f f c 6 3C>3 -S)+-3 `f0 Stub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R- City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. ❑COMMERCIAL (] RESIDENTIAL 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. Jk Sq. FULF BTUs Gallons Amps squares For Solar: Kw t' at Panels Roqukas sNrruafural For Commerclai Projects Only: Occupancy Type: Construction Type: Occupancy Load: Square Footage: Project Value: (Contract value or the cost of pI materials and labor included in the entire project) 2960 OWNERICONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all its shown and allegations made arc accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner ofthe property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this budding permit application, warrant the truthfulness of the information provid on the appli ti CIRCLE ONE: (OWNER) (CO RACT ORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Sirmatnre (Nim and last same): DATE:Z- Printed Name: 'TV+'4'-k ZONING COMMENTS. Reviewer. BUILDING DEPARTMENT COMMENTS: Reviewer. PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE OVLY OCCUPANCY CLAN3SMATION: CONSTRUCTION TYPN~_,,,_ Building Division Valuation: