HomeMy WebLinkAbout202201710 4625 Swadley_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Electrical Service Change/Upgrade/Electrical Work
Date: Thursday, July 28, 2022 12:30:17 PM
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PERMIT APPLICATION Electrical Service
Change/Upgrade/Electrical Work
This application is exclusively for RESIDENTIAL ELECTRICAL SERVICE
CHANGE OR UPGRADE (200 amps or less).
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 application for
Yes
electrical service
change or upgrade -
200 amps or less?
PROPERTY INFORMATION
Is this Residential or
Residential
Commercial?
Property Address
4625 Swadley St Wheat Ridge, CO 80033
Property Owner Name
Alan Keller
Property Owner Phone
303-882-8022
Number (enter WITH
dashes, eg 303-123-
4567)
Attach City of Wheat
Wheat Ridae Payment Form 2022.Odf
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business Blue Sky Plumbing & Heating
Name
Contractor's License 017835
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone 303-407-7967
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
randyp@blueskyplumbing.com
Address
Retype Contractor
randyp@blueskyplumbing.com
Email Address
DESCRIPTION OF WORK
Is this an electrical
Upgrade
service upgrade or
change?
Number of Amps
125 to 200
Location of work
house
(garage, house, etc)
Provide additional
n/a
details, if needed.
Project Value (contract
7647.00
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.
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 Randy Palato
Pe rm it
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