HomeMy WebLinkAbout202201754 - 2801 Gray St_Page_1From: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Electrical Service Change/Upgrade/Electrical Work
Date: Monday, August 8, 2022 3:28:17 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 No
electrical service
change or upgrade -
200 amps or less?
PROPERTY INFORMATION
Is this Residential or Residential
Commercial?
Property Address 2801 gray st
Property Owner Name Can keiser
Property Owner Phone 303-949-6529
Number (enter WITH
dashes, eg 303-123-
4567)
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
wheat ridae Davment.Ddf
CONTRACTOR INFORMATION
Contractor Business Thor Electric Llc
Name
Contractor's License 190212
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone 720-257-9090
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
thor.electric.colorado@gmail.com
Address
Retype Contractor
thor.electric.colorado@gmail.com
Email Address
DESCRIPTION OF WORK
Scope of Work
125 amp sub panel in garage, underground feed to garage, 60
amp electric vehicle charger in garage, 50 amp range circuit in
kitchen
Location of work
garage, house
(garage, house, etc)
Provide additional
2x gnd rod garage
details, if needed.
Project Value (contract
5215
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 Ryszard Szymanski
Pe rm it
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