HomeMy WebLinkAbout202201785 - 4580 Saulsbury_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 10:41:30 AM
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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
4580 Saulsbury st wheat ridge co, 80033
Property Owner Name
Michael Gates
Property Owner Phone
303-550-8685
Number (enter WITH
dashes, eg 303-123-
4567)
Attach City of Wheat
Electronic Payment Form New (2) 202202021540092706 (1).Odf
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business Absolute Electrical Heating and Air
Name
Contractor's License 140291
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone 720-381-1767
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
yazmin@absolutefix.com
Address
Retype Contractor
yazmin@absolutefix.com
Email Address
DESCRIPTION OF WORK
Is this an electrical
Upgrade
service upgrade or
change?
Number of Amps
200
Location of work
house exterior
(garage, house, etc)
Provide additional
200 amp panel upgrade
details, if needed.
Project Value (contract
6500.00
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 Yazmin Galvan
Pe rm it
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