HomeMy WebLinkAboutB13-0468 Application Department of Community Development
75 Sou#h Frontage Ra�d
T�ll��1 Of V���. �' W�;�,co a�s57
Tel:97il-47"9-2128
www.vaiigov_com
Dev�lopment Review Coordina#pr
BUILD�ING PERM�T APPL�CATION
(Separate applications are required for afarm 8�sprinkler)
Projec#Street Address: �rojec##: PRJ 13-0 617
S29 Red Sandstone Rd. 95D
€�RB#:
(Numher} (5treet} (Suite#)
Building/Comp€ex Name:
SanclStone 70 guilding Fermit#: B 13-0 4 6 8
Contraetor Infomnation Lot#: $�a�� �u��;u���p�; Unp 1 a t t e d
Business�las�e: ����i�ey Sweeps of Arnerica
Business Address: 11900 W.44t�Ave_ Woric GEass; i�Eew(Q} A�ditian(Q) Altsration('�
C� Wheat Ridge S�t�_ GO zip: 80033 Type of Build'ang:
ContacE Nareie= ��n��Yp��s Srngle-Family(� Dupfex{�} �47u1ti-FamilY{�+ )
Comrnercial(� pther(�)
Gonzact Phone: 720-94�-672't
Contaet E-Mail: �on a[,?chPrnneyswreepsofamerica.com INoric Ty�ae: interior(Q} Exterior(�] Both��
i hereby a�dtnowledge that I have fead this applir.afion,fslleci out Valuation o'f
in full the informatian required,campletect an accurate p!o#plan, Work Included Plans fnciuded Work
and state thaf al!�e informaiion as required is correcd_ 1 agree ta Electrical (�'es �No {�1'es (�io
cflmply with tf�e infarmation ancf plot plan,to coanply with all Town
ordinances and state laws, and to build this structure according to �ech�nica� �Yes �NO I�i YES (QNo 4609.04
fhe town's zoning and subdivisi4n codes, design review ap-
�roved,Inierraational Building and Residential Codes and�other Plumbing {�Yes �No �Yes �,No
o�iinances c�f the Tovvn appficabte t�tereto.
Building (�Yes �No �Yes �No
,,
� �--- - Va1€�e of afl worfc being per�ormed� $ '��0�
pwner wne�s Repr�sen ive 5ignature(Required) (vdlue based an 6gC Sec[ioa 109.3&IRC Sectiars 108.3)
Ele�trical Square�QOtage N/A
App3icant lnfomoa6on Detailed 5co�e and Locatian c�f Work:
Applicant Name: �°���yP��s Firepiace located in Sandstane 7� '15U
ApplicantPhone: 72�-�d���� Wood burning to wood burning (certified)
AppEicar�t�-fVIa�I: Jon@chimneysw��psofamenca.com
Project Infamtation
Owner i�lame: ��'���� Pave 1 i ch
Parce!�: 21030�4���52
(FOr Parcel#,corthact Eagle Cau�rty pssessors OHice at{97fl�28�640 or visit
wrww.eag 4ecourrty.uslpatie}
(use additional sheet if necessary}
For Qfficc L'+se O�t��_
Fee Paid:
Date Received:
Received Frvm:
�5�, `��k� RECEI VED
CC: Ysa 1 iNC Last 4 CC# ex�date:
�"��'# By David Rhoades at 1:09 pm, Oct 15, 2013
2013-F�eb O1