2. Permit Number assigned to project*
4. PROPERTY INFORMATION
6. Permit Number*
8. Property Address*
10. Property Owner Name*
    **DO NOT ENTER PROPERTY MANAGER OR CONTRACTOR INFORMATION**
12. Property Owner Phone Number (enter WITH dashes, eg 303-123-4567)*
    **DO NOT ENTER CONTRACTOR INFORMATION**
14. Property Owner Email Address
    **DO NOT ENTER CONTRACTOR INFORMATION**
16. CONTRACTOR INFORMATION
18. Contact Name*
20. Contact Phone Number (enter WITH dashes, eg 303-123-4567)*
22. Contact Email Address*
    CHECK FOR TYPOS! Your permit will be emailed back to this address.
24. Retype Contact Email Address*
    CHECK FOR TYPOS! Your permit will be emailed back to this address.
26. DESCRIPTION OF WORK
28. Detailed Revised Scope of Work - Provide a detailed description of the change in scope of work including mechanical, electrical, plumbing work occurring, adding/removing walls, etc*
    Indicate what is changing from the original permit with a detailed description
30. Engineer Letter (if applicable)
32. Additional Documents on Letter Size
34. Are plans or documents locked for editing?*

    1. Yes
    2. No
    3. No plans needed
36. If any documents are locked, provide passcode
38. Construction Plans scanned on 11"x17" or larger
    Plans must be scanned in on at least 11" x 17" paper. The application will be rejected with drawings scanned in on 8 1/2" x 11" paper. No exceptions.
40. Additional Project Value Only add what the revised scope of work is valued at. *
42. Attach City of Wheat Ridge Electronic Payment Form - **DO NOT ATTACH A PICTURE OF A CREDIT CARD***
    https://www.ci.wheatridge.co.us/DocumentCenter/View/1305/Electronic-Payment-Form
44. SIGNATURE OF UNDERSTANDING AND AGREEMENT
46. 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.*

    1. Yes
48. I understand that work may not begin on this property until a permit has been issued and posted on the property.*

    1. Yes
50. I certify that I have been authorized by the legal owner of the property to submit this application and to perform the work described above.*

    1. Yes
52. I attest that everything 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.*

    1. Yes
54. Person Submitting Revision*
    Must be a person's name, not the name of the company or the application will be rejected. Must be listed as a person able to pull permits for the licensed contractor.
Leave This Blank:


58. 1. Receive an email copy of this form.
59. Email address

    This field is not part of the form submission.

60. Submit

* indicates a required field