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2. This application is exclusively for ASBESTOS ABATEMENT
   
   After this application is submitted, you will be contacted to complete payment. 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.
4. Is this project Residential or Commercial?*

   1. Residential
   2. Commercial
6. Provide copy of CDPHE State Permit or Stamped Approved CDPHE State Permit Application *
   Do not attached random documents. You must attach a copy of the CDPHE State Issued Permit -or- a stamped approved permit application. State permit applications not bearing a CDPHE approved stamp will be rejected.
8. PROPERTY INFORMATION
10. Property Address*
12. Property Owner Name*
    **DO NOT ENTER PROPERTY MANAGER OR CONTRACTOR INFORMATION**
14. Property Owner Phone Number (enter WITH dashes, eg 303-123-4567)*
    **DO NOT ENTER CONTRACTOR INFORMATION**
16. Property Owner Email Address
    **DO NOT ENTER CONTRACTOR INFORMATION**
18. CONTRACTOR INFORMATION
20. Contractor Business Name*
22. Wheat Ridge Contractor's License Number (This is a 5 or 6 digit number for the City of Wheat Ridge)*
24. Contractor Phone Number (enter WITH dashes, eg 303-123-4567)*
26. Contractor Email Address*
    CHECK FOR TYPOS! Your permit will be emailed back to this address.
28. Retype Contractor Email Address*
    CHECK FOR TYPOS! Your permit will be emailed back to this address.
30. DESCRIPTION OF WORK
32. State Permit No. or Application Approval Date with Initials of CDPHE Employee approving application.*
    If the application has not been approved, the application will not be accepted.
34. Location of Abatement *
    For example: "Asbestos Abatement of wall between kitchen and living area"
36. Square Footage Area of Abatement*
38. Has the abatement been completed*

    1. Yes
    2. No
40. If abatement has been completed, upload the clearance report.
42. Project Value (contract value or cost of ALL materials and labor)*
44. PAYMENT INFORMATION
46. Payment Options*

    Payment for this permit may be submitted online, over the phone, in person, or via mail. Please indicate how you intend to submit payment:

    1. Online
    2. Over the Phone
    3. In Person
    4. Mailed Check
48. Online Payment Contact*

    Please provide the NAME and EMAIL of the person who will be paying for this permit. City staff will contact this person with payment directions when we are ready to receive payment. 

    CHECK FOR TYPOS! Errors may delay processing.

50. Phone Payment Contact*

    Please provide the NAME and PHONE NUMBER for the person who will be paying for this permit. City staff will contact this person when we are ready to receive payment. 

    CHECK FOR TYPOS! Errors may delay processing.

52. SIGNATURE OF UNDERSTANDING AND AGREEMENT
54. 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
56. I understand that work may not begin on this property until a permit has been issued and posted on the property.*

    1. Yes
58. 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
60. Person Applying for Permit *
    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.
62. 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
Leave This Blank:


66. 1. Receive an email copy of this form.
67. Email address

    This field is not part of the form submission.

68. Submit

* indicates a required field