Form Center

2. This application is exclusively for REPLACEMENT WATER HEATERS - LIKE FOR LIKE ONLY.
   
   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.

   Do Not use this form if the Water Heater is changing locations or if this is a conversion to a Tankless Water Heater.  Please use the General Permit Application for a more comprehensive review.

4. Is this application for a replacement water heater like for like?*

   1. Yes
6. PROPERTY INFORMATION
8. Property Address*
10. Property Owner Name*
12. Property Owner Phone Number (enter WITH dashes, eg 303-123-4567)*
14. Property Owner Email Address (Leave blank if not known)
    If homeowner email is not known, leave this field blank
16. CONTRACTOR INFORMATION
18. Contractor Business Name*
20. Contractor's License Number (This is a 5 or 6 digit number for the City of Wheat Ridge)*
22. Contractor Phone Number (enter WITH dashes, eg 303-123-4567)*
24. Contractor Email Address*
    CHECK FOR TYPOS! You will be notified via this email address when your permit is ready for pick-up.
26. Retype Contractor Email Address*
    CHECK FOR TYPOS! You will be notified via this email address when your permit is ready for pick-up.
28. DESCRIPTION OF WORK
30. Number of gallons*
32. Is the water heater GAS or ELECTRIC?*
34. If GAS, enter # of BTUs. If electric, enter n/a*
36. Where is the water heater located (for example, basement, crawlspace, etc)?*
38. Project Value (contract value or cost of ALL materials and labor)*
40. PAYMENT INFORMATION
42. 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
44. 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.

46. Phone Payment Contact*

    Please provide the NAME and PHONE NUMBER 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.

48. SIGNATURE OF UNDERSTANDING AND AGREEMENT
50. 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
52. I understand that work may not begin on this property until a permit has been issued and posted on the property.*

    1. Yes
54. 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
56. 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
58. 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.
Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit

* indicates a required field