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HomeMy WebLinkAbout4425 Allison StreetCERTIFICATE OF OCCUPANCY Permit #: 202001982 � �� Wh6atpsig COMMUNITY DEVELOPMENT Stipulations: A.T. Smith & Co. 7500 W 29TH AVE WHEAT RIDGE CO 80033-8001 Date: 10/30/2020 This certificate verifies that the building constructed and/or the use proposed of the building and/or premises, under the above permit number and on property described below, does comply with the Wheat Ridge Building Code, Zoning and other related land use and development laws of the City of Wheat Ridge, and may be occupied for the use specified. OWNER: DAWN PROPERTIES, LLC ADDRESS: 8790 W Colfax Ave 103, Lakewood, CO 80215 CONTRACTOR/ADDRESS: Rockbridge Construction 3121 Rockbridge Dr, Highlands Ranch, CO 80129 PROPERTY ADDRESS: 4425 Allison St, Wheat Ridge, CO 80033 PARCEL #: 39-232-05-054 ZONING: UA OCCUPANCY: B TYPE OF CONST: V -B OCC LOAD:21 FOR THE FOLLOWING PURPOSE: Bus. License Report Code Editions: 2012 ICC / 2017 NEC No change shall be made in the Use of this building without prior notice and a new CERTIFICATE OF OCCUPANCY from the City of Wheat Ridge Certificate MUST be posted by front door of commercial occupancies Chief Building Official Zoning Administrator Sprinklered: No City of Wh6at idge BUSINESS LICENSE INSPECTION PERMIT NO. 202001982 BUSINESS NAME: A.T. • Smith & CO ADDRESS: 4425 Allison Street CONTACT NAME: Zach 31137 SQ FT _OCCUPANCY TYPE ! OCCUPANCYLOAD CONSTRUCTION TYPE ❑ SPRINKLERED ❑ NOWSPRINKLERED InspeWr iy/z Date INSPECTION DAYTIME at B F I INSPECTION DAY/TIME INSPECTION DAY/TIM � ► 44" City of Wheat Ridge '/� Commercial Sign PERMIT - 202002070 PERMIT NO: 202002070 ISSUED: 10/21/2020 JOB ADDRESS: 4425 Allison St EXPIRES: 10/21/2021 JOB DESCRIPTION: Install non -illuminated sign on east elevation - 32.92 sq ft total Tenant: A.T. Smith & CO *** CONTACTS *** OWNER (303)313-3547 DAWN PROPERTIES, LLC SUB (303)596-6415 TOM NGUYEN 060026 TOM SIGNS *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 330 / General Retail BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 11584.00 FEES Total Valuation 0.00 Plan Review Fee 41.54 Use Tax 33.26 Permit Fee 63.90 ** TOTAL ** 138.70 *** COMMENTS *** *** CONDITIONS *** A printed copy of the permit and city stamped on-site plans must be available on-site for the first inspection. Approved per plans and red -line notes on plans. Must comply with 2018 IBC, 2020 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections. **Prior to final inspection approval - As-builts are required before approval of the Building Final Inspection and Certificate of Occupancy can be issued. 44" City of Wheat Ridge _A� Commercial Sign PERMIT - 202002070 PERMIT NO: 202002070 ISSUED: 10/21/2020 JOB ADDRESS: 4425 Allison St EXPIRES: 10/21/2021 JOB DESCRIPTION: Install non -illuminated sign on east elevation - 32.92 sq ft total Tenant: A.T. Smith & CO I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this�permrt. I further attest that I am leg ally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180, days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and��procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all requ�ired inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. From: no-reolv(alci.wheatridae.m. us To: CommDev Perm is Subject: Online Frohn Submittal: Commercial Sign Date: Tuesday, October 13, 2020 1:19:11 PM Commercial Sign This application is exclusively for Commercial Signs YOU MUST ATTACH A VALID ELECTRONIC PAYMENT 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 Commercial Signs? PROPERTY INFORMATION Property Address 4425 allison st Property Owner Name steave smith Property Owner Phone 720-313-3547 Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email ssmith@atsmithco.com Address Attach City of Wheat Electronic Payment Form - Revised 5-1-20 Ridge Electronic Fillable 202005011620013849 202006081141368198.Ddf Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" APPLICANT INFORMATION Applicant Name tom signs, LLC What is your role in the General contractor project? Wheat Ridge 060026 Contractor's License Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contact Phone Number 303-596-6415 (enter WITH dashes, eg 303-123-4567) Contact Email Address for Plan Review Comments Retype Contact Email Address DESCRIPTION OF WORK Scope of Work tomsigns8@yahoo.com tomsigns8@yahoo.com install a non lit sign Square Footage 32.92 Name of Business Tom Signs, LLC Location of Sign East Elevation Is structural required? No Upload any 8 1/2" x 11 ,, AT Smith detail 1 ndf pages Sign Installation Plan AT Smith sitelan n ndf Set on 11'x17" only. Project Value (contract 1584 $1,584 Valuation is value or cost of ALL OK 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. Person Applying for tom nguyen Permit 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. Email not displaying correctly? View it in your browser. T0: FI': Tom Nguyen viv JI I c rLr�IvJ Ph: 303.596.641 UST BE ON SITE FOR INSPECTI att: ALL Projects are S'e t to i I ns ections Email: tomsigns8@ SIGN SPECIFICATIONS MATERIALS [ELECTRICAL SPECIFICATIONS Landlord appml : N Y Reviewed for Zoning Compliance by the City of Wheat Ridge Planning Division APPROVED BY: DATE: 10/14/2020 COMMENTS: complies With Sign code ''Dimensional letters mounted on an aluminum I. 158 on V A J %r 'J�� 1_-# sign total square feet: 32.92 City of ]�cormMUNI"1Y UEVELUI'MENT APPROVED Reviewed for Code Compliance Randy Slusser 10/20/2020 Plans Examiner vate Validity of oermll: The issuance of a permit or gpprow0 of pbns spedficomm andoornpurahons shah not be o permit for, or an approval of, any violation Eo any of the provisbm of the burifty code or of o{W Cnl' ordinances. Aermlts presunvng to give authority to vioiollt or cancel the prowdons of the OUM&q coda ar other ordinonces of the Gty shah not be vo?A o Toin Signs To Approve This, Please Sign Below and fax it back to us, thanks Copyright Notice This drawing and all quality signs at affordable prices. Customer Signature reproductions thereof are the property of TomSigns,com and may not be 5 519 W. Mississippi Ave . Lakewood, CO 80226 Print Name Date:ory reproduced, published, changed y used in an wa without written consent. 303-596.6415 Fax:303-474-4978 Reviewed for Zoning Compliance by the .► 1, City of Wheat Ridge Planning Division V YY APPROVED BY: DATE: 10/14/2020 COMMENTS: complies with sign code WEST 44 Tm AVENUE CONCRETE CURB CUT CONCRETE �a 80.02 CONCRETE SIDEWALK N89°41 '45 "E CONCRETE WALL I I I I I— 4 II II II N 00 D CONCRETE BLOCK/WOOID SIGN I C/) I I O _ D N o I ZD m Qp m = I I 0 D _T1 v m D I I D r I I = F_ CONCRETE CURB CONCRETE CURB I D co COVERED CONCRETE PORCHI I I I I I 1 Ly 25.5 I 48.0' i ,6'9 I Do (nrm0M no I I O I 0m �\ I N I I �u COVERED ENTRY I 5.0' C mr � 00 I N I z N I I F_ W�=o I O r\ (� I 0 r- m D oo 00 =9M = " nN r-. 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Z m� City I( uzA O�Xm (n��m Z m D Wheat F z m D C r Q o0� M Building z g ii R U _ Olde Tyme Architecture LLC A.T. SI�fITH ' m ���m y-���� superior architecture + design rn .. .. .. 3 < N rn WP�a `�i��4,5��5�i,o �u' o M yII\\Y 15 Z N- L L U f-6 N OmArR � ���Tzpy� 'n „��im GO I IFAI �. s -d m o A o An W i N H MN I�� 9 g. 7-- 4 LAMES ERASER, AIA r- M 0 z G A a D_ 6400 W_ DAVID DRIVE, LITTLETON, COLORADO 80128 .a -i s 6+ - Dr�u� 12M8 M o� � �� "<� A � 4425 ALLISON STREET 303.881.8983 z a D jFRASER@OTARCH.COM Z ��� __ WHEAT RIDOE COLORADO 80033 z�o~ fa^ AMEMBER OF THE AMERICAN INSTITDTE OF ARCHITECTS )f tidge ivision )f tidge ivision Report By: Double T Balancing Company 609 W. Littleton Blvd. Suite 212 Littleton, CO 80120 CERTIFIED TEST, ADJUST, AND BALANCE REPORT q2,5 4/1,sO--1 5 -**'- Z69 f q 0 1 2 if Report: Test and Balance Date: 9/17/2020 r1hont Pacific Air, Inc Engineer Michael E. Harvey P.E., LLC Powered by 49 FACILIDIJILD www.facilibuild.com r -A �n Double T Balancing Company 114114 CERTIFICATION PROJECT: 570 — A.T. Smith & Company DATE: 9/18/2020 SUBMITTED & CERTIFIED BY: DOUBLE T BALANCING COMPANY REGISTERATION NUMBER: 2631 CERTIFIED BY: Daniel Pegues CERTIFICATION EXPIRATION DATE: 03/31/2021 THE DATA PRESENTED IN THIS REPORT IS A RECORD OF SYSTEM MEASURMENTS AND FINAL ADJUSTMENTS THAT HAVE BEEN OBTAINED IN ACCORDANCE WITH THE CURRENT EDITION OF THE NEBB PROCEDURAL STANDARDS FOR TESTING, ADJUSTING, AND BALANCING OF ENVIRONMENTAL SYSTEMS. ANY VARAINCES FROM DESIGN QUANTITIES, WHICH EXCEED NEBB TOLERANCES, ARE NOTED IN THE TEST -ADJUST - BALANCE REPORT PROJECT SUMMARY. Double T Balancing Company Project: 570 - A.T. SMITH & COMPANY Table Of Contents Section Page # Summary Data 3 Split Sys Furnace 4 FAN - Exhaust 10 Powered by FociliBuild! Date: 9/17/2020 Page 2 of 12 www.facilibuild.com = _ Double T Balancing Company Project: 570 - A.T. SMITH & COMPANY 'Et 611 o Project Summary Outside air CFM on all Furnace's is the difference between the actual measured supply air CFM less the actual measured return air CFM. Initially (E)FURN-1, was measured at 102% of design. Fan motor is in high speed, and manual dampers were adjusted to reach design airflow. Initially FURN-2, was measured at 104% of design. Fan motor is in high speed, and manual dampers were adjusted to reach design airflow. Initially FURN-3, was measured at 116% of design. Fan motor is in high speed, and manual dampers were adjusted to reach design airflow. No access to manual volume dampers for return registers #1 thru 4, above hard ceiling. EF -1, EF -3 & EF -4 Single speed direct drive motor. Double T Balancing Company Project: 570 - A.T. SMITH & COMPANY System/Unit: Split Sys Furnace Asset: (E)FURN1 AREA: Unit Data Motor Data Design Actual MFG N/G RUUD Model Num N/G UGPJ-12EARJR Serial Num - E25D307F39001 23267 Num Filters Size 1 - 1 Filter Size Size 1 - 20X25X1 Completed By: Anthony Short on 09/17/2020 Notes: Static Pressure Profile: -0.18/-0.36/0.25/ 0.22 Fiberglass Filters Diffuser Supply (GRD) (E)FURN1 Motor Data Design Actual Design Actual Motor MFG N/G EMERSON Frame - 48Y Horsepower N/G 0.75 Motor Rpm 1075 1075 Phase 1 1 Voltage 120 115 Amperage - 9.50 Service Factor - N/G Completed By: Anthony Short on 09/17/2020 Notes: Static Pressure Profile: -0.18/-0.36/0.25/ 0.22 Fiberglass Filters Diffuser Supply (GRD) (E)FURN1 Performance Data Test Data Design Actual Design Actual SF CFM 1475 1422 SF RPM - D.D. Motor Speed SetPt - HIGH SPEED RL Voltage - 122 RL Amperage - 7.22 RA CFM 1260 1190 OA CFM 215 232 Brake Horse Power - 0.85 Performance Data MFG Design Actual Suction ESP - -0.18 Discharge ESP - 0.22 Total ESP - 0.40 Fan Inlet SP - -0.36 Fan Discharge SP - 0.25 Total Fan SP - 0.61 DX Coil Delta SP - 0.03 Final Filters Delta SP - 0.18 Asset Area Served MFG Type Size DESIGN CFM CFM(1) CFM(2) FINAL CFM %to design (E)FURN1-SGRD1 TITUS CD 6" 100 100 98 98.0 (E)FURN1-SGRD2 TITUS CD 6" 100 60 95 95.0 (E)FURN1-SGRD3 TITUS CD 6" 135 136 124 91.9 (E)FURN1-SGRD4 TITUS CD 6" 125 158 120 96.0 (E)FURN1-SGRD5 TITUS DELETED 8" (E)FURN1-SGRD6 TITUS CD 8" 225 156 210 93.3 (E)FURN1-SGRD7 TITUS CD 8" 150 123 147 98.0 (E)FURN1-SGRD8 TITUS SW 12X6 1 320 1 554 1 333 1 104.1 (E)FURN1-SGRD9 TITUS I SW I 12X6 1 320 1 214 1 295 1 92.2 Completed By: Anthony Short on 09/17/2020 Asset Area Served Notes Double T Balancing Company Project: 570 - A.T. SMITH & COMPANY System/Unit: Split Sys Furnace Diffuser Ret/Exh (GRD) (E)FURN1 Asset Area Served MFG Type Size DESIGN CFM CFM(1) CFM(2) FINAL CFM %to design (E)FURN1-EGRD1 TITUS RG 6" 125 120 118 94.4 (E)FURN1-EGRD2 TITUS RG 8" 140 130 133 95.0 (E)FURN1-EGRD3 TITUS RG 8" 205 210 192 93.7 (E)FURN1-EGRD4 TITUS RG 8" 205 213 188 91.7 (E)FURN1-EGRD5 TITUS RG 10" 585 541 559 1 95.6 Completed By: Anthony Short on 09/17/2020 Asset Area Served Notes Double T Balancing Company Project: 570 - A.T. SMITH & COMPANY System/Unit: Split Sys Furnace Asset: FURN2 AREA: Unit Data Motor Data Design Actual MFG CARRIER CARRIER Model Num 59SC5B060S17- 14 59SC5B060S17 Serial Num - 3119A46924 Num Filters Size 1 - 1 Filter Size Size 1 - 16X25X1 Completed By: Anthony Short on 09/17/2020 Notes: Static Pressure Profile: -0.31 / -0.48 / 0.42 / 0.36 MERV-8 Filters Diffuser Supply (GRD) FURN2 Motor Data Type Size Design Actual Motor MFG - BROAD OCEAN Frame - N/G Horsepower 0.50 0.75 Motor Rpm - 1050 Phase 1 1 Voltage 120 120 Amperage - 8.80 Service Factor - N/G Completed By: Anthony Short on 09/17/2020 Notes: Static Pressure Profile: -0.31 / -0.48 / 0.42 / 0.36 MERV-8 Filters Diffuser Supply (GRD) FURN2 Asset Test Data Type Size Design Actual SF CFM 1385 1368 SF RPM - D.D. Motor Speed SetPt - HIGH SPEED RL Voltage - 122 RL Amperage - 4.42 RA CFM 1185 1165 OA CFM 200 203 Brake Horse Power - 0.52 Asset Performance Data Type Size Design Actual Suction ESP - -0.31 Discharge ESP - 0.36 Total ESP 0.50 0.67 Fan Inlet SP - -0.48 Fan Discharge SP - 0.42 Total Fan SP N/G 0.90 DX Coil Delta SP - 0.06 Final Filters Delta SP - 0.17 Asset Area Served MFG Type Size DESIGN CFM CFM(1) CFM(2) FINAL CFM %to design FURN2-SGRD1 TITUS CD 6" 125 140 120 96.0 FURN2-SGRD2 TITUS CD 6" 100 146 106 106.0 FURN2-SGRD3 TITUS CD 8" 265 298 262 98.9 FURN2-SGRD4 TITUS CD 8" 200 215 215 107.5 FURN2-SGRD5 TITUS CD 6" 75 128 71 94.7 FURN2-SGRD6 TITUS CD 8" 220 257 224 101.8 FURN2-SGRD7 TITUS CD 10" 400 263 370 92.5 Completed By: Anthony Short on 09/17/2020 Asset Area Served Notes Double T Balancing Company Project: 570 - A.T. SMITH & COMPANY System/Unit: Split Sys Furnace Diffuser Ret/Exh (GRD) FURN2 Asset Area Served MFG Type Size DESIGN CFM CFM(1) CFM(2) FINAL CFM %to design FURN2-EGRD1 TITUS RG 10" 240 211 247 102.9 FURN2-EGRD2 TITUS RG 10" 360 270 348 96.7 FURN2-EGRD3 TITUS RG 10" 200 233 199 99.5 FURN2-EGRD4 TITUS RG 10" 295 240 276 +210!5 FURN2-EGRDS TITUS RG 6" 90 64 95 .6 Completed By: Anthony Short on 09/17/2020 Asset Area Served Notes Double T Balancing Company Project: 570 - A.T. SMITH & COMPANY System/Unit: Split Sys Furnace Asset: FURN3 AREA: Unit Data Motor Data Design Actual MFG CARRIER CARRIER Model Num 59SC5B060S17- 14 59SC5B060E17 Serial Num - 3019A51906 Num Filters Size 1 - 1 Filter Size Size 1 - 16X25X1 Completed By: Anthony Short on 09/17/2020 Notes: Static Pressure Profile: -0.25 / -0.43 / 0.40 / 0.36 MERV-8 Filters Diffuser Supply (GRD) FURN3 Motor Data Type Size Design Actual Motor MFG - BROAD OCEAN Frame - N/G Horsepower 0.50 0.75 Motor Rpm - 1050 Phase 1 1 Voltage 120 120 Amperage - 8.80 Service Factor - N/G Completed By: Anthony Short on 09/17/2020 Notes: Static Pressure Profile: -0.25 / -0.43 / 0.40 / 0.36 MERV-8 Filters Diffuser Supply (GRD) FURN3 Asset Test Data Type Size Design Actual SF CFM 1225 1253 SF RPM - D.D. Motor Speed SetPt - HIGH SPEED RL Voltage - 122 RL Amperage - 4.31 RA CFM 1025 1043 OA CFM 200 210 Brake Horse Power - 0.51 Asset Performance Data Type Size Design Actual Suction ESP - -0.25 Discharge ESP - 0.36 Total ESP 0.50 0.61 Fan Inlet SP - -0.43 Fan Discharge SP - 0.40 Total Fan SP N/G 0.83 DX Coil Delta SP - 0.04 Final Filters Delta SP - 0.18 Asset Area Served MFG Type Size DESIGN CFM CFM(1) CFM(2) FINAL CFM % to design FURN3-SGRD1 TITUS CD 10" 320 371 324 101.3 FURN3-SGRD2 TITUS CD 10" 300 248 303 101.0 FURN3-SGRD3 TITUS CD 10" 250 265 256 102.4 FURN3-SGRD4 TITUS CD 6" 75 1584 77 102.7 FURN3-SGRD5 TITUS CD 10" 280 373 293 104.6 Completed By: Anthony Short on 09/17/2020 Asset Area Served Notes Double T Balancing Company Project: 570 - A.T. SMITH & COMPANY System/Unit: Split Sys Furnace Diffuser Ret/Exh (GRD) FURN3 Asset Area Served MFG Type Size DESIGN CFM CFM(1) CFM(2) FINAL CFM %to design FURN3-EGRD1 TITUS RG 10" 285 257 257 90.2 FURN3-EGRD2 TITUS RG 10" 267 248 248 92.9 FURN3-EGRD3 TITUS RG 10" 250 220 220 88.0 FURN3-EGRD4 TITUS I RG j 10" j 223 1 318 318142.6 Completed By: Anthony Short on 09/17/2020 Asset Area Served Notes FURN3-EGRD1 No access to manual volume dampers for return registers #1 thru 4, above hard ceiling. Double T Balancing Company Project: 570 - A.T. SMITH & COMPANY System/Unit: FAN - Exhaust Asset: EF1 AREA: Unit Data Motor Data Design Actual MFG S&P GREENHECK Model Num FF100 SP-8110-QD Serial Num - 92861549-0018 Completed By: Anthony Short on 09/17/2020 Notes: Single speed direct drive motor. Motor Data Design Actual Motor MFG - GREENHECK Frame - N/G Horsepower 0.117 N/G Motor Rpm 623 950 Phase 1 1 Voltage (rated) 120 115 Amperage (rated) - 1.15 Service Factor - N/G Completed By: Anthony Short on 09/17/2020 Notes: Single speed direct drive motor. Test Data Design Actual CFM 75 138 Fan RPM D.D. D.D. System SetPt - SINGLE SPEED RL Voltage - 122 RL Amperage - 0.88 Fan Inlet SP - ATM Fan Discharge SP - NAC Total Fan SP 0.375 NAC Brake Horse Power - 0.10 Double T Balancing Company Project: 570 - A.T. SMITH & COMPANY System/Unit: FAN - Exhaust Asset: EF3 AREA: Unit Data Motor Data Design Actual MFG S&P GREENHECK Model Num FF100 SP-B110-QD Serial Num - 92861549-0005 Completed By: Anthony Short on 09/17/2020 Notes: Single speed direct drive motor. Motor Data Design Actual Motor MFG - GREENHECK Frame - N/G Horsepower 0.117 N/G Motor Rpm 623 950 Phase 1 1 Voltage (rated) 120 115 Amperage (rated) - 1.15 Service Factor - N/G Completed By: Anthony Short on 09/17/2020 Notes: Single speed direct drive motor. Test Data Design Actual CFM 75 127 Fan RPM D.D. D.D. System SetPt - SINGLE SPEED RL Voltage - 122 RL Amperage - 0.90 Fan Inlet SP - ATM Fan Discharge SP - 0.08 Total Fan SP 0.375 0.08 Brake Horse Power - 0.11 Double T Balancing Company Project: 570 - A.T. SMITH & COMPANY System/Unit: FAN - Exhaust Asset: EF4 AREA: Unit Data Motor Data Design Actual MFG S&P GREENHECK Model Num FF100 SP-B110-QD Serial Num - 92861549-0001 Completed By: Anthony Short on 09/17/2020 Notes: Single speed direct drive motor. Motor Data Design Actual Motor MFG - GREENHECK Frame - N/G Horsepower 0.117 N/G Motor Rpm 623 950 Phase 1 1 Voltage (rated) 120 115 Amperage (rated) - 1.15 Service Factor - N/G Completed By: Anthony Short on 09/17/2020 Notes: Single speed direct drive motor. Test Data Design Actual CFM 75 136 Fan RPM D.D. D.D. System SetPt - SINGLE SPEED RL Voltage - 122 RL Amperage - 0.88 Fan Inlet SP - ATM Fan Discharge SP - NAC Total Fan SP 0.375 NAC Brake Horse Power - 0.10 Em Double T Balancing Company INSTRUMENT CALIBRATION REPORT MANUFACTURER MODEL SERIAL APPLICATION CALIBRATION DATE Extech 380935 971107686 VOA -700A A/C 8/12/2019 Extech 461825 Q669462 RPM 8/12/2019 Extech 850187 H196324-187 Temp/Humidity 8/12/2019 Extech 407907 H.196324 Temp Meter 8/12/2019 Extech 850186 H.196324-186 Temp Probe 8/12/2019 Shortridge ADT442 Tem Probe N/A Temp Probe 8/12/2019 Shortridge HDM-300 W98026 Hydronic - Pressure Diff. 8/12/2019 Shortridge ADM -860C M05784 CFM -Velocity -Pressure -Temp 8/12/2019 Shortridge ADT446 N/A Temp Probe 8/12/2019 Alnor RVA+ 70630361 Air Velocity 8/12/2019 Fluke 1325 144160325WS True-rms Clamp Meter 8/21/2019 Fluke 1971 12418208 ITemperature Humidity Meter 8/22/2019 ,�'�- Double T Balancing Company N Abbreviations Symbol Description Symbol Description A/C Air Cond. - Split System KH Kitchen Hood AHU Air Handling Unit LD Linear Diffuser Atm Atmosphere Mfg Manufacturer BCU Blower Coil Unit MUA Make Up Air Unit BHP Brake Horse Power MZ Multizone Unit CD Ceiling Diffuser Mm Moduline - Master CFM Cubic Feet per Minute Ms Moduline - Slave CL Center Line NA Not Applicable CRAC Computer Room Air Conditioner NAC Not Accessible CUH Cabinet Unit Heater NG Not Given DD Direct Drive NIC Not in Contract DP Differential Pressure OA Outside Air EC Evaporative Cooler P Pump EF Exhaust Fan PSI Pounds per Square Inch EG Exhaust Grille RA Return Air EGRD Exhaust Grille/Register/Diffuser RD Round Diffuser EH Electric Heat RF Return Fan / Relief Fan EHE Electric Heating Element RG Return Grille ERV / ERU Energy Recovery Unit RGRD Return Grille/Register/Diffuser ESP External Static Pressure RH Relief Hood FCU Fan Coil Unit RL Running Load FH Fume Hood RPM Revolutions per Minute FPB Fan Powered Box RTU Roof Top Unit FPM Feet per Minute SF Supply Fan FP VAV Fan Powered Variable Air Volume SGRD Supply Grille/Register/Diffuser Ft Feet SP Static Pressure Ft Hd Feet of Head SR Supply Register FUR Furnace SW Sidewall Grille GH Gas Heat TF Transfer Fan GPM Gallons per Minute TR Troffer HP Heat Pump Trav Traverse HX Heat Exchanger UH I Unit Heater HP I Horse Power UTO I Unable to Obtain Hz I Hertz VAV IVariable Air Volume Michael E. Harvey, P.E., LLC Mechanical Consulting Engineer _1041 Saddleback Circle. Parker CO 80138 Phone: (720) 218-1154 / Fax: (720) 851-6633 September 22, 2020 Mr. Jim Fraser, AIA Olde Tyme Architecture, LLC 6400 West David Drive Littleton, CO 80128 2-0/`1 © / ",/ / RE: A.T. SMITH & COMPANY — 4425 Allison Street, Wheat Ridge, CO 80433 Dear Mr. Fraser, I have reviewed the Test and Balance Report Dated 9/17/20 and visited the site today to review the installation of the HVAC system based on the Contract Documents dated 05/24/19. There were modifications to the building as requested by the owner and subsequent revisions to the HVAC system to meet these modifications. Based on what I have found, both the installation and Test & Balance meets the intent of the Contract Documents with the owner modifications. Therefore, the HVAC system as installed and balanced is acceptable, provided it is acceptable to the owner with the modifications. If you have any questions or concerns, please do not hesitate to contact me. Respectfully, Pn� REG �a�••�L E. tiq ' F9� cZ MICHAEL E. HARVEY, P.E., LLC Michael E. Harvey, P.E........... President `� OM � /- 0 Page 1 of 1 i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: `..FO 3pr—1 XZ Job Address: .4/l Ste?" Permit Number: `j (fl' / 7 ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes � 1` 6 When corrections have been made, schedule for re -inspection online at: http✓/www.ci. wheatridge. co. ushnspection Date: /Z 2 Inspector: i DO NOT REMOVE THIS NOTICE 44, CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: '`1500 Permit Number: ❑ No one available for inspection: Time AM/PM Re -Inspection required: Ye=NW When corrections have been made, s 'hedul f r re-insMe ion online at: http✓/www.ci.wheatridge.co.us,rinspecon `> . Date , � sp tor: MISTER MECHANICAL INC HEATING AIR CONDITIONING FAN COILS BOILERS PO BOX 622030 LITTLETON, CO 80127 303.946.3028 ;:,K,,.'--.- �-:Z �,1.::,Z::.--3:.: 9-11-2020 Inspection of combustion air 4425 Allison Mr Smith, Upon our inspection of the heating equipment located on the ground level in the closet At the north most end of the building. We found more than adequate free air opening that directly communicates with the outdoor area for combustion air as per building code. The heating plant is a 120,000 btu upflow furnace. 120,000/ 3000 = 40sq inches We found two openings that communicate directly with the outdoors equaling 78.5 sq in Upper and 60 sq in for the lower. Don Kramer Mister Mechanical i CITY OF WHEAT RIDGE Building Inspection Division r4000or (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address:'�/� Permit Number: 2 0/ '� G. ! j Ci � 'g 71 ® ❑ No one available for inspection: Time AWP-D-)�/ Re -Inspection required: e� No When corrections have bee de, schedule for re -inspection online at: httpYlwww.ci. wheatridge.co.usfiInspection Date: Inspector: S;00 DO NOT REMOVE THIS NOTICE City of Wheat Ridge Comm. Tenant Finish PERMIT - 201901211. PERMIT NO: 20190/211 ISSUED: JOB ADDRESS: 4425 Allison St EXPIRES JOB DESCRIPTION: Commercial tenant finish - 3,137 sq ft total Service change - 200 amps; No added valuation W *** CONTACTS *** OWNER (720)313-3547 SMITH STEVE GC (303)901-6328 ROBERT J DAMERON SUB (720)231-0346 LARRY ROMERO SUB (303)934-6831 DALE EARNEST SUB (303)757-5661 LARRY D. BELL 07/15/2019 10/17/2020 190147 ROCKBRIDGE CONSTRUCTION 022097 PACIFIC AIR INC. 019526 EARNEST ELECTRIC, INC. 017174 BELL PLUMBING & HEATING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 330 / General Retail BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUA'T'ION: 143,676.00 FEES Total Valuation 0.00 Plan Review Fee 920.30 Use Tax 3,017.20 Permit Fee 1,415.85 Extend Expired Permi 240.00 ** TOTAL ** 5,593.35 *** COMMENTS *** *** CONDITIONS *** All roughs to be done at Framing Inspection. Approved per plans and red -line notes on plans. Must comply with 2012 IBC, 2017 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to .field inspections. **Prior to final inspection approval - As-builts are requir.•ed before approval of the Building Final Inspection and Certificate of Occupancy can be issued. One (1) additional parking space must be provided, for a total of 12. Will be confirmed at final inspection. Landscaping removed or damaged during construction must be replaced prior to final inspection. The issuance of a building permit should not be construed to be approval of a business license. Business licenses are independent of the building permit and can not be approved until completion and approval of the associated building permit. I_q i—d t A r City of Wheat Ridge Comm. Tenant Finish PERMIT - 201901211 PERMIT NO: 201901211 ISSUED: JOS ADDRESS: 4425 Allison St EXPIRES JOB DESCRIPTION: Commercial tenant finish - 3,137 sq ft total Service change - 200 amps; No added valuation 07/15/2019 10/1.7/2020 I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this!er mit and perform the work described and approved inconjuncton with this permit. I further attest that I am legally authorized to include aentities named within this document as parties to the work tobe performed and that all worktobe performed is disclosed in this doment and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the pen -nit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpennit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4, No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all re uired inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division, 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable ye�g.or any ordure or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. -(j'010 �/ City of Wheat] 0 COMMUNITY DEVELOPMENT ge City of Wheat Ridge Municipal Building 7500 W. 296 Ave. Wheat Ridge, CO 80033-8001 P: 303.235.2855 F: 303.237.8929 Permit Extension Request Form Permits expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days may be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. Please complete this form in its entirety and submit to the Building Division at permits(a.ci.wheatrid eg co.us or fax to 303-237-8929. Party requesting permit extension: C.A f11 P $ l Fle c l iti c 1n & Permit # )01q 0 17-1 1 Property Address: yg25- /9//1 30A 5 f Phone # 3/J/l - 535 -1 Email Address: To`/dem rlio Yo C' m c4 sa / ne -1 Reason for extension request: 0 Number of days requested: 3 U d u S M1 f Printed Name: /0 [td 6oet j Signature::r Date: /6 For office use only This request hasbeen �_ Approved by: � X Approved ❑ Denied Extended until: 10/17/2020 2-�� Date: 09/17/2020 nti wxi.wheatridge.co.us i CITY OF WHEAT RIDGE Building Inspection Division ci (303) 235-2855 Office i ­�'6. INSPECTION NOTICE Inspection Type: Job Address: 7, , 4 ., — �0yi Permit Number: ZV / Z ❑ No one available for inspection: Time �AI�I%PM arP Re -Inspection required:i�"Yes No When corrections have been made, schedule for re -inspection online at: http.11www.ci.wheatridge.co.uMnspection Date: ?///t,�,0ZV Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: F Job Address: G �- fO� 7 Permit Number: ❑ No one available for inspection: Time /0 F 2,7, 4@0M Re -Inspection required e No When corrections have been made, schedule for re -inspection online at: h ttpYlwww. ci. whea tridge. co. usrns pec ti on Date: /c/6,0--tqnspector: _f DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE: Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type:F- LELT- Job Address: 14 L Jj a Permit Number: ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, sclt d f -inspection online at: http://www.ci.wheatridge.co.usrnspe do Date: i specto;.. r i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type:.'' Job Address:°i.! Permit Number: / f- ❑ No one available for inspection: Ti _ Re -Inspection required: Yes(__ N0 When corrections have been made, schedule for re -inspection online at: httpYAvww.ci. wheatridge.co. ualinspectioh "---� _ Date ,-�.�-4rispector: t �r i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: l�cJ Job Address: Permit Number: --y/4 LJNo one available for inspection: Time 49 •P3 A M Y Re -Inspection required: y�es� No S ym When corrections have been made, schedule for re -inspection online at: http✓/www.ci. wheatridge.co.usrnspection Date: ?A/�G'2V7 Inspector: 5/0 DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: ,Z�/.rte Permit Number- 04!2 9 a ❑ No one available for inspection: Time Re -Inspection required: Yes When corrections have been made, schedule for re -inspection online at: http✓/www.ci. wheatridge.co. usAnspection Date: 741131 !V2clnspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: t�,/--5- Job Address: -5'- ,A Permit Number: ;>0 / 6 ! z r ❑ No one available for inspection: Time / :'30 Re -Inspection required: Yes No ,. I' ll *When corrections have been made, schedule for re -inspection online at: http://www.ci. wh ea tridge. co. ussfin spe c tio n Date: /7 `f � Z.45 Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: /xj L -5 - Job Address: S /�i�ri! _57 71 - Permit Number: 2-01 9 d / a ❑ No one available for inspection: Time .� V Km --)Pm Re -Inspection required: Yes When corrections have been made, schedule for re -inspection online at: http://www.ci. wheatridge.co. usdnspection Date: ZOZO Inspector: S DO NOT REMOVE THIS NOTICE e i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type:" Job Address: Permit Number: ❑ No one available for inspection: Time i -'fes A Re -Inspection required: es No When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. usfinspection Date: G nspector: 7� DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Permit Number: I C. J No one available for inspection: Time KAMIPM Re -inspection required: Yes "�No, When corrections have been made, schedule for re -inspection online at: http://Www.ci. wheatridge.co. usVinspection Date: Inspector: DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Permit Number: Lj No one available for inspection: Time Re -Inspection required: (,Y'es No When corrections have been made, schedule for re -inspection online at: http;llwww.ci.wheatridge.co. uslinspection Date:— r,,:, - J, inspector: IC, / DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: -3cl Job Address: Permit Number: :z i I A 11 �4,- < J No one available for inspection: Time PM Re -Inspection required: ",YO,SNo When corrections have been made, schedule for re -inspection online at: http.IA,vww.cLwheatridge.co.uslinspection Date: Inspector: /rJ DO NOT REMOVE THIS NOTICE STUD108.18 E N G I N E E R I N G May 26, 2020 I Wheat Ridge Building Division 7500 W. 29th Avenue Wheat Ridge, CO 80033 Re: 4425 Allison St Permit No: 201901211 2.V; UI 2i� -27.20 k This letter is to confirm that this office has made periodic site observations of the referenced project, including the addition roof framing, and the change from TJI rafters to 2x10 dimension lumber rafters (which this office designed), and the existing roof/ceiling framing in the existing building. The new roof construction was performed in accordance with plans and specifications prepared by this office. Upon reviewing the existing roof/ceiling framing, we made recommendations for reinforcing the roof in order to support the Code specified roof snow load of 30 psf. Further observations confirmed this reinforcing was installed as directed. Items which were not in compliance were called to the Contractor's attention and have been corrected. Sincerely, Cody B. Bohall, P.E. CEO/President Studio 8.18 Engineering, PC www.5tudio818Engineering.com 7611 Grandview Ave. info@studio818engineering.com Arvada, CO 80002 Cody Bohall 25==== P:303.255.3664 CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: 767S `7t7� Job Address: �'4/? Permit Number: ❑ No one available for inspection: Time 111 -° t A M Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: h ttp://www. cL wheatridge. co. uslinspection Date:__ Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: 3/3 P/Z:, Z 731Y Job Address:Y4/2-5 Permit Number: -ZU/c/ V/ _S J No one available for inspection: Time ll*.'CI'C, AM/PM Re -inspection required: Yes No When corrections have been made, schedule for re -inspection online at: httpYlwww.cL wheatridge. co. uslinspection Date:- 47'- Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: 3GC 1-ki?' J Job Address: ST.` Permit Number: i ❑ No one available for inspection: Time ANI/PM) t Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: http.I www. ci. wheatridge. co. uslinspection Date:--"-/- 2c: Inspector: k, r; DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE . . Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: 313 A?cll P4. Job Address: Permit Number: ��� c•; �i� - &� — the i i ❑ No one available for inspection: Time is // ,'AM/1PM 111____. -- Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: httpYA,vww.ci. wheatridge.co. uslinspection Date: Inspector: DO NOT REMOVE THIS NOTICE r a.: CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: 30/ 1?(2 %K Job Address: ` Z5 AW_?5C,1 S4 Permit Number: ZGJy G/ Z/1 ® -. /%C</_- 4< ,-_ - p /'ilk -O <® -.'/�L•� n �r� .fit '-ILL.�.r�� " ��a'112f�i�S'� is�/i /7fr 5 /7�ii ❑ No one available for insp tion: Time /J: 30' A M Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: httpYlwww.ci. wheatridge. co. us4nspection Date: =.1c� Inspector: '(1`.1-n DO NOT REMOVE THIS NOTICE 4 �i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type:' �✓ �> i�3:� 51 ,f�``�' S'`z' Job Address: 57 Permit Number: ?c,,, & 6, ) 2 I ❑ No one available for inspection: Time ' ; (I�-' (AM/P Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. uarinspection Date: -'Y'- ,7- <''% Inspector: DO NOT REMOVE THIS NOTICE Inspection Type: Job Address: Permit Number: CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE kz� IJ No one available for inspection: Time - Ag/p M Re -inspection required: Yes No When corrections have been made, schedule for re -inspection online at: http://Www.ci. wheatridge.co. uslinspection, N Z I . Date: i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office ` IN,SPECTION NOTICE � Inspection Type: Job Address: Permit Number: --;7,, -)1 ❑ No one available for inspection;, -Time l AM/PM- Re -Inspection required: Yes(/ No When corrections have been made, schedule for re -inspection online at: http✓/www.ci. wheatridge.co. usdnspection Date: '%__. f71 Inspector: DO NOT REMOVE THIS NOTICE o i CITY OF WHEAT RIDGE 1 Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE r Inspection Type: �� 7 Job Address: Permit Number: d� ❑ No one available for inspection: Time, Re -Inspection required: Yes <No D When corrections have been made, schedule for re -inspection online at: h ttp://www. ci. wheatridge. co. uslinspection Date: � /;r - / J' Inspector: ®O NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE "Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type:�- Job Address: Permit Number: ';J e .+ ❑ No one available for inspection: Time"!: --,,1M ' AM/ M Re -Inspection required: Yes,---'1"14(j p When corrections have been made, call for re -inspection at 303 -234 - Date: /V,- Inspector: L _____ DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE _1�9rBuilding Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax I SPECTION NOTIC /0-7 -D - Inspection Type: A96, 1 Cit Job Address: -5— Permit Number: r2 zc� ❑ No one available for inspection: Time Re -Inspection required: Yes,',- No When corrections have been made, call for re -inspection at 303-234-5933 Date: ' % , �� , /"-/ Inspector: /,>.— DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: ) Job Address: IS 7 -- Permit —Permit Number: F. ❑ No one available for inspection;Trne-N1 Re -Inspection required: Yes No When corrections have been made, cali for re -inspection at 303-234-5933 Date:` r') , 1!T Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: c2Da Sewer Uryie(- 1aierj* car Job Address: 4H.'a-5 A I 1 i a n S4, Permit Number: �®1 1 l O ��;z 1 I ❑ No one available for inspection: Time Re -Inspection required: Yes r_ No When corrections have been made, call for re -inspection at 303-234-5933 Date:`- ' `�� Inspector: a R, DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address:G`! Permit Number:-, �.=�� I � +'7 ).a Ll No one available for inspection: Time M _ -� �� -AM/i�M , Re -Inspection required: Yeses -No When corrections have been made, call for re -inspection at 303-234-5933 Date: ate' ',_Inspector:" DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: ' 4 ❑ No one available for inspection: Timer A (&- Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Dated � - ('T Inspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Plumbing PERMIT - 201901774 PERMIT NO: 201901774 ISSUED: 08/22/2019 JOB ADDRESS: 4425 Allison St EXPIRES: 08/21/2020 JOB DESCRIPTION: Sewer repair - 65 ft; waterline repair - 95 ft *** CONTACTS *** OWNER (303)313-3547 DAWN PROPERTIES, LLC SUB (303)519-0240 R. ANDREW RUSSELL *** PARCEL INFO *** ZONE CODE: UA / Unassigned SUBDIVISION CODE: 330 / General Retail 120161 THE ELITE PIPE MD USE: UA / Unassigned BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 14,750.00 FEES Total Valuation 0.00 Use Tax 309.75 Permit Fee 283.55 ** TOTAL ** 593.30 *** COMMENTS *** *** CONDITIONS *** All work shall comply 2012 International Codes, 2017 NEC (if applicable), and ordinances adopted by the City of Wheat Ridge. Work is subject to field inspections. I, by in signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this�ppermit. I further attest that I am leggally authorized to include all entities named within this document as parties to the work to be perto d and that all work to be ertormed is disclosed in this document andlor its'/accompanying approved plans and specifications. Si e of OWNER r CONTRACTOR rcle one) Date 1. This permit was issued a miction provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This. permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Budding Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable cod�any ordinance pr regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Builditig Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of W heat pd�c COMMUNITY DEVELOPMENT Building & Inspection Services 7500 W. 291 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: perm itsCc_ci.wheatridae.co.us FOR OFFICE USE ONLY Date: j IL Plan/Permit # go �qo Plan Review Fee: Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: Property Owner Property Owner Email: Tenant Name (Commercial Projects Only) ,5v^ i k Property Owner Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer: ArchitectlEngineer E-mail: Phone: r�- Contractor Name: 0 � Z—t , k 'e_ xf Phone:/ L 33�3�76 City of Wheat Ridge License #: 6((l Phone: ?� ' GGZ" tj � ri Contractor E-mail Address: ��/I �`EDe_k0-y' 0C." e • LV "^ For Plan Review Questions & Comments 1(please print): 1 CONTACT NAME (please print): ' S btu' �r'16 L' Phone: CONTACT EMAIL(p/ease print): Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. ✓ COMMERCIAL ❑ RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. 6 5, co 0-7, c3" e, 0+ Pz b ,' 5 + Sett' e �-- 5C (-V " CI& G ; (' i� ��(L- 0'� (::�vi,�'-er 5 - rL� tV C' L " V'U —ra V11 Sq. FULF BTUs Gallons Amps Squares For Solar: KW # of Panels Requires Structural For Commercial Projects Only: Occupancy Type: Construction Type: Occupancy Load: Square Footage: Project Value: (Contract value or the cost of all materials and labor included in the entire project) 1 IV 50 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that 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; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CO CTO or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): DATE: ZZ' Printed Name: ) .. t 5(n Lv ('C L ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Lv� TL�Wmlul Building Division Valuation: TULLIO ENVIRONMENTAL SERVICES 833 S. Vance St. Suite 102 Lakewood, Colorado 80226 (303) 842-6361 tullioenviro@gmail.com ATTN: j e To whom it may concern: Attached are the results of Phase Contrast Microscopic (PCM) analysis for airborne fiber concentration through the air -filter samples that were taken and analyzed for clearing project number )!j d -"4 on C ! . This project is located at _ 4_JCrW ,�r C..�.. c -r �r � 4k �„`, . All of T.E.S.'s PCM analysts participate and are proficient in the Industrial Hygiene Proficiency Analytical Testing (IHPAT) under the American Industrial Hygiene Association's (AIHA) Laboratory Quality Assurance Program. Under the IHPAT. Before samples are analyzed, our chain -of -custody procedures assure that the air sample casings and sealant are inspected for damage on intake. Samples are logged and recorded into our company log book and are given a unique LN number for internal record keeping and precision sample tracking. All of our client's records are considered confidential and will not be discussed with any person or agency not associated with your organization. The results detailed in this report apply only to the samples received. Standard analytical procedures include the removal, quarter -sectioning, and slide preparation of the cellulose -ester membrane filter. Using a positive phase -contrast microscope equipped with a Walton -Beckett graticule, fibers are counted and samples are calculated in accordance with NIOSH Method 7400. Only fibers grater than five microns in length with a length -width ratio equal to or greater than 3:1 were counted. If you have any questions regarding the content of this report or would like to make any suggestions that may improve our quality of service, please do not hesitate to contact US. Analyst W V I J W F J W Fa- 2 W Z cW Z w O a Ix W W J O C- J _I = O U m C. N z a� R m Cf CL 7 U d O. N t% 0 d N c ti 16 0 U) r_ 0 0 I a. 0 IN co 00 4b Qm w w w LU ul ul LL. th v a� LL M lZ t 0- F4- , tj E 0 > 19 ui w0 (zj w w 0 0- 0 < UJ w ON, !�„� 0.sl M ui Z LU Ix U, 0 LL 't �. ` 0, w I x z x w 0 w 94 O U? 0 0- w Z = 'm Z W oli �- mz W w w z0 z X W Z a 0.- C'4 0 aa U 0 2 �e w E'jw U. 0 Z LU X CL z w It (D LU z ui . .... . ... w 0 2 V11 9 z w z CM CM 00 < 2 IL CL lij CL CL z 0 z w .,v u C E IL OW 0 w 0. <x w w lz m co —1en ID 0 w >- j 0 77� ti 16 0 U) r_ 0 0 I a. 0 IN co 00 4b Qm w w w LU ul ul r TULLIO ENVIRONMENTAL SERVICES FINAL CLEARANCE MONITORING PHASE CONTRAST MICROSCOPY (PLEASE PRINT NEATLY) Client: Project No: "€At9t_ A Project Location: Contractor: —,X- Work Area: T.E.S. Representative: ]1,A" Ace,,,.,1% "-pproximate rootage;Akr Yes No(Put Why at Bottom) Sample No: .- # - -"Results O p41> / f/cc T.E.S. R Supervi Final Clearance Samples Clearance Standards raQ•Z .► ... i PASS CLEARANCE STANDARDS Failed clearance Standards ✓ EPA clearance guideline of 0.01 f/cc All Clearance samples to be less than the background samples Other (Please list) Samples were analyzed utilizing the NIOSH 7400 Method as reference. Comments: Comments must be made when less than five samples were collected. AHARA regulations require five samples for all containment's. If aggressive air sampling wasn't used. City of Wheat Ridge Comm. Tenant Finish PERMIT - 201901211 PERMIT NO: 201901211 ISSUED: 07/15/2019 JOB ADDRESS: 4425 Allison St EXPIRES: 07/14/2020 JOB DESCRIPTION: Commercial tenant finish - 3,137 sq ft total *** CONTACTS *** OWNER (720)313-3547 SMITH STEVE SUB (303)901-6328 ROBERT J DAMERON 190147 ROCKBRIDGE CONSTRUCTION SUB (720)231-0346 LARRY ROMERO 022097 PACIFIC AIR INC. SUB (303)934-6831 DALE EARNEST 019526 EARNEST ELECTRIC, INC. SUB (303)757-5661 LARRY D. BELL 017174 BELL PLUMBING & HEATING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 330 / General Retail BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 143,676.00 FEES Total Valuation 0.00 Plan Review Fee 920.30 Use Tax 3,017.20 Permit Fee 1,415.85 ** TOTAL ** 5,353.35 *** COMMENTS *** *** CONDITIONS *** All roughs to be done at Framing Inspection. Approved per plans and red -line notes on plans. Must comply with 2012 IBC, 2017 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections. **Prior to final inspection approval - As-builts are required before approval of the Building Final Inspection and Certificate of Occupancy can be issued. One (1) additional parking space must be provided, for a total of 12. Will be confirmed at final inspection. Landscaping removed or damaged during construction must be replaced prior to final inspection. The issuance of a building permit should not be construed to be approval of a business license. Business licenses are independent of the building permit and can not be approved until completion and approval of the associated building permit. City of Wheat Ridge Comm. Tenant Finish PERMIT - 201901211 PERMIT NO: 201901211 ISSUED: 07/15/2019 JOB ADDRESS: 4425 Allison St EXPIRES: 07/14/2020 JOB DESCRIPTION: Commercial tenant finish - 3,137 sq ft total I, by my signature, do hereby attest that the work to be performed shall comply with all accompanyingg approved plans and specifications= applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the erty and am authorized to obtain this permit and perform the work described and approved in conjunction with this ppermit. I further att t tha am legally authorized to include ali entities named within this document as parties to the work to be performe4nd that all ork to e performed is disclosed in this document and/or its accompany}ng approved plans and specifications. Signature of OWNER or CONTRACTOR (Circleno e) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, po plans and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and_procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall ilot be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any oyd['ince or regulitn of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official' Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of y Wheat d, COMMUNITY DEVELOPMENT Building S Inspection Services 7500 W. 2V Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line. 303-234-5933 Email: permits fti.wheatridge.co.us FOR OFFICE USE ONLY Date: ��12/r9 Plan/Permit # �/ 4�10 /21/ Plan Review Fee: Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: �-1 `i 2 S ti 1 -7`4 5 fl -r , L, J1 P, C o 0 o a 3 3 Property Owner (please print): ST -S Vc� 5M % T -M Phone: 4-2 61 1►3 •3s'W 7 - Property Owner Email: 5 5 P'k 1 i 1-1 -s_ A 1- Sri 1 r -)-F c o Tenant Name (Commercial Projects Only) S A M 6 ^ S o w Af c£ fz- Property Owner Mailing Address: (if different than property address) Address: S -4'ro 1..5. Ca L- r9x A I * I o3 City, State, Zip: LA 14 6-W O Ca f L o JJ 02 157 QLpS 'I1XAtr All -G/ -J )1-G'Cjv��� f: 1.0 Architect/Engineer: S A ,- z S t~ p. S&Cfz , A I {i Architect/Engineer E-mail: JF(zrq (Z R -A CTit cN' &-'&I Phone: 3 r 3 �� t 5 4 5 3 Contractor Name: City of Wheat Ridge License #: d l Phone: Contractor E-mail Address: .6%Q L {" c�G 9L �, , r , (. 4 a yr.,, For Plan Review Questions & Comments (please print): ---CONTACT NAME__ (please prino: Jf') M 1-5 r(? A SE -('-l_ %_J ^-_Ph_One. 3 03 CONTACT EMAIL(please print): J r KN _%,F & @ OT A P -C 1q, c Dh Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: yq f t+.ror 1:-:7 .'C. Plumbing: I d 7. iv -e" vot 0- %.rp. L Mechanical: '} A t.# _Cl< J0l f"- W.R. City License #1 V t q 5z 6 W.R. City License # W.R. City License # a2z og� Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. �f COMMERCIAL ❑ RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. -r.T 'f oN A 0'51'U'f SS d$x . wo jz1 Sq. FULF 17 C 3 -4 BTUs Gallons y0 Amps _15_ Squares For Solar: -- Kw # of Panels Requires Structural For Commercial Projects Only: Occupancy Type: S Construction Type: V, a Occupancy Load: 3 2. Square Footage: 3,f� 3 I,$, r - Project Value: (Contract value or the cost of all materials and labor included in the entire project) OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record: that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that 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; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application. warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CONTRACTOR) orHORIZED REPRESENTATIVE) of tjWNE (CONTRACTOR) Signature (first and last name): DATE: (2 ' 1 "( Printed Name: JA, -t F I DEPARTMENT USE ONLY ZONINGCOMMMENTS: NKALGy W( ca'�-M&As Reviewer: BUILDING DEPARTMENT COMMENTS: viewer: PUBLIC WORKS COMMENT Reviewer: OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE:. fQ011opC,L - 3I07) ADD ITPIV - 100 sF -� W IaZ°t i� LF Building Division Valuation: City of h6atI L �. • g SUB—CONTRACTOR AUTOORIZATION FORM This form must be signed by each sub -contractor. This form will not be accepted with missing information. Subcontractor's City of Wheat Ridge License number must be provided in the applicable space. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: A, l k sc_- S= Permit #: General Contractor:-, r �� s Electrical Sub -Contractor Company Name: State License #: Phone #: Master #• Wheat Ridge License #: (required field) Signature of Authorized Agent I Plumbing Sub -Contractor Company Name: State License #: Date Phone #: Master #: Wheat Ridge License #: (required field) Signature of Authorized Agent Date I Mechanical Contractor i Company Name: Pacific Air Inc Phone: 7202310346 Wheat Ridge License #• 022097 (required field) Lot«y g m e to Si¢nature of Anthnri,7Pdi A4vo..t 6/20/2019 Date City of IY Wh6atp,idge COMMUNITY DEVELOPMENT SUB -CONTRACTOR AUTOORIZATION FORM This form must be signed by each sub -contractor. This form will not be accepted with missing information. Subcontractor's City of Wheat Ridge License number must be provided in the applicable space. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: 4 4 Z!5 a iy 5c, t -T Permit #: i L General Contractor: �� G, .� f ? c J -J -s-{• Electrical Sub -Contractor I Company Name���%�S�` r✓L��t'` Pf�e #•�f g' -3S/ State License #: e7d`K Master Wheat Ridge License #: 42 1 JAS( (required field) Signature of Authorized Agent Date Plumbing Sub -Contractor Company Name: State License #: Wheat Ridge License #: Signature of Authorized Agent Phone #: Master #• (required field) i Date Mechanical Contractor I Company Name: Phone: Wheat Ridge License #: (required field) Signature of Authorized Agent Date d City of Wh6atRsJ_dd COMMUNITY DEVELOPtvtENT�e g SUB -CONTRACTOR AUTHORIZATION FORM This form must be signed by each sub -contractor. This form will not be accepted with missing information. Subcontractor's City of Wheat Ridge License number must be provided in the applicable space. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: 4 4'Z-< # E k�,ye_ + -S= Permit #: � 11 General Contractor: cSG �� f �, (:� a j- 5±, v C,� �, a J-_3 Electrical Sub -Contractor Company Name: Phone #: State License #: Master #. Wheat Ridge License #: (required field) Signature of Authorized Agent Plumbing Sub -Contractor Date Company Name: BCAJ jrn�. Spl"hone #: - 566 f State License #: Master # Wheat Ridge License #: 171741 (required field) Signature f A orized Agent Mechanical Contractor Company Name: Wheat Ridge License #: Signature of Authorized Agent 'I/IV/ I JL Date Phone: (required field) Date Dina Kemp From: James Fraser <jim@otarch.com> Sent: Wednesday, June 12, 2019 12:46 PM To: CommDev Permits Subject: 4425 Allison: Permit application accepted - West Metro Fire Protection District Good Afternoon, Please see below the fire department acceptance for the 4425 Allison permit I dropped off this morning. Thank you! Thanks, Jim Olde Tyre Architecture, LLC * superior architecture + design Olde 'lime Architecture, LLC James Fraser, AIA 6400 West David Drive Littleton, Colorado 80128 303.881.5953 ifraser(a)otarch.com From: NoReply@mobile-eyes.com [mailto:NoReply@mobile-eyes.com] Sent: Tuesday, June 11, 2019 7:55 AM To: jfraser@otarch.com Subject: Permit application accepted - West Metro Fire Protection District Your permit request for Vacant at 4425 Allison Street Wheat Ridge, CO 80033 has been accepted. The Job Number is: 190611001 Description: Tenant finish for a business use, including new walls, mechanical, plumbing, and electricala work. Also a small addition. Thank you for submitting to West Metro Fire. Our typical review turnaround is approximately 3 - 4 weeks. If additional information is required, you'll receive a notice from the reviewer assigned, or a no -reply notice from Mobile Eyes. Please be sure to check your junk folder if you feel you are not receiving the Mobile Eyes notices and select "Not Junk". NOTE: Re -submissions shall only include the pages that are affected and additional pages that may be required for the needed corrections. Re -submission of full sets, unless specifically requested, shall result in the rejection of plans. 2 zo 1 101 Z-1 l KORDZIEL =--" _- ENGINEERING, INC. www kordizielenginevTing com P.O. Box 16267 Golden, CO 80402-6005 phone 303-216-1919 fax 303-216-9292 SOIL AND FOUNDATION INVESTIGATION PROPOSED ADDITION 4425 ALLISON STREET WHEAT RIDGE, COLORADO Prepared by.- Joseph y:Joseph C. Kordziel, P.E., Principal SPD 0 l /C�, ' �o , � K . ti� �Q� �90.� seph C Digitally signed by cj • . h i •, Joseph C. Kordziel 291M �: rdziel Date: 2019.05.07 0- •. 17:38:37-06'00' 4NAIL �� " j". Prepared for: ROCKBRIDGE CONSTRUCTION AND MANAGEMENT COMPANY ATTN: BOB DAMERON 3121 ROCKBRIDGE DRIVE HIGHLANDS RANCH, COLORADO 80129 dhr of Wheat Ridge PROJECT NO. 2237 MAY 7, 2019 TABLE OF CONTENTS SCOPE 1 CONCLUSIONS 1 PROPOSED CONSTRUCTION 2 SITE CONDITIONS 2 INVESTIGATION 2 SUBSURFACE CONDITIONS 3 EXCAVATIONS AND SHORING 4 SITE PREPARATION 4 BUILDING FOUNDATIONS 5 SLAB -ON -GRADE CONSTRUCTION 6 LATERAL LOADS AND SUBSURFACE DRAINAGE 6 SURFACE DRAINAGE 7 LIMITATIONS 7 FIGURE 1 — LOCATION OF EXPLORATORY BORING FIGURE 2 — LOG OF EXPLORATORY BORING FIGURE 3 — GRADATION TEST RESULTS FIGURE 4 — TYPICAL FOUNDATION DRAIN %at Wheat Ridge SCOPE This report presents the results of a soils and foundation investigation for a proposed addition to the structure at 4425 Allison Street in Wheat Ridge, Colorado. The test hole (TH-1) location is indicated on Figure 1. The purpose of our investigation was to evaluate subsurface conditions at the site and provide geotechnical recommendations for the proposed construction. The report presents a description of subsurface conditions encountered at the site, recommended foundation system, and design and construction criteria influenced by the subsurface conditions. The report is based on data developed during the field and laboratory investigations and our experience. A summary of our findings and recommendations is presented below. CONCLUSIONS 1. Subsurface materials encountered in TH-1 consisted of a thin layer of asphalt, underlain by 9 feet of silty sand, underlain to 16 feet by gravelly, silty sand, underlain by claystone bedrock to the maximum depth explored of 20 feet. The soils encountered are non -expansive at the proposed foundation depth. 2. Free water was encountered at 9 feet at the time of drilling and rose to a depth of 8 feet when checked 10 minutes after drilling. The test hole had caved in at a depth of 15 feet. 3. The proposed addition can be constructed with a spread footing foundation system bottomed on natural soils. The spread footing foundation system will have a low risk of movement. Design and construction criteria are presented in the body of the report. 4. The soils are suitable for support of slab -on -grade construction with a low risk of movement or cracking. Any slabs supported on grade should be free to move vertically, and not tied to the structure. 5. An exterior foundation drain may be installed below slab elevations to reduce the risk of water entering slab or foundation areas. 6. Positive drainage down and away from all foundation walls should be established and maintained at all times. City of `I, Wheat Ridge .Building Qiviron Soils and Foundation Investigation Project No. 2237 Page 2 PROPOSED CONSTRUCTION An addition to the structure with no basement is proposed at the site. A structure with no basement currently exists on the site. The proposed addition will consist of concrete and wood frame construction and relatively light construction loads are anticipated. A maximum foundation depth of 3 to 4 feet below the surface elevation is anticipated. SITE CONDITIONS The site consists of an existing structure located in an established residential and light commercial area of Wheat Ridge, Colorado. The locations of the existing structure and exploratory boring are presented on Figure 1. The slopes gently to the north. The site has an asphalt parking area in the front lot with some landscaped grass and some established, mature trees in the rear of the site. INVESTIGATION Subsurface conditions were investigated by drilling one exploratory boring at the location indicated on Figure 1. The boring was advanced using a 4 -inch diameter continuous flight auger powered by a CME -45 drilling rig. Samples were taken at select intervals using a California sampler, which was driven into the soil by dropping a 140 -pound hammer through a free fall of 30 inches. The number of blows required to drive the sampler into the soil is known as a penetration test. The number of blows required for the sampler to penetrate 12 inches is evaluated and gives an indication of the consistency or relative density of the soils and bedrock. The results of the penetration tests and log of the material encountered are presented on the Log of Exploratory Boring, Figure 2. Samples were returned to the laboratory where they were visually classified and testing was assigned to evaluate the engineering properties of the soil layers. Laboratory testing consisted of moisture content detesot4ations and gradation test analysis. The results of the laboratory tests are presented o ig rres 2 -iJreatR�d Soils and Foundation Investigation Project No. 2237 Page 3 SUBSURFACE CONDITIONS Subsurface materials in TH-1 consisted of a thin layer of asphalt, underlain by 9 feet of silty sand, underlain to 16 feet by gravelly, silty sand, underlain by claystone bedrock to the maximum depth explored of 20 feet. The soils encountered are non -expansive at the proposed foundation depth. Free water was encountered 9 feet at the time of drilling and was measured at a depth of 8 feet when checked 10 minutes after drilling. Additional subsurface details are presented on Figure 2. The geotechnical practice in the Denver and surrounding area uses a relative scale to evaluate swelling potentials. When the sample is wetted under a surcharge pressure of 1000 pounds per square foot (PSF), the measured swell is classified as low, moderate, high, or very high. It is important to note that measured swell is not the only criteria for slab - on -grade recommendations and additional factors are considered by the geotechnical engineer when evaluating the risk for slab -on -grade construction. The following table presents the relative classification criteria. The classification criteria is in conformance with guidelines established by the Colorado Association of Geotechnical Engineers (CAGE). Risk Category Low__ Moderate High Very High Percent Swell Under A 1000 PSF Surcharge Pressure 0—<2 -- Greater than 6 Granular soils were encountered that were judged to be non -expansive within the influence of the proposed foundation. Gradation test results are presented on Figure 3. F, Mdt W1,010doe n 1 0 1"" Soils and Foundation Investigation Project No. 2237 Page 4 EXCAVATIONS Excavations should not remain open for extended periods of time, permitting wetting or drying of the bearing materials. Moisture changes of the bearing materials may increase the risk for movement. The materials encountered within the depth of excavations on site are categorized as Type B according the Occupational Safety and Health Administration (OSHA). Based on published OSHA guidelines, the temporary excavations in the Type B soils can have a maximum temporary slope of 1.0:1.0 horizontal -vertical (H:V) or 45 degrees. These inclinations are reasonable for the conditions at the site. Exceeding these inclinations will increase the chance of deformation, especially over a long time period. Some localized deformation of the bank may occur, especially during wet weather, loading or with vibrations. Care should be taken when working near the sides of the excavation at all times, and the slopes should be monitored by onsite personnel during construction for evidence of sloughing, bulging or toppling of the sidewalls or cracking at the ground surface. Surcharge loading at the top of the cut by equipment, materials, or vehicles must be avoided, since surcharge loading will increase the risk of caving. Spoils of the excavation must be placed a minimum of 2 horizontal feet from the edge of the excavation. Where the recommended excavation inclination crosses property boundaries or is within the influence (1:1) of the bottom of shallow foundations on adjacent properties, we recommend slopes be stabilized by shoring the adjacent excavation. An excavation shoring design is not anticipated due to the proposed shallow excavation depth. SITE PREPARATION 1 Organic material and debris should be removed from the foundation a a a waste �8t Ridge off site or used for non-structural purposes. Where required, structural fill s� beplacE Soils and Foundation Investigation Project No. 2237 Page 5 in 8 -inch uncompacted thickness lifts and compacted to 95 percent of the standard Proctor maximum dry density (MPD) within 2 percent of the optimum moisture content (OMC). Structural fill is a material that classifies as sand according to the Unified Soil Classification System possessing a silt and clay fraction less than 25 percent, a liquid limit less than 40 and a plasticity index less than 20. Coarse-grained material larger than 3 inches in diameter should not be utilized. Structures supported by insufficiently compacted structural fill may settle. Any fill not utilized for structural purposes should be compacted to 90 percent MPD within 2 percent of the OMC. A geotechnical engineer should review earthwork placement activities. BUILDING FOUNDATIONS The soil encountered at anticipated foundation elevations of approximately 3-4 feet below ground surface consists of silty sand. We recommend proposed structure be constructed with spread footings. Basement footings for the addition should be designed for a maximum allowable bearing capacity of 1500 PSF. Spread footing foundations should be designed and constructed to meet the following criteria. 1. All footings must be supported by native soil or structural fill overlying native soil. Any soils loosened by the excavation or forming process should be removed from the footing areas prior to placing concrete. Soils in the footing excavation should not be allowed to dry excessively. Drying of the soil can increase the movement potential. The footing excavations should be observed by a geotechnical engineer to confirm subsurface conditions. 2. We recommend minimum footing widths of at least 16 inches for continuous footings, and 24 inches square for concrete pads supporting columns. Larger sized or interrupted footings may be necessary depending on structure loads. 3. Continuous foundation walls should be reinforced to span local anorestrlmmo s in subsoil. Walls should be reinforced to span an unsupported length of 10 fw6ural steel reinforcement should satisfy the appropriate building codes and design. e Soils and Foundation Investigation Project No. 2237 Page 6 4. Footings must be protected from frost action. Footings should be covered with a minimum of 3 feet of soil for frost protection. SLAB -ON -GRADE CONSTRUCTION The natural soil at the site is suitable for support of slab -on -grade construction, with a low risk of slab movement. Where fill is required or exists, sub -slab fill (and fill beneath exterior flatwork) should be removed and re -compacted to a minimum of 95 percent of the standard Proctor maximum dry density as determined by ASTM D698. Fill should be placed in 8 inch lifts for best results and a low risk of settlement at recommended compaction densities presented above. Slabs should be separated from exterior walls with a flexible joint, which allows the slab to move freely. Minor movement of slabs is possible. We recommend con- struction of a structural floor system with a minimum 24 inch void below the floor in finished living areas if the owner is not willing to accept the risk of slab movement. If the owner is will- ing to accept the risk of slab movement, the slabs can be constructed as "floating" slabs which are free to move in a vertical direction. The slabs should not be attached to interior or exterior bearing members. LATERAL LOADS AND SUBSURFACE DRAINAGE Below grade walls must be designed for lateral loads. For "active" conditions, the walls should be designed for an equivalent fluid pressure of 40 pounds per cubic foot (PCF). For "at rest" conditions, equivalent fluid pressures of 50 PCF should be used. These loads do not include swelling pressures, hydrostatic loads or surcharge loads such as sloping backfill or vehicles. Expansive soil should not be used for backfill. A foundation drain perimeter of the structure may be installed but is not required with proper su The foundation drain will reduce the risk of water entering the foundation area an Soils and Foundation Investigation Project No, 2237 Page 7 of hydrostatic pressures. The foundation drain should lead to a positive gravity outlet or a sump where water can be removed by pumping. The foundation drain should be installed similar to the details presented on Figure 4. SURFACE DRAINAGE The risk for wetting of foundation soils can be reduced by carefully planned and maintained surface drainage. The following precautions should be observed during construction and be maintained at all times after the structure(s) are completed. 1. Excessive wetting or drying of open foundation excavations should be avoided as much as possible during construction. 2. Backfill adjacent to foundation walls should be moistened and compacted. Any settlement of backfill after completion of the structure should be repaired and positive drainage reestablished. 3. The ground surface surrounding the structure should be sloped to drain away from the structure in all directions. A minimum slope of 12 inches in the first 10 feet should be achieved and maintained after construction. Where hardscape is present, a minimum 2 percent slope away from the structure should be achieved and maintained. 4. Roof downspouts and drains should discharge to the surface well beyond the limits of all backfill. Irrigated landscaping should not be placed within 10 feet of the foundation walls. 5. Plastic membranes should not be used to cover the ground surface immediately surrounding the structure. These membranes trap moisture and prevent normal evaporation from occurring. Geotextile fabrics are a suitable option to control weed growth and allow some evaporation. LIMITATIONS Although the boring was located to obtain a reasonably accurate determination of foundation conditions, variations in the subsoil conditions are possible. If subsurface conditions or the proposed construction differs from those described herein, ---.v Of notified. Excavations should be observed by a representative of our offii� ,w &ost 'd9e Soils and Foundation Investigation Project No. 2237 Page 8 construction observations is not included in this investigation. An environmental assessment of the site is outside our scope of work for this project. If we can be of further service in discussing the contents of this report, or in the analysis of the influence of subsurface conditions on the design of the structures, please call. Kordziel Engineering, Inc. JCK/jck 3 copies sent, ecopy sent city of Wheat R1�+ . Build' Divrso �f 4425 ALLISON STREET WHEAT RIDGE, COLORADO NTS W d& IS TH-1 City Of IMAGE FROM GOOGLE MAPS Ck y 4f a I ge KORDZIEL SCALE: NTS a I ge DATE: 5-7-19 LOCATION OF EXPLORATORY RING ft REV. DATE: BugdkV:Diwvtson ------ DES. BY. JCK DRAWN BY: JCK ENGINEERING, INC. PROJECT NO. 2237 FIGURE 1 5 10 u w w LL 0 15 20 25 EXPLANATIONS. ® ASPHALT (2-3 INCHES) TH-1 13i 12 WC - 13 2 -200 - 28 50.!9 0 SAND. SILTY. LOOSE -MEDIUM DENSE, MOIST TAN SAND, SILTY GRAVELLY, DENSE TO VERY DENSE, WET, LIGHT BROWN rA CLAYSTONE BEDROCK. WET, GRAY -BROWN f l 13;12 INDICATES THAT 13 BLOWS OF A 140 POUND HAMMER FALLING 30 INCHES WERE �J REQUIRED TO DRIVE A 2.5 INCH O D SAMPLER 12 INCHES 0 INDICATES DEPTH TO FREE WATER AND THE NUMBER OF MINUTES DAYS AFTER DRILLING THE MEASUREMENT WAS TAKEN 10 INDICATES DEPTH TO TEST HOLE CAVE AND THE NUMBER OF MINUTES AFTER DRILLING THE MEASUREMENT WAS TAKEN 20 25 NOTES 1 THE EXPLORATORY BORING WAS DRILLED ON 4-12 19 USING A 4 -INCH DIAMETER CONTINUOUS FLIGHT AUGER POWERED BY A CME 45 DRILLING RIG 2 FREE WATER WAS ENCOUNTERED AT THE TIME OF DRILLING THE BORING WAS CHECKED 10 MINUTES AFTER DRILLING AND WATER WAS PRESENT AS INDICATED AB E CwoR 3 WC WATER CONTENT(%) DD = DRY DENSITY (PCF) -200 = PERCENT OF FINES PASSING THE NUMBER 200 SIEVE Wheat Ridge KORDZIEL SCALE NTS i� �,,�n DATE:05/7/2019 LOG OF EXPLORATORY BO C; REV DATE: DES BY JCK DRAWN BY: JCK ENGINEERING, INC. PROJECT NO. 2237 FIGURE 2 1000 900 80o 70.0 60.0 Q 5(1.0 `e u y 40.0 30.0 20.0 10.0 0.0 KORDZIEL ENGINEERING, INC. (radation Test Results -200 =1 #50 =30 416 #8 #4 3i8" VA., D V. I 1 10 100 Diameter of Particle in Millimeters DESCRIPTION: Sand, silty (SM) GRAVEL 0% HOLE / SAMPLE TH-1 SAND 71% DEPTH 4' FINES 28% LIQUID LIMIT MOISTURE 13.2% PLASTICITY INDEX DRY DENSITY (pcf) N/A DATE: 5/7/2019 NAME: 4425 Allison Street PROJECT NO.: 2237 city of Wheat Ridge FIG E 3 LIMITED ASBESTOS CONTAINING MATERIALS SURVEY TULLIO ENVIRONMENTAL SERVICES 833 S. Vance St. Suite 102 Lakewood, Colorado 80226 (303) 842-6361 tuilioenviro@gmail.com May 21 n , 2019 Steve Smith Re: 4425 Allison St., Wheatridge, Colorado 442 5 A �sM -- aUlqulall On May 20`h , 2019, I Robert Tullio a certified State of Colorado Asbestos Inspector, Number 4585 did collect and submit for analysis 24 bulk samples for P. L. M. This report is for the sole purpose of remodeling the building. * Check foot notes LIST OF HOMOGENOUS AREAS Category 1, Dry-,i�all white in color with a rnedium texture located in the entry way halfway and bathroom on the walls, this area is accessible with a high potential for disturbance, in good condition approximately 300 Sq. Ft. * (F) Class 6** sample number SMW-001 through SMW-003 Category I, Drywall white in color with a smooth texture located in the south west office on the walls and ceilings, this area is accessible with a high potential for disturbance, in good condition approximately 100 Sq. Ft. * (F) Class 6** sample number SMW 004 through SMW-006 Category I, Drywall white in color with a heavy texture located in the south side in the hallway on the walls and ceiling, this area is accessible with a high potential for disturbance, in good condition approximately 250 Sq. Ft. * (F) Class 6** sample number SMC -007 through SMC -009 Category I, Drywall white in color with a light texture located in the south side garage arearthesand ceiling, this area is accessible with a high potential for disturbance, in good condition approximately 400 Sq. Ft. (F) Class 6** sample numbers SMW-010 through SMW-012 Category III, Joint compound white in color with a smooth texture located throughout the r this area is accessible with a high potential for disturbance, in good condition (N/F) Class 7 sample numbers JC -013 through JC -015 Category I, Drywall brown in color with a knock down texture located in the north side throughout on the walls, this area is accessible with a high potential for disturbance, in good condition approximately 600 Sq. Ft. * (F) Class 6** sample numbers SMW-016 through SMW-018 Category I11, Ceiling tile white in color with a pitted texture located throughout the lower part of the north side of the building, area is accessible with a high potential for disturbance, in good condition approximately 500 Sq. Ft. * (F) Class 7 sample numbers CT -0 19 through CT -021 Category 1, Drywall white in color with a popcorn texture located in the north side second floor on the ceiling. this area is accessible with a high potential for disturbance, in good condition approximately 500 Sq. Ft. * (F) Class 6** sample numbers SMC -022 through SMC -024 SUMMARY OF SAMPLED AREAS AND MATERIAL FOR P L M I bulk sample taken from the Entry bathroom east wall sample number SMW-001 I bulk sample taken from the Entry bathroom east wall sample number SMW-002 1 bulk sample taken from the Entry bathroom east wall sample number SMW-003 1 bulk sample taken from the South west office north wall sample number SMW-004 1 bulk sample taken from the South west office north wall sample number SMW-005 1 bulk sample taken from the South west office north wall sample number SMW 006 1 bulk sample taken from the Hallway ceiling sample number SMC -007 1 bulk sample taken from the Hallway ceiling sample number SMC -008 1 bulk sample taken from the Hallway ceiling sample number SMC -009 1 bulk sample taken from the South side south wall sample number SMW-010 1 bulk sample taken from the South side south wall sample number SMW-011 1 bulk sample taken from the South side south wall sample number SMW-012 1 bulk sample taken from the Joint compound sample number JC -013 1 bulk sample taken from the Joint compound sample number JC -014 1 bulk sample taken from the Joint compound sample number JC -015 I bulk sample taken from the North side middle office west wall sample number SMW-016 1 bulk sample taken from the North side middle office north wall sample number SMW-017 1 bulk sample taken from the North side middle office south wall sample number SMW-018 I bulk sample taken from the Ceiling tile sample number CT -0 19 1 bulk sample taken from the Ceiling tile sample number CT -020 1 bulk sample taken from the Ceiling tile sample number CT -021 I bulk sample taken from the North side upstairs ceiling sample number SMC -022 1 -•bulk sampl'taken from the North side upstairs ceiling sample number SMC -023 1 bulk sampltaken from the North side upstairs ceiling sample number SMC -024 SUMMAR10F ANALYSIS OF SAMPLES Sample number SMW-001 contains 2% Chrysotile Asbestos in texture Sample number SMW-002 contains 2% Chrysotile Asbestos in texture Sample number SMW-003 contains 2% Chrysotile Asbestos in texture Sample number SMW-004 contains No Asbestos Sample number SMW 005 contains No Asbestos Sample number SMW 006 contains No Asbestos Sample number SMC -007 contains No Asbestos Sample number SMC -008 contains No Asbestos Sample number SMC -009 contains No Asbestos Sample number SMW-010 contains No Asbestos Sample number SMW-011 contains No Asbestos Sample number SMW-012 contains No Asbestos Sample number JC -013 contains No Asbestos Sample number JC -014 contains No Asbestos Sample number JC -015 contains No Asbestos Sample number SMW-016 contains No Asbestos Sample number SMW 017 contains No Asbestos Sample number SMW-018 contains No Asbestos Sample number CT -0 19 contains No Asbestos Sample number CT -020 contains No Asbestos Sample number CT -021 contains No Asbestos Sample number SMG -022 contains 10% Chrysotile Asbestos in texture Sample number SMC -023 contains 10% Chrysotile Asbestos in texture Sample number SMC -024 contains 10% Chrysotile Asbestos in texture RECOMMENDATIONS AND SUMMARY Some of the materials listed above are regulated asbestos containing building materials and do need to be removed by a licensed asbestos abatement contractor. THIS WOULD BE ALL OF THE WALLS AND CEILING TO BE DISTURBED IN THE SOUTH SIDE ENTRY HALLWAY AND BATHROOM. THIS IS A CATEGORY I CLASS 6 FRIABLE SURFACING MATERIAL APPROXIMATELY 300 SQ. FT. THERE IS ALSO CEILING TEXTURE LOCATED ON THE NORTH SIDE 2ND FLOOR CEILING THAT IS ALSO A CATEGORY I CLASS 6 FRIABLE SURFACING MATERIAL APPROXIMATELY 500 SQ. FT. This is also a limited survey. If any additional material is found and is suspect all work must stop. Other areas behind walls and above ceilings and under floors were considered inaccessible and were not tested. If suspected materials found during renovation or demolition activities then all work must stop and materials tested. of the materials do contain asbestos then a licensed asbestos abatement contractor must remove tercels o. according to all Federal, State and Local regulations. The area then must be cleared before yrthetivio,�, o N (0 renovation or demolition activities can continue. ANALYTICAL PROCEDURES The samples collected were delivered to F.R.S. A National Voluntary Laboratory Accreditation Program (NVLAP) asbestos laboratory, located in Denver Colorado for analysis with a Rush turnaround time. All samples are archived for 30 days unless otherwise stipulated by the client. According to the Laboratory, the samples were analyzed in accordance with the E.P.A. Method 600/R 93/116. This is a limited asbestos survey. This is not a complete demolition survey. The laboratory reports are enclosed. Submitted by: Robert T Ilio State of Colorado Asbestos Inspector #4589 ** Any surfacing material that is blown on such as fire proofing, texture or block filler may have associated over spray that is visible or inaccessible around the areas where it had been applied. *The quantities that are listed in the list of homogeneous areas are just approximations and should not be used for bidding purposes. Categories: I is Surfacing Material II is TSI III is Miscellaneous Class: 1 damaged or significantly damaged TSI 2 damaged friable surfacing ACM 3 significantly damaged friable surfacing ACM 4 damaged or significantly damaged friable miscellaneous ACM 5 ACBM with potential for damage 6 ACBM with potential for significant damage 7 any remaining friable ACBM or friable suspected ACBM If there is any construction debris that contains any amount of asbestos or is assumed to contain asbestos you must notify the land fill per the Hazard Communication Act. Such as roofing materials that are tar impregnated, weather proofing, floor tiles and mastic and any other OSHA material deemed to be non -friable. These materials must be kept non -friable you can not saw, sand, grind or in any other way pulverize said materials. Even if the material contains less then I% asbestos then OSHA standards and regulations apply. All materials greater than I% are considered asbestos containing and regulated by OSHA, EPA, State of Colorado and NESHAP. Client: Address: City: State: U —zip: . ­.-�' _;c Telephone: CiF FAX*:C____) Person to Contact: Alternate Phone( FRS GEOTECH, INC. Bulk Chain of Custody 1441 W. 46'h Ave., Suite 14 Denver, CO 80211-2338 (303)477-2559 or (800)386-3136 FAX: (303)477-2580 Accept/ Sample Sample Reject Number Date 7A. e-mail: Asbestos Mold FRS Lab No.: Page of.—;, Job D at c. Description:: #: Turnaround .time. requested: Rush— 1-d4 5 -day_ Other: Return Sait$ies *NOTE: Specifying a FAX number authorizes FRS Geotech. Inc. to FAX confidential reports to that number. Sample Description and Location 6 s -by(Nape, ate,'tyine) Rec v d bFv1N a2mCe, date, time): !T I 2. Client. i (i �.r.t'., = FRS GEOTECH, INC. FRS Lab No.: Paee of Address: '3 ;, _ 1�-t+Bulk Chain of Custody Jo� I Description: 1441 W. 46th Ave., Suite 14 City: �' P.O. State: (( Zi ;' Z Denver, CO 80211-2338 p� Turnaround time requested: Telephone:( (303)477-2559 or (800)386-3136 Rush_ 1 -dam 5 -day Other: T _ �' [ FAX*:' FAX: (303)477-2580 Return Satnples Person to Contact: a -mail: �s � . _ _ ..._ _ "NOTE: Specifying a FAX number Alternate Phone(_} Asbestos _Mold authorizes FRS Geotech, Inc. to FAX Accept/ Sample Sample ..a,.aliu�IJL at 1 c vt Lw LU Ludt nuunver. Sample Description Reject Number Date and Location EJ {(�� -(Z4 Relinquishecji -� �,'i}atel tim )' % Re c rued by_ame, Aate, time): 1. f %. ;,� ;1��' I. 2-6 i 1 "6� �nYo 2. 2. wheat eu,idr.►g n„„m 1- rn u 0�0 O 6i a C N { a I c N o d l d A o 01 �' a o e 0 o,, �! �I 4) d� U (A .0 G o � b i `A V r� b ap � w Wq 10 1 —111 0 •� � �x O QI VI al s li m a� C6 w w a " F U z°� w ° CY IL � a Q U .a F �x w� W W N N 4 r Ut m � %• II II. 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C C E '• J E •CQ G i-Li � � l yf4O0/JJI1I cal1 a E• r 5 I m v T N C: 101 �c IU # m E E 3 N: d to N UY a y di �d�L LT P lLl Ui (1F P a P a m � h ds U J. v i C co O E L f1 •� C W '' C M K 11o -1c O Q M v M v Z a. c m E E 3 N: d to N UY a y di �d�L LT P lLl Ui (1F P a P a m � O U J. v i C r E L f1 •� C W '' U a. m E E 3 N: d to N UY a y di �d�L LT P lLl Ui (1F P a P a m I y ff py\ 3 \ jv OY p"V city ol It ( \\jVheat Ridge Ruilding Div"011' V '• V �� IL LCL p0 ,p2� I City of Wheat Ridge Residential Asbestos Abatement PERMIT - 201901409 PERMIT NO: 201901409 ISSUED: 07/10/2019 JOB ADDRESS: 4425 Allison St EXPIRES: 07/09/2020 JOB DESCRIPTION: Asbestos abatement - State Permit No. 19J84136A *** CONTACTS *** OWNER (303)313-3547 DAWN PROPERTIES, LLC SUB (303)997-5175 JOHN HANEY 190186 ECO TECH ENVIRONMENTAL *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 330 / General Retail BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,490.00 FEES Total Valuation 0.00 Demolition Fee 50.00 ** TOTAL ** 50.00 *** COMMENTS *** *** CONDITIONS *** Work shall comply with 2012 IRC & 2017 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. I, by in signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicale building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by �e1�ga�wner of theroperty and am authorized to obtain thisthisermifuhez thatIam legally authorized toinclude alperrmedd t all to be ormed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER (Circle one) Date -7 —Lo — l l 1. This permit was issued ormation provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, po plans and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180. days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Off-cial and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a pe it shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable code any ordinanc T regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of �%� W heatp_ MUNITY DEVELOPMENT Building & Inspection Services 7500 W. 2911 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(cDci.wheatridge.co.us FOR OFFICE USE ONLY Date: 71101lq Plan/Permit # Q01 C� o Plan Review Fee: Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: `76/ A L_L-t.iv N a - Property Owner (please print): q�N �z� res', L.LC Phone: �O� 2) _ -3sg7 Property Owner Email: �_>sWSVA I ! 1✓} -CO , C Tenant Name (Commercial Projects Only) /vX Property Owner Mailing Address: (if different than property address) Address: g 7 Q w . Goc_,;:7ja )C.. 2 1.o- z. City, State, Zip:CQ 20 % L� Architect/Engineer: A%P Architect/Engineer E-mail: Contractor Name: City of Wheat Ridge License #: Phone: Phone: $-k7-487e Contractor E-mail Address: For Plan Review Questions & Comments (please print): CONTACT NAME (please print): .� , ©L-� N /U'' Phone: M �� 7 — Fj78 CONTACT EMAIL(please print): Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. Nn COMMERCIAL ❑ RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. Sq. FULF em-oVA�- ©� Foo D ►v ��� w ra-c�� BTUs 0-1�- ASR es -mm Gallons Amps Squares For Solar: KW # of Panels Requires Structural For Commercial Projects Only: Occupancy Type: Construction Type: Occupancy Load: Square Footage: Project Value: (Contract value or the cost of all materials and labor included in the entire project) r •I OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that 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; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information prooyided un the application. CIRCLE ONE: (OWN R) (CONTRA or ( T IZED �RESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last nam\e): DATE: Printed Name: \ O tkh DEPARTMENT USE ONLY ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: _ CONSTRUCTION TYPE: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: Building Division Valuation: N '— --� w, 2 W 2 ?: a� Q� I } F a (D •,., p.. N > LT N oa `->O N gCOI NU d0 O a N N NN0 C) mU U% U ;aU a m z o o_W U om rn N L O U Q d Q 00 mm Oaf r -j m i c 1 °a 0 LL= Mc, J �, Q p o�oX 3 p ? 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M a Q. o O a) aO N O N `c N O :� co 4)O U U) U 0— U U 0 Q UM d 4 U ' v >. a N � N U N N � a m O N L_ o .3 O O a 3 m c m >, O` L � C -o p Q EO C C � � c m m- m OU N p N 7 U C O cc N � N y L 7 o0 °= Ny a—Co c 3 a) to (M U N v >i N fa O N ca x 3 m o °3 a 'omo a)Q O N• N ti p V 5— a wU) a> m0 10 a�a O N .� O O)a TD O a OL d L S O• C 5 m L v o m -o o 4) 'O -0O a E C 3 N w. U 3 O 8, N L c c - m 3 a m _ N m N m N O DO 46 °m m m c Y m tE0ca m�'�`°Ecow N Em Q aS U N w000OQQ c U City of -�?W heat -Midge MAAMIUNiTy DEVELOPMENT City of Wheat Ridge Municipal Building 7500 W. 29th Ave. Wheat Ridge, CO 80033-8001 P: 303.235.2846 F: 303.235.2857 April 23, 2019 OFFICIAL ADDRESS CHANGE NOTIFICATION is hereby given that the following address has been assigned to the property/properties as indicated below: NEW ADDRESS: 4425 Allison Street CURRENT ADDRESS: 4425 and 4429 Allison Street • Winslow Addition Subdivision, Lot 3, Section Parcel #: 39-232-05-054 NOTES: This is a courtesy notification. They only address being dropped is 4429 Allison Street, the building AUTHORIZED BY DISTRIBUTION: DATE:123' 1 q 1. Property Owner 2. AddressingL&Jeffco.us Jefferson County Assessor: Data Control, Lacey Baker; Jefferson County Elections: Holly Roth; Jeffco IT Services (Mapping): Steve Mitchel 3. Jeffco Public Schools, ATTN: Communication Services, 1829 Denver West Dr., Bldg. 27, Golden, CO 80401 4. U.S. Post Office, 4210 Wadsworth Blvd., Wheat Ridge, CO 80033 5. Email to erlinda i.martinezAusps.gov and arlene.a.vickrey_Ausps.gov and sheena.l.abeyta(q-)usps.gov 6. Xcel Energy, sandra.cardenas(n xcelenerg. 7. Century Link, Capacity Provisioning Specialist, 5325 Zuni St., Room 728, Denver, CO 80221 8. Comcast, Attn: Scott Moore, 6850 S. Tucson Way, Englewood, CO 80112 9. Wheat Ridge Water District 10. Wheat Ridge Sanitation District 11. West Metro Fire District 12. Wheat Ridge Planning Division 13. Wheat Ridge Building Division 14. GIS Specialist 15. Log File NOTE: Please notify all other parties concerned. ADDRESS MAP UPDATED BY: www. ci.w h eatridge.com s DATE: Vicinity Map 0 i CITY OF WHEAT RIDGE �(303) Building Inspection Division (303) 23475933 Inspection line 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Q0 R- r, o. I Job Address: H q a /c� 11 s c n SIL Permit Number: -3 01 g 0 0 7 44 `2 ❑ No one available for inspection: Time �� M M Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: ' 3 I q_Inspector: ) b DO NOT REMOVE THIS NOTICE t° i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: / Q o c `7 1--1 -7 ❑ No one available for inspection: Time] o = y y OMM PM Re -Inspection required: Yes I&o When corrections have been made, call for re -inspection at 303-234-5933 Date: 14 y a t, t q Inspector: --T-b DO NOT REMOVE THIS NOTICE INSPECTIORE� R Occupancype N INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Inspections will not be performed unless this card is posted on the project site. **Request an inspection before 11:59 p.m. (midnight) to receive an inspection the following business.day.** Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Comments Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Comments Sewer Service Plumbing Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing Mid -Roof Lath / Wall Tie Rough Electric Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw/ Nail Final Inspections Date Inspector Initials Comments Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage ins ctions call 303-235-2861. For fire inspections ontact the Fire Protection District for your project. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection I Fire Protection Dist. f Final Electrical , Final Plumbing Final Mechanical C Roof Final Window/Doors Final Building NOTE. All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy. "For low voltage permits — Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather City of Wheat Ridge Residential Electric PERMIT - 201704257 PERMIT NO: 201704257 ISSUED: 07/18/2017 JOB ADDRESS: 4425 Allison ST EXPIRES: 07/18/2018 JOB DESCRIPTION: Install 200 amp switch ahead of meter *** CONTACTS *** OWNER (303)233-3976 DON PROPERTIES SUB (720)364-2094 Ron Samson 080168 Mr Volt's Electric *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 330 / General Retail BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 1,000.00 FEES Total Valuation 0.00 Use Tax 21.00 Permit Fee 43.50 ** TOTAL ** 64.50 *** COMMENTS *** *** CONDITIONS *** Must comply w/ 2012 IRC & 2014 NEC. Subject to field inspection. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applica le building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this ermtt. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date I .This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and maybe subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of an manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be ed to be a permit for or an approval of, any violation of any provision of any applicable code or any ordinance or regulation o thi risdiction. �al of pr is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of Wheat Ridge Residential Electric PERMIT - 201704257 PERMIT NO: 201704257 ISSUED: 07/18/2017 JOB ADDRESS: 4425 Allison ST EXPIRES: 07/18/2018 JOB DESCRIPTION: Install 200 amp switch ahead of meter *** CONTACTS *** OWNER (303)233-3976 DON PROPERTIES SUB (720)364-2094 Ron Samson 080168 Mr Volt's Electric *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 330 / General Retail BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 1,000.00 FEES Total Valuation 0.00 Use Tax 21.00 Permit Fee 43.50 ** TOTAL ** 64.50 �f l � 4 *** COMMENTS *** 4_� *** CONDITIONS *** Must comply w/ 2012 IRC & 2014 NEC. Subject to field inspection. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be perfor at all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Sig ture o OWNER or CONTRACTOR (Circle one) Date 1. his permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not b"onstrued to be a permit for, or an approval of, an violation of any provision of any applicable code or any ordinance or regulation oft s jurisdicti nova of rk is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. A CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office - (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 16� m Job Address: 4 4 IS 1A t l S 4 P Permit Number: ') 0 I `) 0 U 5' '� 9 ❑ No one available for inspection: Time V -'3 AM/PM Re -Inspection required: Yes No *When corrections have been made, callfor re -inspection at 303-234-5933 Date: ' = �'- Inspector: DO NOT REMOVE THIS NOTICE °t i CITY OF WHEAT RIDGE Building Inspection Division Pp�- (303) 234-5933 Inspection line C �� (303) 235-2855 Office - (303) 237-8929 Fax V INSPECTION NOTICE Inspection Type: '!� M R Job Address: u q -1 W 11; st, �r Permit Number: :-lot? 6 o 9 ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No *When corrections have been made, calf for re -inspection at 303-234-5933 Date Inspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Electric PERMIT - 201700549 PERMIT NO: 201700549 ISSUED: 04/24/2017 JOB ADDRESS: 4425 Allison ST EXPIRES: 04/24/2018 JOB DESCRIPTION: Electrical service upgrade - 200 amps *** CONTACTS *** OWNER (303)233-3976 FREESE LAURA SUB (720)364-2094 Ron Samson 080168 Mr Volt's Electric *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 330 / General Retail BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 2,250.00 FEES Total Valuation 0.00 Use Tax 40.50 '? Permit Fee 93.35 ** TOTAL ** 133.85 *** COMMENTS *** *** CONDITIONS *** Must comply w/ 2012 IRC & 2014 NEC. Subject to field inspection. I by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be perto d that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date I . This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This, permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalermit fee. 3. if this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change, of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or grantilig of a per fall no be -onstrued to be a permit for, or an approval of, an violation of any provision of any applicable code o e or r his jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptimerequestgci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. City of Wheat 'ge COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 29" Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits a1ci.wheatridge.coms I FOR OFFICE USE ONLY I Date: Add to Permit # (` JU � j� Building Permit Revision/Amendment Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: �! `� S ALLlj,(-),q Property Owner (please print): OL-) 0 Rllpd 110r /_6 � Phone:., o_;� Property Owner Email: Mailing Address: (if different than property address) r Address: Z S �L Z_ / 6 C> City, State, Zip: �vil�Ar/' /6 Submitting Company: P'4 7jJy r Contact Person/�:o '� 4"9 SPhone: 72� z ( l Contractor: Contractors City License #: �� % Phone: 7Z © 3 Contractor E-mail Address: Please Note: Additional valuation must include all general and subcontracted work to be performed related to the revisions and/or amendments declared in the description of work and which were not included in the original permit valuation. If revisions or amendments increase the original valuation, additional fees will be due at the time of approval. Depending on the scope of work, additional plan review fees may be due upon approval ($60.00 an hour — 2 hour minimum). Description of revised/amended work: Sq. FULF Amps Btu's Squares Gallons Other Additional Project Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above) OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I asspme full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perforin the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) PRINT NAME: ZONING COMMMENTS: Reviewer. BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: SIGNATURE: PROOF OF SUBMISSION FORMS Fire Department ❑ Received ❑ Not Required Water District ❑ Received ❑ Not Required Sanitation District ❑ Received ❑ Not Required DEPARTMENT USE ONLY DATE: OCCUPANCY CLASSIFICATION: Building Division Valuation: $