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HomeMy WebLinkAbout4851 Independence Streetmmu? w ?* ©< mmu?I ?* y< Expiration Date: 2/11/2014 4851 Independence St. Wheat Ridge, CO 80033 Inspected by Co"40 Code Consulting LLC City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303-237-8929 Please feel free to invoice. HEM= m M* Z�f 2 ®< 111111111njj+ » < »�� Location #: 7 Address: 4851 Independence St. Elevator ID: 1 m HK MUM MA. 0 # - MMUEUME mmawam Expiration Date: 2/1/2013 wire =17 MrITIM" (frTrAM7 4851 Independence St. Wheat Ridge, CO 80033 Inspected by Co o Code Consulting LLC RE: Elevator/Escalator Registration Dear Elevator/Escalator Owner or Managing Agent: If you have any questions feel free to contact the of at (303)235-2855 am= wwwxi.wheatridgexoms InMOOM City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303-237-8929 To: Jefferson Ctr for Menta ealth s. Payable) 4851 Inde ence St., Wheat Ri g 0033 OF 1! • �11111 :111 111!j 1" jpi�;;1�11111 Mease MrYreTrl ; invoice. U�• Location #: 7 Address 4851 Independence St. Elevator • im Building Dppartment 116 This is to certify that the el for as indicated-l""on this certificate has been o v Npi inspected on the d' "a"""'I'Shown below and w und safe to carry 3000 lbs. T gy" Inspected by Del Regional Council of Governmehi (DRCOG) fflmr • `, mmm i� 1162mm 0. 0. SEEM I Expiration Date: 2/11/201U Jefferson Ctr for Mental Health (Accts. Payable) 4851 Independence St. Wheat Ridge, CO 80033 WCURMWI I M.i2 <22 M 11 To: Jefferson Ctr for Mentat 4851 Independence St. Wheat Ridge, ■ 003 :Dalth s. Payab e) 1"VA K, M"I invoice. U�» » §�: 1111 F 3MS= Location M 7 Address: 4851 Independence St. Elevator ID: I INVOICE City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-235-2857 Date: 12/4/2009 To: Jefferson Ctr for MentaM. ealth s. Payable) 4851 Independence SLIM Wheat Ridge, F 80033 RUN O Your annual elevd&finspection fee of $210 is due -,lfQr location # 7 elevate located at 4851 Independence St. -juNheatAt RE-N, 3� mF -- � -, " '�4ffi-%Mffl- AM -m Please remit payment Ad.-later tha 1, 2 MUMF A-MV19 MEET Please feel free to coh'' tact otth Mce if yp, tions regarding your E �,g invoice. A MR-M." , Z "--- Thank you, ID: I Please detach and send this stub in with your payment. Location #: 7 Address: 4851 Independence St. Elevator ID: 1 Amount due: $21 Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29� Ave. Wheat Ridge, CO 80033 Byilding Department This is to certify that the elevator Andica n this certificate has been inspected on the dery shown below and was• ound safe to carry 3000 lbs. Inspected by De ru. egional Council of Governmeiat (DRCOG) Location Number: Building Name: Location: ID Number: Elevator Tvpe: HP Safety Inspection Date: 7/712010 Elevator Inspection Date: 7/712010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Jefferson Ctr for Mental Health (Accts. Payable) 4851 Independence St. Wheat Ridge, CO 80033 Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29� Ave. Wheat Ridge, CO 80033 Bu ilding Department 6 This is to certify that the elevator as indicatWn this certificate has been inspected on the date-shown below and wasbund safe to carry 3000 lbs. Safety Inspection Date: 1/14/2010 Elevator Inspection Date: 1/14/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 211/2011 Jefferson Ctr for Mental Health (Accts. Payable) 4851 Independence St. Wheat Ridge, CO 80033 Inspected by DOW Regional Council of Governmer'«t (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Safety Inspection Date: 1/25/2007 Elevator Inspection Date: 7/25/2007 Certificate Issue Date: 511/2009 Expiration Date: 211/2010 Jefferson Ctr for Mental Health (Accts. Payable) 4851 Independence St. Wheat Ridge, CO 80033 Inspected by De egional Council of Govern me (DRCOG) INVOICE City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-235-2857 ID: 1 Please feel free to invoice. if regarding your Thank you, va" y ata# Please detach and send this stub in with your payment. Location M 7 Address: 4851 Independence St. Elevator ID: 1 Amount due: $210 Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Department This is to certify that the elevator as indicate this certificate has been inspected on the dae'shown below and wasl,lfbund safe to carry 3000 lbs. Safety Inspection Date: 9/3012006 Elevator Inspection Date: 7/25/2007 Certificate Issue Date: 2/112008 Expiration Date: 2/112009 Jefferson Ctr for Mental Health (Accts. Payable) 4851 Independence St. Wheat Ridge, CO 80033 Inspected by DenveC- 'Regional Council of Government "(DRCOG) 'lip 4 Cit COMMUNITY DEVELOPMENT July 9, 2008 Jefferson Ctr for Mental Health (Accts. Payable) Attn: Elevator /Escalator Owner or Managing Agent 4851 Independence St. Wheat Ridge, CO 80033 Re: Elevator and Escalator Registration Dear Elevator /Escalator Owner or Managing Agent: The Division of Oil and Public Safety (OPS) is the implementing agency for The Elevator and Escalator Certification Act (Title 9, Article 5.5, Sections 101 through 120 Colorado Revised Statutes [CRS]) ( "the Act"). Pursuant to this Act ( §9 -5.5 -111 (1) CRS), all existing and newly installed conveyances must be registered with the OPS by August 1, 2008. Conveyances that are regulated by the Act include any commercial conveyance, accessible to the public, that is an elevator, escalator, moving walk, dumbwaiter, platform lift, personnel hoist, or stairway chair lift, and excluding those listed under §9 -5.5 -104 (2) CRS. The OPS is requesting that you complete this one -time registration for regulated conveyances located in Colorado that you own or operate by one of the following methods: 1) Access the website at http: / /oil.cdle.state.co.us and select the Conveyance Section link, then the Conveyance Registration Procedures link. Follow the instructions provided to register the conveyance. Submit the completed registration form and registration fee payment ($200.00 per conveyance, payable to CDLE, Division of Oil and Public Safety) to the address listed below: CDLE, Division of Oil and Public Safety Conveyance Section 633 Street, Suite 500 Denver, CO 80202 -3660 2) If you do not have internet access, contact Michael Stewart or Greg Johnson with OPS. A Registration Notice form will be faxed or mailed to you. The completed form and registration fee payment must be submitted to the address in 1) above. The OPS conveyance identification number or the facility address must be included on the fee payment check. The City of Wheat Ridge appreciates your cooperation in registering your conveyances. Please address correspondence to the OPS Conveyance Section contacts listed below. Michael Stewart Conveyance Technical Specialist 303 - 318 -8530 michael.stewart(u)state.co.us Greg Johnson Conveyance Program Manager 303 - 318 -8536 greg.iohnson(a)state.co.us Sincerely, City of Wheat Ridge Building Division 7500 W. 29" Ave. Wheat Ridge, CO 80033 303 - 235 -2855 f �LEV,}7 - 0iQS •.. y r Das/e DaVe eerYiF�Yo1'e',- �ac/ed �.Da.Ye .nK PY Xece yoK meeived F sC NexK daXe of 9;7,r 4e dLGy io - :z s yzs 6 j -5 /IFS 3 $3� i tr�--CZ - 7 - &9 ��� �(•�. 5 °9.00 I Ica, 0 I 43l rs:_ !�2 �Jl C �?A O \ 2i5 \�� �t< _ -- ( 69D it it l ci I Ili i:� ThyssenKrupp Elevator 'JAN 2 5 2008 HYDRAULIC INSPECTION & TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) 4 ANNUALTEST DATE ACCEPTANCE TEST OFFICE 4��4 NAME OF BUILDING Q C l°-c— �AVC C VZ LOC ATION ELEVATOR SERIAL N 3 °�4t ° C ITY &STATE `J h mil, ti 1 g�C (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO. vMLE a5 ( z� BUILDING ELEVATOR NO. 1 CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR RATED CAR SPEED i CN F.P.M. RATED CAPACITY LES. TYPE OF ELEVATOR o� RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACEMENT REQUIRED NOT MORE THAN 6 YEAR INTERVAL. Flex Hose and Fittings Tested at Relief Pressure For 30 Sec. Hose Replace ent Date r Hose Tagged With Replacement Date & SAE Type Condition of Reservoir Oil Physical Dimension of Reservoir e ` Make (3) Round Trips Before Setting Relief Valve J,✓' Test the relief valve setting by first inching the empty car up to engage the plunger stop ring, and then by applying additional pump pressure as required to check the setting. The maximum setting must be no greater than 125% of working pressure to comply with the American National SafQt y Code ANSI A17.1 Rule 1005 & 303. Relief Valve Setting P.S.I. (Should be 125% of Heavy Load Up Working Pressure) Corrected Relief Valve Setting P.S.I. (If Required) No Load Working Pressure: U P.S.I. No Load Car Speed: Up — F.P.M. Down 1� F.P.M. Relief Valve Sealed: ¢� NOTE: Code Requires Relief Valve Setting Be Sealed. See Rule 1005 and locate car at any convenient level. Open the disconnect switch and locate the elevation of the platform with respect to a convenient reference. Do not shut off any valves in the line. Provide adequate timbers or pipe as well as safety slings to support car and load if entering the pit. Tank Oil Level At Start of Standing Test t� Tank Oil Temperature At Start of Standing Test 44 After a minimum of 15 minutes, note the position of the platform with respect to the chosen reference. Length of Time Car Standing -Empty ` Amount Car Settled During Standing Period �t �-- Oil Temperature At End of Standing Period y Tank Oil Level At end of Standing Perio Z: Amount of Leakage At Packing During Test xn _-AN: — Condition of Piston Packin NOTE: A CHANGE IN CAR POSITION WHICH CANNOT BE ACCOUNTED FOR BY VISIBLE OIL LEAKAGE OR TEMPERATURE CHANGE OF THE OIL INDICATES A LEAK IN THE CYLINDER OR IN THE UNDERGROUND PIPING, AND NEED FOR FURTHER INSPECTION TESTS OR REPAIRS. Pres. Swifth Rule 306.14 Tested i *Heavy Load Working Pressure: Up *Heavy Load Car Speed: Up F.P.M. Dowr - F.P.M. Normal and Final Terminal Stopping Devices Tested Standby (Emergency Battery Lowering) Power Operation sted` Power Door System Tested: Torque - Z --::; # Kinetic Izz Ft. # Emergency Terminal Speed Limiting Device Tested-( Was the Test Satisfactory: Yes b No If not, explain. Representative of the Insurance Company, City or State Inspector or Owner, Present at test: Name and MECHANIC'S SIGNATURE SUPT. SIGNA Copy of this Report Given to Customer: Yes V No CUSTOMER'S SIGNATURE "Acceptance Test Only WHITE - BRANCH COPY YELLOW - CUSTOMER COPY PINK -ZONE COPY MAHI &TO301 CITY OF WHEATRIDGE ELEVATOR INSPECTION 1 BUILDING ADDRESS CITY ZIP CODE BUI } DING NAME OWNER AbDPESS CITY ZIP CODE PHONE "MB MANUFACTURE UNIT NUMBER I - �h HYDRAULIC PASS FRT CABLE ,Q Vo_ PASS FRT ESCALATOR 11 DUMBWAITER II Dauer- � n � r qzu T SAFETY TEST fg i° NEXT DUE DATE / / - MATERIAL LIFT [ ] wheelchair lift DATE INSTALLED CAPACITY �.� RECORDED (INSPECTIONS ipp JL zs -da w F .J I I I Y OF ELEVA't'Oft 1NS['f:CCIOtI 3Ul LUf I1G 'i011D f $ CITY is f 1' COUE - ZIP ). 11*'I!' -A 0D11{:S -- ( - -- CODE %FAIIU FACTURE O;dll' MUhIUCIt DItAULCC (A:f1f.11 SS vin A FRI wrl DA l' C '-:CC)RU PEC" f'T IS 21 - -�- - 3_- 'x'96._ ! 2Gi 9 97 z vu CITY OF . ✓t DEPARTMENT OF COMMUNITY DEVE V' - "e - fi ELEVATOR INSPECTIONS C/SS/ Zn g/e� 6OAeaV �.�c� BUILDING ADD RE S CITY ZIP COD _. n /_STCQN F_ n� c NA �. OWNER ADDRESS _.. CITY - -- ZIP COD _.. // "J j i 2zi lJd 0 U— F A MANUFACTURE U UNIT NUMBER H HYDRAULIC C CABLE N�q IZPASSENGER - S SSENGER ❑GE ILDIXu ADDRESS \CITY M UFACTURE UNIT NUMBER M ( HYDRAULIC : 70 E A, ❑GEC PASSENGER E] FREIGHT PASSE NGE FREIGHT GEC LAST SAFETY TEST NEXT DUE DA CONDITION 1 N'Ii RECORDED INSPECTIONS zev oi, ice, - , �� �G se, zg; Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify that the elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 3000 lbs Inspector: Bill Gardner TION ID NUMBER Independence St. TYPE SAFETY 1 HP 9130/06 K & E Properties 10268 W. Centennial Rd., Ste. 107 Littleton, CO 80127 Inspection Issue Expiration Date Date Date 7/24/06 2/1/07 211/08 K & E Properties 10268 W. Centennial Rd., Ste. 107 Littleton, CO 80127 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify that the elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 3000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 4851 Independence St. 1 HP 5/30/05 K & E Properties Inspection Issue Expiration 10268 W. Centennial Rd., Ste. 107 Date Date Date 1/17/06 2/1/06 2/1/07 Littleton, CO 80127 K & E Properties 10268 W. Centennial Rd., Ste. 107 Littleton, CO 80127 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify that the elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 3000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 4851 Independence St. 1 HP 5/30/04 K & E Properties Inspection Issue Expiration 10268 W. Centennial Rd., Ste. 107 Date Date Date 1/6/05 2/1/05 2/1/06 Littleton, CO 80127 K & E Properties 10268 W. Centennial Rd., Ste. 107 Littleton, CO 80127 WE ARE MOVING K & E PROPERTIES EFFECTIVE FEBRUARY 1S 2005 K & E PROPERTIES IS MOVING INTO THEIR NEW LOCATION IN THE KEN CARYL EXECUTIVE PLAZA 10268 W. CENTENNIAL RD., SUITE 107 LITTLETON, CO. 80127 ALL TELEPHONE NUMBERS REMAIN UNCHANGED ALL NOTICES, DEMANDS AND COMMUNICATIONS SHOULD BE MAILED TO: K & E PROPERTIES, LLC 10268 W. CENTENNIAL RD., SUITE 107 LITTLETON, CO. 80127 KEN HAUGHEY 303- 504 -9834 CITY OF WHEAT RIDGE 7500 West 29th Avenue Wheat Ridge, CO 80033 Phone: 303-235-2855 INVOICE November 19, 2004 K & E Properties 2696 S. Colorado Blvd. #587 Denver, CO 80222 Elevator ID # 1 Total Cost Due: $132.00 Elevator Inspection For: 4851 Independence St. Property /Elevator Location # 7 K & E Properties 2696 S. Colorado Blvd. #587 Denver, CO 80222 w Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify that the elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 3000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 4851 Independence St. 1 HP 5/30/02 K BE E Properties Inspection Issue Expiration 2696 S. Colorado Blvd. #587 Date Date Date Denver, CO 80222 7/17/02 12/18/02 12118103 K 8E E Properties 2696 S. Colorado Blvd. #587 Denver, CO 80222 City of Wheat Ridge Building Department 7500 W. 29th Avenue Wheat Ridge, CO 80033 o: 303 - 235 -2855 / f: 303 - 235 -2857 December 4, 2002 K & E Properties or Current Occupant 4851 Independence St. Wheat Ridge, CO 80033 Re: 1 Elevator(s) at location # 7 / 4851 Independence St. To Whom this may Concern, According to our records, elevator inspection fees for 4851 Independence St. have not been paid for the 2001 and 2002 fiscal year(s). Please remit the amount of $132.00 per elevator, plus and additional $33.00 administration fee per elevator, per year prior to Dec. 30, 2002. Should payment not be received by the above mentioned deadline, elevator service and inspections will be cancelled immediately. If you have any questions, or proof of payment please contact our office immediately at 303 - 235 -2855. Your total amount due to the City of Wheat Ridge is: $330.00 Thank you for you cooperation. Sincerely, Kristy Shutto Building Dept. Secretary r *c ON i� t cc: K & E Properties c/o Ken & Elizabeth Haughey, 353 1 Q 7, elevator file Fx �vIA� C ��2zz City of Wheat Ridge Building Department 7500 W. 29th Avenue Wheat Ridge, CO 80033 o: 303 - 235 -2855 / f: 303 - 235 -2857 December 4, 2002 K & E Properties or Current Occupant 4851 Independence St. Wheat Ridge, CO 80033 Re: 1 Elevator(s) at location # 7 / 4851 Independence St. To Whom this may Concern, According to our records, elevator inspection fees for 4851 Independence St. have not been paid for the 2001 and 2002 fiscal year(s). Please remit the amount of $132.00 per elevator, plus and additional $33.00 administration fee per elevator, per year prior to Dec. 30, 2002. Should payment not be received by the above mentioned deadline, elevator service and inspections will be cancelled immediately. If you have any questions, or proof of payment please contact our office immediately at 303 - 235 -2855. Your total amount due to the City of Wheat Ridge is: $330A0 ' Thank you for you cooperation. Sincerely, Kristy Shutto Building Dept. Secretary I cc: K & E Properties c/o Ken & E (° Englewood, CO 80110; a U elevator file �` V V D -317, 71 "F 3 901 9844 6452 4580 M 7160 3901 9844 6452 4573 •-® j BUILDING DEPARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE i 1 .:correction Notice i Job Located at :T nr' er a n 1A CO �. I have this day inspected this strueture-and- these- pFeirilses and have found the following violations of City and/or State laws gov- erning same: M I You are hereby notified to correct the foregoing violations. When corrections have been made, call for inspection. F E" Date Inspector for Building Dept. DO NOT REMOVE THIS TAG qfi FORM WR6 -22 ` Correctio .; Job Located at ....:......:....... I have this day inspected have found the following governing same: ........... � .- Notice is strctt,re arari fieseffipreises and lations of City and /or State laws ................ ......... ....... ... ..:�. ... .... You a(ections hereby notified to correct the foregoing violations. When,cor have been made, call for inspection. t: n. 4r C' Date.. ...... ....'.... , . ......... ....... Inspector for Building Dept. - DO NOT REMOVE THIS TAG FORM WRG-22 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify that the elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 3000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 4851 Independence 1 HP 5/101 F 8300 8th Ave. Inspection Issue Expiration W at Ridge, CO 80033 Date Date Date 5/24/00 8/28/00 7/31/01 ELEVATORS OR COMPANY` CI ANNUAL TEST �❑ ACCEPTANCE TEST HYDRAULIC INSPECTION & TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) DATI g OFFICI NAME OF BUILDING C C°Cu -&-1 t "j)t LOCATION ELEVATOR SERIAL NO. (i _7 (7 CITY & STATE 1 - (IF NONE, USE MOTOR OR CONTPyOL SERIAL NO.) DOVER SERVICE CONTRACT NO. 6 ' o� % ((3 & BUILDING ELEVATOR No.. ', / CUSTOMER P.O. NO. JOB NO. .MAKE OF ELEVATOR CAR SPEED _ F.P.M. RATED CAPACITY 3 LBS. TYP OF ELEVA RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI At 7.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACEMENT REQUIRED NOT MORE THAN 6 YEAR INTERVAL. q� + Flex Hose and Fittings Tested at Relief Pressure For 30 Sec. Hose Replacement Date r Hose Tagged With Replacement Date & SAE Type � Condition of Reservoir Oil I Physical Dimensions of Reservoir Make (3) Round Trips Before Setting Relief Valve ❑ Test the relief valve setting by first inching the empty car up to engage the plunger stop ring, and then by applying additional pump pressure as required to check the setting. The maximum setting must be no greater than 125 %of working pressure tgComply with the American National Safety Code ANSI At 7.1 Rule 1005 & -203. 1 Relief Valve Settin P.S.I. (Should Be 125% of Heavy Load Up Working Pressure) Corrected Relief Valve Setting— P.S.I. (If Required) No Load Working Pressure: Up t P.S.I. / No Load Car Speed: Up (�� C� F.P.M. Down ! 0� F.P.M. Relief Valve Sealed: ) NOTE: Code Requires Relief Valve Setting Be Sealed. e See Rule 1005 and locate car at any convenient level. Open the disconnect switch . and locate the elevation of the platform with .respect to ..a convenient reference. Do not shut off any valves in the line. Provide adequate timbers or pipe as well as safety slings to support car and load if entering the pit. ,.f Tank Oil Level At Start of Standing Test G � Tank Oil Temperature At Start of Standing Test tl1J^ l M - After a minimum of 15 minutes, note the positio he platform with respect to the chosen reference. Length of Time Car Standing -Empty 7 Amount Car Settled During Standing Period --- Oil Temperature. At End of Standing Period /A J �'a°-U/1 . Tank Oil Level At End. of Standing Period � ��- Amount of Leakage At Packing During Test .'y _ Condition of Piston. Packing NOTE: A CHANGE IN CAR POSITION WHICH CANNOT BE ACCOUNTED FOR BY VISIBLE OIL LEAKAGE OR TEMPERATURE CHANGE OF THE OIL INDICATES A LEAK IN THE CYLINDER OR IN THE UNDERGROUND PIPING, AND NEED FOR FURTHER INSPECTION TESTS OR REPAIRS. Pres. Switch Rule 306.14 Tested *Heavy Load Working Pressure: UpP.S.I. - *Heavy Load Car .Speed: Up F.P.M.Down F.P.M.. Normal and Final Terminal Stopping Devices Tested t Standby (Emergency Battery Lowering) Power Operation Tested Power Door System Tested: Torque - 3 # Kinetic Ft. #. - Emergency Terminal Speed Limiting Device Tested ❑ Was The Test Satisfactory: YesA No ❑ If not, explain. Representatives of the Insurance Company, City or State Inspector or Owner, Present at test (indicate Name and Title) - - MECHANIC'S SIGNATURE t SUPT. SIGNATURE Copy of this Report Given to Cu tomer: Yes ❑ No CUSTOMER'S SIGNATURE *Acceptance Test Only - Dc -sacs WHITE - BRANCH COPY YELLOW - CUSTOMER COPY PINK - ZONE COPY. Date : 11/4/99 LUTHERAN MEDICAL CENTER 8300 W 38TH AVENUE Wheat Ridge, CO 80033 Quantity Description 1 Elevator inspection for: 4851 INDEPENDENCE ST Total Cost $90.00 LUTHERAN MEDICAL CENTER 8300 W 38TH AVENUE Wheat Ridge, CO 80033 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify that the elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 3000 lbs. Inspector Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 4851 INDEPENDENCE ST HP 1 4/1/98 LUTHERAN MEDICAL CENTER Inspection Issue Expiration 8300 W 38TH AVENUE Date Date Date Wheat Ridge, CO 80033 2/23/99 7/23/98 7/31/99 LUTHERAN MEDICAL CENTER 8300 W 38TH AVENUE Wheat Ridge, CO 80033 8 D$ b 8 6 0 Date: 11/4/1999 K & E Properties 3531 Logan St., Suite D -317 Englewood, CO 80110 Quantity Description 1 Elevator inspection for: 4851 INDEPENDENCE ST Total Cost $120.00 K & E Properties 3531 Logan St., Suite D -317 Englewood, CO 80110 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify thatthe elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 3000 Inspector: JACK BULTMAN LOCATION 4851 INDEPENDENCE ST LUTHERAN MEDICAL CENTER 8300 W 38TH AVENUE wheat Ridge, CO 80033 ID NUMBER Inspection Date ibs. 8/11/97 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify thatthe elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 3000 lbs. Inspector: JACK BULTMAN LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 4851 INDEPENDENCE ST HP 4/1/97 LUTHERAN MEDICAL CENTER 8300 W 38TH AVENUE Wheat Ridge, CO 80033 Inspection Issue Expiration Date Date Date 9/11/96 10/8/96 9/30/97 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify thatthe elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 3000 lbs. Inspector: JACK BULTMAN LOCA TION ID NUMBER TYPE SAFETY INSPECTION DATE 4851 INDEPENDENCE ST HP 5/1/96 LUTHERAN MEDICAL CENTER Inspection Issue Expiration 8300 W 38TH AVENUE Date Date Date Wheat Ridge, CO 80033 9/22/95 10/16/95 9/30196 C werfifiratt of �ns ee#io , �lkeat t��lye, Colo�cu BUILDING DEPARTMENT. C� 7 This is to certify that the, ;� levator 'as N has been insp cted on the shown below and was found sat AM A ^ k ,m .^l .w 1 MAN, 5 ( l T Prtifira te of � 6ptr#io `_ � o� `�ltizut e, Colouu watifira of cJUSPa#io City a� W ,heat_ e,' Color N' ,`.BUILDING DEPAIdTMENT ", This is to certify that the , Elevator as, has been inspected on the date shown below anti was found sa4 Inspector „ LOCATION - i "' ` IQ NUMBER 4851 Independe6ce Stixeet [ Lutheran Medical Center " 7- 3 8300 W. 38th Avenue ' I F Wheat Ridge, 00 80033 m 1 L �1 ro ',eA"'A ' "" m'.'.� .mn+"3 *am•axm" - Cher #tf tttt # e >x #nsEC#ty } "BUILDING DEPARTMENT ' a This is to certify that the t`E$eVator }; as has been inspected on theldate show n. below ar l wadou�nd saf PIP .Inspector e ^� �r LOCATION — _ i Np NUMB 4851 Independenco,Street <7 t, cy Lutheran Medical Center k 8300 W. 38th Avenue Wheat Ridge, CO 80033 92 12 I ��� � � OF INSPECTION "¢tea C�Pr#ifiratr of ;4lnspatirn City o� GU,keat �cl9e;. ..COIo� ,``BUILDING DEPARTISA6i , This is to certify that the $? t as has been inspected on the date shown below and,was found saf<` r 7 Inspector 9 I:OCATION , . (D-NI.lIvIBER 4851 Y.ltL:vC vz4f.. '�6X UU� r.0 i CC' , — IOGi - A t l !' r ae C9- IOGi - A t l !' r ae C9- r e.t v 2 2 DATE L OF INSPECTION m1rdifirair of ;xtspec#iu �Btl1LDING DEPARTMENT -K� This is to certify that the `as, has been inspected on the'-date shown below and ,was foundsaf Inspector ID NUMBER F Oe z� u F C; 9 a 'ter.. eon .m �,^ DATE II f� L OF INSPECTION , 21r dtf ir a te of ;Wnspertia BUILDING DEPARTMENT." This is to certify that the' . E�!.L TOR as has been inspected on the date shown below and was found `safi Inspector F Pro- U cJ rl Street 5<<: #r e4$ t7 as — 3' Den CO J 0 1 , 26.5 DATE L OF INSPECTION J LOCATION ID NUMBER v C7. C'iG 2 "„C2 tjs'' F Pro- U cJ rl Street 5<<: #r e4$ t7 as — 3' Den CO J 0 1 , 26.5 DATE L OF INSPECTION J