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Whca-tRLiddgc-
BUSINESS
LICENSE INSPECTION
PERMIT NO. 202000319
BUSINESS NAME: Ashley Manor
ADDRESS: 3802 Parfet Street
CONTACT NAME: Liz Rojas
will provide
SQ FT
" OCCUPANCY TYPE
Z' �5' OCCUPANCYLOAD
CONSTRUCTION TYPE
'-�sPRINKLERED
❑ NON-SPRINKLERED
INSPECTION DAY/TIME Thurs., Feb. 27th @9am
INSPECTION DAY/TIM
INSPECTION DAY/TIME
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City of
`r
Whca-tRLiddgc-
BUSINESS
LICENSE INSPECTION
PERMIT NO. 202000319
BUSINESS NAME: Ashley Manor
ADDRESS: 3802 Parfet Street
CONTACT NAME: Liz Rojas
will provide
SQ FT
" OCCUPANCY TYPE
Z' �5' OCCUPANCYLOAD
CONSTRUCTION TYPE
'-�sPRINKLERED
❑ NON-SPRINKLERED
INSPECTION DAY/TIME Thurs., Feb. 27th @9am
INSPECTION DAY/TIM
INSPECTION DAY/TIME
Da. e
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:L.�
Job Address:
Permit Number:��'?
MEN
�2— —K CZC -2�c
❑ No one available for inspection: Time
Re -Inspection required: Yes , No
When corrections have been made, schedule for re -inspection online at:
http✓/www. ci. wheatridge. co. us-Vinspection
Date:; : 7 Inspector: -,' ,.-
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:L.�
Job Address:
Permit Number:��'?
MEN
�2— —K CZC -2�c
❑ No one available for inspection: Time
Re -Inspection required: Yes , No
When corrections have been made, schedule for re -inspection online at:
http✓/www. ci. wheatridge. co. us-Vinspection
Date:; : 7 Inspector: -,' ,.-
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Commercial Roofing PERMIT - 201703550
PERMIT NO: 201703550 ISSUED: 07/10/2017
JOB ADDRESS: 3802 Parfet ST EXPIRES: 07/10/2018
JOB DESCRIPTION: Remove and replace damaged roof; 61.48 squares
*** CONTACTS ***
OWNER (720)301-7436 KEYSTONE WEST INVESTMENTS LLC
SUB (719)638-0016 Robert Maestas 170241 D&P Construction & Restoration
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 110 / Senior Living BLOCK/LOT#: 0
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 34,372.00
FEES
Total Valuation 0.00
Use Tax 721.81
Permit Fee 557.05
** TOTAL ** 1,278.86
*** COMMENTS ***
*** CONDITIONS ***
In order to pass a final inspection on commercial elastomeric or similar type roofing, a
letter of inspection and approval from the manufacturer technical representative stating
that "the application of the roof at (project address) has been applied in accordance with
the installation instruction for (roof material brand name) roof covering" is required to
be on site at the time of final inspection. Effective December 1, 2014, asphalt shingle
installations require an approved midroof inspection, conducted when 25-75 percent of the
roof covering is installed, prior to final approval. Installation of roof sheathing (new or
overlay) requires an approved inspection prior to installation of ANY roof coverings and is
require on the entire roof when spaced or board sheathing with ANY gap exceeding one half
inch exists. Asphalt shingles are required to be fastened to the roof deck with a lainimum
of 6 nails per shingle. A ladder extending 3 feet above the roof eave and secured in place
is required to be provided for all roof inspections. Roof ventilation is required to comply
with applicable codes and/or manufacturer installation instructions, whichever is more
stringent.
Occupancy/Type
66 INSPECTION RECORD
_
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection —
y1r�rnw
V4 IF INSPECTION REQUEST LINE: (303) 234-5933
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 inspect}on the following business day.**
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections Date InspectorInitials
Pier f
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Do Not Pour Concrete Prior To Approval Of The Above Inspects s V
Underground/Slab Inspections
Date Inspector Comments
Initials
Electrical
Comments
Sewer Service
Plumbing
nn Nnt Cnver Underground or Below/in-Slab Work Prior To Approval Of The Above Inspections
Rough Inspections
Date
Inspector
Initials
Comments
Wall Sheathing
Mid -Roof
' ( , 7
WAI
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
inspections call 303-235-2861. For fire inspections
contact the Fire Protection District for your project.
ROW & Drainage / Public Works Dept.
Floodplain Inspection (if applicable)
Fire Inspection / Fire Protection Dist.
Final Electrical
Final Plumbing
Final Mechanical
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
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: IN 0
Job Address: a f' ` 7 Y
Permit Number:
A 1,0r P u,(
❑ No one available for inspection: Time 3''� AM/PM
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: M 1t 0
Job Address: -3903, P A C.
Permit Number: ';L 0 / -7 0 -�) 5 S
e r P j V -( �
❑ No one available for inspection: Time 3'`/ AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date:- ` 1 9' /7 Inspector:
DO NOT REMOVE THIS NOTICE
IV 44
�i
k
i
CITY OF WHEAT RIDGELL`
Building Inspection Division'
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: 0
Job Address: U
Permit Number: ?,0170_365o
0
❑ No one available for inspection: Time7 ' �'�PIVI
Re -Inspection required: Yes No
When corrections have been made, call for
),10,/
re-inspection
/alt 30,3-234-5933
Date:' 3a • 7 Inspector: Gi IL*
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Commercial Roofing PERMIT - 201703550
PERMIT NO: 201703550 ISSUED: 07/10/2017
JOB ADDRESS: 3802 Parfet ST EXPIRES: 07/10/2018
JOB DESCRIPTION: Remove and replace damaged roof; 61.48 squares
*** CONTACTS ***
OWNER (720)301-7436 KEYSTONE WEST INVESTMENTS LLC
SUB (719)638-0016 Robert Maestas 170241 D&P Construction & Restoration
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 110 / Senior Living BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 34,372.00
FEES
Total Valuation 0.00
Use Tax 721.81
Permit Fee 557.05
** TOTAL ** 1,278.86
*** COMMENTS ***
*** CONDITIONS ***
In order to pass a final inspection on commercial elastomeric or similar type roofing, a
letter of inspection and approval from the manufacturer technical representative stating
that "the application of the roof at (project address) has been applied in accordance with
the installation instruction for (roof material brand name) roof covering" is required to
be on site at the time of final inspection. Effective December 1, 2014, asphalt shingle
installations require an approved midroof inspection, conducted when 25-75 percent of the
roof covering is installed, prior to final approval. Installation of roof sheathing (new or
overlay) requires an approved inspection prior to installation of ANY roof coverings and is
require on the entire roof when spaced or board sheathing with ANY gap exceeding one half
inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum
of 6 nails per shingle. A ladder extending 3 feet above the roof eave and secured in place
is required to be provided for all roof inspections. Roof ventilation is required to comply
with applicable codes and/or manufacturer installation instructions, whichever is more
stringent.
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION
City of Wheat Ridge
Commercial Roofing PERMIT - 201703550
201703550
3802 Parfet
Remove and
ST
ISSUED: 07/10/2017
EXPIRES: 07/10/2018
replace damaged roof; 61.48 squares
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 ermit. I further attest that I am ]e 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 i_ s�d�isclosed 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 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 pen -nit for, or an approval of, an violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
V.
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 insptimerequest@ei.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.
•o City of
"�Wh6atfdge
COMMUNITY DEVELOPMENT
Building & Inspection Services Division
7500 W. 291h Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(a)-ci.wheatridge.co.us
FOR OFFICE USE ONLY I
Date:
Plan/Permit #
Plan Review Fee:
Building Permit Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address: 3 62 PC P_jr-� S t- wAC"f
Property Owner (please print): , �,,;,oa Phone: ?20-'2 -7 `36
Property Owner Email: fir• h� Tc,��n . ��,
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Arch itect/Enaineer:
Architect/Engineer E-mail:
Contractor: ,0 &.1 /' "-, ectc�lsti
Phone:
Contractors City License #: 1702(-11 Phone: :2 4 - oo)A
Contractor E-mail Address:
Sub Contractors:
Electrical
W.R. City License #
Other City Licensed Sub:
City License #
Plumbing:
W.R. City License #
Other City Licensed Sub:
City License #
Mechanical:
W.R. City License #
Complete all information on BOTH sides of this form
0150,MMERCIAL ❑ RESIDENTIAL
Description of work: (Check all that apply)
❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE
❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING
❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING
❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT
❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
@,OTHER (Describe) -A gc3oF
(For ALL projects, please 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.) vvj pe jiiLo actA,,Seef C -c t, -F 4iAket,5
Ayhk4 Sh,kl /C's
Sq. FULF �i. / Btu's
Amps
Squares
Gallons
Other
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. 1, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER)CONTR CA O >
Signature (first and last name): DATE: 7—le---bo
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
Building Division Valuation: $
Framing
Insulafio4 6
Dryw all Scream,
HEALTH FACTUIJES AND EMERGENCY
c 0
MEDICAL SERvrCEs DIVISION
4300 Cherry Creek Drive South - A2
Denver, CO 80246-1530
LIFE SAFETY CODE
0
4toice: 303-692-2800 Fax: 303-753-6214
www healthfacif ifies. info
Colorado Department
of Public Health
and Environment
BUILDING DEPARTMENT
Sign off for Local Authorities
Name of Facility:
Facility Type: (Hospital, Long-Term, Care, e
Address:
Street City
Name of Contact Person: Phone: JR���-3�CFax: (JEKDD-1 q�
PIJIWOSE OF APPLICATION: Initial Ucensed Facility
(Check A L I that apply)
Change in Secured Beds From: To:
(Only a n — opt ion fo r A L R car 1, TC — Pc i1i, ties)
Change of Ownership
SLUVION B: TO HE; COMPLKYED BYTHL UTY/UOUNTY BUILDIN(i I)EPARYMENT
Building Department having Jurisdiction:
The above named facility meets the requirements of the local Authority Having Jurisdiction for the occupancy based on work
indicated in Section A:
(If "no" please explai n a_!Uarate attachment.) YES ]NO
Name of Person to Contact: —kaz412QM—;:r Phone: LAR�55��
Address: 7,5'00 a,
I?or uestion lease contact Life Safet Code intalre ersonnel 3fi3 - 4988,
Voice: 303-692-2800 Fax: 303-753-6214
www, healthfaej lities, info
.tc;'I'21 Y SP4.1 Colorado Depanment
of Public Health
ZONING DEPARTMENT and Environment
Sign off for Local Authorities
N1 I IVIN A: I V 1% k-VMrLt, I UV JJ Y I M Arrl,11-AN I
UM
Street City County
Name of
I Phone: 7. by - 7 - 7) b9 - q
)
C ontact Person: Alk&—U ""' 4p,3_ 4ax: (1__
PURPOSE OF APPLICATION: Initial L,icensed Facility
(Check all that apply)
Zoning Department having J
The above named facility meets the requirements of the local Authority Having Jurisdiction for the occupancy based on work
indicated in Section A:
(If "no" please explain on a separate attachment.) [,Sd YES NO
Name of Person to Contact: M—R—es-- Phone:
Address: 40V
VV—LA
Kis
I or uestions lease contact I fe Saf t C Cade intake ersonnel 303 -4988.
HEALTH FACILITIES AND EmFRGFNCY
MEDICAL SERVICES DIVISION
4300 Cherry Creek Drive South - A2
Denver, CO 80246-1530
Voice: 303-692-2800 Fax: 303-753-6214
www.cdphe,state.co,us/tif/hfd.asp
Contact the ciz)y or county department in your area and have the director or designee sign below. The original signed
form must be returned to the attention of Life Safety Code Plan Review Intake at the address listed above.
SECTION A: TO BE COMPLETED BY THE APPLICANT
Street City County
. I
Name of Contact Person: 4*N I [QS Phone: Fax:
77
Change of Facility Location From:
To:
Addition/Renovation Scope of Project:
� �)Ylowv-r room I
JJV, t—UMML I U) UY I 11E I-111 Y1t—k-)UJNt Y t Wh Uh FAK t NWN I
Fire Department having Jurisdiction: O N X
A�_WX MAO �
A IMOM
EgL ons lease Coontact Life Saf�e�,tCo& intake )ersonnel (AA) 69I -4QR
ar
Building Permit Application
(Complete all highlighted areas)
(please print):
Phone:
Re
,OMMENM
Ater:
W: 0 approved wl comments 0 disapproved 13 no review required f
Address
Zoniiig Property in the flood Plain?
Lot Size: sq, fl, of Width- ff
Maximurn Lot Coverage: %
Proposed It
House: sq, ft.
Addition to House: sq, ft.
Shed: sq. ft,
Detached Garage: sq, ft.
Proposed Lot Coverage. (Total) %
(-" 17 Y s q, ft,
Existing Irnproverrient(s):
House:
sq. ft.
Sh sq.
Detached Garage:
Other: sq. 11.,
sq. ft,
M
Reqrured Setbacks. FR, S S_ S xV
R
Provided Setbacks: FR, 6 S X r 'V
MaxiTTIUM ReigI)t ft
Proposed Height, ft
J
Maximurn Size A sq, ft.
Proposed Size: A'I " ,', Z,12 I sq. fl,
Access Notes
For one and two-fanuly dwellings, the first 25' of driveway area from the existing edge of pavernent into t1
shall be surfaced with concrete, asphalt, brick pavers or sunflaT materials,
L,andscaRing.Notes
For one-and two-lanaly dwellings, one tree f o r a very 70 feet of street fiontage is required,
100% of die front yard and 25% of the entire lot must be landscaped prior to issuance of CO.
Street nees required: Street trees provided:
i t s , (I
Building rt io Serv Division
75&,) W, 9 " Ave- Wheat Ridge, , CO 003
Office 303-235-2855 ' ax: 303-237-8929
inspection Request Line: 303
Property Address'
Property Ow p6nt')
Mailing Address, (if ofiff.,+e iit than prot.,)ert
A d �i��i
Contractors City License en Phone.
Date:
j Ott*
Plan #
P
Phone
Sub Contractors:' _
Itnc.. ,
t ` :.: #
City License #
City License #
r n
(Fully describe work to be performed - Attach additional sheet it necessary)
.N p '
1 o 6' , " � ratr t t wor
tot ,
Re view Fee fdu( ,, at hmrs of subnar t a=,).
t ?tt NFRiCONTR k (AtM SIGNATU 01: AND AGREEMENT
0'l ..: "*+� ?S�.,t, Pt. d4. a=atec'a, Est, rig €ka , "ti {(r;t.,, ,i.'c' dat „t,' @3Y;I$a„ hbilYi do not 6klka .b�S�"tif�,`zi�Y�{: tkF ;�d S2'vYPlt °L "a:.
.t;'c sa , ow or t # k\ he i J2v t?s t.e+� , °1a.PxtS , u,'�s��e "lt10W, or tw-,TM`Ir °)& , of dccorcj, Owl 2M ataa.'>;� ":.�t3Yti °t3ic "iRtw ��ha<r.�a� <� %std
etaa the , G � tiara:' i a, i
&c'�a at xtY. i "s�El �„ S4at a,rr � ;ai, ��,.t,[ a, Fr €k ,s$"��b� %�' 6�t�a �.. 32;b ��I �� �`_;='!t i�ta�i', �;. t:ctitar�° ;�.1 - ¢ t>S"<�S4t�3Ra. t,'4 �ta�' 41`ttP �. i #� ➢L�i'? s3Yt�' �}l� "I "�7t ;s`.'�El�.'€a �r;7t±t `t:{ <)f2
01C ,t ej, oN%nu or �tmcl hcrol rmOwci /t:'d 174 0 "k, k, iBY &l�S.`t` ea6 a'a r }t,,;a; v' to p5.rfi'T'F'!a ��3;•r" a�a °^,�s`o�b�`�� m a74k
aY5 n r der all" 'mil", irtdu(k - tt on thi to L'0mr, iqz th ; z4pp Hk :�mon,
J "itd� "t 1NIE_ � t
DEPAR USE ONLY
µ . u;vt; cw !A,1 EN` S'
Boning
ORKS tib;tON ; OCCUPANCY-
t RE 0FF Mt - , :Ns apq. r., d 1�i commoot,� „x' <%ap r`� vea t t� review r "V���t�C� FS1d9 � m
HEALTHYACHaTIES AND EMERGENCY _ - -
MEDICAL SERVICES DIvISION
4300 Cherry Creek Drive South State Licensure Program
Denver, CO 50246 -
Voice: 303- 692 -2800 Fax: 303 -753 -6214 ASSISTED LIVING RESIDENCES
www. cdplie.state.co.us/hf/hfd.asp
ZONING DEPARTMENT
Sign off for Local Authorities
Written evidence of compliance with local zoning codes must be obtained prior to issuance of a state license for
operation of a health facility. Contact the city or county department in your area and have the director or designee
sign below. The original signed form must be returned to Health Facilities and Emergency Medical Services Division .
(HFEMSD) as part ofyour application packet.
A; i V
PURPOSE OF APPLICATION:
1 ) Initial
1 1 Change of Ownership
1 1 New Secured Unit
[)I-jncrease in Beds: From 16
1 1 Change of Location: From
To 12
X910 W BiascaJ 17:T1111 ■1"
Current Name of Facility:
Proposed Name of Facility (if applicable): 0
No. of Licensed Beds Requested: a 1 iy o✓� t/
Name of Person to Contact : L 1 1 P)k)gmy"d n Phone: ( 720 ) Zx(4 1306 (7 Fax: (303)205 (DD3
TO BE COMPLETED BY THE CITY /COUNT Y LVINIIvu
Zoning Department having Jurisdiction: W M,55fr
The above -named facility meets t requirements fog approval: [�] YES [ ] NO
(If "no" please explain on 7sep Wahment. r m \
Signature: Date:
f
Name of Person to Contact: / tt(QWI l 1�71� _Pho//n--e: -- (��3) 23 5 Z$Y ax: 3�3 a7
Address: _ ���� (�✓ �i q �� l i ked / t re03 3
SECTION D: FOX HI1EfV1JD CU1y11'1. 11Vf
Initial Notification to Zoning Department by
Effective Date of License:
Final Notification to Zoning Department by _
on
on (Date)
HEALTH FACILITIES AND EMERGENCY
MEDICALSERHICISS DIVISION tiQ�
430 eh Creek Drive South State Licensure Program
Denver, CO 80246
Voice: 303- 692 -2800 Fax: 303 -753 -6214 T Department
www. edphe. state- co. us/hf/hfd.asp ASSISTED LIVING RESIDENCES Coloado Department
of Public Health
and Environment
BUILDING DEPARTMENT
Sign off for Local Authorities
Written evidence of compliance with local building codes must be obtainedprior to issuance of a state license for
operation of a health facility. Contact the city or county department in your area and have the director or designee
sign below. The original signedform must be returned to 11eatth Facilities and Emergency Medical Services Division
(HFEMSD) as part of your application packet.
H: 1 V DG l.V1V1r LG 1 GL D I 1 RL` !]l l" LIl, h11Y 1
PURPOSE OF APPLICATION: ( I Initial
]Change of Ownership
( I New Secured Unit
Increase in Beds: From 1 To 1
1 Change of Location: From
15: 1 V ish
Name of Facility: _ Aso k _lyy /
Address:
City C of
No. of Licensed Beds Requested :: / 2 [ i c d
Name of Person to Contact: �17I (pi \cl tb�t �Qx�LV� Phone: (016) 2-'70 :3R b Fax: a03 2 5— (e 03�
19N C.'VMPLE rltll 15Y 1HE C:11Y /C:VU1N I V
Building Department having
The above -named facility meets the requirements for building approval: [A] YES [ ] NO
(If "no" please explain on a separate attachment.)
I .
Signature:
l®
i 'l
Name of Person to Contact: K,Rk Phone: (3a3 �S.,7glc Fax: ( Zo_? d3S•.2857
Address: 7S25o a 7 9'2W r &e 9 —F001
22
HEALTH FACILITIES AND EMERGENCY of Wto
MEDICAL SERVICES DIVISION p
ye
e t
4300 Cherry Creek Drive South State Licensure Program
*Y
Denver, CO 80246 • lath a
Voice: 303-692-2800 Fax: 303-753-6214 ASSISTED LIVING RESIDENCES Department
cHlth
www.cdphe.state.co.us/bf/hfd.mp Colorado of Public Health
and Environment
BUILDING DEPARTMENT
Sign off for Local Authorities
Written evidence of compliance with local building codes must be obtained prior to issuance of a state license for
operation of a health facility. Contact the city or county department in your area and have the director or designee
sign below. The original signedform must be returned to Health Facilities and Emergency Medical Services Division
(HFEMSD) as part ofyour application packet.
A: TO BE COMPLEI ED B Y I HE
PURPOSE OF APPLICATION: 1 1 Initial
1 1 Change of Ownership
1 J New Secured Unit
Increase in Beds: From 10 To ~2
1 p Change of Location: From
SECTION B: TO BE COMPLETED BY THE APPLICAN"I'
Name of Facility: Aso k4~. Y&N46a-
' 1 ~r ~
Address: t t)1 uL `f C ntfy*~' e~
City
No. of Licensed Beds Requested: 2- ja",kj ~i an-a
Name of Person to Contact: Uv1 wx ~ Phone: (02-b) 27b :309 Fax: a63 2aS-
C:
Building Department having Jurisdiction: 6%r e si/.~lbr loin/f.
The above-named facility meets the requirements for building approval: fx] YES [ ] NO
(If "no" please explain on a separate attachment.)
tFIle-10
Name of Person to Contact: KtR L/ /'o~ Ti Phone: (303 )o~dS ...?g!o Fax: ,3o3 :23.x• 2857
Address: 7: 2~o w g?(77,4 ✓&E wr .erJG~ e O, - goel
22
OF'~OC
HEALTH FACILITIES AND EMERGENCY - - - - O
Q4'r - 9~
MEDICAL SERVICES DIVISION State Licensure Program °
4300 Cherry Creek Drive South
Denver, CO 80246 x • IgT6 t x
Voice: 303-692-2800 Fax: 303-753-6214 ASSISTED LIVING RESIDENCES Colorado Department
www.cdphe.state.co.us/hf/hfd.asp of public Health
and Environment
ZONING DEPARTMENT
Sign off for Local Authorities
Written evidence of compliance with local zoning codes must be obtained prior to issuance of a state license for
operation of a health facility. Contact the city or county department in your area and have the director or designee
sign below. The original signed form must be returned to Health Facilities and Emergency Medical Services Division
(HFEMSD) as part of your application packet.
O DG COMPLETED DI iiiii
PURPOSE OF APPLICATION: I I Initial
l 1 Change of Ownership
l ]New Secured Unit
LXtncrease in Beds: From D To 12,
I 1 Change of Location: From
B:
Current Name of Facility: ~ A 9W I,
Proposed Name of Facility (if applicable):
~g
Address:
st
ed:
No. of Licensed Beds Reque
aL1 1~0 W
~2_
es
r
Contact:
t
f P
/
Pal l~t~V~u n~9~✓~ Phone:
(72D ) Z763C6(7 Fax:
(303) 2oS'Co
erson
o
Name o
TO BE COMPLETED BY THE
Zoning Department having
The above-named facility meets
(If "no" please explain on a sepf
Name of Person to Contact: n a.N/1 i
Address: 7-~-<oo W. xqfpi
approval: YES [ ] NO
2AI v
L 23S•zQy ax: 303 23S Qi7
FOR
Initial Notification to Zoning Department by
Effective Date
Final Notification to Zoning Department by
on (Date)
on (Date)
♦ A i CITY OF WHEAT RIDGE
Building Inspection Division
6,011111111111111 (303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: _1r&e1AZ
Job Address: .3So2 PAR)c2~7-
ST•
Permit Number: 4114
//OCkF~Se ~F/~S Ff1om /d ro 12
AP~~1/Ed
❑ No one available for inspection: Time F'd AM~
Re-Inspection required: Yes No
"When corrections have been made, call fforrrre-inspection at 303-234-5933
Date: 311ello Inspector:
~eA,P
DO NOT REMOVE THIS NOTICE
8o Z I~a.C~C~ C_Z'3~
February 12, 1997 A1-100
~ Fire-LireOaLarms Ms-9200(c)
~ incorPOraTeo Addressable
Fire Alarm Control Panel
Section: Addressable
GENERAL
The MS-9200 is a compact, cost-effective, addressable
fire alarm control panel with a capacity of 198 Fire•Lite
300 Series devices. A single Signaling Line Circuit (SLC)
loop supports up to 99 smoke detectors and 99 control or
monitor modules. The panel uses surface-mount technol-
ogy and is designed for ease of installation and program-
ming. It eatures the latest in fre protection technology,
including maintenance alert and automatic detector test.
MEA
76-94
(MS-9200 & M302)
3-94-E
(M300, M307,1300,
SD300, CP300)
326-94-E
(S0300T C304)
u~ FM
OX9A3.AY
5624
(MS-9200, CP300,
SD300, BG-10LX,
M300. M307, M302,
FEATURES
• SLC supports up to 198 addressable devices (99 detec-
tors and 99 monitor or control modules).
• SLC can be configured for Style 4, 6, or 7 operation.
• Dual Integral Notification Appliance (bell, signal) Circuits
(NACs), Sryle Y or Z(Class B or A).
• 3.0 Amp Notification Appliance (bell, signal) power, ex-
pandable to 6.0 Amperes.
• NAC's may be programmed for Steady, March Time,
Temporal or California Code (requires software P/N
73750 or greater).
• Alarm, trouble and supervisory relays, standard.
• Maintenance alert wams when smoke detector dust
accumulation is excessive.
• Optional UDACT-F Digital Alarm Communicator reports
56 zones or 198 points to a Central Station.
• Optional LCD-40 alphanumeric, 40-character, backlit
remote serial annunciators operate over hig h-speed EIA-
485 port. Up to 32 may be supported by MS-9200
(requires sokware P/N 73750 or greater).
• Optional printer interface - UL listed for permanent
attachment.
• Integral 40-character LCD display with backlighting.
• Keypad programmable on panel, with lwo user-defined
passwords, plus an Autoprogram feature.
• Custom English labels per point may be manually en-
tered or selected from an internal library file.
• Autoprogram and Walk Test features identify 2 or more
devices set to same address.
• Real-time clock/calendar.
• History file with 500-event capacity.
• Waterflow or supervisory selection per monitor point.
• System alarm verification, smoke only.
• Presignal delay option per NFPA 72.
• Silence Inhibit and Auto Silence timer options.
• Battery charger for up to 60 hours of standby power.
• Fuseless,power-IimitedtechnologymeetsnewULpower-
limiting requirements, effective May 1, 1995.
California c304, isoo)
State Fire (RequiresOP-9200)
Marshal OY6A3.AY(so3007)
7165-0075:156
QLC) (MS-9200)
7300-0075:159
(M300, M301,1300, C304)
CS68 7300-0075:162
(MS-9200) (M302)
7272-0075:172
(SD300, SD300T)
• Rapid poll algorithm for manual stations. Responds to
alarm/activation in iess than two seconds.
• Operates with untwisted, unshielded wire (up to 1,000
feet) for retrofit applications (U.S. Patent 5,210,523).
• 300 Series addressable devices feature decimal address
selection. Address of each device can be easily set in the
field by use of a screwdriver. Smoke detectors also
feature a plug-in wiring connector for ease of installation
and serviceability.
• RemoteAcknowledge/Silence/ReseUDrillviaM300mod-
ules.
• SLC loop maximum length 10,000 ft. @ 12 AWG.
This tlocument is nol intended to be usetl for installation purposes. We lry to kee0 our
producl informalion up-to-date and accurate. We wnnot cover all specifc applications or ISO-9001
anticipate all repuirements. All specifications are suEject Io change wilhout nolice. For Engineefing end ManUfactUfing
more information, contacl Fire•Lite. Phone: (203) 484-7161 FAX: (203) 484-7178 Qualih/ System Certified fo
~ FIfELiTB'AL8ffT15 72 Ciintonville Road, NoM1hfoM, Conneclicut 06472 International Standard ISO-9007 Maae in the U.S.A.
rca.or..eo
DF-57276 - Page 1 of4
COMPATIBLE ADDRESSABLE DEVICES
S6300(A) Addressable Photoelectric Smoke
Detector. Includes mounting plate and
plug-in wiring terminal block.
SD300T(A) Same as SD300, plus a 135°F thermostat
heat detector.
CP300(A) Addressable lonization Smoke Detector.
BG-10LX(A) Addressable Manual Station based on the
popular Fire•Lite BG-10L dual-action
station.
M300(A)
Addressable Monitor Module for one zone
of normally open dry contact initiating
devices. Mounts in standard 4" box.
Includes plastic cover plate and end-of-
line resistor. Features polling/alarm LED
and decimal address switches. May be
configured for either Style B(Class B) or
Style D (Class A) operation.
M301(A)
Miniature version of M300. Excludes LED
and Sryle D option. Connects with wire
pigtails. May mount in device backbox.
M302(A)
Similar to M300, but may monitor up to 20
conventional 2-wire detectors. Requires
extemal 24 VDC power. (Consult factory
for compatible smoke detectors.)
C304(A)
Addressable Control Module for one Style
Y/Z (Class B/A) zone of supervised
polarized Notification Appliances, or may
be configured as a dry contact (Form-C)
relay rated at 2 amps. Mounts in standard
4" box. Features polling LED and decimal
address switches. Notification Appliance
Circuit option requires external 24 VDC
power. (Consult factory for compatible
Notification Appliances.)
1300(A)
This module isolates the SLC loop from
short circuit conditions (required for Style
7 operation).
Note: A" suffix should be included only when ordering
ULC listed units (e.g. SD300A, M300A).
COMPATIBLE ANNUNCIATORS
LCD-40: 40-character; backlit LCD fire annunciator ca-
pable of displaying English-language text (requires DIM-
485).
AFM-16ATX1AEM-16ATF: The AFM-16ATX displays
alarm and trouble for 16 zones. Expandable to 64 zones
using up to three AEM-16ATFs. The first four switches
from one annunciator may be used to remotely acknowl-
edge, silence, reset, or to perform drill function. Serial
remote annunciator modules may be located up to 6,000
feet from the panel.
AFM-32AX/AEM32AP: Alarm-oniy indication by zone,
with 32 alarm LEDs per module. AFM-32AX may support
one AEM32AF for a maximum of 64 zones.
AFM-16AF: Alarm-only indication by zone, with 16
alarm LEDS and common trouble LED. Mounts to stan-
dard 4-gang box only.
Note: For additional information on AFM/AFM-X Series
annunciators and 6ackboxes, please re(er to the AFM/
AFM-X datsheet, Document DF-51465.
LDM Graphic Annunciator Driver: LDM-32F and
LDM-E32F inay be used for custom graphic annunciators
which may be located up to 6,000 feet from the panel.
PIELD-PROGRANIMING FEATURES
OfT-Line Programming: Create entire program in
your office using a DOS-based PC computer (order pro-
gramming kit PK-9200 separately). Upload/Download
system programming Iocally to the MS-9200 in less than
one minute.
Auto-Programming: Command the MS-9200 to pro-
gram itself (takes less than 30 seconds). In the Auto-
Program mode, the MS-9200 scans for all possible de-
vices at all addresses, stores the device types, and ad-
dresses found, and then loads default values for all op-
tions (General Alarm). It also checks for two or more
devices set to the same address.
On-Line Edit: While still providing fire protection, the
MS-9200 may be programmed from the front panel. Sim-
ple menu trees displayed on the LCD allow the trained
user to perform all functions without referring back to the
programming manual.
English Label Library: Quickly select labels from a
standard library of more than 50 adjectives/nouns, such
as "FLR 3 HALLWAY," or enter custom labels letter-by-
Ietter. Use recall function to repeat previously used label.
Program Check: Automatically catch common errors,
such as relays not linked to any zone or point.
MAINTENANCE ALERT
The MS-9200 continually monitors each smoke detector
and responds to a reading of 80% of the detectors alarm
threshold. If the detector continually reports an 80%
threshold reading (8/10 of what is required to be an alarm
condition) for 24 hours, a trouble condition is created.
This reduces the risk of false alarms due to dust and dirt
by alerting a trouble (maintenance) condition rather than
initiating a false alarm.
AUTOMATIC TEST OPERATION
The MS-9200 performs an automatic test of each detector
every 2 hours. Failure to meet the test limits causes an
AUTO TEST FAIL trouble type. System Reset clears this
troubie.
NFPA STANDARDS
The MS-9200 complies with the following NFPA 72-1993
Edition, Fire Alarm Systems:
• LOCAL (Automatic, Manual, Waterflow, and Sprinkler
Supervisory).
• AUXILIARY (Automatic, Manual, and Waterflow) (re-
quires RTM-BF).
• REMOTE STATION (Automatic, Manual, and Water-
flow) (requires RTM-8F or UDACT-F).
• PROPRIETARY (Automatic, Manual, and Waterflow).
• CENTRALSTATION(Automatic,Manual,andWaterflow)
(requires UDACT-F).
DF-51276 - Page3of4
Features
. • 24 vott strobe models: 15. 15/75, 75 and 110 candela • Universal mounting plate included with each unit
• 12 volt ;vobe models: 15 and 15/75 candela • One screw mounting of strobe and horn/strobe to mounting
• Horn models operare on 12 and 24 volts ptate
• Low cuaent draw: reductions as high as 45 % • SpectrAlert strobe and hom/strobe take up zero room in the
•'IWO field selectable/reversible hom tones back box.
- 3000 Hz Interrupted
- Electromechanical
• Field selectabte/reversible high-low dBA output on horn
(low outpu[ on 24 volt models only)
- 101 peak dBA Q 10 tt. high output'
- 96 peak dBA p 10 ft. low output`
• Field selectable/reversible temp 3 pattem or non-temp 3
mntinuous pattern on hom
• Horn/stro6e can be wired either in tandem or independently
• Single gang mounting without the use of a mounting plate
(horn model only)
• Self-contained screw covers
• Aesihetically pleasing design
• Synchronize horn and strobe with Sync•Circuit" module
• Silence hom on horn/svobe over a single pair of wires using
SynrCircuit madule
' Sound output varies with rone and output op[ions selec[ed; sound
levels based upon anechoic room measurements.
Specifications
Inpu[ terminafs: 12 to 18 AWG Mounting: 4" x 4" x 1'/2' or
Size of strobe and 2" x 4" x I'/s" standard boxes
horn/s[robe wi[h Operating temperature: 32° to 120° F(0° to 49° C)
universal plate: S" x 55/e' x 215/1e° Voltages: 12 or 24 VDC and
Size of strobe and FWR unfil[ered
horn/strobe with Operating
small footprint plate: 31/a" x SS/s" x 25/16° voltage range'": 12 V, 10.5 - 17 V
Size of horn with 24 V, 20 - 30 V
universal mounting pla[e: 5' x 55/a " x 15/1e' " These products should be operated within their rated voltage range;
Size of horn without UL does, however, test functional integrity to -20% and + IO% ot
manufacmrer's stated ranges.
mounting plate: 215/16" x 551 16" x 15/1e"
Weight, horn only: 7,2 oZ,
Weight, strobe and yL U I`' 0. F M MEA
horn/strobe: 8.8 oZ. L approved
vvAweo
° Sysrem Sensor 4/97 This document is no[ inrended [o be used (or installuion purposes. A05-936-02
BG-10LX
Addressable Manual Pul I S[ation
GENERAL
The BG-lOLX is an addressable manual pull station with a
key-lock reset featwe. It provides the MS-9200 with one
addressable alarm inidating input.
FEATURES
• Highly visible.
• Easily operated (Dual-Action).
• Attracfive shape and textured finish.
• Semi-tlush, mounts to a standard single-gang (2.125" min.
depth), double-gang, or 4" square electrical box.
• Operates with or without a crush tube.
• Handle latches in ihe down position to clearly indicate the
sta[ion has been operated.
• Key reset.
• Screw terminals for easy connection to SLC Loop Chan-
nel.
• Optional trim ring.
CONSTRUCTION
• Shell, door, and handle are molded of durable LEXANm
with a textured finish.
• 16 gauge steel back plate.
OPERATION
Pulling the handle down causes it to la[ch in the down
posiaon. The handle is restored manually by using a me-
chanical key which allows the top of the case to pivot
fonvazd and the spring-loaded handle to return [o i[s nortnal
posidon. The case can then be pivoted back to its nortnal
position and secured with the key.
Each manual station, on command from the convol panel,
sends data to the panel representing the state of the manual
switch. A pair of rotary decimal switches allows [wo digit
address-setdng.
PRODUCT LINE INFORMATION
Mnde1 Descriotion
13G-TR ..............Optional trim ring. 6 1/2" High, 5 1/8"
Wide, 5/32" Deep.
SB-10 Surface back box.
&Firelffe'Al_arm12 sClintonvilleRoad
Northtord, CT 06472
uicoraoraTeo Phone:(203)484-7161
FAX: (203)484-7118
O Calitomia
L State Fire
Marshal
7150-0075:103
S711
The BG-IOI.X
Addressab[e Manual Pull Station
ISO-9oo,
Engineering and Manufacturing
Oualiry System Cerofied [o
Intema6onal S[andard IS69001
DF-51366
PaBe 1 of 2
July s, 1994
SD300/SD300T
Addressable Photoelectric Detectors
GENERAL
The SD300 and SD300T Addressable Photoelectric Detec-
[ors are used wi[h the FireLi[e MS-9200 Addressable Fire
Alarm Control Panel. Since these detectors are addressable,
they will help firemen to more quickly locate a fire during
i[s eady stages. The SD300T offers the same features as the
SD300 with the addition of a 135° F internal [hermal
element.
FEATURES
• Unique op[ical sensing chamber.
• Optional integral 135° F. (58° C.) fixed temperamre
[hermal de[ectoc (SD300T)
• Superior signal-to-noise ratio.
• Stable photoelectric operation.
• 1.6% nominal sensi[ivity for panel alarm Ihreshold level.
• Fully coated circuit boards and superior RF/transien[
protection.
• Addressable by device.
• Direct DECADE 01-99 entry of address.
• 2-Wire loop connec[ion.
• Visible LED "blinks" every time the uni[ is addressed,
and illuminate steady on alarm.
• In[egral communica[ions and built-in device type iden[i-
fication.
• Compact, stylish design.
• Built-in func[ional [es[ switch activa[ed push-in pin type
switch.
Califomia M EA
State Fire
Marshal
72 0075:157 3-94-E(SD300)
72
S1059 (SD300 only) 326-94-E (SD300T)
• Low standby current.
• Listed to UL-268.
• Built-in tamper-resistant feature.
• Designed for Direct Surface or Elec[rical Box Mounting.
• Sealed against back pressure.
• Removable terminal bbck.
• Easy wiring via removable 6-pin terminal block allows for
detector to be removed from system without loss of power
to remaining loop.
• Mounts ro single gangbox, a 3.5" or 4" octagonal box, a 4"
squaze electrical box by using a plaster ring.
• Plugs inro separate base for ease of installation and main-
tenance.
• 94-VO plastic flammability rating.
• Removable cover and insect screen for field deaning.
• Remote LED output connection.
12 Clintonville Foad ISO-9001 oF-stszo
~ Fire~uTe a~arms Northfofd, CT 06472 Engineering and Manufacturing Page 1 012
If1C01'P0r8T@D Phone: (203)484-7161 Quality 5ystemCertifiedto danuary 24,7995
FAX: (203) 484-7118 Inremazional Standard ISO-9001 Matle in ihe U.S.A.
~ FII'e•LIT-G''ALaf"I'71S
incorPOraTeD
HD-600
Heat Detectors
Catalog Section: Conventional Initiating Devices
October 20, 1995
GENERAL
The FireLite/Notifier HD-600 Heat Detector is attractive and du-
rable, and features combination rate-oi-rise and fixed-tempera-
ture detectors. Heat detectors are available in 135°F and 200°F
temperature ratings.
Rate-of-rise elements detect heat by quickly responding to rapid
temperature increase. HD-600 detectors use the same reliable
pneumatic rate-of-rise element used in former models, but offer
added aesthetic appeal. The pneumatic rate-of-rise element
responds to a rapid rise in temperature, approximately 15°F
(8°C) per minute, by expansion ot air within the sealed chamber
faster than it can escape through a calibrated vent. The result-
ant increase in pressure depresses the diaphragm, causing the
electrical contact to close the circuit. HD-600 rate-of-rise units
have a wide spacing allowance of 50-foot centers. See Specifi-
cation Table for details.
Fixed•temperature elements react to heat by responding to a
specific temperature setting. The fixed-temperature element
uses a fusible alloy. When activated, the external heat collector
drops away to provide quick visual confirmation that the element
has operated.
The units protrude only 1-3/8" from the ceiling surface with a
junction box mounting. They have pleasing contours and an all-
white finish that conforms to ceiling aesthetics.
FEATURES
• Rate-of-rise and fixed-temperature.
• One- or two-circuit, normally open.
• Easy installation.
• Low-profile design.
• Visual indication.
• Operation testing.
INSTALLAiION
Each detector includes a patented reversible mounting plate. In
one position, it easily attaches to a 3-1/4" octagon box.
In reverse, the plate can be used for open wiring without a
junction box. A 1/4" space between detector and mounting
surface allows tor wire connections. Ali mounting screws are
concealed.
The detector attaches simply to the mounting plate with a push
and twist motion. No special tools are required.
° The mounting plate is molded of white self-extinguishing thermo-
plastic rated at 105°C. The plate is extremely strong, yet adapts
to uneven mounting surfaces.
UL
~
52517
ON3A8.AY (HD621, HD601/HD602)
OF4A3.AY (HD603/HD604,
m HD622/H0623, HD624)
Cal'rfomia
~ State Fire
Marshal
7270-0075:168
MEA
U~~ (except HD602250-94-E
and HD622)
JuncNon Box Mountlng Celling Surlace MounNng
E.a~~
34/4' Outlet Box
e-32'
Round
Head
Screws
5,8 ro i•
s-92-
Flat
Head
waoa
Screws
Wa [ry to keep our product inlorma[lon up-to-tlate antl accurate. We cannot cover all specific i$0-9001
applicalions or anlicipate all requirements. All specifiCalion5 are sublact to change without Efl ineerin and Manufacturin
notice. For more information, contaq FirrLib. Phone: (203) 4847161 FAX: (203) 484-71 iB 9 9 9
Ouality System CeRified to
~FIf2L1T@'ALBrMS 72 Clintonville Road, Northlorq Connacticut 06472 IntematiOnal Standard ISO-9001
nco,.o,.,eo Maaa m me us.n.
CuflorsuAece Reversible
moun6ng-7 Mounting
~ FII'e•LITe° ALaI'I'Y1S
incorPOraTeo
MS-9200
Addressable Modules
July 28, 1995
~ California M EA
State Fire
Marshal 3-94-E (M300. M301, 1300)
OY2A3.AY (M300) ~ 7300-0075:159 16-94-E (M302)
0Y4A4.AY (M301) 52424 CS68 (M300, M301, 1300, C304) 326-94-E (C304)
0Y1A1.AY(M302) 7300-0075:162
0V2A3.AY (1300) (M302)
OY6A9.AY(C3041
C304
Gonfrol Module
The Fire•Lite C304 Control Module
is used with the MS-9200 to provide
Q O~O O
0
a Style D(Class A) or Style B(Class
B) Notification Appliance (Signal)
p
Circuit (NAC). Alternately, the C304
may be converted to an address-
able Form-C relay by removing a
break off tab. The C304 may be pro-
~ O O O
grammed to operate dry contacts for
door holders, Air Handling Unit shut-
C304
down, etc., and to reset 4-wire smoke
detector power.
Fealures:
• Internal circuitry and relay powered directly by 2-wire SLC
loop. NAC configuration requires second loop for Notification
appliance power.
• Integral LED blinks each time it communicates with the MS-
9200 and latches on in alarm.
• Mounts in standard 4-inch square (2-7/8" deep)junction box.
• Direct dial entry of decade address (01-99).
Specificaf ions:
Operating voltage: 75-28 VDC (Peak).
Maximum current in alarm: (refer to the MS-9200 Technical
Manual).
Standby current: 200 UA maximum.
Contact rating: 2.0 amps 0 30 VDC (resistive).
1.0 amp 0 30 VDC (inductive, 0.6 PF);
0.3 amps @ 110 VAC (0.35 PF);
0.6 amps @ 30 VDC (pilot duty, 0.35 PF).
Temperature range: 32°F. to 120°F.
Relative humidity: 10% to 95%.
Weight: 150 grams (5 oz.).
Ordering Informafion:
C304 Addressable Control Module.
C304A Addressable Control Module, ULC Listed
SMB500 Optional surface mount backbox.
1300
Faulf Isolator Module
The 1300 Fault Isolator Module is ~ C
used with the MS-9200 to protect
the syslem against wire-to-wire
short circuits on the SLC loop. The
1300 should be placed between
each device on the SLC loop, to
isolate a short-circuit problem be- (D
tween the modules. It is required ~ C
for true Style 7 operation so that
other devices can continue to oper-
ate normally in the event of a short-
circuit on the SLC.
~O O
a
O
0
0 O O
1300
Feafures:
• Powered by SLC loop directly, no external power re-
quired.
• Mounts in standard 4-inch square (2-1/8" deep) junction
boxes.
• Integral LED blinks to indicate normal condition. Illumi-
nates steady when short circuit condition is detected.
• High noise (EMF/RFI) immunity.
Speeificafions:
Opereting voltage: 15-28 VDC (peak).
Maximum current upon activation due lo short circuit: (reter to
the MS-9200 Technical Manual.)
Standby current: 400 NA mauimum.
Temperature range: 32°F. to 120°F.
Relative humidity: 10% to 95°/a.
Weight: 150 grams (5 oz.)
Ordering Informafion:
1300 Isolator Module.
1300A Isolator Module, ULC Listed
SMB500 Optional sur(ace mount backbox.
We Iry m keep our pmduct infonnalion up to daie and eccurele. We cannot wver all specifi< I$Q-9001
applications or amicipate all requiremen6. All specifcations are subjea ta chauge wilhom nolice. For Engineering and Manufacturing
more informaiion, contact Fire•Lite. Phone: (203) 4844I6I FAX: (203) 484-7 I18
Quality System Ccrtificd lo
~Flf@-LITB' AL2ffY'IS 12 Climmnville Road, Nonhford, Connecticut 06472 Inlemalional Slandard ISO-9001 Made in tne 11.S.A.
ncorron*eo
Western States Fire Protection Co.
iA 7@6 South Tucsnn ~~'ay
ittnglewo6d Colorado %(1112 (303) 792-0022 (}03) 192-9049FAX
Fire Pmcection Systems
Dcsign • fabrication • Installation
CoinmcrcWl ~ InduaviW • Rc~idcnlinl • In:lilulional
5p;(r.J hlvza~Js • I liyh Tcch • Dclnnc • I Inng:n'n
Itulnd'ii • tiercicc • Inepcaian • htaimm~:uxe
pctober 15, 1997
Mr. Dave Roberis
Wheat Ridge Fire Dcpartment
3880 Upham Slreet
Wtieal Ridgc, CO 80034
Re: Asltley Manor Care Center
Dear Davc;
Cnclosed is a revised drawing of Ulc fire sprinkler riscr assembly.
This assembly has bcen rclocated to the off~ce on thc main levcl adjacent to the porch. I have spoken with
Gan Davis, tlte contraaor, and he will providc a doset in the office with bi-fold doors for access to 1he
riser.
An auixiliary drain has bean added to the main in Ibe crawl space fot maintenance and draining.
IC you have any quesuons please contact me at yow convenicnce.
Sincctely,
Alan Bruch
Projec[ Manager
encl
cc: Mike Rothmier _ Wes[ern States Fire Protection
g
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ASHLtY MANUK " ~~K
SBiH Q p,tFE7
wF+EAr RiocF, co
CONTRqCT NO: 94528 SCALE: 1~4•~7'-p'
DRAwN By: /L BRUCH DRqWING UMBER
OATE: 'p_15_ N
9) 94326At
rrestern ZJLaLes
Fire prot~e . tion Co.
EnB28 South
zrQdo w lew 2
Te1.:.303 o e°° a
-7gy_ 8011
Color Fax: 303-782_pp48
~ ndb 3lef. e_ . .
DEARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : 6263
r" ` UILDING iNSPECTION bNIS10N - 235-2855
CITY OF WHEAT RIDGE Date : 11/21/97
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Property Owner : .
ProperlyAddress : 3602 PARFET ST ` Phone : 377-4580
Contractor License No. : 17665
Company : Universal Development, Inc. Phone : 423 2466
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
1 herebX ce ~Y that the aetbadc distances propoa
and do not vblate opplicabb ordinances, rulea or
covenanb, easements or rcstrictiona of reco N
made aro acairete; that I heve read and a r M
application, and that I essume full respon ~ h
Code (U.B.C.) and all other spplicabb at id
(OWNER)(CONTRAGTOR)
Description :
6' PRIVACY FENCE
Constructiort Value :
Permit Fee :
Plan Review Fee :
Use Tax:
Total
$100.50
$0.00
$60.00
$160.50
BUILDING DEPARTMENT USE ONLY
SIC : Sq. Ft. :
Approval : SM 11120187 PROPOSED FENCE WILL BE LOCATED OUTSIDE OF SITE
Zoning : R-2 TRIANGLES (AS SHOWN ON PLAN)
Approval
Approval :
Occupancy : Walis : Roof : Stories : Residential Units :
Electricat License No : Plumbing License No : Mechanical license No :
Company : Company : Company :
Expiration Date :
Approval :
.
(1)
(2)
(3)
(5)
(8)
inspector
Expiration Date : Expiration Date :
Approval : Approval :
I n
with the provislonsaet forth in yopur eppliCaUOn end is subject to tlhe laws of ihe Ste(e of Cobredo entl M the Zoning
~at Ritlpe~ Cdoisdo M a'ry otlier appliceWe ortlinances M e Ctty.
autlw~iteA k not comrtre~rced wNhin sbdy (60) daya hom iesue dale or (8) tlhe building autlwized is suapended a
fl ~engas are ~de a auspenebn or ~ aba ~rMonment
ny e8U~S~N~Sbn ~or sb~anG ~t ~has irot exceed~ ~ are Iy(~u9ear. d' P ~
I~ IOf B IM~Vpe Iflill.
Ihat will dwnpe the netural flow of water eausinp a drainage proWem.
pector twantyfour (24) twurs In advance far aIl mspedions and shall recehre w~iGen approval on Inspeetlon cartl befae
ttM ~b.
ral o(d~awings andapeciReatlons aMall nM be constnced m be a pertnk for, nw an epprovel of, arry Wola6on W the proNabna
nBpce, lew, Nle a reWlatbn. .
PERMIT VALID QNLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
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DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number :
- BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE Date :
7500 WEST 29TH AVENUE .
WHEAT RIDGE, CO 80215
PropertyOwner:~file ~4nc~ ~VV~ fevS
PropertyAddress: ?i5>'c2 Phone~~c8~~7~-Siss3n
Contractor License No. : 176 4 S
Company : lA h~ Su ~(~e ~ e lo~,~,~'~ Phone : y'~3 s?y~~
g9fl' ~A6 7-,~46; le
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify lhat the setback distances proposed by this pertnit appliwtion are accurate,
and do not violate appliwble ordinances, rules or regulations ot the City t Wheat Ridge or
covenants, easemenls or restriUions of record; that all measuremenis s wn, and aliegations
made are accurete; that I have read and a9 e to abide by ali condition printed on this
application, and lhat I assume full responsi liry for compliance Wheat Ridge Building
Code (U.B.C.) and all other appliwble t Ridge ordin~~ce~ wo~under this pertnit.
(OWNER)(CONTRACTOR) SIGfF~~YG~~ DATE -?d
Description : V~ ~'Yt r ( - pt~5+1^C II:0' e L
r~JtiC~ f fnCe_ Q$
Construction Value : S ooa , ua
Permit Fee :
Plan Review Fee :
Use Tax :
Total :
Cle r 5 F'c'* c lt4
BUILDING DEPARTMENT USE ONLY
mlffmft-I I1/m/4Q- SIC : Sq. Ft. :
APProval:~n.i- t~t loea4e~ dwtS~6+-~ a~fe--+'e-ia'
Zoning :t2- ' p
lulfding'Cbments':7 ~an sk,.ri..l-n o~
Approval :
;Qbl
Approval :
Occupancy : Walls : Roof : Stories : Residential Units :
Electrical License No : Plumbing License No : Mechanical License No :
Company : Company : Company :
Expiretion Date : Expiration Date : Expiretion Date :
Approval: Approval: Approval:
im [P1~~ffam 0 iei~aqairWW ~ 92028auttsa~
(t) TTis pemut was Issued in accortlance wiVM Vro proWSbro set forth in yopur aODliation anE la suEjM to Ne laws of tne Stale of CoWnEO and W Ne Zonin9
Regulallana and BuilAing Cotle of Wheat Ridge, Cobndo a any oUer applitaMe oMinarices ol the Ciry.
- (2) TTis pertnil sMll expm B(A) Ne wo(k auNOnzetl n not commencetl wiNin wety (BO) days hom Issue Eate or (8) Na CuiMing auNaizeO is suspentled or
a0andoixE for a parbE o1120 Oays.
(3) I( tNs pertnit ezpims, a new permil may be ecquired lor a fee of one-lulf Ne amount nortnaly requireQ Orovided ra Uangea have Ceen or will be maEe in Ne
Onginal plans anC spatiflcatbnf arM any suspensbn or a0an0anmenl lus nol exueEetl one (1) year. I/ chanqes are maCe or if suspension w a0andonmenl
exceeCS ona (1) year, NII fees slwll be paid lot a new permit.
(4) No work of srry manner sMll be Cone Uiat will changa Ihe naWral flow ol water causing a d2inage DroGem.
(5) Contractw sAall rrolify Me Builtlinq Inspector twenry-lour (21) hours in aCVance Iw all inspections and shall receive wntlen approwl on inspection wrd 6elore
proceeEiinq wiN successive p~aaes ot Ue'a0.
(6) The Iasupertnit w Ne ap0mv t o~drewings and specillwGons shall not be mnslrued to be a permit for, nor an approvai o( arry violation af the provisions
of Ne E lalnq ea w any olner ortl' ance, law, rula or regulatian.
/
C' t-Eluilding Inspecto For Mayor
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
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PEXMIT NUMBER
BP;F 97-5618
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Personal Printer/Faxlfopier
Fax Log Report for
DEVREVFAX
303 235 2857
Dec-22-97 09:01 AM
Identification Rrsult Pa¢es Tvce Datc Time Duration DiaPuostic
912083778310-120 OK 01 Sent Dec-22 08:59A 00:02:14 002184230020
].AO
COMPLETEIENGINEERING 2796350
Po3f-it° Fax Note 7671 Dsee ~
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COMPLETE ENGINEERING SERVICES, INC.
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Fax
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t- l)2 37
PROJECT NO: 96-3935
BCTILDER: DATE: August 15, 1996
Universal Development
P 0 Box 1061
Arvada, CO 80001-1061 AZ"PN: Mr. Gary Kraft
SWECT: Foundation Footing Inspection
LOCATTON: 3802 Parfet Street, Haas Subdiviaion, Wheat Ridge,
Colorado
Foocing Erame construction at the aubject location was observed and
found to be conducted in compliance with the referenced plans and
accepted footing construction standards.
Reference:
Soils:
Engineer CES.. project No. 96-3935
Foundation:
Engineer KLP Project No. Aehlev Manor
Reinforcing Steel: Total Bars 2 Size 4 Grade 60
Inspected By: SM/EDF
Approved Hy:
Edward D. Ford, P.E.
912 1WELFTH STRFET • GOLDEN, COIORADO 80401 a (303) 27&6418 • FAX: 279-6350
DATE:
T0: PUBLIC WORKS DEPARTMENT
FROA7: Building Depar,tment
RE:
The property at ~902- has been
signed off by the Building DepaAment and is ready for a CO
inspection.
Once the inspection has been completed, please inform the
building department as to the status.
Thank you.
PUBLIC WORKS APPROVAI, ~ r • _abil!
Remarks:
DATE:
A CERTIFICATEOO~ OCCUPANCYY AS B~EN REQUESTED FOR:
3 0 F L l~
raG p He
PURPOSE OF STRUCTURE:
Suilding Dept. Approval:
Remarks: Zoning Approval:
Remarks:
iNSpECTIC)NS oL
_ , Jt IViADE UIVLESS
THIS CARD IS POSTED ON THE BUILD!NG SITE
HOURS NOTICE REQUIRED FOR ENSPECTIONS
WHEAT RIDGE, COLORAt30
7500 WEST 29th AVENUE (303) 234-5933
INSPECTIO'N RECORD
JOBADDRESS ~ RpV0-K ~ e'{" S I
G ~jyPE oCCUPANCY
I
BUILDING PERMIT N0. !7" J G~ I cY DATE ISS~U}ED
OWNER n /-L 7 +-l~c- ~)r11 n - 2 C ~ 2 E t 9~ E' r"3 I
CONTRACTOR j~L}j I u t~ Y 5 C1 ~ `J L~ rif2 J'J1S=v' t
SETBACKS fROM PROPERTY LINES: NORTH SOUTH
EAST
WEST
INSPECTOR MUST SIGN ALL SPACES PERTAINING TQ ?'HIS JOB
INSPECTION DATE _ _~NSPECTOR
Foundations
Footings
Caissons
Reinforcing or Monolithic Q. .
°
6
Weatherproofing f
y
a - -
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
Slab
Electrical
Plumbing (Ground Work)
Heating (Ground Work)
DO NOT POUR FLOOR UNTIL ABOVE HAS Ii~EN 51GNED
Rough Electrical
~ -
Rough Plumbing
Air Test Gas Piping ,
G
G
Rough Heating & Ventilation p. (
ian.,vo muct he sioned nrior to framina insveotionl ~
Framing
Insulation
Drywall nailing
Roofing
Refrigeration
Electrical underground
7
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-
Final
Electrical
Plumbin
a G 47
~
Heatin & Ventilation 2&
Frame - - 7
-tl
-
R.O.W. & Drainage
Fire Department
Parking 8 Landscaping
~
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE Ur
OCCUPANCY IS ISSUED
PROTEC` ` .-'IS CARD r - `'HF • 'p
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DEPARTMENT OF PLANNING AND DEVELOPMENT
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215 -
Property Owner : A ssis-~~d Ll v)tiS C~ke -
Property Address : 3 2r°~ S t
Contractor License No. : 171) 7 g
Company : S c, 7 S y s~~-~--, s
Building Permit Number :
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certity that the setbaek distances proposed by this pertnit application are accurate,
and do not violate appliwble ordinances, rules or regulations of the Ciry ot Wheat Ridge or
covenants, easements or restrictions ot record; that all measurements shown, and allegations
made are accurate; that I have read and agree to abide 6y all conditions printed on this
application, and thal I assume full responsibiliry for compliance with the Wheat Ridge Building
Code (U.B.C.) and all other appliwble Wheat Ridge ordinances, for work under this permit.
(OWNER)(CONTRACTOR) SIGNED ',Nbl DATE ) I
~
Description : 1 r.~ Q r O-k 1 a M IN ",.k cH"i
ZBTiT _.~.`if9mbfr~.. mmm
Approvai:
Zoning :
eu-ira ni-9 cbMffffFn-tgl
Approval:
PUtiI
Approval :
Occupancy : Walls
Date : a" 17
Phone :
Phone : 417 7 SSOa
ConstructionValue: i050no
Permit Fee :
Plan Review Fee :
Use Tax :
Total: BUILDING DEPARTMENT USE ONLY
Roof : Stories
SIC : Sq. Ft. :
Residential Units :
Plumbin9 License No : Mechanical License No :
Electrical License No :
Company :
Company :
Company .
Expiration Date ExPiration Date : Expiration Date :
:
Approval : Approvai : Approval :
it I&3Rm n rP.lM!RSCO [~UU~I ~ rimism ~
(1) This permit wu baued in accatlarce wim the prohstans mt bM in ycCut aDdicaha^ and is suDject ro the laws o1 the Sbte of Cdondo antl to the Zoning
RequlaUOns an0 BuilCi CoEe o1 VMeat Ridga, CWaado u any oUw apWwaDle oNinanas ol tne Ciq.
(2) lnis pemiit anan eapirei (A) tlro work autlwnzed is not commencea witnin sizry (60) Oavs hom issue tlate a(B) the euiwilq auUarized is suspenEed w
aCantloneE fw a pMcd o(120 tlays. mal (3) Iorl9nal ~p ~ sPeci ~UO~ns a^dme^Y sua~penisreon or aDanEOnmentehas not eYUUeded u~e (requi
Ye D vovided ' n9e ara m~atle or is uabeen penianlo~a0an0onment rmit azceedS me (1) Yaar. Nll lxs sMll Oe p+i0 br a new pertnit.
(d~ No wuk ol any mnner shall Oe dona Mal mil change the nalural flaw ol waler nusing a Ereinage probkm
(5 CoNratlor sliall noUfy Na Builtling Inspector tweny-lour (24) hours in aEvance br all inspecllons and shall receNe written approval on Inspection aM belare
iinq vnU eucceasiw Ohases oi Ne,'o0.
(8) It~e Du'~aIEa o oo0es or i eny oUrof otdlna~eea ~w~ ^+le or d regualion~ons shall not Ce mnstrueE W be a pennll lor, nor an aDW~'al of, any violation ol Ne provisions
ot
Chief Building Inspector For Mayor
THIS PERMIT VALID O ALL W 34 5933 24 HOURS PRIOR TO I~N PIECT ON ECTOR AND MAYOR
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1/ I I \J 1.r ~
7500 West 29th Avenue The City of
Wheat Ridge, Colorado Wheat
Telephone 303/ 237-6944 Ridge
DATE: November 7, 1997
OFFICIAL ADDRESS NOTIFICATION
NOTIFICATION is hereby given that the following address has been assigned to the
property/properties as indicated below:
PROPERTY OWNER(S): Ashlgy Manor Care Centers Inc
OLD ADDRESS: 10925 W. 38th Avenue
NEW ADDRESS: 3802 Parfet treet
SUBDIVISION: See Below LOT(s)BLOCK
LEGAL DE5CRIPTION: Lot 1 together with the south 48.45' of lot 2, Haas Subdivision, City of
Wheat Ridge, Jeffreson County, State of Colrado.
AUTHORIZED BY: DATE:
DISTRIBUTION:
1. Property Owner
2. Jefferson County Assessor, ATT'N: Data Control, 100 Jefferson County Pazkway, Golden, 80419
3. Jefferson County Mapping, ATTN: Addressing, 100 Jefferson County Pazkway, Golden, 80419
4. U.S. Post Office, 4210 Wadsworth Blvd., Wheat Ridge, 80033
5. Public Service Co., ATTN: Correspondence, 990 Bannock St., Denver, 80204
6. U.S. West Communications, 1801 Califomia St., Room 2400, Denver, 80202
7. Water District: C ns. Mu ual
8. Sanitation District: Westrid e
10. Wheat Ridge Planning Division
11. Log File
12. Other:
NOTE: Please notify all other parties concemed.
ADDRESS MAP UPDATED BY: DATE:
"The Carnation City"
WEl
~
DEVELOPMENT Buildirrg Permit Number
N - 235-2855
3f' nata
7500 WEST 29TH AVENUE
' WHEAT RFD6~, Cd 80215
Property Owner ;
PropeRy Address : 3802 PARFET ST
Conttactor License No. : 17665
Company : Universal Development, Inc.
BUILDING
~r
Approval': SM 7118197
Zoning : 12-2
ApProval:
Approvat : C3K 814187
4ccupaney : SFR Walls
. 5618
sisrs7
Phone : 423-2466
Phone : 423 2466
--.-Permit Fee ; $1,145.00
Pian Review Fee : $0.00
Use T2x : , $1,800.00
Total: $2,945.00
I'MENT USE ONLY
SIC :
Sq. Ft. : 3872
i.
SEE ATTACHED P.W. REVIEW SHEET AND Sf7197 IETTER
Roof
Stories : Residentiai Units
1
Electrieai License No :1?4y1 Plumbing License No :C1(s 3(p Mechaniqt License No :
Compapy . Company : F~L Company :
EcpiraNon Date : Ezpiration Date : Expioatlon Date :
Approval : Approval : ApProval :
a 11111101101111 i 0 r
(1) 7nis perrtYtwa4iawedinaccmtlencewNhfheWOWslonseetkMinYOPLw aDOoetionand'uaWlaf3tomelswaoftheStabot.Cotaradoamito.tMZoNnp
. RepWdiWnt end 8uCode ~ VNeeai y~, CoWpdoor anY other apq~'cabW ortlinences ofthe City.
(2) This Pw~ahbtl oxMCe $IM IAO wqk autliOGfratl (c ~ot.conxrqntsd wlWn ebcty (80) daya ttom iesue dab or (8) tlte buNdnp~BWiorlseC b susPentleO or
eDinGOneQ tM a pxbd W 110
(3) M tl1i8 p6f11tlt expites. a naW ~meY be aWWkedfor.a he Of aie-htlf IM amoimt normaM reqjMed,p~rovq~ noehenglahiVS 6eellw wW be made N Uie o~ICNreFR~en4 andand enY stor ~n~n or abentlanmetlt hm not m~tletl one (1) Ym. N fhanpm are mede a H suepsneiw~ a abandonmart
(4) exceeCeona(tlY~.ndlhesshaBbepMdanewp~g, . Nowakt#'+MnunnersPaNDSAOnb~wiNd+e~eMen~turallk+wofwaterowd~8adreinagepo0le~n.
. CpoqM~laCta' ahaB noly IM BuplkhlaX~g9a 8~~qb~nH•bur (24) houn In advance fw all inspaGlons arM aliMl racelvo xrtaCen approwl on NupecUOn tiM be/ore (B) 'Iha ~19euq d a pNtl1B . aM)roYa~ Wdrawinp9 eM spotlflCatlons ehMl rot Ce wnstrirotl to be a pemYt for, nw an aDPoW ot anY vklftlmW ihe Proviebna
of tlre h IMlirgj~°08 or My dher adMenca, lew, ndb.or repuletlon.
-(,~.~-,b ( s(~~~4%~C~
C i Buihiinglospector F ayor
IS PERNRT VALID dNtY WHEN StGNED BY THE CHIEF BUILDINCa iN3PEGTORAND MAYOR
CALL: 234-5833 24 HOURS PRIOR TO INSPECTION'
OWNERICONFRACTOR SIGNATURE OFLNDERSTANUING ANO AGREEMENT
DEPHRTNIENT OF PLANNING AND DEVELOPMENT Building Permit Number :
.BUILDING INSPECTION DNISION - 235-2855
CITY OF WHEAT RIDGE Date :
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Property Owner: A.~/e, 4~q1"" Ckre ~P•rfrrs
- "
Property Address : Phone : yZ3 - ~
Contractor License No. : 171p65-
Company:Glh,'uc-r~Q/ ~eue%rr..e1nc, phone:~YJ1-~~67
OWNERiCON7RACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Construction Value : lSD, o~
I hereby certify that the selback distances proposed by this permit application are acwrate,
PBfflllt FEe
: l/ wS c-d
and do not violate applicable ordinances, rvles or regulations o( the City of Wheat Ridge or
covenants. easements or restrictions of rec rd; that all measurements s own, and allegations
made are accurate; lhat I have read and ag e to abide by all condition printed on this
applicatlon, and ihai I assume full responsi lity for compliance w~h eat Ridge Building
Plan Review Fee
.
Use Tax
:
:
Code (U.B.C.) and all other applicable W t Ridge o~linnces/S wo under lhis permit.
(OWNER)(CONTRACTOR)
J
Total :
Description: A55is
4 ~ .
J
BUILDING DEPARTMFNT USE ONLY 1
SIC : Sq. Ft. : 3812 µ
Approval
Zoning :~Z2 ~ yyI•- y~ ,~,a~
Bulfding'.Co
Approval:~
v
Pl3til c . 5C'e bi[acNED Y.%K• c~,~cw s~~C1 'c, 5 1-4 Iw-4 (c{~~.
Approval : C . a 9 7
Occupancy : Wa Is : Roof : Stories : Residential Units :
Electrical License No : Plumbing License No : Mechanical License No :
Company: Company: Company:
Expiration Date : Expiretion Date : Expiration Date :
Approval : Approval : Approva; :
IM KFi~ri~~mr~n~ ~ iMRSquiren~ m BeraMMMM
(1) TTis permit was luucd in aaoNanm vntn the provisions sel lorth in yopur appliwGon and is sub'ect m the laws ol Ne State ol Cobrado antl lo Ne Zonia9
Regulations and Building Cotle ol Nfieat RiEge, Colontlo or any otner apolrcaWe orEinances ol e Ciry.
(2) This pertnll shall expire d(A) the work authonzed is not cammenced vnNin sixry (60) days imm issue Oate or (B) the EuilCing authorized is suSpenEeO or
aeanaoned lor a penoE ol 720 aays.
(7) If tnis permd e:pires, a new permM1 may Ee acQuiretl lor a lee of one-hart the amount normalty reQUireC, proNAeC no cnanges have Oeen or vnll be maEe in the
onginal plans anO specifitalions and any suspension or aDandonment has rat exceeded one (t) year. II Uangez are matle or i1 wspension or a0andonment
exceeds one (t) year, lull (ees shall be paitl tor a new pemit.
(4) No work ol any manner shall De Eone that will change (Oe natural Ilaw ol water tausing a Erainage Dro61em.
(5) Conlracior shail notiy the Builtling Ins~tor iwenry-four (24) hours in aEVance for all inspectwns anE shan receive wntlen apprrnal on inspeclion wN belore
oroce wahsuccessive pnases o t~e 7o0.
(6) TTe i u ce of a rmil or Ihe ap0mval o! C2wings and speciGwlions shall nol ba consWeE to Oe a pertnil lor, nor an approval ol, any violation of Ne proWSions
i
ol Rle 0 IOlnq es ar any o r ordi nce, law, rule or regulaUOn.
ief Building Inspector For ayor
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
>7
NOT RIDGI flRI PRO1E11N DISIRIC1
P.O. Box 507
3880 Upham Street
Wheat Ridge, Colorado 80034
(303) 424-7323
July 25, 1497
To:John Eckert
Cluef Building Official
City of Wheat Ridge
Wheat Ridge, Co.
80033
Subject: Building Plan Review for Assisted Living, Ashley Manor Care Centers, 38 & Parfet
Dear John,
After a review of the proposed building for Assisted Living, Ashley Manor Caze Center
located at 38 Ave & Parfet, I am submitting the following information /requirements conceming
this project:
After a review of the Uniform Building Code and Uniform Fire Code, both 1991 edition, it
is my determination that this particulaz building is an I-2 Occupancy and therefore, a11 the
requirements regazding an I-2 Occupancy will apply.
2. The proposed building will require a fire alarm system designed to meet the criteria of
NFPA 72 and must be addressable. Plans must be submitted for approval prior to
installation. The system must be and must remain monitored by an outside agency at time
offinal tests.
3. The proposed building will require the installation of a complete fire sprinkler system
designed to meet the criteria of NFPA-13. The sprinkler system will be required to be tied
into the fire alarm system. System design must include the attiq crawl space, and gazage.
4. The proposed building will require the installation of a fire hydrant on the north side of 38
Ave on Parfet Street located within 150 feet of the fire department connection for the
structure.
The proposed kitchen will require the installation of a commercial hood and duct system
complete with an internal fire suppression system tied into the fire alarm system.
6. Issues not addressed at this time will be addressed as the need azises.
PUBLIC WORKS REVIEW FEE STRUCTURE FOR BUILDING PERMIT APPLICA710NS
PIEASE PRINT CLEARLY AND FILL OUT FORM COMPLETEIY
Building Permit Number Date a/A
Address
J
)
^t
~j%
crS
-
Applicant
State Zip Phone
City
Location of Construdion (address) 3~bo2
Purpose of Construdion iNn..► 0-6-613}G6
Commercial
Building Permit Value $ IS~ -
~
Residential
-
DEVELOPMENT REVIEW FEES (this section to be completed by Ciry)
i
i
00
'
mum
n
Base Development Review Processing Fee: $50.00 m
•
Single Family Residential: .003 x(value of improvement) $25 minimum fee
$YS~. ~
[includes review of construction drawings for improvements in public right-of-way]
Mutti-Family/Commerrial: .0050 x(value of improvement) $50 minimum fee
$
[includes review of construction drawings for improvements in public right-of-way,
review of preliminarylfinal drainage study and erosion control plan(s) if required]
Site Plan: $50.00 (Not applicable for single family residential)
$
e recording fee
OOl
a
40
00 + $S
$ - ~
p
g
.
.
Right-of -Way/Easement: $
00 Commercial = $100.00
tial = $50
id
R
$ - • `
.
en
es
Development Agreement
lication fee
00 a
$75
it
P
$
pp
.
ertn
:
State Highway Access
rocessing fee
$100
00
t
R
$
p
.
epor
:
Traffic Impact Review &
00
00 Class II =$150
I=$75
Cl
$
.
.
ass
Flood Plain Variance:
00
TOTAL REVIEW FEES: (due at time of building permit issuance)
$ The above fees include one follow up review to verify that initial deficiencies noted are
correc[ed. Additional review and/or processing past the follow up review and/or processing
will be charged against the building pertnit applipnt at the above fee schedule.
Please note that additional fees will be assessed for those permits related to construction of
public improvements. If you have any questions, please feel free to contad.the Development Review
otfice at 235-2868.
Signature of Applicant Date
qv-HR42~'
DEPARTMENT OF PUBLIC WORKS BUILD/NG PERMIT APPLICATION REV/EW
Date: `b 1-4 CaseBuilding Permit No.:
Location: -JBOZ :]P~am 45rr•
Attention: Building Department
I have reviewed the attached materials submitted in application for approval of a
at the above referenced address. Please note the summary comments below.
1. ✓
2.
3. !
4. ~
Boundary Closure: K OK _ Not OK; refer to stipulations.
Drainage:
a. Drainage plan and report needed _
b. Drainage plan not needed
c. Drainage provisions have been reviewed and are found to be:
JC OK Not OK; refer to stipularions.
NPDES Permit Required: Yes X No
Legal Description: JC OK _ Not OK; refer to stipulations.
If not OK, please explain:
5. _ Public Improvements:
a. street paving needed: lC Yes _ No
b. curb and gutter needed: x Yes _ No
c. sidewalk needed: x Yes No
d. street lights needed: _ Yes z No
e. storm sewer needed: Yes x No
f. escrow required: ~ Yes No
If an escrow is required, for what improvements? • ~Aw ab t i na+ s o.n T~ Ge SSeew~C.e
Amount bf escrow: b
6. ~ Development Agree ent required: X Yes _ No
If Yes, for w'3~t~ A.xrn.a ~~nore.~unun~~
7. ✓ Traffic impact analysis and report requi ed: _ Yes k No
8. ~ State Highway Access Permit needed: _ Yes X No
9. New roadway or alley R.O.W. dedication recommended: _ Yes x No
If yes, what is recommended?
10. All eacisting dedicated roadwaYs/alleys meet the andards of the City:_ Yes X No
ff no, w' o not and what is requested: i~~ L-~ be %Mor013e4 ee...
~ns
11. / APP V : The lic W rks Department has reviewed this request and hereby gives its
appr al bject the ab e and/or attached stipulations.
4 9-7
S:gn ture eg Knudson Date-~
12: _ NO APP OVAL: The Public Works Department has reviewed this request and does not give
its approval for the reasons stated:
/ S"ture Greg Knudson Date
13. _ Stipulations attached: X Yes No
14. L Summary qQmments: en.jC&.]~~ 4_,fuG ~h~ ~..~je .a
The City of
7500 WEST 29TH AVENUE
~
WHEAT RIDGE, CO 802 7 5-67 7 3
(303) 234-5900
W
h e at
Ciry Admin. Pax tl 234-5924
Police DepL Farz k 235-2949 ~i d
ge
May 7, 1997
Mr. Bruce Erickson, P.E.
Acklam & Associates, Inc.
P.O. Box 795
1001 East Bridge Street
Brighton, Colorado 80601
Re: Haas Subdivision West 38th Avenue & Parfet Street - Approval
of Final Drainage Study, Erosion Control Plan & Street
Construction Drawings
Dear Mr. Erickson,
This letter is to inform you that the final drainage study,
erosion control and street construction plans for the above
referenced project have been reviewed and approved for
construction. Please be aware of the following items regarding
the construction of the project:
1. The proposed drainage facilities shall be constructed and
approved by the City of Wheat Ridge prior to issuance of the
Temporary Certificate of Occupancy.
2. Erosion control for the project shall be placed in conformance
with the approved drainage/erosion control plan and shall be
maintained as needed during the course of construction.
3. All drainage improvements shall be constructed in conformance
with the approved drainage report and plan.
4. It will be the responsibility of the respective contractor(s)
for the project to repair any damage to the existing public
improvements on West 38th Avenue as a result of related
construction traffic in the area. Also, the respective
contractor(s) will be responsible for maintaining West 38th
-Avenue on a regular basis such that it is free of construction
debris and tracking from construction traffic accessing the
site.
5. Upon completion of the drainage improvements the engineer,
Acklam & Associates, Inc., shall provide to the City of
wheat Ridge a letter of certification stating that the various
improvements, as defined in the drainage report and plan, have
been accurately surveyed to confirm that their construction is
in accordance with these documents. The certification letter
shall be written and stamped by the engineer who prepared the
4" RECVCLED PAPER
Jul 30,1997 04:15pM FROM Rshley Manor TO 13032352857 P.02
AcS1-1LxY MANOQ
CA12E CCNTERS, INC
July 30, 1997
John Ekert
Building Department
Wheat Ridge, Colorado
Dear John:
As per our conversation on July 29, 1997; here are the responses to the questions
that you posed and needed written replies.
1. Maximum of residents would be ten (10).
2. A maximum of three (3) caretakers per shifl.
Our sifts are: 7:00 A.M. - 3:00 P.M.
3:00 P.M. - 11:00 P.M.
11:00 P.M. - 7:00 A.M.
3. l'his is a restricted access facility. The front door will have a coded entry. The
back door will not be loeked, but will lead to an enclosed back yard.
4. The facility will meet Life Safety Code for residential facilities for ten (10)
beds ar less.
5. The front door will automatically open if the alarm goes off.
6. We will have six (6) designated parking spaces that will be off street.
7. The facilities will house only Alzheimer's / Dementia patients.
Thank y0u tor your assistance and guidance, John. Your suggestion on sound
proofing the building was greatly appreciated and will be used.
Cordially, „
iCQ'J//l~~'~/~/ij`'`~,`) wr Dougl~~ M. Ewing
Ashley Manor Care Centers, Inc.
PO Box 1176 Meridian, tD 57680-I l75 370-7298
TOTRL P.02
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re FwPrirr„^.na±aa'=un. "P".?'RSS~a+a"aF~~&G?M,s^'~'mx3R.r,.,~en .^.rw .rm^w=q'7~.'tm^ . . ,•;aAs4...aru-m
~;:,DEPARTMEN7 OF PLANNING AND DEVELOPMENT Building Permit Number : 6030
BUIL[3fNG lMSPECTION DIVI310N - 235-2855
CITY OF WHEAT RIDGE Date : 10/13/97
75001MEST 29TH AVENUE
WHEAT RtE)t'aE, CO 80215
Property Owner :
Property Address
Contractor License No.
Company
3802 PARFET ST
19704
Grinnell Fire Protection
pWNERfGQNTRACTOR SlGNATURE OF UNpERSTANDING AND AGREEMENT
dtstgnces
Description : FIRE ALARM SYSTEM
Approval :
Zaning ;
Approvei:
APProval :
BUILDING DEPARTMENT USE ONLY
OccupBncy : Walis
3 C~ of oWheat f
ents shown, ard
Iftbns winted on
Phone :
Phone : 355 0500
Construction Value : $6,000.00 ' I
Pertnit Fee : $93.00
Use Tax: $72•00
Total: $165.00
SIC : Sq. Ft. :
Roof : Stories : Residential Units :
Electrieaiticense'No' Plumbing License No : Mechanical License No :
Company : Company : Company :
Expiration pate : Expiration Date : Expiration Date :
Approval : Approval : Approvai :
(1) rnis aerr,n ance wxn ft aro*rone se rorn, u, ropw eaaloff+lo+•nd Is wow m u,e iews ame srero m caomw ena w ms zoning
RqnWwra ann ewaMp coas a wne.t~ ca«aao w em omeraPPawae orarw~as a cxy.
(2) Thk pertNt atudaxpiro (t(A) Yis wak a ed innot commenced withln sizfY (DO) deri hom laeue Aab w(8) the bWl~9 auMorized is auapendad or
..abandlNned f a apBADd of 12Ud~s
(3) ~ H ihis PemYl ~W~, e r~aw varmrc mer be aawirea ror a ree a a~ena~r tns emoum nomreiy reqWred,Wov~dad ~ro chanpea Mve been or wIN be made in tM aigMei pWns and epeafleatbns anel ~ny wspensWnor abandonmant has na exceetled ona (t) ywr. tt cha~gas are mada or ft suepenslon w eCantlonmaril exoeeda W!a (1) Yee~, MUtea8 shall be ptild for a new pefmit. . .
(4J .No.Wak ot airy menner sti811 be doM ihatwlN chahge ihe naNral ibw of watar causNg a d'ainape problem. .
(5a . Cp~aoc,beascNW, 3haF,Wtlry me 6upiMhinp ~nosptd~~etopr blwenry•rour (za) rroura In aavar~ce ror au inspectlons ana meu receNe writPon eppova~ o~ inepxuon cerd Oef«e wlih (e) The Ias ~:e ot a~tlie eppmval o(drewinqs and apedfleafions shall not be wnsWed b bs a pam~it for, rror an approval of, arry vidatlon o( die provisiaia . otlheDU@dNWsO~soranYOtlhelordinance.law,n+bwre9ula6on. .
PERMIT VALID ONLY 1MHfN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 2345933 24 HOURS PRIOR TO INSPECTION
DEPARTMENT OF PLANNING AND DEVELOPMENT
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
041
Property Owner: L
Property Address :
Contractor License No. :
Company: ~inJiJL?zL
Building Permit Number :
Date :
Phone : %
Phone: :y.~~ -OS~Ij
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify ihat the setback distances proposed by lhis pertnit appliwtion are accurate,
and do not violate applicable ordinances, rules or regulations of the Ciry of VJheat Ridge or
covenants, easements or resirictions of record; thal all measurements shown, and allegations
made are accurate; that I have tead and agree to bide I wnditions printed on this
application, and that I assume full responsibi d or co lia with the Wheal Ridge Building
Code (U.B.C.) and all other applicable Whea Ridge o in f r is pe
(OWNER)(CONTRACTOR) SIGNED DATE ~G 3 C/
Descriptian
i '
BUILDING DEPARTMENT USE ONLY
SIC : Sq. Ft. :
Approval:
Zoning :
Butiding Co_ en ~i
Approval:
PatilrSIWbP
Approval:
Occupancy : Walls : Roof : Stories : Residential Units :
Electrical License No : Plumbing License No : Mechanical License No :
Company: Company: Company:
Expiration Date : Expiration Date : Expiration Date :
Approval: Approval: Approval:
~ &P.Iafi37R~Ui~ed~ ~ ~13fl~!RSt~l1iPAU~ ~ [EI~ft3SK8~UiP8'C~
(1) This pertnil was luuetl in aaordance with the provisions set forth in yoWr appliration and Is sub'ect ta the laws of the SWIe ol CdaaEO antl lo the Zonirg
Regulations anE BuilEing Code ot Wheat RiOge, Colorado or any other appliwDle ordinances af ~e Ciry.
(2) This permit shall expire A(A) tne work authonzed is not commence0 wiNin si:ry (60) tlays lrom Issue Oale or (8) the Wilding auUaized is suspeMed or
abandoneC lor a periatl a1120 Eays.
(7) II this pertnit ex0ires, a new pertnil maY be a[puired lor a fee of one-Aall Ne artaunl nortnaly repuired. provideE no changes have been or vrill be made in the
original plans and speciliwlions and any suspenslon or abandonment has not ezceeded one (1) year. II Uanges are made or il suspension ar aEanCOnmenl
exceeds one (7) year, tull lees shall be paid br a new permil
(4) No work ol any manner shall be Eone Nal will rhange the nalural Oow ol water causing a drainage pmDlem.
(5) Gonvactor snan notiry the euileing Inspeclor twenry-lour (24) houn in advance for all inspecl'ans and shall receive wntlen approvai on inspeclion wN beiore
vroceediing wiN successive phases of Ihe 7ob.
(6) The issuance of a pertnit or the approval o! Erdwin9s anE speciGCalians shall not De mnsWe0lo Ue a pertnil lor, nor an approval ol, any violaGon ol the provisions
ol the buil0ing Wdes or any olner ordinance, law. Nle or regula0on.
Chief Building Inspector For Mayor
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
ConstructionValue: 6p' 000
Permit Fee : //3
Plan Review Fee :
Use Tax :
Total :
S00
0
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STATE OF COLORADO
DIVISION OF FIRE SAFETY
PLAN REGISTRATION FORM
DateJ b- ~ Contractor RegistraHon Number /97~ L
Contractors NameWee~ fWz wOI~' IJ
Mailing Address _702(a S R IC'f=f] 0 )AAY
Comments
(for additional comments use separate sheet)
Distribution: Original copy goes to Division of Fire Safety upon total completion of form. Copy to local fire department.
Copy to contractor and copy to building owner upon completion and sign-off.
Certification Na (Certified Fire Suppression Inspector)
DEPAR7MEMT 4F PLANNING AND DEVELOPMENT Building Permit Number : 6068
` "'$U14QINiG 1NSPECTI4N DIVISION - 235-2855
CITY OF WHEAT RIDGE
Date : 10/20/97
750Q WE3T 29TH AVENUE
WHE11t RIDGE, GO 80215
Property Dwner :
Property Address : 3802 PARFET ST
Phone :
Contractor License No, : 17809
Company : Westem States Fire Protection
Phone : 792-0022
OWNEWCOfJTRACTQR SIC3NATURE OF UPJDERSTANDING AND AGREEMENT
C NA
C~g~cbh V81ue : $21,600.00
'I hereby certlfy tltaC tlosaetbadc distancea proposed by this:pertnft application aro ac~ctirate;
nAesor reguhtions ofthe Ciry of Wheet RMge or
licable oMknances
l
t
d
t~
d
Permit Fee: $313.00
.
,
va
e
and
o no
a
pp
b strictions oc recoN• that all measuremaMS ahown and allegatwns
t
t
Plan RevieW F62 :$0.00
ri
a
covenants, easeme s tre . mede ere ~~te: that ihave rmad.: andag ree toabide by all condkions pdMed on Nis . .
. application, mrM thet I assume lull respansibitity for complian~ with the WRuat Ridge Building. . U58 T2X : $25920
Cotle. (U.B.C:) and all ptt~r applicsbla . t Rklge ottlfr~an , krwoAc. under this peenit. Total : $57220
. (OWNER)(CONTRACTOR) SIGNED ErL-ci-- .
Description : COMPLETE FIRE SPRINKLER SYSTEM
BUILDiNG DEPARTMENT USE ONLY
SIC : Sq. Ft. :
ApProva{ :
Zoning :
Approval :
Approval ;
Occupancy : Walls i Roof : Stories : Residential Units :
Electrical Liceose No :
` Company :
Expiration Date :
APproval :
~
(1) T1tbPwrntt "s 1!!tM
RepuladoMandBtDa
(2) mispermii aheN expk
8bandonOC tOr e pem
(3) if thi9 Pwn* exPires, 1
rnipinai dWM and ape
. axceedsona(?)Xaar.
(4) No wak of aM' mamu
(5) .ContraetarBhqllno0(y
qrq wNheua
. (9) ~e builtfing=
C.
Aef Building {
Plumomg ucense rvo :
Company :
Expiration Date :
Approval :
a
arovisbne set 4wM in YoWr appXeeilon arW fs
tlie
m~ uan~wru~.cnw -
Company :
Expiration Date :
Approval :
to 1M Zoning
dle IX(B)1fM.bIlIlA1119 BUlhOfiLBd 16 5U6Pwtdod Of
pmyyed no ctwn0es Mava bean or wiU be me0e k~ lfle
It d~an4es Ne metle a H sueMnaia^ w aEantlaimeM
llow dwater ceusUp e tlrainage proDbm.
n in advance for all inepecdons and shatl moelve wAtten epqovel on hePectlon cerd befae
aibns shell rot be conaWad to bo e pertnR for, nor an aOWa'al M. enY violetlon M Me prwlalons
~ THIS PERMIT VALID ONLY 4VHEN SIGNED 8Y THE CHIEF BUILD{NG INSPECTOR AND MAYOR
CALI. 2345833 24 HOURS pR10R TO INSPECTION
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number :
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE Date :
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Property Owner :Ar_~Y "6~~6r__ d Property Address : 5jjl ~Z~-~ `~T• Phone :,"jce . -37G--7,;L~
Contractor License No. :
Company:µl~g-f~-t~1 Phone:3a3-7,Ja-m_rA-
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify lhat the setback distances proposed by this permit application are accurate,
and do not violate ap0liwble ordinances, rules or regulations of the City ot Wheat Ridge or
covenants, easements or restrictions of rewrd; 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 (ull responsibility tor compliance with the Wheat Ridge Building
Code (U.B.C.) and all other applicable Wheat Ridge ordinances, (or work under lhis permit.
(OWNER)(CONTRACTOR) SIGNED~~~.l~-.fd~LGL~~DATE1Q-,>0-1T
Construction Value :
Permit Fee :
Plan Review Fee :
Use Tax :
Total :
~a Co 00 .00
Description : LorqPL4q--E- r-Irr, 6pp4Nk_L.EW-'>YS7-F►-+l PF-P- ti1. r~ A, 13JL4:~A~ eap".
BUILDING DEPARTMENT USE ONLY
Zo-fiin'WCSIC : Sq. Ft. :
Approval :
Zoning :
Bulid nf g~Co en ~
Approval :
Approval:
Occupancy : Walls : Roof : Stories : Residential Units :
Electrical License No : Plumbing License No : Mechanicai License No :
Company : Company : Company :
Expiration Date : Expiretion Date : Expiration Date :
Approval: Approval: Approvai:
g LPia~~utr~a~ 10 ILPlR~qutcen~ 0 ~~tt~qmr~a~
(1 ) This permit was Issued i~ aaordance wiN the provisio~s set IoM in yopur applkation and is suq~M lo the Wws ol Ure 51a1e of Cobra7o and lo the Zonin9
Requlatiaos antl Builtlin9 CoEe o/ VJneat RiEge, Colo2do or any other aOWicabk ortlinaMes ol lhe Ciry.
(2) This pertnd shall expire d(A) the vroM authonze0 u not commenceE vrilhin wxty (60) Oays trom issue Oate w(8) Ilx WiWing authaized is 5usperMed or
aDandoneA lor a penoE o( 120 days.
(7) II this pertnit ezpires, a new pennil may 6e acpuired for a fee of one-hall the artaunl aomully repuired, proddetl tw Uangee have been w vnll be maEe in the
onginal plans arW spenfirations and any suspension ar aOanCanmenl lus rol exceeded one (i) year. If Uanqes ara made or il suspensbn or aDandonment
exceeds one (7) year, tull lees shall be paiE lor a new permil
(a) No work o/ any manner shall be tlone Ihal will change the natural Oow o( water wusing a Orainage Dro01em.
(5) Contractor snall notiy the Builtling Inspector twenry-four (24) houn in aEvaMe la all inspecibns anC shall receive written approval on inspection fard Oelore
proceEdii 'th su ssive phases ot the ob.
(6) 7Te is an of asmit or the appr val o~drawinge and specififations shatl rwt be consWed lo be a pertnit br, nor an approval ol, any viWaGon of the Orovisions
ol lhe~6ui1 Ing oran~ er ema , law, rule or regulauon.
Inspector
For Mayor
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
i'aPw,n~urm ,
, . . . . ~ . . . . - , . . . . . . . , . „ .e: , .
DEPEIRTMENT OF Pi.ANNIN(3 AND DEVELOPMENT Building Permit Number : 6110
BUI6DING iNSPECTiON DIYISIQN - 235-2855
CITY OF WHEAT RIDGE Date : 10/24197
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80275
Property Owner :
Property Address : 3802 PARFET ST Phone :
Contractor License No. : 18111
Company Cooper Heating & Cooling Phone : 466 4209
OWNERlCONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I heroby certity thet the satbadc distances propoaedby thbpemikappIicaYwnare eaurete,
and do mt violate appIkqble ord'mances, rules or regulaNons of the City of Wheat Ridge or
covenaMS, eaaements or restridions Mrecord; Nat all meeaurements ahown, and albgaGons
made are accurete; fhat I.heve reedand agroNetyro ebide pby ell wndiUona Pdnted onfhie lication
that
assume CoPde (U.B.C.Oand all ottrer apP'~~~~ t R`dg OrdMances forworlc uhndor thb~ppB~l~ing
(OWNERxCONTRACTOR) SIGNED DATE
Description : GLASS 1 HOOD
Constnrction Value :
$3,500.00
PermR Fee :
$88.00
Plan Review Fee :
$0.00
Use Tax :
$42.00
Total:
$130.00
BUILDING DEPARTMENT USE ONLY
Approval :
Zoning :
Approval:
Approval :
Occupancy : Walls
Roof : Stories
Plumbing License No :
Company:
ElecMcal License No :
Company :
Expiration Date :
Approval :
■
(t)
(2)
(3)
f5f
(8)
SIC
Sq. Ft. :
~
Residential Units :
Mechanical License No :
Company :
Expiration Date ; Expiration Date :
Approval : Approval :
a s
xOVisions aet foM in yopur epplieatlon afM la subiect to the lawa M tlhe State d Cobrado and M the Zoning
Coloiado a a`ry other applicabb adinencea of the Ctty.
itl M ~ot commanceC wiMm alxy (90) tleye ttam Issua date of (8) Ma buXdiq aWwAzed la aiuupendod a
Ldrea ror a ree a ono-narc me amoum rwimaly requlrea, arovlaea no cheiqee hsro beai or vAU ce maae m me
~nsbn or abandonment hae nM ezceeded ane (1) year. If charqes are meOe M X auepensbn or abandonment
a new pertnil
='auw(zij~iw rs~in ad~re~ r«or~~ 9ape rns"antlahemrecelve writlen approval on inapectlon aM Oerore
wingc end epeciflceibns ahall nM De cansWed to be a pemtlt tor, na an apqwel ol, any vbletlon of the proviebns
w, rule or repulatlon. .
gef Buiiding Inspector
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number :
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE Date : 101 a-7
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Property Owner :
Property Address Pw"~~~ t 5+" Phone :
Contrector License No. :4 j g iI I
Company: Phone:
11,780 0I0e Blvct_
OWNER/CONTR.4CTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
1 hereby certity that the setback tlistances proposed by this pertnit application are accurate,
and do not violate appliwble ordinances, rules or regulations of the City of Wheat Ridge or
covenants, easements or restrictions of recortl; that all measurements shown, anC allegations
made are accurate; that I have read and agree to abide by all conditions printed on this
application, and that I assume tull responsiDility tor wmpliance with the Wheat Ridge Building
Code (U.B.C.) and all other applicable Wheat Ridge ordinances, tor work under this permit.
(OWNER(CONTRACTOR)SIGNED C` _DATE 10I)4IG-I
Description: yj, H(:'v'5..
Construction Value : ~ 3~
Permit Fee :
Plan Review Fee :
Use Tax :1 l-i 2,
Total I -_'IC)
BUILDING DEPARTMENT USE ONLY
Zoning'Comments; SIC : Sq. Ft. :
Approval :
Zoning : ~ Buifdig Comments: ~ Approval
Public' WoFrks'Cmments:
APProvai
Occupancy : Walls : Roof : Stories : Residentiai Units :
Electrical License No :
Company:
Plumbing License No :
Company:
Mechanical license No :
Company:
Expiration Date : Expiretion Date : Expiretion Date :
Approval: Approvai: Approval:
Plans Requiredr~~' i'Plans Requiredn °Plans Required'v7
(t) TTis permit was issueE in accordance wifn Ine Orovisions set toM in yopur ap0iiuuon anC is subject to the laws of tne State of Coloratlo anE to [ne Zoning
Regulations antl Building Cotle of Nrtheat RiCge, Colora0o or any other appliraDle ordinances of tne Ciry.
(2) This permit snall expire il (A) the work aulnonze0 rs not commenceC witnin sixry (60) tlays from issue Eate or (B) tne CuilEing autnonze0 is suspenOeE or
aEandonetl tor a penoE of 720 days.
(3) If t0is permit ezpires, a new pertnii may be acquireE Iw a fee of one-half the artwunt noi*nally require4 proviEetl no changes have Deen or will Oe made in tne
original Dlans anE specifirations and any suspension or abantlonment has nol ezceeEed one (7) year. If Uanges are matle or if suspension or aban0onmenl
eaceeds one (t) year, full /ces shall Ce paiE tor a new permit.
(a) No work of any manner shatl De Oone that will change Ne nawral llow of water wusing a Orainage problem.
(5) Contractor shau notiry the Buiitling Inspeclor twenry-four (24) houre in aEVance Por all inspeclions anE shail receive wntten approval on inspeclion rarC Defore
procee 'bg wiM successive phases of lhe 7ob.
(6) The s ance of a pertnit or the apDr val f tlrawings an0 SpedGration5 shall not De wnstrueE to De a pertnit br. nor an approval ol. any violation of the Drovisions
of e iltling~COOes or any r di ce. law. Nle or regulation.
~ GL
ief Building Inspector For Mayor
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
IC DESIGN INFORMATION SHEET
NAME: ASHLEY MANOR CARE CENTER DATE: 10/12/97
LOCAT(ON: 38T" AVE. 8c PARFET STREET
AREA NUMBER: CRAWL SPACE SYSTEM NO.:
CONTRACTOR: Westem States Fire Protaction CONTRACT NO.: 95610
CALCULATED BY: SIGMA DRAWING NO.: FP-I OF 3
CONSTRUCTION: 2 COMBUSTIBLE ❑ NON-COMBUSTIBLE CEILING HT.: 3'
OCCUPANCY: CRAWL SPACE
HAZARD CLASSIFICATION
ONFPA 13 ❑LIGHT HAZARD SORD. HAZ. GP Z1 ❑2 ❑3 DEX. HAZ.
ONFPA 23l ❑N£PA 231C ❑FIGURE ❑CURVE
❑O'I'I-ER (SPECIFY)
❑SPECIFIC RULING MADE BY: DATE:
SYSTEM DESIGN
AREA OF SPRINKLER OPERATION:
DENSITY
AREA PER SPRINKLER
HOSE ALLOWANCE GPM; INSIDE:
HOSE ALLOWANCE GPM; OUTSIDE:
RACK SPRINKLER ALLOWANCE
1500 1 SYSTFMTYPE
.15 1 OWET ❑DRY ❑DELUGE ❑PREACI'ION
130 MAX I SPRIIVKLER OR NOZZLE
0 1 MAKE: RELIABLE MODEL F1FR
250 1 SIZE: K-FACTOR 5.62
1 TEMPERATURE RATING: 165
CALCULATION SUMNIARY
GPM REQUIRED: 326.04 PSI REQUIRED: 56.58 AT NODE 0
"C"FACTOR USED: OVERHEAD 150 UNDERGROUND 140 OTFER 120
WATER FLOW TEST
DATE & TIME 10/1/97
STATIC PSI:
RESIDUAL PSI:
GPM FLOWING:
ELEVATION:
LOCATION: At Site
COMMODITY:
STORAGE HEIGHT:
STORAGE ME1T-IOD: %
~ FIRE PUMP DATA
~ RATED CAPACITY
70 1 RATED GPM
64 1 RAT'ED PSI
1400 1 ELEVATION
0 1
I TANK OR RESERVOIR
I CAPACITY
I
~ ELEVATION
I
I
WATER FLOW INFORMATION
SOURCE OF INFORMATION: Wheat Ridge Water
COMMODITY STORAGE
CLASS: LOCATION:
AREA: SQ. FT. AISLE WIDTH:
PALLETIZED % RACK %
RACK INFORMATION
❑SINGLE ROW ❑CONVENTIONAL PALLET ❑AUTOMATIC STORAGE ❑DOUBLE ROW ❑SLAVE
[3PALLET ❑SOLIDSHELVING OMULTIPLE ROW ❑OPEN DENCAPSULATED EINON-
ENCAPSULATED
OFLUE SPACE IN INCHES ❑LONGITUDINAL ❑TRANSVERSE
CLEARANCE FROM TOP OF STORAGE TO CLG.: FEET IN
~HES
HORIZONfAL BARRIERS PROVIDED: Signature• Rax C, ire:son
utiy , ~`rre Protection Co•
Nscet Le-;re: FV
Rpgistrafion #073287
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FIR80UT SUBMITTAL CREAT&D 10-12-1997 15:41:14
ASHLEY MANOR CARE CENTER CRAWL SPACE
38TH AVE. & PARFBT STRfiST
WHEAT RIDGE, CO
ORDINARY GROUP I .15/1500
WESTBRN STATES FIRE
7026 S. T[JCSON WAY
ENGLEWOOD, CO 80112
303-792-0022
PROTECTION COMPANY
COLOR.ADO STATE REGISTRATION N0. 032
FLOW TEST RFsSULTS
STATIC 70.00 PSI
RESIDUAL AT 1400.0 GPM 64.00 PSI
PRESSURfi AVAILABLE AT 576.0 GPM 68.84 PSI
SLTNA7ARY OF SPRINKLER OUTFLOWS
ACTIJAL
MINIMUM
SPR
PRESSURB
FLOW
FLOW
K-FACTOR
101
19.26
24.67
18.60
5.62
102
13.94
20.98
18.60
5.62
103
11.59
19.13
18.60
5.62
104
10.95
18.60
18.60
5.62
105
18.53
24.19
14.87
5.62
106
18.41
24.11
14.87
5.62
107
14.29
21.24
14.87
5.62
108
14.19
21.17
14.87
5.62
109
13.16
20.39
14.87
5.62
110
13.07
20.32
14.87
5.62
111
19.78
25.00
18.60
5.62
112
15.38
22.04
14.87
5.62
113
15.28
21.97
14.87
5.62
114
14.17
21.15
14.87
5.62
115
14.07
21.08
14.87
5.62
TOTAL WATER REQUIRED FOR SYSTEM
326.04
GPM
OUTSIDE
HOSE STREAMS AT 0
250.00
GPM
TOTAL WATBR REQUI
REMPsNT
576.04
GPM
PRESSURE
REQUIRfiD
AT 0
56.58
PSI
MAXIMUM
PRESSURE
UNBALANCE
IN LOOPS
0.016
PSI
MAXIMUM
VEs'LOCITY
IN PIPES
30.60
FPS
PAGS 1
FIREOUT SUSMITTAL CRBATSD
ASHLBY MANOR CARS C&NTPsR CRAWL SPACB
38TH AVB. & PARFET STRSBT
WHBAT RIDGE, CO
ORDINARY GROUP I .15/1500
FROM TO FLOW DIAM SQUIV
GPM IN PIPE
LEN/FT
103 104
1.0549
Q
18.60
BN2
102 103DQ
19.13
1.0549
Q
37.73
BN2
101 102DQ
20.98
1.0549
Q
58.71
BN2
14 101DQ 24.67 1.0549
Q 83.38
BN1
113 115 1.0549
Q 21.08
BN6
16 113DQ 21.97 1.0549
Q 43.05
BN5
112 114 1.0549
Q 21.15
BN6
15 112DQ 22.04 1.0549
Q 43.19
BN5
L
F=0 F
C150 T
L
F=0 F
C150 T
L
F=0 F
C150 T
L
F=0 F
C150 T
L
F=0 F
C150 T
L
F=0 F
C150 T
L
F=0 F
C150 T
L
F=0 F
C150 T
108 110
1.0549
L
Q
20.32
F=0
F
BN4
C150
T
106 lOSDQ
21.17
1.0549
L
Q
41.49
F=0
F
BN4
C150
T
16 106DQ
24.11
1.0549
L
Q
65.60
F=0
F
BN1
C150
T
10-12-1997 15:41:14
P-LOSS PRSSSURB
PS I / FT SUfvDMARY
PSI
8.67 0.0732 PT 10.95 (104)
0.00 PE 0.00
8.67 PF 0.63
8.67 0.2711 PT 11.58 (103)
0.00 Pfi 0.00
8.67 PF 2.35
8.67 0.6142 PT 13.93 (102)
0.00 PE 0.00
8.67 PF 5.33
1.25 1.1752 PT 19.26 (101)
0.00 PE 0.00
1.25 PF 1.47
PT 20.73 ( 14)
13.00 0.0923 PT 14.07 (115)
0.00 PE 0.00
13.00 PF 1.20
11.75 0.3459 PT 15.27 (113)
0.00 PE 0.00
11.75 PF 4.06
PT 19.33 ( 16)
13.00 0.0929 PT 14.17 (114)
0.00 PE 0.00
13.00 PF 1.21
11.75 0.3481 PT 15.38 (112)
0.00 PE 0.00
11.75 PF 4.09
PT 19.47 ( 15)
13.00 0.0862 PT 13.07 (110)
0.00 PS 0.00
13.00 PF 1.12
13.00 0.3231 PT 14.19 (108)
0.00 PE 0.00
13.00 PF 4.20
1.25 0.7541 PT 18.39 (106)
0.00 Pfi 0.00
1.25 PF 0.94
PAGB 2
PIREOUT SUBMITTAL CREATED 10-12-1997 15:41:15 PAGB 3
ASHLSY MANOR CARE CENTER CRAWL SPACE
38TFI AVE. & PARFST STRBBT
WHEAT RIDGS, CO
ORDINARY GROUP I .15/1500
FROM TO FLOW DIAM EQUIV P-LOS5 PRSSSURE
GPM IN PIPS PSI/FT SUNIlMARY
LEN/FT PSI
13 16DQ 43.05 1.2910 L 0.71 1.0842 PT 19.33 ( 16)
Q 108.65 F=T/T F 12.00 PE 0.31
NR1 C120 T 12.71 PF 13.78
12 13 2.7309 L 7.58 0.0282 PT 33.42 ( 13)
Q 108.65 F=0 F 0.00 PE 0.00
NC1 C120 T 7.58 PF 0.21
PT 33.63 ( 12)
107 109 1.0549 L 13.00 0.0868 PT 13.16 (109)
Q 20.39 F=0 P 0.00 PE 0.00
BN4 C150 T 13.00 PF 1.13
105 107DQ 21.24 1.0549 L 13.00 0.3251 PT 14.29 (107)
Q 41.63 F=0 F 0.00 PE 0.00
BN4 C150 T 13.00 PF 4.23
15 lOSDQ 24.19 1.0549 L 1.25 0.7588 PT 18.52 (105)
Q 65.82 P=0 F 0.00 PE 0.00
BN1 C150 T 1.25 PF 0.95
12 15DQ 43.19 1.2910 L 0.71 1.0910 PT 19.47 ( 15)
Q 109.01 F=T/T F 12.00 PE 0.31
NR1 C120 T 12.71 PF 13.87
11 12DQ 108.65 2.7309 L 11.00 0.1020 PT 33.65 ( 12)
Q 217.66 F=0 F 0.00 PE 0.00
NC1 C120 T 11.00 PF 1.12
PT 34.77 ( 11)
14 111 1.0549 L 7.50 0.1265 PT 19.78 (111)
Q 25.00 F=0 F 0.00 PE 0.00
BN3 C150 T 7.50 PF 0.95
11 14DQ 83.38 1.2910 L 0.71 1.0792 PT 20.73 ( 14)
Q 108.38 F=T/T F 12.00 PE 0.31
NR1 C120 T 12.71 PF 13.72
10 11DQ 217.66 2.7309 L 27.38 0.2154 PT 34.76 ( 11)
Q 326.04 F=0 F 0.00 PE 0.00
NC1 C120 T 27.38 PF 5.90
2 10 4.3280 L 5.71 0.0229 PT 40.66 ( 10)
Q 326.04 F=S/2T F 50.00 PE 0.47
FM1 C120 T 55.71 PF 1.28
1 2 4.0260 L 300.00 0.0325 PT 42.41 ( 2)
Q 326.04E=E,2CV/GV,E F 66.00 PE 0.00
FR1 C120 T 366.00 PF 11.89
FIRBOUT SUHMITTAL CRSATSD 10-12-1997 15:41:15 PAGS 4
ASHLI3Y MANOR CARS CENTER CRAWL SPACE
38TH AVS. & PARFBT STRBBT
WHEAT RIDGB, CO
ORDINARY GROUP I .15/1500
FROM TO FLOW DIAM EQUIV P-LOSS PRBSSURfi
GPM IN PIPS PSI/FT SI7NIldARY
LSN/FT PSI
0 1 4.1550 L 58.00 0.0210 PT 54.30 ( 1)
Q 326.04 F=T,GV/8 F 50.00 PE 0.00
UN C140 T 108.00 PF 2.27
PT 56.57( 0)
PR&SSURB AVAILABLB AT NODE 0 AT 576.0 GPM 68.8 PSI
MAXIMUM PRBSSURE UNBALANCB IN LOOPS 0.016 PSI
MAXIMUM VBLOCITY IN PIPI3S 30.60 FPS
HYDEtAUL1C DES[GN INFORMATION SHEET
NAME: ASHLEY MANOR CARE CENTER
LOCATION: 38'" AVE. & PARFET STREET
AREA NUMBER: ATT(C
CONTRACTOR: Western States Fire Protection
CALCULATED BY: SIGMA
CONSTRUCTION: 0 COMBUSTIBLE
OCCUPANCY: UNUSED ATTIC
❑ NON-COMBUST[BLE
DATE: 10/ 12/47
SYSTEM NO.:
CONTRACT NO.: 95610
DRAWING NO.: FP-3 OF 3
CEILING HT.: VARIES
HAZARD CLASSIF[CATION
EINFPA 13 ELIGHT HAZARD ❑ORD. HAZ. GP ❑ 1 ❑2 ❑3 ❑EX. HAZ.
FINFPA 231 ONFPA 231C ❑FIGURE ❑CURVE
❑OTHER (SPECff7Y)
❑SPECIFIC RULING MADE BY: DATE:
SYSTEM DESIGN
AREA OF SPRINKLER OPERATION:
DENSTIY
AREA PER SPRINKLER
HOSE ALLOWANCE GPM; INSIDE:
HOSE ALLOWANCE GPM; OUTSIDE:
RACK SPRINKLER ALLOWANCE
1500 1 SYS]'EMTYPE
.10 1 OWET ❑DRY ODELUGE OPREACTION
225 MAX I SPRlNKLER OR NOZZLE
0 1 MAKE: RELIABLE MODEL F1FR
250 ~ SIZE: K-FACTOR 5.62
~ TEMPERAT[JRE RATING: 212
CALCULATION SUMMARY
GPM REQUIRED: 169.93 PSI REQUIRED: 6128 AT NODE 0
"C" FACTOR USED: OVERHEAD 150 UNDERGROUND 140 OTHER 120
WATER FLOW TEST ~ FtRE PUMP DATA ~ TANK OR RESERVOIR
DATE & TIME 10/1/97 ~ RATED CAPACTII' ~ CAPACTTY
STATIC PSI: 70 ~ RATED GPM I
RESIDUAL PSI: 64 ~ RATED PSI ~ ELEVATION
GPM FLOWING: 1400 ~ ELEVATION I
ELEVATION: 0 I ~
WATER FLOW INFORMATION
LOCATION: At Site SOURCE OF INFORMATION: Wheat Ridge Water
COMMODITY:
STORAGE HEIGHT:
STORAGE METHOD: %
COMMODITY STORAGE
CLASS:
AREA: SQ. FT.
PALLETIZED %
LOCAT'ION:
AISLE WIDTH:
RACK %
RACK INFORMATION
E]SINGLERow OSHELVING N ❑M[JI,TIPLE❑ROW ~OEN S ~NCAP~ AOTED ~NONOSLAVE
~PALLET ~ENCAPSULATEDSOL
[]FLUE SPACE IN INCFES OLONGITUDINAL E]TRANSVERSE
CLEARANCE FROM TOP OF STORAGE TO CLG.: FEET INCHES
HORIZONTAL BARRIERS PftOV[DED:
I
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~
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FIREOUT SUBMITTAL CRBATSD 10-12-1997 16:33:24
ASALEY MANOR CARS CENTER ATTIC
38TH AVE. & PARPET STRBBT
WHfiAT RIDGE, CO
LIGHT HAZARD .10/1500
WESTERN STATES FIRE PROTECTION COMPANY
7026 S. TUCSON WAY
BNGLSWOOD, CO 80112
303-792-0022
COLORADO STATE RfiGISTRATION N0. 032
FLOW TEST RESULTS
STATIC 70.00 PSI
RfiSIDUAL AT 1400.0 GPM 64.00 PSI
PRBSSURE AVAILABLE AT 269.9 GPM 69.71 PSI
SUNID7ARY OF SPRINKL$R OUTFLOWS
ACTUAL
MINIMUM
SPR
PRESSURE
FLOW
FLOW
K-FACTOR
201
23.44
27.21
17.32
5.62
202
10.14
17.89
17.32
5.62
203
9.50
17.32
17.32
5.62
204
9.52
17.34
17.32
5.62
205
10.54
18.25
17.32
5.62
206
10.35
18.08
17.32
5.62
207
9.79
17.58
17.32
5.62
208
9.83
17.62
17.32
5.62
209
11.00
18.64
17.32
5.62
TOTAL WATER REQUI
RED FOR SYSTBM
169.93
GPM
OUTSIDE
HOSE STREAMS AT 0
100.00
GPM
TOTAL WATER REQUI
REMENT
269.93
GPM
PRESSURE REQUIRED
AT 0
61.28
PSI
MAXIMUM
PRESSURE
UNBALANCE
IN LOOPS
0.032
PSI
MAXIMUM
VfiLOCITY
IN PIPES
32.37
FPS
PAGB 1
FIRSOUT SUBMITTAL CRSATBD 10-12-1997
ASHLSY MANOR CARE CBNTSR ATTIC
38TH AVB. & PARFBT STREBT
WHBAT RIDGB, CO
LIGHT HAZARD .10/1500
FROM TO FLOW DIAM EQUIV P-LOSS
GPM IN PIPE PSI/FT
LfiN/FT
208
207
1.0549
L
Q
3.41
F=0
F
BL1
C150
T
209
208DQ
17.62
1.0549
L
Q
21.03
F=0
F
BL1
C150
T
57
209DQ
28.64
1.0549
L
Q
39.68
E=0
F
BL1
C150
T
49
57
1.0549
L
Q
39.68
F:T/B
F
RN1
C150
T
48
49
1.0549
L
Q
39.68
F=0
F
CM2
C150
T
47
48DQ
-4.83
1.0549
L
Q
34.84
F=0
F
CM2
C150
T
46
47DQ
-6.34
1.0549
L
Q
28.50
F=0
F
CM2
C150
T
45
46DQ
37.78
1.0549
L
Q
66.28
F=0
F
CM2
C150
T
44
45DQ
-11.76
1.0549
L
Q
54.52
F=0
F
CM2
C150
T
43
44DQ
-18.94
1.0549
L
Q
35.58
8=0
F
CM2
C150
T
42
43DQ
-4.39
1.0549
L
Q
31.19
F=0
F
CM2
C150
T
60 42DQ -20.77 1.0549 L
Q 10.42 F=0 F
BL2 C150 T
16:33:24
PRESSURE
SUNAIARY
PSI
12.79 0.0032 PT 9.79 (207)
0.00
P8
0.00
12.79
PF
0.04
12.79
0.0919 PT
9.83 (208)
0.00
PE
0.00
12.79
PF
1.18
1.63
0.2975 PT
11.01 (209)
0.00
PE
0.00
1.63
PF
0.48
1.33 0.2975 PT 11.49 ( 57)
11.00
PE
0.58
12.33
PF
3.67
3.00
0.2975
PT
15.74
( 49)
0.00
PE
0.00
3.00
PF
0.89
6.33
0.2339
PT
16.63
( 48)
0.00
PE
0.00
6.33
PF
1.48
3.17
0.1613
PT
18.11
( 47)
0.00
Pfi
0.00
3.17
PF
0.51
4.29
0.7686
PT
18.62
( 46)
0.00
P£
0.00
4.29
PF
3.30
7.21
0.5355
PT
21.92
( 45)
0.00
PE
0.00
7.21
PF
3.86
1.00
0.2431
PT
25.78
( 44)
0.00
PS
0.00
1.00
PF
0.24
5.54
0.1906
PT
26.02
( 43)
0.00
PE
0.00
5.54
PF
1.06
64.33
0.0251
PT
27.08
( 42)
0.00
PE
1.19
64.33
PF
1.61
PAGB 2
FIRSOUT SUBMITTAL CRIIATED
ASHL&Y MANOR CARB CENTER ATTIC
38TH AVB. & PARFET STRSET
WHBAT RIDGS, CO
LIGHT HAZARD .10/1500
FROM TO FLOW DIAM fiQUIV
GPM IN PIPE
LEN/PT
32 44 1.0549 L
Q 18.94 F=0 F
BL2 C150 T
33 32DQ 31.19 1.0549 L
Q 50.12 F=0 F
CM1 C150 T
34 33DQ 31.60 1.0549 L
Q 81.73 F=0/T F
CM1 C150 T
41 42 1.0549 L
Q 20.77 F=0 F
CM2 C150 T
40 41DQ -10.21 1.0549 L
Q 10.56 F=0 F
CM2 C150 T
30 40 1.0549 L
Q 10.56 F=fi/E F
BL2 C150 T
31 30 1.0549 L
Q 10.56 F=0 F
CM1 C150 T
54 41 1.0549 L
Q 10.21 F=T/E F
RN1 C150 T
50 54 1.0549 L
Q 10.21 F=0 F
BL1 C150 T
31 50 1.0549 L
Q 10.21 F=T/E F
RN1 C150 T
60 31DQ 10.56 1.0549 L
Q 20.77 F=0 F
CM1 C150 T
21 34 2.7309 L
10-12-1997 16:33:25
P-LOSS PRSSSURfi
PSI/FT SUNffNARY
PSI
65.54 0.0757 PT 25.73 ( 44)
0.00
PE
0.43
65.54
PF
4.96
3.00
0.4584
PT
31.12 (
32)
0.00
PE
0.00
3.00
PF
1.38
1.17
1.1325
PT
32.50 (
33)
8.00
PE
0.00
9.17
PF
10.39
PT
42.89 (
34)
6.88
0.0898
PT
27.04
( 42)
0.00
Pfi
0.00
6.88
PF
0.62
6.08
0.0257
PT
27.66
( 41)
0.00
PE
0.00
6.08
PF
0.16
54.50
0.0257
PT
27.82
( 40)
6.00
PS
0.00
60.50
PF
1.55
8.21
0.0257
PT
29.37
( 30)
0.00
PE
0.00
8,21
PF
0.21
PT
29.58
( 31)
1.33
0.0241
PT
27.67
( 41)
11.00
PE
-0.58
12.33
PF
0.30
54.50
0.0241
PT
27.39
( 54)
0.00
PE
0.00
54.50
PF
1.31
1.33
0.0241
PT
28.70
( 50)
11.00
PE
0.58
12.33
PF
0.30
2.75
0.0895
PT
29.58
( 31)
0.00
PE
0.00
2.75
PF
0.25
PT
29.83
( 60)
4.00
0.0645
PT
42.88
( 34)
PAGE S
Q 169.93 F.B P 6.00 PB 0.00
FM2 C120 T 10.00 PF 0.64
FIR80UT SUBMITTAL CRSATSD 10-12-1997 16:33:25
ASHLSY MANOR CARE CENTfiR ATTIC
38TFI AVS. & PARFBT STRBBT
WHEAT RIDGS, CO
LIGHT HAZARD .10/1500
FROM TO FLOW DIAM SQUIV P-LOSS PRBSSURB
GPM IN PIPE PSI/FT SUbIINARY
LEN/FT PSI
20 21 2.7309 L 10.50 0.0645 PT 43.52 ( 21)
Q 169.93 F=0/E F 6.00 PE 4.55
FR2 C120 T 16.50 PF 1.06
2 20 3.3399 L 49.50 0.0242 PT 49.13 ( 20)
Q 169.93 F=T/4E F 35.00 Pfi 0.00
FM1 C120 T 84.50 PF 2.04
1 2 4.0260 L 900.00 0.0097 PT 51.17 ( 2)
Q 169.93F=fi,2CV/GV,E F 66.00 PE 0.00
FR1 C120 T 966.00 PF 9.37
0 1 4.1550 L 58.00 0.0063 PT 60.54 ( 1)
Q 169.93 F=T,GV/E F 50.00 PS 0.00
UN C140 T 108.00 PF 0.68
PT 61.22( 0)
PRBSSURfi AVAILABLfi AT NODE 0 AT 269.9 GPM 69.7 PSI
MAXIMUM PRSSSURfi UNBALANCE IN LOOPS 0.032 PSI
MAXIMi7M VELOCITY IN PIPES 32.37 PPS
PAGE 6
FIREOUT SUHMITTAL CREATED 10-12-1997 16:33:24
ASHLEY MANOR CARfi CENTER ATTIC
38TH AVE. & PARFET STRE$T
WHEAT RIDGE, CO
LIGHT HAZARD .10/1500
WESTERN STATES FIRE PROTECTION COMPANY
7026 S. TUCSON WAY
ENGLEWOOD, CO 80112
303-792-0022
COLORADO STATE REGISTRATION N0. 032
FLOW TEST RESULTS
STATIC
RESIDUAL AT 1400.0 GPM
PRESSURE AVAILABLE AT 269.9 GPM
SUMMARY OF SPRINKLSR OUTFLOWS
70.00 PSI
64.00 PSI
69.71 PSI
ACTUAL
MINIMUM
SPR
PRfiSSURE
FLOW
_ . FLOW_
-
K-FACTOR
201
23.44
27.21
17.32
5.62
202
10.14
17.89
17.32
5.62
203
9.50
17.32
17.32
5.62
204
9.52
17.34
17.32
5.62
205
10.54
18.25
17.32
5.62
206
10.35
18.08
17.32
5.62
207
9.79
17.58
17.32
5.62
208
9.83
17.62
17.32
5.62
209
11.00
18.64
17.32
5.62
TOTAL WATER REQUIRED FOR SYSTEM 169.93 GPM
OUTSIDE HOSE STREAMS AT 0 100.00 GPM
TOTAL WATER REQUIREMENT 269.93 GPM
PRESSURE REQUIRED AT 0 61.28 PSI
PAGE 1
MAXIMUM PRESSURE UNSALANCE IN LOOPS 0.032 PSI
MAXIMUM VELOCIZ'Y IN PIPES 32.37 FPS
FIRBOUT SUBMITTAL CRSATSD
ASHLEY MANOR CARE CENTER ATTIC
38TH AVB. & PARPBT STREET
WHSAT RIDGB, CO
LIGHT HAZARD .10/1500
FROM TO FLOW DIAM FQUIV
GPM IN PIPE
LEN/FT
208 207 1.0549
Q 3.41
209 208DQ
4
BL1
17.62 1.0549
21.03
BL1
57 209DQ
4
49 57
4
48 49
4
L
F=0 F
C150 T
L
F=0 F
C150 T
18.64 1.0549 L
39.68 F=0 F
BL1 C150 T
1.0549 L
39.68 F=T/E F
RN1 C150 T
1.0549 L
39.68 F=0 F
CM2 C150 T
47 48DQ -4.83 1.0549 L
Q 34.84 F=0 F
CM2 C150 T
46 47DQ -6.34 1.0549 L
Q 28.50 F=0 F
CM2 C150 T
45 46DQ 37.78 1.0549 L
Q 66.28 F=0 F
CM2 C150 T
44 45DQ -11.76 1.0549 L
Q 54.52 F=0 F
CM2 C150 T
43 44DQ -18.94 1.0549 L
Q 35.58 F=0 F
CM2 C150 T
42 43DQ -4.39 1.0549 L
Q 31.19 F=0 F
CM2 C150 T
60 42DQ -20.77 1.0549 L
Q 10.42 F=0 F
BL2 C150 T
10-12-1997 16:33:24
P-LOSS PRESSURB
PSI/FT SUhIlKARY
PSI
12.79 0.0032 PT 9.79 (207)
0.00
Pfi
0.00
12.79
PF
0.04
12.79
0.0919
PT
9.83
(208)
0.00
PE
0.00
12.79
PF
1.18
1.63
0.2975
PT
11.01
(209)
0.00
PS
0.00
1.63
PE
0.48
1.33
0.2975
PT
11.49
( 57)
11.00
PE
0.58
12.33
PF
3.67
3.00
0.2975
PT
15.74
( 49)
0.00
PE
0.00
3.00
PF
0.89
6.33
0.2339
PT
16.63
( 48)
0.00
PE
0.00
6.33
PF
1.48
3.17
0.1613
PT
18.11
( 47)
0.00
PE
0.00
3.17
PF
0.51
4.29
0.7686
PT
18.62
( 46)
0.00
PE
0.00
4.29
PF
3.30
7.21
0.5355
PT
21.92
( 45)
0.00
PE
0.00
7.21
PF
3.86
1.00
0.2431
PT
25.78
( 44)
0.00
PE
0.00
1.00
PF
0.24
5.54
0.1906
PT
26.02
( 43)
0.00
Pfi
0.00
5.54
PF
1.06
64.33
0.0251
PT
27.08
( 42)
0.00
PE
1.19
64.33
PF
1.61
PAG$ 2
FIRBOUT SUBMITTAL CREATED 10-12-1997
ASHLSY MANOR CARB CENTER ATTIC
38TH AVH. & PARFET STRBET
WHEAT RIDGE, CO
LIGHT HAZARD .10/1500
FROM TO FLOW DIAM EQUIV P-LOSS
GPM IN PIPE PSZ/FT
LEN/FT
32 44 1.0549 L
Q 18.94 F=0 F
BL2 C150 T
33 32DQ 31.19 1.0549 L
Q 50.12 F=0 F
CM1 C150 T
34 33DQ 31.60 1.0549 L
Q 81.73 F=0/T F
CM1 C150 T
41 42 1.0549 L
Q 20.77 F=0 F
CM2 C150 T
40 41DQ -10.21 1.0549 L
Q 10.56 F=0 F
CM2 C150 T
30 40 1.0549 L
Q 10.56 F=E/E F
BL2 C150 T
31 30 1.0549 L
Q 10.56 F=0 F
CM1 C150 T
54 41 1.0549 L
Q 10.21 F=T/E F
RN1 C150 T
50 54 1.0549 L
Q 10.21 F=0 F
BL1 C150 T
31 50 1.0549 L
Q 10.21 r^=T/E F
RN1 C150 T
60 31DQ 10.56 1.0549 L
Q 20.77 F=0 F
CM1 C150 T
21 34 2.7309 L
16:33:25
PRESSURS
SUMMARY
PSI
65.54 0.0757 PT 25.73 ( 44)
0.00
PE
0.43
65.54
PF
4.96
3.00
0.4584
PT
31.12 (
32)
0.00
PE
0.00
3.00
PF
1.38
1.17
1.1325
PT
32.50 (
33)
5.00
PE
0.00
9.17
PF
10.39
PT
42.89 (
34)
6.88
0.0898
PT
27.04 (
42)
0.00
Pfi
0.00
6.88
PF
0.62
6.08
0.0257
PT
27.66
( 41)
0.00
PE
0.00
6.08
PF
0.16
54.50
0.0257
PT
27.82
( 40}
6.00
PE
0.00
60.50
PF
1.55
8.21
0.0257
PT
29.37
( 30)
0.00
PE
0.00
8.21
PF
0.21
PT
29.58
( 31)
1.33
0.0241
PT
27.67
( 41)
11.00
PE
-0.58
12.33
PF
0.30
54.50
0.0241
PT
27.39
( 54)
0.00
PE
0.00
54.50
PF
1.31
1.33
0.0241
PT
28.70
( 50)
11.00
PE
0.58
12.33
PF
0.30
2.75
0.0895
PT
29.58
( 31)
0.00
PE
0.00
2.75
PF
0.25
PT
29.83
( 60)
4.00
0.0645
PT
42.88
( 34)
PAGE 5
Q 169.93 F-S P 6.00 PB 0.00
FM2 C120 T 10.00 PF 0.64
FIREOUT SUBMITTAL CRfiATfiD 10-12-1997 16:33:25 PAGE 6
ASHLEY MANOR CARE CENTER ATTIC
38TH AVS. & PARFET STREET
WHEAT RIDGE, CO
LIGHT HAZARD .10/1500
FROM TO FLOW DIAM fiQUIV P-LOSS PRBSSURE
GPM IN PIPE PSI/FT SUNQ7ARY
LEN/FT PSI
20 21 2.7309 L 10.50 0.0645 PT 43.52 ( 21)
Q 169.93 F=0/E F 6.00 PE 4.55
FR2 C120 T 16.50 PF 1.06
2 20 3.3399 L 49.50 0.0242 PT 49.13 ( 20)
Q 169.93 F=T/4E F 35.00 PE 0.00
FM1 C120 T 84.50 PF 2.04
1 2 4.0260 L 900.00 0.0097 PT 51.17 ( 2)
Q 169.93F=E,2CV/GV,E F 66.00 PE 0.00
FR1 C120 T 966.00 PF 9.37
0 1 4.1550 L 58.00 0.0063 PT 60.54 ( 1)
Q 169.93 F=T,GV/E F 50.00 PE 0.00
UN C140 T 108.00 PF 0.68
PT 61.22( 0)
PRESSURE AVAILABLE AT NODS 0 AT 269.9 GPM 69.7 PSI
MAXIMUM PRESSURE ZJNBALANCE IN LOOPS 0.032 PSI
MAXIMUM VELOCITY IN PIPES 32.37 FPS
HAALTN FACIWTIESAND EMERGENCY
MEDICAL SERVICES DIVISIOM State Licensure Program
4300 Cherry Creek Drive South
Denver, co 80246 Assisted Living Residences
VoiQ~~ ~Q~ 03-753-6214
~~V6~ ~}~SAe.~al~.WT/hfd. asp
AUG 3 0 2005 Form: Sign off for Local Authorities
CADeptofPublicHealth&Env ZONING DEPARTMENT
HF&EMSD
Co Oept of Public Health & Env
HF$EMSD
Written evidence of comp[iance with local zoning codes and ordinanres must be obtained Contact the city or county
deparJments in your area and have the director or designee sign below or otherwise indicale approva[. Return this
form, signed by the proper authorities, to comp[ete your license application. A final inspection cannot be conducted
urctil these approvals are obtained. A license cannot be issued until the comp[eted jorm, with the original signature, is
-n f;la w;th the Division.
Zoning Department having Jurisdiction: L i±.+ ci-s ii.l V°~ V,`~G
i
The above-named facility meets the requirements for zoning approvaL [X j YES NO If "no" please
explain on a
sepazate attachment.
Signature: '/V`~ Date: g' 2-1 'd S
Name ofPerson to Contact:,(V\ ey'r-cr kPhone: (~i_12'iS •7$`{8 Fax: 303 7_3S - 7-$S4~
Address: A'Sl)O vJ
USE ONLY-- OFFICE USE ONLY-- OFFICE USE ONLY--OFFICE USE ONLY
[ J Application for a new license
[ ] Change of Ownership
[ ] Granting of a License
Change
Effective:
( ] New secured unit
[ ] NameChange
6ncrease/Decrease of Beds
__to: / a
From:
Change effective:
Change effective: r~f S00 S~
[ ] Action taken against the License
Effective:
[ ] Faciliry Closure bttecuve:
]nitial Notification to Zoning Dept. date:
~ Final Notification to Zoning Dept date: ~ by:
No. of Licensed Beds Requested: IC)
Name of Person to ContactAwn~Y1"G~t'114e- Phone: ( 303 )9I 3"WS Fax: ( 3a3 )d!844' -S'l 34
HEALTHFACIWTIESANDEMERGENCY MeDIcnL SeevIces DrvIsion State Licensure Program
4300 Cherry Creek Drive South
Denver, CO 80246 Assisted Living Residences
Voice:303-692-2800 Fm:303-753-6214
www.edphe.slate.co-us/hf/hfd.asp
Form: Sign off for Local Authorities
BUILDING DEPARTMENT
ell,,
Written evidence ojcompliance with loca[ building codes must be obtained. Contact the ciry or counry departments in
your aiea and have !he director or designee sign be[ow or otheswise indicate approval. Return this form, signed by the
proper authorities, to complete your license application. A ftnal inspection cannot be eondueted until these approvals
are obtained. A license cannot be issued until the comp[eted form, with [he original signature, is on ftle with the
Division. : _ r fl A_
Name of Facility:
Address: ~'L~~~rfe. r ~
No. of Licensed Beds Requested: _4Q
Name of Person to Contact: Y1N ~ F
Building DepaRment having ]urisdiction:
The above-named facility meets the requi
If "no" please explaiaoy~t- sepcat~
Phone:
County
~
for building approval: Pli-YES [ ]
Name of Persoryfo Contaet:
Address:
9
USE ONLY-- OFFICE USE ONLY-- OFFICE USE ONLY--OFF]CE USE ONLY
[ ] Application for a new license
[ ] Change of Ownership Change
] Granting of a License Effectil
I [ ] New secured unit
[ ] Name Change Change effective:
Increase/Decrease of Beds Change effective: z.'0 ~
From: ~ to:
[ j Action taken against the License Effective:
[ ] Facility Closure Effective:
[~~vtnitial Notification to Zoning Dept. date: ~-:U by:
. ~
Final Notiticauon to
Phone: (333S-~ax:
~2t eid9s C'a
/
9
3~ O
~6/.;. . 1005
HEALTHFACILiT1ESANDEMERGENCY RECEIVE M
MEDICAL SERVICES DIVISION 4300 Cherry Creek Drive Sou[h State Licensure Program Denver, co soza6 Assisted Living Residences AUG 3 0 2Voice:303-692-2800 Fax:303-753-6214
www.cdphe.state.co.us/hf/hfd.asp Co Dept of Public H~~~~
HF&EMS~ d Ent
Form: Sign off for Local Authorities
FIRE DEPARTMENT
Written evidence of compliance with local fire codes must be obtained Contact the city or county departments in your
area and have the director or designee srgn below or otherwise indicate npproval. Return this jorm, signed by the
proper authorities, to complete your license application. A final inspection cannot be conducted unti/ these approvals
are obtained A license cannot be issued unti/ the completed jorm, with the original signature, is on file with the
Division. „
w
Name of Facility:
No. of Licensed Beds Requested:
Name of Person to Contact: Phone: ( ) Faac:
Fire Department having Jurisdiction:
The above-named facility meets the requirements for fire safety. ~4 YES NO
If "no" please explai a pazate chment o in the Comments section, below.
Signature: Date:
Name of Person to Contact: Phone: (fQ+ )%F~clz Faac: (~oT 9%O -03~ o
Address:_ :7 -eL~~
CODE(S) APPLIED AND EDITION: Z'C 01 G~G '7-c~ ~~-sa~
OFFICE USE ONLY-- OFFICE USE ONLY-- OFFICE USE ONLY--OFFICE USE ONLY
[ ] Application for a new license
[ ] Change of Ownership Change effective:
[ ] Granting of a License Effective:
[ ] New secured unit
[ ] Name Change Change effective:
Inerease/Decrease of Beds Change effective: D C~
From: ~_to: ~L
~
[ ] Action [aken against the License Effective:
[ ] FaciliTy Closure Effective:
Initial Notification to Zoning Dept. date: CC S by: 00
( X] Final Notification to Zonin De t date:
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: &L,1
Job Address: _EJ _ ���9V a; 7— f' Z=
Permit Number: flD,59
❑ No one available for inspection: Time d a!�)PM
Re -Inspection required: Yes No /
When corrections have been made, sch—e-ddule for re -inspection online at:
http✓/www. ci. wheatridge.co. uslinspection
Date Z, ?,-4 Inspector:
DO NOT REMOVE THIS NOTICE