HomeMy WebLinkAbout4655 Parfet Street3
City of Wheat Ridge
Residential Demoliti PERMIT - 201709588
PERMIT NO: 201709588 ISSUED: 12/14/2017
JOB ADDRESS: 4655 Parfet ST EXPIRES: 12/14/2018
JOB DESCRIPTION: Residential Demo permit for removal of fire causing asbestos major spill,
Asbesto spill response along with 835 sqft of fire damage asbestos drywall
to be removed.
*** CONTACTS ***
OWNER (720)934-9137 OCONNOR PAUL T
SUB (720)242-9043 Scott Tash 170697 ALM Abatements
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2408 / FRUITDALE, LEES, STONERIDGE BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 12,000.00
FEES
Total Valuation 0.00
Investigative Fees 50.00
Demolition Fee 50.00
** TOTAL ** 100.00
*** COMMENTS ***
*** CONDITIONS ***
Work shall comply with 2012 IRC & 2014 NEC. Per IRC Sec. R314, smoke detectors are required
to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every
level of the structure.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
appl�ca le building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the and
and am authorized to obtain this permit and perform the work described and approved in conjunction with
this permit. I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be
performed and that all work to be per ormed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This. permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Budding
Official and may be subject to a fee equal to one-half of the originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Budding Official and is not guaranteed.
4, No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
M 1I Signature of Chief Building Official�"Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City Of
_,40rW heat Midge
COMMUNITY DEVELOPMENT
Building & Inspection Services Division
7500 W. 29i1 Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: Perm its(a-)ci.wheatridge.co.us
FOR OFFICE US ONLY
Date: ✓J
Plan/Permit #CXU qb
% l
Plan Review Fee: loo'o'
�
Building Permit Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address.
Propertv Owner
Property Owner Email:
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Architect/Engineer: A/4
Architect/Engineer E-mail: Phone:
Phone:
Contractor: L / A lz) "�l C n' r_ 7 5
Contractors City License #: T L' Lql Phone: PV�5
Contractor E-mail Address: 1 >J
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): S Po4/ ( A � Phone:
CONTACT EMAIL(p/ease print):%
Sub Contractors:
Electrical:
W.R. City License #
Other City Licensed Sub:
City License #
City License #
Plumbing:
W.R. City License #
Other City Licensed Sub:
Mechanical:
W.R. City License #
Complete all information on BOTH sides of this form
❑ COMMERCIAL -DIRESIDENTIAL
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)
(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.)
Sq. Ft./LF
Amps
six
/0--f ryy, Sv c I f� Lj e-
iZr
Btu's
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. I, the applicant for this building permit application, warrant the
truthfulness of the information provided -application.
CIRCLE ONE: (OWNER) ONTRACT 'or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last name): DATE:
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
Building Division Valuation: $
Colorado Department of Public Health and Environment
Air Pollution Control Division — Stationary Sources Program — Indoor Air Unit
4300 Cherry Creek Drive South, APCD-SS-131
Denver, Colorado 80246-1530
Phone: 303-692-3100— Fax: 303-782-0278
E-mail: asbestos@state.co.us
ASBESTOS APPROVAL NOTICE
This notice is granted subject to Colorado Air Quality Control Commission Regulation No.
8, Part B, adopted December 16, 2003, and effective March 2, 2005, the Colorado Air
Pollution Prevention and Control Act C.R.S. (25-7-101 and 25-7-501 et seq). It is only for
the purpose of allowing asbestos abatement.
As a contractor, you may be subject to other licenses and permits, depending on the
requirements of the county and municipality in which the work is being performed. The
Colorado Department of Public Health and Environment, Air Pollution Control Division
strongly suggests that you check with county and municipal authorities in order to determine
any other local building/permitting requirements that must be met.
THE ORIGINAL PERMIT MUST BE POSTED ON SITE AT ALL TIMES.
Immediately notify the Unit of project modifications by fax (number above) or e-mail (address above) and
the appropriate county health department by fax. Project modifications include changes in the scope of
work or the scheduled work dates, etc.
This asbestos approval notice is valid beginning 11/20/2017 through 11:59 PM on 12/6/2017.
The actual scheduled work dates are from 11!20/2017 through 12/6/2017.
Approval issued on: 11/15/2017
Record number: 132512
Notice Number: 17JE6872N
For the location specified below:
Oconnor residence
Main floor living room, bathroom
4655 Parfet St
Wheatridge
Jefferson County
This notice has been issued to:
Amount paid: $60.00
Check number: Cc 7911
A.L.M. Abatements LLC Issued bv: SM
7830 W Alameda Ave. 4304
Lakewood, CO 80226
C.Co Submit form to:
Colorado Dept. of Public Health and
4 � Colorado Department of Public Health and Environment
APCD-I E -11 I
(°= Environment 4300 Cherry Creek
DrivrSoutL
Denver, CO 80246-1530
* Air Pollution control Division Phone -303-092-3100
1876' Fax. 303-782-0278
Single -Family Residential Dwelling
Area of Public Access Opt -out Form
Owner Name: Paul Oconnor -
Street Address: 4655 Parfet Street
City: Wheatridge State- CO County: Jefferson Zip: 80033
Phone Number: 720-934-9137
Start Date of Project: 1111q417
Completion Date of Project: J 30bJ
In June 2001, Colorado implemented a"new law that extended the regulatory umbrella of asbestos abatement protections
to single-family residential dwellings with regulations that, until recently, have only applied to public and commercial
buildings.
Asbestos is a known human carcinogen and is an airborne hazard. Once airborne, asbestos fibers can stay suspended in
the air for days, weeks or even months before settling out of the air, only to become airborne again because of some
minor disturbance. Moreover, asbestos fibers can easily migrate through the air and, because of their microscopic size,
ignore barriers like fences or locked doors that easily restrict people but not microscopic fibers. Since the air in buildings
can move from room to room as a result of many factors, fibers, riding the air currents, can and will migrate to other areas
of a building.
Uncontrolled asbestos abatement projects or renovation projects that disturb asbestos may cause latent asbestos
hazards that could expose people to asbestos in the future, long after the renovation activity occurred. For example,
removal of asbestos texturing without any engineering controls may allow asbestos residues to accumulate in cracks,
crevices, storage cabinets, lighting fixtures, door and window frames, ventilation ducts, radiators, vents, etc. This
asbestos residue may not release fibers until the occupants, who, by turning on the air -conditioner, opening a window or
door, or changing out a light fixture, disturb it. The airborne asbestos fiber concentrations resulting from this disturbance
may result in a significant exposure to the current and future occupants of the home.
Currently in public and commercial buildings, asbestos abatement work is regulated and monitored by the Colorado
Department of Public Health and Environment. Asbestos abatement workers must be trained in asbestos abatement,
certified by the Colorado Department of Public Health and Environment, and follow work practices known to prevent or
contain the release of asbestos fibers when asbestos is disturbed. Companies that perform asbestos abatement are
required to use safe work practices, but only if the asbestos abatement removal work takes place in an area of public
access.
Since the scope of previous public health regulations did not include single-family residential dwellings, the Colorado
Department of Public Health and Environment was unable to protect homeowners from these exposures. With this new
law homeowners who reside in the home they wish to renovate can now choose to be afforded the same protections as
they are entitled to in a public and commercial building, unless the homeowner chooses to waive this protection.
To waive these protections, the homeowner must sign this form declaring that they do not want their home to be
considered an "Area of Public Access" for purposes of determining the applicability of portions of Colorado's asbestos
regulation. The term "Area of Public Access" is unique to Colorado's asbestos regulation and basically determines if an
abatement permit, engineering controls, and air clearance testing is required. if a building is not an "Area of Public
Access" then only certification, notification and asbestos disposal requirements in Colorado's regulation are
applicable. This declaration will not affect you in any other way as it only determines your home's status with respect to
Colorado's asbestos abatement regulation.
As with most regulatory protections, there is a monetary cost_ The cost of the asbestos abatement project in your home
will be greater if your home is considered an "Area of Public Access" because the contractor will have to comply with
stringent requirements necessary to protect public health. The project will require an abatement permit from the Colorado
Department of Public Health and Environment and will thus be regulated and fall under the contractor compliance
monitoring program administered by the Colorado Department of Public Health and Environment.
Page 1 of 2
Form: SFRD08 Rev.07120J08
The following are the Notification and Permitting Fees for all work on single-family residential dwellings that is not
performed by the owner:
Pursuant to Colorado law (25-7-502(1)(c), C.R.S.) I, the undersigned, hereby request that my single-family residential
dwelling not be considered an area of public access, as defined in 25-7-502 C.R.S.
I hereby certify that the home for which this waiver applies is a single-family residential dwelling with the address given on
page one, that I own the residential dwelling located at the above address and that it is my primary place of residence. I
do not rent or lease any part of the dwelling to another person or company or use it as a business. I further attest that 1
have no plans to demolish, sell, or rent my home at the conclusion of the Project. 1 understand that any work conducted
on the outside of my home is always in an area of public access and that I cannot use this opt -out form for work
conducted on the outside of my house.
All notifications to the Division of the intent to abate asbestos containing materials above the trigger levels, whether in an
area of public access or not, require a 10 -working day waiting period prior to any work staring on the project The waiting
period is required for the Division to process the notification and schedule any inspection of the project. The Division may
decide, on a case-by-case basis, to waive all or part of the required waiting period_ I understand that signing this Opt -out
form in no way affects the Division's decision on whether or not to waiver the10 working -day waiting period.
Where the homeowner has chosen to opt -out, the residential dwelling will revert to being an area of public access subject
to all the protective requirements contained in Colorado Air Quality Control Commission's Regulation No. 8, Part B: 1) at
the time of the homeowner's choosing; 2) when the homeowner no longer own the single-family residential dwelling; or, 3)
if the dwelling ceases being the homeowner's primary residence, whichever is first.
If you wish to designate an opt -out expiration date at this time, please fill in a date in the space provided:
Opt -out Expiration Date: • `�
You may also designate an opt -out expiration date at some point in the future by contacting the Air Pollution Control .
Division at the number provided below.
I have read both pages of this form and understand its content I understand that by making
this declaration, most of the protective requirements contained in Colorado Air Quality
Control Commission's Regulation No. 8, Part B, on asbestos will not be applicable to my
dwelling and I will not be afforded all the protections provided by this regulation.
By signing below, 1 acknowledge that the;ia ove statements are true and correctf _
Homeowner:
Homeowner:
Signature
Signature
General Asbestos Contractor (GAC)
ALM Abatements
GAC Phone Number with Area Code: 720-242-9043
GAC Fax Number with Area Code: 720-242-9137
If you have any questions, please call the Air Pollution Control
Division at (303) 692-3100.
Visit our web site at httpi//Www.cdphe-state.co.uslap/asbeshom.asi)
Date
Date
Notification Fee for Opt-
Out and Non -Friable
Permit Fee for Projects on Friable Asbestos -Containing
Materials — Includes the $55 Notice Fee
Project Len th
Date Received:
Projects in Single -Family
1 — 30 days
31 - 90 days
91 - 365 days
Amount of Asbestos being Abated:
Residential Dwellings
Less than 50 linear feet or 32 square feet or the volume equivalent
of a 55 -gallon drum
$0
$0
$0
$0
Greater than 50 linear feet or 32 square feet or the volume
equivalent of a 55 -gallon drum, but Less than or equal to 260 linear
$60
$180
$300
$420
feet or 160 square feet or the volume equivalent of a 55 -gallon drum
Greater than 260 Linear feet or 160 square feet or the volume
equivalent of a55 -gallon drum
$60
$400
$800
$1200
Pursuant to Colorado law (25-7-502(1)(c), C.R.S.) I, the undersigned, hereby request that my single-family residential
dwelling not be considered an area of public access, as defined in 25-7-502 C.R.S.
I hereby certify that the home for which this waiver applies is a single-family residential dwelling with the address given on
page one, that I own the residential dwelling located at the above address and that it is my primary place of residence. I
do not rent or lease any part of the dwelling to another person or company or use it as a business. I further attest that 1
have no plans to demolish, sell, or rent my home at the conclusion of the Project. 1 understand that any work conducted
on the outside of my home is always in an area of public access and that I cannot use this opt -out form for work
conducted on the outside of my house.
All notifications to the Division of the intent to abate asbestos containing materials above the trigger levels, whether in an
area of public access or not, require a 10 -working day waiting period prior to any work staring on the project The waiting
period is required for the Division to process the notification and schedule any inspection of the project. The Division may
decide, on a case-by-case basis, to waive all or part of the required waiting period_ I understand that signing this Opt -out
form in no way affects the Division's decision on whether or not to waiver the10 working -day waiting period.
Where the homeowner has chosen to opt -out, the residential dwelling will revert to being an area of public access subject
to all the protective requirements contained in Colorado Air Quality Control Commission's Regulation No. 8, Part B: 1) at
the time of the homeowner's choosing; 2) when the homeowner no longer own the single-family residential dwelling; or, 3)
if the dwelling ceases being the homeowner's primary residence, whichever is first.
If you wish to designate an opt -out expiration date at this time, please fill in a date in the space provided:
Opt -out Expiration Date: • `�
You may also designate an opt -out expiration date at some point in the future by contacting the Air Pollution Control .
Division at the number provided below.
I have read both pages of this form and understand its content I understand that by making
this declaration, most of the protective requirements contained in Colorado Air Quality
Control Commission's Regulation No. 8, Part B, on asbestos will not be applicable to my
dwelling and I will not be afforded all the protections provided by this regulation.
By signing below, 1 acknowledge that the;ia ove statements are true and correctf _
Homeowner:
Homeowner:
Signature
Signature
General Asbestos Contractor (GAC)
ALM Abatements
GAC Phone Number with Area Code: 720-242-9043
GAC Fax Number with Area Code: 720-242-9137
If you have any questions, please call the Air Pollution Control
Division at (303) 692-3100.
Visit our web site at httpi//Www.cdphe-state.co.uslap/asbeshom.asi)
Date
Date
Page 2 of 2
Form: SFRDQe R—.0272t M
FOR APCD USE ONLY
I
Date Received:
3
Approved By:
Notice/Permit Number:
Page 2 of 2
Form: SFRDQe R—.0272t M
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SCHAAN
Environmental Testing
ASBESTOS MICRO -VACUUM SAMPLING INSPECTION REPORT
4655 Parfet Street
Wheat Ridge, CO 80033
Report Date: August 11, 2017
Inspection/Testing Date: August 9, 2017
SET File: 17-0854
Prepared by:
Blake Bradley
Colorado Certified
Asbestos Building Inspector, 16862
Lead Based Paint Inspector, 17225
Certified Mold Inspector and Assessor
Limited Scope of Report
The micro -vacuum sampling performed for the client was to identify the presence or absence
of asbestos -fibers on contents surrounding a minor asbestos spill that occurred after a fire in
the above-mentioned property. Asbestos -containing building materials were identified on a
previous inspection and additional sampling was requested to determine the extent of
contamination. The micro -vacuum dust collection samples were of the subject property as
they existed at the time of the inspection. The inspection was limited to the areas that were
visually and physically accessible. The inspection was not a risk assessment, physical
inspection of systems, or structure of the subject property, as it relates to their serviceability.
The Inspector has prepared this written Asbestos Inspection Report for the sole use and
benefit of the client. The asbestos -fiber micro -vacuum inspection report shall identify, report,
and make recommendation for future evaluation. The use of this report and information
contained herein by others, in whole or in part, is not authorized without the client
authorization.
Purpose and Scope
The limited inspection and micro -vacuum sampling was conducted to identify any asbestos -
containing settled dust within the residence, in -order to determine the scope of
decontamination and define the areas in which professional abatement activities would be
required to clean the contents.
Performance of this asbestos inspection is intended to reduce, but not eliminate, uncertainty
regarding the presence of ACM in connection with the above referenced property. No
guarantee SET cannot be held accountable for restrictions placed on us by the client,
conditions or information that remained unknown, or areas that were inaccessible at the time
of the inspection.
INN
Regulatory Review
The limited micro -vacuum asbestos inspection was conducted by an Environmental
Protection Agency (EPA) and CDPHE certified Asbestos Building Inspector according to ASTM
D5755-09 recommended procedures for the collection of micro -vacuum samples and indirect
analysis of non -airborne dust for levels of asbestos structures. The inspection procedures
included identifying the areas in which micro -vacuum samples were to be collected, collecting
the micro -vacuum samples, submitting samples to an accredited laboratory for analysis and
compiling a final report detailing the inspection and the analytical results of the samples.
The analysis of the micro -vacuum samples and blank was performed by Transmission Electron
Microscopy (TEM) for the presence or absence of asbestos structures by a third -party,
National Voluntary Laboratory Accreditation Program (NVLAP) accredited lab in Denver,
Colorado. In the event of an asbestos spill involving less than or equal to the trigger levels,
the area is consequently subject to the requirements in Reg. 8, Section III.T.2. — Minor
Asbestos Spills
The micro -vacuum samples were collected at medium flow rate from each location within the
room for a collective composite sample. Samples were collected on 25 -millimeter (mm)
mixed -cellulose, ester -membrane filters with a 0.8 -micron pore size and an effective
collection area of 385 mm. All filters were pre -assembled by the manufacturer in three -stage,
conductive sampling cassettes with extension cowls. A field blank was also submitted and
analyzed along with the micro -vacuum samples.
3
Background
Schaan Environmental Testing (SET) was called to the subject property by Team K Services
following a couch fire in the living room resulting in damaged asbestos -containing building
debris disturbed during fire -fighting efforts. An initial asbestos inspection performed and
confirmed that asbestos containing building materials (ACBM) were present in the home and
had been disturbed. Less than trigger levels were disturbed by the fire department, and SET
was contracted to collected micro -vacuum samples from contents around the minor asbestos
spill area.
Micro -Vac Testine
(Samples in RED are asbestos containing)
Micro -vacuum surface samples were collected from the residence on August 9, 2017. The
area was deemed a minor asbestos spill, but additional samples were collected at the request
of Team K Services. Sample collection began in the nearest to the entry and throughout the
remaining rooms with the most contents. Five (5) composite micro -vacuum samples were
collected in addition to one (1) blank. One (1) of the micro -vacuum samples contained
asbestos fibers; however due to visible debris in the living room, SET recommends this area
be cleaned as part of a minor asbestos spill. The sampling collection sites are as follows:
Sample
Location
Results
MV -1
Entry/Laundry Room
None -Detect
MV -2
Kitchen
None -Detect
MV -3
Southeast Bedroom
None -Detect
MV -4
Northwest Bedroom
Chrysotile
MV -5
Living Room
None -Detect
MV -6
Blank
Not Analyzed
Conclusion
Micro -vacuum sampling confirms the presence of asbestos -fibers in the northwest bedroom.
The remaining rooms in the home were negative for asbestos.
SET recommends that the northwest bedroom and living room (from visible debris) be
cleaned according to the non -mandatory recommendations found in Reg. 8, Section III.T.2. —
Minor Asbestos Spills as outlined below. The building owner or contractor should take the following
non -mandatory steps:
• Restrict entry to the area and post warning signs to prevent entry to the area by
persons other than those necessary to respond to the incident.
• Shut off or temporarily modify the air handling system to prevent the distribution of
fibers to other areas in the building.
• Seal all openings between the contaminated and uncontaminated areas. This is to be
accomplished by using polyethylene sheeting to cover all areas such as windows,
doorways, elevator openings, corridor entrances, drains, grills, grates, diffusers, and
skylights.
• HEPA vacuum or steam clean all carpets, draperies, upholstery, and other non -clothing
fabrics in the contaminated area, or discard all contaminated materials in accordance
with subsection III.R. (Waste Handling).
• Launder or discard contaminated clothing in accordance with subsection III.R. (Waste
Handling).
• HEPA vacuum or wet clean all non -fabric surfaces in the contaminated area.
• Conduct air monitoring as described in paragraph III.P.3. (Final Clearance Air
Monitoring and Sample Analyses); air samples shall be collected aggressively as
described in 40 C.F.R. Part 763, Appendix A to Subpart E (EPA 1995), except that the
air stream of the leaf blower shall not be directed at any friable ACM that remains in
the work area.
Materials containing less than 1% asbestos are not regulated by CDPHE Regulation 8, Part B —
Asbestos. However, all demolition/abatement activities should be performed following the
applicable Occupational Safety and Health Administration (OSHA) regulations. This would
include, but not limited to, the appropriate asbestos training for the type of material being
removed/disturbed as well as having a properly trained supervisor onsite, using wet removal
methods, wearing adequate personal protective equipment (NEPA-filtered particulate
respirators), medical surveillance of workers, personal -exposure air monitoring, area air
monitoring in occupied buildings, etc. There may also be landfill disposal requirements for
these materials, depending on the facility. SET recommends that all demolition/renovation
areas involving any amount of asbestos be subjected to visual inspections and a final
clearance air testing by a CDPHE-certified Air Monitoring Specialist (AMS) after the work has
been completed, but before any containments are dismantled and the area is reoccupied.
61
RSn4bs 81 M—ftl ML en eo c J�j 1. =5
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RE. Reservoirs Environmental, Inc.
'WW!
August 11, 2017 Subcontract Number. NA
Laboratory Report: RES 386833-1
Project # 1 P_O_ # 17-OBU
Project Description: (rearm K)
MdCe Schaan
Schaan Environmental Testing
9795 Quay Loop
Westminster CO 80021
Dear Customer,
Reservoirs Environmental, Inc_ is an analytical laboratory accredited for the analysis of Industrial Hygiene and
Environmental matrices by the National Voluntary Laboratory Accreditation Program (NVLAP), Lab Code 101896-0
for Transmission Eiecron Microscopy (TEM) and Polarized Light Microscopy (PLM) analysis and the American
Industrial Hygiene Association (AIHA), Lab ID 101533 - Accreditation Certificate #480 for Phase Contrast
Microscopy (PCM) analysis. This laboratory is currently proficient in both Proficiency Testing and PAT programs
respectively.
Reservoirs Environmental, toe. has analyzed the following samples for asbestos content as per your request. The
analysis has been completed in general accordance with the appropriate methodology as stated in the attached
analysis table_ The results have been submitter to your office_
RES 386833-1 is the job number assigned to this study. This report is considered highly confidential
and the sole property of the customer. Reservoirs Environmental, Inc. will not discuss any part of this study with
personnel other than those of the client The results described in this report only apply to the samples analyzed.
This report must not be used to claim endorsement of products or analytical results by NVLAP or any agency of the
U.S. Government. This report shall not be reproduced except in full, without written approval from Reservoirs
Environmental, Inc. Samples will be disposed of after sixty days unless longer storage is requested. If you have any
questions about this report please feel free to call 303-964-1986_
Sincerely,
Jeanne Spencer
President
P 3C' -1486 SKI Lagan Weet SLY@ VX DM— CO SW 5
Pape i of
Rezvraft Enfra F, M Otme,a wi 1, ms
ReWoC 's E1Krasma j OA Menai T1GAa0L2ff Rewv s em&mmemw 9A MW&IM.me
RESERVOIRS ENVIRONMENTAL, INC.
NVLAP Lab Cade 10189M
TABLE : TEM PRESENCEtABSENCE ANALYSIS
RES Job Number.
RES 386833-1
Client_
Schaan Environmental Testing
Client Project Number/P.0:
17-0854
Client Project Description
(Team K)
Date Samples Received:
August 9, 2017
Method:
D5755 -M Presence/Absence. Oust
Turnaround-
24 Flour
Date Analyzed:
August 10, 2017
Client
Lab Asbestos
ID Number
ID Number Minerals Present
MV -Entry Laundry
EM
1917367
NO
M.1- Kitchen
EM
1917368
NO
MV -SE Bed
EM
1917369
NO
MV -NW Bed
EM
1917370
Chrysotile 4*1111111111111
MV -Living Roam
EM
1917371
NO
MV -Blank
EM
1917372
NA
Data OA: --
C3ina Vettraina
s
f
SET assumes no liability for any loss, injury, claim or damages arising directly or indirectly from any use
or reliance on this report or the opinions expressed herein. SET makes no risk assessment, warranty,
guarantee or insurance policies of any kind, express or implied. This report is limited only to the
samples taken and locations sampled. There are no risk assessments, warranties, guarantees, or
insurance available or provided by SET. Additional sampling may be needed to further identify other
pollutants, or other mold/fungus affected areas inside the subject property.
This report was prepared pursuant to the contract SET has with the client. That contractual
relationship included an exchange of information about the subject property that was unique and
between SET and its client and serves as the basis upon which this report was prepared. Because of
the importance of the communication between SET and its client, reliance or any use of this report by
anyone other than the client, for whom it was prepared, is prohibited and therefore not foreseeable
to SET. No warranty is made. SET liability and that of contractors and subcontractors arising from any
service rendered hereunder shall not exceed the total fee paid by the client to SET.
Thank you for the opportunity to work with you on this project. Please call at 720.323.3949 with any
questions or concerns. Thank you.
Sincerely,
Ms. Blake Bradley
Schaan Environmental Testing
Colorado State Certified
Asbestos Building Inspector
Air Monitoring Specialist, 16862
Colorado Department
of public Health
and Etvironmem
ASBESTOS
CERTIFICATION*
This certifies that
Blake Bradley
Certification No.! 16862
.a
has me[ the requirements of 25-7-507, C.R.S. and Air Quality Control
Commission Regulation No. 8, Part B, and is hereby certified by the
state of Colorado in the following discipline:
Building Inspector*
Issued: July 07, 2017
Expires: July 3l, 2018
�YM"Wfineu..OA-ly W4W WP--W.,f. / s
va.�.b..
SEX
9
Aw
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and FJnironmtnt
ASBESTOS CONSULTING FMI
'Ibis c,"tifics tbat
Schaan Fnvironniental Testing
Regisirutio" Nrk- ACT - 19793
has inat the registfaimb requirrownt, of 23-7-5177, C.R.S, and the Air Oualoty ControlCtuml�i•m Rtgu6tim No. P. Pan R. and i. Itcrcby authorized to pwfemi ahbemos Zom.fting
actin it ic; as req v it ed u a dcr R,:; u fat i or. So S. Part B. in the state of Colorado.
Lssacd: July qT, 2W7
Expires: July 26. Zols
10
Mark Inspections, Inc.
P.O. Box 1082
Englewood, Colorado 80150-1082
(303) 653-7583
August 6, 2017
Kyle Keegan
Team K Services
15468 E Hinsdale Circle
Centennial, CO 80112
RE: Asbestos Testing PLM— Project #TKP55- O'Connor
4655 Parfet St, Wheat Ridge, CO 80033
Dear Mr. Keegan:
On August 2, 2017, random samples of building materials at the above referenced
address were taken and tested for asbestos content per client request. The samples
were submitted to REI Lab, Inc. for analysis via EPA 600/R-93/116 Method using
Polarized Light Microscopy.
Guidelines used for the inspection were established by the Environmental Protection
Agency (EPA) in order to comply with the Air Quality Control Commission
Regulation No. 8, Part B "Emission Standards for Asbestos." Field Information was
organized as per the AHERA (Asbestos Hazard Emergency Response Act) concept
of Homogeneous Area. A Homogeneous Area is defined as a suspect material of
similar age, appearance, function, and texture. If damage is extensive enough that
the homogeneous areas cannot be defined, samples will be randomly obtained per
functional space. Each material was grouped together as a specific Homogeneous
Area or obtained from a specific functional space, sampled, and then assessed for
condition. The number of samples of surfacing material, such as drywall texture, is
dependent on the square footage of the drywall to be removed. Due to the square
footage of the smooth textured wall and ceiling materials to be removed in the
laundry closet and rear entry, less than 1,000 square feet, the Homogenous areas
textured drywall will require at least three samples of each type according to
AHERA. Due to the square footage of the rough textured ceiling materials to be
removed in the kitchen, less than 1,000 square feet, the Homogenous areas textured
drywall will require at least three samples of each type according to AHERA.
Due to the square footage of the textured wall materials to be removed in the
kitchen, less than 1,000 square feet, the Homogenous areas textured drywall will
require at least three samples of each type according to AHERA. Due to the
square footage of the circular patterned textured ceiling materials to be removed in
the living room and bedrooms, less than 1,000 square feet, the Homogenous areas
textured drywall will require at least three samples of each type according to
AHERA. Due to the square footage of the circular patterned textured wall materials
to be removed in the living room, less than 1,000 square feet, the Homogenous areas
Page 2
textured drywall will require at least three samples of each type according to
AHERA. Due to the square footage of the sanded textured wall materials to be
removed in the bedrooms, less than 1,000 square feet, the Homogenous areas
textured drywall will require at least three samples of each type according to
AHERA. Due to the square footage of the smooth textured wall and ceiling
materials to be removed in the bathroom and hallway, less than 1,000 square feet, the
Homogenous areas textured drywall will require at least three samples of each
type according to AHERA. All materials sampled have been slated for demolition.
Consequently invasive techniques may have been utilized to obtain or clear areas of
suspect (Asbestos Containing Materials) ACM. Material quantities are approximate
as exact amount of demolition may vary depending on a number of factors such as
success of dry -out, extent of smoke damage, etc. Consequently, for these types of
environments we recommend the contractor verify exact material amounts. Any
materials not tested but mentioned in this report are non -suspect materials (wood,
metal, plastic, rubber, or glass). Mark Inspections, Inc. adheres to the AHERA
recommended guidelines for sampling frequency of homogeneous materials.
However, we reserve the right to conduct additional sampling procedures after the
initial bulk sampling lab results are received if warranted. Please be advised neither
the EPA or the Colorado Dept. of Health and Environment have established specific
regulations regarding inspections related to inspecting or sampling in a restoration
environment. Consequently, Mark Inspections, Inc. makes every effort to comply
with the regulations associated with renovation type environments.
Scope of Work -
This survey was requested as the result of fire and water damage at the address listed
above. Seven suspect materials involved in the demolition scope provided by the
onsite restoration contractor are considered to be surfacing building materials:
texture/tan and white compound (6), and white and tan granular plaster. Drywall,
tape, joint compound, perlitic material, brown fibrous material, white fibrous woven
material, vermiculite, adhesive, resinous material, leveling compound, ceramic tile,
mastic, floor tile, caulk, and fibrous material with resinous material are to be
considered miscellaneous building materials. These building, materials were used on
the interior of the residence. No additional suspect materials were observed which
are slated for removal. This survey was characterized by a close visual inspection of
all accessible affected areas. All materials sampled have been slated for demolition by
the onsite restoration contractor. Suspect materials have been sampled and
inventoried. The suspect materials which are slated for removal, their corresponding
locations, and bulk sampling lab results can be found in the following material
classification section. The actual lab report is also attached to this report.
Page 3
INTERIOR WALL AND CEILING MATERIALS, laundry closet and rear entry -
Material Classification -
Surface Materials: texture/tan and white compound
Miscellaneous materials- drywall, tape, perlitic material, and joint compound
Laundry Room- south wall: 1" off of west wall, 63" off of floor (sample #1TKP55)
Sample tan compound was POSITIVE for 2% asbestos containing materials (2%
Chrysotile)
Sample tan joint compound was POSITIVE for 3% asbestos containing materials
(3% Chrysotile)
Laundry Room- ceiling: 49" off of north wall, 22" off of east wall (sample #2TKP55)
Sample tan compound was POSITIVE for 2% asbestos containing materials (2%
Chrysotile)
Laundry Room- east wall: 4" left of doorway, 49" off of floor (sample #3TKP55)
Sample was negative for asbestos containing materials (non -ACM)
INTERIOR CEILING MATERIALS, kitchen -
Material Classification -
Surface Materials: texture/tan and off white compound
Miscellaneous materials- drywall
Kitchen- ceiling: 1" off of north wall, 65" off of west wall (sample #4TKP55)
Sample tan compound was POSITIVE for 3% asbestos containing materials (3%
Chrysotile)
Kitchen- ceiling: 49" off of north wall, 33" off of east wall (sample #5TKP55)
Sample tan compound was POSITIVE for 3% asbestos containing materials (3%
Chrysotile)
Kitchen- ceiling: 36" off of south wall, 22" off of west wall (sample #6TKP55)
Sample off white compound was POSITIVE for 3% asbestos containing materials
(3% Chrysotile)
Page 4
INTERIOR CEILING MATERIALS, kitchen walls -
Material Classification -
Surface Materials: texture/tan and off white compound
Miscellaneous materials- drywall and brown fibrous material
Kitchen- north wall: 5" left of north doorway, 59" off of floor (sample #7TKP55)
Sample off white compound was POSITIVE for 2% asbestos containing materials
(2% Chrysotile)
Kitchen- west wall: 8" right of west doorway, 24" off of ceiling (sample #8TKP55)
Sample off white compound was POSITIVE for 2% asbestos containing materials
(2% Chrysotile)
Kitchen- east wall: 49" off of north wall, 40" off of ceiling (sample #9TKP55)
Sample off white compound was POSITIVE for 2% asbestos containing materials
(2% Chrysotile)
INTERIOR CEILING MATERIALS, living room and bedrooms ceiling -
Material Classification -
Surface Materials: texture/tan and white/off white compound
Miscellaneous materials- drywall, tape, and joint compound
Living Room- ceiling: 50" off of north wall, 99" off of east wall (sample #10TKP55)
Sample tan compound was POSITIVE for 2% asbestos containing materials (2%
Chrysotile)
East Bedroom- ceiling: 71" off of south wall, 1" off of west wall (sample #11TKP55)
Sample white/off white compound was POSITIVE for 2% asbestos containing
materials (2% Chrysotile)
Sample off white joint compound was POSITIVE for 3% asbestos containing
materials (3% Chrysotile)
West Bedroom- ceiling: 33" off of south wall, 12" off of east wall (sample #12TKP55)
Sample white/off white compound was POSITIVE for 2% asbestos containing
materials (2% Chrysotile)
Page 5
INTERIOR WALL MATERIALS, living room -
Material Classification -
Surface Materials: texture/tan, white, and off white compound
Miscellaneous materials- drywall, tape, white fibrous woven material, and joint
compound
Living Room- east wall: 1" off of south wall, 53" off of floor (sample #13TKP55)
Sample tan compound was POSITIVE for 2% asbestos containing materials (2%
Chrysotile)
Sample tan joint compound was POSITIVE for 3% asbestos containing materials
(3% Chrysotile)
Living Room- north wall: 57" off of east wall, 35" off of floor (sample #14TKP55)
Sample tan compound was POSITIVE for 2% asbestos containing materials (2%
Chrysotile)
Living Room- south wall: 4" right of kitchen doorway, 24" off of floor (sample
#15TKP55)
Sample off white compound was POSITIVE for 4% asbestos containing materials
(4% Chrysotile)
INTERIOR WALL MATERIALS, bedrooms -
Material Classification -
Surface Materials: texture
Miscellaneous materials- drywall, tape, and joint compound
East Bedroom- north wall: 2" off of west wall, 30" off of ceiling (sample #16TKP55)
Sample texture was POSITIVE for less than 1% asbestos containing materials (<1%
Chrysotile)
Sample tan joint compound was POSITIVE for 2% asbestos containing materials
(2% Chrysotile)
West Bedroom- south wall: 8" right of entry doorway, 48" off of floor (sample
#17TKP55)
Sample texture was POSITIVE for less than 1% asbestos containing materials (<1%
Chrysotile)
West Bedroom- east wall: 36" off of south wall, 25" off of ceiling (sample #18TKP55)
Sample texture was POSITIVE for less than 1% asbestos containing materials (<1%
Chrysotile)
Page 6
INTERIOR WALL AND CEILING MATERIALS, bathroom and hallway -
Material Classification -
Surface Materials: white plaster and tan granular plaster
Miscellaneous materials- brown fibrous material and drywall
Bathroom- ceiling: 2" off of east wall, 15" off of north wall (sample #19TKP55)
Sample tan granular plaster was POSITIVE for less than 1% asbestos containing
materials (<1% Chrysotile)
Bathroom- ceiling: 51" off of east wall, 2" off of south wall (sample #20TKP55)
Sample tan granular plaster was POSITIVE for less than 1% asbestos containing
materials (<1% Chrysotile)
Hallway- east wall: 6" right of living room doorway, 53" off of floor (sample
#21TKP55)
Sample was negative for asbestos containing materials (non -ACM)
MISCELLANEOUS MATERIALS
Material Classification- Miscellaneous materials: attic insulation
Attic- white perlitic material (sample #22TKP55)
Sample was negative for asbestos containing materials (non -ACM)
Attic- brown fibrous material and gray/tan vermiculite (sample #23TKP55)
Sample was negative for asbestos containing materials (non -ACM)
Material Classification- Miscellaneous materials: flooring
Living Room- yellow adhesive, off white resinous material, gray leveling material,
and off white ceramic tile(sample #24TKP55)
Sample was negative for asbestos containing materials (non -ACM)
Bathroom- black mastic and light brown/multi colored floor file (sample #25TKP55)
Sample was negative for asbestos containing materials (non -ACM)
Material Classification- Miscellaneous materials: wall paneling
Kitchen- caulk and tan fibrous material with off white resinous material (sample
#26TKP55)
Sample was negative for asbestos containing materials (non -ACM)
Page 7
Bathroom- caulk and tan fibrous material with off white resinous material (sample
#27TKP55)
Sample was negative for asbestos containing materials (non -ACM)
Bathroom Tub Surround- caulk and brown fibrous material with off white resinous
material (sample #28TKP55)
Sample was negative for asbestos containing materials (non -ACM)
Page 8
SUMMARY- Asbestos containin-a building materials found
As stated in the attached report, REI Lab, Inc. indicated that the below
homogenous building material area was determined to be POSITIVE for asbestos
containing materials:
*texture and joint compound on walls and ceilings in laundry closet and rear entry
*texture on ceiling in kitchen
*texture on walls in kitchen
*texture on ceilings in living room and bedrooms
*texture and joint compound on walls in living room
*texture and joint compound on walls in bedrooms
*plaster on walls and ceilings in bathroom and hallway
*floor tile and mastic in bathroom
These samples are required to be point counted in order to determine if the asbestos
content is actually 1% or less according to the Colorado Department of Public Health
and Environment (CDPHE) guidelines, or it is determined these homogenous areas
and building materials to require asbestos abatement according to the Colorado
Department of Public Health and Environment (CDPHE) guidelines
As stated in the attached report, REI Lab, Inc. indicated that the attic insulations,
ceramic floor tile, and wall paneling and caulk were determined to be negative for
asbestos containing materials.
**Due to the visible damage to the ceilings and walls in the living room and rear
entry, it is my opinion that the house is to be considered a major asbestos spill.
The information in this report pertains to the affected areas at the above referenced
address only. Mark Inspections, Inc. has made every effort to survey and randomly
sample all affected suspect building materials associated with this project. However,
in some cases hidden or patched in building materials may be present which were
not readily observed. If during the demolition a new type of material in quantities
that exceed acceptable trigger levels for removal is discovered due to visual obscurity
or change in project scope, it is recommended additional inspection and sampling be
employed.
Sincerely,
Mark Peltz, Building Inspector
Colorado Certification No.:16310
Mark Inspections, Inc.
Asbestos Consulting Firm
Reg. No. ACF: 18001
i CITY OF WHEAT RIDGE
_:�9�Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: fyy iD
Job Address: 4
Permit Number:
T
,61
No one available for inspection: Time AMM
Re -Inspection required: Yes No
When corrections have been made, call for -re -inspection at 303-234-�(j _� 5933
O
Date: ,z Inspector:
, jibr*�&"
DO NOT REMOVE THIS NOTICE
INSPECTION RECORD o ccupancy /Type
'? - INSPECTION LINE: (303) 234 -5933
I�
I f,.
rn
CO POUR No CONCRETE UNTIL ABOVE HAS BEEN SIGNED
NCRETE SLAB. FLOOR - -.
Electrical (Underground)
Plumbing (Underground)
Heating (Underground) #E
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
Inspections will not be made unless this card is posted on the building site
Call by 3:00 PM to receive inspection the following business day.
Sheathing
Lath / Wall tie -
Plumbing
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB
FOUNDAT PECTIONS
DATE
INSPECTOR
INITIALS
COMMENTS: -
Footings /
-
Roof
.Rough Plumbing
Stemwall Concrete
Encased
Gas Piping;
Building Final
Reinforcinolithic
Rough Mechanical
j
Fire Department
Weatherpnch Drain
R.O.W & Drainage
Sewer Sees
INSPECTIONS FOR PLANNING &I ZONING, FIRE AND PUBLICE WORKS -.
SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
Parking & Landscaping,.,.
Water Sers
- 2 �tNOTF: ALL ITEMS MUST DE COMPLETED iAND APPROVED B Y-PL AND ZONING; BUILDING'AND PUBLIC WORKS - A
CERTIFICATE OF OCCUPANCY IS ISSUED. 'FINAL INSPECTION By THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION
-- OFA.CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. - - —
-
ROUGHS
Sheathing
Lath / Wall tie -
Plumbing
/ g /
�G L?J /7MBn$ iJ Sit/ P7c1� 'f
Mid -Roof '' _
Electrical Service
Rough Electric
-
Roof
.Rough Plumbing
Gas Piping;
Building Final
Rough Mechanical
j
Fire Department
nbvvt INLYCbuUN. IU bt SIUNtU YKIUK IV PKUCLLUING
Framing ..
Insulation
Drywall Screw
FINALS
Electrical
Plumbing
Mechanical
-
Roof
Building Final
j
Fire Department
R.O.W & Drainage
INSPECTIONS FOR PLANNING &I ZONING, FIRE AND PUBLICE WORKS -.
SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
Parking & Landscaping,.,.
- 2 �tNOTF: ALL ITEMS MUST DE COMPLETED iAND APPROVED B Y-PL AND ZONING; BUILDING'AND PUBLIC WORKS - A
CERTIFICATE OF OCCUPANCY IS ISSUED. 'FINAL INSPECTION By THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION
-- OFA.CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. - - —
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED
PROTECT THIS CARD FROM THE WEATHER
♦ i CITY OF WHEAT RIDGE
Building Inspection Division
lr (303) 234-5933 Inspection line
r~(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: s l>c~ !
Job Address: 4q b 'Sc x
Permit Number: CR 3 ~
❑ No one available for inspection: Time .f^ Af PPM
Re-Inspection required: Yes CN
When corrections have been made, call for re-inspection at 303-234-5933
J'
Date: 3 Inspector: R~
DO NOT REMOVE THIS NOTICE
♦ i CITY OF WHEAT RIDGE
Bung Inspection Division
(303) 234-5933 Inspection line
]~;'r(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: lv)< - orot~F
Job Address: 4655 r~l ~C~Ei c'~
Permit Number: <f~?307
~e7' ulca~
lVole-
❑ No one available for inspection: Time AM/PM
Re-Inspection required: Yes No
When corrections have been made, calf for re-inspection at 303-2345933
Date: &>-15--66~ Inspector: ;-fJ
DO NOT REMOVE THIS NOTICE
A 1 City of 'Wheat Ridge
Residential Roofing PERMIT - 093317
PERMIT NO: 093317 ISSUED: 10/14/2009
JOB 'ADDRESS:: 4655 PARFET ST EXPIRES:: :.04/12/2010
DESCRIPTION:. Reroof20 sqs
***.CONTACTS
owner 720/934-9147 Paul O'Connor
sub 866/948-0933 Chris Nussbeck 09-0168 ASI Contracting
**.PARCEL INFO
ZONE `CODE: UA ASE: UA
SUBDIVISION:. UA BLOCK/LOT#: 0/
FEE SUMMARY ESTIMATED PROJECT VALUATION: -.4,600.00
FEES
Permit Fee 144.70
Total Valuation
oo ' >GhAi2~'2-aG~7,F ,
Use Tax 82.80
**'TOTAL 227.50
Conditions:`
6 nail installation mid roof inspection required. Board sheathing spaced more
than a 1/2 of an inch apart requires plywood overlay on entire roof. Ice. and
water shield required from eave edge to 21 inside exterior walls.
***Contractor/Property owner shall ,provide ladder.(s) secured in place for
inpsections.
Subject to field inspection.
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 the wheat'Ridge -Building. Code (I.B.C) and.all other
applicable Wheat Ridge Ordinances, for work under this permit. Plans subject to field inspection.
Signature contractor/owner date
L. This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the
State of Colorado and to. the zoning Regulations and Building Codes of wheat Ridge, Colorado or any other applicable
ordinances of the City.-,.
? This permit shall expire 480 days from the issue date. Requests for an extension must be received prior to expiration
date. m extension may be granted at the discretion of the Building Official.
3. If this permit expires, :a new permit may be acquired for a fee of : one-half the amount normally required, provided no
changes have been or will be made in the original plans and specifications and any suspension or. abandonment has not
♦~4I
City of
`r Whea-t~dge Date:
COMMUNITY DEVELOPMENT Permit
ovu vv. /a- r-\Ve., vvneaf mloge, ~,,v ouvoo a3_t its
Office: 303-235-2855 * Fax! 303-237-8929
Inspection Line: 303-234-5933 M
Facsimile Building Permit Application
655 ?e'l-r -~ZA 15A -
Property Owner (please print): Tck-,31 Q' ,nom Phone: ~t3~t'9i4~
Mailing Address: (if different than property address)
Address:
City State Zip: u3yQC-+ cp-\4 S-o
Contractor License Ph e: q':~e 9g10 d 1806
9
Company amec6 License Expiration Date: TradefProfession: Approval:
Use of s ace (description):
ion Value: S
17u ~ 5 ' h5~~ Q Plan Review (due at time of submittap: $
Sq. FL/L.Ft added: Squares 318. BTU's Gallons Amps
-OWNERICONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate, and do nol 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 primed on this application andthat I assume full
responsibility for compliance
with the Wheat Ridge Building Code (I:B.C) and all other applicable Wheat Ridge Ordinances, (or work
under this permit Plans subject to field Ins ection.
CIRLCEONE:: (OWNER) CONTRACTOR) r PERSONAL REPRESENTATIVE of (OWNER) (CONTRATOR) jb~l~
PRINT NAME: SIGNATURE: Date
's-O i
Credit Card Paymen Use credit card listed on file. Date
Print name: ~,~rCh&C L}r- Signature:
~ V
r
♦ i CITY OF WHEAT RIDGE
Building Inspection Division
r (303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: '7 r , lies
Job Address: W"SS S
Permit Number: 0It'3 o~c'
~Pr ~`iMeS
B~~ d'8sJ,4` PtFO }
❑ No one available for inspection: Time A /PM
Re-Inspection required: Yes No
When corrections have been made, call f r r inspection of 3~3-234-5933
Date: l--A Inspector:
DO NOT REMOVE THIS NOTICE
" 1 City of Wheat Ridge
Res. Miscellaneous PERMIT - 093760
PERMIT NO: 093760 !ISSUED:` 11/02/2009
JOB ADDRESS: 4655 PARFET ST: EXPIRES: 05/01/2010
DESCRIPTION:' Replace 14 sqs. of vinyl siding
CONTACTS
owner 720/934-9147 Paul O'Connor
SUB 866/948-0933 Chris Nussbeck 09-0168 ASI Contracting
**PARCEL 'INFO
ZONE CODE: UA USE: UA
SUBDIVISION:: UA iBLOCK/LOT#: 0/
FEE SUMMARY ESTIMATED PROJECT VALUATION: 6,200.00:
FEES
Permit Fee 181.10 rc.
Total Valuation .00 1fZvr;2~~~~6
Use Tax 111.60 ,s
TOTAL 292.70 : 4...._._..a
Conditions: -
Subject to field inspections.
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
ements shown, and allegations made are accurate; that I have read and agree to abide: by all conditions printed on this
appl on this
ati nd'. hat I assume full responsibility, for compliance with.the Wheat Ridge Building Code -(I B.C) and all other
appli ab e Wh at idge Ordinances, for work under T is ereit. Plans ;subject to field inspection.
2 6
%rlatAre of contractor/owner 3date
1. This permit was issued in accordance with the. provisions set forth in your application and is subject to the laws of the
State of Colorado and to the zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable
ordinances of the City.
? This permit shall expire 180 days from the issue date. Requests for an extension must be received prior to expiration
date. A extension may be granted;. at the discretion of the Building Official-
3. If this permit expires, a new permit may be acquired for a fee of one-half the amount normally required, provided no
changes have been or will be made in the original plans and specifications and any suspension or abandonment'. has not
exceeded one :(1) year. If changes have been or if suspension or abandonment'` exceeds one (1) year, full fees ?shall
♦~A
'r City of Date:
Wheat,]
COMMUNITY DEVELOPMENT Permit
7500 W. 29 Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 " Fax7 303-237-8929 Sr~b
Inspection Line: 303-234-5933 s' SQ
Facsimile Building Permit Application Nwkd&:
-?hone#:
IUMMA I y6SS r~~f ff
Property Owner (please print): Phone:
7an.y3y-y/4~Y
Mailing Address: (if different than property address)
Address:
City, State, Zip:
7': A. c7..1 . l~~rt cock i~ay
Contractor License Qq~ ((0 $ Phone: CJ'+0 •q~f0 ~ga~
F~a
ompanV ame: License Expiration Date: Trade/Profession: Approval:
Use of space (description): $*;4/ 4
1?190. e,--~
Plan Roview (due of time of submittaQ: b
Sq. Ft./L.Ft added: Squares BTU's Gallons Amps
OWNERICONTRACTOR 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 Whest.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 the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
under this permit. Plans subject to field.t<ispection. -
CIRLCE ONE: (OWNE (CONTRACTOR ? PERSONAL REPRESENTATIVE of (O NER) ONTRATOR)
PRINT NAME: T.ZJ.QKI% Ftk- SIGNATURE: 5 Date
i~~ ~"Elkq-alt FUl~~~
F 4s' >c- -v ~q-Ek " iS~ r-n ;t7t;211
7500 West 29th Avenue
Planning:
Parks & Recrention:
Public Wo^ks:
Fax;
• Wheat Ridge, CO 80215
Phone # (303) 235-2846
Phone # (303) 235-2877
Phone # (303) 235-2861
Phone # (303) 235-2857
DATE 7-OI
Name:
Orgnnization
Fax:
Phone:
From:
Dept:
Subject:
5L) } - L130i 7qU7
1 d
NCk tQ (1,
Plnnning ff~ Pnrks & Recreation ❑ Public Works ❑
# af Pages: (Including cover page),
Comments:
_ , .
e
S -f~ eA f
pe~
r .
Original to follow in the mail ❑ Yes ❑ No
HP OfficeJet
Personal Printer/Fax/Copier
93034671656
Fax Log Report for
DEVREVFAX
303 235 2857
Feb-23-01 10:22 AM
Result Paaes Tvce Date Time
Error 02 Sent Feb-23 10:20A
on pages 1,2
00:02:23 002385430028536
o
Certificate of Completion
AND/OR
Compliance
CITY OF WHEAT RIDGE
7500 W. 29TH AVENUE
WHEAT RIDGE, COLORADO 80215
THIS CERTIFICATE VERIFIES THAT THE PROPERTY DESCRIBED BELOW, DOES
COMPLY WITH THE WHEAT RIDGE BUILDING CODE, ZONING AND OTHER
RELATED LAND USE AND DEVELOPMENT LAWS OF THE CITY OF WHEAT RIDGE
FOR THE FOLLOWING PURPOSE:
Replace meter can
Permit # 11688
OWNER: Paul O'Connor ADDRESS: 4655 Parfet Street
PROPERTY ADDRESS: 4655 Parfet Street Wheat Ridge. Co 80033
DATE 3/07/01 CHIEF BUII,DING OFFICIA
ZONING ADMINISTRATOR
Building Permit Number: 11688
Job Address : 4655 Parfet St.
Description of Permit : Replace meter can
Inspection List
Number
Type
Date
A roval
Remarks
29796
Meter???
/16/200
29819
FE
/17/200
OKIBB
EMR
29835
FE
/17/200
r
~ n,,,v n;
",.~.Y:yK . . x , 1 a.., ....Ui~4 . . .lo , ~ . .
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : 11688
, BUILDING INSPECTION LINE - 303-234-5933
CITY OF WHEAT RIDGE Date : 1/15/2001
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215 - (303-235-2855)
Property Owner :
Property Address : 4655 Partet St. Phone : 3039494119
Contractor License No. : 19009
Company : ASHLEY ELECTRIC CO. Phone : 452-5794
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permk application are accurate,
and do not vialate applicable ordinances, rules or regulations of the City of Wheat Ridge or
wvenants, easements or restrictions of record; that all measurements shown, and allegations
made are accurate; that I have read and ayree to abide by all conditions printed on this
appliwtion, and that I assume full responsibiliN for compliance with the Wheat Ridge Building
Code (U.B.C.) and all other applicable Wheat Ridge ordinancesJoypork under this pertnit.
(OWNER)(CONTRACTOR)
Description : Replace meter can
Construction Value :
$250.00
Permit Fee :
$23.50
Plan Review Fee : ,
$0.00
Use Tax :
$3.75
Total:
$27.25
Use:
Electrical License No : pqgg Plumbing License No :
Company : Company :
Mechanical License No :
Company :
Expiration Date : Expiration Date : Expiration Date :
Approval: Approval: Approval:
(1) Rigulations antl Build in Cotle of Wh at Ridgee Coiloratlo or an otheraurll ePblemortlinances of the C~ ~ laws of the State of Coloredo and to the Zoning
(2) This permit shall expire f(A) the work authorizatl is nol mmmend withPn sixry (80) days trom issue date or (B) the building authorized is suspended or
abandonetl tor a perio0 of 120 days.
(3) If this permR eupires, a new pertnit may be acquiretl for a fee of one-half the amount nortnaly required, provided no changes have been Or will be matle in the
original plans and specificadons and any suspension or abantlonmenl has not euceeded one (7) year. If changas are made or if suspension or abandonment
euceetls one (1) year, tull fees shall be paiA for a new peimit.
(4) No work of any manner shall be done that will changa the natural fiow of water causin9 a dreinage problem.
(5) Contractor shall notify Me Buildinp Inspector twenry-four (24) hours in edvance for all inspections and shall receive written approval on inapection wrtl before
proceediing with successive phases of the job.
(6) The iasuance W a permit or the approval M tlrawings and speci(cations shall not be consWetl to Oe a permit Mr, nor an approval of, any violation of Me provisions
otMe building codes or WK other ordinance, Iaw, rule or regulation.
DEPARTMENT OF PLANNING AND DEVELOPMENT
BUIIDING INSPECTION LINE - 303-234-5933
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215 - (303-235-2855)
Praperty Owner
Property Address
Contrector License No.
Company
~
1~6 sS A, f~ ~ st-
Building Permit Number :
OWNErZCONTRACTOR SIGNATURE OF UNDERST:aNDING AND AGRE_MENT
I hereby certify that the setbatk distances prooosetl by this permit apolication are accurate,
antl do not violate applicahle ortlinances, rvles or regulatians of the City of Whea[ Ritlge or
covenants, easements or restriCions of reeortl; that all measurements shown, and allegations
made are accurate; that I have rea0 antl agree to abiCe hy all cantlitions pnnteC on this
application, antl that I assume full responsihility for compliance with Ne Wheat Ridge Building
Cade (U.B.CJ and all other applicable Whe t R qe ortlinan s, ~ ork under this pertnit.
(OWNER)(CONTRACTOR) SIGNED 2 - _ DATE
DescripGOn : 1711L, t.P~
:7 y
e.ou
Approval:
Zoning :
6R
Approval :
_KQ61[L~tlffdllt~~
Approval :
Occupancy': 'Nalis
Electrical License No:
Company :
Expiration Date :
Approvai:
Construction Value : ~2 i C) I Cr']
Permit F=e :
Use Tax :
Total :
VbC:
BUILDING DEPARTMENT USE ONLY
SIC
Sq. Ft. :
Roof : Stories : Residential Units :
Plumbing License No : Mechanical License No :
Company: Company:
Expiretion Date : Expiration Date :
Approval : Approval :
(1) Thii pertnit wat iasueE in aOOOtdammvyjryh the pmvjyony ut fOM ifl yepul applletlon ind u wbjett tp ryte lawy o( the State
Regulatlans antl BuiWLig C,oEe a Wry.W Rbge. CobraCO ar o(ColonEO antl W pfe Loninq
arty oC~er applip6le ordlnancey pf Ma Ciry.
(2) Thu permit ahall erzPira d(A) pro wone autlforcaA ia nat mmmenceC wiNin uxty (84) aaya M1om iawa Earo or (8) Ine buila(ny autnanze0 is susPenacd ar
abantloneC for a penoE of 720 yyy,
(3) on inale a a antl aan~ ~Y ~~1°M for a fae ot ano-half Ne artwunt narmaity rpQuireC, pmviy~y npare p~ matle anqes or it have Eeen or vnll be matle in Ne
exceeda one (1) P Year. !WI ~ (etley ~yyl~ be~ w~AO^ °~,~4°^^re^t ha mt ^.xcKdaC one (1) year. If Uangey wspenaion ar abanCOnmen[
(a) No wark of arry mannar yiaN pw Cpne N PaiA a~ !,~rippr a new awge pne naNral Ilcw at watx puaing a Eninaqe qoblem.
(5) CanUaRar shall npy(y ryy BuiWig In~paefor (wen(y{pur (24) haun in atlvance br all iroP~ans anC yhall2u:ive w~itten aPProval on insP~an nrtl 6eMia
iviceeCling wiN suauavsphaws ttt
(e) piha iaauance M a emot or pb ~p~y e=n9s ana 3pecrffmtlons sliall rrot he mnaW M to pe a ot tlte buiWing ~airy a oNinante. law. mle or reguWtlan. Pemit lar. nor an aPPmval o!, any violatlon ot Ne pmvisions
Chief Bwidina Insoee~
Date :
~,o>
Phone:
Phane: 3O
DEPARTMENT OF COMMUNITY DEVEIAPMENT ME91114842
7500 WEST 29tn AVENUE BUILDING INSPECTION DIVISION PERMIT N0. NMI
237-6944 ExT. 255 P.o. eOx 83a CITY OF WHEAT RIDGE, COLO.
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUIlDIN6 INSPECTOR AND RECEIPTED BELOW.
PPL lt7lON FOR MISCELLANEOUS PERMITPC ~j cCvo~ n~r
JOB ADDRESS fi OWNER
CONTRACTOR ADORESS
ADORESS d PHONE 21P CODE
CITY ZIP CODE G~ CONTRACT PRICE $ ~-W
~1
_
PNONE q~ri - 0.0V7 LICENSE NO. 4ag
12. MATERIAL Totol SQuore Feet
$IGN$ 3. ILLUMINATION Ya❑ No❑ TYW ElW. Permif No._
I. TYPE GrounA
Wall❑ Proicctinp❑ OtMr SaDFoae
W Zorn__ ApqovM, 2ona Inapeeta
_ . _ _ _ Dh°pprowd
4 SET BACN FROM PROPERTY LINE N- !
(Spxify whicA is fronl ) ❑
1. TYPE SolidO More Thon 80%
FENCES
Lm
MATERIAL
3. SET BACN FROM PROPERTY LINE
(SOSCify whieh ia front)
N_ S_ E_
❑ ❑ ❑
OTHER
3.
DRAW SKETCH OR SHOW BELOW,THE FENCE,SIGN,OR OTHERSTRUCTUR
(SETBACKS OR PROJECTIONS INClUDEO)
STREET NAME
SHOW DISTANCES FROM THE MAIN BUILDING TQAOJOINING H~iuSES, STR
DISTANCE TO PROPERTY LINES, NOT MAXIMUM OR AVERAGE DISTAI
APPLICATION FOR PLUMBING; ELEC
THIS APPLICATION WILL BECOME A PERMIT TO PERFORM THE INDICATE
PERMIT WILL EXPIRE 60 DAYS FROM OATE OF ISSUAN
INSPECTION TICKET
JOB
ADDRESS C
DATE: BLDG. PERMITM LIEV~?
PERMITN
BLDG. CONTR.
SUBCONTRACTOR
DATE INSP. REQ.~"~ /
TYPE OF INSP. V • `'~-:~.-vv,v~.
INSPECTION MADE
REMAR ~O Q Z 7
~C--" C,
W.R. PORM &19 Osror+.
IXtl-'~' / ~r
ELECTRICAL PERMJj
PLUMBIN
~
q
STATE LICENSE NO
49
STATE UCENSE NC.
.
-
~ E Sol«
00R
F1
BSM
IST
2N0
3RD
4TH
N0.
Fl~~`~YW
ALUMINUM WIRE UNDEH SIZE 8 ILLEGAL
,
FqICEp &"R - pTU
~
WATER CLASET
HOT WATER - BTU
TEMPORARY METER
WASH BOWL
STEAM - BTU
NEW SERVICE AMPS
BATH TUB
AIR CONDITIONIN6-BN
CHANGE SERVICE-AMPS
SHOWER
OTHER
LI6HTING
SINK
REFRIGERATION SYSTEM
HEATING
GARBAGE DISF
ATER
Rafri ront Gou
ppWER SUB-GFCU~TS
WATER NE
pp~nd~ CAa •
UTILITY(RANGE,DISPOSER,ETC.)
AUTO.WASHER
pU7p~ATICSPRINKLERSYSTEM
FIXTURES
DISH WASHER
ElEVA70R
WIRING MOTORS d CONTROLS
FLOOR DRAIN
SIGNS
URINAI
TRANSFORMERS 9 RECTFIERS
SEWERS
ADDITION 10 OLD WORK
OTHER
MOTORS OVER I HP
TOTAL FIXTURES
n
a~ ~
o t, et^r,lx l
REMARKs v~
c 6-
saX e I ,
NOT VALID UNLESS RECEIPTE[
-
PERMIT FEE
Vur1V.J>
I hereby ocknowlsdqe thot thin opvlicu-
h
t I
a
tion i6 correct ond understand t
USE TAX
oonnot atart tAis Drojecf until ihia oppli-
E
cntion is approved. I shall comply witn
TOTAL FE
the lowt of the State o1 Colorado and to
ildi
APPROVED
-
7
np
the Zoninq Requlolions and Bu
Code of tne City ot Wheat Ridqe. Any
l
DISAPPROVED
CHIEF BUILDING
✓
SPECTOR, Cityof Wheat idqe
couse
vioiation ot the above terma wil
CALL237-8944 EXT.255
this permit
f
immediate revocation o
24 HOURS IN ADVANCE
'
1
i j
/
9
FOR INSPECTIONS
Date Issued
~
`
~
~ en ~ 9i0nalm•