HomeMy WebLinkAbout3270 Moore CourtAsbestos Air Clearance Report
Prepared for:
Premier Environmental
15508 East 19th Avenue Suite H
Aurora, CO 80011
Sampling Location:
3270 Moore Street
Wheat Ridge, CO 80033
Date:
March 17, 2022
Project ID:
MAR1722SB-04
S BEST LLC 2705 S Kendall Way
Environmental Consulting and Testing Denver, CO 80227
sbestllc@gmail.com 303-549-7118
S BEST LLC 2705 S Kendall Way
Environmental Consulting and Testing Denver, CO 80227
sbestllc@gmail.com 303-549-7118
March 17, 2022
This report serves to document the final visual inspection and the final air clearance
performed on March 17, 2022, following the abatement activities on the property located
at 3270 Moore Street, Wheat Ridge, CO 80033. Abatement was performed under a
CDPHE permit. The abatement of asbestos containing materials was completed on
March 17, 2022.
A final visual inspection and final air clearance were performed by Susan Bailey, a
Colorado licensed Air Monitoring Specialist and Building Inspector (CDPHE #13996).
Premier Environmental performed abatement to remove approximately 2981 total
square feet of asbestos containing material (ACM). The debris was removed under a full
containment following an approved method under Colorado Regulation 8. This
abatement work was done to remove approximately 2981 sq fl of texture on drywall
from the main level of the residence. Knowledge of safe asbestos handling in Colorado
must be used for any known asbestos containing material (ACM) removal.
A visual inspection was performed to confirm the completeness of asbestos removal in
accordance with the American Standard for Testing and Materials Standard Practice for
Visual Inspection of Asbestos Abatement Projects. All asbestos materials, including
contaminated dust, debris, or residues were satisfactorily determined to have been
removed. Asbestos containing materials were abated inside a full containment and
tagged for disposal. An air clearance was performed to ensure complete abatement. A
Premier Environmental abatement supervisor was present for the final inspection and
any residual dust or debris was addressed before the aggressive air clearance.
An aggressive final air clearance was performed as required by Colorado Reg. 8. Air
samples were collected inside the contained area utilizing aggressive air sampling
techniques as described in 40 CFR Part 763, Appendix A to Subpart E (EPA 1995). A
leaf blower was used to disturb (aggress) the air and a box fan(s) was placed in the
work area to keep air movement during sampling time. Clearance air samples are
required to determine compliance with subsection III. P (Clearing Abatement Projects)
for an abatement project involving greater than the trigger levels of ACM indicated in
Reg 8. Samples were analyzed utilizing Phase Contrast Microscopy, an approved
method for clearance projects of all fiber types and is the NIOSH 7400 method of
analysis. When PCM is used as the method of analysis the Maximum Allowable
Asbestos Level (MARL) is 0.01 fibers per cubic centimeter of air (f/cc') which is
equivalent to 10,000 fibers per cubic meter of air (Hmm').
S BEST LLC 2705 S Kendall Way
Environmental Consulting and Testing Denver, CO 80227
sbestllc@gmail.com 303-549-7118
The results of the PCM analysis were all below 0.01 fibers/cc, indicating fiber
concentrations below the (MARL), as required by EPA and CDPHE following abatement
activities cleared by PCM.
Services were performed with the level of skill and care that conforms to standard
industry practice. S Best Environmental Services Testing is not responsible for any
hazards or risks other than those included in this report. This report is not intended to be
used for billing, budgeting or bidding and is only for use at the location sampled. The
objective of this project was identifying the level of airborne fibers under the regulatory
standards during abatement activities and final aggressive air clearance. S BEST is a
Colorado licensed asbestos consulting fine (CO# ACF21764 expires 06/2022). S BEST
is enrolled in the ANA PT program (PAT -222785) and is currently proficient.
Contact S BEST if you have any questions or need further assistance.
Prepared by:
Susan Bailey
Owner/Senior Consultant
Industrial Hygienist
AMS/BI (13996)
RA (13355)
HAZWOPER
Erin Orthun
Industrial Hygienist
AMS/BI (21523)
Meth. Consultant (ML -1356)
HAZWOPER
Mold Professional
Asbestos Consulting Firm (ACF -25582)
Asbestos Laboratory (AL -21765)
Lead Consulting Firm (LEF-26340)
Meth. Consulting Firm (ML -F133)
Women's Business Enterprise (WaENC Nadonal Certlfcetlon Number. ME2102454)
Attachments: Final visual clearance
Air data sheet
Pictures
Certifications
S BEST LLC 2705 S Kendall Way
Environmental Consulting and Testing Denver, CO 80227
sbestllc@gmail.com 303-549-7118
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Environmental Consulting and Testing Denver, CO 80227
sbestllc@gmail.com 303-549-7118
S BEST LLC 2705 S Kendall Way
Environmental Consulting and Testing Denver, CO 80227
sbestllc@gmail.com 303-549-7118
S BEST LLC 2705 S Kendall Way
Environmental Consulting and Testing Denver, CO 80227
sbestllc@gmail.com 303-549-7118
ASBESTOS
CERTIFICATION*
Phis certifies that
Susan Bailey
Certification No.: 17996
has mel the requirements of 25-7-907, C.R.S. and Air Quality Control
Commission Regulation No. 9. Pan a, and is hereby certified by the
state of Colorado in the following discipline:
Air Monitoring Specialist*
Issued: April OR. 2021
Expires: Islay 26, 2022
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Environmental Consulting and Testing Denver, CO 80227
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Wheat
UNITY DEVEIOPMEM �� '
Building & Inspection Servlees
7500 W. 29" Ave., Wheat Ridge, CO 80033
Office: 303 -235 -2855 -Far: 303-237-8929
Inspection Line: 303-2395933
Email. ocimheairidnecous
FOR OFp7CE USE ONLY
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PaePermar Za'ZZ W SSS
Pan Rena - 346.
Building Permit Application
... Complete all applicable highlighted areas on both sides of this form.
InncNoumlp✓le�te applications my not be processed. ^^•
Properly Addteas: �'3' ^3l 11 / 1 IOyfy��Y�'e 6V
Proparly0wirmr(pleaseptilm ��OYI II fASlaazc� Ph ' -,20-
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
ArchhecflEngllleer E—mall:
----------- ___
City of wheat Ridge License 0: II`LImn/ Plwne:s�'J-g9,23-`a;;l-I
Contractor E-mail Address: CAr f,P YrtElr�ol,e'C�OrPMaY?nJifD,y1P'i'
For Plan Review Questions & Commsaft (pinseesp)I pi
CONTACT NAME (please print): /
desDL 1�
CONTACT EMAII-Wease orinn:
Sub Contractors (Must provide Wheat Ridge Ucalns No & Signed Subcontractor Authaltratlon foss):
Elsoncal: Plumbing: Mechanic:
W.R. City Ucense e WR. Cq License e WR, City License a
Other City licensee Sub. 011ier City Licensecl Sub:
Cly License 0 Ciy License e
Complete all highlighted fields.
❑COMMERCIAL RL RESIDENTIAL
Provide description of Work: For ALL projects, provide a detatletl desaiption Cf 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 amunt of materials to be used, etc.
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For Commercial Projects Only: Occupancy Type: _ Construction Type:
Occupancy Load: _ Square Footage: _
Poapetwara:(Conedvalue or ibe cost of rpmatede and labor irnudeel In one entre proled)
0WN6M.'ONT Amro 6IGNAT O➢LT'DERSIANDN'G AND AGREZfENT
I Nonny mnffy that tom nbaek diamnon pmpwd by ons pem,N application are ucman and do not m1 aft: applicable onkol a., micam
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CIRCLE ONE. (OHNEW (COM W a (AOT90 80 FEPBBSEMATIM Of (Oa'NEV XO�ME"cIOI)
EiednlnrtlnM.m Mn�sF RATE:
Printed N 3
DEPARTMENT USE ONLY
ZONING COINNERM OCCaPINCygAT*!I'D(xl:�
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BU DN6WARIMENf GNIMENTS:
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i CITY OF -WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
��(304
3) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: '203— Sc fo-P� U✓i(�'(/cPr�ir�rd-�f�i0r
Job Address: 32 70 11'4, We' C -t,
Permit Number: '? olk'Nt q2
Vt--) d 4 L,,P,-- 40 Pl-a VIcbT
❑ No one available for inspection: Time
Re -Inspection required: Yes ,,'No
When corrections have been made, call for re -inspection at 303-234-5933
Date: Z -Z2 / i Inspector: bares Ldye
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Sewer Repair PERMIT - 201802843
PERMIT NO: 201802843 ISSUED: 10/25/2018
JOB ADDRESS: 3270 Moore Ct EXPIRES: 10/25/2019
JOB DESCRIPTION: Repair sewer line in yard with pipe burst method
*** CONTACTS ***
OWNER (303)594-7083 SEIGER STEVE L
SUB (303)766-7500 Jeff Belk 021818 Plumbline Services
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,000.00
FEES
Total Valuation 0.00
Use Tax 168.00
Permit Fee 172.60
** TOTAL ** 340.60
*** COMMENTS ***
*** CONDITIONS ***
ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive
written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection
by any Sanitation District representative. Inspection and approval of work by any
Sanitation District representative DOES NOT grant authority to cover work without the
approval of the Building Division.
**For trenchless sewer replacements - The contractor will verify proper slope of new sewer
piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed
specifically by the applicable code. The plumbing contractor will provide verification of
proper slope and drainage in writing as a condition of approval of the permitted work.**
City of Wheat Ridge
Residential Sewer Repair PERMIT - 201802843
PERMIT NO: 201802843 ISSUED: 10/25/2018
JOB ADDRESS: 3270 Moore Ct EXPIRES: 10/25/2019
JOB DESCRIPTION: Repair sewer line in yard with pipe burst method
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 ermrt. I further attest that I e ally authorized to include all entities named within this document as parties to the work to be
performed and that all work a per rmed is disclosed in this document and/or its' accompanying approved plans and specifications.
to14,5Ai
Signature of OWNht —®r CONTRACTOR (Circle one) Date
1. This permit was issued based on the information provided in thepermit application and accompanying Flans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of an manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division,
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of CYVI0X/VW*'1'_" Date
REQUESTS MUST BE MADE Y 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
W heat jdge
COMMUNITY DEVELOPMENT
Building & Inspection Services
7500 W. 291h Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(oki.wheatridge.co.us
FOR OFFICE USE ONLY
Date:to %
Plan/Permit #w r03
Plan Review Fee:
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address: 3 ala Moore G®or --
Property Owner (please print): Steve- es' Phone: 31"-`1+-i- 7483
Property Owner Email:
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address:
City, State, Zip:
Architect/Engineer:
Architect/Engineer E-mail:
Contractor Name: �yvh�nl,nf� SerVA�e)
Phone:
City of Wheat Ridge License #: ��r i ��� Phone: J 7GG-�SOt7
Contractor E-mail Address: tie -r -m � Iv>h�cil�neS�rJ�e�S, CO�"1
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): Phone:
CONTACT EMAIL(p/ease print):
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Complete all highlighted fields, if applicable.
[—]COMMERCIAL
RESIDENTIAL
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, square footage, existing condition and
proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.
Sq. FULF
BTUs
r"\el�d(Q
1
Gallons
Amps Squares For Solar: KW # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$ 18006
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
1 hereby certify that the setback distances proposed by this pen -nit 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 pen -nit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) (CONTRACTOR) or (A RIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
SiEnature (first and last name): DATE: C� as
Printed Name: � (T en N tqq kstn ne
I —Ili
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Building Division Valuation:
City of Wheat Ridge
Residential Roofing PERMIT - 201700984
PERMIT NO: 201700984 ISSUED:
JOB ADDRESS: 3270 Moore CT EXPIRES:
JOB DESCRIPTION: Reroof Tamko Heritage - 33 squares
*** CONTACTS ***
OWNER (303)594-7083 SEIGER STEVE L
SUB (303)948-5556 DALLAS ROBERT GREEN 130142 1ST COLORADO ROOFING
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 23,210.00
FEES
Total Valuation 0.00
Use Tax 417.78
Permit Fee 426.20
** TOTAL ** 843.98
*** COMMENTS ***
** CONDITIONS ***
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 k/2 -inch exists. Asphalt shingles are required to
be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is
required. Eave and rake metal is required. 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 manufacturera€ms installation
instructions, whichever is more stringent. In order to pass a final inspection of
elastomeric or similar type roof coverings, a letter of inspection and approval from the
manufacturer's 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.
��'
�� Mckt, INiPP1ETI N RECORD Occu�ancy/Type
%° INSPECTION REQUEST LINE: (303) 234-5933
Inspections will not be performed unless this card is posted on the project site.
Call the inspection request line before 11:59 p.m. to receive an inspection the following business day.**
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections Date Inspector CommentsInitials
Pier
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Do Not Pour Concrete Prior To Approval Of The Above Inspections
_—T—Inspector Comments
Underground/Slab Inspections Date Initials
Electrical
Sewer Service
Plumbing
nn Mnf t^.nver underground or Below/In-Slab Work Prior To Approval Of The Above Inspections
_ _ - _ - - - -
Rough Inspections
Date
Inspector
Initials
Comments
Wall Sheathing
Mid -Roof
5 pil i
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
l.f n nnw ic iczinArl Approval of the Final Buildinq 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.
*"For Inspection Time Window — Please email insptimefequest C(71' Ci.Wheatridge.Co.US by 8:00 A.M. the morning of the
inspection with the property address in the subject line of the email. Time window is based on the inspector's route.
Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued
Protect This Card From The Weather
City of Wheat Ridge
Residential Roofing PERMIT - 201700984
PERMIT NO: 201700984 ISSUED: 05/30/2017
JOB ADDRESS: 3270 Moore CT EXPIRES: 05/30/2018
JOB DESCRIPTION: Reroof Tamko Heritage - 33 squares
*** CONTACTS ***
OWNER (303)594-7083 SEIGER STEVE L
SUB (303)948-5556 DALLAS ROBERT GREEN 130142 IST COLORADO ROOFING
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 23,210.00
FEES
Total Valuation 0.00
Use Tax 417.78
Permit Fee 426.20
** TOTAL ** 843.98
*** COMMENTS ***
*** CONDITIONS ***
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 k/2 -inch exists. Asphalt shingles are required to
be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is
required. Eave and rake metal is required. 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&4Erms installation
instructions, whichever is more stringent. In order to pass a final inspection of
elastomeric or similar type roof coverings, a letter of inspection and approval from the
manufacturer's 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.
City of Wheat Ridge
Residential Roofing PERMIT - 201700984
PERMIT NO: 201700984 ISSUED:
JOB ADDRESS: 3270 Moore CT EXPIRES:
JOB DESCRIPTION: Reroof Tamko Heritage - 33 squares
05/30/2017
05/30/2018
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanyingg approved plans and specifications,
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am t7ie legal owner or have been authorized
by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this permit. I further attest hat I am legally authorized to include all entities named within this document as parties to the work to be
performed and that all workto beiformed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or ONTRACTO (Circle one) Date
1. This permit was issued base rmation provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2, This. permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and_procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change. of the natural flow of water without prior and specific approval.
5, The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all 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. a permit shallt be construed to be a permit for, or an approval of, an violation of any provision of any
applicable code or any i regul l lfis 'urisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us
between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line.
City of
/'�
Wheat P,,dige
Ct7MNAUN1TY DEVELO MEN7
Building & Inspection Services Division
7500 W. 29" Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: perm its(a)ci.wheatridge.co.us
FOR OFFICE USE ONLY
Date: i
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: '�Z -� 0 m c g'_t C
Owner
Property Owner Email: SS e i ti e r Lo MCusT 11P.T
Mailing Address: (if different than property address)
Address:
Com, State, Zip:
Arch itect/En g 1 neer:
Arch itect/Eng 1 neer E-mail:
Contractor: ' I� , Qbf4
Phone:
Phone: 3
Contractors City License #: (3o Phone: 3075,— *- SSS 6
Contractor E-mail Address:
Sub Contractors:
Electrical:
W.R. City License #
Other City Licensed Sub:
City License #
5+.
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
❑ COMMERCIAL 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)
(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
Btu's
Gallons
Squares 3 ) a Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
).7,10, 06
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 th on this atio
CIRCLE ONE: (OWNER) (CONTRALTO or AUTHORIZED REPRESENTA E) of (OWNER) (ONTRACTOR
PRINT NAME: SIGNATURE: DATE: U
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
PROOF OF SUBMISSION FORMS
Fire Department ® Received ❑ Not Required
Water District ❑ Received ❑ Not Required
Sanitation District ❑ Received ❑ Not Required
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION:
SPRINKLERED:
OCCUPANT LOAD:
Building Division Valuation: $
City of
Wh6atIR
MMUNITY DEVELOPMENT
Building & Inspection Services Division
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-23778929
Inspection Line: 303-234-5933
Email: perm its(a)ci.wheatridQe.co.us
I 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:
Property Owner (please print): Phone:
Property Owner Email:
Mailing Address: (if different than property address)
Address
City, State, Zip:
Architect/Engineer E-mail:
Contractor:
Contractors City License #:
Contractor E-mail Address:
Sub Contractors:
Electrical
W.R. City License #
Other City Licensed Sub:
City License #
Plumbing:
W.R. City License #
Phone:
Phone:
Other City Licensed Sub:
City License #
Mechanical:
W.R. City License #
Complete all information on BOTH sides of this form
i CITY'OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type -
Job Job Address: }70 jyI oa ilc C T
Permit Number: 7 Q /,% O 6 `; SIke
Re-lnspection-req uirec�;�—N
sP
When corrections have been made, call for re -inspection Of 303-234-5933
Date: / i Inspector: ./ �'
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: 1?01r—
Job
p Yp Address: 75_Z'-"0 /t/� CO /1-zz'7 C.
Permit Number: 2_D i C 0
❑ No one available for inspection: Time '�' AM/PM
Re -Inspection required: Yes et No ,
When corrections have been made, call for re -inspection at 303-234-5933
Date: Inspector:
i
DO NOT REMOVETHISNOTICE
A4, CITY OF WHEAT RIDGE
Building Inspection Division
/ (303) 234-5933 Inspection line
(303) 235-2855 Office - (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address: Al00 2
Permit Number:
❑ No one available for inspection: Time 2 O AMklR
Re -Inspection required: Ye< DNo
* When corrections have been made, call for re -inspection at 303-234-5933
Date: Inspector: prm"'Ll
DO NOT REMOVE THIS NO ICE
FOR OFFICE USE ONLY
Date:
Gty of
Wh6atl��d, e r10' -q11&
COMMUNITY DEVELOPME'NT Plan/permit #
Building & Inspection Services Division 0q01(a 0 IA17
7500 W. 29" Ave., Wheat Ridge, CO 80033 Plan Review Fee:
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
p000w*~ 3270 Moore Court
Address,
W.-
Brothers Plumbing Heating & Electric
KJOW
mickmorgan@brothersplumbing.com
Electrical:
W.P. City License #
Other City Licensed Sub:
City License #
Plumbing-,
W.R. City License #
Mechanical:
W.P. City License #
Complete all information on BOTH sides of this form
(Check all that apply)
NEW COMMERCIAL STRUCTURE Q ELECTRICAL SERVICE UPGRADE
NEW RESIDENTIAL STRUCTURE El 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 SYSTEMIAPPLIANCE REPAIR or REPLACEMENT
OTHER (Describe)
Sq. FULF Btu's — Gallons
Amps — Squares — Other —
® RD Occupancy/Type
5933
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.
Do - l/'
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB
FOUNDATION INSPECTIONS
DATE
INSPECTOR
INITIALS
COMMENTS:
Footings /Caissons
Mid- Roof
Stemwall /.(CEG)Concrete
Encased Ground
Electrical Service
-
Reinforcing or Monolithic
Rough Electric
Weatherproof / French Drain
Rough Plumbing
Sewer Service Lines _.
Gas Piping
-..
Water Service Lines -
Rough Mechanical '
ruUK rvU l UNGKt i t UN I IL HnUVe nAJ D=LN 01UNCU
CONCRETE SLAB FLOOR
Electrical (Underground)
Plumbing (Underground)
Heating ( Underground)
ROUGHS...
..Sheathing
Lath/ Wall tie
Mid- Roof
Electrical Service
Rough Electric
Rough Plumbing
Gas Piping
Rough Mechanical '
-
- .ABOVE INSPECTIONS TO BE
SIGNED PRIOR TO PROCEEDING
Framing
.Insulation
Drywall Screw
- -
FINALS
.Electrical '.
Plumbing
Mechanical
-
Roof
.Building Final
1
Fire Department
-
R.O.W.$ Drainage
INSPECTIONS FOR PLANNING $, ZONING, FIRE AND PUBLICE WORKS
SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
Parking & Landscaping
* * NOTE: r ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A
CERTIFICATE OF OCCUPANCY ISISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION
- OF CERTIFICATE OF OCCUPANCY NOR - PERMISSION FOR OCCUPANCY.
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED
PROTECT THIS CARD FROM THE WEATHER
♦ i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: Fi~wL Age/
Job Address: 3 7a m2g l✓i
Permit Number: 1_9911nv
❑ No one available for inspection: Time AM/W
Re-Inspection required: Yes (E O2
*When corrections have been made, call for re-Inspection at 303-234-5933
Date: 2/S1iO Inspector: ez-
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE `
r Building Inspection Division
1 (303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: h'/i012ev /l
Job Address: A 7o me?r Ag G°7"
Permit Number: eJgl/$g
❑ No one available for inspection: Time AMI M
Re-Inspection required: Yes /No-')
*When corrections have been made, call forge-inspection at 303-234-5933
Date: 1,9111r7 Inspector: Z~~
DO NOT REMOVE THIS NOTICE
♦ i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 inspection line
(303) 235-2855 Office • (303) 235-2857 Fax
INSPECTION NOTICE
Inspection Type: lM"k, rc/
Job Address: q 7fi 1411m "If .
Permit Number: 00//~/Q
" F~A.Ctr
❑ No one available for inspection: Time 30 A&M
Re-Inspection required: Vg o ro'~ P/,"61.ren¢
'When corrections have been made, call for re-inspection at 303-234-5933
Date: g 1ele~G, Inspector: - i~ UUT-
DO NOT REMOVE THIS NOTICE
Gi>
City
of Wheat Ridge
Residential Roofing PERMIT - 091188
PERMIT NO: 091188
ISSUED: 08/10/2009
.
JOB ADDRESS: 3270 MOORE
. CT
EXPIRES: 02/O6/2010
DESCRIPTION: Reroof 36
sqs.. with 30. yr shingles
CONTACTS
owner 303/594-7083
Steve Seigler
sub 303/366-1514 -
Jennifer Rimkus
09 0094 Total Home Exteriors Inc.
"
PARCEL 'INFO
ZONE CODE: UA
USE: UA
SUBDIVISION: 0647
BLOCK/LOT#: 0/
FEE SUMMARY
-ESTIMATED
PROJECT VALUATION: 9,184.50
}
FEES
Permit' Fee
235.70
-
Total Valuation
.00
C~
'
Use Tax
165.32
Abb'n
TOTAL
- 401.02
4J Conditions:.
r 6nail ...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 fromeave edge to 21 inside exterior walls.'
Subject to field inspections.
y„
a I hereby certify. that. the setback distances proposed by this permit application are accurate, and do not violate applicable
ordinances, rules or r gulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all
measurements shown, aria allegations made are accurate; that I have read and agree to abide by all conditions. printed on this
x; appl c tion and that I a ume full responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other
appl'ca e ~Ordi ances, for work under this permit. Plans subject to field inspection.
Signature of contractor/owner date
a;
Ji 1. This permit was issued in accordance with the provisions set forth in your-application and is subject to the laws of the
5 ordinances of the City.
be paid for a new permit.
g, Signature of Ce ldmg. Official date
l„ o
REQUESTS INS
PECTIO R MUST BE EQUEST MADE LINE: BY 3(3PM 03)2 ANY 34-5933 BUSINESS DAY FOR BUILDING OFFICE: `INSPECTION (303 THE ).235 2855
. FOLLOWING BUSINESS DAY.
g
f
Y
State of Colorado and to the Zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable
2. This permit shale. expire 180 days from the issue date. Requests for an extension must be received prior to expiration
date. An extension may be '
y granted at the discretion of the Building Official.
t 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
4. No work of any manner shall be done that will change the natural flow of water causing a drainage problem.
5 Contractor shall notify the Building Inspector twenty-.four (24). hours in advance for all inspections and shall receive :
written approval on inspection card before :proceeding with successive phases of the job.
z
6. The issuance of a permit or the :approval of drawings and specifications shall not be construed to be a permit for, nor.
an approval of, any violation of the
y provisions of the building codes or any other ordinance, law, rule or regulation.
All. plan review s. ect to field inspections.
0
a City of Wheat Ridge Building Division
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-235-2857
Inspection Line: 303-234-5933
Date: f U
Plan
Permit
Building Permit Application
Property Address:
3A 70 M a -re, (~_T
Property Owner (please print):
Phone) 6q
Mailing Address: (if different than property address)
Address:
State, Zip:
Contractor:
Contractor License Phone: . Is-( q
Sub Contractors:
Electrical City License
Company:
itfS
Plumbing City License
Company
Mechanical City License
Company:
Exp. Date: Exp. Date: Exp. Date:
Approval: Approval: Approval:
Use of space (description): Q kcx ' ~~2 J Construction Value: $
Description of work: Y~ (as calculated per the Building Valuation Data sheet)
1. J l~ Plan Review (due at time of submittal): $
Sq. Ft./L.Ft added: Squares3~ BTU's Gallons _ Amps
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 1 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. N
CIRLCE ONE: (OWNER) ((CONTCTOZ)) or P RSONAL REPRESS N~TA~TIVVEpoof}(,(qS t~ERR) (CONTRATOR) I
PRINT NAME:rj" A V "or~'uIGNATURE:I KJ`~V / IL~tL~I~V Date: p
PUBLIC WOr,KS COMMENTS:
Reviewer.
~FIRE DEPARTMENT:: ❑ a It) pproved wX comm,jits dis2ppf0#!2d D no reVieW required I Bldg Valuation: $ 7~-
COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
When corrections have been made, call for re-inspection at
303-234-5933. ~ ,
DO NOT REMOVE THIS NOTICE
Job Address: 32-70 MoARE 67'
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING INSPECTION LINE - (303-2345953)
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
Building Permit Number
Date
77079
4/29/2004
Property Owner: STEVE SEIGER
Property Address : 3270 MOORE CT
Contractor License No. : 17569
Company : Brothers Plumbing & Heating, Inc.
Phone : 274-5975
Phone : 451-5057
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit applicalion are accurate, and
do not violate applicable ordinances, rules or regulatlons of the City of W heal Ridge or
covenants, easements or restnctions of record; lhat 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 responsibiliry for compliance with the Wheat Ridge Building
Code (U.B.C.) and all other applicable Wheat Ridge inances, for work under this pe it.
(OWNER)(CONTRACTOR) SIGNED DATE q
Construction Value :
$4,500.00
Permit Fee :
$144.70
Plan Review Fee :
$0.00
Use Tax :
$54.00
Total:
$198J0
Use:
Description : INSTALL A NEW 125,000 BTU BOILER REPLACE EXISTING BOILER
tp - ss
BUILDING DEPARTMENT USE ONLY
SIC : Sq. Ft. :
ZonI64&j&ft
Approval :
Zoning :
0~i.~f~8-Cai~rmen
Approval :
01001172M& Comwota
Approval :
Occupancy : Walis : Roof : Stories : Residential Units :
Electrical License No :
Company:
Expiration Date :
Approval:
Plumbing License No :
Company :
Expiration Date :
Approval:
Mechanical License No :
Company :
Expiration Date :
Approval :
(1) This permit was issued in accordance with the provisions set forth in yopur application and is subjecl to the laws of the State of Colorado and to the Zoning
Regulations and Building Code of Wheat Ridge. Colorado or any othar applicable ordinances of the City.
(2) This permit shall expire if (A) the vrork authorized is not commenced within siuty (60) days from issue date or (B) the building authorized is suspended or
abandoned for a period of 720 days.
(3) I( this pertnit expires, a new pertnit may be acquired for a fee of one-half the amount normally required, provitletl no chan9e5 have been or will be matle in the
original plans and specifcations and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspension or abandonment
exceeds one (1) year, full tees shall be paid for a new pertnit.
(4) No work of any manner shall be done that will change the natural ilow ot water causing a drainage problem.
(5) Contredor shall notity the Builtling Inspector lwenty-four (24) hours in advance for all inspections and shall raceive written approval on inspection card before
proceediing with successive phases of the job.
(6) The issuance o/ ertnit or the aPproval of tlrawings and specifcations shall not be construed to be a pertnit for, nor an approval of, any violation of the
provis a mldi es or anyb'ther_ordinance, law, rule or regulation.
Chief Building Inspec or
Please sign Terms and Conditions on reverse side of page.
COMMUNITY DEVELOPMENT DEPARTMENT Building Pemtit Number:
o` WHE4T
BUILDING INSPECTION LINE - 303-234-5933 Date:
CITY OF WHEAT RIDGE
V m 7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
~ac oa ~o°
APPfr sl l.`~+~~ Y~TIO;~,y
Y ~
PropertyOwner: S}~ue- SQ~c;ef
PropertyAddress: 32-70 yy~p~~e COUr'r Phone:3&3
Contractor License No.:
Company:[gn,`'\riers ~(1Lu.~Hec~~wci Phone:;3o3-USD-Niyf'y
~T
ON'NER/CONTRAC70R 9GNATURE OF UNDERSTANDINC AttD AGAEEMENT
1 hereby cMify thal the setback disiances proposed by this pertnit application are accurate,
and do not violatc applicable ordinanca, rula or rcgulations of the Ciry o( Wheat Ridgc or
covenanu, cascmrnis or restnctions of record; that all mcasurcmcnts shown, and allcgations
madc att accuretr, that I have read and agrce to abideq by all condi ns printed on this
application and that I assumc full responsibiliry fw,compliance the Whcat Ridge
Bmiding Codc (UB.C) and ail other applicable Wiieat Ridgc 00fiances. (or work under
this pennit.
~ . --v ...r~ ~/~7-v~
Construction Value:$ `1S[~D`
Permit Fee:$
Plan Review Fee:$
Use Tax:$
Total:$
(OKTERxCOMRACfOR):PRI!TE¢,' . DATE
j
%
DESCRIPTION: ~~g+,~~~u ne.:~ 12S,o~o G3h: r3o~ce.- r(fPb+)ur~( '9A'St(y'C I k"301tep.
BUILDING DEPARTMENT USE ONLY
SIC: Sq.Ft:
ZONIN6 COMMENTS:
Approval:
Zoning:
BUILDING COMMENTS:
Approval:
PUlIIC WORNS COMMlNTE:
Approval:
Occupaney: Wuiis: Roof: Sturies: Rcsidential Units:
Electrical License No: Plumbing License No: Mechanical License No:
Company: Company: Company:
Expuation Date: Expvation Date: Expuation Date:
Approval: Approval: ADProval:
41) This pennit wss issued in accordance with the provisions sn forth in your appliuuov and is subjai W the hws of 0e Stam of Cobndo+nd to Lhe Zoning
Regulstwns and Building Codcs of Whwl Ridge. Cobrado or my oJier appliobk ordivnca of ihc Ciry.
This yemnit shall czplrt if(A) the work amhorized is wi commenced within sixry (60) days fmm fuue dam or (B) the building awhorized is smpeoded or
abandond for i penod of 120 days.
(J) If 1his pemiii exyires, a new permit may be acquired t« a fee of one-half LM1e amoum nomully rcquirtd. provided no changes have been or will be made
in the origind plvu and spa'ifications uM any suryensioo or abandonmml hu nol ezceeded one (1) ym . If changes luv< been or if susyensan or
abandonmem exceeds one (1) yeu, fuli fees shall be paid for a new pennii
(4) Na work of any manncr shall be don< that wiU chmge the mmnl /bw of ~~awr ousing a dnimg< pmbkm.
(5) Conmctor sha0 wufy the BuiNiny Lnspecwr 1wrnry-(our (24) hours in advance fof a11 imytcoons vM shell rteivx wrinen npDroval on inryecaon card
before procadinY with succesivs pluus of thejob.
(6) The issuance of a permit w ihe appronl of dnwings and specifications sMll m1 bc consoved b be a pemil for, nor an appmval of, any valalion of the
provisions of Ih< buiNing <oda m any ah<r orAinunce, law, ruk or rtgu6uon.
Chief Building Inspector