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12490 W. 35th Avenue
ELECTRONIC INSPECTION RECORD Inspection online form: http://www.ci.wheatridge.co.us/inspection Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Inspections will not be performed unless this card is posted on the project site Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business day PERMIT: 202100871 ADDRESS- 12490 W 35th Ave JOB CODE: RePd1f5eNef Foundation Inspections Date Inspector Initials Comments 102 Caissons / Piers 103 Footing / P.E. Letter 104 Foundation Setback Cert. 105 Stem Walls 106 Foundation wall Insulation Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground / Slab Inspections Date Inspector Initials Comments 201 Electrical / Cable/ Conduit 202 Sewer Underground Int. 203 Sewer Underground Ext. 204 Plumbing Underground Int. 205 Plumbing Underground Ext. 206 Water Underground Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections Rough Inspection Date Inspector Initials Comments 301 Rough Framing 302 Wall Sheathing 303 Roof Sheathing 304 Sheer Inspection 305 Insulation 306 Mid -Roof 307 Metal / Lath / Stucco 308 Rough Electrical Residential 309 Rough Electrical Commercial 310 Electrical Meter Residential 311 Electrical Meter Commercial 312 Temp. Const. Meter 313 Rough Plumbing Residential 314 Rough Plumbing Commercial 315 Shower Pan PERMIT: ADDRESS: JOB CODE: 202100871 12490 W 35th Ave Repw,ewe, Rough Inspection (continued) Date Inspector Initials Comments 316 Rough Mechanical Residential Commercial 318 Boiler/ Furnace 319 Hot water tank 320 Drywall screw and Nail 321 Moisture board / shower walls 322 Rough Grading 323 Miscellaneous Final Inspections Date Inspector Initials Comments 401 Gasline 402 Gas Meter Release 403 Final Electrical Residential 404 Final Electrical Commercial 405 Final Mechanical Residential 406 Final Mechanical Commercial 407 Final Plumbing Residential 408 Final Plumbing Commercial 409 Final Roof 410 Final Window/Door 411 Landscape/Park/Planning* Inspections from these entities shall be requested one week in advance. *For landscaping and parking inspections please call 303-235-2846 **For ROW and drainage inspections please call 303-235-2861 ***For fire inspections please contact the Fire Protection District for your project. 412 Row/Drainage/Public Works** 413 Flood plain Inspection** 414 Fire Insp. / Fire Protection*** 415 Public Works Final** 416 Storm Water Mgmt.** 417 Zoning Final Inspection* 418 Building Final Inspection Note: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building Inspection does not constitute authorization of occupancy. For Low Voltage permits please be sure that rough inspections are completed by the Fire District and Electrical low voltage by the Building Division. 12490 W 35th Ave. Gas Line Schematic Contact: Thomas Burney Blue Devil Builders, Inc. bluedevilbuilders@gmaii.com 9� MUMM Z-® Z- 0 ® 2 -S z-1 I 22' black iron @ 1" 41' black iron @ 3/4" 34' effective length 60' effective length Capacity: 243 kbtu Demand: 199 kbtu r*%heem 199 Kbtu Tankless UAM Loz.. 104 kbtu Demand: 80 kbtu Goodman 80kbtu furnace Inspection Type: Job Address: Permit Number: CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE J No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections are complete, schedule re -inspection online. Date: Inspector: DO NOT REMOVE THIS NOTICE A CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2355 Office -, INSPECTION NOTICE Inspection Type:/--� Job Address: "l� Gt%.'`-4. Permit Number: ❑ No one available for inspection: Time le> '` SZ� PPM Re -Inspection required: Yes Vo When corrections are complete, schedule re -inspection online. Date: 7, -5 —20? -o Inspector: --� DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Z- 7-' 'fl Permit Number: a- e? e> d2 j IJ No one available for inspection: Time AM_/PM Re -Inspection required: Yes No, When corrections are complete, schedule re -inspection online. Date: Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: C? LZ Permit Number: F ❑ No one available for inspection: Time 1 0 AM/PM Re -Inspection required: Yes When corrections are complete, schedule Date`� 11141 Inspector A ®_ CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: P Job Address: -% `� 0 w 1, xlxx Permit Number: -Q aC 0 Z— 3 -f '� C, 117 f ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections are complete, schedule re -inspection online. Inspector: DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: 0 I/V 5 11, Ale, Permit Number: r2 -Z_. LJ No one available for inspection: Time AM/PM Re -inspection required: Yes No When corrections are complete, schedule re -inspection online. Date: 7", —Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Permit Number: ❑ No one available for inspection: Time 'M/PM Re -Inspection required: 'Yes ; No When corrections have been made, schedule for re -inspection online at: http://www. ci. wheatridge.co. uslinspection Date: Inspector: DO NOT REMOVE THIS NOTICE � ► � i City of Wheat Ridge Residential Remodel PERMIT - 202002349 PERMIT NO: 202002349 ISSUED: 12/11/2020 JOB ADDRESS: 12490 W 35th Ave EXPIRES: 12/11/2021 JOB DESCRIPTION: Residential interior remodel of entire home including all plumbing, electrical and mechanical including new insulation and remodel of bathrooms and kitchen. Replacing 2 garage doors. **REVISION: Reconfigure both upper level bathrooms for code compliance and functionality, reconfigure main level SW bath to reconnect previously removed toilet, reconfigure basement bath for code compliance, reconfigure basement laundry area, add closet in main level SW bedroom to make it conforming. Total bathroom count is now 5: ( 3 ) full, ( 2 ) 3/4. Total bedroom count is now 5, all conforming. Changes are bubbled in attached floor plans. Added valuation: $5,800 Sq ft: 31020 *** CONTACTS *** OWNER (317)260-0735 APOLLONIA RESIDENTIAL LLC SUB (317)260-0735 THOMAS BURNEY 190320 BLUE DEVIL BUILDERS INC SUB (303) 755-0832 JIM KING 130219 JK ELECTRIC LLC SUB (303)990-6466 JOSE ISABEL SAUCEDO 190189 INFINITY HEATING & AIR SUB (303)378-9020 MICHELE LEYNER 190353 AKINS'S PLUMBING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 126,313.00 FEES Total Valuation 0.00 Plan Review Fee 849.03 Use Tax 21652.57 Permit Fee 11306.20 ** TOTAL ** 41807.80 *** COMMENTS *** *** CONDITIONS *** All roughs to be done at Framing Inspection. A printed copy of the permit and city stamped on-site plans must be available on-site for the first inspection. Approved per plans and red -line notes on plans. Must comply with 2018 IRC, 2020 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections. 1* ► � i City of Wheat Ridge '/� Residential Remodel PERMIT - 202002349 PERMIT NO: 202002349 ISSUED: 12/11/2020 JOB ADDRESS: 12490 W 35th Ave EXPIRES: 12/11/2021 JOB DESCRIPTION: Residential interior remodel of entire home including all plumbing, electrical and mechanical including new insulation and remodel of bathrooms and kitchen. Replacing 2 garage doors. **REVISION: Reconfigure both upper level bathrooms for code compliance and functionality, reconfigure main level SW bath to reconnect previously removed toilet, reconfigure basement bath for code compliance, reconfigure basement laundry area, add closet in main level SW bedroom to make it conforming. Total bathroom count is now 5: (3) full, (2) 3/4. Total bedroom count is now 5, all conforming. Changes are bubbled in attached floor plans. Added valuation: $5,800 Sq ft: 31020 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 municpal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this�permrt. I further attest that I am leg ally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180, days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and��procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all requ�ired inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. From: no-reolv(alai.wheatridae.m. us To: CommDev Pets Subject: Online Form Submittal: Revision to Permit Application Date: Wednesday, January 6, 20212:38:06 PM Revision to Permit Application Permit Number 202002349 assigned to project PROPERTY INFORMATION Permit Number 202002349 Property Address 12490 W 35th Ave Property Owner Name Apollonia Residential LLC Property Owner Phone Number (enter WITH dashes, eg 303-123- 4567) 317-260-0735 Property Owner Email bluedevilbuilders@gmail.com Address CONTRACTOR INFORMATION Contact Name Thomas Burney Contact Phone Number (enter WITH dashes, eg 303-123-4567) Com@ a FRI91inw-ArGRm 317-260-0735 bluedevilbuilders@gmail.com Retype Contact Email bluedevilbuilders@gmail.com Address DESCRIPTION OF WORK Detailed Revised Scope of Work - Provide a detailed description of the change in scope of work including mechanical, electrical, plumbing work occurring, reconfigure both upper level bathrooms for code compliance and functionality, reconfigure main level SW bath to reconnect previously removed toilet, reconfigure basement bath for code compliance, reconfigure basement laundry area, add closet in main level SW bedroom to make it conforming. Total bathroom count is now 5: (3) full, (2) 3/4. Total bedroom count is now 5, all conforming. Changes are bubbled in attached floor plans. adding/removing walls, etc Engineer Letter (if Field not completed. applicable) Additional Documents infinityheatinaE0187.1.odf on Letter Size Are plans or No documents locked for editing? Construction Plans 12490 W 35th Revised floor nlan.Ddf scanned on 11'x17" or larger Additional Project 5800 Value Only add what $5,800 added the revised scope of valuation is OK work is valued at Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" Electronic Payment Form - Blue Devil Builders.odf SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have Yes been authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Submitting Thomas Burney Revision Email not displaying correctly? View it in your browser. z O 5 z z �O U� Z5 =w� �In�a Z_ h ❑ Z = OwQ~ H 0 i 3 Z H u3 w 000LL ¢¢m°z N J Q h Wwz M O W J IL W Q O] J 0QQ¢ z L�z— �wa0� Z>3U� W 2018 IRC R402.4.1.1 Air Barrier and Insulation Requirements. N N 28'-6" INTERIOR FINISH • The air barrier installed at exterior walls adjacent to showers and tubs shall separate thewall fr m the shower or tub. 18'-12 • Exterior walls adjacent to showers and tubs shall be insulated. bi PROJECT SUMMARY: Code: 2078 IRC Occupancf. R-3 Construction Type: Type VB Use: Single Family Residential Total Floors in Building: 1 plus Finished Basement 29'-5" EXTERIOR FINISH 3'-0" 8'-9 3-421" 15'-12' 28'-6" INTERIOR FINISH PROPOSED UPPER LEVEL PLAN SCALE: 1/411= 1'-0" A t? ON SITE PLANS 28'-6" INTERIOR FINISH LL MUST BE ON SITE FOR INSPECTION II 18'-12 ALL Projects are bi 10'-0 Subject to Field Inspections o Z LL 2 VOID 13-11" 242 �ri r r M C IN MASTER a V C BEDROOM LL ° BEDROOM C N THREE C 3 307 b 0 4 304 W A 18'-2" x 10'x" b Rr 0 10'-0" x 14'-1" O N ® 0 K z LL i iS 5 O O it w 12'-12' 3'-12' 6 UPPER LEVEL f\ N N 1 EXISTING WALLS TO u, /y� City of W11eat`�gc UPPER LEVEL Y CoMMumiIY UfV EIVYMFNT TO REMAIN APPROVED IST G ALLS TO Review tl cd rrPor�eCor lienee LINEN Randy Slusser 1/08/2021 TO E IN FW .�e�n.mnw✓�oxmexaew�rpcwwifarmsot wry wmm�m 0 mYNmeYu'wru al me Lwdx9 mAaa/©EMYaEuou<n hrmm peuumnBb pM auMlly to Mw'Wlwmn'el MepmnYmf afIM IWIIYp U it 2'-0" x 2'-6" U Q z� O BATH 3 U4-6 ®3 =in CLOSET 303 (� 308 0 Oc ww� o�z Xo mes on J m p] ri d � � N »O. 1>1 BATH 2 mm�� W BEDROOM 3090� FOUR 0 8'-0" x 8'-0" _x N F301 13'-0" 8'-3" O o a x 21-42' 31-71 6-102' UPPER LEVEL DN r EXISTING WALLS TO TO REMAIN 3'-0" 8'-9 3-421" 15'-12' 28'-6" INTERIOR FINISH PROPOSED UPPER LEVEL PLAN SCALE: 1/411= 1'-0" A t? 0 2 5 A7 12.28.20 ON SITE PLANS 4 LL MUST BE ON SITE FOR INSPECTION II ALL Projects are bi Subject to Field Inspections o Z LL 2 r r M C a a V C LL ° C C 3 OC W A a A O N ^' ` `1 K z LL i iS 5 O O it w z f\ N N REVISION u, /y� City of W11eat`�gc Y CoMMumiIY UfV EIVYMFNT APPROVED Review tl cd rrPor�eCor lienee Randy Slusser 1/08/2021 Plans Examiner Date .�e�n.mnw✓�oxmexaew�rpcwwifarmsot wry wmm�m 0 mYNmeYu'wru al me Lwdx9 mAaa/©EMYaEuou<n hrmm peuumnBb pM auMlly to Mw'Wlwmn'el MepmnYmf afIM IWIIYp U Nv tlemf/wMivnfbtM (XY MOM nN 1eMm U Q z� (� Oc ww� o�z mes on J m p] ri d � � N »O. mm�� 0 2 5 A7 12.28.20 z O 5 z z �O U� Z0 =w� Z_ v 0 Z = z W Q H o zo �w�� o0W1c 000u= ¢¢m°z N J Q z�0h WWz MO W J I W Q m J Q�j¢ zpQ L�z— �w¢0, Z>3Ut W 38'-9" INTERIOR FINISH 10'-5" 1 4'-3" 1 1 5'-10" 1 1 171-6" o I I BET o0 M 3'-102' 1 6'-62' A, = 2 CV Z z _ LL LL w w O 0 K rxW W W :Q F N N 9 II BEDROOMONE 5'-0" x 2'-0" PROJECT SUMMARY: "--t Code: 2078 IRC Occupancy R-3 Construction Type: IType VB Use: Single Family Residential Total Floors in Building: 1 plus Finished Basement CLOSET 2 F2_1 1 3'-102' BATH 1 200 207 r HALL 201 3'-10" KITCHEN 205 '77� � 9 9 38'-9" INTERIOR FINISH LIVING ROOM 203 Y M PROPOSED MAIN LEVEL PLAN SCALE: 1/411 = 1 1-0" DINING ROOM 204 NEW PONY WALL BELOW 10'-5" 11 V ON SITE PLANS 4 MUST BE ON SITE FOR INSPECTION ALL Projects are Subject to Field Inspectionsbi 0 a a UP GARAGE 0 28'-3" x 22'S" R LL Z LU 2 I— J M L M S 00 O V)Q LJJ fkf 30 O Lu V CV Q W 2 3 REVISION '�CdY of �W heatR�dge APPROVED R,,e for CW,Compliance Randy Slusser 1/08/2021 Mans Examiner Dane �� me mw..ol apemne•yy�ewalKm,v�Y;��aA wn.wwmw ww.a, o- a onmtp, n a, aper a o/ aM wane. m ara,kro,�,a.� am.nwMs.p.a,aavanaa�..ranm lvnum�p,a PH eu;Miirn wwrw rntl m, wanYart,H melWf'N �r.e•an.,a�a�...am.u.,na ne,x..w. 0 O Tr U Zi N (�D W W z J m p] ri Q o N » 0: m m M 5 A8 1 12.28.20 z O 5 zz �O U� Z0 =w� �rn�a Z_ riw� W h ❑ Z = OwQ~ 0 Zzu`3 w ofw� 000u= Q Q m Z N J Q w_w MO LL J LL w O7 J O<< )< z L�z— ace<0 , w>3Ux Z w 0 PROJECT SUMMARY: Code: Occupancy: Construction Type: Use: Total Floors in Building Y i� FINISH 2018 IRC R-3 Type VB Single Family Residential 1 plus Finished Basement PROPOSED BASEMENT PLAN SCALE: 1/4" = 1'-0" 15'-9" v i� 4 ih 19 ON SITE PLANS 4 MUST BE ON SITE FOR INSPECTION II `a ALL Projects are ^hi Subject to Field Inspections o H II i' LL Z LU L2 _ J M Iss— v ) LU 3 REVISION City a �WheatR�dge Caxmuwrn uneuwmarr APPROVED Reviewed for Cade Camoronee Randy Slusser 1/08/2021 Plans E>amner Date vYux. a�....x � me rs�wr. of a pxninn eopeiw aaiN. aRJNu�N�N wv wroN.n ,�weeaemmuh<ranwwwotan �waenm mYKge Vm'N�++V tte bN]N9tNem Mu0aM1b0iwrn, himb or.,�.,.re a s+• a anNrY ro wrow a�.n,.i xe eroN+NN 9rn. w+uw r. nan..eanss.aa.aY nAx�xn.ws 5 A9 12.28.20 FAMILY 0ROOM ® WET BAR F1 -01 37-7" x 134" Verify in field 11'az' S'-1 a' combustion air requirements N A m N CLOSET 0 4'-0"x3'-0" MECH CLOSET W H ROOM UP 106 FURNACE 6'-Tx3'-0 10 10 STORAGE 105 LAUNWASHER qFl-02-1111'-7'X 7FOUR15'-9"x9'-6" Exhaust fan required 2018 IRC R-3 Type VB Single Family Residential 1 plus Finished Basement PROPOSED BASEMENT PLAN SCALE: 1/4" = 1'-0" 15'-9" v i� 4 ih 19 ON SITE PLANS 4 MUST BE ON SITE FOR INSPECTION II `a ALL Projects are ^hi Subject to Field Inspections o H II i' LL Z LU L2 _ J M Iss— v ) LU 3 REVISION City a �WheatR�dge Caxmuwrn uneuwmarr APPROVED Reviewed for Cade Camoronee Randy Slusser 1/08/2021 Plans E>amner Date vYux. a�....x � me rs�wr. of a pxninn eopeiw aaiN. aRJNu�N�N wv wroN.n ,�weeaemmuh<ranwwwotan �waenm mYKge Vm'N�++V tte bN]N9tNem Mu0aM1b0iwrn, himb or.,�.,.re a s+• a anNrY ro wrow a�.n,.i xe eroN+NN 9rn. w+uw r. nan..eanss.aa.aY nAx�xn.ws 5 A9 12.28.20 1* � � i City of Wheat Ridge �� Resid. Windows/Doors PERMIT - 202002306 PERMIT NO: 202002306 ISSUED: 11/09/2020 JOB ADDRESS: 12490 W 35th Ave EXPIRES: 11/09/2021 JOB DESCRIPTION: Installing 18 windows and 3 doors. U -value is .30 *** CONTACTS *** OWNER (317)260-0735 APOLLONIA RESIDENTIAL LLC SUB (317)260-0735 THOMAS BURNEY 190320 BLUE DEVIL BUILDERS INC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 91650.00 FEES Window Replacement 50.00 Total Valuation 0.00 Use Tax 202.65 ** TOTAL ** 252.65 *** COMMENTS *** *** CONDITIONS *** Windows shall comply with all applicable codes, have a .30 or better U -factor and shall be safety glazing if within a tub enclosure, less than 18 inches above the floor or within 24 inches of a vertical edge of a door. I, by my signature, do hereby attest that the work to, be performed shall comply with all accompanying approved plans and specifications, applicae building codes, and all applicable municpal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this�permrt. I further attest that I am leg ally authorized to include alI entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180, days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and��procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all requ�ired inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. From: CommDev Permits TO: Dina Kemp Subject: Fw: Online Forth Submittal: Residential Window/Door Replacement Permit Application Date: Sunday, December 13, 2020 3:58:05 PM Residential Window/Door Replacement Permit Application This application is exclusively for RESIDENTIAL REPLACEMENT WINDOWS and DOORS - LIKE FOR LIKE ONLY. YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM AND WINDOW/DOOR CUTSHEET (SPEC SHEET) IN ORDER FOR THE PERMIT TO BE PROCESSED. Your Permit will be emailed to the email address provided below once it is processed. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. Is this application for Yes replacement window(s) and/or door(s) like for like? PROPERTY INFORMATION Property Address 12490 W 35th Ave Property Owner Name Apollonia Residential LLC Property Owner Phone 3172600735 Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email bluedevilbuilders@gmail.com Address Attach City of Wheat Blue Devil Builders Electronic Payment Form - Word.docx Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" CONTRACTOR INFORMATION Contractor Business Blue Devil Builders, Inc. Name Contractor's License Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone Number (enter WITH dashes, eg 303-123- 4567) Contractor Email Address Retype Contractor Email Address DESCRIPTION OF WORK 190320 K�rdza�a�rK�7 bluedevilbuilders@gmail.com bluedevilbuilders@gmail.com What is being replaced Windows, Doors Number of window and/or doors being replaced Location of window(s)/door(s) being replaced (for example, master bedroom, kitchen, bathroom, etc): What is the u -value of the window(s)/door(s)? City of Wheat Ridge requires the u -value to be .30 or better on windows.. Attach copy of window/door cut sheets showing sizes and u - value 18 windows, 3 doors All windows and exterior doors. Locations are specified in the uploaded file. .30 or better Project Value (contract 9650 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have Yes been authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying for Thomas E. Burney Permit Email not displaying correctly? View it in your browser. � ► � i City of Wheat Ridge Residential Remodel PERMIT - 202002349 PERMIT NO: 202002349 ISSUED: 12/11/2020 JOB ADDRESS: 12490 W 35th Ave EXPIRES: 12/11/2021 JOB DESCRIPTION: Residential interior remodel of entire home including all plumbing, electrical and mechanical including new insulation and remodel of bathrooms and kitchen. Replacing 2 garage doors. Sq ft: 3,020 *** CONTACTS *** OWNER (317)260-0735 APOLLONIA RESIDENTIAL LLC SUB (317)260-0735 THOMAS BURNEY 190320 BLUE DEVIL BUILDERS INC SUB (303) 755-0832 JIM KING 130219 JK ELECTRIC LLC SUB (303)990-6466 JOSE ISABEL SAUCEDO 190189 INFINITY HEATING & AIR SUB (303)378-9020 MICHELE LEYNER 190353 AKINS'S PLUMBING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 120,513.00 FEES Total Valuation 0.00 Plan Review Fee 823.88 Use Tax 21530.77 Permit Fee 11267.50 ** TOTAL ** 41622.15 *** COMMENTS *** *** CONDITIONS *** All roughs to be done at Framing Inspection. A printed copy of the permit and city stamped on-site plans must be available on-site for the first inspection. Approved per plans and red -line notes on plans. Must comply with 2018 IRC, 2020 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections. 1* � � i City of Wheat Ridge �� Residential Remodel PERMIT - 202002349 PERMIT NO: 202002349 ISSUED: 12/11/2020 JOB ADDRESS: 12490 W 35th Ave EXPIRES: 12/11/2021 JOB DESCRIPTION: Residential interior remodel of entire home including all plumbing, electrical and mechanical including new insulation and remodel of bathrooms and kitchen. Replacing 2 garage doors. Sq ft: 31020 I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am leg ally authorized to include alI entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180, days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and��procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all requ�ired inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. From: no-reolv(alci.wheatridae.m. us To: CommDev Perm is Subject: Online Form Submittal: Residential Interior Remodel Date: Thursday, November 12, 2020 7:06:52 AM Residential Interior Remodel This application is exclusively for Residential Interior Remodels and other scopes of work which do not have a specific form already available. YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN ORDER FOR THE PERMIT TO BE PROCESSED. Your Permit will be emailed to the email address provided below once it is processed. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. PROPERTY INFORMATION Property Address 12490 w 35th ave Property Owner Name Apollonia Residential LLC Property Owner Phone 317-260-0735 Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email bluedevilbuilders@gmail.com Address Attach City of Wheat Blue Devil Builders Electronic Payment Form - Word.docx Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" APPLICANT INFORMATION Applicant Name Thomas Burney What Is your role In the Property Owner, General Contractor project? Are you performing the No work yourself, live in the home and will be living in the home 1 year after completion? Wheat Ridge 190320 Contractor's License Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contact Phone Number 317-260-0735 (enter WITH dashes, eg 303-123-4567) Contact Email Address bluedevilbuilders@gmail.com for Plan Review Comments Retype Contractor bluedevilbuilders@gmail.com Email Address DESCRIPTION OF WORK Detailed Scope of 12490 W 35th ave scope of work Demolition: Remove separation Work - In the space wall between kitchen and dining room, Remove separation walls below (not as an and closets in basement laundry area, Remove/replace attachment), Provide a wallboard in kitchen and shower areas for electrical access, detailed description of Remove paneling at North and West basement perimeter walls work including for insulation access, Plumbing: New fixtures in existing mechanical, electrical, locations, including kitchen, (2) full bathrooms, (2)'/ bathrooms, (1) % bathroom; Repair inadequate pipe slope at laundry, New plumbing work water heater in existing location, Plumbing Contractor: David occurring, Ottersberg —Akins's Plumbing; Electrical: New fixtures and adding/removing walls, devices in existing locations; Add smoke/CO detectors per IRC; etc New service entrance/meter/panel, replace (2) existing sub panels, Add lighting in living room and kitchen area (install drop ceiling if necessary to avoid disturbing friable asbestos), Replace baseboard heaters in upper level, Add A/C disconnect, kitchen circuitry, breakers per NEC, Electrical Contractor: Jim King —JK Electric, Mechanical: New gas forced air furnace in existing location, Add central A/C to forced air system in main level and basement, Add evaporative cooler at upper level, Mechanical Contractor: Jose Saucedo — Infinity Heating&Air; General Replace kitchen cabinets/countertops/appliances; (4) bathroom renovations including shower/tub surrounds, New GWB as necessary, Replace batt insulation where accessible, (anticipated) new floating frame walls and insulation at North and West basement exterior, Cosmetic improvements to doors, millworks, floor coverings, Replace 2 garage doors Other Permits Replace all windows and doors (separate permit already issued), I, the applicant, I have entered a detailed scope of work. understand my application will be rejected if I do not include a Detailed Scope of Work. Location of Work Entire interior of the house Square Footage Area of Work Being Performed Asbestos Report Upload letter size documents here Construction Plans scanned on 11'x17" or larger Project Value (contract value or cost of ALL materials and labor) 3020 12490 W 35th Ave Asbestos Reoort. odf Field not completed. 12490 Permit Drawina Set.odf if M -118I81 SIGNATURE OF UNDERSTANDING AND AGREEMENT 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. Yes Main & Upper Floor: 11 70s + 680 sf = 1850sf (x) $48.98 = $90,613 Basement: 920sf (Living space) x $32.50 = $29,900 Total: $120,513 I understand that work may not begin on this property until a permit has been issued and posted on the property. I certify that I have been authorized by the legal owner of the property to submit this application and to perform the work Yes Yes described above. Person Applying for Thomas Burney Permit I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Email not displaying correctly? View it in your browser. r�4f City of -.4V Wh6atj�,Ae COMMUNI TY DEVELOPMENT SUBCONTRACTOR AUTHORIZATION FORM Electrical Subcontractor This form must be completed & signed by the ELECTRICAL SUBCONTRACTOR performing electrical work on site. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address:I aggb W35'h Ay General Contractor: FORM WILL NOT BEACCEPTED WITH MISSING INFORMATION Company Namek: �Y,, Contact Phone #: Zn2 A-a5—C p Wheat Ridge Contractor License #: � tj(Q\ q (required field) State License #: MQ jL\—+ Master License #: LCM I b\ A Y(n Qpy?n Printed Name of Authorized Agent Nu-A,r,n r,n n1% Signature ofAuthoriz'ed Agent Date 12/3/2020 �0, Gmail (no subject) 1 message Thomas Burney <bluedevilbuilders@gmail.com> To: bluedevilbuilders@gmail.com Gmail - (no subject) City Of Wye,, COMMUNITY atR ITY DR ELop, c] ;. Thomas Burney <bluedevilbuilders@gmail.com> Thu, Dec 3, 2020 at 5:28 PM SUBCONTRACTOR AUTHORIZATION FORM This form must be completed & signed by the PLUMBING SUBCONTRACTOR performing plumbing work on site. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: General Contractor: EXU£ , uN RUjl)f✓((S FORM WILL NST BE AQC PTED WITH MISSING INFORMATION Company Name:'/ ` ' /I Contact Phone #:I cxJ'�%� Wheat Ridge Contractor License #: (required field) State License #: ��0,. 000 S Q 1 I Master License #: 1\0, O St) ©� `,� (-i Printed Name of An orized Agent ignatu e o zed Agent 1�1 S5 S�3 Date https://mail.google.com/mail/u/0?ik=1 aef1 ff826&view=pt&search=all&permthid=thread-f%3Al685105396884794344&simpl=msg-f%3Al68510539688... 1/1 Analytical V Z 51 Analytical 5177 South V evNra. Way R Centennial, CO 80015 303-210-1349 Fax 303-632-8226 �an2(d,comcastnet CONSTRUCTION SPECIFIC ASBESTOS INSPECTION REPORT RESIDENCE 12490 West 35th Avenue Wheat Ridge, Colorado R' Analytical Project Number R220-93 October 27 & November 3, 2020 Abatement Contratcor needed. RS 11/24/20 City of Wheat Ridge Building Division TABLE OF CONTENTS SECTION 1 SITE SUMMARY/ SCOPE OF WORK SECTION 2 INSPECTION METHODOLOGY SECTION 3 RESULTS /CONCLUSIONS SECTION 4 DATE OF INSPECTION SECTION 5 LOCATION OF INSPECTION SECTION 6 R ANALYTICAL REPRESENTATIVE SECTION 7 CLIENT REPRESENTATIVE CONTACTED SECTION 8 EXCLUSION STATEMENTS SECTION 9 SAMPLING RATIONAL/INVESTIGATION METHODOLOGY SECTION 10 INACCESSIBLE AREAS ATTACHMENTS ATTACHMENT #1 BULK SAMPLE ANALYSIS TABLE & SAMPLE LOCATION DRAWINGS ATTACHMENT #2 LABORATORY ANALYSIS REPORT ATTACHMENT #3 STATE OF COLORADO INSPECTOR ACCREDITATION City of Wheat Ridge Building Division Construction Specific Asbestos Inspection Report 12490 West 35th Avenue, Wheat Ridge, CO R2 Analytical Project Number R220-93 SECTION 1 SITE SUMMARY: R2 Analytical performed a construction specific asbestos survey in the basement at 12490 West 35th Avenue, Wheat Ridge, CO, in conjunction with the planned remodel of this Residence. The house was constructed approximately in the 1960's -70's. The dividing walls and ceilings are textured drywall. Floors are wood and ceramic tile with sheet vinyl. SCOPE FOE WORK • Perform visual, tactile inspection of suspect ACM. • Identify, locate and areas to be sampled or presumed ACM • Collect samples of friable and non -friable ACM and presumed ACM • Provide sample analysis by polarized light microscopy • Provide project report with laboratory results and conclusions SECTION 2 INSPECTION METHODOLOGY: The asbestos inspection was conducted in general accordance with the guidelines of the National Emissions Standards Hazardous Air Pollutants (NESHAPS) 40 CFR Part 61 and the Colorado Department of Public Health and Environment (CDPHE) Regulation 8. The construction specific asbestos survey was performed by collecting samples from suspect asbestos containing material (ACM) in areas designated by the client that will be impacted by this project. This survey was conducted in general accordance with EPA National Emissions Standards for Hazardous Air Pollutants (NESHAPS) and the Occupational Safety and Health Administration's (OSHA) regulation 29 CFR 1926.1101. The inspection included a physical assessment of suspect ACM materials. Identification of homogeneous areas; assessment of the condition of the areas sampled; and collection of samples for laboratory analysis. The ACM sampling was performed by collecting random samples from each type of suspect ACM. 1 City of Wheat Ridge Building Division Homogeneous Area divisions Suspect ACM are grouped into homogeneous areas based on physical characteristics and functional application. Homogeneous areas were divided into one of three categories as designated by Colorado Department of Public Health & Environment (CDPHE) Regulation 8 and the EPA. 1. Thermal systems insulation — (TSI) Insulations to control thermal conductivity pipe/ duct wrap, boiler & chiller insulations and tanks etc. 2. Surfacing material — (SM) Sprayed —on or troweled onto structural members or walls (i.e. fire -proofing on structural steel or drywall finishes) 3. Miscellaneous — (MM) remaining suspect materials (i.e. flooring, gaskets, shingles, ceiling tiles fixtures etc.) Sampling was conducted per Colorado Regulation 8 protocol, specifying the minimum collection of: • 3 samples of surfacing materials less than 1,000 square feet in size. • 5 samples of surfacing materials between 1,000 and 3,000 square feet in size; and • 7 samples of surfacing materials greater than 3,000 square feet in size. • 2 samples were collected from miscellaneous materials Colorado Regulation 8 and the EPA define asbestos containing material (ACM) as material that contains greater than one -percent asbestos. Building materials that contain trace (less than 1%) asbestos are not regulated by the State of Colorado or the US EPA. OSHA regulations for worker protection do apply to trace asbestos containing materials and appropriate measures should be used during demolition activities. All samples were submitted to Reservoirs Environmental, Inc., 5801 Logan Street, Denver CO under proper chain -of -custody procedures. Laboratory analysis of the suspect asbestos Bulk sample building materials was performed by polarized light microscopy (PLM) according to EPA 600/R/116, July 1993 methodology. Reservoirs Environmental, Inc. participates in the National Voluntary Laboratory Accreditation Program (NVLAP) for asbestos SECTION 3 SAMPLE RESULTS /CONCLUSIONS Inspection determined the following building materials were identified as suspect ACM; • Homogeneous area A — Smooth/slick ripple textured drywall • Homogeneous area B — Wall paper • Homogeneous area C — Popcorn Ceiling Texture • Homogeneous area D — smooth orange peel textured drywall Kitchen ceiling City of Wheat Ridge 2 Building Division • Homogeneous area E — Mud joint & tape (drywall finishing components) • Homogeneous area F - Slick orange peel textured drywall • Homogeneous area G — Cross pattern texture on drywall basement Ceiling • Homogeneous area H — Rough Ceiling texture on basement dividing walls drywall • Homogeneous area I — Ceramic the grout Shower Basement • Homogeneous area J — Ceramic the adhesive Shower basement • Homogeneous area K — Ceramic the grout Bathroom floor basement • Homogeneous area L — Ceramic the adhesive Bathroom floor basement • Homogeneous area M — Ceiling the 12"x 12" white • Homogeneous area N - Smooth textured drywall • Homogeneous area O — Ceramic the grout Bathroom floor ground level • Homogeneous area P — Ceramic the adhesive Shower ground level • Homogeneous area R — Master Bathroom Shower shower -board ground level • Homogeneous area S — Master Bathroom Shower shower -board ground level • Homogeneous area T — Master Bathroom Shower shower -board 2nd level • Homogeneous area U — Master Bathroom Shower shower -board 2nd level • Homogeneous area V — Kitchen Floor Sheet vinyl Ground level • Homogeneous area W — Northeast bedroom 2nd level Texture on window frames • Homogeneous area X — smooth textured drywall Dining room ceiling Ground level • Homogeneous area Z — Rough texture drywall basement Storage room laundry & Closet Laboratory analysis detected ACM in the following Homogeneous areas; • Homogeneous area A — Smooth/slick ripple textured drywall observed on the 1 St level wall between the front door and living room. The textured drywall contains 3% chrysotile asbestos and covers 144 square feet. If remodel plans require alteration or removal of the ceiling material in excess of 3 8 square feet a state permitted abatement will be require by a Colorado licensed General asbestos contractor (GAC) using all engineering controls for a friable asbestos abatement Photo #I ACM Texture on the dividing wall City of Wheat Ridge 3 Building Division • Homogeneous area D —smooth orange peel textured drywall Kitchen ceiling • Homogeneous area X (not pictured) smooth textured drywall Dining room ceiling the areas contain 3% to 1.25% chrysotile asbestos. The combined areas cover approximately 200 square feet. If remodel plans require alteration or removal of the ceiling material in excess of 38 square feet a state permitted abatement will be require by a Colorado licensed General asbestos contractor (GAC) using all engineering controls for a friable asbestos abatement pwi Homogeneous area G —Cross pattern texture on drywall basement Ceiling The cross pattern textured drywall contains 3% chrysotile asbestos and covers 630 square feet. If remodel plans require alteration or removal of the ceiling material in excess of 38 square feet a state permitted abatement will be require by a Colorado licensed General asbestos contractor (GAC) using all engineering controls for a friable asbestos abatement n City of Wheat Ridge Building Division • Homogeneous area N -Smooth textured drywall the smooth textured drywall contains 3% chrysotile asbestos and covers 142 square feet. in the basement Rec-room wall by the entrance If remodel plans require alteration or removal of the ceiling material in excess of 38 square feet a state permitted abatement will be require by a Colorado licensed General asbestos contractor (GAC) using all engineering controls for a friable asbestos abatement Results and Conclusion Homogeneous areas A, D and X on the 1St level of the Residence must be considered ACM and abated as friable asbestos prior to any demolition activity. Homogeneous areas G and N on the Basement level must be considered ACM and abated as friable asbestos prior to any demolition activity. The quantities of drywall to be abated will be determined by the extent of remodel requirements. Removal of the Drywall must be performed by a Colorado State Certified General Asbestos Contractor (GAC) using all appropriate engineering controls for a friable asbestos abatement per Colorado Regulation 8 prior to remodel activity Reference Attachment #1 for The Bulk Sample Table and Sample locations. Reference Attachment #2 for supporting REI Laboratory Analysis data. RES #476809 & 477522 City of Wheat Ridge 5 Building Division SECTION 4 DATE OF INSPECTION: October 27 & November 3, 2020 SECTION 5 LOCATION OF INSPECTION: 12490 West 35u` Avenue, Wheat Ridge, CO SECTION 6 Rz ANALYTICAL REPRESENTATIVES: U.S. Environmental Protection Agency (EPA) and State of Colorado accredited inspector Mr. Robert L Ragan # 3143: Signature Reference Attachment #3 for EPA and Sate Inspector Accreditation. SECTION 7 CLIENT REPRESENTATIVES CONTACTED: Thomas Burney Blue Devil Builders, Inc. 317.260.0735 bluedevilbuilders@gmail. com SECTION 8 EXCLUSION STATEMENTS: R2 Analytical warrants that the findings contained herein have been with the level of care and skill exercised by experienced and knowledgeable environmental consultant who is licensed or otherwise trained to perform asbestos inspections pursuant to the scope of work required on this project. The asbestos inspection included inspection of accessible materials such as above or behind suspended ceilings or other non -permanent structures. RZ Analytical made reasonable effort to access behind walls and within ductwork to survey otherwise City of 6 Wheat Ridge Building Division inaccessible areas. For the purpose of this warrant, inaccessible is defined as areas of the building that could not be tested (sampled) without unauthorized destruction of the structure or a portion of the structure. In the event that access to a portion of the building was not obtained (which otherwise would have been tested). . The quantities of materials identified in this study as ACM are approximate. Contractor providing asbestos remediation services must verify all field conditions and estimated quantities. SECTION 9 SAMPLING RATIONAL/INVESTIGATION METHODOLOGY: Sample locations were selected in a random manner. The number of samples were collected of each homogeneous material identified as suspect ACM in accordance with the referenced Colorado Regulation 8 protocol. SECTION 10 INACCESSIBLE AREAS: Reasonable efforts were made to locate and inspect concealed areas in accordance with 40 CFR 763. Only the areas and the materials listed were surveyed as part of this inspection. 7 City of Wheat Ridge Building Division ATTACHMENT #1 BULK SAMPLE ANALYSIS TABLE SAMPLE LOCATIONS & DESCRIPTIONS City of Wheat Ridge Building Division Resid5th ence, 12490 West 3Avenue, Wheat Ridge, CO ASBESTOS INSPECTION SUMMARY DATE SAMPLED: 10/27/2020 AHERA CODE: Material Damaged/Significantly Damaged Thermal (6) PSD ACM = Potential for Significant damage Asbestos Containing Material System Insulation Condition ACM (2) D FSM = Damaged Friable Surfacing Material Type &Description Quantity of AHERA Greater Sample Number Sample Location of Sampled Material Material Code 1-8 Than 1% Al Wall between front door & living Smooth ripple textured drywall Approx. 7 Yes AA As Above NR Not Required TBD To Be Determined room S 144 sq It City of 3.0% chrys A2 AA AA AA 7 Yes 3% chrys A3 AA AA AA 7 Yes resumed Bl Wall Between Kitchen & Dining Wall paper (Iv1Iv1) Approx. NR No Room 128 sq ft B2 AA AA AA NR No B3 AA AA AA NR No Cl Ground level stairwell Ceiling Popcorn ceiling texture (Slvl) < 650 sq ft NR No C2 Ground level Ceiling AA AA NR No C3 2° level by bathroom Ceiling AA AA NR No Dl Kitchen ceiling ground level Smooth orange peel texture on 65 sq IT 7 Yes drywall 3% chrys D2 AA AA AA 7 Yes 3% chrys D3 AA AA AA 7 Yes 3% chrys AHERA CODE: (1) D/SD TSI = Damaged/Significantly Damaged Thermal (6) PSD ACM = Potential for Significant damage Asbestos Containing Material System Insulation (7) F ACM G = Friable Asbestos Containing Material in Good Condition (2) D FSM = Damaged Friable Surfacing Material (8) NF ACM G = Non -Friable Asbestos Containing Material in Good Condition (3) SD FSM = Significantly Damaged Friable Surface Material (4) D/SD FMM = Damaged/Significantly Damaged Friable Miscellaneous Material MATERIAL TYPE: MM = Miscellaneous Materials TSI = Thermal System Insulation SM = Surfacing Material (5) PD ACM = Potential for Damage Asbestos NA Not Available AA As Above NR Not Required TBD To Be Determined City of Wheat Ridge Building Division Residence, 12490 West 35a' Avenue, Wheat Ridge, CO ASBESTOS INSPECTION SUMMARY DATE SAMPLED: 10/27/2020 AHERA CODE: (1) D/SD TSI = Damaged/Significanfiy Damaged Thermal (6) PSD ACM = Potential for Significant damage Asbestos Containing Material System Insulation (7) F ACM G = Friable Asbestos Containing Material in Good Condition (2) D FSM = Damaged Friable Surfacing Material (8) NF ACM G = Non -Friable Asbestos Containing Material in Good Condition (3) SD FSM = Significantly Damaged Friable Surface Material (4) D/SD FMM = Damaged/Significantly Damaged Friable Miscellaneous Material MATERIAL TYPE: MM=Miscellaneous Materials TSI =Thermal System Insulation SM = Surfacing Material (5) PD ACMPotential for Damage Asbestos NA Not Available AA As Above NRNot Required TBD To Be Determined City of Wheat Ridge Building Division Material Condition ACM Type &Description Quantity of AHERA Greater Sample Number Sample Location of Sampled Material Material Code 1-8 Than 1% El Garage wall west Mud -joint compound & tape (IMM) < 100 sq ft NR No E2 Garage ceiling East AA AA NR No Fl Northeast Bedroom Window side Orange peel slick texture on drywall Approx NR No (SM) 120 sq ft F2 AA AA) AA NR No F3 AA AA AA NR No G1 Basement Rec-room ceiling 10" cross pattern texture on Approx 7 Yes d all SM 1 630 sq ft presumed G2 Basement ceiling of room with AA AA 7 Yes raised floor 3% chrys G3 Basement ceiling over cabinets AA AA 7 Yes 3% chrys Hl Utility room & Laundry ceilings Rough texture on drywall dividing < 500 sq ft NR No walls H2 Piano Room Ceiling AA AA NR No H3 Bathroom ceiling & walls AA AA NR No Il Bathroom shower wall Ceramic tile grout Approx NR No 65 sq ft AHERA CODE: (1) D/SD TSI = Damaged/Significanfiy Damaged Thermal (6) PSD ACM = Potential for Significant damage Asbestos Containing Material System Insulation (7) F ACM G = Friable Asbestos Containing Material in Good Condition (2) D FSM = Damaged Friable Surfacing Material (8) NF ACM G = Non -Friable Asbestos Containing Material in Good Condition (3) SD FSM = Significantly Damaged Friable Surface Material (4) D/SD FMM = Damaged/Significantly Damaged Friable Miscellaneous Material MATERIAL TYPE: MM=Miscellaneous Materials TSI =Thermal System Insulation SM = Surfacing Material (5) PD ACMPotential for Damage Asbestos NA Not Available AA As Above NRNot Required TBD To Be Determined City of Wheat Ridge Building Division Residence, 12490 West 35a' Avenue, Wheat Ridge, CO ASBESTOS INSPECTION SUMMARY DATE SAMPLED: 10/27/2020 AHERA CODE: (1) D/SD TSI = Damaged/Significanfiy Damaged Thermal (6) PSD ACM = Potential for Significant damage Asbestos Containing Material System Insulation (7) F ACM G = Friable Asbestos Containing Material in Good Condition (2) D FSM = Damaged Friable Surfacing Material (8) NF ACM G = Non -Friable Asbestos Containing Material in Good Condition (3) SD FSM = Significantly Damaged Friable Surface Material (4) D/SD FMM = Damaged/Significantly Damaged Friable Miscellaneous Material MATERIAL TYPE: MM = Miscellaneous Materials TSI =Thermal System Insulation SM = Surfacing Material (5) PD ACMPotential for Damage Asbestos NA Not Available AA As Above NRNot Required TBD To Be Determine City of Wheat Ridge Building Division Material Condition ACM Type &Description Quantity of AHERA Greater Sample Number Sample Location of Sampled Material Material Code 1-8 Than 1% Jl Bathroom shower wall Ceramic tile adhesive (MM)e Approx NR No 65 sq ft KI Bathroom Floor Ceramic tile grout (v1Iv1) Approx NR No 40 sq ft L1 AA Ceramic tile adhesive (MM) AA NR No Ml Basement Bedroom ceiling 12"x12" ceiling tile white (Iv1Iv1) Approx. NR No 88 sq ft M2 AA AA AA NR No N1 Rec-Room wall by entrance Smooth textured drywall (SM) Approx 7 Yes 140 sq ft 3% chrys N2 AA AA AA 7 Yes 3% chrys N3 Stub -wall in stairwell AA AA 7 Yes 3% chrys Ol Ground level common Bathroom Ceramic tile grout (v1Iv1) Approx NR No shower wall 50 sq ft Pi AA Ceramic tile adhesive (MM) AA NR No RI Ground level Master Bathroom Ceramic tile grout (v1Iv1) Approx NR No shower wall 50 sq ft Sl AA Ceramic tile adhesive (MM) AA NR No AHERA CODE: (1) D/SD TSI = Damaged/Significanfiy Damaged Thermal (6) PSD ACM = Potential for Significant damage Asbestos Containing Material System Insulation (7) F ACM G = Friable Asbestos Containing Material in Good Condition (2) D FSM = Damaged Friable Surfacing Material (8) NF ACM G = Non -Friable Asbestos Containing Material in Good Condition (3) SD FSM = Significantly Damaged Friable Surface Material (4) D/SD FMM = Damaged/Significantly Damaged Friable Miscellaneous Material MATERIAL TYPE: MM = Miscellaneous Materials TSI =Thermal System Insulation SM = Surfacing Material (5) PD ACMPotential for Damage Asbestos NA Not Available AA As Above NRNot Required TBD To Be Determine City of Wheat Ridge Building Division Residence, 12490 West 35a' Avenue, Wheat Ridge, CO ASBESTOS INSPECTION SUMMARY DATE SAMPLED: 10/27/2020 Sample Number Sample Location Type &Description of Sampled Material Quantity of Material Material Condition AHERA Code 1-8 ACM Greater Than 1% T1 2"d level Master bathroom Shower Wall (Iv1Iv1)) Approx. 60sgft NR No Ul AA AA AA NR No vi Ground level Kitchen Floor Sheet vinyl flooring multi colored Q," 100 Sq ft NR No V2 AA AA AA NR No W1 2° level bedroom Northeast Window frame Texture on frame (SM) Approx 20 Sq ft NR No W2 AA AA AA NR No W3 AA AA) AA NR No X1 Ground level Dining room ceiling Ad'acent to kitchen ceiling Smooth textured drywall (SM) 144 sq ft 7 Yes 1.25% chrys X2 AA AA AA 7 Yes 1.25% chrys Zl Basement storage East wall rough textured drywall (SM) Approx 98 Sq ft NR No Z2 Basement laundry room west wall AA AA NR No Z3 Basement storage room closet AA AA NR No AHERA CODE: (1) D/SD TSI = Damaged/Significanfiy Damaged Thermal (6) PSD ACM = Potential for Significant damage Asbestos Containing Material System Insulation (7) F ACM G = Friable Asbestos Containing Material in Good Condition (2) D FSM = Damaged Friable Surfacing Material (8) NF ACM G = Non -Friable Asbestos Containing Material in Good Condition (3) SD FSM = Significamly Damaged Friable Surface Material (4) D/SD FMM = Damaged/Significantly Damaged Friable Miscellaneous Material MATERIAL TYPE: MM = Miscellaneous Materials TSI =Thermal System Insulation SM = Surfacing Material (5) PD ACMPotential for Damage Asbestos NA Not Available AA As Above NRNot Required TBD To Be Determined City of Wheat Ridge Building Division ATTACHMENT #2 LABORATORY ANALYSIS REPORT City of Wheat Ridge Building Division Reservoirs Environmental, Inc Effective October 09, 2020 Reservoirs Environmental QA Manual Q:\QAQC\Lab\Reservoirs Environmental QA Manual.pdf REI LAB Reservoirs Environmental, lnc_ October 28, 2020 Bob Ragan R2 Analytical 5177 S. Ventura Way Centennial CO 80015 Dear Bob, Subcontractor Number: Laboratory Report: Project #/P.O. #: Project Description RES 476809-1 R220-93 12490 West 35th Ave Wheat Ridge 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 Electron 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, Inc. 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 submitted to your office. RES 476809-1 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, by William Spells Jeanne Spencer President (303) 9641986 5801 Logan St, Suite 100, Denver, CO 80216 (866) RESI-ENV City of Wheat Ridge Building Division -.reilab.com http s://clients.reilab.com Reservoirs Environmental, Inc. Reservoirs Environmental GAManual iso: N!ZAT1•1i:ilanWi :IQ 011LVA ia0111Mai01Lei NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 476809-1 Client: R2 Analytical Client Project Number/ P.O.: R220-93 Client Project Description: 12490 West 35th Ave Wheat Ridge Date Samples Received: October 27, 2020 Effective October9, 2020 Q AGAGCALabAReservoirs Environmental GA Manual.. eat Method: EPA 6001R-931116 - Short Report, Bulk ND=None Detected Turnaround: Priority TR=Trace, <1% Visual Estimate Trem/Act=Tremolite/Actinolite Date Samples Analyzed: October 28, 2020 Client L Asbestos Conteril Non Non - Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R (%) M (%) (%) Al A Yellow paint 2 NO 0 100 B White compound 25 Chrysotile 3 0 97 C White compound w/ white paint 30 NO 0 100 D White/tan drywall 43 NO 25 75 A2 A Gray/white paint 6 NO 0 100 B White compound 15 Chrysotile 3 0 97 C White/tan drywall 79 NO 10 90 A3 A White tape 3 NO 90 10 B White compound w/ gray/white paint 15 NO 0 100 C White joint compound 15 NO 0 100 D Off white/tan drywall 67 NO 10 90 31 A Tan/green/white wall paper 6 NO 35 65 B White compound w/ white paint 15 NO 0 100 C Pink/tan drywall 79 NO 15 85 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1 %. City of Wheat Ridge Building Division P'. 303-964-1986 5801 Logan Street, Suite 100, Denver, CO 80216 1-866-RESI{NV F. 303-477-4275 wwwreilab. com Page 1 of 8 Reservoirs Environmental, Inc. Reservoirs Environmental GAManual iso: N!ZAT1•1i:ilanWi :IQ 011LVA ia0111Mai01Lei NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 476809-1 Client: R2 Analytical Client Project Number/ P.O.: R220-93 Client Project Description: 12490 West 35th Ave Wheat Ridge Date Samples Received: October 27, 2020 Effective October9, 2020 Q AGAGCALabAReservoirs Environmental GA Manual.. eat Method: EPA 6001R-931116 - Short Report, Bulk ND=None Detected Turnaround: Priority TR=Trace, <1% Visual Estimate Trem/Act=Tremolite/Actinolite Date Samples Analyzed: October 28, 2020 Client L Asbestos Conteril Non Non - Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R (%) M (%) (%) 32 A White tape 4 NO 90 10 B Tan/multi-colored wall paper 15 NO 35 65 C White joint compound 26 NO 0 100 D White compound w/ white paint 55 NO 0 100 33 A White compound w/ off white paint 15 NO 0 100 B Off white/tan drywall 85 NO 10 90 C1 A White foamy texture w/ white paint 100 NO 4 96 C2 A White foamy texture w/ white paint 100 NO 4 96 C3 A White foamy texture w/ white paint 100 NO 4 96 D1 A White compound 5 Chrysotile 3 0 97 B Gray/white paint 8 NO 0 100 C White/tan drywall 87 NO 10 90 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1 %. City of Wheat Ridge Building Division P'. 303-964-1986 5801 Logan Street, Suite 100, Denver, CO 80216 1-866-RESI{NV F. 303-477-4275 wwwreilab. com Page 2 of 8 Reservoirs Environmental, Inc. Reservoirs Environmental GAManual iso: N!ZAT1•1i:ilanWi :IQ 011LVA ia0111Mai01Lei NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 476809-1 Client: R2 Analytical Client Project Number/ P.O.: R220-93 Client Project Description: 12490 West 35th Ave Wheat Ridge Date Samples Received: October 27, 2020 Effective October9, 2020 Q AGAGCALabAReservoirs Environmental GA Manual.. eat Method: EPA 6001R-931116 - Short Report, Bulk ND=None Detected Turnaround: Priority TR=Trace, <1% Visual Estimate Trem/Act=Tremolite/Actinolite Date Samples Analyzed: October 28, 2020 Client L Asbestos Conteril Non Non - Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R (%) M (%) (%) D2 A White compound 5 Chrysotile 3 0 97 B Gray/white paint 8 NO 0 100 C White/tan drywall 87 NO 10 90 D3 A White compound 5 Chrysotile 3 0 97 B Gray/multi-colored paint 8 NO 0 100 C White/tan drywall 87 NO 10 90 E1 A White compound 5 NO 0 100 B Gray/tan drywall 95 NO 10 90 E2 A White tape 3 NO 90 10 B White compound 8 NO 0 100 C White joint compound 8 NO 0 100 D Gray/tan drywall 81 NO 15 85 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1 %. P'. 303-964-1986 5801 Logan Street, Suite 100, Denver, CO 80216 F. 303-477-4275 Page 3 of 8 City of Wheat Ridge Building Division 1-866-RESI{NV wwwreilab. com Reservoirs Environmental, Inc. Reservoirs Environmental GAManual iso: N!ZAT1•1i:ilanWi :IQ 011LVA ia0111Mai01Lei NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 476809-1 Client: R2 Analytical Client Project Number/ P.O.: R220-93 Client Project Description: 12490 West 35th Ave Wheat Ridge Date Samples Received: October 27, 2020 Effective October9, 2020 Q AGAGCALabAReservoirs Environmental GA Manual.. act Method: EPA 6001R-931116 - Short Report, Bulk ND=None Detected Turnaround: Priority TR=Trace, <1% Visual Estimate Trem/Act=Tremolite/Actinolite Date Samples Analyzed: October 28, 2020 Client L Asbestos Conteril Non Non - Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R (%) M (%) (%) F1 A White compound w/ off white paint 10 NO 0 100 B Gray/tan drywall 90 NO 10 90 F2 A White compound w/ off white paint 10 NO 0 100 B Gray/tan drywall 90 NO 15 85 F3 A White tape 3 NO 90 10 B White compound w/ off white paint 15 NO 0 100 C White joint compound 15 NO 0 100 D Gray/tan drywall 67 NO 10 90 G1 A White compound w/ white paint 25 NO 0 100 B Pink/tan drywall 75 NO 15 85 G2 A Gray/white paint 3 NO 0 100 B White compound 45 Chrysotile 3 0 97 C White/tan drywall 52 NO 20 80 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1 %. P'. 303-964-1986 5801 Logan Street, Suite 100, Denver, CO 80216 F. 303-477-4275 Page 4 of 8 City of Wheat Ridge Building Division 1-866-RESI{NV wwwreilab. com Reservoirs Environmental, Inc. Reservoirs Environmental GAManual iso: N!ZAT1•1i:ilanWi :IQ 011LVA ia0111Mai01Lei NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 476809-1 Client: R2 Analytical Client Project Number/ P.O.: R220-93 Client Project Description: 12490 West 35th Ave Wheat Ridge Date Samples Received: October 27, 2020 Effective October9, 2020 Q AGAGCALabAReservoirs Environmental GA Manual.. eat Method: EPA 6001R-931116 - Short Report, Bulk ND=None Detected Turnaround: Priority TR=Trace, <1% Visual Estimate Trem/Act=Tremolite/Actinolite Date Samples Analyzed: October 28, 2020 Client L Asbestos Conteril Non Non - Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R (%) M (%) (%) G3 A Off white compound 25 Chrysotile 3 0 97 B Off white/tan drywall 75 NO 15 85 H1 A White texture w/ off white paint 15 NO 0 100 B Gray/tan drywall 85 NO 10 90 H2 A White compound w/ white paint 20 NO 0 100 B Pink/tan drywall 80 NO 10 90 H3 A White compound w/ off white paint 30 NO 0 100 B Pink/tan drywall 70 NO 15 85 11 A White ceramic tile 20 NO 0 100 B White granular material 80 NO 0 100 J1 A White fibrous woven material 3 NO 95 5 B White granular material 6 NO 0 100 C Gray granular material 91 NO 0 100 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1 %. P'. 303-964-1986 5801 Logan Street, Suite 100, Denver, CO 80216 F. 303-477-4275 Page 5 of 8 City of Wheat Ridge Building Division 1-866-RESI{NV wwwreilab. com Reservoirs Environmental, Inc. Reservoirs Environmental GAManual iso: N!ZAT1•1i:ilanWi :IQ 011LVA ia0111Mai01Lei NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 476809-1 Client: R2 Analytical Client Project Number/ P.O.: R220-93 Client Project Description: 12490 West 35th Ave Wheat Ridge Date Samples Received: October 27, 2020 Effective October9, 2020 Q AGAGCALabAReservoirs Environmental GA Manual.. eat Method: EPA 6001R-931116 - Short Report, Bulk ND=None Detected Turnaround: Priority TR=Trace, <1% Visual Estimate Trem/Act=Tremolite/Actinolite Date Samples Analyzed: October 28, 2020 Client L Asbestos Conteril Non Non - Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R (%) M (%) (%) K1 A Gray granular material 8 NO 0 100 B Off white granular material 15 NO 0 100 C White ceramic tile 77 NO 0 100 L1 A Gray granular material 100 NO 0 100 M1 A Brown/white fiberboard 100 NO 80 20 M2 A Brown/white fiberboard 100 NO 75 25 N1 A Tan fibrous material w/ white/multi-colored paint 10 NO 40 60 B White compound 25 Chrysotile 3 0 97 C Off white/tan drywall 65 NO 15 85 N2 A Tan fibrous material w/ white/green paint 6 NO 40 60 B White compound 30 Chrysotile 3 0 97 C White/tan drywall 64 NO 10 90 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1 %. P'. 303-964-1986 5801 Logan Street, Suite 100, Denver, CO 80216 F. 303-477-4275 Page 6 of 8 City of Wheat Ridge Building Division 1-866-RESI{NV wwwreilab. com Reservoirs Environmental, Inc. Reservoirs Environmental GAManual iso: N!ZAT1•1i:ilanWi :IQ 011LVA ia0111Mai01Lei NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 476809-1 Client: R2 Analytical Client Project Number/ P.O.: R220-93 Client Project Description: 12490 West 35th Ave Wheat Ridge Date Samples Received: October 27, 2020 Effective October9, 2020 Q AGAGCALabAReservoirs Environmental GA Manual.. eat Method: EPA 6001R-931116 - Short Report, Bulk ND=None Detected Turnaround: Priority TR=Trace, <1% Visual Estimate Trem/Act=Tremolite/Actinolite Date Samples Analyzed: October 28, 2020 Client L Asbestos Conteril Non Non - Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R (%) M (%) (%) N3 A White paint 3 NO 0 100 B White compound 8 Chrysotile 3 0 97 C Off white/tan drywall 89 NO 10 90 01 A White resinous material 4 NO 0 100 B White/pink ceramic tile 21 NO 0 100 C White plaster 75 NO 0 100 P1 A Tan adhesive 4 NO 0 100 B White resinous material 6 NO 0 100 C Pink/white ceramic tile 90 NO 0 100 R1 A White caulkw/ tan paint 35 NO 0 100 B Tan/white fiberboard 65 NO 80 20 S1 A White caulk w/ tan paint 4 NO 0 100 B Tan/white fiberboard 96 NO 80 20 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1 %. City of Wheat Ridge Building Division P'. 303-964-1986 5801 Logan Street, Suite 100, Denver, CO 80216 1-866-RESI{NV F. 303-477-4275 wwwreilab. com Page 7 of 8 Reservoirs Environmental, Inc. Reservoirs Environmental GAManual iso: N!ZAT1•1i:ilanWi :IQ 011LVA ia0111Mai01Lei NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 476809-1 Client: R2 Analytical Client Project Number/ P.O.: R220-93 Client Project Description: 12490 West 35th Ave Wheat Ridge Date Samples Received: October 27. 2020 Effective October9, 2020 Q AGAGCALabAReservoirs Environmental GA Manual.. eat Method: EPA 6001R-931116 - Short Report, Bulk ND=None Detected Turnaround: Priority TR=Trace, <1% Visual Estimate Trem/Act=Tremolite/Actinolite Date Samples Analyzed: October 28, 2020 Client L Asbestos Contenl Non Non - Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R (%) M (%) (%) T1 A White caulk 6 NO 0 100 B Red grout 20 NO 0 100 C White ceramic tile w/ yellowadhesive 74 NO 0 100 U1 A Red grout 8 NO 0 100 B White ceramic tile w/ yellowadhesive 92 NO 0 100 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1 %. 5` Landon Spells Analyst / Data QA City of Wheat Ridge Building Division P'. 303-964-1986 5801 Logan Street, Suite 100, Denver, CO 80216 1-866-RESI{NV F. 303-477-4275 wwwreilab. com Page 8 of 8 Reservoirs Environmental, Inc Reservoirs Environmental QAManual REI LAB Reservoirs En vironmen to/, /nc. Effective October 09, 2020 Q:\QAQC\Lab\Reservoirs Environmental QA Manual.pdf RES Job #: 476809 SUBMITTED BY INVOICE TO CONTACT INFORMATION SERIES Company: R2 Analytical .................................................................................................................................................................................................................................................. Company: R2 Analytical Contact: Bob Ragan ......................................................................................................................... -1 PLM Priority Address: 5177 S. Ventura Way .................................................................................................................................................................................................................................................. Address: 5177 S. Ventura Way Phone: (303) 210-1349 ......................................................................................................................... .................................................................................................................................................................................................................................................. Fax: ......................................................................................................................... A Centennial, CO 80015 Centennial, CO 80015 Cell: Project Number and/or P.O. #: R220-93 Final Data Deliverable Email Address: .................................................................................................................................................................................................................................................... Project Description/Location: 12490 West 35th Ave Wheat Ridge rragan2@comcast.net a o z °N ASBESTOS LABORATORY HOURS: Weekdays: 7am - 7pm & Sat. 8am - 5pm REQUESTED ANALYSIS VALID MATRIX CODES LAB NOTES PLM / PCM / TEM DTL RUSH 1PRIORITY STANDARD a Air = A Bulk = B s............................................ 61 i e i C € O 2'• z° 1062, • a o z °N Dust Paint Surface_ = D = P SU ¢Swab Food = Soil = = F S SW CHEMISTRY LABORATORY HOURS: Weekdays: 8am - 5pm Dust RUSH PRIORITY STANDARD : r ._ J FZ _ � i N C . Y .� ........................................ Tape ............................... = T Wipe = ......MN: W *PRIOR NOTICE REQUIRED FOR SAME DAY TAT — e : ° w E .2 o 0 } ' a """""""""" Metals RUSH PRIORITY STANDARD m € € € _ € N J o Drinking Water = DW N N Q N Q E E E N N O Q 00 ... - `_ .s - ............................................................................... Waste Water = WW Organics" SAME DAY RUSH PRIORITY STANDARD M Q € 2 V_ > cu m o o cu � a) � - f = a a S O N � o ° o 0uj LS **ASTM E1792 o a approved wipe media only** MICROBIOLOGY LABORATORY HOURS: Weekdays: 8am - 5pm Viable Analysis"" PRIORITY STANDARD —TAT DEPENDENT ON SPEED OF MICROBIAL GROWTH ° E a ori ?? COLCO � _ � , 5 m E a ._ o � a °- Medical Device Analysis RUSH STANDARD 'CZ` Y ' a j° E 10 _ _° ° o ` 00 CL E p m N 2O m w 0° E m C N: r Mold Analysis RUSH PRIORITY STANDARD O N_ T N co o € Q o a o �, : O _ ocu M s o a a ""Turnaround times establish a laboratory priority, subject to laboratory volume and are not guaranteed. Additional fees apply for afterhours, weekends and holidays " a a € € �, �': z € Q ; M N a W L. c€, w .o o a `� u; a z° 3 W' o E a o o o o Laboratory Analysis Special Instructions: Only pt. count tr to 2% o a : i a '• O Viables Q L J o 0 o Instructions Client Sample ID Number (Sample ID's must be unique) ASBESTOS CHEMISTRY MICROBIOLOGY 1 Al . . . . . . X .............. ¢...... ¢...... ¢......................... ¢........................... . . . . . . X .............. ¢...... ¢...... ¢.................. ...... ¢........................... . . . . . . X .............. ¢...... ¢...... ¢......................... ¢........................... . . . . . . X .............. ¢...... ¢...... ¢........................................................... . . . . . . XB ..................... ¢......¢......¢........................¢...........................¢......¢...... . . . . . . X .............. ¢...... ¢...... ¢........................................................... . . . . . . X .............. ¢...... ¢...... ¢........................................................... . . . . . . X .............. ¢...... ¢...... ¢........................................................... . . . . . . X . . . . . . X .............. ¢...... ¢...... ¢.................. ...... ¢........................... . . . . . . X .............. ¢...... ¢......¢........................¢...........................¢......$...... X ¢...............................................¢................................................ X . . ¢............. . . ¢...... $ ...... . . ¢............. . . ¢ ...... . . . . ¢ ...... . . ¢ ...... . . ¢ ...... . . . . ¢...... $ ...... . . ........... ........................................ ........... ........... ...........¢...........¢.........................¢........... ........... ........... ........... ........... ...........¢...........¢.............. ........... . ¢........... . . ¢........... . ¢........... . . ¢........... . ¢........... . ¢........... . . ¢........... . ¢............ . . B ¢.............. ........... . . B . . .................................... B ¢.............. ........... . . B ¢.............. ........... . . . . B ¢.............. ........... . . B ¢.............. ........... . . B ¢.............. ........... . . B . . B ¢.............. ........... . . B ...........¢........... B ................ ............. B . ¢....................... . . ¢....................... . ¢........... . . ¢........... . ¢........... . ¢........... . . ¢........... . ............ . . ¢.................................................... . . .................................................... ¢ . . ¢.................................................... . . ¢ ........... ¢ .................................................... . . ........ ¢...¢.................................................... . . ¢ ........... ¢ .................................................... . . ¢ ........... ¢.................................................... . . ¢ ........... ¢ .................................................... . . . . ¢................................................................ . . ¢...........¢.................................................... ............ ¢.................................................... PC PC PC PC PC PC PC PC PC PC PC PC PC 2 A2 3 A3 4 B1 5 B2 6 B3 7 C1 8 C2 9 C3 10 D1 11 D2 12 D3 13 E1 REI will analyze incoming samples based on information received and will not be responsible for errors or omissions in calculations resulting from the inaccuracy of original data. By signing, client/company representative agrees that submission of the following samples for requested analysis as indicated on this Chain of Custody shall consitute analytical services agreement with payment terms of NET 30 days. Failure to comply with payment terms may result in a 1.5% monthly interest surcharge. relinquished By: ° �� Bob Ragan Date/Time: 10/27/2020 13:35:02 Sample Condition: Acceptable City of received By: Jesse Lewis Date/Time: 10/27/2020 13:35:02 Carrier: Hand Wheat Ri Ruilrling nk (303) 964-1986 5801 Logan St, Suite 100, Denver, CO 80216 vwvw.reilab.com (866) RESI-ENV Page 1 of 2 https:Hclients.reilab.com ge ;;ion Reservoirs Environmental, Inc Reservoirs Environmental QA Manual Effective October 09, 2020 Q:\QAQC\Lab\Reservoirs Environmental QA Manual.pdf (303) 964-1986 5801 Logan St, Suite 100, Denver, CO 80216 (866) RESI-ENV Page 2 of 2 City of vulluills U�. www.reilab.com https:Hclients. reilab. com REQUESTED ANALYSIS VALID MATRIX CODES LAB NOTES E I- E E E Air= A Bulk = B REI LAB Reservoirs Environmental, lnc. o ' ' i - J o ............................................. = D .......................................... Food F E —= : E E z �; o E E - o m m ..............Dust Paint = P .¢. Soil = S - N Q _ M C) C) Z) M0" — 06 0)N a O _o............................................................................................. .............................................. Surface=U ........................................... Swab= SW Oo • E Tape = T Wipe = W m � E '• jn (n N U) U) U Q o O � ..............................................h............................................. Drinking Water = DW EQ E E o a) U 0> �� �0 m m o : P ........................................................................................... _ `n' `nnn' Waste Water � J� : : : + N + m 0 M N— �Q 5 : � � _ 8 N (6 J C Z)� C w C N .....................................e. **ASTM E1792 approved V V............... V............................ wipe media only** Res Job#: 476809 (( - uJN '_�UO - > (6 3: E ~ E E _O U cr 0 Q LLU O = O\ J O (6 N Submitted By: R2 Analytical O j z 0 C/)N J ° o CO >� > o U� � m w 0� o -2 m Q+ o Q ��M0 �� �_a)�� Q Q Q C) o c o � -0 m o o o Q ,off >O a o wo� n =; �, ENS z E o 0 c� a _ E Q+ J O Q a W N U w Q z> W o o Q Laboratory Analysis a a o Viables E �, Cn J o o f Instructions Client Sample ID Number (Sample ID's must be unique) ASBESTOS CHEMISTRY MICROBIOLOGY 14 E2 . . . . X .........¢.................¢.......¢.......¢.......................................................................?....... . . . . X .........¢.................¢...............¢......................¢....................................................... . . . . X .........¢.................¢.......¢.......¢......................¢......................................¢.............. . . . . 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X .........¢.................¢.......¢.......¢......................¢......................................¢.............. . . . . X .........¢.................¢.......¢..............................¢....... . . . . X .........¢.................¢.......¢..............................¢....... . . . . X .........¢.................¢.......¢.......¢......................¢.......?...............................¢.......?....... . . . . X .........¢.................¢.......¢.......¢......................¢.......?...............................¢.......?....... . . . . X .........¢.................¢.......¢.......¢......................¢....... X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................................... . . ....................................... . . ....................................... . . ....................................... . . . . ...............................¢.......?....... . . ...............................¢.......?....... . . . . ............................................... . . . . . . . . . . ........0....... . . . . . . . . . . . . ....... . . . . . . . . . . ....... . . ....... . . ....... . . ....... . . . . . . . . . . . . .............¢.............¢................¢.............¢.............¢.............¢.............................................................. . . .............¢.............¢................¢.............¢.............¢............................................................................ . . .............¢.............¢................¢.............¢.............¢.............¢.............................................................. . . .............¢.............¢................¢.............¢.............¢.............¢.............................................................. . . .............¢.............¢................¢.............¢.............¢.............¢ . . .............¢.............¢................¢.............¢.............¢.............¢.............................................................. . . .............¢.............¢..............................¢.............¢.............¢............................................................... . . .............¢.............¢..............................¢.............¢.............¢............................................................... . . .............¢.............¢..............................¢.............¢.............¢............................................................... . . .............¢.............¢................¢.............¢.............¢.............¢.............................................................. . . .............¢.............¢................¢.............¢.............¢.............¢.............................................................. . . .............¢.............¢................¢.............¢.............¢.............¢............................................................... . . .............¢.............¢................¢.............¢.............¢.............¢............................................................... . . .............¢.............¢................¢.............¢.............¢.............¢............................................................... . . ...........................¢..............................¢.............¢.............¢.............................................................. . . ...........................¢..............................¢.............¢.............¢.............................................................. . . .............¢.............¢................¢.............¢.............¢.............¢.............................................................. . . .............¢.............¢................¢.............¢.............¢............................................................................ . . .............¢.............¢................¢.............¢.............¢.............¢.............................................................. . . .............¢.............¢..............................¢.............¢.............¢............................................................... . . .............¢.............¢..............................¢.............¢.............¢............................................................... . . .............¢.............¢................¢.............¢.............¢.............¢............................................................... . . .............¢.............¢................¢.............¢.............¢.............¢............................................................... . . .............. .............¢................¢.............¢.............¢.............¢.............................................................. . . . . B PC . . . . B PC . . . . B PC . . . . B PC . . . . B PC . . . . .............................................................. B PC . . . . B PC . . . . B PC . . . . B PC . . . . B PC . . . . B . . . . B . . . . B . . . . B . . . . B . . . . B . . . . B PC . . . . B PC . . . . B PC . . . . B . . . . B . . . . B . . . . B . . . . B B 15 F1 16 F2 17 F3 18 G1 19 G2 20 G3 21 H1 22 H2 23 H3 24 11 25 J1 26 K1 27 L1 28 M1 29 M2 30 N1 31 N2 32 N3 33 01 34 P1 35 R1 36 S1 37 T1 38 U1 (303) 964-1986 5801 Logan St, Suite 100, Denver, CO 80216 (866) RESI-ENV Page 2 of 2 City of vulluills U�. www.reilab.com https:Hclients. reilab. com ATTACHMENT #3 STATE OF COLORADO INSPECTOR ACCREDITATION City of Wheat Ridge Building Division i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Permit Number: ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co, uslinspection Date: Inspector: DO NOT REMOVE THIS NOTICE INSPECTION RECORD. Inspection online form: http://www.cl.wheatridge.co.us/inspection Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Inspections will not be performed unless this card is posted on the project site Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business day PERMIT: Z-01-1CA"t`'>k ADDRESS: � �'�f Cts (,v ��5�` ��JOB CODE: 9-�' Foundation Inspections Date Inspector CommentsInitials 102 Caissons / Piers 103 Footing / P.E. Letter l 104 Foundation Setback Cert. `- 105 Stem Walls 106 Foundation wall Insulation Do Not Pour Concrete Prior To Approval Of The Above inspeciions Underground / Slab Inspections 201 Electrical / Cable/ Conduit 202 Sewer Underground Int. 203 Sewer Underground Ext. 204 Plumbing Underground Int. Date I Inspector Initials Comments 205 Plumbing Underground Ext. 206 Water Underground Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections Rough Inspection Date Inspector Initials Comments 301 Rough Framing 302 Wall Sheathing l 303 Roof Sheathing `- 304 Sheer Inspection 305 Insulation 306 Mid -Roof%' - 307 Metal / Lath / Stucco 308 Rough Electrical Residential 309 Rough Electrical Commercial 310 Electrical Meter Residential 311 Electrical Meter Commercial 312 Temp. Const. Meter 313 Rough Plumbing Residential 314 Rough Plumbing Commercial 315 Shower Pan SEE OVER FOR ADDITIONAL INSPECTIONS PERMIT: Lf1� 1ADDRESS: 12+,,�[\,(, jou,,, JOB CODE:1� (Rough Inspection (continued) I Date I Inspector Initials I Comments 316 Rough Mechanical Residential 317 Rough Mechanical Commercial 318 Boiler / Furnace 319 Hot water tank 320 Drywall screw and Nail 321 Moisture board / shower walls 322 Rough Grading 323 Miscellaneous Final Inspections Date Inspector Initials Comments 402 Gas Meter Release 403 Final Electrical Residential 404 Final Electrical Commercial 405 Final Mechanical Residential 406 Final Mechanical Commercial 407 Final Plumbing Residential 408 Final Plumbing Commercial 409 Final Roof 410 Final Window/Door 411 Landscape/Park/Planning* Inspections from these entities shall be requested one week in advance. *For landscaping and parking inspections please call 303-235-2846 **For ROW and drainage inspections please call 303-235-2861 ***For fire inspections please contact the Fire Protection District for your project. 412 Row/Drainage/Public Works** 113 Flood plain Inspection** 114 Fire Insp. / Fire Protection*** 115 Public Works Final** 116 Storm Water Mgmt.** 417 Zoning Final Inspection* 118 Building Final Inspection Note: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building Inspection does not constitute authorization of occupancy. For Low Voltage permits please be sure that rough inspections are completed by the Fire District and 06 Electrical low voltage by the Building Division. 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: &I /0 Job Address: b � qO L-✓ 4✓e Permit Number: �G17® 76®0 6 ❑ No one available for inspection: Time. /"/ 'J—/AM/PM Re -Inspection required: When corrections have beers' call for re -inspection at 303-234-5933 ' Date: I M/?A7 Inspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Roofing PERMIT - 201709006 PERMIT NO: 201709006 ISSUED: 11/13/2017 JOB ADDRESS: 12490 W 35th AVE EXPIRES: 11/13/2018 JOB DESCRIPTION: Permit to remove 22 squares dim. and install Lifetime warranty Ownes Corning Duration, 25 squares 4/12 pitch *** CONTACTS *** OWNER (303)257-7009 LAWLER THELMA B SUB (303)667-9517 Tim Gower 170292 Tops Construction LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,425.00 FEES Total Valuation 0.00 Use Tax 134.93 Permit Fee 156.75 ** TOTAL ** 291.68 *** COMMENTS *** *** CONDITIONS *** Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be required for both the midroof and final inspections. The 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the Homeowner. REGARDING ROOF VENTILATION: Roof ventilation shall comply with IBC Sec. 1203.2 or IRC Sec. R806. The installation of ridge venting requires the installation or existence of soffit venting. For calculation purposes, one hat or turtle vent equal to one-half of one square foot of opening. 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) is required on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and mid -roofs may be called in at the same time, one hundred percent of the sheathing must be complete and 25-75 percent of the mid -roof may be complete. 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 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 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. PERMIT NO: JOB ADDRESS: JOB DESCRIPTION City of Wheat Ridge Residential Roofing PERMIT - 201709006 201709006 12490 W 35th AVE ISSUED: 11/13/2017 EXPIRES: 11/13/2018 Permit to remove 22 squares dim. and install Lifetime warranty Ownes Corning Duration, 25 squares 4/12 pitch I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed d t all work to be performedis disclosed in this document and/or its' accompanying approved plans and specifications. / — 0,11 -/7 Sig ture of OWNER or CONTRACTOR (Circle one) Date l,, his permit was issued based on the information provided in the pennit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. This permit shall expire 365 days after the date of issuance regardless of activity. Re pests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made 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 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 o las rth'uri diction. 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. Antoinette Kulick IQ)0f From: no-reply@ci.wheatridge.co.us Sent: Sunday, November 12, 2017 12:53 PM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Antoinette Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received and due to the volume of requests, time to process varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes residential roof? How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123-4567) �,,-,o. /c/ 1// 7 12490 W. 35th Ave. Wheat ridge CO 80033 Thelma Lawler 303-237-8249 21 Property Owner Email N/A Address Do you have a signed Yes contract to reroof this property? Applications cannot be submitted without an executed contract attached below. Attach Copy of Executed Thelma Lawler contract.pdf Contract CONTRACTOR INFORMATION Contractor Business Name Contractor's License Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone Number (enter WITH dashes, eg 303-123-4567) Contractor Address (Primary address of your business) Tops Roofing 170292 303-257-7009 13495 N. Wincheser Way Parker CO 80138 Contractor Email Address jwinniel@hotmail.com Retype Contractor Email jwinnel@hotmail.com Address DESCRIPTION OF WORK TOTAL SQUARES of 25 the entire scope of work: Project Value (contract Q_6200 value or cost of ALL materials and labor) Are you re -decking the roof? Is the permit for a flat roof, pitched roof, or No Pitched roof (2:12 pitch or greater) 22 both? (check all that apply) What is the specific pitch of the PITCHED roof? How many squares are part of the PITCHED roof? Describe the roofing materials for the PITCHED roof: Type of material for the PITCHED roof: Provide any additional detail here on the description of work. (Is this for a house or garage? Etc) 4:12 All Remove 22 sq Dim. put on Lifetime warranty Owens Corning Duration 25 sq. Asphalt R/R all Debris SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that this Yes application is NOT a permit. I understand I will be contacted by the City to pay for and pick up the permit for this property. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have been Yes authorized by the legal 23 owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Name of Applicant Johnny Wingate Email not displaying correctly? View it in your browser. 24 TOPS Roofing 13495 N. Winchester Way • Parker, CO 80138 timtopsroofing 2ya hoo.com SELECTION OF MATERIALS AND CONTRACT FOR CONSTRUCTION CONTINGENT UPON INSURANCE APPROVAL I/We authorize TOPS Roofing to work directly with the insurance company to determine the insurable loss. I/We authorize TOPS Roofing to communicate directly with any claims adjusters and/or the insurance company. If the work under this contract is being provided as the result of an insurable loss, the Contractor will provide the labor and materials selected by the Owner and authorized by the insurance company. If however the insurance company denies coverage, then the selection of materials and this Contract shall be null and void. The Owner agrees that the Contractor is to be included on any checks issued by the insurance company t the Owner. it is further understood that it is a requirement of the law to pay the deductible on an insurance claim. TOPS Roofing agrees to install the following materials selected by the customer. The customer selects the following materials and directs TOPS Roofing to furnish this material and its labor in a good and workmanlike manner according to standard practices in the industry. Any modifications, changes, or additions must be in writing and agreed to between the parties as evidence by their signatures. Proper installation of the roof system may require replacement of existing flashing. During such replacement, siding adjacent this flashing which has deteriorated may crack, break, or tear. TOPS Roofing will make every reasonable effort to avoid damage, but will not be responsible for any consequential damage to siding_ During the application of the roof system, vibration from the roof may be transmitted throughout the building. TOPS Roofing is not responsible for rotted siding, paint and sheetrock damages due to vibration. The customer further assumes responsibility for all objects hung from exterior and interior walls and from ceiling and soffits. These have been known to fall during the installation and TOPS Roofing will not be responsible for these occurrences. it Is further understood that vent and gas pipes penetrating through the roof may shift during construction. TOPS Roofing recommends that these pipes be Inspected by a licensed plumber but will not pay the expense of such an inspection. This agreement is contingent upon insurance approval. if the insurance company denies coverage, this agreement is null and void, If the insurance company approves coverage the total out of packet expense will be the deductible for complete roof replacement. No money will be due until the Insurance company has approved and paid the claim and/or construction is completed on the property. Tile Metai Slate Wood Csphalt/Shingle',-�' Flat TYPEr o REMOVE EXISTING ROOF AND INSPECT DECKING o RE -DECK ROOF_Nr 9 o INSTALL _�, / . E.` r INCH EDGE METAL/COLOR o APPLY A ! r vJ��xn ' t�' l UNDERLAYMENT SYSTEM o NAILS Y ft}f}tt+`j 6 /<4//n}6°Le o SCREWS o SPECIAL FASTENERS o SIDEWALL FLASHING WHERE NEEDED o CHIMNEY FLASHING: FLASH, CAULK AND PAINT o INSTALL COVERS FOR PVC PIPE JACKS AND VENTS o INSTALL TYPE VENTILATION o CLEAN UP CONSTRUCTION SITE AND HAUL AWAY DEBRIS o SPECIAL INSTRUCTIONS/NOTES/UPGRADES fa�.l Grand Totat:=i_. _ j 1?C�.. Insurance Company Policy It(F Payment to be mode as�llows. Terms and Conditions D'- 1 fes ( , Home City, State, Cell or Woi I 1 - ,�—, G xe- k: (t -t i k— have read the following contract known as Addendum A and Agree with The Terms and Conditions. By the acceptance of this Contract, the Owner agrees to pay for the work and/or materials at the prices set forth in Addendum A. A. Customer Signature: Date: 11 7 1 TOPS Roofing Representative: Date: t i i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: a2C'/7D yG6G ❑ No one available for inspection: Time AM/F Re -Inspection required: Yes Nol� *When corrections have been made, call for re -inspection at 303-234-5933 Date:-/ 'r` ��{� Inspector: DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type: 41A1,41 Aoe>l Job Address: /,,� Y5 e2 w . 351;W Permit Number: 07 VI93 P ❑ No one available for inspection: Time AM/ Re- Inspection required: - Yes Va, When corrections have been made, call „ for g e- inspection at 303- 234 -5933 Date: � /G�U7 Inspector: /; c DO NOT REMOVE THIS NOTICE INSPECTION 'RECORD Occupancv�vpe ®'INSPECTION LINE: (303) 234 -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. FINALS qL c 1 INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB FOUNDA ECTIONS c1 ECTOR COMMENTS: - Footings / umbin g g Stemwall oncrete Encased echanlcal -.. ABOVE INSPECTIONS TO BE Reinforcinolithic ff Parking & Landscaping Weatherpch Drain `Insulation -- Sewer Ses Drywall Screw Water Service Lines'. .` .POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED CONCRETE SLAB FLOOR Electrical (Underground) Plumbing (Underground) - s Heating (Underground) Dd NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ROUGHS' : g. FINALS Lath Wall Plumbing Mechanical' '.; /'" c1 l Service WMech anical lectric IF umbin g g Fire Department echanlcal -.. ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING .Framing Parking & Landscaping `Insulation -- Drywall Screw I, W; F 'NOTE: ALL ITEMS MUST RF COMPI FTPn LNn APPPM /Frl RV P/ ANNINl� Amn 7l1NINl_ Q//ll lllNr_ dNRPIrRr IC WOPICS.RFFOPF 4 CERTIFICATE OF OCCUPANCY iS ISSUED.:FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION Flo`, OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED Electrical FINALS r Plumbing Mechanical' c1 Roof 09 IF 'Building Final I, W; F 'NOTE: ALL ITEMS MUST RF COMPI FTPn LNn APPPM /Frl RV P/ ANNINl� Amn 7l1NINl_ Q//ll lllNr_ dNRPIrRr IC WOPICS.RFFOPF 4 CERTIFICATE OF OCCUPANCY iS ISSUED.:FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION Flo`, OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED Electrical Plumbing Mechanical' Roof 09 'Building Final 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 PROTECT, THIS CARD FROM THE WEATHER CITY OF WHEAT RIDGE ~r Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: et&d,ern r Job Address: Permit Number: yl5 a. E k ❑ No one available for inspection: Time a AM PM 7 Re-Inspection required: Yes No ' When corrections have been made, call for re-inspection at 303-234-5933 ~ 1111!' C ? j InspecDate: tor: rrrr;i J DO NOT REMOVE THIS NOTICE ~oFW"egT~io City of Wheat Ridge Building Division s m 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 . Fax: 303-237-8929 °o<oaaoo Inspection Line: 303-234-5933 Property Address: Property Owner (plea Mailing Address: (if different than property address) Date: Plan Permit 4~~-1A Address: ~S~,Y ~~a d\ City, State, Zip_ G9w =~~v SO 033 Contractor: S l Y arr o w n ~r 3 0 3 7- 2 Contractor License Phone: Sub Contractors: Electrical City License Plumbing City License Mechanical City License Company: Company Company: l Exp. Date: Exp. Date: Exp. Date: Approval: Approval: Approval: Use of space (description): W res,r( ne) Construction Value: $ Description of work; ~ (as calculated per the Building valuation Data sheet) Plan Review (due at time of submittal): $ K,lct c roo Sq. Ft.fL.Ft added: Squares BTU's Gallons Amps OWNEWCONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT 1 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. CIRLCE ONE, (OWNER) 1 (CONTRACTOR) or PERSONAL REPRESENTATIVE of (OWNER) (CONTgRATOR2, n D I PRINTNAME: _ 1 UT,% P3 L&,664441e SIGNATURE: r2r 7~~1 ` i/XO ti Dat/e~ l Building Permit Application