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11435 W. 32nd Avenue
City of Wheat Ridge ter, Residential Demoliti PERMIT - 201707995 PERMIT NO: 201707995 ISSUED: 10/04/2017 JOB ADDRESS: 11435 W 32nd AVE EXPIRES: 10/04/2018 JOB DESCRIPTION: Residential demolition for total demolition of house and shed. House State demo permit#17JE5613D Shed State demo permit#17JE5612D *** CONTACTS *** OWNER (303)888-3314 MW REAL ESTATE ACQUISITIONS LL SUB (303)467-3366 Dave Stefanich 080140 All Demolition Excavation *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4.,500,.00 FEES Total Valuation 0.00 Demolition Fee 50.00 ** TOTAL ** 50.00 *** COMMENTS *** *** CONDITIONS *** Work shall comply with 2012 IRC & 2014 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanyingg approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this ermrt. I further attest that I am le ally authorized to include all entities named within this document as partes to the work to be perfpor t all work to be performed is disclosed in this document and/oras' accompanying approved plans and specifications. Xgrtature of /DWNER ok, CONTRACTOR (Cycle one) , Date / 1. This permit was issued base ion provided in the permit application and accompanying )tans 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 maybe subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of LA uilding Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of Wheat.PJdgc Building & Inspection Services Division 7500 W. 29`h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email:rmlj, Ct ci.svheatndae.co.us FOR OFFICE USE ONLY r Date: 0 J /7 1 Pian/permit #4)o o f �5 `/ Plan Review Fee: 60,670 Building Permit Application **" Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** ® I l i a r I I —) --% A' `/ 1 Property Address: 1%`e Owner (please print): l t l � � '� � � Phone: Property Owner Email: ,P�- /iR I J�� Drytm , cp/n- Mailing Address: (if different than property address) Address: Y" r) x/ ' qbal 9 City, State, Zip: L/6 kp Lt2©0k (' n ArchitectiEngineer: Architect/Engineer E-mail: Contractor: R It "61 Phone: Contractors City License #: r -3r3 `�y Phone: Contractor E-mail Address: IeY A -A 4i) A'1 1 f E6 P 7� , /� ,e 4/- Sub Contractors: Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all information on BOTH sides of this form ❑ COMMERCIAL ❑ RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT /� L %� 19 OTHER (Describe) `tt��G� l P.lY7D j;�, v� nJ k' o -q15 -P kn�S he- [Y (For ALL projects, please provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.) Sq. FtAF Amps Btu's Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ 4, 5DCD OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. 1, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE of (OWNER) (C NTRACTOR) Electronic Signature (first and last name): DATE: 40/e//7 ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer. DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Building Division Valuation: $ Colorado Department of Public Health and Environment Air Pollution Control Division — Indoor Environment Program — Asbestos/IAQ Air Unit 4300 Cherry Creek Drive South, APCD-IE-131 Denver, Colorado 80246-1530 Phone: 303-692-3100—Fax- 303-782-0278 E-mail: asbestos@state.co.us DEMOLITION APPROVAL NOTICE This approval notice is granted subject to Colorado Air Quality Control Commission Regulation No. 8, Part B, adopted December 21, 2007, and effective January 30, 2008 and the Colorado Air Pollution Prevention and Control Act C.R.S. (25-7-101 and 25-7-501 et seq). This noticc signifies that the structure was inspected for asbestos, luminous exit signs (containing radioactive material), and Ozone -Depleting Refrigerants and the demolition contractor has properly notified the Colorado Department of Public Health and Environment pursuant to Regulation No. 8, Part B. As a contractor. \ ou may be subject to other demolition licenses and permits, depending on the requirements of the county and municipality in which the work is being perfornicu. Department of Public Health and Environment, Air Pollution Control Division, strongly suggests that you check with county and municipal authorities in order to determine any other local building/permitting requirements that must be met. Please note that certain asbestos -containing materials (ACM) may remain in the structure during demolition. Therefore, any demolition debris left behind after the completion of post - demolition site cleanup may constitute a "reason to know of asbestos -contaminated soil" at the site, subject to the requirements of Section 5.5 of the Solid Waste Regulations (6 CCR 1007-2, Part 1). THE ORIGINAL APPROVAL NOTICE MUST BE POSTED ON SITE AT ALL TIMES. Immediately notify the AsbestosIL4Q Unit of project modifications by fax (number above) or e-mail (address above) and the appropriate county health department by fax. Project modifications include changes in the scope of work or the scheduled work dates, etc. This demolition approval notice is valid beginning 9/25/2017. The actual scheduled work dates are from 9/25/2017 through 10/25/2017. �pprovai issued on: yI i 4ilu 17 Record number: 130829 Notice Number: 17JE5613D For the location specified below: SFRD 11435 W. 32nd Ave Wheatridge Jefferson County This notice has been issued to: All Demolition Excavating 6300 W. 49th Dr Wheat Ridge, CO 80033 Fee Paid: $55.00 Check number: 46398 Asbestos Building Inspector: Derek D'Avignon Cerification No.: 10177 Inspection Date: 09/01/2017 Issued by: CLB of cry + 1876 Colorado Department of Public Health and Environment DEMOLITION NOTIFICATION APPLICATION FORM APPLICATION FEE MUST ACCOMPANY THIS FORM INCOMPLETE APPLICATIONS WILL BE RETURNED (Notice will be mailed to the demolition contractor unless specified otherwise) Fee: $50 + $5 per 1000 ftz of area to be demolished = $ (See instruction #1 on reverse side) Submit form to: Permit Coordinator Colorado Dept. of Public Health and Environment APCD-IE-B1 4300 Cherry Creek Drive South egulated asbestos -containing materials means (a) friable asbestos -containing material, (b) Category I nonfriable ACM that has become friable. (c) Category I nonfriable ACM that will be or has been subjected to sanding, grinding, cutting, or abrading or (d) Category 11 nonfriable ACM that has a high probability of becoming or has become crumbled, pulverized, or reduced to powder by the forces expected to act on the material in the course of demolition or renovation operations regulated by this regulation. Note: Asbestos -containing sheet vinyl and linoleum must be properly abated/removed prior to demolition. corm. DNA09 C mpany k4ame I/ tl _/ �Xre; U es„ �) I" r� ; IW Building Name- ame: —R l o Street. ,1 i !CJ; tit ' L' Square footage of footprint of facility or portion of facility to be demolished 170 SJ -- State: i Zip f✓Ce� _� i Street: 'J3 p Telephone # Fax # (�� >C! 3 6 (c>�L>3 -� y City: County Zip Code: = o ll Project Manages Cell Phone # C.O— Proposed St rtDat ! Proposed ompleti Date 7 4_11 I certify tot the Certified Asbestos Building Inspector has informed me l: Method/Mbans bf Demolition: O E about any remaining asbestos -containing materials in the facility to be demobs tv D 0 wrecking ❑ Bumingt ❑ Implosion, ❑ Moving Q Other, specify. Pn t Name- requires additional authorization - Please call (303) 692-3100 and ask LLanRiving BuildiVDis:tBurning 1 to speak to the Open Burning Permit Coordinator General Abatement }Contractor (GAC) L Owner's Name: _ p R w 3Street: CPPHE Asbestos Permit # Total Quantity of Asbestos Removed N o a (D L t - - =' -7 -� N c., ^° L 0 15 `� � �J�- zr,f ` t IR int C, 2, H _� Date Removal Completed Telephone # Cip� State: Code: Type(s) of Asbestos -Containing Material Removed:�n m ,Contact's Name: Telephone # 4q } With my signat re below, I certify that I possess current AHERA accreditation and state of Colorado certification as an Asbestos Building Inspector. I also certify that I have thoroughly inspected the facility to be demolished, as listed in the Demolition Site block above, sampled all suspect materials, had all samples analyzed for the presence of CL asbestos by a NVLAP-accredited laboratory, and have determined that no Regulated ACM exists anywhere in the facility.' I also certify that I have informed the owner/operator of the facility or the demolition contractor that any N o asbestos -containing material allowed to stay in the facility must remain non -friable during demolition. Specify type(s) NM of ACM remaining, below. (check appropriate box(es)): -6= U) v❑ Vinyl asbestos floor tile (VAT) Q VAT mastic ® Tar/asphalt impregnated roofing ❑ Asphaltic pipe coatings ❑ Spray -applied tar coatings [Z Caulking 0 Glazing ❑ Other, specify: IV Signature: (In tluelnk) Printed Name: (D { Derek D'Avignon Date of Final I spectiori CO 1�11Cert # Expiration Date Telephone # Cell Phone # I t�� --1 t 10177'' 10/7/17 (303) 382-1175 (303) 949-2965 Lp 1 verify that all refrigerants from air conditioning/refrigeration appliances have been properly recovered in accordance with AQCC Regulation No. 15 (for information on CFC requirements call 692-3100). 1 further verify that all luminous exit signs (containing radioactive material) have been C disposed of in accordance with 6 CCR 1007-1 subpart 3.6.4.3 (for information on luminous exit sign requirements call 303-692-3320). v! CHECK THE APPROPRIATE BOX: mO C' ❑ Building Owner Contractor ❑ Other Date: U i Signature.�- --- � -- -- Print Name— amed i /a HIS BOX Is FOR CDPHE USE ONL Postmark or Hand Delivery Date: ? , Approved By: Code: initial -310 ❑ transfer -380 Form of Payment & #: `R p ermit#:� Reco ` " , 1 Date Issued: egulated asbestos -containing materials means (a) friable asbestos -containing material, (b) Category I nonfriable ACM that has become friable. (c) Category I nonfriable ACM that will be or has been subjected to sanding, grinding, cutting, or abrading or (d) Category 11 nonfriable ACM that has a high probability of becoming or has become crumbled, pulverized, or reduced to powder by the forces expected to act on the material in the course of demolition or renovation operations regulated by this regulation. Note: Asbestos -containing sheet vinyl and linoleum must be properly abated/removed prior to demolition. corm. DNA09 Colorado Department of Public Health and Environment Air Pollution Control Division - Indoor Environment Program - Asbestos/IAQ Air Unit 4300 Cherry Creek Drive South, APCD-IE-B1 Denver, Colorado 80246-1530 Phone: 303 -692 -3100 -Fax: 303-782-0278 E-mail: asbestos@state.co.us DEMOLITION APPROVAL NOTICE This approval notice is granted subject to Colorado Air Quality Control Commission Regulation No. 8, Part B, adopted December 21, 2007, and effective January 30, 2008 and the Colorado Air Pollution Prevention and Control Act C.R.S. (25-7-101 and 25-7-501 et seq). This notice signifies that the structure was inspected for asbestos, luminous exit signs (containing radioactive material), and Ozone -Depleting Refrigerants and the demolition contractor has properly notified the Colorado Department of Public Health and Environment pursuant to Regulation No. 8. Part B. As a contractor, you may be subject to other demolition licenses and permits, depending on the requirements of the county and municipality in which the work is oemg performeu. 1 he k__,vi,)raaU Department of Public Health and Environment, Air Pollution Control Division, strongly suggests that you check with county and municipal authorities in order to determine any other local building/permitting requirements that must be met. Please note that certain asbestos -containing materials (ACINI) may remain in the structure during demolition. Therefore, any demolition debris left behind after the completion of post - demolition site cleanup may constitute a "reason to know of asbestos -contaminated soil" at the site, subject to the requirements of Section 5.5 of the Solid Waste Regulations (6 CCR 1007-2, Part 1). THE ORIGINAL APPROVAL NOTICE MUST BE POSTED ON SITE AT ALL TIMES. Immediately notify the AsbestosIL4Q Unit of project modifications by fax (number above) or e-mail (address above) and the appropriate county health department by fax. Project modifications include changes in the scope of work or the scheduled work dates, etc. This demolition approval notice is valid beginning 9/25/2017. The actual scheduled work dates are from 9/25/2017 through 10/25112017. r-�ppro\ ai issuea on: ti/ 14/2017 Record number: 130828 Notice Number: 17JE5612D For the location specified below.- Shed elow:Shed 11435 W. 32nd Ave Wheatridge Jefferson County This notice has been issued to: All Demolition Excavating 6300 W. 49th Dr Wheat Ridge, CO 80033 Fee Paid: $55.00 Check number: 46398 Asbestos Building Inspector.- Derek nspector:Derek D'Avignon Cerification No.: 10177 Inspection Date: 09/01/2017 Issue4*. CLB of colo 9a DEMOLITION NOTIFICATION APPLICATION FORM Colorado Department »'A7APPLICATION FEE MUST ACCOMPANY THIS FORM ofl'ublicHealth INCOMPLETE APPLICATIONS WILL BE RETURNED andEn-;ronment (Notice will be mailed to the demolition contractor unless specified otherwise) Fee: $50 + $5 per 1000 ft2 of area to be demolished = $ (See instruction #1 on reverse side) Submit form to: Permit Coordinator Colorado Dept of Public Health and Environment APCD-IE-Bt 4300 Cherry Creek Drive South Regulated asbestos -containing materials means (a) friable asbestos -containing material, (b) Category I nonfriable ACM that has become friable, (c) Category I nonfriable ACM that will be or has been subjected to sanding, grinding, cuffing, or abrading or (d) Category 11 nonfriable ACM that has a high probability of becoming or has become crumbled, pulverized, or reduced to powder by the forces expected to act on the material in the course of demolition or renovation operations regulated by this regulation. Note: Asbestos -containing sheet vinyl and linoleum must be properly abated/removed prior to demolition. F.I., DNA08 Com any Name:i r " �� to �, Building Name: Street: ; I V i Square footage of footprint of (rtcil' ffortio g facility to be demolished /// �� (�) O JJ i !ty I State: 1 Zi Code: G�C Co "r'j',S Street: 1 w i i i L1 VJ Ave Te phone # ( Fax # (' 33 C 3G3) 4 G3 C} 1t� fn City. ty' Zip Code: _ o ect Manager. ' k. ` ( 3 `13;e � e 4 / I� �6 L i/ l �f W ^611 C� O ProposedISya at,� r Propgsed ompPf n D L' 4)a ! t/lfl' ate i �° " 1 certify Ihfthe Certified Asbestos Building Inspector has informed me E i Method/Me ns ofDemolition: O E about any remaining asbestos -containing materials in the facility to be demolished. N 0 i t ® wrecking ❑ Burning ❑ Implosion. ❑ Moving ❑ Other, specify S re: P' t Name L Awt /C i A Landfill Re g Building Deb 7" �� ' tBurning requires additional authorization — Please call (303) 692-3100 and ask 1J I to speak to the Open Burning Permit Coordinator L General Abatement Contractor (GA �) 0 '' ` Owner's Name _ C Mer. pof .�. CDPHE Asbestos ermit # Total Quantity of Asbestos Removed 3 Street: �. Date Removal Corppleted Te hone # 5 C State: Zi Code: co y O Type(s) of Asbestos -Containing Material Removed: m ! Contac♦t's Name: J� Telephone # 0-3 RS With my signature below, I certify that I possess current AHERA accreditation and state of Colorado certification as o` an Asbestos Building Inspector. I also certify that I have thoroughly inspected the facility to be demolished, as listed in the Demolition Site block above, sampled all suspect materials, had all samples analyzed for the presence of Q. asbestos by a NVLAP-accredited laboratory, and have determined that no Regulated ACM exists anywhere in the cfacility.* I also certify that I have informed the owner/operator of the facility or the demolition contractor that any coo asbestos -containing material allowed to stay in the facility must remain non -friable during demolition. Specify type(s) wM of ACM remaining, below: (check appropriate box(es)): Q❑ Vinyl asbestos floor tile (VAT) ❑ VAT mastic'] Tar/asphalt impregnated roofing ❑ Asphaltic pipe coatings a v ❑ 5pray-applied tar coatings ❑ C ulking ❑ Glazing ❑ Other, specify: w Signature: (In Blue Ink) Printed Name: ` Y P'� .- Derek D'Avignon Date ofinal,Inspection O Cert # , Expiration Date �( i 10177 Telephone # Cell Phone # I -� 10/7/17 (303) 382-1175 (303) 949-2965 1 verify that all refrige4ants from air conditioning/refrigeration appliances have been properly recovered in accordance with AQCC Regulation No. ` 15 (for information on CFC requirements call 692-3100). 1 further verify that all luminous exit signs (containing radioactive material) have been p disposed of in accordance with 6 CCR 1007-1 subpart 3.6.4.3 (for information on luminous exit sign requirements call 303-692-3320). ay i CHECK THE APPROPRIATE BOX: mO O= ❑ Building Owner Contractor EJOther Date: Signature" Print Name:,,_. 6 f �ahi, It 4- Postmark is Box is FOR CDPHE SE ONLY: v - -transfer or Hand Delivery Date: Approved By: Code:initial-310 0 -380 transfer-380Form Form of Payment & #: T Permit #: i Record -i, 'Date Issued: Regulated asbestos -containing materials means (a) friable asbestos -containing material, (b) Category I nonfriable ACM that has become friable, (c) Category I nonfriable ACM that will be or has been subjected to sanding, grinding, cuffing, or abrading or (d) Category 11 nonfriable ACM that has a high probability of becoming or has become crumbled, pulverized, or reduced to powder by the forces expected to act on the material in the course of demolition or renovation operations regulated by this regulation. Note: Asbestos -containing sheet vinyl and linoleum must be properly abated/removed prior to demolition. F.I., DNA08 City of Wheat Ridge Residential Demoliti PERMIT - 201700648 PERMIT NO: 201700648 ISSUED: 05/10/2017 JOB ADDRESS: 11435 W 32nd AVE EXPIRES: 05/10/2018 JOB DESCRIPTION: Complete structure demolition of SFR & 2 sheds - State Permit No. 17JE1775D *** CONTACTS *** OWNER (720)276-3277 MERKER STEVEN SUB (303)421-3366 Jim Gochis 020761 Alpine Demolition *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 9,800.00 FEES Total Valuation 0.00 Use Tax 176.40 Demolition Fee 50.00 ** TOTAL ** 226.40 -- *** COMMENTS *** *** CONDITIONS *** Work shall comply with 2012 IRC & 2014 NEC. I, by my signature, do hereby at 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 properly and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date i I 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 an manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chie icial -r_ Date REQUESTS MUST B BY". 59PM ANY BUI S DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. City of " Wheat j, d�' COMMUt* I -I -Y DEVELOPMENT Building & Inspection Services Division 7500 W. 29`h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(a)-ci.wheatridge.co.us FOR OFFICE USE ONLY Date: C- Plan/Permit# I Ict) Vq Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: \\`1'SS N' 32 Nyt-, Property Owner (please print): Phone: -12o - 2-1 co - 32?1 Property Owner Email: Mailing Address: (if different than property address) Address: State. Zi Architect/Engineer: N I Vk Architect/Engineer E-mail: Contractor: Aw�rc_ �2�'��'�or-� \(\c - Contractors City License #: Phone: Phone: 303- �t21- 33h, Contractor E-mail Address: �, r•, �\ ri�nc �e:��.� �bn . M Sub Contractors: va `lov Electrical: W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form ❑ COMMERCIAL RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT El ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT OTHER(Describe) V- 2 gV,.CA (For ALL projects, please provide a detail d description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.) Sq. FULF Amps Btu's Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CONTRACTOR) Lr (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Electronic Signature (first and last name): DATE: tl DEPARTMENT USE ONLY ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: Building Division Valuation: $ Colorado Department of Public Health and Environment Air Pollution Control Division — Indoor Environment Program — Asbestos/IAQ Air Unit 4300 Cherry Creek Drive South, APCD-IE-B1 Denver, Colorado 80246-1530 Phone: 303-692-3100 —Fax: 303-782-0278 E-mail: asbestos@state.co.us This approval notice is grantedsubject to Colorado Air Quality Control Commission Regulation No. 8, Part B, adopted December 21, 2007, and effective January 30, 2008 and the Colorado Air Pollution Prevention and Control Act C.R.S. (25-7-101 and 25-7-501 et seq). This notice signifies that the structure was inspected for asbestos, luminous exit signs (containing radioactive material), and Ozone -Depleting Refrigerants and the demolition contractor has properly notified the Colorado Department of Public Health and Environment pursuant to Regulation No. 8, Part B. As a contractor, you may be subject to other demolition licenses and permits, depending on the requirements of the county and municipality in which the work is being performed. The Colorado Department of Public Health and Environment, Air Pollution Control Division, strongly suggests that you check with county and municipal authorities in order to determine any other local building/permitting requirements that must be met. Please note that certain asbestos -containing materials (ACM) may remain in the structure during demolition. Therefore, any demolition debris left behind after the completion of post- ' --volition site cleanup may constitute a "reason toknow of asbestos -contaminated soil" at site, subject to the requirements of Section 5.5 of the Solid Waste Regulations (6 CCR 1007-2, Part 1). THE ORIGINAL APPROVAL NOTICE MUST BE POSTED ON SITE AT ALL TIMES. Immediately notify the Asbestos/IAQ Unit of project modifications by fax (number above) or e-mail (address above) and the appropriate county health department by fax. Project modifications include changes in the scope of work or the scheduled work dates, etc. This demolition approval notice is valid beginning 4/11/2017. The actual scheduled work dates are from 4/11/2017 through 7/11/2017. Approval issued on: 3/30/2017 Record number: 126208 Notice Number: 17JE1775D For the location specified below: SFRD 11435 W. 32nd Ave Wheatridge Jefferson County This notice has been issued to: Alpine Demolition 5790 W 56th Ave, Ste. C Arvada, CO 80002 Fee Paid: $65.00 Check number: CC 2586 Asbestos Building Inspector: Derek D'Avignon Cerification No.: 10177 Inspection Date: 03/21/2017 Issued by: M 80VN4 u 0:1 'uog!lowap of joud panowej/pelege Apadoud aq lsnw wnaloup pue !!u!n laaUs 6u!u!eluoo-sols9gsV :aloN -uogeln6ai s!yl (q palelnbaj suo!lejado uoyenouW Jo uog!lowap jo asinoo ayl ui leualew ayl uo pe of paloadxe sago; ayl (q japmod of poonpai jo 'pez!uanind palgwnio awooeq sey Jo 6wwooeq to l!!!gegoud y6!y a sey leyl NOV alge!�uou !i o ale(] (p) jo 6u!peuge jo ' u�' u!puu '6u!pues of paloafgns uaaq sey jo aq ll!m leyl NOV a!ge!.quou l�ioEaales r�1 'ainpi n aWnnan SP.11 lelll IN'lH alaeniuou I AJObGre-7(a) 'leualew wweluoo-solsagse a!geul (e) sueaw sleualew bu!u!eluoo-solsagse paleln6ay :panssl ale pjOoab wad �'I d%A��#J d :# 8luawAed)o iwod LI IA Z C :ale(] tian!lad pueH Jo >pewlsod O8£-jalsuejl ❑ OL£-le!l!u!o :apoO : (8 panaddy :J,71N0 3sn 3Hda3 NOJ sl XOS s!HI :aweN luud :ajnleu6!S n ale0 �ay10 ❑ 'ope�luo0 �aump 6u!p!!n8 ❑ 7 co :X08 31VIMd0MddV 3H1 NO3Ho CL w � '(OZEE-Z69-£OE Ileo sluawannlow u6s l!xa snou!wnI uo uogelwo w. joi) £'7 '9'E l�edgns i -L00 L a(](]9 4l!m aoue 000e u! l Pasods!p o uaaq aney (leualew an!loeo!peJ 6u!u!eluoo) s!u6!s l!xa snou!wnl lie leyl Chian jayunl 1'(00 LE -Z69 Ileo sluawannbei (]d(] uo uogewuolul jol) 9l 'ON uogelnbaa OOoV yI!m aouep000e u! paianooei Apadoid uaaq aney seoue!!dde uogej96u)aj(6u!uog!puoo j!e wa; slueja6u19i lie leyl duan ! 996Z -6t6 (£0£) i 9LIT-Z8£ (£0£) t/LO/Oi LLPI l`Z �o!o # auoyd IaO aleuoex3# 000 pads I leu!d i ale0 n a0u21nV,Q x=(j 1 :aweN paluud ()lul 901a ul 'amleu6!S <D ° poa s 'Jay;O E] ulzelJ LgIneO Ez Soup -00 Je; pall e- eJ n s6u!leoo adid ogIeydsV ❑ 6uUooJ paleubaJdwi llegdse/Jel ollsew 1VA m (1VA) all; fool} so;sagse IAUTA [ 4 rr° :((sa)xoq ejeudoidde )13ayo) :nnolaq '6ululewaJ NOd jo a o (s)ad�(l A}ioadS -uoi;Ilowep 6uunp algelJ;-uou uiewaa;snw �(;llloel ay} ul (els o; pannolle leualew 6ulule;uoo-solsagse F (n Aue leyl JoloeJ;uoo uoilllowap ay; Jo A;liloe; ay; ;o Jo;eJado/Jaunno ay; pawjo;ul aney I ;eq; dll:fao osle i ayl ul aJagmAue slslxe NOV pa;eln6a�j ou leyl pauluJJalap aney pue 'AJoleJogel pa;lpaJooe-d` -IAN a Aq solsagseCD jo aouesaJd ayl jo; pazAleue saldLues Ile pey 'sleua;ew;oadsns Ile paldwes 'anoge �Polq a;!S uollllowaa ayl ul S palsil se 'pagsllowep aq of A;!Iloel ay; pa;oadsul AlgbnoJogl aney I;eq; A3llJao OSI8 l 'Joloadsul 6ulpilne so;sagsV ue -+ se uolleowlJao opeJoloO;o alels pue uoge;lpaJooe Vf iDHd luaJJno ssessod 1 ;ey; A4l),Jao I 'nnolaq q'Jnleu6ls Aw q;!AA (d a ���C co U i ln #auoydalal :aweN s,pelu�3 O :panowa�{ leu leyy 6u!u!eluo0-solsa sy to (s)adRl PaAC OD :apo0 drz :alelS :Al!0 b —# I 1 Palald o0 !e owaM ale0 O' ✓T 3 °O 0 4 S S 2 91 —fit panasos 40 I!u dbV d:laajis aweN sdaum0 (0 0) 10loeiluo0 luawalegV leiaua0 Joleu!pJoo0 l!wJad Buiwne ua 0 ayl of ileacls of else pue 001,£-Z69 (COC) Ileo aseald — uowzuoylne leuo!I!ppe sannbai bu!wng+ su a 6u! m 6u!n!aoa i ue g 0 pl 8 ?J IIJP l aweN luud ,a1nlLAS pads'jayl0 bu!noyy ❑ uo!soldwl ❑ 6u!wne [] 6u!�!oa�/N � 0 3 paysgowap v U aq of A81pe1 ayl u! sleualew buimeluoo-solsagse 6u!u!ewaj /ue inoge O :uo!i!iowa(] 091L�2 oylaW ow pawolu! sey joloadsul 6u!plmg solsagsV pag!lja0 ayl leyl /i!yao 1 — 1 + -�'�1Z (-Z�iL) --„ _ ;ate — 0 O ale0 uo!la!dwo9 pa od leo a pasodad '+ auo a :jabeue oafa # 4d II O W i d o V ;o vic a - �, ( Com) Zh (<-°� :aPo R �UnoO : Io N e # xed # auoydalal 0 19/7 V y ,. 11 OO 1,X10 :leads apos drl :a1eIS pays!lowap aq of Al!lpel to uopod io . a�lyo luu to a6elool a�enbs Iaa�IS aweN 6u!pl!n8 :aweN /uedwo0 sn•oo alels@@solsagsV 9LZO-Z9L-£0£ :xed 0NC-Z69-COC auoyd 0£9 L -97Z09 00 'Janua0 y1noS anu(I 3i@aJO /way0 00£7 I9 -31-03d V lu9wua!nu3 pue ylleaH o!lgnd !o 'Idea opeiolo0 Joleu!pjoo0 l!wjad :ol uuol i!wgnS (ap!s asJanaJ uo l,# uog3nj4sui eas) $ = pays(Iowep eq of eaJe;o Zl_} 0006 .lad 9$ + 09$ :aad (aslnnJ }o pal;loads ssalun JoloeJluoo uol;llowap ayl o; papew aq II!M aolloN) C13Mj 11824 �18 AWA SN0LV01-1ddV El13ldA00NI W�IOd SIHL ANVdW000`d LSf1W �18d N0IiV01-1ddd W1:10=1 N011V01lddd NOIld01=1110N N011110W30 luauruO.nAWJ pue TPH 01Tgnd 3° luow edaQ opE.10107 Colorado Department of Public Health and Environment Air Pollution Control Division — Indoor Environment Program — Asbestos/IA Q Air Unit 4300 Cherry Creek Drive South, APCD-IE-B1 Denver, Colorado 80246-1530 Phone: 303-692-3100— Fax: 303-782-0278 E-mail: asbestos@state.co.us ILI This approval notice is granted subject to Colorado Air Quality Control Commission Regulation No. 8, Part B, adopted December 21, 2007, and effective January 30, 2008 and the Colorado Air Pollution Prevention and Control Act C.R.S. (25-7-101 and 25-7-501 et seq). This notice signifies that the structure was inspected for asbestos, luminous exit signs (containing radioactive material), and Ozone -Depleting Refrigerants and the demolition contractor has properly notified the Colorado Department of Public Health and Environment pursuant to Regulation No. 8, Part B. As a contractor, you may be subject to other demolition licenses and permits, depending on the requirements of the county and municipality in which the work is being performed. The Colorado Department of Public Health and Environment, Air Pollution Control Division, strongly suggests that you check with county and municipal authorities in order to determine any other local building/permitting requirements that must be met. Please note that certain asbestos -containing materials (ACM) may remain in the structure during demolition. Therefore, any demolition debris left behind after the completion of post - demolition site cleanup may constitute a "reason to know of asbestos -contaminated soil" at site, subject to the requirements of Section 5.5 of the Solid Waste Regulations (6 CCR 1007-2, Part 1). THE ORIGINAL APPROVAL NOTICE MUST BE POSTED ON SITE AT ALL TIMES. Immediately notify the Asbestos/IAQ Unit of project modifications by fax (number above) or e-mail (address above) and the appropriate county health department by fax. Project modifications include changes in the scope of work or the scheduled work dates, etc. This demolition approval notice is valid beginning 4/11/2017. The actual scheduled work dates are from 4/11/2017 through 7/11/2017. Approval issued on: 3/30/2017 Record number: 126210 Notice Number: 17JE1777D For the location specified below: Large Shed 11435 W. 32nd Ave Wheatridge Jefferson County This notice has been issued to: Alpine Demolition 5790 W 56th Ave, Ste. 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(25-7-101 and 25-7-501 et seq). This notice signifies that the structure was inspected for asbestos, luminous exit signs (containing radioactive material), and Ozone -Depleting Refrigerants and the demolition contractor has properly notified the Colorado Department of Public Health and Environment pursuant to Regulation No. 8, Part B. As a contractor, you may be subject to other demolition licenses and permits, depending on the requirements of the county and municipality in which the work is being performed. The Colorado Department of Public Health and Environment, Air Pollution Control Division, strongly suggests that you check with county and municipal authorities in order to determine any other local building/permitting requirements that must be met. Please note that certain asbestos -containing materials (ACM) may remain in the structure during demolition. Therefore, any demolition debris left behind after the completion of post- dPmolition site cleanup may constitute a "reason to know of asbestos -contaminated soil" at site, subject to the requirements of Section 5.5 of the Solid Waste Regulations (6 CCR 1007-2, Part 1). THE ORIGINAL APPROVAL NOTICE MUST BE POSTED ON SITE AT ALL TIMES. Immediately notify the AsbestosAAQ Unit of project modifications by fax (number above) or e-mail (address above) and the appropriate county health department by fax. Project modifications include changes in the scope of work or the scheduled work dates, etc. This demolition approval notice is valid beginning 4/11/2017. The actual scheduled work dates are from 4/11/2017 through 7/11/2017. Approval issued on: 3/30/2017 Record number: 126209 Notice Number: 17JE1776D For the location specified below: Small Shed 11435 W. 32nd Ave Wheatridge Jefferson County This notice has been issued to: Alpine Demolition 5790 W 56th Ave, Ste. 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I, by my signature do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable buildi g codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal ow r of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I fit her attest th I am legally authorized to include all entities named within this document as parties to the work to be performed and to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of WNE or CONTRACTOR (Circle one) Date 1. This rmit w 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 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 r any ordit�nce or r ulation 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. Inspection time requests will be accepted by email only. Please email requests to insptimerequesteaci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. City of Wheatj.jgle COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 FOR OFFICE USE ONLY Date: Plan/Permit # 1v l J O j q l' Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: � ? � J 4 ✓z �l Property Owner (please print): �it� r.,� I ���, II Phone: 7 Zc r g fs-Z 3 Property Owner Email: 0�_TCerna; arc,-EZf'1--Iw���l2o�v�s QM Mailing Address: (if different than property address) Address: (- i3Q, 5c I S City State Zip: ice„ J[ - Arch itect/Engineer: /,//,# Architect/Engineer E-mail: Phone: Contractor: Contractors City License #: 31'0 Phone: T10 3 0 3 Contractor E-mail Address: Sit v c r- C) M c.: -,k j, -)o c(" skies . (_ e, M Sub Contractors: Electrical: W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESIDENTIAL ADDITION ❑ WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ©--ETHER (Describe) c f -i ; L d (For ALL projects, please provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.) Sq. FULF Amps . , T--- � Btu's Squares G e -J Slime ,A K © os;, i7e ,To S" See c ^ vw,. ( re ., 4 L Pa f a BJ l.1 r r Cvw""" Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. CIRCLE ONE: (OWNER) (COor (CONTRACTOR) (AUTHORIZED REP SENTATIVE) of (OWNER) (CONTRACTOR) PRINT NAME: < �,-, M -"-t,; SIGNATURE: DATE: / Z/ DEPART ENT USE ONLY ZONING COMMMENTS Reviewer BUILDING DEPARTMENT COMMENTS Reviewer. PUBLIC WORKS COMMENTS Reviewer PROOF OF SUBMISSION FORMS Fire Department ❑ Received ❑ Not Required Water District ❑ Received ❑ Not Required Sanitation District ❑ Received ❑ Not Required OCCUPANCY CLASSIFICATION. Building Division Valuation: $ AA Boulder Environmental Inc. 2400 Broadway St., Unit B, Boulder, CO 80304 Phone: (303) 382-1175 Fax: 1 (866) 699-4121 October 25, 2016 Merkwood Homes Mr. Steve Merker Steven e,Merkwoodhomes.com SUBJECT: Asbestos Survey and Bulk Sampling for Building Demolition 11435 West 32"d Avenue, Wheat Ridge, Colorado Dear Mr. Merker: Attached is the report for the bulk sampling of suspected asbestos -containing materials at 11435 West 32"d Avenue, Wheat Ridge, Colorado. This report must be used for complete building demolition purposes only. This investigation was conducted on behalf of and for the exclusive use of Merkwood Homes (client), solely for use in a limited asbestos survey of the property. This report and the findings herein shall not, in whole or in part, be disseminated or conveyed to any other party, nor used by any other party, in whole or in part, without prior written consent of Boulder Environmental Inc. The results of this survey are limited to materials that were assessable and foreseeable to the inspector. Additional materials may exist behind hard surfaces. Personnel knowledgeable of asbestos containing materials should always oversee demolition activities. Demolition work should be halted and sampling performed by a state of Colorado licensed building inspector if additional materials, which are suspected of containing asbestos, are encountered. If you have any questions regarding the contents of this report, please do not hesitate to contact us. Sincerely, Chris Maron Project Manager IIPag'e Boulder Environmental Inc. 2400 Broadway St., Unit B, Boulder, CO 80304 Phone: (303) 382-1175 Fax: 1 (866) 699-4121 ASBESTOS SURVEY AND BULK SAMPLING REPORT FOR BUILDING DEMOLITION OF 11435 West 32"d Avenue, Wheat Ridge, Colorado Introduction: On October 18, 2016, Boulder Environmental Inc.'s building inspector, Derek D'Avignon, conducted an asbestos -containing materials survey. The purpose of the survey was to identify asbestos containing materials (ACM) and materials presumed to contain asbestos (PALM) as defined by the Environmental Protection Agency (EPA) for the purposes of eventual building demolition. Sampling: During the sampling process, suspect ACM was separated into three EPA categories. These categories are thermal system insulation (TSI), surfacing ACM, and miscellaneous ACM. TSI includes all materials used to prevent heat loss or gain or water condensation on mechanical systems. Examples of TSI are pipe coverings, boiler insulation, duct wrap, and mud packed fitting cement. Surfacing ACM includes all ACM that is sprayed, trowelled, or otherwise applied to a surface. These applications are most commonly used in fireproofing, decorative and acoustical applications. Miscellaneous materials include all ACM not listed in the thermal system insulation or surfacing categories, such as linoleum, vinyl asbestos flooring, and ceiling tile. Boulder Environmental Inc. followed EPA recommended sampling guidelines for identification of asbestos in bulk matrices. A set of one (1), three (3), five (5), or seven (7) samples were collected for each material type and analyzed by Polarized Light Microscopy (PLM). Each sample set was systematically analyzed. Upon determination that a sample in a set contained asbestos, analysis of the remaining samples in the set was discontinued. If no asbestos was detected during the analyses, the suspect material was determined to be negative for asbestos content. *Asbestos*Lead* Industrial Hygiene*Safety*Final Air Testing* *Health and Safety Training* Boulder Environmental Inc. 2400 Broadway St., Unit B, Boulder, CO 80304 Phone: (303) 382-1175 Fax: 1 (866) 699-4121 Results: The following materials are presumed to be asbestos containing: PRESUMED ASBESTOS CONTAINING MATERIALS MATERIAL LOCATION Condition/ friability CONTENT Paper and/or tape — 50 square feet wrapped around 10 -18 -DD -10 heating duct work, duct seams, and Good/ friable register boots Transite siding — 500 square feet on the exterior of the Good/ friable garage and garage small storage room Good/ non -friable interior east wall. Window glazing* — 24 square feet on 20 windows of house Good/ non -friable and 4 windows of large shed Tar impregnated roofing* — 2,000 square feet on roof of Good/ non -friable house/garage, large shed and small shed Floor tiles and associated mastic* — 450 square feet in the kitchen, basement, Good/ non -friable common bathroom, and northeast bathroom *Certain non -friable asbestos containing materials as noted may remain in the building during complete conventional demolition using work practices that preserve the materials in a non -friable state. The following materials were analyzed and determined to be asbestos -containing utilizing polarized light microscopy (PLM). ASBESTOS -CONTAINING MATERIALS MATERIAL Condition/ friability SAMPLE LOCATION SAMPLE ID CONTENT Joint compound on Northeast bathroom, northeast 10 -18 -DD -10 3% Chrysotile drywall system* corner Good/ friable Stipple #1 textured North hall, north wall (dw) 10 -18 -DD -11 D 3% Chrysotile drywall and plaster North hall, ceiling (p) 10 -18 -DD -12D Good/ friable Common bathroom, ceiling 10 -18 -DD -13D * The asbestos concentration of a drywall system with asbestos containing joint compound applied only to joints, tape, screws and/or nails may be calculated as a composite of other components or layers of the drywall system (i.e. tape, mesh, paper, gypsum) as long as the system is not finished with a skim coat of joint compound. The composite asbestos concentration of this drywall system is 1% asbestos or less and may remain in the building during conventional building demolition *Asbestos*Lead*Industrial Hygiene*Safety*Final Air Testing* *Health and Safety Training* Boulder Environmental Inc. 2400 Broadway St., Unit B, Boulder, CO 80304 Phone: (303) 382-1175 Fax: 1 (866) 6994121 ASBESTOS -CONTAINING MATERIALS MATERIAL SAMPLE LOCATION SAMPLE ID CONTENT Condition/ friabili Bumpy textured plaster Living room, ceiling Rough textured Common bathroom, east wall 10 -18 -DD -14E 3% Chrysotile drywall Common bathroom, north wall 10 -18 -DD -15E Good/ friable Common bathroom, west wall 10 -18 -DD -16E Stipple #2 textured Northeast bedroom, west wall 10 -18 -DD -18F 5% Chrysotile drywall and plaster North bedroom, south wall 10 -18 -DD -19F Good/ friable North bedroom, north wall 10 -18 -DD -20F Slap -brush Stairwell, ceiling 10 -18 -DD -21 G 4% Chrysotile textured drywall Stairwell, east wall 10 -18 -DD -22G Good/ friable Stairwell, north wall 10 -18 -DD -23G Stomp #2 textured East hall, west wall 10 -18 -DD -25H 3% Chrysotile drywall East hall, west wall 10 -18 -DD -26H Good/ friable East hall, west wall 10 -18 -DD -27H The following materials were analyzed and determined to be trace asbestos -containing utilizing polarized light microscopy (PLM). TRACE ASBESTOS -CONTAINING MATERIALS MATERIAL SAMPLE LOCATION SAMPLE ID Condition/ friability Bumpy textured plaster Living room, ceiling 10 -18 -DD -IA Dining room, ceiling 10 -18 -DD -2A Good/ friable I East hall, ceiling 10 -18 -DD -3A* * The sample contained a trace of asbestos and was further analyzed by point count method; otherwise the material would require abatement. The result of the re -analyses was that the material contained less than I% asbestos and could remain in the building during demolition as long as OSHA work guidelines are followed. *Asbestos*Lead*Industrial Hygiene* Safety* Final Air Testing* *Health and Safety Training* Boulder Environmental Inc. 2400 Broadway St., Unit B, Boulder, CO 80304 Phone: (303) 382-1175 Fax: 1 (866) 699-4121 The following materials were analyzed and determined to be non asbestos -containing utilizing polarized light microscopy (PLM). NON ASBESTOS -CONTAINING MATERIALS Discussion: Sample analyses results are reported in percentages of asbestos and non -asbestos components. The EPA defines any material that contains greater than one percent (I%) asbestos, utilizing PLM, as being an asbestos containing material. Materials that are identified as "none detected" are specified as not containing asbestos. Asbestos removal permit or notification requirements: When the quantity of ACBM to be removed exceeds "> 260 LF or 160 SF or a 55 - gallon drum", a permit or notification and a ten working day waiting. period are required before a permit is valid. These circumstances also require a notification fee of $80 for a non -friable asbestos removal or a permit fee of $400 for a friable asbestos removal. These trigger levels apply to all SFRD's which are intended to be demolished. Obtaining a State Demolition Permit: Prior to building demolition/relocation/burning, Colorado requires a state issued demolition permit. The building, or portion thereof, must be free of regulated asbestos containing materials before application for the demolition permit. There is a 10 working -day advance notification requirement for permit applications. Day 1 is the Ft business day following the postmark or hand -delivery date. (Working Day means Monday through Friday and including holidays that falls on any of the days Monday through Friday.) *Asbestos*Lead *Industrial Hygiene*Safety*Final Air Testing* *Health and Safety Training* Living room, north wall Stomp #1 textured plaster 10 -18 -DD -4B Dining room, south wall 10 -18 -DD -5B East hall, east wall 10 -18 -DD -6B Smooth plaster Southeast bedroom, ceiling 10 -18 -DD -7C Kitchen, ceiling 10 -18 -DD -8C North bedroom, ceiling 10 -18 -DD -9C 12"x 12" ceiling the Northeast bedroom, ceiling 10 -18 -DD -17 12"x12"ceiling tile Southeast bedroom, ceiling 10 -18 -DD -24 Scratch plaster Basement, ceiling 10 -18 -DD -281 Basement, north wall 10 -18 -DD -291 Basement, south wall 10 -18 -DD -301 Drywall no compound) Large shed, west room, west wall 10 -18 -DD -31 Discussion: Sample analyses results are reported in percentages of asbestos and non -asbestos components. The EPA defines any material that contains greater than one percent (I%) asbestos, utilizing PLM, as being an asbestos containing material. Materials that are identified as "none detected" are specified as not containing asbestos. Asbestos removal permit or notification requirements: When the quantity of ACBM to be removed exceeds "> 260 LF or 160 SF or a 55 - gallon drum", a permit or notification and a ten working day waiting. period are required before a permit is valid. These circumstances also require a notification fee of $80 for a non -friable asbestos removal or a permit fee of $400 for a friable asbestos removal. These trigger levels apply to all SFRD's which are intended to be demolished. Obtaining a State Demolition Permit: Prior to building demolition/relocation/burning, Colorado requires a state issued demolition permit. The building, or portion thereof, must be free of regulated asbestos containing materials before application for the demolition permit. There is a 10 working -day advance notification requirement for permit applications. Day 1 is the Ft business day following the postmark or hand -delivery date. (Working Day means Monday through Friday and including holidays that falls on any of the days Monday through Friday.) *Asbestos*Lead *Industrial Hygiene*Safety*Final Air Testing* *Health and Safety Training* Boulder Environmental Inc. 2400 Broadway St., Unit B, Boulder, CO 80304 Phone: (303) 382-1175 Fax: 1 (866) 699-4121 An inspector accredited by the EPA and CDPHE must sign a statement (in blue ink) certifying that the building is eligible for demolition to begin the demolition permit application process. If a demolition follows a permitted or noticed asbestos abatement project within 10 business days of the completion of the abatement project, the 10 working -day advance notification requirement will be waived. Upon request, (as it typically serves your project timeline), BEI will forward the required original application, signed in blue ink, directly to the demolition contractor if you have selected one. This way you are not deemed a courier and do not incur further inconvenience prior to beginning the ten working days after CDPHE receives the fee and application necessary to obtain a demolition permit. Emergency asbestos abatement / demolition pen -nits may be issued if project circumstances pose an immediate hazard to public health and environment. CDPHE does not typically waive permit waiting periods because of financial hardships or planning issues. Requests for emergency asbestos abatement / demolition permits must be made in writing by the building owner to: Permit Coordinator, Colorado Dept. of Public Health and Environment, APCD-SS-B 1, 4300 Cherry Creek Drive South, Denver, CO 80246- 1530, Phone: 303-692-3100, Fax: 303-782-0278, Email: cdphe.asbestos(Z�state.co.us. Please note that walk-in business address for CDPHE is different from the mailing address on CDPHE forms. Their physical address is 700 South Ash Street, Denver, Colorado. *Asbestos*Lead*Industrial Hygiene*Safety*Final Air Testing* *Health and Safety Training* Boulder Environmental Inc. 2400 Broadway St., Unit B, Boulder, CO 80304 Phone: (303) 382-1175 Fax: 1 (866) 699-4121 Conclusion: No asbestos removal is necessary prior to complete, conventional building demolition of the large shed and small (tuff) shed. Please contact Boulder Environmental Inc. and instruct us where to send the demolition notification application. CDPHE will only process complete applications, bearing the signature of a qualified building inspector signed in blue ink. Prior to application for building demolition, Boulder Environmental Inc. must verify the abatement or removal of the following asbestos containing materials: • — 50 square feet of paper and/or tape wrapped around forced air heating duct work, taped duct seams, and wall register boots • — 500 square feet of transite siding on the exterior of the garage and garage small storage room interior east wall • — 350 square feet of stipple #1 textured plaster and drywall in the hall (walls and ceiling), and common bathroom (ceiling) • — 150 square feet of rough textured drywall in the common bathroom (walls). • —700 square feet of stipple #2 textured drywall on walls in the north bedroom and northeast bedroom • — 250 square feet of slap -brush textured drywall on the walls and ceilings of the stairwell • — 125 square feet of stomp#2 textured drywall on the west wall of the east hall Further inspection of inaccessible areas must be performed prior to application for demolition to assure all regulated asbestos containing materials are properly removed prior to application for demolition: 1. Regulated asbestos containing materials may be concealed behind ceilings in the northeast and southeast bedrooms. 2. Regulated asbestos containing materials may be concealed behind drywall walls and ceilings. Workers disturbing asbestos containing materials must be OSHA/EPA trained and asbestos containing materials must be disposed of in a land -fill approved by the EPA to receive asbestos waste. *Asbestos*Lead*Industrial Hygiene* Safety* Final Air Testing* *Health and Safety Training* Boulder Environmental Inc. 2400 Broadway St., Unit B, Boulder, CO 80304 Phone: (303) 382-1175 Fax: 1 (866) 6994121 The following presumed asbestos containing materials remain in the building as long as they remain non -friable during conventional building demolition: • — 450 square feet of floor tiles and associated mastic in the kitchen, basement, common bathroom, and northeast bathroom • — 24 square feet of window caulking and glazing on 20 windows of house and 4 windows of large shed. • — 2,000 square feet of tar impregnated roofing on roof of house/garage, large shed and small shed. Non -friable asbestos containing materials as noted may remain in a building during demolition. Occupational Safety and Health Administration guidelines should be followed while disturbing or handling these materials. State of Colorado licenses and certifications for asbestos handling are not required so long as materials remain non - friable. Workers disturbing asbestos containing materials must be OSHA/EPA trained and asbestos containing materials must be disposed of in a land -fill approved by the EPA to receive asbestos waste. The following materials were determined to contain one percent asbestos or less: • — 325 square feet of bumpy plaster on ceilings in the living room, dining room, and east hall. • — 200 square feet of drywall and joint compound wall systems in the northeast bathroom (walls and ceiling), and northeast bedroom closet (walls and ceiling). Workers disturbing materials that contain 1% asbestos or less must be OSHA trained and follow OSHA handling guidelines while handling and disposing such materials. The following materials were determined to be non -asbestos -containing: • — 650 square feet of stomp 41 textured plaster in the living room (north, west and south walls), and east hall (east wall). • — 875 square feet of smooth plaster in the kitchen (walls and ceiling), north bedroom (ceiling), and southeast bedroom (walls). • — 200 square feet of 12"x12" ceiling tiles in the northeast bedroom. • — 150 square feet of 12''x12" ceiling tiles in the southeast bedroom. • 900 square feet of scratch plaster on the walls and ceiling of the basement. • 200 square feet of drywall remnants in the west room of the large shed. *Asbestos*Lead*Industrial Hygiene* Safety* Fina l Air Testing* *Health and Safety Training* Boulder Environmental Inc. 2400 Broadway St., Unit B, Boulder, CO 80304 Phone: (303) 382-1175 Fax: 1 (866) 699-4121 The results of this survey pertain only to materials tested. The laboratory reports supporting these findings above are attached. Please contact Boulder Environmental Inc. if you have any questions or concerns regarding this report. Sincerely, Chris Maron Project Manager *Asbestos*Lead*Industrial Hygiene*Safety*Final Air Testing* *Health and Safety Training* Reservoirs Environmental, Inc. Effective January 1, 2015 Reservoirs Environmental OA Manual T \DAOC\Lab\Reservoirs Environmental DA Manual doc REI T Reservoirs Environmental, /nE. October 19, 2016 Subcontract Number: NA Laboratory Report: RES 363452-2 Project # / P.O. # None Given Project Description: 11435 W. 32nd Ave Derek D'Avignon Boulder Environmental, Inc. 2400 Broadway, Unit B Boulder CO 80304 Dear Customer, Reservoirs Environmental, Inc. is an analytical laboratory accredited for the analysis of Industrial Hygiene and Environmental matrices by the National Voluntary Laboratory Accreditation Program (NVLAP), Lab Code 101896-0 for Transmission 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 363452-2 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. 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Boulder, CO 80304, Phone: (303) 382-1175, Fax: 1 (866) 699-4121, Email ChrisLl3ouiaertnvironmentai.com LOCATION• 114;r Ld 3 Z ^' O61C COMPANY BILLING INFO: &[rs ,,.,,j ;a ,pct S Demo contractor: AME: ST6yc5 iheAx6& -61111- - sjc,- g �ltZitl��u6�.tic��t�c•�� s Cv� CONSTRUCTION ER SCOPE: acomplete building demolition [}'Residential [34Gewws4ial— garW sheds fiflJrt!5[t7r8tlon mrmit w ueD w %r I n n c f -s O(iflc f 7 eamnles if>5-W0s_f SAMPLE ID MATERIAL SAMPLED BUILDING/LOCATION Z On -C C, c r 4 w 6; r3 V &L - S. w . 4� I r - C% buble cher - o ipes (radiant /domestic) flue B�nent Q,�J Transom CC SED: yawl space Basement ttic insulation type: (] R,Dof: ,� sh✓�ucc+; heck under carpeting, built up floors heck heating system(s) ype: teem, orced air, oetric bas t2rd E3`Siove FOR� euro APPLICATION FOR demo APPLICATION For Br�sd GiiMoQE ��fco1 /f �•'G-nyl asbestos floor the VAT [g VAT mastic ❑ vinyl asbestos floor tile VAT ❑ VAT mastic [gfar/asphaltti�imp�regnated roofing ❑ Asphaltic pipe coatings ar/asphalt impregnated r ng Q Asphaltic pipe coatings [9,&ulking [I dazing ❑ other Caulking ❑ Glazing other .ri&,,- S U, ti, w/ PACMD"�.�,� _ �- t -)Z A�t1EA,(s) INACCESSIBLE (( (E% mss' //VIV6 t S•t T%IZ*Wh f -K S P riv4r - ^jwS f g'r6W'0 A/ It/ 1" : C s PLES COLLECTED BY: ' A' ika DATE:1_7LqjjTIME: PLES RECEIVED BY: DATE: TIME: yq i Boulder Environmental Inc. OCATION: Rk< W - 3 ZN')A vd BULK SAMPLE LOG DATE: j�is!(� SAMPLE ID MATERIAL SAMPLED BUILDING/LOCATION Z) S'�►"'� rnL•�'`�t P'Hex, c, E 7� Sc� rte-- GJ qvo D I LX ltt •- N(x' L LIEU 11 - IV k t�#V0Sn< 5 ZAw �,I► '� �` ZX (L� 20a� Homogeneous Areas aterial Locations Quantity Z) S'�►"'� rnL•�'`�t %' 7 rL- Odra -- �$� S� S� E 7� Sc� rte-- GJ qvo D I LX ltt •- N(x' L LIEU 11 - k t�#V0Sn< 5 ZAw �,I► '� �` iIkA 20a� Page _ of 3 0 0 oulder Environmental Inc. OCATION: [143i- Lv_ 3ZNf0,4-sr BULK SAMPLE LOG DATE: Io/,Sd,G SAMPLE ID MATERIAL SAMPLED BUILDING/LOCATION ' D. - ► S n z 01"i r. &11- - vv,w -F -tv t JV /V 6e - 5. LI. - Io F '. e, 6e. Ai 6 640 - pif C m tom+ F c -C Z.o s M�- GC v - 74 12 �Z �-► 5� C 2 - Homogeneous Areas aterial Locations Quantity w /rsr�ti *A - fC o q,"w -c t] -tv t JV sa Sr '. e, 6e. Ai 6 640 - pif C m tom+ F -C Z.o s M�- GC - w f Z.tv NL`FAI-G I _ 51� ILA- - c Paga-� of .4 3 3 3 P I 3, oulder Environmental Inc. OCATION: (I J3�- 5 z /fvt" BULK SAMPLE LOG DATE: 1(1/1 0s - SAMPLE ID MATERIAL SAMPLED BUILDING/LOCATION _ t4y Z wt c Ivo Dw /vc .re- its E Set - w;Z K . W. •.� Homogeneous Areas Material Locations Quantity Z wt c Ivo Page of T 3 L7 a c v > .� Q N Y N ul 0 O C�i O � u 3 L O m a r+ c Ln > v 'c C: a o io .i M C O O 4.j > Qj �l n ti 0Qj0 L � U � Qu 0 QJ t2 0 0 U U) c .o �o — ti i O t _: Ln Qjw c O U 4- Q6) -v o Q O a U o v c v O � b v� Gl -Q � O O � w O F- u LJ a Ln Z U Z_ J Z) m r' O -4 oN U o N Lr Q Ln N O� N c 00 tp o0 Q o v Q a O •• a Z o a' 00 o m a u w m m O L 0 t' u O n Z w L a OD c E L on 0 0- m m 17 O Q) a c a a0 m m c m O J .�- W W N c u 01) O G ` a \� c U C a a 0 CY �2� � o v; c 00 C fir 04 o EA O r', E t a•6 C � Z v C L L. TT .O L4^� c .O E > cc O u U cc cn o a � x .� W INSPECTION ; RD- OccupancvlTVpe 'VANSPECTION 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. INSPECTOR, MUST SIGN ALL SPACES PERTAINING TO THIS JOB UNDATION INSPECTIONS k DATE. INSPECTOR INITIALS COMMENTS: Foo tings/Caissons wall/ (CEG) Concrete rn ased Ground - Reinforcing or Monolithic Weatherproof /French Drain Sewer Service Lines Water Service Lines POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED SLAB FLOOR nderground) F nderground) Heating (Underground) _ DO N OT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ROUGHS Sheathing Lath /Wall tie Mid-Roof Electrical Service Rough Electric Rough Plumbing Gas Piping Rough Mechanical ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING Framing Insulation Drywall Screw FINALS Electrical Plumbing Mechanical Roof Building .-Final Fire Department R.O.W & Drainage INSPECTIONS FOR PLANNING & ZONING FIRE AND PUBLICE WORKS Parking & Landscaping , SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. "`NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A CERTIFICATE OF OCCUPANCY IS ISSUFD. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION t OF A'CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. - UCCUPANGY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSI" PyROTECT THIS CARD FROM THE WEATHER ~T J r M S 'Y ♦ i CITY OF WHEAT RIDGE r Building Inspection Division 1 (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE i Inspection Type: ~fXr . Job Address: f lLl ? ~ Wt JP""Alf Permit Number: 'C ❑ No one available for inspection: Time AM/PAM f Re-Inspection required: Yes No I /11 When corrections have been made, call for re-inspection at /303-234-5933 Date: Inspector: lja Y„ r!" IfiSPrfro DO NOT REMOVE THIS NOTICE ♦ ♦ CITY OF WHEAT RIDGE V Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: ,lB9so.P,a= Job Address: V95 1v . ~i~0 Permit Number: 0,7.x,5® f AM/,r_0 ❑ No one available for inspection: Time 11,x.20 AM/PM Re-Inspection required: Yes No When corrections have been made, call for re-inspection at 303-234-5933 Date: / l_e Inspector: z ? DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: 0ir) t Job Address: ; ~t( 7 l rf' s Permit Number: 5R) a' ue~~= ❑ No one available for inspection: Time A M Re-Inspection required: Yes No "When corrections have been made, call for re-Inspection at 303-234-5933 f ~ 11 Date: 10-74~q inspector: r ds, DO NOT REMOVE THIS NOTICE ► City of Wheat Ridge rooooo"F, Residential Roofing PERMIT - 092509 PERMIT NO: 092509 ISSUED: 09/17/2009 ~ "',JOB ADDRESS: 11435 W 32ND AVE EXPIRES: 03/16/2010 te PDESCRIPTION:. T/o: Install 32.7 sqs-Tamko 30yr & I/W -shield CONTACTS owner 303/238-1849 Jeanette Patrick 'gc 303/425-1083 Matthew Rock 01-7908 Rock's Roofing PARCEL INFO S,ZONE CODE : UA USE: UA r SUBDIVISION:. 0191 BLOCK/LOT#: 0/ FEE SUMMARY ESTIMATED PROJECT VALUATION: 7,800.00 FEES Permit Fee 199.30 Total Valuation .00 tnt......r ' - Use Tax 140.40 TOTAL 339.70 Ng Conditions; --6 nail installation & mid-roof inspection required. Board sheathing spaced more q..,"than a 1/2 of an inch apart requires plywood overlay on entire roof. Ice and water shield required from save edge to 2' inside exterior walls. Subject to field inspection. `I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all r 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 applicalyl'_ Wheat idge Ordinances, for work under this permit. Plans subject to field inspection. Signature of onto ractor/owner date This permit was issued in accordance with the provisions. set. forth in your application and is subject to the laws of the State of Colorado and to the zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable t ordinances of the city. - This permit shall expire 180 days from the issue date. Requests for an extension must be received prior to expiration v^ date. An extension may be granted at the discretion of the Building Official. 3. If this permit expires, a new permit may be acquired for a fee of one-half the amount normally required, provided no changes have been or will be made in the original plans and specifications and any suspension or abandonment has not i exceeded one (1) year. If changes have been or if suspension or abandonment exceeds one (1) year, full fees shall be paid for a new permit. "4. No work of any manner shall be done that will change the natural flow of water causing a drainage problem. is ':'~5. Contractor shall notify the Building Inspector twenty-four (24) hours in advance for all inspections and shall receive written approval on inspection card before proceeding with successive phases of the job. The issuance of a permit or the approval of drawings and specifications shallnot be construed to be a permit for, nor an approval of, any violation of the provisions of the building codes or any other ordinance, law, rule or regulation. All plan review is subj t to field inspections. - „S ignature. of Chief g Official .'date - INSPECTION R UES -LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855 ;REQUESTS MUO BE. MADE. BY 3PM ANY BUSINESS DAY. FOR INSPECTION. THE FOLLOWING BUSINESS DAY.: s DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number: of wReq r P BUILDING INSPECTION LINE - 303-234-5933 Date: °m CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 - (303-235-2855) COL ORPOO APPUCATION Property Owner: J2a-n?- e Rk4-i 6 Property Address: 11t-I35 tk~' 30 d A\J Phone:31.13 -ie)L1q Contractor License No.: I 1 D Company: QV , t> Q~ P~~ 1 Ylc'~ ~ ~ , Phone: 31 L1'4~5 - I C?12y5 OWNERICONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this petvdt application are accurate, and do not violate applicable ordinances, rules or regulations ofthe City of Wheat Ridge or covenants, easements orrestrictions oftecord; 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 (U.B.C) and all other applicable Wheat Ridge rdinances, for work under this permit ----I is A /7 (OWNERXCONTRACIOR): Construction Value:$1% oo . LN Permit Fee:$ Plan Review Feel Use Tax:$ Total:$ Description: Tea ~ y\q QC-C 3 1 as p fX i.\,Q~ I Cy0.reY-c Q, 1 ~R0.~1 Q What+ S11;tnc~les, P~-`~1~ ~ ~-airvli~ ~U~f t~r;kclLq~. 0►c~ ~in~lcsh ~~-ter Side '1s Ll 112 wed ice- CLnA U.7ct,-ACr- OLLn-bey- c)Sauccy-es 3 ~ a~3 BUILDING DEPARTMENT USE ONLY SIC: Sq.Ft.: ZONING COMMENTS: Approval: Zoning: f BUILDING COMMENTS: Approval: PUBLIC WORKS COMMENTS: Approval: Occupancy: Walls: Roof: Stories: Residential Units: Electrical License No: Plumbing License No: Mechanical License No: Company: Company: Company: Expiration Date: Expiration Date: Expiration Date: Approval: Approval: Approval: (1) This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the State of Colorado and to the Zoning Regulations and Building Codes Of Wheat Ridge, Colorado or any other applicable ordinances of the City. (2) This permit shall expire if (A) the work authorized is not commenced within sixty (60) days from issue date or (B) the building authorized is suspended or abandoned fm a period of 120 days. (3) If this permit expires, anew permit may be acquired for a fee of one-half the amount normally required, provided no changes have been or will be made in the original plans andspeclfications and any suspension or abandonment has not exceeded one (1) year. If changes have been or if suspension orabandonmeN exceeds one (1) year, full fees shall be paid far a new permit. (4) No work of mymamm shall be done that will change the annual flow of water causing a drainage problem. (5) ConnactorsballnetifytheBuildingInspector twenty-foar(24)boom in advance for all inspections and shall receive written approval on inspection card before proceeding with successive phases ofthejob. (6) The issaance of a permit or the approval of drawings and specifications shall not be consmted to be a permit for, nor an approval of, any violation of the provisions of the budding codes or any other ordinance, law, ode or regulation. Chief Building Inspector