HomeMy WebLinkAbout3723-3733 Wright StreetIC) -1Z
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: t� 12 - 6�z(r FIN -l(-
Job Address:
7-7-33 (,�tllG) �r W * %
Permit Number: I C1 U
I N 00M
❑ No one available for ins ion: 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: 3-13-202-0 Inspector: r�
DO NOT REMOVE THIS NOTICE
e CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
_:�9r
INSPECTION NOTICE
Inspection Type:"
Job Address:
Permit Number: `� '?
❑ No one available for inspection: Time�� AM/PM
Re -Inspection required: Yes o
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t
When corrections have been made; -schedule for re -inspection online at:
http.I www. ci. wheatridge. co. uslinspection
Date:_5 f ( Inspector:/-k""�-------___..
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: Tim ' _(O/ AM/PM
Re -Inspection required: Yes Na
When corrections have been made, schedule for re -inspection online at:
http✓/www.ci.wheatridge.co.uslinspyonDat"� �+ specDO NOT REMIS NOTICE
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
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Insjoection Type: fill -V r-4./ SAGS 1-721A4
Job Address: 37-3-3 Gz4_re1,4r ST_
Permit Number: :�70Q 02 G5'4/
❑ No one available for inspectiorl: Time l 31 AM M
Re -Inspection required: YesI
When corrections have been made, schedule for re -inspection online at:
http://www. ci. wheatridge. co. uslinspection
Date: 3 2y Inspector: /�-t17•
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: Ti M
Re -Inspection required:Ye No
When corrections have been made, schedule for re -inspection onll-
http✓/www. ci. wheatridge.co. usfins pectipn
Date t • Insp tore
DO NOT REMOVE THIS NOTIL
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:
Job Address: ' Q r?,4 C- *-C-45 �4(
Permit Number:
❑ No one available for inspecti= ' e
1
Re -Inspection required: Yes (,,No
When corrections have been made, schedule for re -inspection online at:
http.-Iwww. ci. wheatridge. co. uslinspection
Date:, �• � Inspector: -A-
DO NOT REMOVE THIS NOTICE
�J 1
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:JobAddress:
Permit Number:
❑ No one available for inspection: Time QPM
A
Re -Inspection required: Yes', -,/No -
When corrections have been made, schedule for re -inspection online at:
http://www.ci. wheatridge.co. uslinspection
Date.'' Inspector: r�---
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: Q.,_"
Job Address: ' i c: -", — r..�
Permit Number: `'-
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❑ No one available for inspection: T`weae-'� `AM/PM
Re -Inspection required: Yes`. r N 1)
When corrections have been made, schedule for re -inspection online at:
http://www.ci.wheatridge.co.uslinspectio,�
Dater�.13- i� Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
13 ,IE� -
INSPECTION NOTICE
Inspection Type:
Job Address: 6�
Permit Number:
❑ No one available for inspection: T=e AM M.
Re -Inspection required: Yes r
When corrections have been made, siedule for re -inspection online at:
http✓/www.ci. wheatridge.co. usrnspection
Date:.. - 2—Vonp Inspector:
DO NOT REMOVE THIS NOTICE
X1141
}_, CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:
Job Address: _21?2_52
Permit Number:
CA-
❑ No one available for inspection: Ti_mef� AM/PI
Re -Inspection required: YetsfNo
When corrections have been made, schedule for re -inspection online at:
http✓/www.ci. wheatridge.co. uslinspection
Date: ` ?. ���� Inspector:
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Basement Finish PERMIT - 201902654
PERMIT NO: 201902654 ISSUED: 01/17/2020
JOB ADDRESS: 3733 Wright St EXPIRES: 01/16/2021
JOB DESCRIPTION: SWO: Basement finish including living room, 2 bedrooms, bathroom, small wet
bar.Canned lighting and outlets, new 100 AMP sub -panel, HVAC is bathroom
fan. Egress windows were installed on a different permit.
Square footage: 1000
***
CONTACTS ***
OWNER (512)585-1073
HEBERLING NATALIE
GC
(720)808-6099
STEVE LINDSEY
090296
LINCO ENTERPRISES
SUB
(303)378-1038
MARTIN O'LAUGHLIN
110059
OMNI CONSTRUCTION SERVICES
SUB
(303)594-1951
JEREMY BROWN
130009
LOGISTICS PLUMBING & HEATING
SUB
(720)244-0493
SHANE/BRANDON MCNITT
160036
MCNITT BROTHERS HEATING & AIR
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 32,500.00
FEES
Total Valuation 0.00
Plan Review Fee 347.13
Use Tax 682.50
Permit Fee 534.05
Investigative Fees 534.05
** TOTAL ** 2,097.73
*** COMMENTS ***
*** CONDITIONS ***
Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all
applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections.
NOT APPROVED AS AN INDEPENDENT DWELLING UNIT.
� A . City of Wheat Ridge
Residential Basement Finish PERMIT - 201902654
PERMIT N0: 201902654 ISSUED: 01/17/2020
JOB ADDRESS; 3733 Wright St EXPIRES: 01/16/2021
JOB DESCRIPTION: SWO: Basement finish including living room, 2 bedrooms, bathroom, small wet
bar.Canned lighting and outlets, new 100 AMP sub -panel, HVAC is bathroom
fan. Egress windows were installed on a different permit.
Square footage: 1000
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 f er attest am le ally authorized to include all entities named within this document as parties to the work to be
per
tha all wo to peirmed is disclosed in this document and/or its' accompanying approved plans and specifications.
0
Signatur ,O R or CONTRACTOR (Circle one) Daae
I. This// a it was issued based on the information provided in thepermit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, po Flans
and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees 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 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, anviolation of any provision of any
applicable c�or any ordinalcp 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.
City of
�W heat midge
MUNITY DEVELOPMENT
Building & Inspection Services
7500 W. 29t' Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(cDci.wheatridge.co.us
FOR OFFICE USE ONLY
Date:
PlaniPermit #
Plan Review Fee:
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address:
Propertv Owner
Property Owner Email:
Tenant Name (Commercial Projects Only)
Phone: 57Z - Sr�'r. I6 73
Property Owner Mailing Address: (if different than property address)
Address:
City, State, Zip:
Arch itect/Eng1neer:
Architect/Engineer E-mail:
Contractor Name: L'�' �G �� •`S `s, L
City of Wheat Ridge License #:
Phone:
Phone: _?0 3- s2L -0 7,eej
Contractor E-mail Address:
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): - J • ,M rl4lee e-- Phone: 3 0-3 93 Gdp
CONTACT EMAIL(p/ease print): S e 5-"-rl-C"%"
-tm0a /eer �h S ijnw"/-e-e»--,
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Complete all highlighted fields, if applicable.
❑COMMERCIAL
RESIDENTIAL
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, square footage, existing condition and
proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.
Sq. Ft./LF R BTUs
Gallons
Amps Squares For Solar: KW # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type: _
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
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 orovided-on*ham apaUcation.
CIRCLE ONE: (OWNER) (CONTRACT or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Si¢nature (first andlastname): DATE: l /i
Printed Name: Ti,I i 01 2
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: 0
CONSTRUCTION TYPE:
Reviewer:
BUILDING
7DEPAZ,,:COMMENTS
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
Building Division Valuation: �"
5366 Godding Hollow Pkwy
EARTH ENERGY ENVIRONMENT (E3) Longmont, CO 80504
Local: 303.902-5851
Industrial Hygiene and Environmental Engineering
January 13, 2020
Mr. Cody Gordon
Xtract Environmental Services
(970) 282-4333
cody(a�xtractes.com
Subject: Ambient Monitoring Samples
3733 N Wright Street
Wheat Ridge, CO 80033
Dear Mr. Gordon:
�,Ojqolll�s y
Following is the ambient sampling report for the property located at 3733 N Wright Street in Wheat
Ridge, CO 80033. The purpose of this report is to document ambient air sample results for the
interior of a property where a fiber release was suspected to have occurred.
An Industrial Hygienist for Earth Energy Environment (E3) performed the ambient air sampling
procedure. Five (5) ambient samples were collected inside of the property where the fiber release
was suspected to have occurred.
Phase Contrast Microscopy (PCM) samples were collected in accordance with the National
Institute for Occupational Safety and Health (NIOSH) method 7400 using cassettes (standard 3
piece, 25 mm dia., 0.8 um NICE filter) purchased from Zefon International, Inc. The asbestos
concentrations in the containment were calculated as airborne fibers per cubic centimeter of air
(F/cc). Table 1 provides a summary of the sample numbers, sample volumes, and calculated
concentrations. The National Emission Standards for Hazardous Air Pollutants (NESHAP)
clearance standard is 0.01 F/cc
PCM Air Clearance
Page 2 of 2
TABLE 1: PCM AIR SAMPLING RESULTS
Date
Unit/ Area
Sample #
ple
Description
Same
Volume
Fibers/cc
Ambient Air
CL -011120-1
955
0.001
Sampling
CL -011120-2
Unit
940
0.002
at:
CL -011120-3
Interior
930
0.001
January
3733 N Wright
CL -011120-4
920
0.001
11, 2019
Street in Wheat
CL -011120-5
915
0.001
Ridge, CO 80033
(Interior Area)
BLK-1
Blanks
-
BRL
BLK-2
-
BRL
*BRL denotes "Below Reporting Limits". The PCM Colorado Department of Public Health and
Environment (CDPHE) clearance standard is 0.01 F/cc.
Conclusion
E3 did not find any suspect dust or debris within the property at the time of the sampling. These
findings along with the air sample results indicate that indoor amplification of asbestos is not
occurring within the property.
Thank you for allowing E3 the opportunity to provide environmental services to you. If you have
questions or require additional information, do not hesitate to contact me directly at (303) 902-5851.
Sincerely,
Eli Willden
Certified Air Monitoring Specialist #20139
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DocuSign Envelope ID: EOC36A8542144240-B42A-48OD26A71A30
Dear CDPHE,
We hired LinCo Construction to perform some work in our home at 3733 Wright St, Wheat Ridge CO.
that resulted in a spill. After 60 sq. ft. had been removed, they realized asbestos could be an issue and
had it tested before any further work was performed. Unfortunately, asbestos was present, and all
production has been stopped until Xtract Environmental Services completes the abatement. We have
relocated for the time being but need our home back in working order as soon as possible. For this
reason, we are asking for a waiver of the 10 day wait on our permit and that you kindly accept our
emergency request. Please let us know if you have any questions.
Thank you,
Natalie Heberling
3733 Wright St
Wheat Ridge, Colorado 80033
�j (A� as k "e'beYl�")
�D�oc'u�Signed by:
;;��
C42E885AFE874E7_.
1/7/2020
Xtract Environmental Services
DocuSign Envelope ID: E651C92D-346E-48A0-B9D1-E6570B9C16C9
COLORADO
Department of Public
Health b Environment
Dedicated to protecting and improving the health and environment of the people of Colorado
Date: 1/7/2020
Customer Information
Company/Individual Name: Xtract Environmental Services / Cody Gordon
Company/Individual Address: 713 not Evans Ave
City: Severance State: Colorado Zip: 80550
Telephone Number: 970-818-7860 Fax: 970-818-7840
Email: Cody@XtractES.com
Payment Information
Payment Amount:
e i an
Payment is for (example: Site or name for APEN or Asbestos permit/ certification etc):
Asbestos Permit
Printed Name of Person on Card: Cody B Gordon
DoeuSigned by:
IEC42E
Cardholder Signature: Date:
Credit Card Number: "** *"' "" 9338
Expiration Date: 08/23
3 -Digit Code: 813
(For office use only)
1/7/2020
Fee Type (Circle): Asb Permit Asb Demo Asb Cert/Class Ld Cert Ld Permit APEN/GP CEC Forms
4300 Cherry Creek Drive S, Denver, CO 80246-1530 P 303-692-2000 www.colorado.gov/cdphe
John W. Hickenlooper, Governor I Larry Wolk, MD, MSPH, Executive Director and Chief Medical Officer
December 27, 2019
Jason Polston
Linco Enterprises
5171 Ward Road, Unit 1
Wheatridge, Co. 80033
Dear Mr. Polston:
P,-
_� T11oz-
Asbestos-Certified
- Building Inspector
RRP Lead Certified
I am pleased to submit this report summarizing an Asbestos Containing Materials
Inspection. The enclosed report details the fieldwork and analytical results
of samples collected. These services were provided to assist with the planning of
asbestos abatement activities for the property. This asbestos inspection was conducted
for the purpose of identifying the presence of Asbestos Containing Materials (ACM)
in the area of the residential property that is part of the scope of work, communicated
to Jacque Dussex, by Jason Polston of Linco Enterprises, as required by State and/or
Federal agencies. This work was authorized by you on December 26, 2019.
I sincerely appreciate the opportunity to provide this service for this project. If you have
any questions regarding this report, please contact Jacque Dussex at (720) 503-6702.
Sincerely,
bwj��.
Jacque Dussex
AHERA/State of Colorado -Accredited Asbestos Building Inspector #21632
Registration No.: ACF - #21635
Asbestos Containing Materials Sampling
Inspection Report
3733 Wright Street
Wheatridge, Colorado 80033
Prepared For:
Linco Enterprises
5171 Ward Road, Unit 1
Wheatridge, Co 80033
Date Prepared:
December 27, 2019
Prepared By:
Jacque Dussex
PO Box 694
Fort Lupton, Co 80621
Table of Contents
1.0 Introduction........................................................
2.0 Field Activities.....................................................
2.1 Building Description & Visual Assessment
2.2 Physical Assessment & Sample Collection
3.0 Laboratory Analysis .............................................
4.0 Regulatory Overview ...........................................
5.0 Findings.................................................................
5.1 Identified Asbestos Containing Materials
6.0 Conclusions & Recommendations .....................
6.1 Major and Minor Asbestos Spill Response Action ...........
7.0 Limitations............................................................
8.0 Photos...................................................................
9.0 Homogeneous Areas Table ............................................
1.0 INTRODUCTION
It is my understanding that there are planned renovation activities at the above referenced address.
Per the United States Environmental Protection Agency (EPA) procedures, published in Code of
Schools and Colorado Regulation 8 (Regulation 8), suspect Asbestos Containing Building Materials
(ACBM) must be properly sampled and analyzed prior to any renovation, restoration, or demolition
activities. EPA regulation 40 CFR 61, National Emission Standards for Hazardous Air Pollutants
(NESHAP), prohibits the release of asbestos fibers to the atmosphere during renovation, restoration,
or demolition activities. The asbestos NESHAP requires that potentially regulated Asbestos Containing
Materials (ACM) be identified, classified, and quantified prior to planned disturbances or demolition
activities. All friable ACM and non — friable ACM that can be rendered friable during demolition
activities must be removed by a licensed general abatement contractor prior to demolition.
The purpose of this sampling was to evaluate for the presence of any ACM in the designated wall
components located in the 1 st level northwest guest bathroom shower surround of this residential
property. The inspection was conducted in accordance with Regulation 8. These inspection protocols
specify requirements for the inspector (Section 763.8), laboratory (Section 763.87), and number of
samples collected during an inspection (Section 763.86).
2.0 FIELD ACTIVITIES
I conducted an asbestos inspection and sampling of the structure located at 3733 Wright Street,
Wheatridge, Co. 80033. The inspection and sampling were conducted on December 26, 2019,
by a Colorado State Certified Asbestos Building Inspector. The inspection and sampling were
conducted in general conformance with the sampling protocols established by 40 CFR 763 and
Regulation 8.
2.1 Building Description & Visual Assessment
My inspection and sampling activities began with visual observation of the designated wall
components located in the 1 st level northwest guest bathroom shower surround to identify
homogeneous areas of suspect ACM. Subtopics 2.2 and 9.0, contain a list of the homogeneous
areas developed for sampling at the subject property. A homogeneous area consists of materials
which appear similar throughout in terms of appearance, color, texture, and date of application.
2.2 Physical Assessment & Sample Collection
A physical assessment of the homogeneous areas of suspect ACM was conducted to assess the
general condition of the materials and determine the friability of the materials. The EPA defines
a friable material as one which, when dry, can be crumbled, pulverized, or reduced to powder by
hand pressure. Non -friable materials cannot be crumbled, pulverized, or reduced to powder by
hand pressure when dry. Friability was assessed by physically touching suspect materials.
Based on the results of the visual observation, bulk samples of suspect ACM were collected in
general conformance with AHERA protocols. Random bulk samples of suspect materials were
collected in the homogeneous areas, using wet methods as applicable to reduce the potential for
fiber release.
Three (3) suspect surfacing ACM samples of Orange Peel Texture were collected from the
homogeneous area (HA #1): 1st Level Northwest Guest Bathroom Shower Surround east wall,
north wall, and west wall.
Three (3) suspect miscellaneous ACM samples of Joint Compound and Pink Drywall were
collected from the homogeneous area (HA #A): l st Level Northwest Guest Bathroom Shower
Surround east wall, north wall, and west wall.
Two (2) suspect miscellaneous ACM samples of Porcelain Wall Tile Tan Glue were collected
from the homogeneous area (HA #B): 1st Level Northwest Guest Bathroom Shower Surround
east wall and north wall.
Samples were placed in sealable containers and labeled with unique sample numbers using an
indelible marker.
3.0 LABORATORY ANALYSIS
The bulk samples were submitted under chain of custody procedures to EMSL of Denver, Co. for
analysis by PLM with dispersion staining techniques per EPA methodology ( 40 CFR 763, Subpart F )
Microscopic visual estimation was used in obtaining the percentage of asbestos in bulk samples.
EMSL is accredited under the National Voluntary Laboratory Accreditation Program (NVLAP).
4.0 REGULATORY OVERVIEW
Title 40 Code of Federal Regulations (CFR) Part 61, regulates asbestos fiber emissions and asbestos
waste disposal practices. It also requires the identification and classification of existing building
materials prior to demolition or renovation activity. Under NESHAP, asbestos containing building
materials are classified as either friable, Category I non — friable, or Category II non — friable ACM.
Friable materials are those that, when dry, may be crumbled, pulverized, or reduced to powder by
hand pressure. Category I non — friable ACM includes packings, gaskets, resilient floor coverings,
and asphalt roofing products. Category 11 non — friable ACM are any materials other than Category I
materials that contain more than 1 % asbestos.
Friable ACM, Category I, and Category II non- friable ACM, which is in poor condition and has
become friable or which will be subjected to drilling, sanding, grinding, cutting, or abrading and
which could be crushed or pulverized during anticipated renovation, restoration, or demolition
activities, are regulated ACM (RACM). RACM must be removed prior to renovation or demolition
activities, regardless of the amount of asbestos materials present. If the amount of RACM exceeds
260 linear feet of pipe insulation or more than 160 square feet in other building components in a
commercial building, or 50 linear feet of pipe insulation or 32 square feet in other building components
in a private residence, the owner or operator must provide the EPA, the State of Colorado Department
of Public Health and Environment — Air Pollution Control Division, with written notifications of
planned removal activities, at least ten (10) working days prior to the commencement of asbestos
abatement activities. Removal of RACM must be conducted by a trained and appropriately licensed
asbestos abatement contractor.
*The Occupational Safety and Health Administration (OSHA) Asbestos standard for the construction
industry (29 CFR 1926.1101), regulates workplace exposure to asbestos. Adherence to OSHA
regulations, regarding occupational exposure during renovation, restoration, and demolition activities
is also mandatory. The OSHA standard requires that employee exposure to airborne asbestos fibers
be maintained below 0.1 asbestos fibers per cubic centimeter of air (0.1 f/cc). The OSHA standard
classifies construction and maintenance activities, which could disturb ACM, and specifies work
practices and precautions which employers must follow when engaging in each class of regulated work.
5.0 FINDINGS
Suspect ACM includes nearly all building materials except glass, natural wood, metal, or rubber.
RACM contains asbestos greater than 1 percent, (> I% asbestos) as confirmed by an accredited
laboratory.
5.1 IDENTIFIED ASBESTOS CONTAINING MATERIAL
Based on the completed PLM results, asbestos was detected in the following materials.
The locations of these materials can be found in Subtopic 6.0.
Friable ACM:
Samples 01,02,03 (HA #1) - The Orange Peel Texture sampled from the 1st Level
Northwest Guest Bathroom Shower Surround east wall, north wall, and west wall
contains .75% - 1.50% Chrysotile.
Samples 01,02,03 (HA #A) - The Joint Compound sampled from the 1 st Level
Northwest Guest Bathroom Shower Surround east wall, north wall, and west wall
contains .75% - 1.50% Chrysotile.
6.0 CONCLUSIONS & RECOMMENDATIONS
The Orange Peel Texture located on the 1st Level Northwest Guest Bathroom Shower Surround
east wall, north wall, and west wall (HA #1) contains .75% - 1.50% asbestos.
The Joint Compound located on the 1st Level Northwest Guest Bathroom Shower Surround
east wall, north wall, and west wall (HA #A) contains .75% - 1.50% asbestos.
*The friable ACM identified in Section 5.1 and 6.0 above, must be removed by a Colorado certified
General Abatement Contractor (GAC) prior to renovation/demolition activities.
6.1 Major and Minor Asbestos Spill Response Action
If the total quantity of significantly damaged ACM spilled, exceeds the regulatory trigger levels,
the area is deemed a "Major Asbestos Spill". The area is consequently subject to the requirements
in Regulation 8, Section III.T.1., Major Asbestos Spills. In the event that an asbestos spill involves less
than or equal to the trigger levels, the building owner or contractor should follow the protocol outlined
in Regulation 8, Section III.T.2., Minor Asbestos Spills. Additional asbestos air or dust sampling
should also be conducted within the remaining areas not directly impacted by the Major Asbestos Spill,
to determine if asbestos -containing dust/debris has spread to adjacent areas. If asbestos fibers are
found within any other areas, or on building contents, they should be included in the scope of
professional abatement and decontamination.
Adherence to the Occupational Safety and Health Administration (OSHA) Asbestos Standard for
the construction industry (29 CFR 1926.110 1), is also mandatory.
*The Major Asbestos Spill originates in the 1 st level northwest guest bathroom, and is a result of the
removal of approximately 70 square feet of RACM: Partial removal of the Shower Surround east wall,
north wall, and west wall. The building owner or contractor should follow the protocol outlined in
Regulation 8, Section III.T.I., Major Asbestos Spills.
7.0 LIMITATIONS
This asbestos inspection was conducted in a manner consistent with the level of care and skill
ordinarily exercised by a member of the profession, currently practicing under similar conditions in
the same locale. The results, findings, conclusions, and/or recommendations expressed in this report,
are based on conditions during my renovation specific inspection of the property. The information
contained in this report, is relevant to the date on which this survey was performed, and should not
be relied upon to represent conditions on a later date. This survey and inspection is considered
a comprehensive inspection, specifically conducted for the renovation of the designated area
in this residential property. Care was taken to sample the accessible materials that are discussed in
this report. Sampling was accomplished using random/representative sampling protocols.
This report has been prepared on behalf of and exclusively for use by the client. Contractors or
consultants reviewing this report must draw their own conclusions, regarding further investigation
or remediation deemed necessary. Jacque Dussex does not warrant the work of regulatory agencies
or other third parties supplying information which may have been used in the preparation of this report.
Jacque Dussex assumes no liability for any loss, injury, claim, or damages arising directly or indirectly
from any use of or reliance on this inspection report or the opinions expressed herein. Jacque Dussex
makes no risk assessment, warranty, guarantee, or insurance policies of any kind, express or implied.
This report was prepared pursuant to the contract Jacque Dussex has with the client, including an
exchange of information about the property, that was unique and between Jacque Dussex and her client.
No guarantees are made arising from any service rendered. Liabilities hereunder, shall not exceed the
total fee paid by the client and Jacque Dussex. No warranty, express or implied is made.
This report does not serve as a scope of work or bidding document.
Should you have any questions or require additional information, please feel free to contact
Jacque Dussex at (720) 503-6702
Sincerely,
Jacque Dussex
AHERA/ State of Colorado- Accredited Asbestos Building Inspector #21632
Registration No.: ACF - #21635
8.0 PHOTOS
Front of Home
Built in 1967
viii
Address of Home
Photo of Asbestos Containing Material:
Orange Peel Texture (HA #1) =.75% - 1.50% Chrysotile
Joint Compound (HA #A) =.75% - 1.50% Chrysotile
9.0 Homogeneous Areas Table
HA— Homogeneous Area SM — Surfacing Material G - Good
FID — Non -Detect MM — Miscellaneous D - Damaged
C. - Chrysotite TSI — Thermal System Insulation SD — Significantly Damaged
---.._
HA #
----
Sample
Nurrbe
- .-----_--------
Maleria4 Oescrttian
---- --- — ---
Same% Location
----
Material
CYassification
_..
Material
Condition
---
Apprnrmnate
Quantity
- - --
Friable or
Non -Friable
-------- _-----
Asbestos
Content
1
I
01
Orange Peel
Texture
1' Lead N.W-Guest
8athmom Shower Summa
E.Watl
SM
SD
70 SF
F
1.25%C.
A
01
Joint Campaundf
Pir* Drywall
Y level NAV -West
Batlmoam Shower Su nmrd
E.Wall
MM
SD
70 SF
F
Joint C-=
.75%C.
B
01
Wall Tile Tan Glue
1' L&M N.w.Guest
Bathmo , S mw Surround
E.Wah
MM
SD
70 SF
Non
ND
1
02
Grange Peel
Texture
1' levet N.W_Guest
MmomShowerSurround
SM
SD
70 SF
F
1..50%C.
A02
Joint Compoundf
Pmts Drywall
t'tfwel N.W_Gtre�
BWJWM N.1 ShOwrSumnd
MM
5D
70 SF
F
Jc>intC_ —
1 M%C.
B
02
Wall Tile Tan Glue
1' level N.W_Gues
Bathmom Shower Surraxxrrd
N.Wai
MM
SD
70 SF
Non
ND
1
03
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Texture
Bahmmm Sh Sumud
W -
SD
70 SF
F
75%C.
A
03
Joint Cornlwundf
Pink Drywall!
1' Level FCW-Gueg Balm=
�troser suraab w.War
MM
SD
70 SF
F
Joint C=
75%C.
I
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Jacqueline Dussex Fac
PO Baa W Received Date: 1:,'2512019 11:20 AM
Fart Lupton, CO 80821 Analysis Date: 12'2812019
Collected Date:
Project 12-i9-1211"3733 WP.IGHTST, WHEATRIDGE. CO
Test R2jmrt: Asbestos Analysis of Bulk Materials via EPA 6 aq?-9X196 Method using Patenzed
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Attention: Jacque Dussex Phone: (7211) 5024702
Jacqueline Dussex Fac
PO Bar 694 Received: 12r -)B t119 11:20 AM
Fart Lupton, CO 50621 Analysis Date: 1297=19
Collected:
Prcgeet 12-19-12D-3733 WRIGHT ST, WHEAMIDGE, COMM
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-931116 Method using
Polarized Light Microscopy. Quantitation using 400 Point Count Procedure
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Atte ben: Jacque Dussex Phone: ; t2131— f—C 'tTM,
Jacqueline Dussex Fac
PO Bane 694 Received: 12126d2t119 11:2D AM
Fort Lupton. CO 80621 Analysis state: 12427,2018
Collected:
Project 12-19-120 733 VVRIGRT ST, VO EATRIDGE. CO BDM3
Test Report: Asbestos Analysis of Bulk Materials via EPA 6001R-931116 Method using
Polarized Light Microscopy. Glusntitation using 400 Point Count Procedure
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Colorado Department
of Public Health
and Environment
ASBESTOS
CERTIFICATION*
This certifies that
Jacqueline R. Dussex
Certification No.: 21632
has met the requirements of 25-7-507, C.R.S. and Air Quality Control
Commission Regulation No. 8, Part B, and is hereby certified by the
state of Colorado in the following discipline:
Building Inspector*
Issued: November 20, 2018
Expires: January 02, 2020
* This certificate is valid only with the possession ofa /
current Division -approved training course certification
in the discipline specified above
thor' d ADCCRepresentative
SEAL
.c
1876
Colorado Department
of public Health
and Environment
ASBESTOS CONSULTING FIRM
This certifies that
Jacque Dussex
Registration No.: ACF - 21635
has met the registration requirements of 25-7-507, C.R.S. and the Air Quality Control
Commission Regulation No. 8, Part B, and is hereby authorised to perform asbestos consulting
activities as required under Regulation No 8, Part B, in the state of Colorado.
Issued: December 03, 2019
Expires: December 30, 2020
Auftrized AFCD Representative
SEAL
RECEIVED
Lary 01
W heatI�idg�_-----
COMMUNITY DEVELOPMENT
SUB—CONTRACTOR AUTHORIZATION FORM
This form must be signed by each sub -contractor.
This form will not be accepted with missing information.
Subcontractor's City of Wheat Ridge License number must be provided in the applicable space.
Subcontractor's insurance and license must be up to date prior to permit issuance.
Project Address: 3733 f,/ /t .S1- Permit #:
General Contractor: &wc C6
Electrical Sub -Contractor
Company Name: 0~/ �sAlIt--, 5,_T fiie*:
State License
Master #:
W t Ridge Lic se (required field)
C� L s-
ignature of A' thorized Ag Date
Plumbing Sub -Contractor
Company Name: &y 13 /fr--S • Phone #:
State License #: Master #:
Wheat Rid a License #:
'gnature o horized Agent
Mechanical Contractor
(required field)
0-1.x 19.
Date
Company Name: A,? 1-Y 131-e - Phone:
Whe 'dge License #: (required field)
;2r
/r' 121?11 -s.
*fi`atur4 of Aut orized Agent Date
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Basement Specs
Finished sgft - 1,015
Floor - concrete slab
Ceiling Height - T4"
Access - window
Framing Specs
Standard install
HVAC Specs
Misc - just bath fan
Misc - Dryer vent
Plumbing Specs
Bathroom
Tub - 5ft standard white
Toilet - Standard
Vanity - Double sink per plan
Net Bar
Sink - standard with GD
Misc - Water line to fridge
Misc - Baseboard heat
Misc - Washer hookups
Electrical Specs
Standard install
Sub panel - Yes
Misc - (3) coax
Misc - Washer/dryer hookups
Insulation Specs
Walls - R1 q batt
Ceilings - R1 Cl finished areas
Contractor Layout
26
r-------------------------—
2618L5
------------------------
--- ------------
2618L5
Working Plan View
Drywall Specs
Texture - Knockdown
Bead - 5quare
Windows - 3 sides
Window Specs
Cb Egress windows - install (2)
N new egress windows and wells
Windows - all mini windows replace
(WKL
Pe. _
NOT APPROVED AS AN
INDEPENDENT DWELLING UNIT
City of
"" Wh�.c�t Ri
COMMUNI TY I)LVLL( W&*N I
APPROVED
Contractor:
The Basement Sanctuary
51'11 Ward Rd Unit 1
Wheat Ridge, c0 80033
Phone:'120-808-60gq
thebasementsanctuary.com
0
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U
X
LU
-7
Homeowner Information:
Natalie Heberling
3133 Wright 5t
Wheat Ridge, CO
Ph: 512-585-1013
3
(�
P11 Examiner We
N
�• Wlidkv 0 permit The issuOnce of a pomit or appreral of pts sperri
3 '
and computations shall not be o permit , or on o
lv pprovoloj, Ony vro
MW of the provisions aj the budding code or of aM City ardr
paaer*V to give authority to vlolohl or t once! the provajopm of the
COM or other ordnanoes of the 0tv shall not be woU
L_
City of Wheat Ridge
Residential Basement Finish PERMIT - 201902654
PERMIT NO: 201902654 ISSUED: 01/17/2020
JOB ADDRESS: 3733 Wright St EXPIRES: 01/16/2021
JOB DESCRIPTION: SWO: Basement finish including living room, 2 bedrooms, bathroom, small wet
bar.Canned lighting and outlets, new 100 AMP sub -panel, HVAC is bathroom
fan. Egress windows were installed on a different permit.
Square footage: 1000
***
CONTACTS ***
OWNER (512)585-1073
HEBERLING NATALIE
GC
(720)808-6099
STEVE LINDSEY
090296
LINCO ENTERPRISES
SUB
(303)378-1038
MARTIN O'LAUGHLIN
110059
OMNI CONSTRUCTION SERVICES
SUB
(303)594-1951
JEREMY BROWN
130009
LOGISTICS PLUMBING & HEATING
SUB
(720)244-0493
SHANE/BRANDON MCNITT
160036
MCNITT BROTHERS HEATING & AIR
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 32,500.00
FEES
Total Valuation 0.00
Plan Review Fee 347.13
Use Tax 682.50
Permit Fee 534.05
Investigative Fees 534.05
** TOTAL ** 2,097.73
*** COMMENTS ***
*** CONDITIONS ***
Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all
applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections.
NOT APPROVED AS AN INDEPENDENT DWELLING UNIT.
� A . City of Wheat Ridge
Residential Basement Finish PERMIT - 201902654
PERMIT N0: 201902654 ISSUED: 01/17/2020
JOB ADDRESS; 3733 Wright St EXPIRES: 01/16/2021
JOB DESCRIPTION: SWO: Basement finish including living room, 2 bedrooms, bathroom, small wet
bar.Canned lighting and outlets, new 100 AMP sub -panel, HVAC is bathroom
fan. Egress windows were installed on a different permit.
Square footage: 1000
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 f er attest am le ally authorized to include all entities named within this document as parties to the work to be
per
tha all wo to peirmed is disclosed in this document and/or its' accompanying approved plans and specifications.
0
Signatur ,O R or CONTRACTOR (Circle one) Daae
I. This// a it was issued based on the information provided in thepermit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, po Flans
and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees 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 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, anviolation of any provision of any
applicable c�or any ordinalcp 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.
City of
�W heat midge
MUNITY DEVELOPMENT
Building & Inspection Services
7500 W. 29t' Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(cDci.wheatridge.co.us
FOR OFFICE USE ONLY
Date:
PlaniPermit #
Plan Review Fee:
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address:
Propertv Owner
Property Owner Email:
Tenant Name (Commercial Projects Only)
Phone: 57Z - Sr�'r. I6 73
Property Owner Mailing Address: (if different than property address)
Address:
City, State, Zip:
Arch itect/Eng1neer:
Architect/Engineer E-mail:
Contractor Name: L'�' �G �� •`S `s, L
City of Wheat Ridge License #:
Phone:
Phone: _?0 3- s2L -0 7,eej
Contractor E-mail Address:
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): - J • ,M rl4lee e-- Phone: 3 0-3 93 Gdp
CONTACT EMAIL(p/ease print): S e 5-"-rl-C"%"
-tm0a /eer �h S ijnw"/-e-e»--,
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Complete all highlighted fields, if applicable.
❑COMMERCIAL
RESIDENTIAL
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, square footage, existing condition and
proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.
Sq. Ft./LF R BTUs
Gallons
Amps Squares For Solar: KW # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type: _
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
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 orovided-on*ham apaUcation.
CIRCLE ONE: (OWNER) (CONTRACT or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Si¢nature (first andlastname): DATE: l /i
Printed Name: Ti,I i 01 2
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: 0
CONSTRUCTION TYPE:
Reviewer:
BUILDING
7DEPAZ,,:COMMENTS
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
Building Division Valuation: �"
5366 Godding Hollow Pkwy
EARTH ENERGY ENVIRONMENT (E3) Longmont, CO 80504
Local: 303.902-5851
Industrial Hygiene and Environmental Engineering
January 13, 2020
Mr. Cody Gordon
Xtract Environmental Services
(970) 282-4333
cody(a�xtractes.com
Subject: Ambient Monitoring Samples
3733 N Wright Street
Wheat Ridge, CO 80033
Dear Mr. Gordon:
�,Ojqolll�s y
Following is the ambient sampling report for the property located at 3733 N Wright Street in Wheat
Ridge, CO 80033. The purpose of this report is to document ambient air sample results for the
interior of a property where a fiber release was suspected to have occurred.
An Industrial Hygienist for Earth Energy Environment (E3) performed the ambient air sampling
procedure. Five (5) ambient samples were collected inside of the property where the fiber release
was suspected to have occurred.
Phase Contrast Microscopy (PCM) samples were collected in accordance with the National
Institute for Occupational Safety and Health (NIOSH) method 7400 using cassettes (standard 3
piece, 25 mm dia., 0.8 um NICE filter) purchased from Zefon International, Inc. The asbestos
concentrations in the containment were calculated as airborne fibers per cubic centimeter of air
(F/cc). Table 1 provides a summary of the sample numbers, sample volumes, and calculated
concentrations. The National Emission Standards for Hazardous Air Pollutants (NESHAP)
clearance standard is 0.01 F/cc
PCM Air Clearance
Page 2 of 2
TABLE 1: PCM AIR SAMPLING RESULTS
Date
Unit/ Area
Sample #
ple
Description
Same
Volume
Fibers/cc
Ambient Air
CL -011120-1
955
0.001
Sampling
CL -011120-2
Unit
940
0.002
at:
CL -011120-3
Interior
930
0.001
January
3733 N Wright
CL -011120-4
920
0.001
11, 2019
Street in Wheat
CL -011120-5
915
0.001
Ridge, CO 80033
(Interior Area)
BLK-1
Blanks
-
BRL
BLK-2
-
BRL
*BRL denotes "Below Reporting Limits". The PCM Colorado Department of Public Health and
Environment (CDPHE) clearance standard is 0.01 F/cc.
Conclusion
E3 did not find any suspect dust or debris within the property at the time of the sampling. These
findings along with the air sample results indicate that indoor amplification of asbestos is not
occurring within the property.
Thank you for allowing E3 the opportunity to provide environmental services to you. If you have
questions or require additional information, do not hesitate to contact me directly at (303) 902-5851.
Sincerely,
Eli Willden
Certified Air Monitoring Specialist #20139
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DocuSign Envelope ID: EOC36A8542144240-B42A-48OD26A71A30
Dear CDPHE,
We hired LinCo Construction to perform some work in our home at 3733 Wright St, Wheat Ridge CO.
that resulted in a spill. After 60 sq. ft. had been removed, they realized asbestos could be an issue and
had it tested before any further work was performed. Unfortunately, asbestos was present, and all
production has been stopped until Xtract Environmental Services completes the abatement. We have
relocated for the time being but need our home back in working order as soon as possible. For this
reason, we are asking for a waiver of the 10 day wait on our permit and that you kindly accept our
emergency request. Please let us know if you have any questions.
Thank you,
Natalie Heberling
3733 Wright St
Wheat Ridge, Colorado 80033
�j (A� as k "e'beYl�")
�D�oc'u�Signed by:
;;��
C42E885AFE874E7_.
1/7/2020
Xtract Environmental Services
DocuSign Envelope ID: E651C92D-346E-48A0-B9D1-E6570B9C16C9
COLORADO
Department of Public
Health b Environment
Dedicated to protecting and improving the health and environment of the people of Colorado
Date: 1/7/2020
Customer Information
Company/Individual Name: Xtract Environmental Services / Cody Gordon
Company/Individual Address: 713 not Evans Ave
City: Severance State: Colorado Zip: 80550
Telephone Number: 970-818-7860 Fax: 970-818-7840
Email: Cody@XtractES.com
Payment Information
Payment Amount:
e i an
Payment is for (example: Site or name for APEN or Asbestos permit/ certification etc):
Asbestos Permit
Printed Name of Person on Card: Cody B Gordon
DoeuSigned by:
IEC42E
Cardholder Signature: Date:
Credit Card Number: "** *"' "" 9338
Expiration Date: 08/23
3 -Digit Code: 813
(For office use only)
1/7/2020
Fee Type (Circle): Asb Permit Asb Demo Asb Cert/Class Ld Cert Ld Permit APEN/GP CEC Forms
4300 Cherry Creek Drive S, Denver, CO 80246-1530 P 303-692-2000 www.colorado.gov/cdphe
John W. Hickenlooper, Governor I Larry Wolk, MD, MSPH, Executive Director and Chief Medical Officer
December 27, 2019
Jason Polston
Linco Enterprises
5171 Ward Road, Unit 1
Wheatridge, Co. 80033
Dear Mr. Polston:
P,-
_� T11oz-
Asbestos-Certified
- Building Inspector
RRP Lead Certified
I am pleased to submit this report summarizing an Asbestos Containing Materials
Inspection. The enclosed report details the fieldwork and analytical results
of samples collected. These services were provided to assist with the planning of
asbestos abatement activities for the property. This asbestos inspection was conducted
for the purpose of identifying the presence of Asbestos Containing Materials (ACM)
in the area of the residential property that is part of the scope of work, communicated
to Jacque Dussex, by Jason Polston of Linco Enterprises, as required by State and/or
Federal agencies. This work was authorized by you on December 26, 2019.
I sincerely appreciate the opportunity to provide this service for this project. If you have
any questions regarding this report, please contact Jacque Dussex at (720) 503-6702.
Sincerely,
bwj��.
Jacque Dussex
AHERA/State of Colorado -Accredited Asbestos Building Inspector #21632
Registration No.: ACF - #21635
Asbestos Containing Materials Sampling
Inspection Report
3733 Wright Street
Wheatridge, Colorado 80033
Prepared For:
Linco Enterprises
5171 Ward Road, Unit 1
Wheatridge, Co 80033
Date Prepared:
December 27, 2019
Prepared By:
Jacque Dussex
PO Box 694
Fort Lupton, Co 80621
Table of Contents
1.0 Introduction........................................................
2.0 Field Activities.....................................................
2.1 Building Description & Visual Assessment
2.2 Physical Assessment & Sample Collection
3.0 Laboratory Analysis .............................................
4.0 Regulatory Overview ...........................................
5.0 Findings.................................................................
5.1 Identified Asbestos Containing Materials
6.0 Conclusions & Recommendations .....................
6.1 Major and Minor Asbestos Spill Response Action ...........
7.0 Limitations............................................................
8.0 Photos...................................................................
9.0 Homogeneous Areas Table ............................................
1.0 INTRODUCTION
It is my understanding that there are planned renovation activities at the above referenced address.
Per the United States Environmental Protection Agency (EPA) procedures, published in Code of
Schools and Colorado Regulation 8 (Regulation 8), suspect Asbestos Containing Building Materials
(ACBM) must be properly sampled and analyzed prior to any renovation, restoration, or demolition
activities. EPA regulation 40 CFR 61, National Emission Standards for Hazardous Air Pollutants
(NESHAP), prohibits the release of asbestos fibers to the atmosphere during renovation, restoration,
or demolition activities. The asbestos NESHAP requires that potentially regulated Asbestos Containing
Materials (ACM) be identified, classified, and quantified prior to planned disturbances or demolition
activities. All friable ACM and non — friable ACM that can be rendered friable during demolition
activities must be removed by a licensed general abatement contractor prior to demolition.
The purpose of this sampling was to evaluate for the presence of any ACM in the designated wall
components located in the 1 st level northwest guest bathroom shower surround of this residential
property. The inspection was conducted in accordance with Regulation 8. These inspection protocols
specify requirements for the inspector (Section 763.8), laboratory (Section 763.87), and number of
samples collected during an inspection (Section 763.86).
2.0 FIELD ACTIVITIES
I conducted an asbestos inspection and sampling of the structure located at 3733 Wright Street,
Wheatridge, Co. 80033. The inspection and sampling were conducted on December 26, 2019,
by a Colorado State Certified Asbestos Building Inspector. The inspection and sampling were
conducted in general conformance with the sampling protocols established by 40 CFR 763 and
Regulation 8.
2.1 Building Description & Visual Assessment
My inspection and sampling activities began with visual observation of the designated wall
components located in the 1 st level northwest guest bathroom shower surround to identify
homogeneous areas of suspect ACM. Subtopics 2.2 and 9.0, contain a list of the homogeneous
areas developed for sampling at the subject property. A homogeneous area consists of materials
which appear similar throughout in terms of appearance, color, texture, and date of application.
2.2 Physical Assessment & Sample Collection
A physical assessment of the homogeneous areas of suspect ACM was conducted to assess the
general condition of the materials and determine the friability of the materials. The EPA defines
a friable material as one which, when dry, can be crumbled, pulverized, or reduced to powder by
hand pressure. Non -friable materials cannot be crumbled, pulverized, or reduced to powder by
hand pressure when dry. Friability was assessed by physically touching suspect materials.
Based on the results of the visual observation, bulk samples of suspect ACM were collected in
general conformance with AHERA protocols. Random bulk samples of suspect materials were
collected in the homogeneous areas, using wet methods as applicable to reduce the potential for
fiber release.
Three (3) suspect surfacing ACM samples of Orange Peel Texture were collected from the
homogeneous area (HA #1): 1st Level Northwest Guest Bathroom Shower Surround east wall,
north wall, and west wall.
Three (3) suspect miscellaneous ACM samples of Joint Compound and Pink Drywall were
collected from the homogeneous area (HA #A): l st Level Northwest Guest Bathroom Shower
Surround east wall, north wall, and west wall.
Two (2) suspect miscellaneous ACM samples of Porcelain Wall Tile Tan Glue were collected
from the homogeneous area (HA #B): 1st Level Northwest Guest Bathroom Shower Surround
east wall and north wall.
Samples were placed in sealable containers and labeled with unique sample numbers using an
indelible marker.
3.0 LABORATORY ANALYSIS
The bulk samples were submitted under chain of custody procedures to EMSL of Denver, Co. for
analysis by PLM with dispersion staining techniques per EPA methodology ( 40 CFR 763, Subpart F )
Microscopic visual estimation was used in obtaining the percentage of asbestos in bulk samples.
EMSL is accredited under the National Voluntary Laboratory Accreditation Program (NVLAP).
4.0 REGULATORY OVERVIEW
Title 40 Code of Federal Regulations (CFR) Part 61, regulates asbestos fiber emissions and asbestos
waste disposal practices. It also requires the identification and classification of existing building
materials prior to demolition or renovation activity. Under NESHAP, asbestos containing building
materials are classified as either friable, Category I non — friable, or Category II non — friable ACM.
Friable materials are those that, when dry, may be crumbled, pulverized, or reduced to powder by
hand pressure. Category I non — friable ACM includes packings, gaskets, resilient floor coverings,
and asphalt roofing products. Category 11 non — friable ACM are any materials other than Category I
materials that contain more than 1 % asbestos.
Friable ACM, Category I, and Category II non- friable ACM, which is in poor condition and has
become friable or which will be subjected to drilling, sanding, grinding, cutting, or abrading and
which could be crushed or pulverized during anticipated renovation, restoration, or demolition
activities, are regulated ACM (RACM). RACM must be removed prior to renovation or demolition
activities, regardless of the amount of asbestos materials present. If the amount of RACM exceeds
260 linear feet of pipe insulation or more than 160 square feet in other building components in a
commercial building, or 50 linear feet of pipe insulation or 32 square feet in other building components
in a private residence, the owner or operator must provide the EPA, the State of Colorado Department
of Public Health and Environment — Air Pollution Control Division, with written notifications of
planned removal activities, at least ten (10) working days prior to the commencement of asbestos
abatement activities. Removal of RACM must be conducted by a trained and appropriately licensed
asbestos abatement contractor.
*The Occupational Safety and Health Administration (OSHA) Asbestos standard for the construction
industry (29 CFR 1926.1101), regulates workplace exposure to asbestos. Adherence to OSHA
regulations, regarding occupational exposure during renovation, restoration, and demolition activities
is also mandatory. The OSHA standard requires that employee exposure to airborne asbestos fibers
be maintained below 0.1 asbestos fibers per cubic centimeter of air (0.1 f/cc). The OSHA standard
classifies construction and maintenance activities, which could disturb ACM, and specifies work
practices and precautions which employers must follow when engaging in each class of regulated work.
5.0 FINDINGS
Suspect ACM includes nearly all building materials except glass, natural wood, metal, or rubber.
RACM contains asbestos greater than 1 percent, (> I% asbestos) as confirmed by an accredited
laboratory.
5.1 IDENTIFIED ASBESTOS CONTAINING MATERIAL
Based on the completed PLM results, asbestos was detected in the following materials.
The locations of these materials can be found in Subtopic 6.0.
Friable ACM:
Samples 01,02,03 (HA #1) - The Orange Peel Texture sampled from the 1st Level
Northwest Guest Bathroom Shower Surround east wall, north wall, and west wall
contains .75% - 1.50% Chrysotile.
Samples 01,02,03 (HA #A) - The Joint Compound sampled from the 1 st Level
Northwest Guest Bathroom Shower Surround east wall, north wall, and west wall
contains .75% - 1.50% Chrysotile.
6.0 CONCLUSIONS & RECOMMENDATIONS
The Orange Peel Texture located on the 1st Level Northwest Guest Bathroom Shower Surround
east wall, north wall, and west wall (HA #1) contains .75% - 1.50% asbestos.
The Joint Compound located on the 1st Level Northwest Guest Bathroom Shower Surround
east wall, north wall, and west wall (HA #A) contains .75% - 1.50% asbestos.
*The friable ACM identified in Section 5.1 and 6.0 above, must be removed by a Colorado certified
General Abatement Contractor (GAC) prior to renovation/demolition activities.
6.1 Major and Minor Asbestos Spill Response Action
If the total quantity of significantly damaged ACM spilled, exceeds the regulatory trigger levels,
the area is deemed a "Major Asbestos Spill". The area is consequently subject to the requirements
in Regulation 8, Section III.T.1., Major Asbestos Spills. In the event that an asbestos spill involves less
than or equal to the trigger levels, the building owner or contractor should follow the protocol outlined
in Regulation 8, Section III.T.2., Minor Asbestos Spills. Additional asbestos air or dust sampling
should also be conducted within the remaining areas not directly impacted by the Major Asbestos Spill,
to determine if asbestos -containing dust/debris has spread to adjacent areas. If asbestos fibers are
found within any other areas, or on building contents, they should be included in the scope of
professional abatement and decontamination.
Adherence to the Occupational Safety and Health Administration (OSHA) Asbestos Standard for
the construction industry (29 CFR 1926.110 1), is also mandatory.
*The Major Asbestos Spill originates in the 1 st level northwest guest bathroom, and is a result of the
removal of approximately 70 square feet of RACM: Partial removal of the Shower Surround east wall,
north wall, and west wall. The building owner or contractor should follow the protocol outlined in
Regulation 8, Section III.T.I., Major Asbestos Spills.
7.0 LIMITATIONS
This asbestos inspection was conducted in a manner consistent with the level of care and skill
ordinarily exercised by a member of the profession, currently practicing under similar conditions in
the same locale. The results, findings, conclusions, and/or recommendations expressed in this report,
are based on conditions during my renovation specific inspection of the property. The information
contained in this report, is relevant to the date on which this survey was performed, and should not
be relied upon to represent conditions on a later date. This survey and inspection is considered
a comprehensive inspection, specifically conducted for the renovation of the designated area
in this residential property. Care was taken to sample the accessible materials that are discussed in
this report. Sampling was accomplished using random/representative sampling protocols.
This report has been prepared on behalf of and exclusively for use by the client. Contractors or
consultants reviewing this report must draw their own conclusions, regarding further investigation
or remediation deemed necessary. Jacque Dussex does not warrant the work of regulatory agencies
or other third parties supplying information which may have been used in the preparation of this report.
Jacque Dussex assumes no liability for any loss, injury, claim, or damages arising directly or indirectly
from any use of or reliance on this inspection report or the opinions expressed herein. Jacque Dussex
makes no risk assessment, warranty, guarantee, or insurance policies of any kind, express or implied.
This report was prepared pursuant to the contract Jacque Dussex has with the client, including an
exchange of information about the property, that was unique and between Jacque Dussex and her client.
No guarantees are made arising from any service rendered. Liabilities hereunder, shall not exceed the
total fee paid by the client and Jacque Dussex. No warranty, express or implied is made.
This report does not serve as a scope of work or bidding document.
Should you have any questions or require additional information, please feel free to contact
Jacque Dussex at (720) 503-6702
Sincerely,
Jacque Dussex
AHERA/ State of Colorado- Accredited Asbestos Building Inspector #21632
Registration No.: ACF - #21635
8.0 PHOTOS
Front of Home
Built in 1967
viii
Address of Home
Photo of Asbestos Containing Material:
Orange Peel Texture (HA #1) =.75% - 1.50% Chrysotile
Joint Compound (HA #A) =.75% - 1.50% Chrysotile
9.0 Homogeneous Areas Table
HA— Homogeneous Area SM — Surfacing Material G - Good
FID — Non -Detect MM — Miscellaneous D - Damaged
C. - Chrysotite TSI — Thermal System Insulation SD — Significantly Damaged
---.._
HA #
----
Sample
Nurrbe
- .-----_--------
Maleria4 Oescrttian
---- --- — ---
Same% Location
----
Material
CYassification
_..
Material
Condition
---
Apprnrmnate
Quantity
- - --
Friable or
Non -Friable
-------- _-----
Asbestos
Content
1
I
01
Orange Peel
Texture
1' Lead N.W-Guest
8athmom Shower Summa
E.Watl
SM
SD
70 SF
F
1.25%C.
A
01
Joint Campaundf
Pir* Drywall
Y level NAV -West
Batlmoam Shower Su nmrd
E.Wall
MM
SD
70 SF
F
Joint C-=
.75%C.
B
01
Wall Tile Tan Glue
1' L&M N.w.Guest
Bathmo , S mw Surround
E.Wah
MM
SD
70 SF
Non
ND
1
02
Grange Peel
Texture
1' levet N.W_Guest
MmomShowerSurround
SM
SD
70 SF
F
1..50%C.
A02
Joint Compoundf
Pmts Drywall
t'tfwel N.W_Gtre�
BWJWM N.1 ShOwrSumnd
MM
5D
70 SF
F
Jc>intC_ —
1 M%C.
B
02
Wall Tile Tan Glue
1' level N.W_Gues
Bathmom Shower Surraxxrrd
N.Wai
MM
SD
70 SF
Non
ND
1
03
Orange Peel
Texture
Bahmmm Sh Sumud
W -
SD
70 SF
F
75%C.
A
03
Joint Cornlwundf
Pink Drywall!
1' Level FCW-Gueg Balm=
�troser suraab w.War
MM
SD
70 SF
F
Joint C=
75%C.
I
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1610 dens Vbad Dm CO @W04
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dtlL�tiMNw.t3473Loam J de wnftbwe L1
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CustoeerlD: JDEL42
Customer Por
Projed ID:
r
AUention_ Jacque Dlssex Phow X720; !C PUX
Jacqueline Dussex Fac
PO Baa W Received Date: 1:,'2512019 11:20 AM
Fart Lupton, CO 80821 Analysis Date: 12'2812019
Collected Date:
Project 12-i9-1211"3733 WP.IGHTST, WHEATRIDGE. CO
Test R2jmrt: Asbestos Analysis of Bulk Materials via EPA 6 aq?-9X196 Method using Patenzed
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Customer 1D: JDFL42
Customer P01
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Attention: Jacque Dussex Phone: (7211) 5024702
Jacqueline Dussex Fac
PO Bar 694 Received: 12r -)B t119 11:20 AM
Fart Lupton, CO 50621 Analysis Date: 1297=19
Collected:
Prcgeet 12-19-12D-3733 WRIGHT ST, WHEAMIDGE, COMM
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-931116 Method using
Polarized Light Microscopy. Quantitation using 400 Point Count Procedure
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EMS Analytical, Inc.
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Customer PQ
Pro}ed Or
Atte ben: Jacque Dussex Phone: ; t2131— f—C 'tTM,
Jacqueline Dussex Fac
PO Bane 694 Received: 12126d2t119 11:2D AM
Fort Lupton. CO 80621 Analysis state: 12427,2018
Collected:
Project 12-19-120 733 VVRIGRT ST, VO EATRIDGE. CO BDM3
Test Report: Asbestos Analysis of Bulk Materials via EPA 6001R-931116 Method using
Polarized Light Microscopy. Glusntitation using 400 Point Count Procedure
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* 18'76
Colorado Department
of Public Health
and Environment
ASBESTOS
CERTIFICATION*
This certifies that
Jacqueline R. Dussex
Certification No.: 21632
has met the requirements of 25-7-507, C.R.S. and Air Quality Control
Commission Regulation No. 8, Part B, and is hereby certified by the
state of Colorado in the following discipline:
Building Inspector*
Issued: November 20, 2018
Expires: January 02, 2020
* This certificate is valid only with the possession ofa /
current Division -approved training course certification
in the discipline specified above
thor' d ADCCRepresentative
SEAL
.c
1876
Colorado Department
of public Health
and Environment
ASBESTOS CONSULTING FIRM
This certifies that
Jacque Dussex
Registration No.: ACF - 21635
has met the registration requirements of 25-7-507, C.R.S. and the Air Quality Control
Commission Regulation No. 8, Part B, and is hereby authorised to perform asbestos consulting
activities as required under Regulation No 8, Part B, in the state of Colorado.
Issued: December 03, 2019
Expires: December 30, 2020
Auftrized AFCD Representative
SEAL
RECEIVED
Lary 01
W heatI�idg�_-----
COMMUNITY DEVELOPMENT
SUB—CONTRACTOR AUTHORIZATION FORM
This form must be signed by each sub -contractor.
This form will not be accepted with missing information.
Subcontractor's City of Wheat Ridge License number must be provided in the applicable space.
Subcontractor's insurance and license must be up to date prior to permit issuance.
Project Address: 3733 f,/ /t .S1- Permit #:
General Contractor: &wc C6
Electrical Sub -Contractor
Company Name: 0~/ �sAlIt--, 5,_T fiie*:
State License
Master #:
W t Ridge Lic se (required field)
C� L s-
ignature of A' thorized Ag Date
Plumbing Sub -Contractor
Company Name: &y 13 /fr--S • Phone #:
State License #: Master #:
Wheat Rid a License #:
'gnature o horized Agent
Mechanical Contractor
(required field)
0-1.x 19.
Date
Company Name: A,? 1-Y 131-e - Phone:
Whe 'dge License #: (required field)
;2r
/r' 121?11 -s.
*fi`atur4 of Aut orized Agent Date
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Basement Specs
Finished sgft - 1,015
Floor - concrete slab
Ceiling Height - T4"
Access - window
Framing Specs
Standard install
HVAC Specs
Misc - just bath fan
Misc - Dryer vent
Plumbing Specs
Bathroom
Tub - 5ft standard white
Toilet - Standard
Vanity - Double sink per plan
Net Bar
Sink - standard with GD
Misc - Water line to fridge
Misc - Baseboard heat
Misc - Washer hookups
Electrical Specs
Standard install
Sub panel - Yes
Misc - (3) coax
Misc - Washer/dryer hookups
Insulation Specs
Walls - R1 q batt
Ceilings - R1 Cl finished areas
Contractor Layout
26
r-------------------------—
2618L5
------------------------
--- ------------
2618L5
Working Plan View
Drywall Specs
Texture - Knockdown
Bead - 5quare
Windows - 3 sides
Window Specs
Cb Egress windows - install (2)
N new egress windows and wells
Windows - all mini windows replace
(WKL
Pe. _
NOT APPROVED AS AN
INDEPENDENT DWELLING UNIT
City of
"" Wh�.c�t Ri
COMMUNI TY I)LVLL( W&*N I
APPROVED
Contractor:
The Basement Sanctuary
51'11 Ward Rd Unit 1
Wheat Ridge, c0 80033
Phone:'120-808-60gq
thebasementsanctuary.com
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Homeowner Information:
Natalie Heberling
3133 Wright 5t
Wheat Ridge, CO
Ph: 512-585-1013
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City of Wheat Ridge
A00" Residential Asbestos Abatement PERMIT - 202000131
PERMIT NO: 202000131 ISSUED: 01/16/2020
JOB ADDRESS: 3733 Wright St EXPIRES: 01/15/2021
JOB DESCRIPTION: Asbestos abatement of a major spill, 60 square feet in kitchen, living
room, bedroom and bathrooms.
*** CONTACTS ***
OWNER (720)251-9879 HEBERLING NATALIE
SUB (970)818-7860 CODY GORDON 202015 XTRACT ENVIRONMENTAL SRVS
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 2,250.00
FEES
Asbestos Abatement 50.00
Total Valuation 0.00
** TOTAL ** 50.00
*** COMMENTS ***
*** CONDITIONS ***
Work shall comply with 2012 IRC & 2017 NEC. Smoke alarms shall comply with 2012 IRC Section
134. INTERIOR ALTERATIONS, REPAIRS, FUEL -FIRED APPLIANCE REPLACEMENTS, OR ADDITIONS, ANY OF
WHICH REQUIRE A BUILDING PERMIT, OCCURS OR WHERE ONE OR MORE ROOMS LAWFULLY USED FOR
SLEEPING PURPOSES ARE ADDED SHALL HAVE AN OPERATIONAL CARBON MONOXIDE ALARM INSTALLED
WITHIN FIFTEEN FEET OF THE ENTRANCE TO EACH ROOM LAWFULLY USED FOR SLEEPING PURPOSES
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 legally authorized to include al[ 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 . 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 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 change, of the natural flow of water without prior and specific approval.
5. The pen -nit 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 gr f ng of a permit shall not be construed to be a permit for or an approval of, any violation of any provision of any
a able code or 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.
��City of
7W heat �gie
COMMUNITY DEVELOPMENT
Building & Inspection Services
7500 W. 291h Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits ci.wheatridge.co.us
FOR OFFICE USE ONLY
Date:
6(�/& / Z-O'Z-b
Plan/Permit #
44
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Plan Review Fee:
Building Permit Application
* Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address: 3-7 3 3 W r , !� k7t :)4, l� i,._�- 121 d(¢, .eJ _ (�> O O 3
Property Owner (please print): Phone: '77-O - Z -C-1-9 -79
Property Owner Email: J C,W-L og obIh-(u� • Lonl\
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address: 3133 Wrj alk J- 5�
City, State, Zip: W�e9-��- 2 o�r-t 2 i LU Soo 3 3
Arch itect/E no 4 neer:
Architect/Engineer E-mail:
Phone:
Contractor Name: `} r,.,k li�vx 'J ,<, / " I �� i CQ S
City of Wheat Ridge License #: � Oc C� / Phone: q 7V-7,!�3 2�-- 433'3
Contractor E-mail Address: (00'J1 CI) X
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): Oo0A 6cc40A. Phone: 1 ZO —St$ -;RO
CONTACT EMAIL(p/ease print):
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: &"40,5 +- Other City Licensed Sub:
City License # City License #
Complete all highlighted fields, if applicable.
❑COMMERCIAL RESIDENTIAL
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, square footage, existing condition and
proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.
`i'LVS P�eCA- s C. �^^ufc-'r 5��, 'CC✓k h r pr�( ��
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Sq. FULF
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BTUs
Gallons
Amps Squares For Solar: KW # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
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)C,C(
Signature (first and last name):
Printed Name: Ol
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
or (AJITHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
DEPARTMENT USE ONLY
DATE: / - 1,5-- 2-0 Zjz,
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Building Division Valuation:
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December 27, 2019
Jason Polston
Linco Enterprises
5171 Ward Road, Unit 1
Wheatridge, Co. 80033
Dear Mr. Polston:
I am pleased to submit this report summarizing an Asbestos Containing Materials
Inspection. The enclosed report details the fieldwork and analytical results
of samples collected. These services were provided to assist with the planning of
asbestos abatement activities for the property. This asbestos inspection was conducted
for the purpose of identifying the presence of Asbestos Containing Materials (ACM)
in the area of the residential property that is part of the scope of work, communicated
to Jacque Dussex, by Jason Polston of Linco Enterprises, as required by State and/or
Federal agencies. This work was authorized by you on December 26, 2019.
I sincerely appreciate the opportunity to provide this service for this project. If you have
any questions regarding this report, please contact Jacque Dussex at (720) 503-6702.
Sincerely,
oi'w_ `ba luk- ,
Jacque Dussex
AHERA/State of Colorado -Accredited Asbestos Building Inspector #21632
Registration No.: ACF - #21635
Asbestos Containing Materials Sampling
Inspection Report
3733 Wright Street
Wheatridge, Colorado 80033
Prepared For:
Linco Enterprises
5171 Ward Road, Unit 1
Wheatridge, Co 80033
Date Prepared:
December 27, 2019
Prepared By:
Jacque Dussex
PO Box 694
Fort Lupton, Co 80621
Table of Contents
1.0 Introduction........................................................
2.0 Field Activities.....................................................
2.1 Building Description & Visual Assessment
2.2 Physical Assessment & Sample Collection
3.0 Laboratory Analysis .............................................
4.0 Regulatory Overview ...........................................
5.0 Findings.................................................................
5.1 Identified Asbestos Containing Materials
6.0 Conclusions & Recommendations .....................
6.1 Major and Minor Asbestos Spill Response Action ...........
7.0 Limitations............................................................
8.0 Photos...................................................................
9.0 Homogeneous Areas Table ............................................
1.0 INTRODUCTION
It is my understanding that there are planned renovation activities at the above referenced address.
Per the United States Environmental Protection Agency (EPA) procedures, published in Code of
Schools and Colorado Regulation 8 (Regulation 8), suspect Asbestos Containing Building Materials
(ACBM) must be properly sampled and analyzed prior to any renovation, restoration, or demolition
activities. EPA regulation 40 CFR 61, National Emission Standards for Hazardous Air Pollutants
(NESHAP), prohibits the release of asbestos fibers to the atmosphere during renovation, restoration,
or demolition activities. The asbestos NESHAP requires that potentially regulated Asbestos Containing
Materials (ACM) be identified, classified, and quantified prior to planned disturbances or demolition
activities. All friable ACM and non — friable ACM that can be rendered friable during demolition
activities must be removed by a licensed general abatement contractor prior to demolition.
The purpose of this sampling was to evaluate for the presence of any ACM in the designated wall
components located in the 1 st level northwest guest bathroom shower surround of this residential
property. The inspection was conducted in accordance with Regulation 8. These inspection protocols
specify requirements for the inspector (Section 763.8), laboratory (Section 763.87), and number of
samples collected during an inspection (Section 763.86).
2.0 FIELD ACTIVITIES
I conducted an asbestos inspection and sampling of the structure located at 3733 Wright Street,
Wheatridge, Co. 80033. The inspection and sampling were conducted on December 26, 2019,
by a Colorado State Certified Asbestos Building Inspector. The inspection and sampling were
conducted in general conformance with the sampling protocols established by 40 CFR 763 and
Regulation 8.
2.1 Building Description & Visual Assessment
My inspection and sampling activities began with visual observation of the designated wall
components located in the 1 st level northwest guest bathroom shower surround to identify
homogeneous areas of suspect ACM. Subtopics 2.2 and 9.0, contain a list of the homogeneous
areas developed for sampling at the subject property. A homogeneous area consists of materials
which appear similar throughout in terms of appearance, color, texture, and date of application.
2.2 Physical Assessment & Sample Collection
A physical assessment of the homogeneous areas of suspect ACM was conducted to assess the
general condition of the materials and determine the friability of the materials. The EPA defines
a friable material as one which, when dry, can be crumbled, pulverized, or reduced to powder by
hand pressure. Non -friable materials cannot be crumbled, pulverized, or reduced to powder by
hand pressure when dry. Friability was assessed by physically touching suspect materials.
Based on the results of the visual observation, bulk samples of suspect ACM were collected in
general conformance with AHERA protocols. Random bulk samples of suspect materials were
collected in the homogeneous areas, using wet methods as applicable to reduce the potential for
fiber release.
Three (3) suspect surfacing ACM samples of Orange Peel Texture were collected from the
homogeneous area (HA #1): 1st Level Northwest Guest Bathroom Shower Surround east wall,
north wall, and west wall.
Three (3) suspect miscellaneous ACM samples of Joint Compound and Pink Drywall were
collected from the homogeneous area (HA #A): 1st Level Northwest Guest Bathroom Shower
Surround east wall, north wall, and west wall.
Two (2) suspect miscellaneous ACM samples of Porcelain Wall Tile Tan Glue were collected
from the homogeneous area (HA #B): 1st Level Northwest Guest Bathroom Shower Surround
east wall and north wall.
Samples were placed in sealable containers and labeled with unique sample numbers using an
indelible marker.
3.0 LABORATORY ANALYSIS
The bulk samples were submitted under chain of custody procedures to EMSL of Denver, Co. for
analysis by PLM with dispersion staining techniques per EPA methodology ( 40 CFR 763, Subpart F )
Microscopic visual estimation was used in obtaining the percentage of asbestos in bulk samples.
EMSL is accredited under the National Voluntary Laboratory Accreditation Program (NVLAP).
4.0 REGULATORY OVERVIEW
Title 40 Code of Federal Regulations (CFR) Part 61, regulates asbestos fiber emissions and asbestos
waste disposal practices. It also requires the identification and classification of existing building
materials prior to demolition or renovation activity. Under NESHAP, asbestos containing building
materials are classified as either friable, Category I non — friable, or Category II non — friable ACM.
Friable materials are those that, when dry, may be crumbled, pulverized, or reduced to powder by
hand pressure. Category I non — friable ACM includes packings, gaskets, resilient floor coverings,
and asphalt roofing products. Category II non — friable ACM are any materials other than Category I
materials that contain more than 1 % asbestos.
Friable ACM, Category I, and Category II non- friable ACM, which is in poor condition and has
become friable or which will be subjected to drilling, sanding, grinding, cutting, or abrading and
which could be crushed or pulverized during anticipated renovation, restoration, or demolition
activities, are regulated ACM (RACM). RACM must be removed prior to renovation or demolition
activities, regardless of the amount of asbestos materials present. If the amount of RACM exceeds
260 linear feet of pipe insulation or more than 160 square feet in other building components in a
commercial building, or 50 linear feet of pipe insulation or 32 square feet in other building components
in a private residence, the owner or operator must provide the EPA, the State of Colorado Department
of Public Health and Environment — Air Pollution Control Division, with written notifications of
planned removal activities, at least ten (10) working days prior to the commencement of asbestos
abatement activities. Removal of RACM must be conducted by a trained and appropriately licensed
asbestos abatement contractor.
*The Occupational Safety and Health Administration (OSHA) Asbestos standard for the construction
industry (29 CFR 1926.1101), regulates workplace exposure to asbestos. Adherence to OSHA
regulations, regarding occupational exposure during renovation, restoration, and demolition activities
is also mandatory. The OSHA standard requires that employee exposure to airborne asbestos fibers
be maintained below 0.1 asbestos fibers per cubic centimeter of air (0.1 f/cc). The OSHA standard
classifies construction and maintenance activities, which could disturb ACM, and specifies work
practices and precautions which employers must follow when engaging in each class of regulated work.
5.0 FINDINGS
Suspect ACM includes nearly all building materials except glass, natural wood, metal, or rubber.
RACM contains asbestos greater than 1 percent, (> I% asbestos) as confirmed by an accredited
laboratory.
5.1 IDENTIFIED ASBESTOS CONTAINING MATERIAL
Based on the completed PLM results, asbestos was detected in the following materials.
The locations of these materials can be found in Subtopic 6.0.
Friable ACM:
Samples 01,02,03 (HA #1) - The Orange Peel Texture sampled from the 1st Level
Northwest Guest Bathroom Shower Surround east wall, north wall, and west wall
contains .75% -1.50% Chrysotile.
Samples 01.02,03 (HA #A) - The Joint Compound sampled from the 1st Level
Northwest Guest Bathroom Shower Surround east wallnorth wall, and west wall
contains .75% -1.50% Chrysotile.
6.0 CONCLUSIONS & RECOMMENDATIONS
The Orange Peel Texture located on the 1st Level Northwest Guest Bathroom Shower Surround
east wall, north wall, and west wall (HA #1) contains .75% -1.50% asbestos.
The Joint Compound located on the 1st Level Northwest Guest Bathroom Shower Surround
east wall, north wall, and west wall (HA #A) contains .75% - 1.50% asbestos.
*The friable ACM identified in Section 5.1 and 6.0 above, must be removed by a Colorado certified
General Abatement Contractor (GAC) prior to renovation/demolition activities.
6.1 Major and Minor Asbestos Spill Response Action
If the total quantity of significantly damaged ACM spilled, exceeds the regulatory trigger levels,
the area is deemed a "Major Asbestos Spill". The area is consequently subject to the requirements
in Regulation 8, Section III.1 L, Major Asbestos Spills. In the event that an asbestos spill involves less
than or equal to the trigger levels, the building owner or contractor should follow the protocol outlined
in Regulation 8, Section III.T.2., Minor Asbestos Spills. Additional asbestos air or dust sampling
should also be conducted within the remaining areas not directly impacted by the Major Asbestos Spill,
to determine if asbestos -containing dust/debris has spread to adjacent areas. If asbestos fibers are
found within any other areas, or on building contents, they should be included in the scope of
professional abatement and decontamination.
Adherence to the Occupational Safety and Health Administration (OSHA) Asbestos Standard for
the construction industry (29 CFR 1926.110 1), is also mandatory.
*The Major Asbestos Spill originates in the ] st level northwest guest bathroom, and is a result of the
removal of approximately 70 square feet of RACK Partial removal of the Shower Surround east wall,
north wall, and west wall. The building owner or contractor should follow the protocol outlined in
Regulation 8, Section III.T.1., Major Asbestos Spills.
7.0 LIMITATIONS
This asbestos inspection was conducted in a manner consistent with the level of care and skill
ordinarily exercised by a member of the profession, currently practicing under similar conditions in
the same locale. The results, findings, conclusions, and/or recommendations expressed in this report,
are based on conditions during my renovation specific inspection of the property. The information
contained in this report, is relevant to the date on which this survey was performed, and should not
be relied upon to represent conditions on a later date. This survey and inspection is considered
a comprehensive inspection, specifically conducted for the renovation of the designated area
in this residential property. Care was taken to sample the accessible materials that are discussed in
this report. Sampling was accomplished using random/representative sampling protocols.
This report has been prepared on behalf of and exclusively for use by the client. Contractors or
consultants reviewing this report must draw their own conclusions, regarding further investigation
or remediation deemed necessary. Jacque Dussex does not warrant the work of regulatory agencies
or other third parties supplying information which may have been used in the preparation of this report.
Jacque Dussex assumes no liability for any loss, injury, claim, or damages arising directly or indirectly
from any use of or reliance on this inspection report or the opinions expressed herein. Jacque Dussex
makes no risk assessment, warranty, guarantee, or insurance policies of any kind, express or implied.
This report was prepared pursuant to the contract Jacque Dussex has with the client, including an
exchange of information about the property, that was unique and between Jacque Dussex and her client.
No guarantees are made arising from any service rendered. Liabilities hereunder, shall not exceed the
total fee paid by the client and Jacque Dussex. No warranty, express or implied is made.
This report does not serve as a scope of work or bidding document.
Should you have any questions or require additional information, please feel free to contact
Jacque Dussex at (720) 503-6702
Sincerely,
Jacque Dussex
AHERA/ State of Colorado- Accredited Asbestos Building Inspector #21632
Registration No.: ACF - #21635
8.0 PHOTOS
Front of Home
Built in 1967
Address of Home
Photo of Asbestos Containing Material:
Orange Peel Texture (HA #1) =.75% - 1.50% Chrysotile
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it
ASBESTUS
CERTIFICATION*
This certifies that
Jacqueline R. Dussex
q Certification No.: 21632
has met the requirements of 25-7-507, C.R.S. and Air Quality Control
Commission Regulation No. 8, Part B, and is hereby certified by the
state of Colorado in the following discipline:
Building Inspector*
Issued: November 20, 2018
Expires: January 02, 2020
7,'
511.
* This certificate is valid anhv with the possession oja
current Division -approved training course certification ��%-' -�
in the discipline specified above. thPdPCC Representative
SEAL
3'y,
« *��
1876
Colorado Department
of public Health
and Environment
ASBESTOS CONSULTING FIRM
This certifies that
Jacque Dussex
Registration No.: ACF - 21635
has met the registration requirements of 25-7-507, C.R.S. and the Air Quality Control
Commission Regulation No. 8, Part B, and is hereby authorised to perform asbestos consulting
activities as required under Regulation No 8, Part B, in the state of Colorado.
Issued: December 03, 2019
Expires: December 30, 2020 2 './0
jG;ori AKO Rer-aseniaNve
SEAL
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:` -T -
Job Address: H2 .� 3 L") a--) & a --T— �_-T—
Permit Number:��
❑ No one available for inspection: Time'Q0, 4:- RM/PM
Re -Inspection required: Yes No
When corrections have been made, schedule for re -inspection online at:
http✓/www. cL wheatridge, co, uslinspection
Date:` 1'1' 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 1/
Re -Inspection required: Yes No
When corrections have been made, schedule for re -inspection online at:
hUpAwww.ci. wheatridge.co. usrinspection
Date:-/,?---' J ' l?' Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: ?=
Job Address: 1 Z -Ai
Permit Number:?/ �*�
❑ No one available for inspection: TimeAM/prM
Re -Inspection required Yes° No
When corrections have been made, schedule for re -inspection online at:
http✓/www. ci. wheatridge. co. usfinspection
Date:'�' /L� /T Inspector:
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Sewer Repair PERMIT - 201902615
PERMIT NO: 201902615 ISSUED: 12/16/2019
JOB ADDRESS: 3723 Wright St EXPIRES: 12/15/2020
JOB DESCRIPTION: Sewer repair in yard, 2-10 feet with 9-11 feet deep, installing dual sweep
C/Os.
*** CONTACTS ***
OWNER (512)585-1073 HEBERLING NATALIE
SUB (303)519-0240 R. ANDREW RUSSELL 120161 THE ELITE PIPE MD
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 3,200.00
FEES
Total Valuation 0.00
Use Tax 67.20
Permit Fee 109.20
** TOTAL ** 176.40
*** COMMENTS ***
*** CONDITIONS ***
ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive
written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection
by any Sanitation District representative. Inspection and approval of work by any
Sanitation District representative DOES NOT grant authority to cover work without the
approval of the Building Division.
**For trenchless sewer replacements - The contractor will verify proper slope of new sewer
piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed
specifically by the applicable code. The plumbing contractor will provide verification of
proper slope and drainage in writing as a condition of approval of the permitted work.**
City of Wheat Ridge
Residential Sewer Repair PERMIT - 201902615
PERMIT N0: 201902615 ISSUED: 12/16/2019
JOB ADDRESS: 3723 Wright St EXPIRES: 12/15/2020
JOB DESCRIPTION: Sewer repair in yard, 2-10 feet with 9-11 feet deep, installing dual sweep
C/Os.
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 legally authorized to include all entities named within this document as parties to the work to be
perfo ed and that 1 wo k to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
M�ar
i& fib//ct
ignature 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 Budding
Official and may be subject to a fee equal to one-half of the originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees 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 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, any violation of any provision of any
apIable code or atiy 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.
City Of
-/�¢ LL resatFjZ.,jge
CC?hMAttiUi' my DEVELOPMENT
Building & Inspection Services Division
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: Hernia its. ci.t.1 ua, icige.co.u�
FOR OFFICE USE ONLY
Date.
Plan/Permit # 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: I V
Property Owner (please print): �ICAIII,e'l , phone: 5W6 ' ,? 107
3
Property Owner Email:t`G
Mailing Address: (if different than property address)
Address
City, State, Zip:
Architect/Eng!neer•
Architect/Engineer E-mail: Phone:
Contractor: Th_�i 0 ;P el
Contractors City License #: I Phone: -7 7a t
Contractor E-mail Address: I
Sub Contractors:
Electrical:
W.R. City License #
Other City Licensed Sub:
City License #
a
Plumbing:
W.R. City License #
Other City Licensed Sub:
City License #
Mechanical:
W.R. City License #
Complete all information on BOTH sides of this form
❑ COMMERCIAL RESIDENTIAL
Description of work: (Check all that apply)
❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE
❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING
❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING
❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT
❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ OTHER (Describe)
(For ALL projects, please provide a detailed description of work to be performed, including current use of areas,
proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and
amount of materials to be used, etc.) i n
Z — (D , /\-
jC
TN SAS—5weef Cc-C'G
Sq. Ft./LF
Amps
Btu's
Squares
Gallons
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
wow
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 or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last name): L DATE.
/z %'6117
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
Building Division Valuation: $
° City of Wheat Ridge
Residential Sewer Repair PERMIT - 201902614
PERMIT NO: 201902614 ISSUED: 12/16/2019
JOB ADDRESS: 3733 Wright St EXPIRES: 12/15/2020
JOB DESCRIPTION: Sewer repair 1-10 feet in yard, 9-11 feet deep, installing dual sweep C/Os.
*** CONTACTS ***
OWNER (512)585-1073 HEBERLING NATALIE
SUB (303)519-0240 R. ANDREW RUSSELL 120161 THE ELITE PIPE MD
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 3,200.00
FEES
Total Valuation 0.00
Use Tax 67.20
Permit Fee 109.20
** TOTAL ** 176.40
*** COMMENTS ***
*** CONDITIONS ***
ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive
written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection
by any Sanitation District representative. Inspection and approval of work by any
Sanitation District representative DOES NOT grant authority to cover work without the
approval of the Building Division.
**For trenchless sewer replacements - The contractor will verify proper slope of new sewer
piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed
specifically by the applicable code. The plumbing contractor will provide verification of
proper slope and drainage in writing as a condition of approval of the permitted work.**
City of Wheat Ridge
Residential Sewer Repair PERMIT - 201902614
PERMIT NO: 201902614 ISSUED: 12/16/2019
JOB .ADDRESS: 3733 Wright St EXPIRES: 12/15/2020
JOB DESCRIPTION: Sewer repair 1-10 feet in yard, 9-11 feet deep, installing dual sweep C/Os.
1, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and 'P
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 legally authorized to include all entities named within this document as games to the work to be
performed an that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
/Z/1G /,-
Sign&ure o 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 maybe 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 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 gra i, g 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 yb ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
F', r
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
1 �
COMMW heat� UNITY DEVELOPMENT
Building & Inspection Services Division
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: ,i-erritsraucimheatridQe.co.us
FOR OFFICE USE ONLY
Date:
Plan/Permit #
4z__11d/9Doo-
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: 7 33 uj <-- -, c, k _� -4-- 1,,n V 1, d cj ti
Property Owner (please print): l o-�qe. A.e' �c r L+ `^ Phone: 51-Z "555- 107 3
Property Owner Email: lvlf4
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Arch itectlEnainear:
Architect/Engineer E-mail:
Phone:
Contractor: k I t `1-e i t Epi 111,19
Contractors City License #: i W t b ( Phone: 7 ?-,,o - 66 a - c -i 3 g I
Contractor E-mail Address:
Sub Contractors:
Electrical
W.R. City License #
Other City Licensed Sub:
City License #
Plumbing:
W.R. City License #
Other City Licensed Sub:
City License #
Mechanical:
W.R. City License #
Complete all information on BOTH sides of this form
❑ COMMERCIAL ESIDENTIAL
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
EfPLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ OTHER (Describe)
(For ALL projects, please provide a detailed description of work to be performed, including current use of areas,
proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and
amount of materials to be used, etc.)
Z 1 t
Sq.
Vl G ► �� i /�
(,►f
C� A l (0 c cJ s.e V -",e C, : S
Sq. Ft./LF
Amps
Btu's
Squares
Gallons
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$ -3 zoo q5g'
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 _ (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last name): DATE: 1 G / 7
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer.
LZ-1�l;7iii'i1*It11101-114191►I_R'1
OCCUPANCY CLASSIFICATION:
Building Division Valuation: $
City of Wheat Ridge
E -Res Egress Window PERMIT - 201902593
PERMIT NO: 201902593 ISSUED: 12/12/2019
JOB ADDRESS: 3733 Wright St EXPIRES: 12/11/2020
JOB DESCRIPTION: Installing one egress window in bedroom. U -value is .21
*** CONTACTS ***
OWNER (303)523-0798 MEIS NINA
SUB (720)626-4221 STEPHEN SENNETT
150231 DENVER EGRESS WINDOW
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 3,000.00
FEES
Total Valuation 0.00
Use Tax 63.00
Permit Fee 93.35
** TOTAL ** 156.35
*** COMMENTS ***
*** CONDITIONS ***
Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all
applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections.
1, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specificationst
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. 1 further attest that [ am legally 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. 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 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 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 changeof the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Dtvision 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 gran n of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any
app le code ora rdmance 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.
Dina Kemp
From: no-reply@ci.wheatridge.co. us
Sent: Wednesday, December 11, 2019 4:07 PM
To: CommDev Permits
Subject: Online Form Submittal: Residential Egress Window Permit Application
Categories: Dina
Residential Egress Window Permit Application
This application is exclusively for RESIDENTIAL EGRESS WINDOWS ONLY.
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM AND
ENGINEER LETTER STAMPED DETAIL SHOWING THE U -VALUE OF THE
WINDOWCUT 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
existing EGRESS
window(s) needing
vertical cuts only?
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-4567)
Property Owner Email
Address - Do not enter a
contractor email address
Attach Credit Card
Authorization Form -
**DO NOT ATTACH
RANDOM
DOCUMENTS
3733 Wright St.
Nina Meis
303-523-0798
Field not completed.
ccform. pdf
CONTRACTOR INFORMATION
I
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)
Denver Egress Window
150231
720-626-4221
Contractor Email Address info@denveregresswindow.com
Retype Contractor Email info@denveregresswindow.com
Address
DESCRIPTION OF WORK
Number of EGRESS 1
windows being replaced
Location of EGRESS bedroom
window(s) being replaced
(for example, master
bedroom, kitchen,
bathroom, etc):
What is the a -value of the .21
EGRESS window(s)?
City of Wheat Ridge
requires the u -value to be
.32 or better on windows.
Attach copy of Engineer Linco Construction -2-3733 Wright St.-Wheatridge-SNTW1810-
stamped letter showing 19832-SIGNED.pdf
vertical cuts detail and u -
value
Project Value (contract 3000
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
2
0
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 been Yes
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 Stephen Sennett
Permit
Email not displaying correctly? View it in your browser.
(720) 626.4221
�x l ON SITE PLAN
VIM MUST BE ON SITE FOR INSPECTION
EXISTING 2X FLOOR
JOISTS AND DECKING
NOTES
FI 1
• TEMPORARY SUPPORT IS REQUIRED
ON ALL LOAD BEARING WALLS PRIOR
TO DECONSTRUCTION HSS 6" x 2" x 1/8" MIN.
TOP OF 8" thk.
• WINDOW WELL SHALL BE 9 SQ. FT.
FOUNDATION
MIN. AREA WITH 36" MIN. CUT SLOT FOR 3" BEARING,
EXISTING WINDOW
CLEARANCE FROM FOUNDATION MIN. TYPICAL BOTH ENDS
\
WALL TO INSIDE OF WELL. A
y
PERMANENT LADDER IS REQUIRED IN
------------
THE WINDOW WELL IF BOTTOM OF IN THE EXISTING CONCRETE FOUNDATION
ih
WELL IS 44" OR MORE BELOW GRADE. CUT A HORIZONTAL SLOT FOR TUBE STEEL
+
PLACEMENT = R.O.+ 9" WIDE X T' DEPTH.
• IN CASES WHERE THE NEW EGRESS CUT HORIZONTAL AND VERTICAL ROUGH
R O. 13"
+i
WINDOW'S R.O. IS LESS THAN OR OPENINGS + 3" FOR TRIMMING ALL SIDES
* VERIFY DIMENSIONS
`?
EQUAL TO THEIFA WINDOW OF NEW WINDOW. ADD NON-STRUCTURAL
WITH WINDOW
zo
WIDTH, THE EXIST ftof INFIL BETWEEN NEW HSS HEADER AND
IS SUFFICIENT O vj ';t tW AS REQUIRED. THE NEW
MANUFACTURER, AND
ADJUST SAWCUT
VERTICAL 2X
TRIMMER
MAXIMUM D ��IiXM II8��1999 LOCATION MAY BE ALIGNED
DIMENSIONS IF
NO ADDITIONAL SUPPORT REQUIRED. WITH BOTH SIDES OF THE EXISTING
REQUIRED.
APPROVED WINDOW.
J
J
OW 101 C0k COM1121W ct
PLACE HORIZONTAL 2X Q p
NAILER SILL SNUGLY
_
BETWEEN VERTICAL
ti
NAILERS.
00 Z
M
TOP
1{
OF FLOOR SLAB
Q
t
n.&maimoff ow" WyMa/406-lpwfi brtl '
OWN p-Mtosrs fiW6rq"M*1o:wowtoroM-'t•nrwowivnia
r��gla wAab a/twsdMeafrwnce� arenas
.w..►.awwrre�r.,Ku•ayyaw�x�r,ww C\A/ 2'-6'X 4'-0" EGRESS WINDOW OPENING - INTERIOR ELEV.
C Y Y SCALE: NONE
Qty: (2) 30" x 48"
Location: Basement right wall
Type: Tilt & Turn
U Value: .21
At existing window YES
Existing lintel or header YES
Window above YES
Floor joist bearing YES
Conventional or wood siding
Building Code: 2012 IRC/IBC
I Mark Benjamin P.E. have
proposed installation and
this detail meets existing
Roof Snow: 30 psf
Ground Snow: 30 psf
Nominal Wind Speed: 105 mph; 3 sec. gust. Exp. C
Seismic Design: Category B
PHI -D&E, INC dba.
crown jade
DESIGN AND ENGINEERING
P.O. BOX 17, FORT COLLINS
COLORADO, 80522-0017
(970)472-2394
www.crownjade.com
STREET ADDRESS:
3733 WRIGHT ST.,
WHEAT RIDGE
observed the
determined that
conditions.
12/10/24-4,'0D) ...`��S Jar
8390
73 ` tL
ON AL'I
tis, •.°• .i"'` .• —��'
ENGINEER'S
JOB #
SNTW1810-19832
SHEET #
1 of 1
(720) 626-4221
EXISTING 2X FLOOR
JOISTS AND DECKING
NOTES
• TEMPORARY SUPPORT IS REQUIRED
N
ON ALL LOAD BEARING WALLS PRIOR
TO DECONSTRUCTION HSS 6" x 2" x 1 /8" MIN.
_�:7
TOP OF 8" thk.
• WINDOW WELL SHALL BE 9 SQ. FT.
FOUNDATION
MIN. AREA WITH 36" MIN. CUT SLOT FOR 3" BEARING,
EXISTING WINDOW
CLEARANCE FROM FOUNDATION MIN. TYPICAL BOTH ENDS
\
WALL TO INSIDE OF WELL. A
y
PERMANENT LADDER IS REQUIRED IN
------------
THE WINDOW WELL IF BOTTOM OF IN THE EXISTING CONCRETE FOUNDATION
WELL IS 44" OR MORE BELOW GRADE. CUT A HORIZONTAL SLOT FOR TUBE STEEL
+
PLACEMENT = R.O.+ 9" WIDE X 2" DEPTH.
• IN CASES WHERE THE NEW EGRESS CUT HORIZONTAL AND VERTICAL ROUGH
R.O. + 3" *
+1
WINDOW'S R.O. IS LESS THAN OR OPENINGS + 3" FOR TRIMMING ALL SIDES
* VERIFY DIMENSIONS
EQUAL TO THE EXIS)ING WINDOW OF NEW WINDOW. ADD NON-STRUCTURAL
-ft
WITH WINDOW
;O
WIDTH, THE EMST %4 of INFIL BETWEEN NEW HSS HEADER AND
IS SUFFICIENT O ea� • W AS REQUIRED. THE NEW
MANUFACTURER, AND
ADJUST SAWCUT
VERTICAL 2X
TRIMMER
MAXIMUM D IAPM LOCATION MAY BE ALIGNED
DIMENSIONS IF
NO ADDITIONAL SUPPORT REQUIRED. WITH BOTH SIDES OF THE EXISTING
REQUIRED.
APPROVEDWINDOW.
J
J
affiftnd for Code CQrnDliinte
PLACE HORIZONTAL 2X Q p
NAILER SILL SNUGLY
UJ
=
BETWEEN VERTICAL
in
NAILERS.
? Z
ih =
TOP OF FLOOR SLAB
l
Q
Ilanc r ' L
aodw On opwadat any WOO ORCQ
swyMypm 11, late* kdWOptodroeelowcayeell eet. pelmilb
C\A/ 2'-6" X 4'-0" EGRESS WINDOW OPENING- INTERIOR ELEV.
ewwroMwmala flow CW Awmalwwd L_ Y Y SCALE: NONE
Qty: (2) 30" x 48"
Location: Basement right wall
Type: Tilt & Turn
U Value: .21
At existing window YES
Existing lintel or header YES
Window above YES
Floor joist bearing YES
Conventional or wood siding
Building Code: 2012 IRC/IBC
Roof Snow: 30 psf
I Mark Benjamin P.E. have
proposed installation and
this detail meets existing
Ground Snow: 30 psf
Nominal Wind Speed: 105 mph; 3 sec. gust. Exp. C
Seismic Design: Category B
PHI -D&E, INC dba.
crown jade
DESIGN AND ENGINEERING
P.O. BOX 17, FORT COLLINS
COLORADO, 80522-0017
(970) 472-2394
www.crownjade.com
STREET ADDRESS:
3733 WRIGHT ST.,
WHEAT RIDGE
DATE: 12/10/20
SCALE: NONE
DRAWN BY: KB
CHECKED BY: MB
observed the
determined that
conditions.
ENGINEER'S
JOB #
SNTW1810-19832
SHEET #
1 of 1
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 1-1 i lC)_1 ADDRESS: _3.7Z. r IL, h+J-- JOB CODE:,
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
uo 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
SEE OVER FOR ADDITIONAL INSPECTIONS
PERMIT: - 1'1 J17l (-o i ADDRESS
3-7 ► !j nt 3 -�- JOB CODE:
Rough Inspection (continued)
Date
Inspector
Initials
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
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.**
ZoningFinal Inspection*Protection
F841
Bui ldingg 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
LElectrical low voltage by the Building Division.
M
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: 3 0 - /71
Job Address: :,-7S�-
Permit Number: C; 1-7 0 f? ► 6 7
Cc,r�
❑ No one available for inspection: Time 'I -- 3) _.Opm
Re -Inspection required: YesIFo
When corrections have been made, call for re -inspection at 303-234-5933
Date:—/ ! /)7 Inspector: --)--t>
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
r
Residential Roofing PERMIT - 201709107
PERMIT NO: 201709107 ISSUED: 11/16/2017
JOB ADDRESS: 3723 Wright ST EXPIRES: 11/16/2018
JOB DESCRIPTION: Permit to install 47 squares Asphalt Owens Corning Duration Storm
*** CONTACTS ***
OWNER (303)914-0973 KOPILOFF FAMILY TRUST
SUB (303)484-9854 Dylan Lucas, Ryan Nichols 120088 Eco Roof and Solar
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 13,000.00
FEES
Total Valuation 0.00
Use Tax 273.00
Permit Fee 251.85
** TOTAL ** 524.85
*** 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.
City of Wheat Ridge
Residential Roofing PERMIT - 201709107
PERMIT NO: 201709107 ISSUED: 11/16/2017
JOB ADDRESS: 3723 Wright ST EXPIRES: 11/16/2018
JOB DESCRIPTION: Permit to install 47 squares Asphalt Owens Corning Duration Storm
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 thispermit and perform the work described and approved in conjunction with
this_permit. I further atte that I am legally authorized to include all entities named within this document as parties to the work to be
perfporn� nd that rk to be pertbrmed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of ER or CONTRACTOR (Circle one) Date
1. This permit was issued based on the information provided in the permit application and accompanying Flans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Off-cial 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, 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 Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Antoinette Kulick I --3 9 [ cj- -1
From: no-reply@ci.wheatridge.co.us
Sent: Thursday, November 16, 2017 8:18 AM
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 Duplex
are on the property?
PROPERTY INFORMATION
Property Address
Property Owner Name
3723 Wright St.
Ludmilla Kopoloff
Property Owner Phone 303-914-0973
Number (enter WITH
dashes, eg 303-123-4567)
Property Owner Email
Address
Do you have a signed
contract to reroof this
property?
Applications cannot be
submitted without an
executed contract
attached below.
Attach Copy of Executed
Contract
Field not completed.
Yes
Kopoloff Wright Contract.pdf
CONTRACTOR INFORMATION
Contractor Business Eco Roof and Solar
Name
Contractor's License 120088
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone 303-484-9854
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address 610 S. Lipan St.
(Primary address of your
business)
Contractor Email Address mharrell@ecoroofandsolar.com
Retype Contractor Email mharrell@ecoroofandsolar.com
Address
DESCRIPTION OF WORK
TOTAL SQUARES of
the entire scope of work:
Project Value (contract
value or cost of ALL
materials and labor)
Are you re -decking the
roof?
Is the permit for a flat
roof, pitched roof, or
47
13000
W
Pitched roof (2:12 pitch or greater)
2
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
47
Owens Corning Duration Storm
Asphalt
Re Roof House
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
3
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 Michael Harrell
Email not displaying correctly? View it in your browser.
ROOF AND SOLAR
THIS AGREEMENT, IS BETWEEN:
61C ipan Street Denver, CO 80223
T 303.484.9854 F 303.600.0062
customerservice@ecoroofandsolar.com
www.ecoroofandsolar.com
blt oac A GaF.
roperty Owner(s) Name)
jbject Property Address)
4 � 1 '80---00 BoOZ 3 (City, State & Zip)
30S 1914 �j q l7p /ydam,o (Phone)
On .� 1 1 'n®V o (Email)
How did you hear about us?
ECO Roof and Solar will advocate the Property Owner'(s) best interest in restoration of property damage and complete all work in accordance to
insurance company agreed scope of loss. Agreed upon price will become the final contract price and ECO Roof and Solar will receive all proceeds
for the work completed by ECO Roof and Solar. Upgrades and any other work will be a separate contract between the Property Owner(s) and ECO
Roof and Solar. If the Insurance Company denies this claim this contract will terminate and neither ECO Roof and Solar nor the Property Owner(s)
are obligated to one another.
ECO Roof and Solar will furnish all labor and materials to construct and complete the following general services:
ear off_ layers of roof covering
CDX lay over exist (if required per code)
❑ Install decking (7/16" OSB) (add cost beyond 5 sheets)
nstall new underlayment
IV install pre -painted eave metal to code -color
,ED' Install new flashings as needed
-11 Replace vents as needed
.r Re -flash chimneys and all wall abutments as needed
Special Instructions:
6 Shingle color ES-IkLe 644A
fPa Shingle, manufacture / model L
❑ Replace gutters and downs outs as required
❑ Valley(s) will be closed open
Z;Kternove all debris resulting from above work
12:,Xlean out gutters
ake a magnetic sweep for removal of any nails
5 year workmanship warranty
ECO Roof and Solar Insured by:
Moody Insurance Agency
8055 east tufts avenue, suite 1000
Denver, CO 80237
T. 303.824.6600 F. 303.370.0118
All construction will be completed in compliance with prevailing building codes of the governing municipality.
Contract Price: (Homeowner agrees to pay ECO Roof and Solar total contract price.)
ECO Roof and Solar will not pay, waive, or rebate all or part of any insurance deductible applicable to this insurance claim. Property owner attests that ECO
Roof and Solar has not promised or agreed to pay, waive or rebate all or part of any insurance deductible, in any form. Initials
Approximate Start Date:
Approximate Completion Date:
SCHEDULE OF PROGRESS PAYMENTS: The schedule of payments outlines the initial payment, due upon material delivery, and the final payment due
upon completion of construction. ECO Roof and Solar will require payment of ACV amount prior to stat of construction. ECO Roof and Solar will
hold in trust any payments received from the customer until materials have been delivered to the subject property or performed the majority of
work.
ACCEPTANCE OF PROPOSAL: In accordance with C.R.S. Section 6-22-104, property owner will have a 72 -hour right to rescind this contract. Customer
will be extended all rights under C>R>S> Section 6-22-104. The above specifications and all terms and conditions are agreed to and hereby
accepted.
Initial Payment $
Construction Completion Payment $
Insurance Company —9 h e Claim #
Mortgage Company Loan / Tracking #
Property Owner Signature: � Date
'�/i�%
ECO Roof and Solar: X Date
Mar 22 16 03:05p Glasson 3039140973 p.1
WMIMAIFTNI MIT"W '914. - - '' - I
4766 IndependeAcs Street
wheat Ridge, CO 80033
303-421-2161
N=*
—Werk Done
level 4 bolter cleaning on red tagged boiler for Co. after cjearing still picking up ppm at lower holes through jacket furnace cernefIled all
area$ where leak might be Corning frOtrL ran combustion o2- 7 t co2- 6.111 co- 16. ambierit co 0. no leaks from jacket, wheat ridge will Inspect
nett week. collected 75 for permit fee
We* Authorization
t�L�n. customer ackR tf..that there "my be other service providers VOWirg to Petl6ml the work at a tow price and that heishe
� 'Vt4.
irlsoderlt jurlds, you eVressly authorize your account Io We
fees,'The use of a check is Customers acknowedgrnent and acceptance of Ihis poRcy and its terms and conciltions,
Mar 2216 03:06p Glasson 3039140973 p2
'I i
Wo Defective ng, Tile or drywall rmeplacernent I roPertY# "# Responsibilities Of #
Sellerpainting or appearance of any suftcM
r # : •Limitations
removedSeger she# do all work In a Competent, vickrh"kc mannerSeger Is n I resperisibie for
pricin
rein does not Include a breakdowrof individual materials and labor. Unless specificallY recluesl0d OtherAfte, all Old parts will be
.. # premises and discarded.
# .,
Exclusions
r; k<
CUSTOMEWS RIGHT TO REPAIR AND REPLACEMENT ARE THE EXCLUSNE REMEDIES AND SELLER SHALL NOT BE LtABLE FOP,
FROM THE MATERJALS PRO\ADED FOR IN THIS QOot
INCIDENTAL OR CONSEQUENTIAL DAMAGES RESULTING
R •from the coverageof #warranty.x conditionslisted under
responsible (or the following, whlch are
'Responsibilities of Quatorner,' 2) Work perlormed by or materials provided by Customer or by others not in this agreement, 3) Defects and
failures frorn rhistreatmarri or neglect, 4) 7he repair Or rOPtacernent Of goors, wall$ or callings where access to the work area is gained, 5)
Damages
# bythe Custpow
i k" s of '"
es Property Customer • toremove Pers
.+ # Nor shall Setter be responsible for the natural consequences of Sellers work
cabineft, and other aPPWe
-' p any improvernents to rest property caused by persons delivering materials Or eWiPmen'
property
nklis, and plants, and Seller shag not be responsible for said Items.
to real pro
22q Including, but not limited to, curbs, sidewalks, walks, driveways, garages. patios, WMW
or for k
10 i
a # " • WIN +
agreementforce.ll remain in
ManagerThank You for Choosing Blue Sky Plumbling and "006"91
arelyt completely satisfed, please call and ask to speak with the Customer Service
I authorize the abaft work to be completed #agree to pay the abovetotal.
ornoWetted to satisfaction and I awft to Pay ft above total.
)v" i
t, cc a c� /T
Inspections performed unless this card is posted on the project
inspectionCall the f p.m. to receive an inspection
Inspector Sign ALL Spaces pertinent to project
I IIi ��i
R 1 t. R Inspections 1+ Inspector Comments
Initials
Monolithic Slab Reinforcement
Concrete Encased Ground (CEG)
Footing/Stemwall"".E. Letter.
�t
U III �u ni a ii
R # • f f R f Inspector #
mments
niti
s« R f R
Sewer Service (Underground)
f
Rough
��.
..
Rough Mechanical
Rough FraminR
larm» f....
DrywallScrew
Final Inspections
# =* Uy #
ls
Final Electrical
Final Plumbing
Final Mechanical
Final Building
Landscaping... Parking Planning De
ROW Drainage PublicR Dept.f'
f « � iXk f, #`� •• .t."'
inspections call 303-235-2861. For fire inspections
Fire Inspection / Fire Protection Dist.
contact the Fire Protection District for your project.
"Note: Aft items must be completed and approved by Planning, Public Works, Fire and Building before a Certifficate
of Occupancy is issued. Approval of the Final Building Inspection does not constitute authorization of occupancy.
Issuid-
Protect This CardFrom+Weather
Ta:
Page 2 of 2 2016-03-16 19:3&31 (GMT) 13034240495From: Jesse Lanyon
FJrY
—ity o 'W ,*. Data,
h`6 at, I
Permits.-VELO
'# '
COMMONITY DL
'gulliding Division
O .
Office: 303436-2855 - Fay .��-0929
InWcbon Line: '303-2-14-6933
Application
FEW
51
N
NO. AMR* �k
M S
A
• t �
a
« a a
*
w
AfT C OR) 4
occupAmy:_
�nn�n�;��tatt
la
INSP'L_ _Y. RECORD Occupancy/TVpe
'°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.
r
INSPECT 6R MUST SIGN ALL SPACES PERTAINING TO THIS JOB
FOUNDATION INSPECTIONS DATE INSPECTOR INITIALS
COMMENTS:
Footings /Caissons
Stemwall / (CEG) Concrete
Encased Ground
Reinforcing or Monolithic
Weatherproof/ French Drain
Sewer Service Lines
1
Water Service Lines
_ INSP- E4r- SiONS= FOR-R-L-ANa1NG- 8cZQNING: FIRE_AND_PUBL-IGEJMR :
- " SHOULD BECALLEb AT LE ASTONEWEEK" PRIOR "TO FINAL "INSPECTIONS : " " "'
CONCRETE SLAB FLOOR
Electrical (Underground)
HAS BEEN SIGNED
Heating (Underground)
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
ROUGHS
*Mechanical ng
all tie
` f
s. l Service
lectric
lumbing
g echanical
ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING
,- Framing
Insulation -
..._ Drywall Screw
F
;<
'r.
N
r
E;
z
�. `NOTE :. ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A
CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING . DIVISION DOES NOT CONSTITUTE AUTHORIZATION
OFA CERTIFICATE OF OCCUPANCY . NOR PERMISSION FOR OCCUPANCY.
lectrical
P lumbing
M echanical
R cot . .
Building Final .
Fire Department
1
._O.� &_Dr_8na e
_ INSP- E4r- SiONS= FOR-R-L-ANa1NG- 8cZQNING: FIRE_AND_PUBL-IGEJMR :
- " SHOULD BECALLEb AT LE ASTONEWEEK" PRIOR "TO FINAL "INSPECTIONS : " " "'
Parking &Landscaping "
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED
♦ i
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234 -5933 Inspection line
(303) 235 -2855 Office • (303) 237 -8929 Fax
INSPECTION NOTICE
Inspection
po, � (
Type:
Job Address:
? 3 3 3 (J, -,cs4s
Permit Number:G(
I'?
❑ No one available for inspection: Time 5 AM
Re- Inspection required: Yes o/
*When correct have been made, call for re- inspection at 30,3 -234 -5933
Date: /24)Q,/7 Inspector:
DO NOT REMOVE THIS NOTICE
r
♦ 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: m Gf% 4 c g S
Permit Number: 9 ,3_~) I-i12
i
r'
E-
t
I'
i
❑ No one available for inspection: Time AM/PM
Re-Inspection required: Yes No
When corrections have been made, call for re-inspection at 303-234-5933
Date: //10 U 6 05 Inspector: g,-5%2 ~ y
DO NOT REMOVE THIS NOTICE
r
PERMIT NO: 093242` ISSUED: 10/12/2009
JOB ADDRESS:' 3723-33 Wright: St `.EXPIRES: 04/10/2010
DESCRIPTION:` Reroof '52 sqs
CONTACTS
owner 303/233-7194 Pater Kopiloff
sub 303/753-0505 Teresita Morris nQ-n't97 T,R, naci nnc
PARCEL INFO
ZONE CODE:
UA <
FUSE:
UA
SUBDIVISION: :
0698
'-BLOCK/LOT#:
0/
FEE SUMMARY
ESTIMATED
PROJECT VALUATION: 14,500.00.
FEES
Permit Fee
326.70
Total Valuation
.00
Use :Tax
261.00
TOTAL
587.70
e l~~i~~flz~~
;
r
Conditions:
Both :front and
back of
permit need to be posted on job site. If
one or the other
City of
Wh6,atP jdge Date:
COMMUNITY DEVELOPMENT Permit ~,q% s -kq,
Building Division
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Facsimile Building Permit Application
Property Address: 3~,t3-333 ~2~CHT St°, aua33
Property Owner (please print) -2 >f 4Ler, r l a Xo,01 Loft F Phone: 303 - ZS
Mailing Address: (rf different than property address)
Address: o2c7 S. C A q_a_lSo r S r_
city state zip: LAKFwco- Cm `3 a2.zb
Contractor:-rN _ cS7x 6c--s IG nJ S
ContractorLicense#: 091D36-:1- Phone: 303---s3-og05
Sub Contractors:
Company Name: License M Expiration Date: Trade/Profession: Approval:
Use of ssppace (description):
Description of work:
Value: S Kam- ~ooR - !U1,
sDo oD
Plan Review (due at 6me ofsubmfttaq: $
Sq. Ft./L.Ft added: Squares 'S2- BTU's Gallons Amps
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances,
rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and
allegations made are accurate; that 1 have read and agree to abide by all conditions printed an this application and that 1 assume full
responsibility for compliance with the Wheat Ridge Building Code (1.B.C) and all other applicable Wheat Ridge Ordinances, for work
underthis permit. Plans subject to field inspection.
C/RLCE ONE:: \\(OWNE`R') (CONTRACTOR) or PERSONAL RETR,ES,ENTAATIVE of (OWNER) (CONTRATOR)
PRINTNAIVIE: ii ARB15a~J SIGNATURE: Date: l0 iu fol
DEPARTMENT USE ONLY
ZONING COMMENTS:
Zoning:
Reviewer.
PUBLIC WORKS COMMENTS: -
Reviewer -
BUILDING DEPARTMENT COMMENTS:- OCCUPANCY:
Reviewer... - -
FIRE DEPARTMENT.-. Q approved w/ comments ❑ disapproved 13 no review required Bldg Valuation: $
Credit Card Payment: Use credit card listed on file. te: ~,w
Print name. eizi Mo22tS Signature: