HomeMy WebLinkAbout9625 W. 35th AvenueCity of Wheat Ridge
E -Res. Furnace Replacement PERMIT - 202101506
PERMIT NO: 202101506 ISSUED: 07/13/2021
JOB ADDRESS: 9625 W 35th Ave EXPIRES: 07/13/2022
JOB DESCRIPTION: Replace furnace in basement with 100 BTU 80% efficiency Gas
*** CONTACTS ***
OWNER (303)316-0906 KENDALL CHARLES ARTHUR
SUB (303)313-3333 MICHAEL ENRIGHT 017953 AAA SERVICE PLUMBING
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 51775.00
FEES
Furnace Replacement 40.00
Total Valuation 0.00
Use Tax 121.28
** TOTAL ** 161.28
*** COMMENTS ***
*** CONDITIONS ***
Both the front and back of this permit are required to be posted on the job site at all
times. If the complete permit is not present, inspections WILL NOT be performed.
Work shall comply with 2018 IRC & 2020 NEC. Smoke alarms shall comply with 2018 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 shall have an operational carbon monoxide alarm installed within fifteen
feet of the entrance to each room lawfully used for sleeping purposes.
1* � � i City of Wheat Ridge
E -Res. Furnace Replacement PERMIT - 202101506
PERMIT NO: 202101506 ISSUED: 07/13/2021
JOB ADDRESS: 9625 W 35th Ave EXPIRES: 07/13/2022
JOB DESCRIPTION: Replace furnace in basement with 100 BTU 80% efficiency Gas
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�permrt. I further attest that I am leg ally authorized to include all entities named within this document as parties to the work to be
performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This.permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180, days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and��procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all requ�ired
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any
�pplicabje code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
07/13/2021
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
From: no-reolv(alci.wheatridae.m. us
To: CommDev Pets
Subject: Online Form Submittal: Furnace/Boiler Replacement Permit Application
Date: Tuesday, July 13, 20217:12:45 AM
Furnace/Boiler Replacement Permit Application
This application is exclusively for RESIDENTIAL REPLACEMENT FURNACE or
BOILER - LIKE FOR LIKE ONLY.
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN
ORDER FOR THE PERMIT TO BE PROCESSED.
Your Permit will be emailed to the email address provided below once it is
processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
Is this application for a Yes
replacement residential
furnace or boiler like for
like?
PROPERTY INFORMATION
Is this Residential or Residential
Commercial?
Property Address 9625 w 35th ave
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
Charlie Kendall
303-316-0906
charlietuna@gmail.com
CONTRACTOR INFORMATION
Contractor Business 5550 Marshall St
Name
Contractor's License 0
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
303-313-3333
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
permits@aaatoday.com
Address
Retype Contractor
permits@aaatoday.com
Email Address
DESCRIPTION OF WORK
What type of unit is
Furnace
being installed?
Number of BTUs
100
What is the efficiency
80
(%) of the unit?
Is the unit GAS or
gas
ELECTRIC?
Where is the furnace or
basement
boiler located (for
example, basement,
crawlspace, etc)?
Project Value (contract
5775
value or cost of ALL
materials and labor)
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full Yes
responsibility for
compliance with
applicable City of
Wheat Ridge codes
and ordinances for
work under any permit
issued based on this
application.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal owner of the
property to submit this
application and to
perform the work
described above.
I attest that everything Yes
stated in this
application is true and
correct and that
falsifying information in
this application is an
act of fraud and may
be punishable by fine,
imprisonment, or both.
Person Applying for carrie
Permit
Email not displaying correctly? View it in your browser.
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: a
Job Address:
Permit Number:
❑ No one available for inspection: Time � /PM
Re -Inspection required: Yes tiN+
When corrections have been made, s edulee fg s ection online at:
http//www.ci.wheatridge.co.innspecfio
D , In�pecto --__
--�_.
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: '` 'k" ' r
Job Address:®
Permit Number:+
o CN 1C
❑ No one available for inspection: Time f r'``= AM/PM
Re -Inspection required: Yes No
When corrections are complete, schedule re -inspection online.
Date: -i—) 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 (? IMyl m
Re -Inspection required Yes No
When corrections are complete, schedule re -inspection online.
Dat1 / Inspector: �V0N0TREM0V THIS NOTICE
v
®� A s_ CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: �>j 5
Job Address: t l CYZ \,) 7�; \\-, �u
Permit Number: CDC, 0 CD U V � U�
61nrc S
❑ No one available for inspection: Time i AM/PM
Re -Inspection required: Yes No';
When corrections have been made, schedule for re -inspection online at:
http✓/www.ci. wheatridge.co. usdnspection
Date:--' %;. Inspector.rD) "
DO NOT REMOVE THIS NOTICE
IV � 4 i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: �_(1
Job Address: C' (d
Permit Number: c)" d 4 0- U
❑ No one available for inspection: Time 'i 1 tam 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`. J -� J Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
91
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:
Job Address:
Permit Number:-) t1r: )
l>
6
d
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Yes' No
�,
When corrections have been made, schedule for re -inspection online at:
http✓/www. ci. wheatridge. co. usrnspection
Date: E Inspector:_
DO NOT REMOVE THIS NOTICE
A i CITY OF WHEAT RIDGE'' `
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:
Job Address: -1
Permit Number: t C)\ -p 0
❑ No one available for inspection: Time AM/PM
Re -Inspection required: No
When corrections have been made, schedule for re -inspection online at:
http✓/www. ci. wheatridge. co. usfnspection
Date: (� 13 � ` � Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: 42 P _
Job Address: G) 11 , �j
Permit Number: D (ic) to
❑ No one available for inspection: Time `
p ` � AM/PM
Re -Inspection required: ,,Yes No
u-"_
When corrections have been made, schedule for re -inspection online at:
http✓/www.ci. wheatridge.co.ueinspection
Date: ' / ti ` Inspector:;'
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: - - K�---
Job Address:
Permit Number:
❑ No one available for inspection: Time r . AM/PM
Re -Inspection required: Yes PO4
When corrections have been made, scheI e -inspection online at:
http✓/www.ci, wheatridge.co.us,rinspection
Da eg � � • _. s � . n pec
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: n t etA r ` " PIT � , ^" $:)
Job Address: (_O(�7 3� 1-L,
Permit Number: C� a 0 U C L_R°�o
_ o
LA%4�Cr P ale
r' C� r.
o" (c �.. `� -� 6. p jar
❑ No one available for inspection: Timot ; AM/PM
Re -Inspection required: es No
When corrections have Z, made, schedule for re -inspection online at:
http://www.ci. wheatridge.co.usdnspection
Date: A 9' -d '9 -1 Inspector:e',
DO NOT REMOVE THIS NOTICE
l
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: _
Job Address:
Permit Number:
6T'o one available for inspection: Ti
Re -Inspection requiredZ:S e� No
When corrections have been made,
http✓l/www. ci. wheatridge.co.usfinspi
Date'-
a�t
M
re -inspection online at.
o ®®i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: \j�
Job Address:
Permit Number: rz > 0- L =-
r'
:., r v
t
4
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Yes No
When corrections have been made, schedule for re -inspection online at:
http✓/www.ci. wheatridge.co. usVinspection
Date: `fir~' a`�v ` Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Ipspectiofj Type:
Job Address: q `Pct W _�>S C
Permit Number: 0 �-- I-)-
❑ Ido one available for inspection: Time ;troly AM/PM
Re -Inspection required: Ce) No
When corrections have been made, schedule for re -inspection online at:
http //www.ci.wheatridge.co.usfnspection
Inspector
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: V U o
Job Address: C'1 LPA 1
Permit Number: _C-) C> ` t, k:= (jQ� LA ()QP
❑ No one available for insp9ction: Time-AM/PM
Re -Inspection required: Ye0 No
*When corrections have been made, schedule for re -inspection online at.
httpYlwww. ci. wheatridge. co. usrns pection
Date Inspector: )-7)"
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE 3
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: E r l I
Job Address: Z 4Vt
Permit Number: O 70 3 67 f
❑ No one available for inspection: Time 03!�M
Re -Inspection required: Yes
When corrections have been made, call for re -inspection at 30 -234 -
Date:— 711311-2 Inspector:_ CA
DO NOT REMOVE THIS NOTICE
'7 -o -I4
City of Wheat Ridge
Residential Mechanic PERMIT - 201703671
PERMIT N0: 201703671 ISSUED: 07/11/2017
JOB ADDRESS: 9625 W 35th AVE EXPIRES: 07/11/2018
JOB DESCRIPTION: New 2.5 ton A/c Elect: new 220 Volt Circuit w/GFI
*** CONTACTS ***
OWNER (303)316-0906 KENDALL CHARLES ARTHUR
SUB (303)421-3572 William Buras 017865 Lakeside Heating & A/C
SUB (303)979-1641 John J. McGrath 019585 McGraths-Overall Electric
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,700.00
FEES
Total Valuation 0.00
Use Tax 98.70
Permit Fee 125.05
** TOTAL ** 223.75
*** COMMENTS ***
*** CONDITIONS ***
Work shall comply with 2012 IRC & 2014 NEC. Per IRC Sec. R314, smoke detectors are required
to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every
level of the structure.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
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 perforin the work described and approved in conjunction with
this ermrt. I further attest that I am le ally authorized to include all entities named within this document as 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 and rocedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Offcial 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 graining of a pen=.j It no be nstrued to be a permit for, or an approval of, any violation of any provision of any
applicable code or e or r is jurisdiction. Approval of work is subject to field inspection.
r
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Inspection time requests will be accepted by email only. Please email requests to insptimerequestgei.wheatridge.co.us
between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line.
qus— w, � �3 (P
Occupancy/Type
V iNSPE T!Q�ECORD
SPECTION ONLINE FORM: http://www.ci.wheatr'idge.co.us/inspection �
►�Ji�,,,� C �,,, J'� � INSPECTION REQUEST LINE: (303) 234-5933
spections will not be performed unless this card is posted on the project site.
**Request an inspection before 11:59 p.m. (midnight) to receive an inspection the following business day.**
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections Date Inspector Comments
Initials
Pier
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground/Slab Inspections Date Inspector
Initials
Comments
Electrical
Comments
Sewer Service
Plumbing
Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections
Rough Inspections
Date
Inspector
Initials
Comments
Wall Sheathing
Mid -Roof
Lath / Wall Tie
Rough Electric
Rough Plumbing/Gas Line
Rough Mechanical
Rough Framing
Rough Grading
Insulation
Drywall Screw / Nail
Final Inspections
Date
Inspector
Initials
Comments
Landscaping & Parking / Planning Dept.
Inspections from these entities should be requested
one week in advance. For landscaping and parking
inspections call 303-235-2846. For ROW and drainage
inspections call 303-235-2861. For fire inspections
contact the Fire Protection District for your project.
ROW & Drainage / Public Works Dept
Floodplain Inspection (if applicable)
Fire Inspection / Fire Protection Dist.
Final Electrical
%
Final Plumbing
Final Mechanical
Roof
Final Window/Doors
Final Building
NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate
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 from the Fire District and electrical low voltage
by the Building Division.
Occupancy Is Not Permitted Until A Certificate of OCCLIP= Issued
Prn'-- -' Y`• Mr!
City of Wheat Ridge
Residential Roofing PERMIT - 201702649
PERMIT NO: 201702649 ISSUED: 06/27/2017
JOB ADDRESS: 9625 W 35th AVE EXPIRES: 06/27/2018
JOB DESCRIPTION: Residential Re -roof to install Owens Corning asphalt shingles with 30 sq.
*** CONTACTS ***
OWNER (303)316-0906 KENDALL CHARLES ARTHUR
SUB (720)501-5700 Stephen Miller 170297 Copper Creek Inc
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,710.00
FEES
Total Valuation 0.00
Use Tax 161.91
Permit Fee 172.60 gym
** TOTAL ** 334.51
*** COMMENTS ***
*** CONDITIONS ***
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) requires an approved inspection
prior to installation of ANY roof coverings and is require on the entire roof when spaced
or board sheathing with ANY gap exceeding A% -inch exists. Asphalt shingles are required to
be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is
required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturers€T'"s installation
instructions, whichever is more stringent. In order to pass a final inspection of
elastomeric or similar type roof coverings, a letter of inspection and approval from the
manufacturer's technical representative stating that "the application of the roof at
(project address) has been applied in accordance with the installation instruction for
(roof material brand name) roof covering" is required to be on site at the time of final
inspection.
City of Wheat Ridge
Residential Roofing PERMIT - 201702649
PERMIT NO: 201702649 ISSUED: 06/27/2017
JOB ADDRESS: 9625 W 35th AVE EXPIRES: 06/27/2018
JOB DESCRIPTION: Residential Re -roof to install Owens Corning asphalt shingles with 30 sq.
1, 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 le ally authorized to include all entities named within this document as parties to the work to be
performed ano that all work tobe performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWER 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.
1 This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Offcial and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subj-eci to field inspection.
c
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us
between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line.
Dan Schultz
From: no- reply@c i.wheatridge.co.us
Sent: Thursday, June 15, 2017 3:54 PM
To: Permits CommDev
Subject: Online Form Submittal: Residential Roofing Permit Application
Categories: Danny
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. 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. Permits are currently being
processed within 3-5 business days, subject to change based on volume.
For all other requests:
Homeowners wishing to obtain a roofing permit must apply for the permit in person
at City Hall. Revisions to existing permits (for example, to add redecking) must be
completed in person at City Hall. All other non -roofing permits must be completed in
person at City Hall. The Building Division will be open from 7:30-10:30 a.m.,
Monday through Friday to process these types of requests.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
REROOFING UNTIL PERMIT HAS BEEN ISSUED.
Is this application for a Yes
residential roof?
How many dwelling units Single Family Home
are on the property?
PROPERTY INFORMATION
Property Address 9625 W 35th Ave
Property Owner Name Kendall
Property Owner Phone 303-316-0906
Number
Property Owner Email steve(aD_coppercreekexteriors.com
3�4-,5�1
Address
Do you have a signed Yes
contract to reroof this
property?
It will need to be
provided at the time of
permit pick-up.
CONTRACTOR INFORMATION
Contractor Name
Contractor's License
Number (for the City of
Wheat Ridge)
Contractor Phone
Number
Copper Creek, Inc.
170297
720-501-5700
Contractor Email Address steveCo)-coppercreekexteriors.com
(permit pick-up
instructions will be sent
to this email)
Retype Contractor Email steve(cDcoppercreekexteriors.com
Address
DESCRIPTION OF WORK
Are you re -decking the No
roof?
Description of Roofing Owens Corning
Material
Select Type of Material: Asphalt
If "Other" is selected Field not completed.
above, describe here:
How many squares of the 30
material selected above? /
Does any portion of the No t/
property include a flat
roof?
If yes, how many squares Field not completed.
on the flat roof?
i
TOTAL SQUARES of all
roofing material for this
project
Provide additional detail
here on the description of
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
Project Value (contract
value or cost of ALL
materials and labor)
30
6/12 pitch, house and garage are combined,
66— '-?-7t o . (Do
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
owner of the property to
submit this application
and to perform the work
described above.
Name of Applicant Steve Miller
Email not displaying correctly? View it in your browser.
3
ryes :amCne-ekLyenors.cont
Exterior Restoration Contract
J
Owner Name Is
Mm Address
J��,9T
Ctry, State, Zip Email
10200 E girardAve C-350
Demob Ca 80231
Offi-7205015700
Fax 303 364 8560
lnsttredeZLicensed
3n. 4 3/r "'aw
Home Phone Cell Phone
Billing Address
State, Zip
The undersigned Property Owner or authorized agent hereby enters into this Contract with Copper Creek Inc. (" onVactoe') to famish all
material, labor and buitding�ern its necessary to perform in a workmanlike manner the replacement and/or repairs as specified below for the sum
$ j�/Agreed Insurance Allowance AIA*Payment for contracted COLLECT
to be made as follows: $ !�[ual
s)
TRUST PRIOR to delivery of materials prior to wk starting onsite), and the balS NOT ceoANY PARS OF THE *AIA* MONIES IN
due upon completion of work. Estimated start date: eplacement Cost Value (RCV***)
conditions, at the sole discretion of CCC, appears to compromise the satimatfety fd completion
ohe o leti n date Z:ai1 subject to change if weather
Claim Specifications
DEMOLITION:
Protect and cover siding, landscaping, driveway, windows, doors, water features, etc. with tarps and plywood as necessary to protect
from damages caused by debris. Remove associated debris from property.
Remove all roofing materials to include vents, flashings, underlayment. Inspect all visible substrate (decking) for rot, damage and
deficiency. Per 8x4 sheet is replaced at a cost of $ per sheet and includes labor.
INSTALLATION ROOFING:
Install new/replace existing substrate (decking) as needed to provide suitable surface for installation of new materials for a cost $
per square foot /_ AIA.
stall new Ice and Water Shield per municipal code and manufacture's specifications as applicable.
Install new underlayment on remaining roof deck surfaces per manufacture's specifications.
,-Install new drip edge metal on all eaves and gables per municipal codes
Install new_ 24" "W ' metal Valley or _ properly flashed closed, California cut Valley.
Install new roofing material of like kind and quality as pre-existing per municipal code (to include nailing pattern) and manufacture's
specifications unless marked: _Material Manufacturer
-tiolor "7"V Q HO initials: date:
Install new hip and ridge caps. t: • Shingle over, ✓ Raised profile, ,_Shingle over ridge vent, —Le Other
_,e'- Install new flashing at all roof protrusions per municipal code and manufacturer's specifications.
Install new vents per municipal code and manufacturer's specifications.
7, Remove and haul away remaining roofing materials and debris. Roil yard and driveway with magnetic roller.
INSTALLATION SIDING:
,x Install. new/replace existing vinyl. siding and identified. trim per loss statement as needed _to -provide suitable surface for installation of
new materials for a cost $ per square foot / AIA. - - - -
Install new/replace existing garage door identified per loss statement as needed to provide suitable surface for installation of new
materials for a cost $ per square foot / AIA,
INSTALLATION WINDOWS:
.. Install newireplace existing window/door and metal wrap casing trim identified per loss statement as needed to provide suitable surface
Ior installation of new materials for a cost $ per square foot! AIA.
NSTALLATION CUTTERS:
Install new/replace existing gutters per -loss statement as needed to provide suitable surface for installation of new materials for a cost
$ per square foot / ,�qIA.
This section�pplies to AIA Contracts only. Provisions 1.6 MUST be initialed by the Property Owner or Agent-
�4m2ntA,� rAc/x'�d' ,f�Lr[7+Ztz/i`'/
INSURANCE COMPANY CLAIM # (( ADJUSTER'S NAME ADJUSTERS CONTACT#
MORTG GE COMPANY LOAN # MORTGAGE CO'S ADDRESS MORT CO'S PHONE #
—tLf/1. Contractor shall complete the Scope of Work based on AIA, with NO ADDITIONAL OUT OF POCKRT FxvFntee Tn
. im ern
Lt , -I- Property Ovmer requests upgrades or additional work in writing ("Change Order") that is not approved by the
j insurer. This Contract is considered AIA only if the Property Owner has full replacement cost insurance coverage. Otherwise,
1G/�/ this is a Contract for roofing/construction services outside of ALA and certain consume protection laws may not apply.
The undersigned hereby gives consent and authorization for the insurance company named above to discuss the Claim,
settlement terms, and supplemental charges/fees and release all pertinent claim information related to the applicable Claim to
% Contractor.
.._ _3. The undersigned hereby agrees to collect and provide all documents and information related to Contractor in a timely manner.
4. The undersigned hereby assigns all amounts due from the Property Owner's insurers and/or mortgagees for work completed by
the Contractor to Copper Creek Inc. This includes, but is not limited to: all direct costs, overhead and profit and any
supplements submitted to and approved by the insurer for additional work, ordinance/code upgrades, cost increases, and
unforeseen repairs. The Contractor reserves the right to request and receive additional payments from Property Owner's insurer
due to material or labor increases, storm environment, unfores= work including but not limited to substrate replacement, or if
measurements and/or other information provided by the Property Owner or the Property Owner's Insurer are incorrect.
_. The undersigned agrees that Contractor may cancel this Contract solely upon Contractor's discretion if the Property Owner's
insurer is unwilling to pay fair market value for work covered under the Property Owner's insurance policy. Contractor shall
make a. good faith effort to reach an Agreed insurance allowance.
/+ 6. The Scope of Work /AIA shall be attached hereto and made part of this Contract as "Addendum I". Once an AIA is retched
with Property Owner's insurer, a Job Start Checklist shall be attached hereto as "Addendum 2".
Notice of Cancellation per SENATE BILL 12-038 / 6-22-101 ACT
You, the buyer, may cancel this transaction at any time prior to midnight on the THIRD BUSINESS DAY after the date of this
transaction. SEE THE ATTACHED NOTICE OF CANCELLATION FORM for an explanation or this right. I/We the
undersigned agree to the terms and conditions of this Contract, including all terms and conditions on the reverse side. This
Contract supersedes all previous Contracts including but not limited to rebates, discounts, or concessions whether written or
oml. Surety & Liability Policy is held by producer: DC INSURERS -MOUNTAIN 3705 KIPLING ST. #106 WHEAT RIDGE,
CO 80033 PH -3034204774 FAX 303420-2882
PRTY 0 RIAGENT SIGN ftTURE f �DATE� l� PR ERTY OWNER! St CAT[JRE /DATE
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: 1 (02 S h/ 35 A yr
Permit Number: 249/ _)0z & V
❑ No one available for inspection: Time (��P/PM
Re -Inspection required: Yes LNp
When corrections have been made, call for re -inspection at 303-234-
Date:- 2 16 Inspector:
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Mechanic PERMIT - 201703671
PERMIT NO: 201703671 ISSUED: 07/11/2017
JOB ADDRESS: 9625 W 35th AVE EXPIRES: 07/11/2018
JOB DESCRIPTION: New 2.5 ton A/c Elect: new 220 Volt Circuit w/GFI
*** CONTACTS ***
OWNER (303)316-0906 KENDALL CHARLES ARTHUR
SUB (303)421-3572 William Buras 017865 Lakeside Heating & A/C
SUB (303)979-1641 John J. McGrath 019585 McGraths-Overall Electric
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,700.00
FEES
Total Valuation 0.00
Use Tax 98.70
Permit Fee 125.05
** TOTAL ** 223.75
*** COMMENTS ***
*** CONDITIONS ***
Work shall comply with 2012 IRC & 2014 NEC. Per IRC Sec. R314, smoke detectors are required
to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every
level of the structure.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved pians 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.
1"e -l'
Signature of OWNER or CONTRACTOR (Circle one) Date I
1. This permit 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, policies and procedures.
2. This. permit shall expire 365 days after the date of issuance regardless of activity. Re nests 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 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 apermit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applicable code or any or mane or regulation of this Jurisdiction. Approval of work is subject to f any
inspection.
.,
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us
between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line.
♦��s
City of
Doft
C�MMUNiiY DEt�,QPMEI�tT pb.rn>ft #: r171
Building Division
7500 W. 29et Ave., Wheat Ridge, CO 80033 • ��'
Office: 303-235-2$55 * Face: 303-237-8929
Inspection Line: 303-234-5933
Facsimile Building Permit Application
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city,side. E;
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t' URE of UNDEMANDING AND AGREMENT
I hereby owify BW ttre aatbaak a["nome pq� 000a tax rfc Q8t a ; 6,- d m rs aorz , aW do not
nd" ar of the Ctty of Wbaat 4; or or of mcoM; that A e3.., ave!
allepatl; rtrade ate aoaaaia; flat I have rand and swee is strideaM corKN Ians pdrs f on oris and dwd I amme fiA
PlowwNlt� Mfiw d RMw Code PAG) and al other Whams FWW for work
Vft PM.,m knowtaL
CHIME ONE: `(t 71'NyN
( or Ptx�ONAL REPREMWA VE of (tit) (CONTRA7oR)
MW NAME 7 L_ , c � � sism IuR& i.� L� s�s�.n �+f�ti4� fie:,T_G�=-�
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Oft Vahat€btt: S
Credft Card Payment: Use crodlt card listed on Me. Date: 7 -
Print name: ,"°,ll f._ Signature: &a&A6&,.. - �
♦ `s CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234 -5933 Inspection line
(303) 235 -2855 office • (303) 237 -8929 Fax
INSPECTION NOTICE
r
Inspection Type: O
Job Address: ,-
Permit Number: 1Lr;
El No one available for inspection: Time `/ %qM /PM
Re- Inspection required: Yes No
When corrections have been made, calf for re- inspection at 303-234-5933
Date: _ 11-19 - / /) Inspector r1 !• ;
DO NOT REMOVE THIS NOTICE
♦ , i CITY OF WHEAT RIDGE
f � Building Inspection Division
(303) 234 -5933 Inspection line
235 -2855 Office • (303) 237 -8929 Fax
INSPECTION NOTICE
Inspection Type: s
Job Address:
Permit Number: A��'o q
i
1ce,d 40 "d -�rf
❑ No one available for inspection: Time A /PM
Re- Inspection required: Yes No
When corrections have been made, call for re inspection at 303 - 234 - 5933
Date / 1 , ///& Inspector
l
DO NOT REMOVE THIS NOTICE
f
City of Wheat Ridge
Residential Roofing PERMIT - 100905
PERMIT NO: 100905ISSUED.:. 04/09/2010
JOBADDRESS: 9625 W.-35TH AVE EXPIRES: 10/06/2010
DESCRIPTION: T/o: Install 30 sqs of Class Fasphalt. shingles.
***.CONTACTS
owner 303/423-9502 Cossman, Leslie
gc 303/659-8241 Alfredo Ramos 06-0036 Ramos Roofing Co.
**:PARCEL 'INFO
ZONE.: CODE: UA USE: UA
SUBDIVISION:, 0620 'BLOCK/LOT#: 0/
FEE SUMMARY -ESTIMATED PROJECT VALUATION: 13,335.0.0
FEES
Permit Fee 308.50
Total Valuation .00(
Use `Tax 240.03-
**TOTAL 548.53
Conditions:
6 nail installation -L mid-roof inspection required. Board sheathing spaced more
than a 1/2 of an inch apart. requires plywood overlay on entire roof. Ice and
water shield required from eave edge to 2' inside exterior walls. ***Contractor
or Property owner shall provide ladder(s) secured in place for inpsections. It
is the responsibility of the person/firm requesting the inspection to insure
roofs are clear for inspection. Scheduled inspections that. cannot be performed
due to inclement weather must be cancelled <prior to 8:30a.m. on the day of
inspection or a re-.inspection fee of $61.0.0 will be assessed.
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 andl agree to abide by all conditions printed on this
application and that I assume full responsibility for compliance with the Wheat Ridge. Building Code (I B.C) and all other
/ap a Wheat Ridge O na/nces, or work under this permit. Plans subject to field inspection.
-R= natur of ontractor/o er 'date
1. This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the
State of Colorado and to the Zoning Regulations and Building: Codes of Wheat Ridge, `Colorado or any other applicable
ordinances of the City.'..'
2. This permit shall 'expire 180 days from the issue date.. Requests : for an extension must be received prior to expiration
date. An extension may be granted at the discretion of the Building Official.
3. If this permit expires;: a new permit may be acquired for a fee of one-half the amount: normally required, provided no
changes have been or will be made in the original plans and specifications and any suspension or abandonment' has not
exceeded one (1) year. It changes have been or if suspension or abandonment exceeds one (1) year,. full fees shall
be. paid for a: new permit.
4. No work of any manner :shall be done that will change the natural flow of water causing `a drainage :.problem
5. Contractor. shall notify the Building Inspector twenty-four (24). hours in advance for all inspections and shall receive
written approval on inspection card before proceeding with successive phases of the job.
6. The issuance of a permit dr;the approval of drawings and specifications shall not be construed to be a permit for, nor
an. approval of a 1 ion of the provisions of the building codes or any other ordinance, law,` rule or regulation. All, plan review is t to field inspections.
Signature of Chief i Idrng :Official 'date
bI
INSPECTION REQUEST LINE: (303)234-5.933 BUILDING OFFICE: (303)235-2855.
REQUESTS MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
1 CitY of
1~,7~ ITeat~Cge Date:
yy
COMMUNITYDEVELOPMENT
Plan #
Building & Inspection Services Division Permit #
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855' Fax: 303-237-8929
Inspection Line: 303-234-5933
Building Permit Application
propertyAddeess ~~Z~~ ~y/es-i ~s ,tire.
Property Owner (please print): (pSSt~tCr r' C-ePhone:
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Contractor";: f ~ !C~ U/iCUS ~ `-rz ~ ~x--~-Contractors City License Phone:
Electrical: Plumbing: Mechanical:
City License # City License # City License #
bescrtntion.wf wor~/k/
Contract Value:
Review Fee (due at time of submittal):
Squares BTU's Gallons Amps Sq Ft. $
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.
CIRCLEONE: (OWNER) (CONTRACTOR) jr (AUTHORIZED REPRESENTATIVE). of (OWNER) (CONTRACTOR)
PRINT NAME: le/N~J{SIGNAT RE: DATE: off//~'//'G
c _ ~ ~ , . r. i_ 'tea rhFR:ORSMFMTrJ ICraN~~h..¢ b
FIRE DEPARTMENT ❑ approved lvj caittmetlts O.,disapproyed ❑ no reviewrJeglilr'ed Bldg Valuation. $
c
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING INSPECTION LINE - (303-234-5933)
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
Property Owner:
Property Address
Contractor License No.
LESLIE COFFMAN
9625 W 35TH AVE
18983
Company : Genesee Mechanical Co. Phone : 237 0234
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I Beretiy certify that the setback distances proposed tiy 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 haveread and agree to abide-by all condiGOns printed on thisapplication, and that I assume full responsibility for compliance with the Wheat Rid9e Buildin9 Code (U.B.C.) and all other applicable Wheat Ridge ordinances, for work under tfiis permit:
(OWNER)(CONTRACTOR)
Description : REPLACE FURNACE, 125,000 BTU ARMSTRONG
Valuation :
$2,500.00
Permit Fee :
$108.30
Plan Review Fee :
$0.00
Use Tax :
$45.00
Total:
$153.30
Use : mo
BUILDING DEPARTMENT USE ONLY
~o`~~i lg~omm~
Approval:
Zoning :
Approval:
n
Appcoval:
Occupancy : Walls
SIC
MINIMUM REQUIREMENT OF 90%AFUE
78289
1/24/2005
Phone : 423-9502
Sq. Ft. :
Roof : Sto"ries : Residential Units :
Electrical License No :
Company:
Plumbing License No
Company :
Mechanical License No :
Company :
Ezpiration Date : Ezpiration Date : Expiration Date :
Approval- Approval : Approval :
(7) This permit was issued in accoNance with the provisions set foRh in yopw applicalion and is sUbject to the lawsof the State of Colorado and lo tfie Zoning
Regulation5 and Builtling Cbde of W heat Ridge, Colorado or any other applicable ordinances of the City. `(2) This pertnit shall.expire if (A) the Work authorized is not commenced withinsizty (60) days from issue date or (B) the building authorizeH is suspentled or ,
- atiandoned for a period of 720 days. (3) If thispermit expires, a new permit may be acquired for a fee of one-half the amount nonnally required, provided no changes Aave been orwill 6e made in theoriginal plans and specifcationsand any suspension or abantlonment has not ezceeded one (i) yeac If changes are made or if suspension or abandonment
. ezceetls one (t) year, full fees shall be paid for a new pertnit. .(4) No work of any manner shall be done that will change the naturel Flow of water causing a drainage problem. (5) Contractor shall notiyihe Building Inspector lwenty-four (24) houre in advance for all inspections and shatl receivewntten approvai on inspection card before
. proceediing with successrve of thejob. ~ (6) The issuance-a per or the approva Jdrawings andspecifiwtions shall nat be construed to be a permit for, nor an approval of, any violation of the
proyisi ~ he mg de ~er ordinance, law, rule or regulation. .
! . . . .
~ Chief Building Inspector
Please sign Terms and Conditions on reverse side of page.
Building Permit Number
Date
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number :
BUILDING INSPECTION LINE - 303-234-5933
CITY OF WHEAT RIDGE Date : iI
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215 - (303-235-2855)
APPL1«T~1oN
Property Owner :LP-,S 1 i C~.
Property Address : q LoaFJ L~u th- G Ue ' Phone : H23- ~°~j(2
Contractor License No. : laq 83
Company CeXX~~~ L0021.-~(- fl iCr"1 ~ Phone :a 3!- G~3LI
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the sethack distances proposed by this permit application are acwrate,
and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or
covenants, easements or restnctions of record; that all measurements shown, and allegations
made are accurate; that I have read and agree ta abide oy aIi conditions pnnted on this
_ application, and that I assume full responsibility for cam Wheat Ridge Building
Code (U.B.C.) and all other applicable Whqat Rid rdinances, fpr wo under this pertnit.
(OWNER)(CONTR,4CTOR)SIGNED/I^~IF~J TE I~~/~
Construction Value
Permit Fee :
Usa Tax:
Total:
Use:
Description : /1) 1 VoQ (3 -Iu J.
BUILDING DEPARTMENT USE ONLY
Approvaf:
Zoning :
Approval:
° - - m ~
Approval :
Occupancy: Walls :
Electrical License No :
Company :
Expiretion Date :
Approval :
SIC : Sq. Ft. :
Roof : Stories : Residential Units :
Plumbing License No : Mechanical License No :
Company: Company:
Expiration Date : Expiration Date :
Approvaf : Approvaf :
(1) This pemit was issueE in a
Regulatl orCance with the pmvisions set forth in yopur appliption anC is su0ject to Ne laws of Ne Sfate of Colo2EO and to Ue Zoning
ons x antl BuilEing CaEe W Wheat Ridge, ColorsCO or any oNer appli(able ortlinances of the Ciry.
(2) This pertnit shall expite i( (A) Na vrork auNOdzeC is npt mmmenced wifhin sixty (80) aays from issue Eate ar (B) the builCing authorized is su5pen7eC or
aban0oned for a penotl o( 720 days.
(3) It Nis pertnit expires, a new petmit may be acpuired (or a fee of ane~half the amount nortnalty requimE, pmviCeE no changes have Ceen or will be maCe in the
onginal plans anC specifiptions antl any wspensian or ahantlanment has not exeee0ed one (t) yeac If changes are matle or if suspension or abanEOnment
exceeCS one (t) year, full fees sMl he paid far a new pertnit
(4) No work ot any manner shall be tlone that will change the natu2l flow of water causing a tlrainage pioblem.
(5) Cantraetor shall nodfy the BuilCing Inspectar hvenry•fpur (24) hours in advance fpr all inspecUons antl shall receive written approval an inspection card Oefore
1p~ihoceediing wkh successivethphases af tAeofp' b. (6) o( M huJEinmoes o i arry atl~ ~bialnce~ law, nme a ~ nd specifirations shail not Ce wnsWeE to be a permit (or, nor an approval o( any violafion af the pmvisions
. 9 cotl regulatlan.
Chief Building Inspector
City of Wheat Ridge
Residential Basement Finish PERMIT - 202000606
PERMIT NO: 202000606 ISSUED: 06/11/2020
JOB ADDRESS: 9625 W 35th Ave EXPIRES: 06/11/2021
JOB DESCRIPTION: Basement finish to include demo of four walls, adding an office, bedroom,
living room, laundry room, entertainment room, utility room, and one
bathroom - 1,158 sq ft total
(requested additional details on description)
*** CONTACTS ***
OWNER (303)31.6-0906 KENDALL CHARLES & TRISHA
GC (720)441-5060 JOSHUA HAEN . 202072 EMPIRICAL CONSTRUCTION
SUB (303)944-3208 Richard Phillips 180047 R&R Electric
SUB (303)909-6255 RUDY GARCIA/DUNG PHAN 202010 COLORADO HVAC
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
***' FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 47,257.92
FEES
Total Valuation 0.00
Plan Review Fee 459.26
Use Tax 992.42
Permit Fee 706.55
** TOTAL ** 2,158.23
*** 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.
BASEMENT NOT APPROVED AS AN INDEPENDENT DWELLING UNIT.
' City of Wheat Ridge
_ Y
Residential basement Finish PERMIT - 202000606
PERMIT NO: 202000606 ISSUED: 06/11/2020
JOB ADDRESS: 9625 W 35th Ave EXPIRES: 06/11/2021
JOB DESCRIPTION: Basement finish to include demo of four walls, adding an office,
living room, laundry room, entertainment room, utility room, and
bathroom - 1,158 sq ft total
(requested additional details on description)
bedroom,
one
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 ermI I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be
performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
1. This permit 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 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 androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Of iipial 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 pe it shall not be construed to be a permit for, or an approval of, any violation of any provision of any
applicable code gw-%iy ordinance pr�regulation of this jurisdiction. Approval of work is subject to field inspection.
f Building Official Date
E MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Needs asbestos contractors
From: no-reolv(alci.wheatridae.m. us
To: CommDev Perm is
Subject: Online Form Submittal: Residential Interior Remodel
Date: Tuesday, March 24, 2020 3:40:56 PM
Residential Interior Remodel
This application is exclusively for Residential Interior Remodels and other scopes
of work which do not have a specific form already available.
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN
ORDER FOR THE PERMIT TO BE PROCESSED.
Your Permit will be emailed to the email address provided below once it is
processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
PROPERTY INFORMATION
Property Address 9625 West 35th Avenue, Wheatridge Colorado 80033
Property Owner Name Charlie and Trisha Kendall
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Address
Attach Electronic
Payment Form - "DO
NOT ATTACH
RANDOM
DOCUMENTS"
303-316-0906
charlietuna@gmail.com
Mar 24, Doc 1.Ddf
CONTRACTOR INFORMATION
Contractor Business Empirical Construction
Name
Wheat Ridge
Contractor's License
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
202072
Contractor Phone 720-951-1140
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email aaron@empiricalcc.com
Address
Retype Contractor
Email Address
DESCRIPTION OF WORK
Scope of Work
aaron@empiricalcc.com
Basement Finish
Location of Work Basement
Square Footage Area
of Work Being
Performed
Asbestos Report
Construction Plans
scanned on 11'x17" or
larger
1,158
Kendall Noted 2.6.20 (2).Ddf
Project Value (contract 37,500
value or cost of ALL
materials and labor)
sq ft 1158' 40.81 = $47,257.92
4/2/2020 BF
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full Yes
responsibility for
compliance with
applicable City of
Wheat Ridge codes
and ordinances for
work under any permit
issued based on this
application.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal owner of the
property to submit this
application and to
perform the work
described above.
Person Applying for Aaron Holstad
Permit
I attest that everything Yes
stated in this
application is true and
correct and that
falsifying information in
this application is an
act of fraud and may
be punishable by fine,
imprisonment, or both.
Email not displaying correctly? View it in your browser.
City of
Wheat,jdge
COMMUNITY DEVELOPMENT
SUBCONTRACTOR AUTHORIZATION FORM
Mechanical Subcontractor
This form must be completed & signed by the MECHANICAL SUBCONTRACTOR
performing mechanical work on site.
Subcontractor's insurance and license must be up to date prior to permit issuance.
Project Address: %Z5 u/a=CT 35'" Ayj=WUL
General Contractor:_&MT�ZTC4L Cpl ZULU -0q
Company Name:_ChLL u-MC'� CoutactPhone#: 90? -261— 31Ce
Wheat Ridge Contractor License #:6&eLo 1 b . (required field)
780 Simms Street, Suite 101 Golden, Colorado 80401 www.enviro-spec.com
Limited Asbestos Bulk Sampling Report
9625 West 35th Avenue Wheat Ridge, Colorado 80033
Report Date: July 25, 2019
Prepared for:
Charlie Kendall 9625 West 35th Avenue Wheat Ridge, Colorado 80033
['age 1 of 13
Table of Contents
ExecutiveSummary .................................................................................................................................................... 3
Introduction.................................................................................................................................................................. 4
Asbestos Inspection
Suspect Asbestos Containing Materials 7
Trace Asbestos Containing Materials ...................................................................................................................... 9
Regulated Asbestos Containing Materials ............................................................................................................ 10
Recommendations 11
General B
Appendices
Appendix A Summary of Laboratory Results
Appendix B Laboratory Results and Chain of Custody
Appendix C Certifications
Appendix D Photos
Page 2 of 13
Executive Summary
,-- EnviroSpec, LLC (EVS) Mr. Michael Ciccotti conducted a limited, area and material
specific, asbestos inspection within the residential structure located at 9625 West 351h
Avenue in Wheat Ridge, Colorado.
,-- This inspection was conducted due to planned renovations potentially causing
damage to suspect asbestos containing materials (ACM).
r Thirty-four bulk samples were collected and submitted for analyses on a 5 -day
turnaround.
Samples were collected of adhesive, floor tiles, sheet vinyl flooring, drywalls (to
include tape and joint compound), and surfacing textures.
� Laboratory results indicated the sheet vinyl flooring underlayment (sample SVF01),
surfacing textures (sample TS03), joint compound (sample CDW01) to contain asbestos
in concentrations greater than 1 %.
r Laboratory results indicated the surfacing texture (sample TS04) to contain trace (11%
or less) asbestos. Due to friable material, trace samples were point counted.
,-- Disturbance activities for friable materials containing 1% asbestos or less should be
performed in accordance with the Occupational Safety and Health Administration
(OSHA) standard, including proper training, work practices, personal protective
equipment, decontamination/cleaning procedures, etc.
Based on the laboratory analytical results, ACM listed in this report (ACM in
concentrations greater than 1%) should be removed by a Colorado State Certified
General Abatement Contractor (GAC).
Page 3 of 13
Introduction
EVS's Mr. Michael Ciccotti conducted a limited, area and material specific, asbestos
inspection within the residential structure located at 9625 West 35th Avenue in Wheat
Ridge, Colorado.
The inspection was conducted due to planned renovations. Materials potentially
impacted were limited to specific areas specified by the client and did not include
suspect materials in which the client stated would not be disturbed during renovation
activities. The Environmental Protection Agency (EPA) and Colorado Department of
Public Health and Environment (CDPHE) Colorado Regulation No. 8 (Reg. 8) requires
that suspect ACM be properly sampled and analyzed prior to any renovation activities
that may disturb these materials. The purpose of this inspection was to identify and
sample specific suspect ACM that could be impacted by renovation activities in these
specific areas as requested by the client.
This asbestos inspection was conducted on July 8, 2019 by Colorado State Certified
Asbestos Building Inspector Mr. Michael Ciccotti, Certificate #15072.
Page 4 of 13
Asbestos Inspection
This limited asbestos inspection was conducted in general accordance with the United
States EPA procedures published in 40 Code of Federal Regulations (CFR) Part 763,
Subpart E — Asbestos -containing Materials in Schools and Colorado Reg. 8. These
inspection protocols specify requirements for the inspector (Section 763.85), laboratory
(Section 763.87), and number of samples collected during an inspection (Section
763.86).
This limited area and material specific asbestos inspection involved identification and
sampling of specific homogenous areas of suspect ACM in the specific areas that could
be impacted by renovation activities as requested by the client. Suspect ACM includes
nearly all building materials except concrete, glass, metal, wood, plastic and ceramic.
A physical assessment of each homogeneous area of suspect ACM was conducted to
assess the general condition of the material and determine the friability of the material.
Under the National Emissions Standards for Hazardous Air Pollutants (NESHAP),
asbestos -containing building materials are classified as either friable, Category I non-
friable or Category 11 non -friable ACM as described below:
Non -friable ACM when dry, cannot be crumbled, pulverized or reduced to
powder by hand pressure. Friable ACM when dry, can be crumbled, pulverized or
reduced to powder by
hand pressure.
r Category I non -friable ACM includes packings, gaskets, resilient floor
coverings, and asphalt roofing products containing more than I% asbestos.
,-- Category 11 non -friable ACM are materials excluding Category I non -friable
ACM materials that contain more than 1 % asbestos.
Bulk samples of suspect ACM were collected in general accordance with the Asbestos
Hazard Emergency Response Act (AHERA) protocols as outlined in Colorado Reg. 8
and Asbestos in Buildings: Simplified Sampling for Friable Surfacing Materials as
referenced in the Pink Book. Random samples of suspect building materials were
collected for the specific areas and materials identified in this report.
Pave 5 of 13
Surfacing materials sampled in this report include, but are not limited to overspray, and
droppings, which may be under flooring materials, adjacent walls, structural beams, and
other concealed areas.
Title 40 CFR Part 61 regulates asbestos fiber emissions and asbestos waste disposal
practices, and requires the identification and classification of existing building materials
prior to demolition or renovation activity.
Pave 6 of 13
Suspect Asbestos Containing Materials
Building materials are historically known to contain asbestos and therefore suspected to
contain asbestos. OSHA maintains comprehensive lists of suspect AGMs frequently
encountered during inspections.
The following suspect AGMs were observed during the inspection and determined
based on review of renovation activities within the structure, to be potentially impacted
and subject to inspection and bulk sampling:
• (CDW01) 5/8" White drywall, tape, and joint compound associated with TS01, TS02,
TS03, TS04 on walls and ceilings in basement (except build- out)
• (CDW02) 5/8" White drywall, tape, and joint compound associated with SOA02 on
east, north, west walls and ceiling of back porch build -out
• (CA01) Tan adhesive associated with carpet in southwest and southeast bedrooms
• (FTC01 ) 12" x 12" Tan floor the with square pattern over 9" x 9" tan floor tile with tan
dots and brown adhesive in utility room, and hallway
• (FTCO2) 9" x 9" Brown floor the with black mastic in living room and main room
• (FTC03) Black and green floor tile with black mastic in basement southeast bedroom,
and main room
• (SOA01) Popcorn ceiling surfacing texture associated with CDW01 in basement
southeast and southwest bedrooms
• (SOA02) Popcorn-type ceiling surfacing texture associated with CDW02 in back porch
build -out
• (SVF01) Tan sheet vinyl flooring with flower pattern, grey felt backing and black
underlayment in basement bathroom, and southwest bedroom closet
• (TS01) Stucco -type surfacing texture associated with CDW01 on walls and ceiling in
basement southwest closet, and ceiling in utility closet
• (TS02) Orange peel surfacing texture associated with CDW01 on walls in basement
southwest bedroom
• (TS03) Light orange peel surfacing texture associated with CDW01 on south wall in
basement main room, walls and ceiling in hallway, walls in bathroom, walls and ceiling
in living room
Paae 7 of 13
• (TS04) Swirl pattern surfacing texture associated with CDW01 on ceiling in basement
bathroom Thirty-four samples were submitted under chain of custody procedures to
Aerobiology
Laboratory Associates, Inc., of Golden, Colorado, for analysis by Polarized Light
Microscopy (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. Aerobiology is an accredited laboratory under the National
Voluntary Laboratory Accreditation Program (NVLAP 200860-0).
Paae 8 of 13
Trace Asbestos Containing Materials
CIDPHE requires additional analysis for friable materials reporting trace -1 % asbestos
under PLM (for additional confirmation by point -count analysis method). Materials
containing 1 % or less asbestos also referred to as "trace asbestos" (when verified by
point count) are not subject to EPA and CIDPHE requirements. However, materials
containing 1 % or less asbestos may be subject to OSHA regulations if air
concentrations are at or above the personal exposure limit (PEL) of 0.1 f/cc or the
excursion limit of 1.0 f/cc
The following friable material is identified by laboratory PLM analysis as trace asbestos
and point counted, noted in bold:
• (TS04) Swirl pattern surfacing texture associated with CIDW01 on
ceiling in basement bathroom
Pave 9 of 13
Regulated Asbestos Containing Materials
ACM was identified in concentrations greater than one percent (>l %) in the following
building materials, noted in bold:
TS03, TS04 on walls and ceilings in basement (except build- out)
w (OYl Slil tile wafv-sAull Vzitil iir�m 9".k 9" tan SItt
vIrr til&-Hitil
tan dots and brown adhesive in utility room, and hallway
• (FTCO2) 9" x 9" Brown floor tile with black mastic in living room and main room
• (FTC03) Black and green floor tile with black mastic in basement southeast
bedroom, and main room
- (SVF01) Tan sheet vinyl flooring with flower pattern, grey felt backing and black
underlayment in basement bathroom, and southwest bedroom closet
Mill 1111111 room, na is ana ceiling in imaj, Tia s in room, Ina is anZ)77eWry
in living room
EPA and CIDPHE regulation to be removed prior to renovation and/or demolition
(which are more likely to release airborne asbestos).
Under renovation activities, all friable and non -friable materials are considered RACM
due to greater potential for direct impact to the non -friable material using hand removal
I%ltI W!lz eN1aIeIllI
renovation activities.
Faae 10 of 13
EVS's Mr. Michael Ciccotti conducted a limited, area and material specific, asbestos
inspection within the residential structure located at 9625 West 35th Avenue in Wheat
Ridge, Colorado. Through laboratory analysis of bulk samples, EVS confirmed asbestos
in concentrations greater than one percent (>1 %) in the following building materials,
noted in bold:
TS03, TS04 on walls and ceilings in basement (except build- out)
flow tile VffIT&-%Lr'ff6 ;1'dR'61YrM6Tr V A V tdfl flow tile 16til
tan dots and brown adhesive in utility room, and hallway
• (FTCO2) 9" x 9" Brown floor tile with black mastic in living room and main room
• (FTC03) Black and green floor tile with black mastic in basement southeast
bedroom, and main room
- (SVF01) Tan sheet vinyl flooring with flower pattern, grey felt backing and blach
underlayment in basement bathroom, and southwest bedroom closet
basement main room, walls and ceiling in hallway, walls in bathroom, walls and ceiling
in living room
The CDPHE requires that a licensed asbestos abatement contractor remove regulated
ACM prior to any activity that may potentially disturb these materials. The proper
removal and handling of these materials is typically addressed through the preparation
of a written "abatement scope of work/specification" document. This document is used
abatement contractor. ACM is subject to OSHA Construction Industry Standard for
Asbestos (29 CFR Part 1926.1101). Based on the laboratory analytical results, ACM
listee, i?% t�is re.Q#K s�oule, �se rem#ve,#. Wy 2 $ti?.te reKifie,*. Q�e?%er2l A�s2temeM
Contractor prior to conducting any renovation activities associated with the asbestos -
containing material mentioned above.
FaLe 11 of 13
Through laboratory analysis of bulk samples, the following trace (11% or less)
containing friable materials have been identified, noted in bold:
- (TS04) Swirl pattern surfacing texture associated with CDWO1 on
ceiling in basement bathroom
Materials classified as containing 1 % or less asbestos are not subject to USEPA and
CDPHE regulations, but are subject to OSHA hazard communication and exposure
assessment provisions, and would be subject to additional requirements, if air
concentrations of asbestos are at or above the permissible exposure limit (PEL) of 0.1
f/cc or the excursion limit of 1 .0 f/cc. Disturbance activities for materials containing 1 %
proper training, work practices, personal protective equipment,
decontamination/cleaning procedures, etc. In occupied buildings, the use of
engineering controls (negative pressure containments) and work practices (proper
waste packaging and decontamination procedures) are appropriate to ensure
construction dust is confined to the construction work area and does not migrate to
adjacent occupied areas.
Page 12 of 13
PlAff MK &5�01J-f rlw-A-f 691
EVS assumes no liability for any loss, injury, claim, or damages arising directly or
indirectly from any use or reliance on this inspection report or the opinions expressed
herein. EVS makes no risk assessment, warranty, guarantee or insurance policies of
any kind, express or implied. This report is limited only to the area(s) inspected. There
are no risk assessments warrant* uarantees or insurance available or provided by
EV".A44it4,n2l e2m�l�rg Y.2y
renovation in the future.
This reDort was DreDared Dursuant to the contract EVS has with the client. includina an
exchange of information about the subject property that was unique and between EVS
and its client. No guarantees are made arising from any service rendered and liabilities
hereunder shall not exceed the total fee paid by the client to EVS. This report does not
serve as a scope of work or bidding document.
EVS greatly appreciates the opportunity to be your environmental consulting company.
Please feel free to call with any questions, comments, or concerns regarding this report.
Regards,
Michael Ciccotti, Senior Environmental Scientists Michael@enviro-spec.com Cell:
303.880.5716
Serina Schenker, Managing Partneri Serina@enviro-spec.com Cell: 303.242.0711
EnviroSpec, LLC 780 Simms Street, Suite 101 Golden, Colorado 80401
Page 13 of 13
Appendix A Summary of Laboratory Results
Material Description Material Location
Estimated Material Quantity
Type and Friability Classification
Material Condition
Potential for Disturbance
Assessment
Category Laboratory Result
(CDW01) 5/8" White drywall, tape, and joint compound associated with TS01, TS02, TS03, TSO4
on walls and ceilings in basement (except build -out)
Friable Miscellaneous Material
Good High 5 Joint compound = 2%
Chrysotile
(FTC01) 12" x 12" Tan floor tile with square pattern over 9" x 9" tan floor tile with tan dots and
brown adhesive
3200 SF
Non -Friable in utility room,
and hallway 100 SF
Category I Miscellaneous
Good High Not
applicable Tile = 3% Chrysotile Material
(FTCO2) 9" x 9" Brown floor tile with black mastic
Non -Friable in living room and
main room 200 SF
Category I Miscellaneous
Damaged High Not
applicable Tfle= 10%® Chrysotile Material
(FTC03) Black and green floor the with black mastic
in basement southeast bedroom, and main room
Non -Friable Category I Miscellaneous Material
Tile = 10%® Chrysotile Mastic = 10% Chrysotile
(SVF01) Tan sheet vinyl flooring with flower pattern, grey felt backing and black underlayment
600 SF
Damaged High Not
applicable
in basement bathroom, and southwest bedroom closet
Good High 5 Underlayment = 10%
EM=
Friable Miscellaneous Material 70 SF
Estimated Material scription Material
De
Locatiao
Quantity
Assessment
Category Laboratory Result
(TS03) Light orange peel surfacing texture associated with CDW01
on south wall in basement main room, walls and ceiling in hallway, walls in bathroom, walls and ceiling in
living room
Friable Surfacing Material
Good High 5 Texture = 2%
Chrysotile
(TS04) Swirl pattern surfacing texture associated with CDW01
2000 SF
on ceiling in
Texture basement bathroom
Trace Chrysotile Point Count = <0.25% Chrysotile SF=Square Feet LF = Linear Feet Under AHERA, friable
materials in each area assessed shall be placed in one of the following categories:
1. Damaged or significantly damaged friable thermal system insulation 2. Damaged friable surfacing AUDI 3. Significantly
damaged friable miscellaneous ACM 4. Damaged or significantly friable miscellaneous Asia 5. ACM with potential for
damage 6. Any remaining friable ACM or friable suspect ACM
Friable 100 SF
Surfacing
Good High 5 Material
Material Type and Friability Classification
Estimat"ri
Material Description Material Location M
Potential for Disturbance Laboratory Result
(CDVV02)5/0' White drywall, tape, and joint compound associated with SCAO2
uneast, north, west walls and ceiling ofback porch build -out
Friable 5U08F
Miscellaneous
Good High None detected Material
(C/\U1)Tan adhesive associated with carpet
Non -Friable insouthwest and southeast
bedrubedrooms2O08F
Category ||Miscellaneous
Good High None detected
Material
(8(]AO1)Popcorn ceiling surfacing texture associated with CDVVO1
inbasement southeast and
southwest bedrooms 3U8SFFriable Surfacing
Material Good High None detected
(SOA02) Popcorn-type ceiling surfacing texture associated with CDW02
inback porch build -out 12OGF Friable Surfacing
Material Good High None detected
(T881)Stucco-type surfacing texture associated with CDVVD1
on walls and ceiling in basement southwest closet, and ceiling in utility closet
400 SF Friable Surfacing
Material Good High None detected
Material Description Material Location Estimated
Quantity
Potential for Disturbance Laboratory Result
(T002)Orange peel surfacing texture associated with CDVV01
onwalls inbasement southwest bedroom 458SFFriable Surfacing
Material Good High None detected
mp=mvuaroFeet Lp=Linear Feet
Sample Description Sample Numbers and Approximate Sample Locations
(CDW01) 5/8" White drywall, tape, and joint compound associated with TS01 . TS02, TS03, TS04 on walls
and ceilings inbasement (except bui|d-out)
CDY\01-01Southeast bedroom, northwest corner, 4'high CDYV01'02Southwest bedroom, southeast
corner, 4'high
(CDW02) 5/8" White drywall, tape, and joint compound associated with SOA02 on east, north, west walls
and ceiling ofback porch build -out
CDVV02-01Northwest corner, 4'high CDVV02'0ZCeiling, 2'frornsouth. west wall
(CA01) Tan adhesive associated with carpet in southwest and southeast bedrooms
CA01-01Southwest bedroom, southwest corner CAD1-O2Southeast bedroom, southwest corner
(FTCO1)12"n12"Tan floor tile with square pattern over S"xS' tan floor tile with tan dots and brown
adhesive inutility room, and hallway
FTC01-01Entrance Loutility room FTCO1-O2�Hallway northwest corner
(FTCO2) 9" x 9" Brown floor tile with black mastic in living room and main room
FTCO2'O1:Living room northwest corner FTCO2'02Northwest corner ofmain room
(FTC03) Black and green floor tile with black mastic in basement southeast bedroom, and main room
FTC05'01Southeast bedroom, southwest corner FTCO3-O2Main room, southeast corner
Sample Description Sample Numbers and Approximate Sample Locations (S0AU1)Popcorn ceiling
surfacing texture associated with CDVVO1 inbasement southeast and southwest bedrooms
8{>AO1-01Southwest bedroom, 4'from east, 4'from west 8{}AO1-O2Southeast bedroom, 5'fronnnorth,
5'from west S0A01'03Southwest bedroom. 1'hnrnwest. 3'hnrnnorth
(SOA02) Popcorn-type ceiling surfacing texture associated with CDW02 in back porch build -out
S{}AO2-01iCeiling, 1'from south, 1'from west 8CAQ2-O2Ceiling, J'8nnoeast, 8'8nnosouth 8CAO2-OJ�
Ceiling closet, 1'from east, 2'from north
(SVIF01) Tan sheet vinyl flooring with flower pattern, grey felt backing and black underlayment in
basement bathroom, and southwest bedroom closet
8VF01'01Basement bathroom floor behind door GVFO1'O2Basement bathroom floor, southeast corner
(T881)Stucco-type surfacing texture associated with CDVV01 onwalls and ceiling inbasement southwest
closet, and ceiling inutility closet
TSO1'O1:Ceiling, 1'from north, 3'from east TSO1'O2:West wall, 2'[runnsouth, 2'high T8O1-O3South
wall, 4/0nnoeast, 5'high
(TS02)Orange peel surfacing texture associated with CDVV01 onwalls inbasement southwest bedroom
TS02'01�East wall, O'from south, 2'high T802'0Z South wall, 3'from west, 7'high T8O2-O3�North wall,
4/from east, 5'high
(TS03) Light orange peel surfacing texture associated with CDWO1 on south wall in basement main room,
walls and ceiling in hallway, walls in bathroom, walls and ceiling in living room
TS03'01Bathroom north wall, 2'from east, 4' high on divider wall TS03-0Z Hallway ceiling, 2' from east,
2'from north TGOS-OSMain room south wall, 2'[ronoeast, 2'high TG83'84:Living room north wall, 2'[rono
west, 4'high T8O8-O5:Living room ceiling bylight fixture
(TS04) Swirl pattern surfacing texture associated with CDWO1 on ceiling in basement bathroom
TS04'01�Ceiling, 2'from south, 2'from east TS84'82Ceiling, 2'from south, 2'from west TSU4'03�
Ceiling, 2'from east, 2'from north
11011STI"d we I iiiiiiii��� =11 111111 111
Client Rame EnviroSpec, LLC Date Collected: 07/08/19 Street
address 780 Simms St., Suite 101 Date Received: 07/08119 City,
State ZIP Golden, CO 80401 Date Analyzed: 07/16/19 Attn: Luke
Bochmann NVLAP Lab Code 200860-0 Date Reported: 07/16/19
Client Project Name: 19-7-409 / 9625 W. 35th Ave. Project ID:
19028685
Test Requested: 3002, Asbestos in Bulk Samples Method:
EPA/600/R-93/116: Method for the Determination of Asbestos in
Bulk Building Materials; EPA -600/M4-82-020: Interim Method for
the Determination of Asbestos in Bulk Insulation Samples
-a • - V
(Y/N)
Percentage Layer
Asbestos Detected
Non -Asbestos Asbestos Percentage Fiber Percentage
Non -Fibrous Matrix Material Material Percentage Composition
19028685-1A
Tan Wallcovering with Gray Paint
IN 5% IND 50 50
19028685-1 B WhiteCompound
IN 5% IND 100 C
19028685-1 C White Tape
IN 5% IND 98 2
19028685-1 D White Joint Compound
5010 ND 100 C
CDW01
19028685-1 E MulticoloredIlcoveri
IN 5% IND 50 50
19028685-1 F White Tape
5010 ND 98 2
19028685-1 G White Joint Compound
5% ND 100 G
19028685-1 H White/Tan Drywall
65010 ND 30 70
19028685-2A Whits Compound with Gray Paint
5% IND 100 C
CDW01
® Off -White
Paint
01®
Jenna Leinber er Talena Oliver Laboratory Analyst Asbestos Lab
Supervisor
Page 1 of 11
TESTING
780 Simms Street
Suite 104 Golden, CO, 80401 303.232.3746 Certificate of
Analysis aerobiology.net
Client Name EnviroSpec, LLC Date Collects 7/08/19 Street
address 780 Simms St., Suite 101 Date Received: 07/08/19 City,
State ZIP Golden, CO 80401 D- -■ -r ■ Attn:
Bochmann NVLAP Lab Code 200860-0 Date R: -•i -i 07116/19
Client Project Name: 19-7-409 / 9625 W. 35th Ave. Project ID:
19028685
Test Requested: Asbestos in Bulk Samplesir.
EPA/600/R-93/116: Method for the Determination of Asbestos in
Bulk Building r- r EPA -600/M4-82-020: In- •fi. for
the Determination of Asbestos in Bulk Insulation Samples
1 0
FIM IN W-1 0
.Ion -Asbestos Asbestos Percentage
FiberPercentage Non-Fibrou
°l0 ND 982
CDW01
19028685-211) Off -White
19028685-21E White/Tan ryll
0°l0 ND 30 70
19028685-3A Brown/White allcov ri
10010 ND 50 50
19028685-3B i Compound with White Paint
10% ND 100 C
CDW02-01
19028685-3C
White Tape
10% ND 98 2
19028685-3D ite Joint Compound
10% ND 100 G
19028685-3E Whiel a ryall
60010 ND 30 70
19028685-4A Whie Micaceous Texture
15010 ND 100 GJVl
CDW02-02
19028685-4B Wh
10010 ND 98 2
Jenna Leinberer Talena Oliver Laboratory Analyst Asbestos Lab
Supervisor
Page 2 of 11
TESTING
780 Simms Street
Suite 104 Golden, CO, 80401 303.232.3746Certificate of
address 780 Simms St., Suite 101 Date Received: 07/08/19 City,
State ZIP Golden, CO 80401 Date Analyzed: 07/16/19 Attn: Luke
Bochmann NVLAP Lab Code 200860-0 Date Reported: 07/16/19
Client Project r1ame: 19-7-409 / 9625 TT. 35th Ave. Project 10".
19028685
Test Requested: 3002,Samples Method:
EPA/600/R-93/116: Method for the Determination of Asbestos in
Bulk Building Materials; EPA -600/M4-82-020: Interim Meth•i,..... for
the Determination of Asbestos in Bulk Insulation Samples
M
f
1on-Asbestos Asbestos Percentage
Fiber Percentage Non -Fibrous Matrix Material Material
19028685-4C White Joint Compound
10% ND 100 G
CDW02-02
19028685-4D White/ n Drywall
65% ND 40 60 G
19028685-5A Multicolre Foam
65010 ND 100
01- 1
19028685-513 Yellow Mastic
35010 ND 100
19028685-6A Black Foo
0°l0 ND 100
O 1 -02
19028685-6B Yellow Mastic
20% ND 100
19028685-7A ie Floor Tile
°l0 ND 100
19028685-7B Yellow Mastic
2% ND 100
FTC01
19028685-7C Multicolored Floor Tile
IN °lo
19028685-71D Ick Mastic
°l0 ND 100
Jenna Leinberger Talena Oliver Laboratory Analyst Asbestos Lab
Supervisor
Page 3 of 11
TESTING
780 Simms Street
Client Rame EnviroSpec, LLC Date Collected: 07/08/19 Street
address :i Simms St., Suite 101Date Received: 07/08/19
*...: ! ■ i iNOTEs
MIRW
the Determination of Asbestos in Bulk Insulation Samples
Sample Identification Physical Description of Sample/Layer Client
Lab Sample Number
•- •_ - -•- ■ • r
19028685-8A ie Floor Tile
°l0 ND 100
19028685-813
Yellow Mastic
2% ND 100
FTC01
-
it
°lo
19028685-81D
Ick Mastic
°l0 ND 100
19028685-9A
rFoam
% IND 100
FTCO2-01
°/® CHRY 10 90 C
19028685-9C lack Mastic
5°l0 ND 100
19028685-1 OA Yellow Mastic
5°l0 ND 100
FTCO2-02
19028685-1 OB Brown Floor Tile
°I° CHRY 10 90 C
19028685-10C Ick Mastic
5°l0 ND 100
Jenna Leinberger Talena Oliver Laboratory Analyst Asbestos La�
Supervisor
Page 4 of 11
TESTING
780 Simms Street
1 11111 ml
111111ii illy,
Client ilame EnviroSpec,Date Collected:07/08119
address :i Simms St., Suite 101Date Received: 07/08/19
State ZIP Golden, CO 80401 Date Analyzed: 07/16/19 Attn: Luke
Bochmann NVLAPa ode 200860-0 Date Reported: 07/16/19
Client Project Name: 19-7-409 / 9625 W. 35th Ave. Project ID:
19028685
Test Requested: 3002,Samples Method:
EPA/600/R-93/116: Method for the Determination of Asbestos in
Bulk Building Materials; EPA -600/M4-82-020: Interim M- rr for
the Determination of Asbestos in Bulk Insulation Samples
Sample Identification Physical Description of Sample/Layer Client
Lab Sample Number
geneous Homo-
(Y/N)
Percentage Layer
Asbestos Detected
Non -Asbestos Asbestos Percentage
Fiber Percentage Non -Fibrous Matrix Material Material
Percentage Composition
19028685-11A Green Floor Tile
N 95% CHRY 10 90 C
FTC03-01
19028685-11 B Black Mastic
N4%ND100T
19028685-11 C Tan Mastic with
Gray Foam
N1%ND100B
19028685-12A Black Fibrous
Tar
N 95% CHRY 10 90 C
FTC03-02
19028685-12B Black Mastic
N2%ND100T
19028685-12C Tan Mastic with
Gray Foam
N3%ND100B
SOA01-01 19028685-13 White
Foamy Texture with White
Paint
N 100% ND 100 C,G
SOA01 -02 19028685-14 White Foamy Texture
N 100% ND 100 C)G
SOA01 -03 19028685-15 White Foamy Texture with White
Paint
N 100% ND 100 C,G
SOA02-01 19028685-16 White Micaceous Texture
N 100% ND Trace 100 GN
Jenne Leinberger Talena Oliver Laboratory Analyst Asbestos Lab
Supervisor
Page 5 of 11
TESTING
780 Simms Street
11111 II:11 11111r� illy
I! IS 111
E M, 611111 111111161�1
Client Rame EnviroSpec, LLC Date Collected: 07/08/19 Street
address 780 Simms St., Suite 101 Date Received: 07/08/19 City,
State ZIP Golden, CO 80401 Date Analyzed: 07/16/19 Attn: Luke
Bochmann NVLAP Lab Code 200860-0 Date Reported: 07116/19
Client Project Name: 19-7-409 / 9625 W. 35th Ave. Project ID:
19028685
Test Requested: 3002, Asbestos in Bulk Samples Method:
EPA/600/R-93/116: Method for the Determination of Asbestos in
Bulk Building Materials; EPA -600/M4-82-020: Interim Method for
the Determination of Asbestos in Bulk Insulation Samples
M��
Lab Sample Number
geneous Homo-
(Y/N)
Percentage Layer
Asbestos Detected
Non -Asbestos Asbestos Percentage
Fiber Percentage Non -Fibrous Matrix Material Material
Percentage Composition
SOA02-02 19028685-17 White Micaceous Texture
N 100% ND Trace 100 G, M
SOA02-03 19028685-18 White Micaceous Texture
N 100% ND Trace 100 G, M
19028685-19A Off-White/Green Sheet Vinyl with White
Foam Backing
N80%ND100B
19028685-19B Gray Mastic
N2%ND100B
SVF01-01
19028685-19C Black Floor Tile
N 18% CHRY 10 90 C
19028685-19D Black Mastic with Gray Plaster
N Trace ND 100 T
19028685-20A Off-White/Tan/Gray Foam Sheet Backing
Vinyl with White
0010 ND 100
19028685-20B Off -White Mastic
3010 ND 100 B
SVF01 2
19028685-20C Black Floor Tile
0/® CHRY 10 90 C
19028685-20D Ick Mastic
1010 ND 100 T
Jenna Leinber er Talena Oliver Laboratory Analyst Asbestos Lab
Supervisor
Page 6 of 11
TESTING
780 Simms Street
Suite 104 Golden, CO, 80401 303.232.3746Certificate of
� r'' •• i.....i 'I
Client Rame EnviroSpec,Date Collected: 07/08/19 --
address 780 Simms St., Suite 101 Date Received: 07/08/19 City,
State ZIP Golden, CO 80401 Date ■ -i i ■ Attn:
Bochmann NVLAP Lab Code200860-0 Date Reported: 07116/19
Client Project Name: 19-7-409 / 9625 W. 35th Ave. Project ID:
19028685
Test Requested: 3002, Asbestos in Bulk Samples Method:
EPA
• i
' iii i # Method for the Determination of Asbestos
Bulk Building -rials; EPA -600/M4-82-020: Int- •• for
the Determination of Asbestos Bulk InsulationSamples
r r ',, ■ - i -
geneous Homo-
(Y/N)
Percentage Layer
Asbestos Detected
Non -Asbestos Asbestos Percentage
Fiber Percentage Non -Fibrous Matrix Material Material
Percentage Composition
19028685-21A White Texture with White Paint
N 50% ND 100 C
TS01-01
19028685-21 B White/Tan Drywall with White Paint
N50%ND1585G
19028685-22A White Texture with White Paint
N56%ND100C
19028685-22B White Tape
N4%ND 991
TS01-02
19028685-22C White Joint Compound
N10%ND100C
19028685-22D Brown Fibrous Material with White Paint
N30%ND 9010
19028685-23A White Texture with White Paint
N 30% ND 100 C
TS01-03
19028685-23B White/Tan Drywall
N70%ND1585G
19028685-24A White Texture with Blue Paint
N
% ND 100 C
TS02-01
19028685-24B White/Tan Drywall with White Paint
N 80% ND 15 85 G
Jenna Leinberger Talena Oliver Laboratory Analyst Asbestos La�
Supervisor
Page 7 of 11
TESTING
780 Simms Street
M1111=71 MICTIMM, =-*
Client ilame EnviroSpec, LLC if: Collected: 07/08119 Street
address 780 Simms St., Suite 101 Date Received: 07/08/19 City,
State ZIP Golden, CO 80401 Date Analyzed: 07/16/19 Attn: Luke
Bochmann NVLAP Lab Code 200860-0 Date Reported: 07/16/19
Client Project Name: 19-7-409 / 9625 W. 35th Ave. Project ID:
19028685
Test Requested: 3002, Asbestos in Bulk Samples Method:
EPA/600/R-93/116: Method for the Determination of Asbestos in
Bulk Building Materials; EPA -600/M4-82-020: Interim Method for
the Determination of Asbestos in Bulk Insulation Samples
W3411110-7-TIT41153-1172111171 mw
a U11
Percentage Layer
Asbestos Detected
Non -Asbestos Asbestos Percentage
Fiber Percentage Non -Fibrous Matrix Material Material
Percentage Composition
19028685-25A White Texture with Blue Paint
N15%ND100C
TS02-02
19028685-25B White/Tan Drywall with White Paint
N85%ND1585G
19028685-26A White Texture with White Paint
N10%ND100C
TS02-03
19028685-26B White/Tan Drywall with White Paint
N90%ND1585G
19028685-27A
White Texture with
White Paint
N20%ND100G
TS03-01
19028685-27B
White/Tan Drywall
with White Paint
N80%ND1585G
TS03-02 19028685-28 White/Tan
Drywall with White Paint
N 100% ND 15 85 G
19028685-29A
White Texture with
Gray Paint
N5%ND100C
TS03-03
19028685-29B
White/Tan Drywall
with White Paint
Jenn
M Leinberger TalenaLaboratory Analyst Asbestos Lai.
Supervisor
........ice i..
P.i- s of
TESTING
imp,
i• ■ �` 1 illyIIIM �
E i i i i i ' 1
Client Rame EnviroSpec,Date Collected: 07/08/19 eet
address 780 Simms St., Suite 101Date Received: 07/08/19
State ZIP Golden, CO 80401 Date Analyzed: 07/16/19 Attn: Luke
moi......chmann NVLt a• Code 200860-0 Date Reported: 07116/19
Client Project Name: 19-7-409 / 9625 W. 35th Ave. Project ID:
19028685
Test Requested:Asbestos Bulk Samplesii',,
EPA/600/R-93/116: Method for the Determinationof Asbestos
..:.i i.... in
Bulk Building MateEPA-600/M4-82-020:- ii, for
the Determination of Asbestos in Bulk Insulation Samples
1 0
Ei. .i ■......i.. on
R.1 i- O IN W-1
Non -Asbestos Asbestos Percentage
Fiber Percentage Non -Fibrous Matrix Material Material
Percentage Composition
19028685-30B White Tape
N4%ND 991
19028685-30C White Joint Compound
N10%ND100G
TS03-04
19028685-30D Tan Compound with Blue Paint
N 10%CHRY298C
19028685-30E White/Tan Drywall
N30%ND1585G
TS03-05 19028685-31 White/Tan Drywall with White Paint
N 100% ND 15 85 G
19028685-32A White Texture with White Paint
N 80% ND 100 C
TSO4-01
19028685-32B White Texture with White Paint
N3%ND100C
19028685-32C White/Tan Drywall
N17%ND1585G
19028685-33A White Texture with White Paint
N 15% CHRY Trace 100 C
TSO4-02
19028685-33B White/Tan Drywall with White Paint
N85%ND1585G
Jenna Leinberger Talena Oliver Laboratory Analyst Asbestos LaW
Supervisor
Page 9 of 11
TESTING
780 Simms Street
ffilwWwAneer-MIUM, =_6
Client Rame EnviroSpec, LLC Date Collected: 07/08/19 Street
address 780 Simms St., Suite 101 Date Received: 07/08/19 City,
State • Golden,CO 80401 Date Analyzed: 07/16/19 Attn:
Bochmann NVLAP Lab Code 200860-0 Date Reported: 07/16/19
Client Project Name: 19-7-409 / 9625 W. 35th Ave. Project ID:
19028685
Test Requested: 3002, Asbestos in Bulk Samples Method:
EPA/600/R-93/116: Method for the Determination of Asbestos in
Bulk Building Materials; : Interim Method for
the Determination of Asbestos in Bulk Insulation Samples
y
Non -Asbestos Asbestos Percentage
Fiber Percentage Non -Fibrous Matrix Material Material
9. ter. r •r.. .: r
19028685-34A White Texture with White
IN °o CHRY Trace 100 C
0-3
19028685-34B ie Texture with White Paint
5°l0 ND 100
19028685-34C White/Tan Drywall
IN 10% IND 15 85
Supervisor
Page 10 of 11
TESTING
780 Simms Street
ffliver LaboratoN Analyst Asbestos La,*
StateClient i'lame EnviroSpec, LLC Date Collected: 07/08119 Street
address 780 Simms St., Suite 101 Date Received: 07/08119 City,
ZIP Golden,:04:
Date Analyzed: 07/16/19 Attn: Luke Bochmann NVLAP Lab Code
200860-0 Date Reported: 07/16/19 Client Project Name:
19-7-409 / 9625 W. 35th Ave. Project I D: 19028685
Test Requested: 3002, Asbestos in Bulk Samples Method:
EPA/600/R-93/116: Method for the Determination of Asbestos in
Bulk Building Materials; EPA -600/M4-82-020: Interim Method for
the Determination of Asbestos in Bulk Insulation Samples
General
i Notes
OWN mai [IIIIIIHM11110A.
sample, but the concentration is less than 1 % and cannot
be quantified i point counting.
,Samples identified as inhomogeneous(moreone
analyzedlayer) are separated into individual layers, and each layer
and reported separately.
II regulated asbestos minerals (i.e. chrysotile, amosite,
crocidolite, atopyllite, tremolite, and actinolite) were
sought in every layer of each sample, but only those
asbestos minerals detected are listed. Amosite is the
common e for the asbestiform variety of the minerals
cummingtonite andrun ri roci olit is the common
name used for the asbestiform variety of the mineral
ria ecie.
foam,Jile, vinyl, plastic,• fine powder i e
contain•- •s fibers of diameter
microns in diameter) that these fibers cannot be detected
by •samples,• - sensitive
undermethods (e.g. TEM, SEM, and XRD) are recommended if
greater certainty about asbestos content is required.
Semi -quantitative bulk TEM floor tile analysis is accepted
+' regulations.
,These results are submitted pursuant to Aerobiology
Laboratory Associates, Inc.'s current terms and conditions
of sale, including the company's standard warranty and
limitation of liability provisions. No responsibility or liability
is assumed for the manner in which the results are used or
interpreted.
,Unless notified in writing to return the samples covered
by this report, Aerobiology Laboratory Associates, Inc. will
store the samples for a minimum period of thirty (30) days
before discarding. A shipping and handling charge will be
assessed for the return of any samples.
.Aerobiology does not guarantee the results of tape lifts,
microvacs, wipe, and/or debris samples. Accurate analysis
cannot be performed due to particle size, media used,
and/or amount of material given. Analysis of these
materials should be preformed by a TEM. A result of ND
does not indicate that the sample area does not
contain asbestos. It means the analyst could not
identify asbestos in the specific sample for the
reasons listed above.
Notes Required by NVLAP
•This report must not be used by the client to claim
product certification, approval, or endorsement by NVLAP,
NIST, or any agency of the Federal Government.
,This test report relates only to the items tested or
calibrated.
,This report is not valid unless it bears the name of a
NVLAP-approved signatory.
• Any reproduction of this document must include the
entire document in order for the report to be valid.
Page 11 of 11
Aerobiology
LABORATORY
ASSOCIATES,
INCORPORATED
Expertise Since
1997
Page
1 of
•1:1:
ELI
TE
NVLAD
cted By
Data:
2-6-19 1, Bochmann
AZCA,
CO, FL
AZ CA.CO, GA, VA, NJ AZ,
CA, CO. VA
hod Byroute: Field Contact
Reporti
ng
Address
By/Data
Rallnqula
Received
By/Date.
GANU,
VA
2 42pm A
Simms Street, Suite 101
Sampler Andersen sampleAire 1 Other
POWJObi :19 7-4
0 9 Reporting
We are pro.com Michel Wepp, winegrepeacom,
w ww .com
Name: Ennall(s)
Routine 24 H 1 Hour 2 Hour
SAMPLING LOCATION ZIP
CODE
CC
Info:
Sample No.
Test Code ICD wol-01
---'"" Ave
Total
Volume/Area
30022 wol-ol 3
CD wod-ol 4 V 02
[CAOI OI 6 V-
-01
LETCO2 01
LECO2 02
V-
02
ISOA01-01
Trinert Non-viahle
LAB USE
ONLY
X
w
A: M&te/PK HOrlog vi
Luite berlita' Wing,
101 egionella 1017 Culture - S WAB Legionella 1010 WATER - Potable - E. coli/total
coliforms 1012 SWAB - E. colAotal cotiforms 1028 SWAB -
Sewage Screen^oiiforms) 2056
WATER - Hete- W ASBESTOS -
Point count 30- ASBESTOS - PLM '\nalysis 3003
ASBESTOS - Particle characterization
- PCM Analysis Phoenix, AZ Cherry Hill, NJ Los Angeles, CA (602)
n
\/124
7007/16/19
Aerobiology
LABORATORY
ASSOCIATES,
INCORPORAIED
Expertise
Since 1997
Aerobiology
i
441-3700 (856) 486-1177 (714)
8958401
U.o
in
1190286
ER
IC
Recio
SoS II
EL
IT
E
Page
3
HYLA
N
Client
AZ, CA, CO FL GA, VA, NU AZ, CA, CO, VA Collected By/Date:
Field
Contact
Relinquished
By/Date:
Phone/Fa
x
PO#Jab#: 19-7-469 Project Name: los 6,35th Are
Emai
18
Soto2-0113002
Cr]
2 IV 03
SVFOL-
v 02 21
—02
SOL oI
0
2
TS03-0
1 .-02
AZ, CO, FL
GAN VA
Total
Volume/Area
04 V
05.
T504-01
-02
Washington, D.C. Atlanta,
GA
(877) 648-9150 (770)
947-2828
Denver, CO (303) 232-3748
Phoenix,
AZ (602)
441-3700
Page 1 of 2
780 Simms Street
Cherry Hill, NJ Los
Angeles, CA
(856) 486-1177 (714)
895-8401
Ft
Lauderdale,
FL
(954)
451-3725
Rovtul
an 12
M
Client Name
nviroec, LLC Date Collected: 07/08/19 Street address
780 Simms St., Suite 101 DateReceived: 07/08/19 City, State
ZIP
Golden, CO80401 Date Analyzed: 07/23/19 Attn:
Luke Bochmann WLAP Lab Code 200860-0 DateReported:
07/23/19 Client Project
19-7-409 / 9625 W. 35th Ave. Project I : 19028685
TestRequested: i in Bulk Samples
/Method: Polarized Light Microscopy / Dispersion
Staining (PLM), etod for the Determination of Asbestos in Bulk
Building Materials. EPA -600/R-93/116, July 1993
r r i ',,. r r ',, ■to -M-711
I
Asbestos
CountMethod 400/1000
19028685-33APaint
r
TESTING
780 Simms Street
Suite 104 Golden, CO, 80401 303.232.3746Certificate of
Client Name Enviroc, LLC Date Collected: 07/08/19 Street
address 780 Simms St., Suite 101 DateReceived: 7/08/19 City,
State ZIP Golden, CO 80401 TESTING
Date Analyzed: 07/23/19 Attn: Luke Bochmann NVLAP Lab Code
200860-0 DateReported: 07/23/19 Client Project
19-7-409 / 9625 W. 35th Ave. Project I : 19028685
General Notes
Negative indicates no asbestos was detected; the method
detection limit is 1 %.
Trace or "<1 " indicates asbestos was identified in the sample,
but the concentration is less than the method detection limit o
1 %.
Notes Required
This test report relates only to the items tested or calibrated.
This report is not valid unless it bears the name of a
VLA -approved signatory.
Any reproduction of this document must include the entire
document in order for the report to be valid.
Page 2 of
All regulated asbestos minerals (i.e. chrysotile, amosite,
crocidolite, antopyllit, tremolite, and actinolite) were sought i
every layer of each sample, but only those asbestos minerals
detected are listed. A osite is the common name for the
asbestiform variety of the minerals cuingtonite and grunerite.
Crocidolite is the common name used for the asbestiform variety
of the mineral riebeckite.
♦ Tile, vinyl, foam, plastic, and fine powder samples may contain
asbestos fibers of such small diameter (< 0.25 microns in
diameter) that these fibers cannot be detected by PLM. For such
samples, more sensitive analytical methods (e.g. TEM, SEM, and
XRD) are recommended if greater certainty about asbestos
content is required. Semi -quantitative bulk TEM floor tile analysis
is accepted under NESHAP regulations.
♦ These results are submitted pursuant to Aerobiology Laboratory
Associates, Inc.'s current terms and conditions of sale, including
the company's standard warranty and limitation of liability
provisions. No responsibility or liability is assumed for the manner
in which the results are used or interpreted.
♦ Unless notified in writing to return the samples covered by this
report, Aerobiology Laboratory Associates, Inc. will store the
samples for a minimum period of thirty (30) days before
discarding. A shipping and handling charge will be assessed for
the return of any samples.
♦ This report must not be used by the client to claim product
certification, approval, or endorsement by NVLAP, NIST, or any
agency of the Federal Government.
Appendix C Certifications
ACCLAIM ENVIRONMENTAL
SERVICES
7959 Ulster Court Thornton Colorado 80602
Tel: 303 424 4647 Fax: 303 432 8669
CERTIFIES THAT
MICHAEL CICCOTTI
Has successfully completed
The EPA -Approved AHERA Annual Refresher Course for
INSPECTOR. This course is EPA -approved under Section
206 of the Toxic Substances Control Act (TSCA) and
meets the requirements of Colorado Regulation No 8
SVOLG
01/09/19
NJA
Course Date: Exam Date: Certificate No : Expiration Date:
Khoah
AE19 002 -BI -R-03
01/09/20
K. Jay Gale, President
OY
Scanned by CamScanner
Appendix D Photos
ACM Inspection 9625 W 35th Ave
CA01
CDW02
CDW01
FTC01
ACM Inspection 9625 W 35th Ave
FTCO2
SOA01
FTC03
SOA02
ACM Inspection 9625 W 35th Ave
SVF01
TS02
TS01
TS03
ACM Inspection 9625 W 35th Ave
TS04
--i
City of
WheatRidge
COMMUNITY DEVELOPMENT
SUBCONTRACTOR AUTHORIZATION FORM
Electrical Subcontractor
This form must be completed & signed by the ELECTRICAL SUBCONTRACTOR
performing electrical work on site.
Subcontractor's insurance and license must be up to date prior to permit issuance.
Project Address: 9625 West 35th Avenue, Wheatridge
General Contractor: Empirical Construction
Company Name: R&R Electric Contact Phone #: 303-944-3208
Wheat Ridge Contractor License #: (required field)
State License #: 4374
Master License #: 3889
Rick Phillips
Printed Name of Authorized Agent
A 5/18/2020
Signature of Authorized Agent Date