HomeMy WebLinkAbout9685 W. 36th Avenuei CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: `��� L- �•� cy .
Job Address:
Permit Number: a2g�;7) j i-) !
❑ No one available for inspection: TomeMI M
Re -Inspection required: Yep r ..No
When corrections have been mabe, schedule for re -inspection online at.
http✓/www. ci. wheatridge. co, uslinspection
Date: ',�:�, -`5 )- I L Inspector: I ----
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: "k,
Job Address: ___ _�� — :=r ✓Y`'
Permit Number:
❑ No one available for inspection ),e
Re -Inspection required: Yes `,q 0
When corrections have been made, schedule for re -inspection online at:
http✓/www. ci, wheatridge, co, uslinspection
Date: ! " -tea_? 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 inspe
Re -Inspection required: Yes
When corrections have been made, schedule for re -inspection online at:
http.VAvww.ci.wheatridge.co.usrinspection-
Date:/O. Inspector'
I`
DO NOT REMCLVE THIS NOTICE
A 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: DCVVAOL.C-e_W
Job Address: )
Permit Number: o n
❑ No one available for inspection: Ti e I V SAM M
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303 -234 -
Date. 14 inspector:-,
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: c
Job Address: (.?`l,, S 'e.5 /0. '
Permit Number: # #`
❑ No one available for inspection: Time /f2 7C� /PM
Re -Inspection required: Yes`, No
When corrections have been made, schedule for re -inspection online at.
http✓/www. ci. wheatridge. co. uslinspection
Date:A. • 1 L-r� Inspector: ---� �-----
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:,
Job Address:i,
Permit Number:-- ~ � ) z
❑ No one available for inspection: Time AM)PM
Re -Inspection required: Yes,' No
When corrections have been made a7tfor re -inspection at 303-234-5933
Date:,�;, 5Q ` (!r. Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
`-j- 1 % l M C—�4-
INSPECTION NOTICE Inspection Type:
Job Address:
Permit Number: c / 'j C)
❑ No one available for inspection: Time � � M/
Re -Inspection require rd 'Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date.` '� ' /i Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: �-
Job Address:
Permit Number: t-•,
❑ No one available for inspection: Tifnb_AM/PM
Re -Inspection required:
When corrections have been
Date: -2— 1
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Homeowner Interior Remodel PERMIT - 201901560
PERMIT NO: 201901560 ISSUED: 07/31/2019
JOB ADDRESS: 9685 W 36th Ave EXPIRES:
JOB DESCRIPTION: Homeowner interior remodel of kitchen, removing current wall between living
room and kitchen. Updating electrical. Adding gas line, new windows and new
plumbing.
*** CONTACTS ***
OWNER (303)589-4330
SUB (303)988-1366
SUB (303)988-1366
Square feet: 600
BENTZ KIMBERLY
JOHN K DELAMETER
JOHN K DELAMETER
021724 CONTINENTAL PLUMBING & HEATING
021724 CONTINENTAL PLUMBING & HEATING
*** 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: 37,700.00
FEES
Total Valuation 0.00
Plan Review Fee 384.51
Use Tax 791.70
Permit Fee 591.55
** TOTAL ** 1,767.76
*** COMMENTS ***
*** CONDITIONS ***
I, the property owner, by my signature, attest that I currently reside at the project
property, intend to reside at the property for a period of one year after completion of the
project, and am personally performing all work, without the assistance of hired or
professional workers. If professionals are hired, those contractors are licensed with the
City of Wheat Ridge and are listed on the permit.
NOTE: Consultations and inspections will only be performed with the homeowner of record
present.
All roughs to be done at Framing Inspection.
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.
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION:
City of Wheat Ridge
Homeowner Interior Remodel PERMIT - 201901560
201901560
9685 W 36th Ave
Homeowner interior remodel
room and kitchen. Updating
plumbing.
Square feet: 600
ISSUED: 07/31/2019
EXPIRES:
of kitchen, removing current wall between living
electrical. Adding gas line, new windows and new
VI, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
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 pen -nit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be
perfomrmed and that
}all �work to ;,§ � be per disclosed in this document and/or its' accompanying approved plans and specifications.
4�__
1S1�!
Siginat4elof OWNER or JCONTRACT0_1k4Circle 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 originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a 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 oV regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
W hca-W dgc
Building & Inspection Services
7500 W. 291 Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email f[�t U; .yLrauiuqu.co.u.
FOR OFFICE USE ONLY
Date);
t 430,/9
Planmermit #
Plan Review Fpq�
sr
Building Permit Application
Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address:
3 L�w fNQ
d vv:?-
Property Owner (please print):,
6 (A 1\ B 2n1�
Phone: 5b3S�61 "0
Property Owner Email: _)1'_AWIbeVLLUl�3 J11+ -LL 6�M kk C -OW
Tenant Name (Commercial Projects Only) _0 JA
Property Owner Mailing Address: (if different than property address)
Address: �AVVV, Dlp dl.\100/�e-
City, State, Zip:
Architect/Engineer: BaY� {�SSb U a'� I � AC -
Architect/Engineer E-mail:13�r iry� 2��? �a w - C" Phone: _'-'�-_3 V+4 1-4.5
Contractor Name: �i I (_� CIDtY\°J o U Vv6Y-V- r,tX_Cej4- Pl4VVL6
"- Cv�ty: l
City of Wheat Ridge License #: Phone:
Contractor E-mail Address:
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): �J I�vVn�e�j V'�' Phone:
CONTACT EMAIL(please print):
Sub Contractors (Must provide Wheat Ridge 1.4cense No & Signed Subcontractor Authorization form):
Electrical: Plumbing: L)q WV -A-tJ Mechanical: 'L)e L3UMJ-�
W.R. City License # W.R. City License #OQ� 1D2+ W.R. City License #'1 i'l-2jf
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
CJ -
Complete all highlighted fields.
❑COMMERCIALRESIDENTIAL
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, square footage, existing condition and
proposed new condition, appliance size and efficiency, type and amount of ma erials to be used, etc.
}z V� (tM 0 A t"-�v ot'l� b (ten s pate CM U'0 }z (�e� . i�12rrv� 0(w(0
1/VaLA le0w- tv'l V,, v i viS MA OtAr �sv-Z ole l—.2d
t Le. c �-�p i c, yy i (1 i� (� �acl e ALA vL�m - r" rel �o� t,� S. f7 l S �cEc(t c%� ovv� t� i 5 W t vi 2iv
Fi- ova cin +msslv�(kvl bef' a� doors 1�-D40V
1 1 8C�yj U� 9-s to ltiv� rl (� �1J UVB U`�-s In r & mvi-1k, &L..9 p1-� 6�
rQyn� �� �u kI G►'� . l i(l �}AU Y� �t i (ell ��C I �.t&eg1 ; c M\Wk Y\z� cu (-Ct " •a y r`g� ��,-�U�r✓tn t.�
tial e Lic,� C' e I�itihn b rn e C1�ct n &tA cr rt ty-'v- f rx- acid 04-C Vra- �'
ra �'pe .
lrl vv 07,0 U ru-S �{Ca�rl =i sir Vzvt�- "A-- V A s"r1k. ASO, tNSiru(1 Y"t �l�crhb �
� CA,s90sa�'y QoF llc� I Ici�J 2Y�vta,l rl►v�ctvWs Wl'rc �Q�i<�'►jy VVi"Ows are fats} Y�c(vtlN�
WI VtAlv he i 5h---- Frew, Ly{ wl . 3(, IInCAii .-fzm' All afpu ayuS W, tti be SVIYO r- Fey d M iniln s., lJ ry w� �► `�
Sq. FULF BTUs `ave �ctdW UV 3d Gallons Y� �IGL-ecl v (J C6yK V ?A ort
Amps Squares For Solar:KW #of Panels Requires Structural t,,w\P-&wv,,94-i-D
d0 `'`iff y -
For Commercial Projects Only: Occupancy Type: Construction TYPe: Qf,-ep*
Plvlrwb
Occupancy Load: Square Footage: N01164 -
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$ 3s,
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. 1, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) [(CO�NT^RACTOR)
Signature (first and last name): DA'L'E: I (,t
\11 .(- J- A _
Printed Name:
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMEN :
Reviewer:
-7l3��ca
PUBLIC WORKS COMMENTS:
Reviewer.
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION: )25
CONSTRUCTION TYPE: VO
W 1AV-)Cw5 CZ, = G Oce
Building Division Valuation:
City of
Y
Wh6atl�i
.Sd�lgle
COMMUNITY DEVELOPMENT
Official Certification of Property Owner Permit
THIS IS TO CERTIFY that I, the property owner, by my signature, attest that I currently
reside at the project property, or intend to reside at the property for a period of one year after
completion of the project, and am personally performing all work, without the assistance of
hired or professional workers, or, if hiring sub -contractors, list them on the permit.
Consultations and inspections will only be performed with the homeowner of record present at
the project property.
Property Owner(s): -a- `�� U,
Project Property: �� 3w I \ VK , O VQ['� - V� !2� OjC
Project Type: ' 1/i Q-1� l; I_ Q V�i1, (an C --,P
Notarized signature# Applicant
State of Colorado }
County of 0e ';Ne'. -0 n } ss
A\ -
The foregoing instrument was acknowledged by me this ..36 day of�T�, 20a by
TAMARA D ODEAN
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20164015481
MY COMMISSION EXPIRES APRIL 22, 2020
4t,--- My Commission Expires_ q/,22J200-4
Notary Public
City of
/,4� +
Wh6at
PNjdge
ONsMUNiTY DEVELOPMENT
SUB -CONTRACTOR AUTHORIZATION FORM
This form must be signed by each sub -contractor.
This form will not be accepted with missing information.
Subcontractor's City of Wheat Ridge License number must be provided in the applicable space.
Subcontractor's insurance and license must be up to date prior to permit issuance.
Project Address: ��� W 3b414 ft Permit #:
General Contractor:
Electrical Sub -Contractor
Company Name:
State License #:
Wheat Ridge License #:
Signature of Authorized Agent
Phone #:
Master #•
(required field)
Date
LPlumbing Sub -Contractor J e� hr A,- �`� ,
Company Name: D2 �01 M WAJ Phone #: JD 2j ((�Q
State License #:
r
Authorized Agent
Master #:
required field)
DateV
Mechanical Contractor J g wh �/_ �De LAWU.,Ate
Company Name: v YV,101 n
Phone: 3b3 91 co 5�3
eat Li e #• c��� -�
��---(required field)
Signat r of Authorize Agent Date
CEM85L
EMSL Analytical, Inc.
1010 Yuma Street Denver, CO 80204
Tel/Fax: (303) 740-57001(303) 741-1400
EMSL Order: 221905267
Customer ID: AVTE25
Customer PO:
Project ID:
Attention: Drue Beasley` V E D Phone: (720) 675-7175
Advent Environmental Consulting Fax:
7830 W. Alameda Ave LReceived Date: 06/28/2019 3:15 PM
Unit 103-216 r+� Analysis Date: 07/08/2019
Lakewood, CO 80226 Per Collected Date: 06/26/2019
Project: 9685 WEST 26TH AVENUE WHEAT RIDGE, CO 80033
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized
Light Microscopy
Non -Asbestos Asbestos
Sample Description Appearance % Fibrous % Non -Fibrous % Type
PL1-1-Skim Coat White 10% Ca Carbonate None Detected
Non -Fibrous 90% Non-fibrous (Other)
221905267-0001 Heterogeneous
Inseparable paint / coating layer included in analysis
PI -1 -1 -Plaster
White
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0001A
Homogeneous
PI -1 -2 -Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
p
221905267-0002
Heterogeneous
Rl
Inseparable paint/coating layerincluded in analysis
PL1-2-Plaster
White
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0002A
Homogeneous
PL1-3-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0003
Homogeneous
Inseparable paint/coating layerinduded in analysis
PL1-3-Plaster
Tan
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0003A
Homogeneous
PI -2 -1 -Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0004
Heterogeneous
Inseparable paint/coating layerinduded in analysis
PL2-1-Plaster
White
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0004A
Homogeneous
PL2-2-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
p
221905267-0005
Heterogeneous
Rl
Inseparable paint / coating layer included in analysis
PL2-2-Plaster
White
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0005A
Homogeneous
PL2-3-Skim Coat
White
15% Ca Carbonate
None Detected
Non -Fibrous
85% Non-fibrous (Other)
221905267-0006
Homogeneous
Inseparable paint/coating layerinduded in analysis
PL2-3-Plaster
Tan
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0006A
Homogeneous
PI -3 -1 -Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
p
221905267-0007
Heterogeneous
Rl
Inseparable paint/ coating layer included in analysis
PI -3 -1 -Plaster
White
5% Ca Carbonate
None .D,?tected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0007A
Homogeneous
Initial report from: 07/08/2019 16:00:56
Printed: 7/8/2019 2:00 PM Page 1 of 3
EMSL Analytical, Inc. EMSL Order: 221905267
1010 Yuma Street Denver, CO 80204 Customer ID: AVTE25
Tei/Fax: (303) 740-5700 / (303) 741-1400
Customer PO:
Project ID:
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-931116 Method using Polarized
Light Microscopy
Non -Asbestos Asbestos
Sample Description Appearance % Fibrous % Non -Fibrous % Type
PL3-2-Skim Coat White 10% Ca Carbonate None Detected
Non -Fibrous 90% Non-fibrous (Other)
221905267-0008 Heterogeneous
Inseparable paint/coating layerinduded in analysis
PL3-2-Plaster
White
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0008A
Homogeneous
PL3-3-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0009
Homogeneous
Inseparable paint/coating layerinduded in analysis
PL3-3-Plaster
Tan
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0009A
Homogeneous
PL4-1-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0010
Heterogeneous
Inseparable paint/ coating layerincluded in analysis
PL4-1-Plaster
White <1% Hair
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-OOIOA
Homogeneous
PL4-2-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0011
Heterogeneous
PL4-2-Plaster
White
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-OOI IA
Homogeneous
PL4-3-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0012
Homogeneous
Inseparable paint/coating layerinduded in analysis
PL4-3-Plaster
Tan
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0012A
Homogeneous
MA1-1-Ceramic Tile
White
100% Non-fibrous (Other)
None Detected
Non -Fibrous
22 190526 7-00 13
Homogeneous
MA1-1-Grout
Beige
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0013A
Homogeneous
MA1-1-Mastic
Yellow
100% Non-fibrous (Other)
None Detected
Non -Fibrous
221905267-00138
Homogeneous
MA1-1-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0013C
Heterogeneous
Inseparable paint/coaling layerinduded in analysis
MAI -2-Ceramic Tile
White
100% Non-fibrous (Other)
None Detected
Non -Fibrous
221905267-0014
Homogeneous
MA1-2-Mastic
Tan
100% Non-fibrous (Other)
None Detected
Non -Fibrous
221905267-0014A
Homogeneous
MA1-2-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0014B
Homogeneous
Inseparable paint/ coating layerinduded in analysis
Initial report from: 07/08/2019 16:00:56
i_0008,_ 0001 - Printed: 7/8/2019 2:00
PM
Page 2 of 3
EMSL Analytical, Inc. EMSL Order: 221905267
Customer ID: AVTE25
1010 Yuma Street Denver, CO 80204 Customer PO:
Tel/Fax: (303) 740-5700 / (303) 741-1400
Project ID:
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-931116 Method using Polarized
Light Microscopy
Non -Asbestos Asbestos
Sample Description Appearance % Fibrous % Non -Fibrous % Type
MA1-2-Plaster Tan 5% Ca Carbonate None Detected
Non -Fibrous 95% Non-fibrous (Other)
221905267-0014C Homogeneous
Analyst(s)
Ashley Boyd (12)
Amanda Hammer (20)
Melanie Rech, Laboratory Director
or Other Approved Signatory
EMSL maintains liability limited to cost of analysis. The above analyses were performed in general compliance with Appendix E to Subpart E of 40 CFR (previously EPA 600/M4-82-020 "Interim
Method"), but augmented with procedures outlined in the 1993 ("final") version of the method. This report relates only to the samples reported above, and may not be reproduced, except in full, without
written approval by EMSL EMSL bears no responsibility for sample collection activities or analytical method limitations . Interpretation and use of test results are the responsibility of the client. All
samples received in acceptable condition unless otherwise noted. This report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NISTialany agency of
the federal government. EMSL recommends gravimetric reduction for all non -friable organically bound materials prior to analysis. Estimation of uncertainty is available A request.
Samples analyzed by EMSL Analytical, Inc. Denver, CO NVLAP Lab Code 200828-0
Initial report from: 07/08/2019 16:00:56
r
^C-� Printed: 718/2019 2:00 PM Page 3 of 3
Pp
After Recording Return To:
FIRST OKLAHOMA MORTGAGE LLC, A SUBSIDIARY OF FIRST OKLAHOMA BANK
100 SOUTH RTVERFRONT DRIVE
JENKS, OK 74037
[Space Above This Line For Recording Data]
Loan Number: 145479
DEED OF TRUST
DEFINITIONS knTltle
GUARANTEE COMPANY
Words used in multiple sections of this document are defined below and other words are defined in Sections 3, 11,
13, 18, 20 and 21. Certain rules regarding the usage of words used in this document are also provided in Section 16.
(A) "Security Instrument" means this document, which is dated JUNE 21, 2019, together with all Riders to this
document..
(B) "Borrower" is DOUG BENTZ AND J. KIMBERLY BENTZ, HUSBAND AND `VIFE, Borrower is the
trustor under this Security Instrument.
(C) "Lender" is FIRST OKLAHOMA MORTGAGE LLC, A SUBSIDIARY OF FIRST OKLAHOMA
BANK Lender is a CORPORATION organized and existing under the laws of OKLAHOMA, Lender's address
is 100 SOUTH RIVERFRONT DRIVE, JENKS, OK 74037. Lender is the beneficiary Larder this Security
Instrument.
(D) "Trustee" is the Public Trustee of JEFFERSON County, Colorado.
(E) "Note" means the promissory note signed by Borrower and dated JUNE 21, 2019, The Note states that
Borrower owes Lender Five Hundred Forty -Six Thousand Two Hundred Fifty And N0/100 Dollars (U.S.
$546,230.00) phis interest. Borrower has promised to pay this debt. in regular Periodic Payments and to pay the debt
in full not later than JULY 01, 2049.
(F) "Property" means the property that is described below raider the heading "Transfer of Rights in the Property."
(G) "Loan" means the debt evidenced by the Note, phis interest any prepayment charges and late charges due
under the Note, and all sums due under this Security Instrument, plus interest.
(H) "Riders" means all Riders to this Security Instrument that are executed by Borrower. The following Riders are
to be executed by Borrower [check box as applicable]:
❑ Adjustable Rate Rider ❑ Condominium Rider ❑ Second Horne Rider
❑ Balloon Rider ❑ Planned Unit Development Rider ❑ Other(s) [specify]
❑ 1-4 Family Rider ❑ Biweekly Payment Rider
(I) "Applicable Law" means all controlling applicable federal, state and local statutes, regulations, ordinances and
administrative rules and orders (that have the effect of law) as well as all applicable final, non -appealable judicial
opinions.
(J) "Community Association Dues, Fees, and Assessments" means all dues, fees, assessments and other charges
that are imposed on Borrower or the Property by a condominium association, homeowners association or similar
organization,
(K) "Electronic Funds Transfer" means any transfer of funds, other than a transaction originated by check, draft,
or similar paper instrument, which is initiated through an electronic terminal, telephonic instrument., computer, or
magnetic tape so as to order, instruct, or authorize a financial institution to debit or credit an account Such term
includes, but is not limited to, point.. -of --sale transfers, automated telle transactions, transfers initiated by
Initisrlsa
COLORADO—Single Family—Fannie Mae/Freddie Rfac UNIFORM LNSTRUNWNT Form 3606 1101 (page I of 13 pages)
telephone, wire transfers, and automated clearinghouse transfers,
(L) "Escrow Items" means those items that are described in Section 3.
(M) "Miscellaneous Proceeds" means any compensation, settlement, award of damages, or proceeds paid by any
third party (other than insurance proceeds paid -tinder the coverages described in Section 5) for: (i) damage to, or
destruction of, the Property; (ii) condenuiation or other taking of all or any part of the. Property; (iii) conveyance in
lieu of condemnation; or (iv) misrepresentations of or omissions as to, the value and/or condition of the Property.
(N) "Mortgage Insurance" means insurance protecting Lender against the nonpayment of, or default on, the Loan,
(0) "Periodic Payment" means the regularly scheduled amount due for (r) principal and interest under the Note,
plus (ii) any amounts tinder Section 3 of this Security Instrument.
(P) "RESPA" means the Real Estate Settlement Procedures Act (12 U.S.C. §2601 et seq.) and its implementing
regulation, Regulation X (24 C.F.R. Part 3500), as they might be amended from time to time, or any additional or
successor legislation or regulation that governs the sauce subject matter. As used in this Security Instrument,
"RESPA" refers to all requirements and restrictions that are imposed in regard to a "federally related mortgage Ioan"
even if the Loan does not qualify as a "federally related mortgage loan" under RESPA,
(Q) "Successor in Interest of Borrower" means any party that has taken title to the Property, whether or not that
party has assumed Borrower's obligations tinder the Note and/or this Security Instrument
TRANSFER OF RIGHTS IN THE PROPERTY
This Security Instrument secures to Lender: (i) the repayment of the Loan, and all renewals, extensions and
modifications of the: Note; and (ii) the performance of Borrower's covenants and agreements under this Security
Instrument and the Note, For this purpose, Borrower, in consideration of the debt and the trust herein created,
irrevocably grants and conveys to Trustee, in trust, with power of sale, the following described property located in
the
County of JEFFERSON
[Type of Recording Jurisdiction] [Name of Recording Jurisdiction]
LOT 12, BLOCK 2, WESTHAVEN, COUNTY OF JEFFERSON, STATE OF CGLORADO
which currently has the address of 9685 W 36TH AVE VMEAT RIDGE
[Street] [City]
Colorado 800335708 ("Property Address"):
[Zip Code]
TOGETHER WITH all the improvements now or hereafter erected on the property, and all easements,
appurtenances, and fixtures now or hereafter a part of the property. All replacements and additions shall also be
covered by this Security Instrument, All of the foregoing is referred to in this SecurityInstrument as the "Property."
BORROWER COVENANTS that Borrower is lawfully seised of the estate hereby conveyed and has the right
to grant and convey the Property and that the Property is unencumbered, except for encumbrances of record.
Borrower warrants and will defend generally the title to the Property against all claims and demands, subject to any
encumbrances of record and liens for taxes for the current year not yet due and payable.
THIS SECURITY INSTRUMENT combines uniform covenants for national use and nan-unifonn covenants
with limited variations by jurisdiction to constitute a uniform security instrument covering real property.
UNIFORM COVENANTS. Borrower and Lender covenant and agree as follows:
1. Payment of Principal, Interest, Escrow Items, Prepayment Charges, nand Late Charges. Borrower
shall pay when duee the principal of, and interest on, the debt evidenced by the Note and any prepayment charges and
late charges due tinder the Note. Borrower shall also pay fiords for Escrow Items pursuant to Section 3. Payments
due tinder the Note and this Security Instrument shall be made in U.S. currency. However, if any check or other
instrument received by Lender as payment ander the Note or this SecuriI
,��_-�4iifrumeat is renamed to Leader uripaid
Initials: 1'i� , v
COLORADO—Single Fauuly Fanmie Mae/Freddie AUc Lfi'IFORM LNSTRUNrEN'T Fara 3006 1/01 (page 2 of L3 pages)
Lender may require that any or all subsequent payments due under the Note and this Security Instrument be made in
one or more of the following forms, as selected by Lender: (a) cash; (b) money order; (c) certified check, bank
check, treasurer's check or cashier's check, provided any such check is drawn upon an institution whose deposits
are insured by a federal agency, instrumentality, or entity; or (d) Electronic Funds Transfer.
Payments are deemed received by Lender when received at the location designated in the Note or at such other
location as may be designated by Lender in accordance with the notice provisions in Section 15. Lender may return
any payment or partial payment if the payment or partial payments are insufficientto bring the Loan current,
Lender may accept any payment or partial payment insufficient to bring the Loan current, without waiver of any
rights hereunder or prejudice to its rights to refuse such payment or partial payments in the future, but. Lender is not
obligated to apply such payments at the time such payments are accepted. If each Periodic Payment is applied as of
its scheduled due date, then Lender need not pay interest on unapplied funds. Lender may hold such unapplied
Rinds until Borrower makes payment to bring the Loan current. If Borrower does not do so within a reasonable
period of time, Lender shall either apply such funds or return them to Borrower. If not applied earlier, such funds
will be applied to the outstanding principal balance under the Note immediately prior to foreclosure. No offset or
claire which Borrower might have now or in the future against Lender shall relieve Borrower from making
payments due under the Note and this Security Instrument or performing the covenants and agreements secured by
this Security Instrument:.
2. Application of Payments or Proceeds. Except as otherwise described in this Section 2, all payments
accepted and applied by Lender shall be applied in the following order of priority: (a) interest due under the Note;
(b) principal due under the Note; (c) amounts due under Section 3. Such payments shall be applied to each Periodic
Payment in the order in which it became due. Any remaining amounts shall be applied fust to late charges, second
to any other amounts due tinder this Security Instrument, and then to reduce the principal balance of the Note.
If Leander receives a. payment fiom Borrower for a delinquent Periodic Payment which includes a sufficient
amount to pay any late charge due, the payment may be applied to the delinquent payment and the late charge, If
more than one Periodic Paymentt is outstanding, Lender may apply any payment received from Borrower to the
repayment of the Periodic Payments if, and to the extent that, each payment can be paid in full. To the extent that
any excess exists after the paymentt is applied to the full payuuent of one or more Periodic Payments, such excess
may be applied to any late charges due. Voluntary prepayments shall be applied first to any prepayment charges
and then as described in the Note.
Any application of payments, insurance proceeds, or Miscellaneous Proceeds to principal due under the Note
shall not extend or postpone the due date, or change the amount, of the Periodic. Payments.
3. Funds for Escrow Items. Borrower shall pay to Lender on the day Periodic Payments are due under the
Note, until the Note is paid in fiull, a. sum (the "Funds' to provide for payment of amounts due. for; (a) taxes and
assessments and other items which can attain priority over this Security Instrument as a. lien or encumbrance on the
Property; (b) leasehold payments or ground rents on the Property, if any; (c) premiums for any and all insurance
required by Lender under Section 5; and (d) Mortgage Insurance premiums, if any, or any stuns payable by
Borrower to Lender in lieu of the payment of Mortgage Insurance premium s in accordancewith the provisions of
Section 10. These items are called "Escrow Items." At origination or at any time during the term of the Loan,
Lender may require that Community Association Dues, Fees,, and Assessments, if any, be escrowed by Borrower,
and such dues, fees and assessments shall be an Escrow Item. Borrower shall promptly furnish to Lender all notices
of amounts to be paid under this Section. Borrower shall pay Lender the Funds for Escrow Items unless Lender
waives Borrower's obligation to pay the Fiords for any or all Escrow Items. Lender may waive Borrower's
obligation to pay to Lender Funds for any or all Escrow Items at any time. Any such waiver may only be in writing.
In the event of such waiver, Borrower shall pay directly, when and wherepayable., the amounts due for any Escrow
Items for which payment of Funds has been waived by Lender and, if Lender requires, shall furnish to Lender
receipts evidencing such payment within such time period as Lender may require, Borrower's obligation to make
such payments and to provide receipts shall for all puuposes be deemed to be a covenant and agreement contained in
this Security Instrument, as the phrase "covenant and agreement" is used in Section 9. If Borrower is obligated to
pay Escrow Items directly,. pursuant to a waiver, and Borrower fails to pay the amount due for an Escrow Item,
Lender may exercise its rights under Section 9 and pay such amount and Borrower shall then be obligated under
Section 9 to repay to Lender any such amount. Lender may revoke the waiver as to any or all Escrow Items at any
time by a notice given in accordance with Section 15 and, upon such revocation, Borrower shall pay to Lender all
Funds, and in such amounts, that are then required under this Section 3.
Lender may, at any time, collect and hold Funds in an amount (a.) sufficient to permit Lender to apply the Funds
at the time specified wider RESPA, and (b) not to exceed the maxima unt a. leader
can require under RESPA.
Initials7. V X)
COLORADO --Single Family—Fannie Mae/Freddie Xfac UNIFORM LNSTRL7j%,jy 1'T Form 3006 1101 (page 3 of 13 pages)
Lender shall estimate the amount of Funds due on the basis of current data and reasonable estimates of expenditures
of future Escrow Items or otherwise in accordance with Applicable Law.
The Funds shall be held in an institution whose deposits are insured by a federal agency, instrumentality, or
entity (including Lender, if Lender is an institution whose deposits are so insured) or in any Federal Home. Loan
Bank. Lender shall apply the Funds to pay the Escrow Items no later than the time specified under RESPA. Lender
shall not charge Borrower for holding and applying the Funds, annually analyzing the escrow account, or verifying
the Escrow Items, unless Lender pays Borrower interest on the Funds and Applicable Law permits Lender to make
such a charge. Unless an agreement. is made in writing or Applicable Law requires interest to be paid on the Funds,
Lender shall not be required to pay Borrower any interest or earnings on the Funds. Borrower and Lender can agree
in writing, however, that interest shall be paid on the Funds. Lender shall give to Borrower, without charge, an
annual accounting of the Funds as required by RESPA,
If there is a swphns of Funds held in escrow, as defined under RESPA, Lender shall account to Borrower for the
excess funds in accordance with RESPA_ If there is a shortage of Funds held in escrow, as definedunder RESPA,
Lender shall notify Borrower as required by RESPA; and Borrower shall pay to Lender the amount necessary to
make up the shortage in accordance with RESPA, but in no more than 12 monthly payments. If there is a deficiency
of Funds held in escrow, as defined under RESPA, Lender shall notify Borrower as required by RESPA, and
Borrower shall pay to Lender the amount necessary to make up the deficiency in accordance with RESPA, but in no
more than 12 monthly payments.
Upon payment in full of all stuns secured by this Security Instrument, Lender shall promptly refiurd to
Borrower any Funds held by Lender.
4. Charges; Liens. Borrower shall pay all taxes, assessments, charges, fines, and impositions attributable to
the Property which can attain priority over this Security Instrument, leasehold payments or ground rents on the
Property, if any, and Community Association Dues, Fees, and Assessments, if any, To the extent that these items
are Escrow items, Borrower shall pay them in the mariner provided in Section 3.
Borrower shall promptly discharge any lien which has priority over this Security Instrurnenf unless Bon•ower:
(a) agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to Lender, but only
so long as Borrower is performing such agreement; (b) contests the lien in good faith by, or defends against
enforcement of the lien in, legal proceedings which in Lender's opinion operate to prevent the enforcement of the
lien while those proceedings are pending, but only until such proceedings are concluded; or (c) secures from the
holder of the lien an agreement satisfactory to Lender subordinating the lien to this Security Instrument. If Lender
determines that any part of the Property is subject to a lien which can attain priority over this Security instrument,
Lender may give Borrower a notice identifying the lien. 'Within 10 days of the date on which that notice is given,
Borrower shall satisfy the lien or take one. or more of the actions set forth above in this Section 4,
Lender may require Borrower to pay a. one-time charge for a real estate tax verification and/or reporting service
used by Lender in connection with this Loan.
5. Property Insurance. Borrower shall keep the improvements now existing or hereafter erected on the
Property insured against loss by fire, hazards included within the term "extended coverage," and any other hazards
including, brit not limited to, earthquakes and floods,, for wlmich Lender requires insurance. This insurance shall be
maintained in the amounts (including deductible levels) and for the periods that Lender requires. What Lender
requires pursuant to the preceding sentences can change during the term of the Loan. The insurance carrier
providing the insurance shall be chosen by Borrower subject to Lender's right to disapprove Borrower's choice,
which right shall not be exercised unreasonably. Lender may require Borrower to pay, in connection with this Loan,
either: (a) a one-time charge for flood zone determination, certification and tracking services; or (b) a one -tune
charge for flood zone detennination and certification services and subsequent charges each time remappings or
similar changes occur which reasonably might affect such determination or certification. Borrower shall also be
responsible for the payment of any fees imposed by the Federal Emergency Management Agency in connection with
the review of any flood zone determination resulting from an objection by Borrower.
If Borrower fails to maintain any of the coverages described above, Lender may obtain insurance coverage, at
Lender's option and Borrower's expense. Lender is under no obligation to purchase any particular type or amount
of coverage. Therefore, such coverage shall cover Lender, but might or might not protect Borrower, Borrower's
equity in the Property, or the contents of the Property, against any risk hazard or liability and might provide greater
or lesser coverage than was previously in effect. Borrower acknowledges that the cost of the insurance coverage so
obtained might significantly exceed the cost of insurance that Borrower could have obtained. Any amounts
disbursed by Lender under this Section 5 shall become additional debt of Borrower secured by this Security
Instrument. These amounts shall bear interest at the Note rate from the f disbursement and shall be payable,
Initials:
COLORADO—Single Family—Fannie Mae/Freddie Mac UNIFORM INSTRUNEENT Form 3006 1101 (page 4 of 13 pagoa)
with such interest, upon notice from Lender to Borrower requesting payment.
All insurance policies required by Lender and renewals of such policies shall be subject to Lender's right to
disapprove. such policies, shall include a standard mortgage clause, and shall name Lender as mortgagee and/or as an
additional loss payee. Lender shall have the right to hold the policies and renewal certificates. If Lender requires,
Borrower shall promptly give to Lender all receipts of paid premiums and renewal notices. If Borrower obtains any
form of insurance coverage, not otherwise required by Lender, for damage to, or destruction of the Property, such
policy shall include a standard mortgage clause and shall nacre Lender as mortgagee and/or as an additional loss
payee.
In the event of lass, Borrower shall give prompt notice to the insurance carrier and Lender. Lender may make
proof of loss if not made promptly by Borrower. Unless Leader and Borrower otherwise agree in writing, any
insurance proceeds, whether or not the underlying insurance was required by Lender, shall be applied to restoration
or repair of the Property,. if the restoration or repair is economically feasible. and Lender's security is not lessened.
During such repair and restoration period, Lender shall have the right to hold such insurance proceeds until Lender
has had an opportunity to inspect such Property to ensure the work has been completed to Lender's satisfaction,
provided that such inspection shalt be undertaken promptly. Lender may disburse proceeds for the repairs and
restoration in a single payment or in a series of progress payments as the work is completed. Unless an agreement is
made in writing or Applicable Law requires interest to be paid on such insurance proceeds, Lender shalt not be
required to pay Borrower any interest or earnings on such proceeds. Fees for public adjusters, or other third parties,
retained by Borrower shall not be paid out of the insurance proceeds and shall be the sole obligation of Borrower. If
the restoration or repair is not economically feasible or Lender's security would be lessened, the insurance proceeds
shall be applied to the sutras secured by this Security Instrument, whether or not then due, with the excess, if any,
paid to Borrower. Such insurance proceeds shall be applied in the order provided for in Section 2.
If Bonower abandons the Property, Lender may file, negotiate and settle any available insurance claim and
related matters. If Borrower does not respond within 30 days to a. notice from Lender that the insurance carrier has
offered to settle a claim, then Lender may negotiate and settle the claim. The 30 -day period will begin when the
notice is given. In either event, or if Lender acquires the Property under Section 22 or otherwise, Borrower hereby
assigns to Lender (a) Borrower's rights to any insurance proceeds in an amount not to exceed the amounts unpaid
under the Note or this Security Instrument, and (b) any other of Borrower's rights {other than the right to any refund
of unearned premiums paid by Borrower) under all insurance policies covering the Property, insofar, as such rights
are applicable to the coverage of the Property. Lender may use the insurance proceeds either to repaii or restore the
Property or to pay amounts unpaid under the Note or this Security Instrument, whether or not then due.
6. Occupancy. Borrower shall occupy, establish, and use the Property as Borrower's principal residence
within 60 days after the execution of this Security Instrument and shall continue to occupy the Properly as
Borrower's principal residence for at least one year after the date of occupancy, unless Lender otherwise agrees in
writing, which consent shall not be unreasonably withheld, or furless extenuating circumstances exist which are
beyond Borrower's control.
7. Preservation, Maintenance and Protection of the Property; Inspections. Borrower shall not destroy,
damage or .impair the Property, allow the Property to deteriorate or commit waste on the Property. Whether or not
Borrower is residing in the Property, Borrower shall maintain the Property in order to prevent the Property from
deteriorating or decreasing in value due to its condition. Unless it is determined pursuant to Section 5 that repair or
restoration is not economically feasible, Borrower shall promptly repair the Property if damaged to avoid farther
deterioration or damage. If insurance or condemnation proceeds are paid in connection with damage to, or the
taking of, the Property, Borrower shall be responsible for repairing or restoring the Property only if Lender has
released proceeds for such purposes. Lender may disburse proceeds for the repairs and restoration in a. single
payment or in a series of progress payments as the work is completed. If the insurance or condemnation proceeds
are not sufficient to repair or restore the Property, Borrower is not relieved of Borrower's obligation for the
completion of such repair• or restoration.
Lender or its agent may make reasonable entries upon and inspections of the Property, If it has reasonable
cause, Lender may inspect the interior of the improvements on the Property. Lender shall give Borrower notice at
the time of or prior to such an interior inspection specifying such reasonable cause.
S. Borrower's Loan Application. Borrower shall -be in default if, during the Loan application process,
Borrower or any persons or entities acting at the direction of Borrower or with Borrower's knowledge or consent.
gave materially false, misleading, or inaccurate information or statements to Lender (or failed to provide Lender
with material information) in connection with the Loan. Material representations include, but are not. limited to,
representations concerning Borrower's occupancy of the Property as B s principal residence.
Initials;
COLORADO—Single Fanuly—Fannie Mae/Freddie Mac UNIFORM LYSTRURIFNr Form 3006 1101 (page 5 of 13 Pages)
9. Protection of Lender's Interest in the Property and Rights Under this Security Instrument If
(a) Borrower fails to perform the covenants and -agreements contained in this Security Instrument, (b) there is a legal
proceeding that might significantly affect Lender's interest in the Property and/or lights under this Security
Instrument (such as a proceeding in bankruptcy, probate, for condemnation or forfeiture, for enforcement of a lien
which may attain priority over this Security, Instrument or to enforce laws or regulations), or (c) Borrower has
abandoned the Property, then Lender may do and pay for whatever is reasonable or appropriate to protect Lender's
interest in the Property and rights tinder this Security Instrument, including protecting and/or assessing the value of
the Property, and securing and/or repairing the Property. Lender's actions can include, but are not limited to:
(a) paying any sums secured by alien which has priority over this Security Instrument; (b) appearing in court; and
(c) paying reasonable attorneys' fees to protect its interest in the Property and/or rights under this Security
Instrument, including its secured position in a bankruptcy proceeding. Securing the Property includes, but is not
limited to, entering the Property to make repairs, change locks, replace or board up doors and windows, digin water
from pipes, eliminate building or other code violations or dangerous conditions, and have utilities turned on or off.
Although Lender may take action under this Section 9, Lender does not have to do so and is not under any duty or
obligation to do so. It is agreed that Lender incurs no liability for not taking any or all actions authorized under this
Section 9.
Any amounts disbursed by Lender under this Section 9 shall become additional debt of Borrower secured by
this Security Instrument. These amounts shall bear interest at the Note rate from the date of disbursement and shall
be payable, with such interest, upon notice from Lender to Borrower requesting payment.
If this Security Instrument is on a: leasehold, Borrower shall comply with all the provisions of the lease. If
Borrower acquires fee title to the Property, the leasehold and the fee title shall not merge unless Lender agrees to the
merger in writing.
10. Mortgage Insurance. If Lender required Mortgage Insurance as a, condition_ of making the Loan,
Borrower shall pay the premiums required to maintain the Mortgage Insurance in effect. If for any reason, the
Mortgage Insurance coverage required by Lender ceases to be available from the mortgage insurer that previously
provided such insurance and Borrower was required to make separately designated payments toward the premiums
for Mortgage Insurance, Borrower shall pay the premiums required to obtain coverage substantially equivalent to
the Mortgage Insurance previously in effect, at a cost substantially equivalent to the cost to Borrower of the
Mortgage Insurance previously in effect, from an alternate mortgage insurer selected by Lender, if substantially
equivalent Mortgage Insurance coverage is not. available, Borrower shall continue to pay to Lender the amount of
the separately designated payments that were due when the insurance coverage ceased to be in effect. Lender will
accept, use and retain these payments as a non-refindable loss reserve in lieu of Mortgage Insurance. Such loss
reserve shall be. non-re5sndable, notwithstanding the fact that the Loan is ultimately paid in full, and Lender shall
not be. required to pay Borrower any interest or earnings on such loss reserve. Lender can no longer require loss
reserve payments if Mortgage Insurance coverage (in the amount and for the period that Lender requires) provided
by an insurer selected by Lender again becomes available, is obtained, and Lender requires separately designated
payments toward the premiums .for Mortgage Insurance. If Leader required Mortgage Insurance as a condition of
making the Loan and Borrower was required to make separately designated payments toward the premiums for
Mortgage Insurance, Borrower shall pay the premiums required to maintain Mortgage Insurance in effect; or to
provide a non-refundable loss reserve, until Lender's requirement for Mortgage Insurance ends in accordance with
any written agreement between Borrower and Lender providing for such termination or until termination is required
by Applicable Law. Nothing in this Section 1.0 affects Borrower's obligation to pay interest at the rate provided in
the Note.
Mortgage Insurance reimburses Lender (or any entity that purchases the Note) for certain losses it may incur if
Borrower does not repay the Loan as agreed. Borrower is not a party to the Mortgage Insurance.
Mortgage insurers evaluate their total risk on all such insurance in force fiom time to time, and may enter into
agreements with other parties that share or modify their risk, or reduce losses. These agreements are on terms and
conditions that are satisfactory to the mortgage insurer and the other party (or parties) to these. agreements, These
agreements may require the mortgage insurer to make payments using any source of funds that the mortgage insurer
may have available (which may include finds obtained fiom Mortgage Insurance premiums).
As a result of these agreements, Lender, any purchaser of the Note., another insurer, any reinsurer, any other
entity, or any affiliate of any of the foregoing, may receive (directly or indirectly) amounts that derive from (or
might be characterized as) a portion of Borrower's payments for Mortgage Insurance., in exchange for sharing or
modifying the mortgage insurer's risk, or reducing losses. If such agreement provides that an affiliate of Lender
takes a share of the insurer's risk in exchange for a. share of the premiums paid to the insurer, the arrangement is
Initials:
COLORADO—Singly Family—Fahnie Mae/Freddie Mac UNITORM INSTRUMENT Form 3006 1/01 (pags 6 of 13 pages)
often termed "captive reinsurance." Further:
(a) Any such agreements will not Affect the amounts that Borrower has agreed to pay for Mortgage
Insurance, or any other terms of the Loan, Such agreements will not increase the amount Borrower will owe
for Mortgage Insurance, and they will not entitle. Borrower to any refund.
(b) Any such agreements will not affect the rights Borrower has — if any — with respect to the Mortgage
Insurance under the Homeowners Protection Act of 1998 or any other Iaw. These rights may include the right
to receive certain disclosures, to request and obtain cancellation of the Mortgage insurance, to have the
Mortgage Insurance terminated automatically, and/or to receive n refund of any Mortgage Insurance
premiums that were unearned nt the time of such cancellation or termination.
11. Assignment of Miscellaneous Proceeds; Forfeiture. All Miscellaneous Proceeds are hereby assigned to
and shall be paid to Lender.
If the Property is damaged, such Miscellaneous Proceeds shall be applied to restoration or repair of the
Property, if the restoration or repair is economically feasible and Lender's security is not lessened. During such
repair and restoration period, Lender shall have theright to hold such Miscellaneous Proceeds until Lender has had
an opportunity to inspect such Property to ensure the work has been completed to Lender's satisfaction, provided
that such inspection shall be undertaken promptly. Lender may pay for the repairs and restoration in a single
disbursement or in a series of progress payments as the work is coumpleted. Unless an agreement is made in writing
or Applicable Law requires interest to be paid on such Miscellaneous Proceeds, Lender shall not be required to pay
Borrower any interest or earnings on such Miscellaneous Proceeds. If the restoration or repair is not economically
feasible or Lender's security would be lessened, the Miscellaneous Proceeds shall be applied to the sures secured by
this Security Instrument, whether or not then due, with the excess, if any, paid to Borrower. Such Miscellaneous
Proceeds shall be applied in the order provided for in Section 2.
In the event of a total taking, destruction, or loss in value of the Property, the Miscellaneous Proceeds shall be
applied to the sums secured by this Security Instrument, whether or not then due, with the excess, if any, pard to
Borrower.
In the event of a partial taking, destruction, or loss in value of the Property in which the fair market value of the
Property immediately before the partial taking, destruction, or loss in value is equal to or greater than the amount of
the stuns secured by this Security Instiument immediately before the partial taking, destruction, or loss in value,
unless Borrower and Lender otherwise agree in writing, the sums secured by this Security instrument shall be
reduced by the amount of the Miscellaneous Proceeds multiplied by the following fraction., (a) the total amount of
the suns secured immediately before the partial taking, destruction, or loss in value divided by (b) the fair market
value of the Property immediately before the partial taking, destruction, or loss in value. Any balance shall be paid
to Borrower.
In the event of a partial taking, destruction, or loss in value of the Property in which the fair markett value of the
Property immediately before the partial taking, destruction, or loss in value is less than the amount of the sums
secured immediately before the partial taking, destruction, or loss in value, unless .Borrower and Lender otherwise
agree in vvrziting, the. Miscellaneous Proceeds shall be applied to the stuns secured by this Security Instr uunent
whether or not the sums are then due.
If the Property is abandoned by Borro-wer, or if, after notice by Lender to Borrower that the Opposing Party (as
defined in the next sentence) offers to make an award to settle a claim for damages, Borrower fails to respond to
Lender within 30 days after the date the notice is given, Lender is authorized to collect and apply the Miscellaneous
Proceeds either to restoration or repair of the Property or to the sums secured by this Security Instrument whether or
not then due. "Opposing Party" means the third party that owes Borrower Miscellaneous Proceeds or the party
against whom Borrower has a. right of action in regard to Miscellaneous Proceeds.
Borrower shall be in default if any action or proceeding, whether civil or criminal, is begun that, in Lender's
judgment, could result in%rfeiture of the Property or other material impairment of Lender's interest in the Property
or rights under this Security Instrument. Borrower can cure such a default and, if acceleration has occurred,
reinstate as provided in Section 19, by causing the action or proceeding to be dismissed with a. ruling that, in
Lender's judgment, precludes forfeiture of the Property or other material impairment of Lender's interest in the
Property or rights tinder this Security Instrument. The proceeds of any award or claim for damages that are
attributable to the impairment of Lender's interest in the Property are hereby assigned and shall be paid to Lender.
All Miscellaneous Proceeds that are not applied to restoration or repair of the Property shall be applied in the
order provided for in Section 2.
12. Borrower Not Released; Forbearance By Lender. Not a Waiver. Extension of the time for payment or
modification of amortization of the sums sectred by this Security Instrument granted by Lender to Borrower or any
Initials:
COLORADO—Single Family—Fannie Nfae/Ereddie Mac UNIFORM LNSTRUNIENT Forex 3004 1/01 (page 7 of 13 pages)
Successor in Interest of Borrower shall not operate to release the liability of Borrower or any Successors in Interest
of Borrower. Lender shall not be required to commence proceedings against any Successor in Interest of Borrower
or to refuse to extend time for payment or otherwise modify amortization of the sums secured by this Security
Instrument by reason of any demand made by the original Borrower or any Successors in Interest of Borrower. Any
forbearance by Lender in exercising any right or remedy including, without limitation, Lender's acceptance of
payments from third persons, entities or Successors in Interest of Borrower or in amounts less than the amount then
due, shall not be a. waiver of or preclude the exercise of any right or remedy.
13. Joint and Several Liability; Co-signers; Successors and Assigns Bound. Borrower covenants and
agrees that Borrower's obligations and liability shall be joint and several. However, any Borrower who co-signs
this Security Instrument but does not execute the Note (a "co-signer'): (a) is co-signing this Security Instrument
only to mortgage, grant and convey the co-signer's interest in the Property under the terms of this Security
Instrument; (b) is not personally obligated to pay the stuns secured by this Security Instrument; and (c) agrees that
Lender and any other Borrower can agree to extend, modify, forbear or make any accommodations with regard to
the terms of this Security Instnunent or the Note without the co-signer's consent.
Subject to the provisions of Section 18, any Successor in Interest of Borrower who assumes Borrower's
obligations under this Security Instrument in writing, and is approved by Lender, shall obtain all of Borrower's
rights and benefits under this Security Instrument. Borrower shall not be released from Borrower's obligations and
liability under this Security Instrument unless Lender agrees to such release in writing. The covenants and
agreements of this Security Instrument shall bind (except as provided in Section 20) and benefit the successors and
assigns of Lender.
14. Loan Charges. Lender may charge Borrower fees for services performed in connection with Borrower's
default, for the purpose of protecting Lender's interest in the Property and rights under this Security Instrument,
including, but not limited to, attorneys' fees, property inspection and valuation fees. In regard to any other fees, the
absence of express authority in this Security Instrument to charge a specific fee to Borrower shall not be construed
as a prohibition on the charging of such fee. Lender may not charge fees that are expressly prohibited by this
Security Instrument or by Applicable Law.
If the Loan is subject to a law which sets maximum loan charges, and that law is finally interpreted so that the
interest or other loan charges collected or to be collected in connection with the Loan exceed the permitted limits,
then: (a) any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted limit;
and (b) any sums already collected from Borrower which exceeded permitted limits will be re€uunded to Borrower.
Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct
payment to Borrower. If a refund reduces principal, the reduction will be treated as a partial prepayment without
any prepayment charge (whether or not a. prepayment charge is provided for under the Note). Borrower's acceptance
of any such refund made by direct payment to Borrower will constitute a waiver of any right of action Borrower
night have arising out of such overcharge.
15. Notices. All notices given by Borrower or Lender in connection with this Security Instrument must be in
writing. Any notice to Borrower m connection with this Security Instrument shall be deemed to have been given to
Borrower when mailed by first class mail or when actually delivered to Borrower's notice address if sent by other
means. Notice to any one Borrower shall constitute notice to all Borrowers unless Applicable Law expressly
requires otherwise. The notice address shall be the Property Address unless Borrower has designated a substitute
notice address by notice to Lender. Borrower shall promptly notify Lender of Borrower's change of address. If
Lender specifies a. procedure for reporting Borrower's change of address, then Borrower shall only report a change
of address through that specified procedure. There may be only one designated notice address under this Security
Instrument at any one time. Any notice to Lender shall be given by delivering it or by mailing it by first class mail
to Lender's address stated herein unless Lender has designated another address by notice to Borrower. Any notice
in connection with this Security Instrument shall not be deemed to have been given to Lender until actually received
by Lender. If arty notice required by this Security Instrument is also required under Applicable Law, the Applicable
Law requirement will satisfy the corresponding requirement under this Security Instrument.
16, Governing Law; Severability; Rules of Construction. This Security Instrument shall be governed by
federal law and the law of the jurisdiction in which the Property is located. All rights and obligations contained in
this Security Instrument are subject to any requirements and limitations of Applicable Law. Applicable Law might
explicitly or implicitly allow the parties to agree by contract or it might be silent, but such silence shall not be
construed as a. prohibition against agreement by contract. In the event that any provision or clause of this Security
Instrument or the Note conflicts with Applicable. Law, such conflict shall not affect other provisions of this Security
Instrument or the Note which can be given effect without the conflicting rovisiou.
Initials:
COLORADO—Single Family—Fannie Mae/Freddie Mac L7UTORM INSTRUNMIN'T Form 3006 1101 (page 8 of I3 pagxv)
As used in this Security Instrument- (a) words of the masculine gender shall mean and include corresponding
neuter words or words of the feminine gender; (b) words in the singular shall mean and include the plural and vice
versa.; and (c) the word "may" gives sole discretion without any obligation to take any action.
17. Borrower's Copy. Borrower shall be given one copy of the Note and of this Security Instnunent..
18. Transfer of the Property or a Beneficial Interest in Borrower. As used in this Section 18, "Interest in
the Property" means any legal or beneficial interest in the Property, including, but not limited to, those beneficial
interests transferred in a bond for deed, contract for deed, installmentt sales contractor escrow agreement, the intent
of which is the transfer of title by Borrower at a. future date to a purchaser.
If all or any part of the Property or any Interest in the Property is sold or transferred (or if Borrower is not a
natural person and a beneficial interest in Borrower is sold or transferred) without Lender's prior written consent,
Lender may require inunediate payment in full of all sums secured by this Security Instrument. However, this
option shall not be exercised by Lender if such exercise is prohibited by Applicable Law.
If Lender exercises this option, Lender shall give Borrower notice of acceleration. The notice shall provide a
period of not less than 30 days from the date the notice is given in accordance with Section I5 within which
BoiTower must pay all sums secured by this Security Instrument if Borrower fails to pay these sums prior to the
expiration of this period, Lender may invoke any remedies permitted by this Security Instrument without further
notice or demand on Borrower.
19. Borrower's Right to Reinstate After Acceleration. If Borrower meets certain conditions, Borrower shall
have the right to have elifarcement of this Security Instrument discontinued at any time prior to the earliest. of, (a)
five days before sale of the Property pursuant to any power of sale contained in this Security Instrument; (b) such
other period as Applicable Law might specify for the termination of Borrower's right to reinstate; or (c) entry of a
judgement enforcing this Security Instrument. Those conditions are that Borrower; (a) pays Lender all sums which
then would be due under this Security Instrument and the Note as if no acceleration had occurred; (b) cures any
default of any other covenants or agreements: (c) pays all expenses incurred in enforcing this Security Instrument,
including, but not limited to, reasonable attorneys' fees, property inspection and valuation fees, and other fees
incurred for the purpose of protecting Lender's interest in the Property and rights under this Security Instrument;
and (d) takes such action as Lender may reasonably require to assure that. Lender's interest in the Property and rights
under this Security Instrument, and Borrower's obligation to pay the sums secured by this Security Instrument, shall
continue unchanged. Lender may require that Borrower pay such reinstatement sums and expenses in one or more
of the following forms, as selected by Lender: (a) cash; (b) money order; (c) certified check, bank check, treasurer's
check or cashier's check, provided any such check is drawn upon an institution whose deposits are insured by a
federal agency, instrumentality or entity; or (d) Electronic Funds Transfer. Upon reinstatement by Borrower, this
Security instrument and obligations secured hereby shall remain fiully effective as if no acceleration had occurred.
However, this right to reinstate sha.Il not apply in the case of acceleration under Section 18.
20. Sale of Note; Change of Loan Servicer; Notice of Grievance. The Note or a. partial interest in the Note
(together with this Security Instaument) can be sold one or more times without prior notice to Borrower. A sale
might result in a change in the entity (known as the "Loan Servicer") that collects Periodic Payments due under the
Note and this Security Instrument and performs other mortgage loan servicing obligations under the Note, this
Security Instrument, and Applicable Law. There also might be one or more changes of the Loan Servicer unrelated
to a sale of the Note. If there is a, change of the Loam. Servicer, Borrower will be giyen written notice of the change
which will state the name and address of the new Loan Servicer, the address to which payments should be made and
any other information RESPA requires in connection with a. notice of transfer of servicing. If the Note is sold and
thereafter the Loan is serviced by a Loan Servicer other than the purchaser of the Note, the mortgage loan servicing
obligations to Borrower will remain with the Loan Servicer or be transferred to a successor Loan Servicer and are
not. assumed by the Note purchaser unless otherwise provided by the Note pu xchaser.
Neither Borrower nor Lender may commence, join, or be joined to any judicial action (as either an individual
litigant or the member of a class) thrat arises from the other .party's actions pursuant to this Security Instrument or
that alleges that the other party has breached any provision of, or any duty owed by reason of, this Security
Instrument, until such Borrower or Lender has notified the other party (with such notice given in compliance with
the requirements of Section 15) of such alleged breach and. afforded theother party hereto a.reasonable period after
the giving of such notice to take corrective action. If Applicable Law provides a time period which must elapse
before certain action. can be taken, that time period will be deemed to be reasonable for purposes of this paragraph,
The notice of acceleration and opportunity to cure given to Borrower pursuant to Section 22 and the notice of
acceleration given to Borrower pursuant to Section 18 shall be deemed to satisfy thenotice and opportunity to take
corrective action provisions of this Section 20.
Initials•
COLORADO—Single Family—Fannie Mae/Freddie A'Iac UNIFORM MTRUMENT Forma 3x06 1/0I (page 9 of 13 pages)
21. Hazardous Substances. As used in this Section 21: (a) "Hazardous Substances" are those substances
defined as toxic or hazardous substances, pollutants, or wastes by Environmental Law and the following substances:
gasoline, kerosene, other flammable or toxic petroleum products, toxic pesticides and herbicides, volatile solvents,
materials containing asbestos or formaldehyde, and radioactive materials; (b) "Environmental Law" means federal
laws and laws of the jurisdiction where the Property is located that relateto health, safety or environmental
protection; (c) "Environmental Cleanup" includes any response action, remedial action, or removal action, as
defined in Environmental Law; and (d) an "Environmental Condition" means a condition that can cause, contribute
to, or otherwise trigger an Environmental Cleanup.
Borrower shall not cause or permit the presence, use, disposal, storage, or release of any Hazardous Substances,
or threaten to release any Hazardous Substances, on or in the Property. Borrower shall not do, nor allow anyone else
to do, anything affecting the Property (a) that is in violation of any Environmental Law, (b) which creates an
Euvironmental Condition, or (c) which, due to the presence, use, or release of a Hazardous Substance, creates a
condition that adversely affects the value of the Property. The preceding two sentences shall not apply to the
presence, use, or storage on the Property of small quantities of Hazardous Substances that are generally recognized
to be appropriate to normal residential uses and to maintenance of the Property (including, but not limited to,
hazardous substances in consumer products).
Borrower shall promptly give Lender written notice of (a) any investigation, claim, demand, lawsuit or other
action by any governmental or regulatory agency or private party involving the Property and any Hazardous
Substance or Environmental Law of which Borrower has actual knowledge., (b) any Environmental Condition,
including but not limited to, any spilling, leaking, discharge, release or threat of release of any Hazardous
Substance, and (c) any condition caused by the presence, use or release of a Hazardous Substance which adversely
affects the value of the Property. If Borrower learns, or is notified by any governmental or regulatory authority, or
any private party, that any removal or other remediation of any Hazardous Substance affecting the Property is
necessary, Borrower shall promptly take all necessary remedial actions in accordance with Enviromnental Law.
Nothing herein shall create any obligation on Lender for an Environmental Cleanup,
NON-UNIFORM COVENANTS. Borrower and Lender fiurther covenant and agree as follows:
22. Acceleration; Remedies. Lender shall give notice to Borrower prior to acceleration following
Borrower's breachof any covenant or agreement in this Security Instrument (but not prior to acceleration
under Section IS unless Applicable Law provides otherwise). The notice shall specify: (a) the default; (b) the
action required to cure the default; (c) a date, not less than 30 days from the date, the notice is given to
Borrower, by which the default must be cured; and (d) that failure to cure the default on or before thedate
specified in the notice may result in acceleration of the sums secured by this Security Instrument and sale of
the Property. The notice shall further inform Borrower of the right to reinstate after acceleration and the
right to assert in the foreclosure proceeding the non-existence of a default or any other defense. of Borrower
to acceleration and sale. If the default is not cured on or before the date specified in the notice, Lender at its
option may require Immediate payment in full of all sums secured by this Security Instrument without
further demand and may invoke the power of sale and any other remedies perwitted by Applicable Law.
Lender shall be entitled to collect all expenses incurred in pursuing the remedies provided in this Section 22,
including, but not limited to, reasonable attorneys' fees and costs of title evidence.
If Lender invokes the power of sale, Lender shall give written notice to Trusteeof the occurrence of an
event of default and of Lender's election to cause the Property to be sold. Lender shall mail a copy of the
notice to Borrower as provided in Section 15. Trustee shall record a copy of the notice in the county in which
the Property is located. Trustee shall publish a notice of sale for the time and in the manner provided by
Applicable Low and shall mail copies of the notice of sale in the manner prescribed by Applicable Law to
Borrower and to the other persons prescribed by Applicable Lara, After the time required by Applicable
Law, Trustee, without demand on Borrower, shall sell the Property at public auction to the highest bidder for
cash at the time and place and under the terms designated in the notice of sale in one or more parcels and in
any order Trustee determines. Trustee may postpone scale of any parcel of the Property by public
announcement at the time and place of any previously scheduled sale. Lender or its designee may purchase
the Property at any sale.
Trustee shall deliver to the purchaser Trustee's certificate describing the Property and the time the
purchaser will be entitled to Trustee's deed. The recitals in the. Trustee's deed shall be prima facie evidence
of the truth of the statements made therein. Trustee shall apply the proceeds of the sale in the following
order: (a) to all expenses of the sale, including., but not limited to, reasonable Trustee's and attorneys' fees;
(b) to all sums secured by this Security Instrument; and (c) any ex ss to the person or persons legally
Initials:
t:OLORADO—Single Family Fannie Nfae/Freddie Mac UNIFORili Nt STRUMENT Form 3006 1/01 (page 10 of l3 pages)
entitled to it.
23. Release. Upon payment of all sums secured by this Security Instrument, Lender shall request that Trustee
release this Security Instrumentand shall produce for Trustee, duly cancelled, all notes evidencing debts secured by
this Security Eustnunent. Trustee shall release this Security Instrumentwithout further inquiry or liability.
Borrower shall pay any recordation costs and the statutory Trustee's fees.
24. Waiver of Homestead. Borrower waives all right of homestead exemption in the Property,
Initials: (1_V,
COLORADO—Single Fsmity—Fannie i4ae/Freddie Jklar UNLFORM L TSTRUM EN'T Form 3006 1/01 (page]] ojl3 pages)
BY SIGNING BELOW, Borrower accepts and agrees to the tearns and covenants contained in this Security
Instraunent and in any Rider executed by Borrower and recorded with it.
Witnesses:
(Seal) \/l (Seal)
�BE ' -Borrower J. 1 MERLY BENT -Borrower
(Seal)
-Botrmver
(Seal)
-Borrower
(Seal)
-Borrower
(Seal)
-Borrower
COLORADO—Singly Family—Fannie Mae/Freddie Mac L—UFO ZM INSTRUNfENT Farms 3006 1/01 (page 12 of 13 pages)
State of COLORADO
Coamty of JEFFERSON
The foregoing insinunent was acknowledged before me this � � G� � � ( C1
by DOUG BENTZ and J. ICMBERLY BENTZ,
(Seal)
0-��E -'-
Notary PiP�I� � m _ aa
Conwussion Expires: (�(
Loan Originator Organization: FIRST OKLAHOMA MORTGAGE LLC, A SUBSIDIARY OF FIRST
OICLLAHOMABANK.; NMLSR ID: 1820353
Individual Loan Originator; KYLE F BRADLEY; NMLSR ID: 485324
KIM AMOS
NOTARY PUBLIC
STAVE OF COLORADO
NOTARY ID 20164036807
My Commission Expires September 26, 2020
COLORADO—Single Family—Fannie MaeJFreddie Mac UNIFORM INSTRUMENT Form 3046 1101 (paga 13 of 13 pages)
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TO VERIFY SITE CONDITIONS, DIMENSIONS, ETC. BEFORE BEGINNING CONSTRUCTION. DISCREPANCIES SHOULD BE
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DATE 07/17/2019
SHEET N0.
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RARTA R ARR[iMATFR
2 SECTION A -A
Scale: 1/2"=1'-0"
ADDRESS: 9685 W. 36th AVE., WHEAT RIDGE, CO 80033
ELEVATION: 5,457' ROOF & DECK DESIGN SNOW LOAD: 30 psf (Designed to 40 psf)
ROOF DEAD LOAD: 15 psf if standard framing (if trusses, verify 10 psf top chord, 10 psf bottom chord)
MEETS 2012 INTERNATIONAL RESIDENTIAL CODE JEFFERSON COUNTY CLIMATE ZONE 5
WIND DESIGN
SEISMIC
SUBJECT TO DAMAGE FROM
WINTER
ICE BARRIER
FLOOD
AIR
MEAN
WIND
TOPO-
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SPEED
GRAPHIC
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DESIGN
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HAZARDS
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EFFECTS
CATEGORY
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DEPTH
TERMITE
TEMP
REQUIRED
INDEX
TEMP
GUST
100 MPH
Yes
"B"
Severe
36"
Slight to
YES
See FIRM
532
50.5
Exposure "B"
Moderate
1 ° F
maps
GROUND SNOW LOAD: 42.9 psf (Roof snow load = 0.7 ground snow load, Section R802.10.2.1 & Section R301.2.3 2012 IRC)
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SHEET NO.
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— 3'-4
EXISTING
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ING
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3 DETAIL C
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CONNECT POST TO BEAM
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EXISTING BEARING WALL
Scale: 1/2"=1'-0"
BARTA & ASSOCIATES
30752 SOUTHVIEW DR. #250
EVERGREEN, CO 80439
(303) 674-3026
ADD 4x6 POST TO
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ADD 3-2x4 STUDS TO
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Scale: 1"=1'-0"
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°ssuED 07/17/2019
SHEET NO.
5ht � of 3
City of Wheat Ridge
Homeowner Demolition PERMIT - 201901403
PERMIT NO: 201901403 ISSUED: 07/09/2019
JOB ADDRESS: 9685 W 36th Ave EXPIRES: 07/08/2020
JOB DESCRIPTION: Homeowner demolition of kitchen wall and vaulted ceiling.
Square footage: 400
*** CONTACTS ***
OWNER (303)589-4330 BENTZ KIMBERLY
*** 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: 30,000.00
FEES
Total Valuation 0.00
Demolition Fee 50.00
** TOTAL ** 50.00
*** COMMENTS ***
*** CONDITIONS ***
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
applicable wilding 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 roperty and am authorized to obtain this permit and perform the work described and approved in conjunction with
this permit. I further attes that I am legm
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.
F —7cl It
Signature o OWNE or CONT CTOR (Circle one) Date
I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the original permit fee.
3 If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4, No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The 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 granf g of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any
appl ga e code or an rdmance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Building & Inspection Services
7500 W. 291 Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: ;rrnitsCd.)d.wheatridqe.co.us
I FOR OFFICE USE ONLY I
Date: � /
Plan/Pennit #
(�2b /
Plan Review Fee:
Building Permit Application
* Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address: I U 16S W • -3cbw en IkA_\ SZ- 0-0 6DD 9
Property Owner (please print): J�`Mb�`��� -�V1�� Phone: 36,5 S `� O
Property Owner Email: LAM oz"
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address) N IV,,,
Address:
City, State, Zip:
Architect/Engineer:
ArchitectlEngineer E-mail:
Contractor Name:
City of Wheat Ridge License #:
Contractor E-mail Address:
Phone:
Phone:
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): Phone:
CONTACT EMAIL(please print):
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Complete all highlighted fields, if applicable.
❑COMMERCIAL
RESIDENTIAL
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, square footage, existing condition and
proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.
�.MWS+ k;V A-CMu D o g-vVO 6W LJ .
Sq. FULF
�60 BTUs
Amps Squares
iV a'dvAou vJ� Pu.uwlo
Ike fav' -tea "e , U, i i
New +
Gallons
For Solar: KW # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) (CONTRACTOR or (AUTHORIZED REPRESENTATIVE) of (OWNER) G(CONTRACTOR)
Signature (first and last name): S DATE:
Printed Name: 30—v � L
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
Building Division Valuation:
® City of
9Wheat 1 e
CCOMMMUNITY DEVELOPMENT
Official Certification of Property Owner Permit
THIS IS TO CERTIFY that I, the property owner, by my signature, attest that I currently
reside at the project property, or intend to reside at the property for a period of one year after
completion of the project, and am personally performing all work, without the assistance of
hired or professional workers, or, if hiring sub -contractors, list them on the permit.
Consultations and inspections will only be performed with the homeowner of record present at
the project property.
Property Owner(s):
Project Property: I �b - LD \��' fNY� Y^�� ('b a1 :33
Notarized signaturL<-of Applicant
State of Colorado }
County of G } ss
t
The foregoininstrument was acknowledged by me this day of V i� 1 L 20 by
D
mel
E
JODI L BAROS
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20144018692
MY CMAISSION EXPRES MAY OIR 2022
/-,-A J, I J
' My Commission Expires� / 20 C
Notary Pu i
EMSL Analytical, Inc.
1010 Yuma Street Denver, CO 80204
Tel/Fax: (303) 740-57001(303) 741-1400
Attention: Drue Beasley
Advent Environmental Consulting
7830 W. Alameda Ave
Unit 103-216
Lakewood, CO 80226
Project: 9685 WEST 26TH AVENUE WHEAT RIDGE, CO 80033
EMSL Order: 221905267
Customer ID: AVTE25
Customer PO:
Project ID:
Phone: (720) 675-7175
Fax:
Received Date: 06/28/2019 3.15 PM
Analysis Date: 07/08/2019
Collected Date: 06/26/2019
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-931116 Method using Polarized
Light Microscopy
Non -Asbestos
Asbestos
Sample Description
Appearance
% Fibrous % Non -Fibrous
°% Type
PL1-1-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0001
Heterogeneous
Inseparable paint/coating layerincluded in analysis
PL1-1-Plaster
White
5°% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267.0001A
Homogeneous
PL1-2-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0002
Heterogeneous
Inseparable paint /coating layerinduded in analysis
PL1-2-Plaster
White
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0002A
Homogeneous
PL1-3-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90°% Non-fibrous (Other)
221905267-0003
Homogeneous
Inseparable paint/coating layerinduded in analysis
PL1-3-Plaster
Tan
5°%Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0003A
Homogeneous
PL2-1-Skim Coat
White
10°% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0004
Heterogeneous
Inseparable paint/coating layerinduded in analysis
PL2-1-Plaster
White
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0004A
Homogeneous
PL2-2-Skim Coat
White
10°% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0005
Heterogeneous
Inseparable paint/ coating layer included in analysis
PL2-2-Plaster
White
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0005A
Homogeneous
PL2-3-Skim Coat
White
15% Ca Carbonate
None Detected
Non -Fibrous
85% Non-fibrous (Other)
221905267-0006
Homogeneous
Inseparable paint/coating layerinduded in analysis
PL2-3-Plaster
Tan
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0006A
Homogeneous
PL3-1-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0007
Heterogeneous
Inseparable paint/coating layerinduded in analysis
PL3-1-Plaster
White
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0007A
Homogeneous
Initial report from. 07/08/2019 16:00:56
_ J Printed: 7/8/2019 2:00
PM
Page 1 of 3
EMSL Analytical, Inc. EMSL Order: 221905267
Customer ID: AVTE25
1010 Yuma street Denver, CO 80204
Tel/Fax: (303) 740-5700 / (303) 741-1400 Customer PO:
Project ID:
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized
Light Microscopy
Initial report from: 07/08/2019 16:00:56
Printed: 7/8/2019 2:00 PM Page 2 of 3
Non -Asbestos
Asbestos
Sample Description
Appearance
% Fibrous % Non -Fibrous
% Type
PL3-2-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
22 190526 7-000 6
Heterogeneous
Inseparable paint / coaling layer included in analysis
PL3-2-Plaster
White
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-OOOBA
Homogeneous
PL3-3-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0009
Homogeneous
Inseparable paint / coating layer included in analysis
131 -3 -3 -Plaster
Tan
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0009A
Homogeneous
PL4-1-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0010
Heterogeneous
Inseparable paint/ coaling layer included in analysis
PL4-1-Plaster
White
<1% Hair 5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0010A
Homogeneous
PL4-2-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0011
Heterogeneous
PL4-2-Plaster
White
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-OOIIA
Homogeneous
PL4-3-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0012
Homogeneous
Inseparable paint/coating layerinduded in analysis
PL4-3-Plaster
Tan
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0012A
Homogeneous
MA1-1-Ceramic Tile
White
100% Non-fibrous (Other)
None Detected
Non -Fibrous
221905267-0013
Homogeneous
MA1-1-Grout
Beige
5% Ca Carbonate
None Detected
Non -Fibrous
95% Non-fibrous (Other)
221905267-0013A
Homogeneous
MA1-1-Mastic
Yellow
100% Non-fibrous (Other)
None Detected
Non -Fibrous
221905267-0013B
Homogeneous
MAI -1 -Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267.0013C
Heterogeneous
Inseparable paint / coating layerincluded in analysis
MA1-2-Ceramic Tile
White
100% Non-fibrous (Other)
None Detected
Non -Fibrous
221905267-0014
Homogeneous
MA1-2-Mastic
Tan
100% Non-fibrous (Other)
None Detected
Non -Fibrous
221905267-0014A
Homogeneous
MA1-2-Skim Coat
White
10% Ca Carbonate
None Detected
Non -Fibrous
90% Non-fibrous (Other)
221905267-0014B
Homogeneous
Inseparable paint/coating layer included in analysis
Initial report from: 07/08/2019 16:00:56
Printed: 7/8/2019 2:00 PM Page 2 of 3
EMSL Analytical, Inc. EMSL Order: 221905267
Customer ID: AVTE25
1010 Yuma Street Denver, CO 80204
Customer PO:
Tel/Fax: (303) 740-5700 / (303) 741-1400
Project ID:
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-931116 Method using Polarized
Light Microscopy
Non -Asbestos Asbestos
Sample Description Appearance % Fibrous % Non -Fibrous % Type
MA1-2-Plaster Tan 5% Ca Carbonate None Detected
Non -Fibrous 95% Non-fibrous (Other)
221905267-0014C Homogeneous
Analyst(s)
Ashley Boyd (12)
Amanda Hammer (20)
Melanie Rech, Laboratory Director
or Other Approved Signatory
EMSL maintains liability limited to cost of analysis. The above analyses were performed in general compliance with Appendix E to Subpart E of 40 CFR (previously EPA 600/M4-82-020 "Interim
Method"), but augmented with procedures outlined in the 1993 ("final") version of the method- This report relates only to the samples reported above, and may not be reproduced, except in full, without
written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations - Interpretation and use of test results are the responsibility of the client. All
samples received in acceptable condition unless otherwise noted. 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. EMSL recommends gravimetric reduction for all non -friable organically bound materials prior to analysis. Esfimation of uncertainty is available on request.
Samples analyzed by EMSL Analytical, Inc. Denver, CO NVLAP Lab Code 200828-0
L
Initial report from: 07/08/2019 16:00:56
ASS -__,R;_;' __x,008_0001 • 1, ` ° Printed: 7/8/2019 2:00 PM Page 3 of 3
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: L
Job Address: UQ
Permit Number:
\i\ r
❑ No one available for inspection: Time AM/PM
Re -inspection required: Yes N9/'
When corrections have been made, call for re -inspection at 303-234-593
Date: —\, t s, Inspector:
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Deck PERMIT - 201900006
PERMIT NO: 201900006 ISSUED: 01/03/2019
JOB ADDRESS: 9685 W 36th Ave EXPIRES: 01/03/2020
JOB DESCRIPTION: Replace deck and extend from 7.5 ft to 8 ft - 128 sq ft total
*** CONTACTS ***
OWNER (303)725-4502 RICE CHRISTOPHER & JULIE
GC (303)421-6548 Joe Thede 021647 SRI
*** 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: 4,900.00
FEES
Total Valuation 0.00
Plan Review Fee 81.28
Use Tax 102.90
Permit Fee 125.05
** TOTAL ** 309.23
*** 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.
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 au sized to Qbtii this permit and perform the work described and approved in conjunction with
this ermrt. I her attest that I am leggally tho ize oinclude all entities named within this document as parties to the work to be
Per
and t t all work to be per Orme osed in this document and/or its' accompanying approved plans and specifications.
Sere of OWNER or CONTRAri
Circle one) Date
1. This permit was issued based on the rovided in the ppermit application and accompanying Flaps and specifications and is
subject to the compliance with thosets, an ble statutes, ordinances, regulations, policies and procedures.
2, This. permit shall expire 365 days after the date of issuance regardre activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Budding
Official and may be subject to a fee equal to one-half of the 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 Budding Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5, The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6, The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
ea
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
`,1V heat d
COMMUNi-ry DEVELOPMEN r
Building & Inspection Services Division
7500 W. 29" Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email:eg rmits(Dci.wheatridge.co.us
I 'FOR OFFICE USE ONLY I
Date: 3117
Plan/Pesmit # ),
Plan Review Fee:
Building Permit Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address:
Owner
Property Owner Email:
Mailing Address: (if different than property address)
Address:
City, State, Zi
Architect/Engineer:
Architect/Engineer E-mail:
Contractor: , )ryni 1
Phone:
Contractors City License #: P
Contractor E-mail A
Sub Contractors:
Electrical:
W.R. City License #
Other City Licensed Sub:
City License #
Plumbing:
W.R. City License #
Other City Licensed Sub:
City License #
W=11KlCIVEC
Mechanical:
W.R. City License #
Complete all information on BOTH sides of this form
❑ COMMERCIAL ❑ RESIDENTIAL
Description of work:, (Check all that apply)
❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE
❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING
❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING
❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT
❑ OMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
$ESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ OTHER (Describe)
(For ALL projects, please provide a detailed description of work to be performed, including current use of areas,
proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and
amount of materials to be used, etc.)
(f P let cc_ ee er� i", f-6 PPO L) Jp
Ra� De_ e4l�
0
Sq. Ft./LF 1 Btu's
Amps
Squares
Gallons
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) (CONTRACTOR) er(AL7THORIZED REPRES N TILE) of (OWNER)(CONTRACTOR
Electronic SiEnature (first and last name): DATE:
DEPARTMENT USE ONLY ��
ZONINGCOMMMENTS: �OKCA �� \. �Wltw� + Y�P�tQ /�,t� ;� OCCUPANCY CLASSIFICATION:
Review u� l
/,?> 1, lel
BUILDING DEPARTMENT COMMENTS:
Reviewer:
it
Building Division Valuation:
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City of
Wheat Ridge
PERMIT:
ADDRESS:
INSPECTION RECORD
JOB CODE: I
7 -�
Inspection online form: http://www.ci.wheatridge.co.us/inspection
Cancellations must be submitted via the online form before 8 a.m. the day of the inspection
Inspections will not be performed unless this card is posted on the project site
Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business
Foundation Inspections
Date
Inspector
Initials
Comments
102 Caissons / Piers
103 Footing / P.E. Letter
104 Foundation Setback Cert.
105 Stem Walls
106 Foundation wall Insulation
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground 1 Slab Inspections
Date
Inspector
Initials
Comments
201 Electrical / Cable/ Conduit
202 Sewer Underground Int.
203 Sewer Underground Ext.
204 Plumbing Underground Int.
205 Plumbing Underground Ext.
206 Water Underground
Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections
Rough Inspection
Date
Inspector
Initials
Comments
301 Rough Framing
302 Wall Sheathing
303 Roof Sheathing
304 Sheer Inspection
305 Insulation
306 Mid -Roof
307 Metal / Lath / Stucco
308 Rough Electrical Residential
309 Rough Electrical Commercial
310 Electrical Meter Residential
311 Electrical Meter Commercial
312 Temp. Const. Meter
313 Rough Plumbing Residential
314 Rough Plumbing Commercial
315 Shower Pan
SEE OVER FOR ADDITIONAL INSPECTIONS
i CITY OF WHEAT RIDGE
_1�9�Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address: 9 6,3 S W
Permit Number: -;�) 1) ! -7 ep�-
❑ No one available for inspection: Time : aZ OAMM
Re -Inspection required: YesNU
When corrections have been made, call for re -inspection at 303-234-5933
Date:_-,; 1/1.1 /yq Inspector: _rt)
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: S o (. - /Z ) , d
Job Address: 96q-5-- to -S & �' �� -e
Permit Number: -? o r -7 o -7 9 L,
❑ No one available for inspection: Time I R = 3 l
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: ► 3 /,9 Inspector: -T_P�
DO NOT REMOVE THIS NOTICE
Is
i CITY OF WHEAT RIDGE
Building Inspection'Division
(303) 234-5933 Inspection line
(303) 235-2855 Office - (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: 3 a 6- M I d
Job Address: 9 to 9 S t-,/ 3 4
Permit Number: -7�) o 1-7 0 -7 C7 (, �5—
® Cy e,— S e J -Cor- (ae
A c, C 0 n t �� �� C+ _0w m 9rz,"Cy /
ro"4 e1ev1� yllll7G0 �e s v r -f- a s-0% ,
PX R®5eG► o r ICe U v
nd La C'i
)-e c, �iI
Ut1r/er /e1 Me r1�` 1') c 0,0e-J,IVr?
❑ No one available for inspection: Time I' = a a IMPM
Re -Inspection required: es No
When corrections have been made, call for re -inspection at 303 -234 -
Date: 1 9 / 46- Inspector: —T --b
DO NOT REMOVE THIS NOTICE
► ' s City of Wheat Ridge
Residential Roofing PERMIT - 201707965
PERMIT NO: 201707965 ISSUED: 10/03/2017
JOB ADDRESS: 9685 W 36th AVE EXPIRES: 10/03/2018
JOB DESCRIPTION: Residential Re -roof to install asphalt shingles - 20 sq Pitch = 2/12
*** CONTACTS ***
OWNER (303)725-4502 RICE CHRISTOPHER
SUB (303)756-7663 Ty Correy 090134 Advanced Exteriors, 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: 9,400.00
FEES
Total Valuation 0.00
Use Tax 197.40
Permit Fee 204.30
** TOTAL ** 401.70
*** COMMENTS ***
*** CONDITIONS ***
Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be
required for both the midroof and final inspections. The 3rd party inspection report AND
THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat
Ridge. The report MUST BE SIGNED by the Homeowner.
REGARDING ROOF VENTILATION: Roof ventilation shall comply with IBC Sec. 1203.2 or IRC Sec.
R806. The installation of ridge venting requires the installation or existence of soffit
venting. For calculation purposes, one hat or turtle vent equal to one-half of one square
foot of opening.
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) is required on the entire roof
when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and
mid -roofs may be called in at the same time, one hundred percent of the sheathing must be
complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required
to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield
is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturer installation instructions,
whichever is more stringent. In order to pass a final inspection of elastomeric or similar
type roof coverings, a letter of inspection and approval from the manufacturer technical
representative stating that "the application of the roof at (project address) has been
applied in accordance with the installation instruction for (roof material brand name) roof
covering" is required to be on site at the time of final inspection.
Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be
required, the 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped
off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the
Homeowner.
City of Wheat Ridge
Residential Roofing PERMIT - 201707965
PERMIT NO: 201707965 ISSUED: 10/03/2017
JOB ADDRESS: 9685 W 36th AVE EXPIRES: 10/03/2018
JOB DESCRIPTION: Residential Re -roof to install asphalt shingles - 20 sq Pitch = 2/12
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications;
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this permit. I further attest that I am leggally authorized to include all entities named within this document as pames to the work to be
performed and that all work to b;performed is disclosed in this document and/or its' accompanying approved plans and specifications.
>O
Signature of O KNER 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, po Flans
and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the 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 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 o granting o it s A t be construed to be a permit for, or an approval of, any violation of any provision of any
applicabl �dma 9n of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Dane Lovett 7o � 7" 7 V
From: no-reply@ci.wheatridge.co.us
Sent: Friday, September 29, 2017 1:11 PM
To: CommDev Permits
Subject: Online Form Submittal: Residential Roofing Permit Application
Follow Up Flag: Follow up
Flag Status: Completed
Residential Roofing Permit Application
This application is exclusively for new permits for residential roofs and for licensed
contractors only. This type of permit is ONLY being processed online --do not come
to City Hall to submit an application in person. Permits are processed and issued in
the order they are received and due to the volume of requests, time to process
varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR
PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE
AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if
your contractor's license or insurance has expired, and you may update those
documents at the time you are issued your permit.
For all other requests:
Homeowners wishing to obtain a roofing permit must apply for the permit in person
at City Hall. Revisions to existing permits (for example, to add redecking) must be
completed in person at City Hall. All other non -roofing permits must be completed in
person at City Hall. The Building Division will be open from 7:30-10:30 a.m.,
Monday through Friday to process these types of requests.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
REROOFING UNTIL PERMIT HAS BEEN ISSUED.
Is this application for a Yes
residential roof?
How many dwelling units Single Family Home
are on the property?
PROPERTY INFORMATION
Property Address 9685 W 36th ave
Property Owner Name chris rice
Property Owner Phone 3037254502
Number (enter WITH
dashes, eg 303-123-4567)
81
1
c-
Property Owner Email
Address
Do you have a signed
contract to reroof this
property?
Applications cannot be
submitted without an
executed contract
attached below.
Attach Copy of Executed
Contract
freddygreen@advancedexteriors.net
Yes
WR.JPG
CONTRACTOR INFORMATION
Contractor Business
advanced exteriors
Name
Contractor's License
090134
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone
3037254502
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address 2200 S VALLEY HIGHWAY
(Primary address of your
business)
Contractor Email Address freddygreen@advancedexteriors.net
Retype Contractor Email freddygreen@advancedexteriors.net
Address
DESCRIPTION OF WORK
TOTAL SQUARES of 20
the entire scope of work: i
Project Value (contract 9400
value or cost of ALL
materials and labor)
Are you re -decking the
roof?
Is the permit for a flat
roof, pitched roof, or
No
Pitched roof (2:12 pitch or greater)
82
both? (check all that
apply)
What is the specific pitch 2/12
of the PITCHED roof?
How many squares are 20
part of the PITCHED
roof?
Describe the roofing shingles
materials for the
PITCHED roof:
Type of material for the Asphalt
PITCHED roof:
Provide any additional house
detail here on the
description of work. (Is
this for a house or
garage? Etc)
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
83
submit this application
and to perform the work
described above.
I attest that everything Yes
stated in this application
is true and correct and
that falsifying
information in this
application is an act of
fraud and may be
punishable by fine,
imprisonment, or both.
Name of Applicant Freddy Green
Email not displaying correctly? View it in your browser.
84
Tra
Lf�(AN 11)
EXTERIORS ErZIORS
Advanced Exteriors, Inc. BBB
Property Owned(s) Customer
Property Address
Via'' --
city, State zip
Insurance Company Claim #
Tear off ( IaVe4S)0f0Omposifion&_Iayeqs)of f-,
Inspect decking F1 Install decking
Install Ice and water shield on
Install 15 # felt n Install 30 # felt
Install premium synthetic deck protection
Install starter course of shingles -entire perimeter
Install drip edge perimeter flashing - color
Install reinforcement in valleys using
Closed valleys F1 open valleys
Replace step flashing on sidewalls, chimney and skylights
Install 6 nails per shin le throughout field area
Roofing product 719."14go.-fR R
Roofing color 27Z&9.
Manufacturer Warranty
Special Instructions/Addiflonal Work
Proposal Date 6-1-rll
Email Address
P—
Standard ridge High pro -file ridge
Install ridge vent
Install turtle vents 0 Install 49.,wA-o-si-- vents
Install pipe jack flashings 2 Install furnace caps
Paint jacks/stacks to match roofing color
Detach and reset
Remove and cover
Install beauty course of ridge shingles on headwalls
Detach and reset satellite Remove satellite
Clean up & remove trash Sweep with magnetic roller
Clean out gutters Provide building permit
Register Manufacturer Warranty
Advanced Exteriors, Inc, Five Year Roofing Labor Warranty
Advanced Exteriors, Inc. $2,000,000 Liability Insurance
ApproAmot-rot e(s)ofSeirvice: 44-4x yment Terms, �A!
Ws delay or denial of On insurance claim, in whole or in part),
fAdvanced Exteriors, Inc, is not responsible for any property carriL
and casualty insurance
Work completed In accordance with these specifications for the price of:
The property owners) ("Custcsrrler"j aufhorizes Pdvanced Exteriors, Inc. ("Company"j to work with Their insurance carrier fio obtain Dollars
fhelkLcopq Of
repairs necessary for restorexfion of storm damage, fits 'Agreement" is not binding upr3n Customer ar Company until the insurance copier approves
Customer's claim and this amount is accepted by Company i 1pon acceptance by Company, the amount a roved by fihe Insurance carder will
t eeome the final contract price and Company vvtll receive the Insurance proceeds far work it has tom feted, e ompony complete specified
work fornoadditional cost to Customer beyond the agreed clalm amount except' for the Insurance deduac r le.
Customer ISE 11 is not [-] intending to make payment from the proceeds of a property and casualty Insurance policy. If Customer's payment is from an
insurance clairn, then pursuant to Colorado Jaw Company (roofing contractor) "Shall not advertise or promise to PW waive, or rebate oil or part of any
insurance deductible applicable to the claim for payment for roofing work on the, covered residential properly' CRS. § 6-22-105, Rhe Company shall
hold in trust any payment received from Customer, until Company has delivered the roofing materials to Customers property or Men Company has
performed a majority of the roofing work on Customers properly.
iZY si
0" n, below I (We) agree to all contract conditions on front and back of this agreement, and have been provided
ce &gWr
ll ,Jo-caa��el both in writing and orally.
Componyl;1115ject Manager
80222 Signature
2200 S. Valley Hwy. www.AdvancedExteriors.com.
Denver, CO
Acceptance Date
303-756-3756 Fox
EMSESM
4
S1 i`
Ele&ical: PlumWng: Mechanical*
City License # City License # City License #
ftlSdogli gj VLOak: (Fully descAbe wo* to be perforffmd - Attach adcOtional shoot If necassary)
&944wAcr w: -Tt-tc i-
L. I t4e- fieOrA - for-,
Squares _ BTUs Gallons _Amps_ Sq R _ jK
INSPECTION RECORD O ccupanc Type
'V INSPECTION LINE: (303) 234 -5933
Inspections will not be made unless this card is posted on the building site
Call by 3:00 PM to receive inspection the following business day.,
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB `
FOUNDATION INSPECTIONS
DATE
INSPECTOR
INITIALS
COMMENTS:
Footings /Caissons
Stemwall / (CEG) Concrete
Encased Ground
Reinforcing or Monolithic
Weatherproof / French Drain
Sewer Service Lines
Water Service Lines
INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS
SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
POUR NO CONCRETE UNTIL ABOVE HAS BEEN JIGNED
CONCRETE SLAB FLOOR
Electrical (Underground)
Plumbing (Underground)
Heating (Underground)
ROUGHS
Sheathi
Lath / Wall tie
Mid -Roof
Electrical Service
Rough Electric
Rough Plumbing
Gas Piping
Rough Mechanical
Framing
Insulation
Drywall Screw
ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING
FINALS
Electrical
Plumbing
Mechanical
Roof
Building Final
Fire Department
R.O.W & Drainage
INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS
SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
Parking & Landscaping
" "NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, . BUILDING AND PUBLIC WORKS BEFORE A
CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION
OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY.
z. OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED
PROTECT THIS CARD FROM THE WEATHER
♦ i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 235-2857 Fax
INSPECTION NOTICE
Inspection Type: (Cr9 F`
Job Address: L, in ( t "j f
Permit Number: 2 t~
❑ No one available for inspection: Time AM/PM
Re-Inspection required: es
"When corrections have been made, ca0 for r -i spection at 303-234-5933
Date: Inspector:
DO NOT REMOVE THIS NOTICE
F
♦ i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection fine
J (303) 235-2855 Office • (303) 235-2857 Fax
PE IOrOTI~E
' A
Inspection Type: i
Job Address: °4 -
Permit Number:
❑ No one available for inspecti Time I E ' A M
Re-Inspection required: Yes
"When correction have been made, calf for ~Fnapecfion at 303-234-5933
Date Inspector:
DO NOT REMOVE THIS NOTICE
♦ ♦ CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
]~;'r(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: FrIAA 2
Job Address: 906o5 w 3 7W
Permit Number: t99V i 7V
,ere7''tr .9'~)zrfe 7°D ,4:~CCU(e F_
d i-~%~%~ ~ar2 i~5la~c7'fOrFe
>2cey/ € r.Jcff Id AA 7V x Try S~~fcTs ,
❑ No one available for inspection: Time 3%+°° AM/PM
Re-Inspection required: No
When corrections have been made, call for re-inspection at 303-234-5933
Date: /a s2~ Inspector:
z
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Roofing PERMIT - 092674
,PERMIT NO: 092674 ISSUED: 09/23/2009
.',JOB ADDRESS: 9685 W-36TH AVE EXPIRES: 03/22/2010
-DESCRIPTION: T/o: Install 27.: sqs O.C. 30yr Duration shingles.
CONTACTS
`owner: 303/618-968G Jeanette Shafer
',gc 720/979-6587 . R.Hendricks 09-0249 Team Construction Services :Inc
PARCEL INFO
=NE CODE: UA USE: UA
=.,SUBDIVISION: 0620 -BLOCK/LOT#: 0/
r
FEE SUMMARY ESTIMATED PROJECT VALUATION: 8,000.00
FEES
Permit Fee 199.30
Total Valuation , pp
Use Tax 144.00
` TOTAL .343.30 e.~
'?'Conditions:
""6 nail installation & mid-roof inspection required.: Board sheathing spaced more
han 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.
v,
.,Subject to field inspection.`
y" I hereby certify that the setback distances proposed by this {permit application are accurate; and do not violate applicable
w, 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
.V application and that I assume full responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other..
applicable Wheat Ridge Ordinances, for work under this permit. Plans subject to field inspection.
Signature of contractor/owner date
g?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 480 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.
g;3. If this permit expires, a new permit.. may be acquired for '.a fee of one-half the amount normally required, provided no
1; changes have been or will be made in the original plans and specifications and any suspension or abandonment. has not
fi' exceeded one (1) year. If changes have been or if suspension or abandonment exceeds one (1) year, full fees skull
" be paid for a new permit.
~elg",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'linspections : and shall.. receive
M1, written approval on inspection card before proceeding with successive phases of the job.
6. The issuance of'geW it or the approval of drawings and :specifications shall not be construed to bea permit for, nor
an approval o^^f, ' lation of the provisions. of the building codes or any other ordinance, law, rule or regulation.
All plan re'g~.e ublect to field inspections.
Signature of Chi of Building Offrc 1 date
.~7
"INSPECTION REQUEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855
REQUESTS MUST BE MADE IBY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
r
a`
N,
A R••i B" g 4 •{n ry ~ if m a r~ 3
City of
' Wheatji ge Date:
MMUNITY DEVELOPMENT Permit
Building Division
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Facsimile Building Permit Application
Property Address: 205' kV M /q / /
Property Owner (please print): /Jy .-e- Z Phone: f 6r/
Mailing Address: (if different than pr erty address)
Address:
City, State, Zip: -Alv
Contractor: T^p(p~~'Ly~
Contractor License Phone: X0-3-X7--(0, c0
Sub Contractors:
Company Name: License Expiration Date: Trade/Profession: Approval:
Use of space (description):
Description of work: 80th1
` Plan Review (due at time of submittal): $
Sq. Ft./L. Ft addeJ: Squares /BTU's Gallons Amps
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
1 hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances,
rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and
allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full
responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
under this permit. Plans subject to field inspection.
CIRLCE ONE:: (OWNER) (CONTRACTOR) or PERSONAL REPRESENTATIVE of (OWNER) (CONTRATOR)
PRINT NAME: SIGNATURE: Date:
DEPARTMENT USE ONLY
ZONING COMMENTS:
Zoning:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer.
BUILDING DEPARTMENT COMMENTS: OCCUPANCY:
Reviewer.
FIRE DEPARTMENT:: ❑ approved w/ Comments ❑disapproved ❑ no review required Bldg Valuation: $
Credit Card Payment: Use c edit card listed on file. D?40:
Print name: C~srv g/, /h~ / e,~'s Signature: /mil.
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COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
Job Address: 3 IC
I ~ /l/• ~~o~~ ~~,os ~H ~s.c-~°, s~
When corrections have been m7e -inspection at
303-234-5933.
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COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number:
oF w"E^T,p BUILDINGJNSPECTION LINE - 303-234-5933 Date:
~ ~ . CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
~~CORPD~ . . fYPPF°l.CATION . .
Property Owner:
PropertyAddress:
ConiractorLicense No.:
Company:
OWNER/CONTRACTOR SIGNATURE OF UNDERSTAtJDING AND AGREEMENT
Phone:
Phone: _?G
I BuildingDept. Valuation Figure: $ r2.G dc'D ~'-t
I hereby certiTy that the setback distances proposed by this permi{ application are
accurate, and do not violale applicable ordinances, rules or regulalions of the City of
W heat 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
condi6ons printed on this application and that I assume full responsibility for
compliance with the Wheat Ridge Building Code (1.8:C) and all otherapplicable Wheat
Ridge Ordinances, for work under jhis perrty'~. Pla28 subject to f eld inspeciion. „ 1'/„~✓i; ~
Value:$
Permit Fee:$
Plan Review Fee:$
Use Tax:
Total:$
Use of Space (description):
Description ofwork: ai*4~-i /z✓S cC- Ca L.' ,Jl
p
Lt-c'~7-"
Sq.Ft.added
COMMENTS:
Approval:
Zoning:
BUII,DINGDEPARTMENTUSEONLY SIC: Sq.Ft.:
.NA~t~ W~ f~ZNEG ~ ZOV3 I M1 G ~ a~~JCGT 1~
COMMENTS:
Approval: ~ V Q
.F~t.d-t^sP
WORKS COMMENTS:
Approval:
DEPARTMENT COMME(JTS:
Approval: Walls: Roof: Stories: Residential
Electrical License No: Plumbing License Na Mechanical License No:
Company: C~_ bkC • Company: Company:
Expiration Date: Expiration Date: Expiration Date:
Approval: Approval: Approval:
(1) This permitwas 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 orany other applicable ordinances of
the City. (2) This permit shall expire if (A) the work authorized is not commenced within sixty (90) days from issue date or (B) the building
authorized is suspended or abandoned for a period of 180 days.
(3) If this permit expires, a new permit may be acquired for a fee of one-hatf the amount normally required, provided no changes
have been orwiil be made in the original plans and specifcations and any suspension or abandonment has not exceeded one
(1) year. If changes have been or if suspension or abandonment exceeds one (1) year, full fees shall be paid for a new permit.
(4) No work of any manner shall be done that wiil change the natural flow of water causing a drainage problem.
(5) Contractor shall notiTy the Building Inspector hventy-four (24) hours in advance for all inspections and shail receive written
approval on inspection card before proceeding with successive phases of ihe job. (6) The issuance of a permit or the approval of drawings and specifications shali not be construed to be a permit for, nor an
approval of, any violation of the provisions of the building codes or any other ordinance, law, rule or re9utation. AII plan review
is subJect to fteld inspections Chief Building Official
Restoration Services,Inc.
5295 Lincoln St.
Denver, Co. 80216
Ph.303-296-4106
Fax.303-296-4223
03113/2006
Estimate: SHAFER CARL D
C1aimNumber:
06-K754-465
Insured: SHAFER, CARL D
Policy Number:
06-10-4452-2
Properiy: 9685W35THAVE
TypeofLoss:
Smoke
WIiEAT RiDGE, CO 50033-5708
Deductible:
$500.00
Price List:
CODE5175A1
Restoration/Sentice/Remodel
F= Factored T
n, D= Do Not APPlY
Date of Loss:
02/22/2006
Date Inspected:
02/24/2006
Summary for 5moke
Line Ttem Total
16,36641
State Sales Tax @ 2.900°/a x
4,379.81
127.01
Loca] Sales Tax @ 4.700% x
4,379.81
205.85
Reptacement Cost Value
16,69927
Less Depreciation
(0.00)
Actuat Cash Value (ACV)
16,699.27
Overhead ~ 10.0% x
16,69928
1,669.93
Profit @ . 10.0% x
16,69918
1,669.93
Acmal Cash Value (Tncluding Qverhead and Profit)
20,039.13
Less Deductible
(500.00)
Less ageed value of salvage retained by the insured
(0.00)
Net Actual Cash Value Payment
$79,539.13
Kevin Thompson
(303) 941-2754
ALL AMOUNTS PAYABLE ARE SUBJECT TO TIIE TERMS, CONDITIONS AND
LiMiTS OF YOUR POLiCY.
contact Steve 303-618-9686 .
7~
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. 4HE
heat Ridge
City of W
Residential Mechanic PERMIT - 060113
PERMIT NO: 060113 ISSUED: 03/20/2006
JOB ADDRESS: 9685 36TH AV EXPIRES: 09/20/2007
DESCRZPTION: inst. 70K BTU furnace, Inst. 2ton ac,Coffman Elec - hookup
CONTACTS gc 303/431-8914 J. Patrick Quinlan 01-8464 B& F Heating & A/C
owner 303/618-9686 Steve Shafer
PARCEL INFO ZONE CODE: UA USE: UA
SUBDIVISION: UA BLOCK/LOT#: 0/
FEE SUMMARY ESTIMATED PROJECT VALUATION: 6,760.00
FEES
Permit Eee 181.10 C,
Total Valuation . .00 ~~j /
Use Tax 121.68
TOTAL 302.78
Comments: -
install 70,000 BTU furnace, install 2 tone AC, Coffman Electric to do AC hookup
? hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable
ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all
measurements shown, and allegations made are accurate; that I have read and agree to abide by all conditions printed on this
application and that I assume full responsibility for compliance with the Wheat Ridge Building Code (I.H.C) and all other
~icable W eat Ridge ordinances, for work under this er t. Plans subject to field inspection.
I I
Signaktur f ontr@ctor/owner te -1. This pemit 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 Huilding Codes of Wheat Ridge, Colorado or any other applicable
ordinances of the City. 2. This permit shall expire if (A) the work authorized is not commenced within sixty (60) days from issue date or (B) the
building authorized is suspended or abandoned for a period of 180 days. .
3. If this pemit expires, a new pemit may be acguired for a fee o£ one-half the amount normally required, provided no
changes have been or will be made in the original plans and speci£ications aad any suspension or abandonment has not
exceeded one (U year. If'changes have been arif suspension or abandonment exceeds one (1) year, full fees shall
be paid for a new pexmit. 4. No work of any manner shall be done that will change the natural £low of water causing a drainage problem.
5. Contractor shall notify the Huilding 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 or the apprwal of drawings and specifications shall not be construed to be a permit for, nor
an approval of, any violation of the provisions of the building codes or any other ordinance, law, rule or regulation.
Al1 plan Sa~ew is s=ield inspections.
of
date
INSPECTION REQUEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855
REQUESTS MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Cih+ of Wheat Ridae PRESCRIPTNE EPdERGY CODE
BOILERS I fURNACES A MINIMUh4 OF 90% AFUE
GAS WATER HEATERS A MINIMUM OF.80 ENERGY FACTOR
ELECTRIC WATER HEATERS A MINIMUM OF.S3 ESERGY FACTOR
SETBACK THERMOSTAT REQUiRED (EXCEPT HYDRONIC HEAT)
R-21 WALIS • R38 CEILINGS o R-19 CRAWLSPACES
Mar 16 06 10:33a Patta Schmidt 303-421-1298
..~j ,~„ruivja1vrv-t'sb-L855
CI7Y OF WHE9'f RtDGE
7500 WEST 29TN AVENUE
WNEAT RlDGE, CO 80213 qppLICATIo N
PrapertyOwner: SfeVe S~CTe(Z
PropertyRddress: 9(pg5 vu3(yY-,-flv-e
Contractor License No. q (0,-/
J+ r !
Company j d f" ft Pct-~ r n~, f 1~-~ D#f ~t~ l
OWNERlCONTRACTOR SIGNATURE OF UN
I here6y certHy tlfal the setbadc Oistances proposed
and do not violate applica6le ordinances, rules or rei
covenants. easemenis or restrictmns of record; thaf
made are accurate; thal 1 have read and agree to ab
applicauon, anC tha[ I assvme full responsrbility for t
Cotle (U.S.CJ and alf other applicahle Wheaf_Ridae
(OWNER)(CONTRqCTOR)
~S-{~c l 1 70
Descrip6on: -t-4 ao 0
~
o t_g,__ p`
Approvat :
Zoning :
_a!_ n , o
Approval:
EaMEMEMEM
Approvai:
AGREEMENT
am
~naa'ons pnntetl on ihis
"Nrth 1be 4Vheat Ridga Building
s, fnr wp/rk unCet Nis pertnit.
"v. 7- DATE
1377-('S -iie-rtrcck-
0 L
Constru----__
Permit Fee
Use Tax
Tafal
--~e:
U
s
-E !ec-f:-;c ~ C~o AC hwk;..p
BUILDING DEPARTMENT USE ONLY
V/ 766 --L
~
/ / /J
SIC : Sq. Ft. :
Citv of Wheat Ridae PRECroLP7
E Nrarv nn~
BOILERS / FURNACES A MINIMUM OF 90% AFUE
tiAS WATER HEA7ERS A MINIMUM OF .60 ENfiRGY fAC10R
ELECTitIC WATER NEATERg q MINIMUM OF :93 ENERGY FACTpR
lETBACK THERMOgTAT REqUiREp (EXCEP7 HYDRONIC HEAn
R-21 WALLS . R~b CEILINGS . R_79 CRAWLSPACES
Occupancy : Walls
Electrical License No : ,~R7
Company .
o9 ~ m n ~.lecki c
Expiration Date :
Approval:
Roof : Stories : Residentiat Units :
Plumbing t,icense No : Mechanfcal License No :
Company: Company:
Expiration Date : Expiration Date :
Approval : Approval :
(i) This permit was issued In aaoNanee wllh re ppviypns set kM in yopur apolkation ena h sup~ to
Regulations and Building Code of Wheat Rldge, ColaaCO or amy olher appGwple oNlnances ofthe Ci ~ SUIe M Cotorapp antl lo ~he toning
(2) Yhispermils~altexpire if(A)iharrofkautho~n.yfanmmmm..,..ew. (3)
a
(5)
{8)
wrtlnn eony (80) days fmm nsua daoe or (8) ihe CWId'me aulharixed is aneMndM or
alf tM amouM nomwly n,yuimy. Prp'dUed no tliMges IUVG 6een wwill be rty~yW M pK
;basrwlaxceeEeUOne(1)year. ttManyesyemayeerHsuspenslonorabantlOnmeM
afwatn pusing a arainage probiem,
atlvance forall inspeclipne entl nha112ttNe wrlRM appipvdt an inspec6on drE Oefwe
s stroll mt b! mnsWCd M be a Dermv!!a. nOr an aPDroval W. anY NoFatiOn ef fhe pmWyipq
Date :
p.Z
Phone : 3!`j3 (p/,? 9 6,?(0
Phone : J03 q3 / gr~
Ghief Building Inspector
e..`~'/-~~FL
qI
1MSf~EC'f14~i+1 TICKET
~oB P
//SS ~J ~ 6~~- I I
ADDRESS !
DATE: I Q .24 BLDG. PERMIT# bQ
PERMIT#
BLDG. CONTR. ~omow• v' I;
SUBCONTRACTOR DATE INSP. AEQ.IQ&
TYPE OF INSP.'IG~'~' ~`~m~ Im
INSPECTION MADE - ,
W.R. FORM 679 / A~/' ~I
qj, 1, c
INSPECTION TICKET
JOB
ADDHESS OF ~
-
f, Ql
DATE: BLDG. PERMITN-AlS
PERMIT#
BLDG. CONTR. Pl~. L, C'-)ft
SUBCONTRACTOR .
DATE INSP.
iYPE OF INSP.
INSPECTION MADE !
REMARKS
W.R. FOFM 619
l+i~z ,~%y/ ✓ .
q
1NSPECTI'[ARI tlGt€E-T
JOB
ADDRESS
DATE: BLDG. PERMIT# 5/6"
PERMIT#
BLDG. CONTR. ~ {f .
SUBCONTRACTOR
DATE INSP. REQ. I '~~6
iYPE OF INS
INSPECTION MADE
REMARKS
INSpECTION TICKET
JoB
ADDRESS
DATE: ~7~~---BLDG. PE MIT#
BLDG. CONTR.
PERMIT#
SUBCONTRACTOR
DATE INSP. REQ.
i i
TYPE OF IP
INSPECTIO
REMARKS
W.R. PORM 619
Suite H 1•5
~
~ 4 8'
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'F~5`
~~~TY
I ` E`MENT ~
I Lot 12
OLOCK 2
I I PATIO - 45.6' W
~ Q Q'M
15.e• 9 685 15.s
3.2~ N(3 N T.7' CO
~ I 0)
N 4 170
~
2o.s °i PJ in
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W 36th Ave, 20T.i' c
)
CERTIFICATION
Survey ~10,283
OHice A E2489
VPeldon B. Robinson
JY
~Regietere/a urveyor Lee M. Robinson Surveying Companp
This is to aertify that on this 24th day of March, 1956 I made a survey of
9685 West 36th Avenue, Lot 12, Block 2, YYESTHAVEN, County of Jefferson, State
of Colorado and found the one story brick and frame house with basement and ~
garage to be locsted eirtirely within the boundary lines of the above described
property as shown on thia plat. The looation and dimensiona of all buildings,
improvmeuts, easementa or right of way in evidence or known to me and enaroach-
meats by or on the premises are accurately shown.
~
SUBDIV[SION, CONSTRUCTION, LOT & IMPROVHMHNT SURVEYS
110 West 13th Avenue
Denver 4, Colorado
suita x i-s
Lee M. Robinson Surveying Companp
SUBDIV[SION, CONSTRUCITON, LOT 9 IMPROVHMfiNT SURVEYS
110 West 13th Avenue
Denver 4, Colorado
L
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fq
\
~ENT
~
l1')
~ 4 8'
LOt 12 ~
13LOCK 2
/ ~
I r-- ~
( PATIO d 45.6' w
I
lni 15,6' n 9685 ~m
's ~ P
fi1---
100
w 36th Ave. (50,)
Survey ~10,283
ot~. n s-2aea
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VPeldon H. Robinson
~
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Lo
7 (9
0)
CERTIFICATION
This is to aertify thst on thia 24th day of March, 1956 I made a survay of
9685 West 36th Avenue, Lot 12, Block 2, YPESTH0.VEN, County of Jefferson, State
of Colorado and found the one story brick and frame house with basement and
garage to be located eutirely within the boundery lines of the above desoribed
property as shown on this plat. The loaation and dimensions ot all buildiaga,
improvmeats, easements or right of way in evidence or ]rnown to me and encroach-
ments by or on the premiaes are accurately shown.
~
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