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3160 Pierce Street
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:N Job Address: Permit Number: a1 101 O Ci`� fer,rr. r�✓A C� U t` ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes 14 When corrections have been made, call for re -inspection, at 303-234-5933 Date: �—( ' �`'G Inspector: 1' DO NOT REMOVE THIS NOTICE *** 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. Consultations and inspections will only be performed with the homeowner of record present. **A MID -INSPECTION IS REQUIRED FOR HOUSE WRAP PRIOR TO SIDING INSTALLATION. A final inspection is required at completion. Work shall comply with 2012 IRC and ordinances adopted by the City of Wheat Ridge. Work is subject to field inspections. A mid -inspection is required for house wrap prior to siding installation. A final inspection is required at completion. City of Wheat Ridge T Homeowner Siding PERMIT - 201900678 !u� :X•T PERMIT NO: 201900678 ISSUED: 04/15/2019 JOB ADDRESS: 3160 Pierce St EXPIRES: 04/14/2020 JOB DESCRIPTION: Remove aluminum siding and replaced with fiber cement siding; 15 squares *** CONTACTS *** OWNER (303)725-9987 CHURCHILL CODY G *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,000.00 FEES Total Valuation 0.00 Use Tax 126.00 Permit Fee 140.90 ** TOTAL ** 266.90 *** 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. Consultations and inspections will only be performed with the homeowner of record present. **A MID -INSPECTION IS REQUIRED FOR HOUSE WRAP PRIOR TO SIDING INSTALLATION. A final inspection is required at completion. Work shall comply with 2012 IRC and ordinances adopted by the City of Wheat Ridge. Work is subject to field inspections. A mid -inspection is required for house wrap prior to siding installation. A final inspection is required at completion. PERMIT NO: JOB ADDRESS: JOB DESCRIPTION City of Wheat Ridge Homeowner Siding PERMIT - 201900678 201900678 3160 Pierce St ISSUED: 04/15/2019 EXPIRES: 04/14/2020 Remove aluminum siding and replaced with fiber cement siding; 15 squares 1, by m signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be pertormed and that all work to be rmed is isclose in this document and/or its' accompanying approved plans and specifications. Signature of OWNt-R dr CONTRACTOR (Circle one) Date 1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Off-cial and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code once r�ti rd ao gulation 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 9 Wh6at i e 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(: Project Property: Project Type: 21 %1 N(' Notarized sighature ofd( plicant State of Colorado } County of aPMLcDs1 } ss The foregcbm instr}}��ment was acknowledged by me this day of lq . _ 20_LJ by TAMARA D ODEAN NOTARY PUBLIC STATE OF COLORADO NOTARY ID 20164015481 MY COMMISSION EXPIRES APRIL 22, 2020 My Commission Expires `7 / -_2 /20 ad Notary Public City of o9rWh6atR dge COMMUNITY DEVELOPMENT Building & Inspection Services 7500 W. 2911 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permitsp_ci.wheatridge.co.us FOR OFFICE USE ONLY Date: / %//1/7 / % 1" / Plan/Permit # Plan Review Fee: t Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address Propertv Owner Property Owner Email: C Tenant Name (Commercial Projects Only) / Property Owner Mailing Address: (if different than property address) Address:lj� City, State, Zip: Arch itect/Eng1neer E-mail: N 14 Phone: Contractor Name: / v City of Wheat Ridge License #: Phone: (2 Phone::�v�.�25�Ic1 Contractor E-mail Address: For Plan Review Questions & Comments (please print): CONTACT NAME (please print): Phone: CONTACT EMAIL(p/ease print): Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. ❑COMMERCIAL IDENTIAL 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. .PAM �l Sq. FULF BTUs GI t' J'J" �P"J q q (to C�1rCGV'P � Gallons Amps Squares For Solar: KW # of Panels Requires Structural For Commercial Projects Only: Occupancy Type: Construction Type: Occupancy Load: Square Footage: Project Value: (Contract value or the cost of all materials and labor included in the entire project) �,�IL 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:�NE (CONTRACTOR) or MUTIVRIZEDREPRESENTARVE) of (OWNER) (CONTRACTOR) Signature (firstandand last e): l �A� �` I /1 / l� DATE: Printed Name: ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: Property Information Cody Churchill 3160 Pierce St Wheat Ridge, CO 80124 Property Type Residential Date of Construction 1961 PH 303-725-9987 Prepared By EnvioCore LLC Asbestos Consulting Firm No. 21660 1685 S. Colorado Blvd Denver, CO 80124 303-GoEnvio (463) 6846 www.goEnvioCore.com info@aoenviocore.com Conducted By Nick Hopkinson Asbestos Building Inspector Cert. No. 23887 Inspection Information Inspection Date 04-10-2019 Arrival Time 01:00 PM Report Date 04-12-2019 Inspection # 0419-32 Churchill, Cody Limited Residential Asbestos Renovation Inspection Report 3160 Pierce St E6� Protocols Followed IL Ar Asbestos AHERA n IV" I E:ore ENVIRONMENTKLINSPECTIONS Lab Information CEI Labs 730 SE Maynard Road Carly, NC 919-481-1413 Asbestos NVLAP Cert # 107168-0 PAGE 1 OF 19 Table of Contents Definitions.................................................................................................................................................... 3 KeyTerms.................................................................................................................................................... 3 LimitedInspection Summary .....................................................................................................................4 General....................................................................................................................................................................... 4 Asbestos......................................................................................................................................................................4 Purposeand Scope of Inspection............................................................................................................. 4 General....................................................................................................................................................................... 4 Asbestos..................................................................................................................................................................I... 4 Background................................................................................................................................................5 Sampling.....................................................................................................................................................5 AsbestosResults Reporting........................................................................................................................ 6 AsbestosInspection Conclusion............................................................................................................... 6 Closing 7 InspectionPhotos....................................................................................................................................... 8 LabResults.................................................................................................................................................12 InspectionCertifications.......................................................................................................................... 10 PAGE 2 OF 19 D ins 1. The term "Certified Inspector" shall mean individual who is identified on the first page of this Limited Inspection Report as conducting the Inspection. 2. The term "Client" shall mean the entity that has ordered the Limited Inspection on the Property on behalf of the Client. 3. The term "Limited Inspection Report" shall mean this report, which summarizes the Inspection, as applicable to the Property. 4. The term "Owner" shall mean the owner of the Property. 5. The term "Property" shall mean the building(s) or structure(s) at the address listed under Property Information on the first page of this Limited Inspection Report. 6. The terms "Work Activity" shall mean any construction, renovation, remediation, decontamination, cleanup, or other work. K r is Asbestos 1. Asbestos is a naturally occuring mineral. Asbestiform varieties include chrysotile, amosite, crocidolite, anthophyllite, tremolite and actinolite. 2. Asbestos abatement is the wrecking or removal of builiding materails that contain friable and non -friable asbestos fibers. 3. Asbestos abatement contractor is any person hired to conduct asbestos abatement. 4. Friable material can be crumbled, pulverized, or rendered to powder by hand pressure when dry. 5. A homogenous area is an area of surfacing material, thermal system insulation material, or miscellaneous material this is uniform in color, texture, construction, application date, and general appearance. 6. Miscellaneous material is interior building material on structural components, structural members, or fixtures, such as floor and ceiling tiles, and does not include surfacing material or thermal system insulation. 7. Non -friable material cannot be crumbled, pulverized, or reduced to powder by hand pressure when dry. 8. Point counting is a secondary analytical technique to verify the presences of asbestos in samples with 10% or lower asbestos. 9. Surfacing material is sprayed, troweled, or otherwise applied on surfaces, such as acoustical plaster on celilings and fireproofing materials on structural members, or other materials on surfaces for acoustical, fireproofing, or other purposes. 10. Thermal system insulation (TSI) is material tha tis applied to pipes, fittings, boilers, breeching, tanks, ducts, or other interior structural components to prevent heat loss, heat gain, or water condesation, or for other purposes. 11. The terms "Asbestos Containing Material" or "ACM" shall mean surfacing, thermal system insulation, or miscellaneous materials that contain 1 % or more of asbestos. 12. The terms "Asbestos Containing Building Material" or "ACBM" shall mean Asbestos Containnig Materials that has been used for construction or improvement of a building or other structure. 1�.�� pre PAGE 3 OF 19 13. The term "Certified Asbestos Consulting Firm" shall mean any person licensed with the State of Colorado and the EPA, hired for a fee to conduct any of the folowing activities, as required by Regulation No. 8, Part B, in the State of Colorado: asbetos builidng inspection and bulk sampling; development of asbestos management plans; air monitoring for asbestos fibers; development of asbestos project designs; and , project management, as specified in Section II.J. 14. The term "Certified Asbestos Laboratory" shall mean a laboratory with accreditation from the National Voluntary Laboratory Accreditaion Program (NVLAP) to analyze bulk samples for asbestos using polarized light microscopy (PLM). 15. The terms "Damaged ACM" and "Significantly Damaged ACM" shall mean friable or non -friable ACM that has deteriorated or delaminated to the point that it has lost its bond to the substratre or has otherwise suffered crumbling, blistering, nonadhesiveness, gouging, water staining, or marring. The term "Damaged ACM' applies when 1 /10 of the entire surface has suffer damage (1 /4 if the damage is localized). The terms "Significantly Damaged ACM" shall apply when more than 1 /10 of the surface has suffered damage. 16. The term "Limited Asbestos Inspection" shall mean an abbreviated inspection by the Inspector of the components of the Property that may be subject to Work Activity. The Inspection shall investigate the presence of ACBM and shall comply with all state and federal laws, rules, and regulations. in�ifed Inspection Sur-rimory General The Client agrees to read the Limited Inspection Report upon receipt and promptly call the Inspector with questions or concerns. This Limited Inspection Report is not intended to be exhaustive in the manner of inspecting the Property and all of its building materials and components. The Inspector only inspected specific areas that may be subject to Work Activity and that are visually and physically accessible. The Limited Inspection was not a risk assessment or physical inspection of systems, structure, or components of the Property. The use of this Limited Report and its contents, in whole or in part by persons or entities other than the Client is not authorized without the written mutual consent of the Client and envioCore LLC. Asbestos The Limited Inspection Report documents the findings of a Limited Asbestos Inspection at the Property. The Limited Asbestos Inspection intended to locate ACBM in areas that might be the subject of Work Activity. The Certified Inspector performed the Limited Asbestos Inspection in accordance with the current state and federal laws at the time of inspection. Purpose and Scope of Inspection Genera The scope of this report included a visual inspection of all affected rooms and/or areas throughout the subject property for visible suspect ACBM and/or Lead Based Paint. This does not include any materials that were covered or hidden by walls, structures, carpeting, wood flooring, multiple layers, wallpaper, texturing, etc. However, the Certified Inspector made every reasonable effort to access and identify all suspect ACM and/or Lead Based Paint. If the scope of work changes, the Client must inform the Certified Inspector to allow the Certified Inspector to supplement the Limited Inspection Report. This Limited Inspection Report is solely a record of activities, observations, analytical results, and recommendations performed to date. Asbestos Bulk asbestos samples were randomly collected from homogenous areas of suspect ACM by the Certified Inspector. If the color, texture, construction, application date, or general appearance differs between materials or if for any reason the Certified Inspector suspects that the materials might differ in any respect, the Certified Inspector will take separate samples from each homogenous area. The Certified Inspector took �"v!'q C®re PAGE 4 OF 19 - representative bulk samples were similar materials, but this does not guarantee that materials of similar appearance are of the some composition. Even similar materials are subject to uneven mixing and distribution, and random sampling can miss ACM. EnvioCore used reasonable diligence and its professional judgment consistent with industry standards in order to identify all suspect ACBM. Bulk samples were analyzed by Certified Asbestos Laboratory. Background' The inspector was called to the subject property by Cody Churchill, Owner. Mr. Churchill was concerned about asbestos containing building materials in the affected areas of the building. Per Mr. Churchill, suspect asbestos containing building materials to be disturbed in the scope of work include: The affected materials sampled: - Siding The affected areas include: - Outside - Garden The Certified Inspector and the Client understand and agree that the Limited Asbestos Inspection shall include only the above -referenced potentially affected areas. If the Work Activity later includes other areas or materials that may contain ACBM, the Client understands that the Certified Inspector will only perform a Limited Asbestos Inspection of these areas upon a subsequent engagement. Sam ling Using methods that are generally accepted in the industry, the Certified Inspector determined that it was necessary to collect 3 bulk samples from the various homogenous areas (see the Asbestos Sampling below for exact areas). All samples were submitted to Certified Asbestos Laboratory. The laboratory results are incorporated into this report. Neither envioCore, LLC nor the Certified Inspector warrants the accuracy of any laboratory results. The Client and any other parties hereby agree that envioCore, LLC and the Certified Inspector shall not be liable in any manner for erroneous laboratory results or other errors with the laboratory testing process. See Data Table (Table 1) Below for Tabulated Results along with Attached Photos (Figure 1 etc.) PAGE 5 OF 14 �cl Table 1: Table of asbestos samples taken during inspection with lab results. ND = Non Detected, Wall "A" in each room is the wall where the front entrance door opening is located (or aligned with the street). Going clockwise and facing wall "A" (the street), wall "B" will always be to your right, wall "C" directly to the rear and wall "D" to the left. Doors, windows and closets are designated as left, center or right depending on their location on the wall. Asbestos Inspection Conclusion Asbestos containing building materials WERE NOT found in the samples analyzed by the laboratory. The affected building materials DO NOT need to be removed according to Regulation 8 of CDPHE Regulation if any renovation or disturbing of the materials occur. Caution should still be taken and OSHA Regulation could still be in effect for the renovation or disturbing of the tested materials. Personal protective equipment and all state and federal regulations should be used during any removal of sampled building materials by all parties. �� PAGE 6 OF 19 Significantly 3160 -IDI -01 damaged To OUTSIDE - MISC. ND N/A N/A Friable friable 500 N/A 3160 -IDI -03 GARDEN GREYREY surfacing ACM Table 1: Table of asbestos samples taken during inspection with lab results. ND = Non Detected, Wall "A" in each room is the wall where the front entrance door opening is located (or aligned with the street). Going clockwise and facing wall "A" (the street), wall "B" will always be to your right, wall "C" directly to the rear and wall "D" to the left. Doors, windows and closets are designated as left, center or right depending on their location on the wall. Asbestos Inspection Conclusion Asbestos containing building materials WERE NOT found in the samples analyzed by the laboratory. The affected building materials DO NOT need to be removed according to Regulation 8 of CDPHE Regulation if any renovation or disturbing of the materials occur. Caution should still be taken and OSHA Regulation could still be in effect for the renovation or disturbing of the tested materials. Personal protective equipment and all state and federal regulations should be used during any removal of sampled building materials by all parties. �� PAGE 6 OF 19 EnvioCore assumes no liability for any loss, injury, claim or damages arising directly or indirectly from any use or reliance on this report or the opinions expressed herein. EnvioCore makes no risk assessment, warranty, guarantee or insurance policies of any kind, express or implied. This report is limited only to the samples taken and locations sampled. There are no risk assessments, warranties, guarantees, or insurance available or provided by EnvioCore. Additional sampling may be needed to further identify other pollutants, or other mold/fungus affected areas inside the subject property. This report was prepared pursuant to the contract EnvioCore has with the client. That contractual relationship included an exchange of information about the subject property that was unique and between EnvioCore and its client and serves as the basis upon which this report was prepared. Because of the importance of the communication between EnvioCore and its client, reliance or any use of this report by anyone other than the client, for whom it was prepared, is prohibited and therefore not foreseeable to EnvioCore. No warranty is made. EnvioCore's liability and that of contractors and subcontractors arising from any service rendered here under shall not exceed the total fee paid by the client to EnvioCore. Thank you for the opportunity to work with you on this project. Please call at (303) GoEnvio (463) 6846 with any questions or concerns. Thank you. Sincerely, Nick Hopkinson Certified Inspector EnvioCore LLC, Environmental Consulting Asbestos Building Inspector Cert. No. 23887 ;,_ PAGE 7 OF 19 lnspedioi,- AW, Figure I - Overview of Exterior 6 0 I j Figure 2- Overview of Address PAGE 8 OF 19 to � � � r ` c J � --�' ,..;= � w.. �.' � �, �. �,lr ��`y� a < : � � C� 1 � t .. ,"." � m z€ n 'r't I I ,i .Fr � } 'f r �, ���", � 4. `'i A � �" 't ,.. , .�� �. `� -�� �' . ,,E:., � � \ tet. ,� ,, - <. ,:.� �� �� y , ..�- �� . ,�� ,�, � .. �' __ ,, �f� ;� ,� r� ` �, Figure 5- Sample location #1 1 .y Figure 6- Sample location #2 PAGE 10 OF 19 - Wk- Figure 7- Sample location #3 " PAGE 11 OF 19 Core e u rof i n s April 12, 2019 EnvioCore 1685 S. Colorado Blvd. Ste. S151 Denver. CO 80222 CLIENT PROJECT: 0419-32 3160, Pierce St CEI LAB CODE: A198087 Dear Customer Enclosed are asbestos analysis results for PLM Bulk samples received at our laboratory on April 12, 2019. The samples were analyzed for asbestos using polarizing light microscopy (PLM) per the EPA 600 Method. Sample results containing >1% asbestos are considered asbestos -containing materials (ACMs) per EPA regulatory requirements. The detection limit for the EPA 600 Method is <1 % asbestos by weight as determined by visual estimation. Thank you for your business and we look forward to continuing good relations Kind Regards, " � /x"_ � //_ � I --- Tianbao Bai, Ph.D., CIH Laboratory Director my( A G NVLAP LAB CODE 101768-0 730 SE Maynard Road • Cary, NC 27511 •919.481.1413 ��PAGE 12 OF 19 ti -W eurofins ASBESTOS ANALYTICAL REPORT By: Polarized Light Microscopy Prepared for EnvioCore CLIENT PROJECT: 0419-32 3160, Pierce St LAB CODE: A198087 TEST METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020 REPORT DATE: 04/12/19 TOTAL SAMPLES ANALYZED: 3 # SAMPLES >1 % ASBESTOS: �< PAGE 13 OF 19 ti-, eurofins PROJECT: 0419-32 3160, Pierce St Asbestos Report Summary By: POLARIZING LIGHT MICROSCOPY LAB CODE: A198087 METHOD: EPA 600 / R931116 and EPA 6001 M4-82 / 020 Client ID Layer Lab ID Color Sample Description ASBESTOS % 3160-ID1-01 A114818 Gray Siding None Detected 3160-ID1-02 3160-01-03 A114819 A114820 Gray Gray Siding Siding None Detected None Detected Page 1 of 1 PAGE 14 OF 19 eurofins ASBESTOS BULK ANALYSIS i By: POLARIZING LIGHT MICROSCOPY Client: EnvioCore Lab Code: A198087 1685 S. Colorado Blvd. Ste. S151 Date Received: 04-12-19 Denver, CO 80222 Date Analyzed: 04-12-19 Date Reported: 04-12-19 Project: 0419-32 3160, Pierce St ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % 3160-ID1-DI Siding Homogeneous 20% Cellulose 40% Binder None Detected A114818 Gray 40% Silicates Fibrous Bound 3160 -IDI -02 Siding Homogeneous 20% Cellulose 40% Binder None Detected A114819 Gray 40% Silicates Fibrous Bound 3160 -IDI -03 Siding Homogeneous 20% Cellulose 40% Binder None Detected A114820 Gray 40% Silicates Fibrous Bound Page 1 of 2 PAGE 15 OF 19 ti'. eurofins LEGEND: Non-Anth = Non-Asbestiform Anthophyllite Non-Trem = Non-Asbestiform Tremolite Calc Carb = Calcium Carbonate METHOD: EPA 600 / R93 /116 and EPA 600 / M4-82 / 020 REPORTING LIMIT: <1% byvisual estimation REPORTING LIMIT FOR POINT COUNTS: 0.25% by 400 Points or 0.1% by 1,000 Points REGULATORY LIMIT: > 1% by weight Due to the limitations of the EPA 600 method, nonfriable organically bound materials (NOBs) such as vinyl floor tiles can be difficult to analyze via polarized light microscopy (PLM). EPA recommends that all NOBs analyzed by PLM, and found not to contain asbestos, be further analyzed by Transmission Electron Microscopy (TEM). Please note that PLM analysis of dust and soil samples for asbestos is not covered under NVLAP accreditation. Estimated measurement of uncertainty is available on request. This report relates only to the samples tested or analyzed and may not be reproduced, except in full, without written approval by Eurofins CEI. Eurofins CEI makes no warranty representation regarding the accuracy of client submitted information in preparing and presenting analytical results. Interpretation of the analytical results is the sole responsibility of the client. Samples were received in acceptable condition unless otherwise noted. This report may not be used by the client to claim product endorsement by NVLAP or any other agency of the U.S. Government. Information provided by customer includes customer sample ID, location, volume and area as well as date and time of sampling. ANALYST: APPROVED BY: Danielle Carrier Tianbao Bai, Ph.D., CIH Laboratory Director NVLA TFSTING NVLAP LAB CODE 101768-0 Page 2of2 AA PAGE 16 OF 19 C C 1. 4 Samples Chain Of Custody (COC) CEI Labs 730 SE Maynord Rood. (ary, NC 27511 Phu—INS -t11.1412 F., 919.481-1442 C Company:='2 Pmjcc: NamaRY—Wr: 0415-32 3180. Pierce S1 S.reat:J.UFd. P-1-Rasuha Via: Emaiy:n LlhamlahanScat.:Carrier Name Fedex HlWllards Ra-hZi :Ph siwl Adtlr.sa: '.aRtbert To:.., Loratlon Phnnr. 7C3-?433L�3 Teleahon. R: Shi in Pricrit : P—x Fealty o—y, IbnoEmaii Add,— h=kF Ly.mlcawm Sh,ppina Confirmation #. 8143997355K. DatalTime ETA: Dat ,"Tuna Ora ff- Tauri 2 of S,,wlus Ralln u1dhIW lGllent: `Jkk Featinaar _ _ r.^Ile uiah D—frime: a:lr,.l'a'3 m Received t'-nh Racar.ad Catrinne! Sample Numb.r Sample Deserfptlen Sampl. Analyala Typ.-TAT- ti.lumelAre. Lamnima Or SamPlc Ta6,.. I 316C -C! O- OUTSOE- GARDENrdiSCSIDRJG *RE" PLt18 FR TAT 41IQ1S 103om Otl-S ]F - C.,IDE`J A11SC SIDING - GRE" PLM3 P R TAT 4.101/c 1 O3nm i 3 OU —5 E- GARDEN L1I5G SIOI`JG - GRE" PLr!-9 FR 1AI 4/10115 1 J i I i i I I i I Rnv Core _ ,. PAGE 17 OF 19 �-)Z-)c{ er 26 tiff E k1 F1) fj n SI -Received-Ay: EUROFINS CEI, INC SAMPLES ACCEPTED ti& , ; f i OV- C 0 1876 Colorado Departuient of Public HA and Environment ASBESTOS -C-bNSULTING FIRM This certifies that envioCore, LLC-, -Registration No ACF 21660 has met the registration :re"' f t e Air Quality Control requirements o 25-7-507, CKS, ind'� h""' Commission Regula!iiW`8,Pift erfoitn' p B;, and is hereby authorized to asbestos:consulting activities as required. g I o o iin�er: e i lation, NP 8, Part B in the state." f C'lorAdo, Issued: February -,14,'2019. jaxpcs _; :L n y 2020 AuthofUed qFAI PAGE 18 OF 19 Core of row, col k I 7' Colorado Department of Public Health and Environment ._ ASBESTOS CERTIFICATION* A This certifies that Nicholas Hopkinson Certification No.: 23887 4� has met the requirements of`25-7-507, C.R.S. and Air Quality Control Curnmission Regulation No. 8, ['art 13, and is hereby certified by the _ state of Colorado in the following discipline: Building Inspector*�� lssuecl: August 16. 2018 Expires: August 10, 2010 p. . F may. �-�• ... ,� ;�` ' IH1+ ++171f7:'rilr� fw rUUrl c�nik A,llh !ht' (rU�4etx%iEn ni t1 rurr.�rtt Ufclurm-:�ly3rtrccal tr�&rlrr�p c r+kr.r r.�rti�7c'etinn f ' / In the dii, fl>lrtir cpr , Ilird above d' AiW;;irrzeoAf=c't,' � sc�s�t�4tr r j, PAGE 19 OF 19 s 2008074342 08/01/2008 03:35:17 PM PGS 1 $6.00 DF $23.74 Electronically Recorded Jefferson county CO Pam Anderson, Clerk and Recorder TD1000 Y II I I I ii �l [ I fI� Ii lI III I I II SII STATE DOCUMENTARY EEE Date: July 30, 2008 WARRANTY DEED 23.74 THIS DEED, Made an this day of July 30, 2008 between I)OUGLAS M. PERRY AND HOWARD E. ERICKSON of the county of ARAPAHOE and State of CO of the Grantor(s), and CODY G. CHURCH2LL AND ELIZABETH J. MILLER whose Legal address is : 3160 PIERCE STREET WHEAT RIDGE, CO 8021.4 of the County of JEFFERSON and state of COLORADO of the Grantee(s): WITNESS, That the Grantor(s), for and in consideration of the sum of ( $237,400.00 ) *** Two Hundred Thirty Seven Thousand Four Hundred and 00/100 *** vOLLARS the receipt and sufficiency of which is hereby acknowledged, has granted, bargained, sold and conveyed, and by these presents does grant, bargain, sell, convey and confirm unto the Grantee(s), their heirs and assigns forever, not in tenancy in common but in joint tenancy, aLL the real property, together with improvements, if any, situate, Lying and being in the County of JEFFERSON and state of Colorado, described as follows: THE SOUTR ONE HALF OF LOT 1 AND THE SOUTH ONE HALF OF THE WEST 10 FEET OF LOT 2, HALLER SUBDIVISION, COUNTY OF JEFFERSON, STATE OF COLORADO. also known as street number 3160 PIERCE STREET WHEAT RIDGE CO 8021.4 TOGETHER with all and singular and hereditaments and appurtenances thereto belonging, or in anywise appertaining and the reversion and reversions, remainder and remainders, rents, issues and profits thereof; and all the estate, right title interest, claim and demand whatsoever of the Grantor(s), either in taw or equity, of, in and to the above bargained premises, with the hereditaments and appurtenances; TO HAVE AND TO HOLD the said premises above bargained and described with appurtenances, unto the Grantee(s), their heirs and assigns forever. The Grantor(s), for himself, his heirs and personal representatives, does covenant, grant, bargain, and agree to and with the Grentee(s), their heirs and assigns, that at the time of the enseaLing and delivery of these presents, he is well seized of the premises above conveyed, has good, sure, perfect, absolute and indefeasible estate of inheritance, in law, in fee simple, and has good right, full power and Lawful authority to grant, bargain, sell and convey the same in manner and form as aforesaid, and that the same are free and clear from aLL former and other grants, bargains, sales, liens, taxes, assessments, encumbrances and restrictions of whatever kind or nature soever, auhject to geaera2 taxa© For the year 2009 and those speoifl. axaeptian. described by refercnee to r orded document. a reflected .i.e the Title Doovments s eepted by ;—tearn) in accordance with aaation 9.1 0XIt2e Review)cof the contraat to Buy and sell Real Estate relat iag to the above described property; distribvttan utility a est. (including cable T )l those spaaifiaaT _y d ... ribed right. o£ tbird parts a. net ah.— by the pvblio --f. of which Grantee(.) hat actual knowledge and which ware acaep ted by Grantee (s) i.n --d— with section 9.2rm.tter. not ahewn by the Pub2ia R ... rd.) and Section a_3 (Survey Review) o£ the Cantraat to Buy and Sell Raaf Entata relating to the above dc.cz-ibed —J. property; in al veioa o£ the Property within say npeai.2 eax dintriat; and, the benafita and burdens of any recorded dncl oration and party wall sgreemeate, i£ any end other NONE The Grantor(s) shatt and will WARRANT AND FOREVER DEFEND the above bargained premises in the quiet and peaceable possession of the Grantee(s), his heirs and assigns, against all and every person or persons Lawfully claiming the whole or any part thereof. The singular number shall include the plural, and the plural the singular, and the use of any gender shall be applicable to all genders_ INAVITNE3SWHEREOF the Grantor(s) has executed this deed on the date set forth above. By. DOUGLAS M. PSRR HOWARD E. ERSCKaoN STATE OF COLORADO _ ) A. P1/�<<� County of DoyGLAs 1 � Y O. 4t' CO P Qo\v,:. Q The foregoing instrument was acknowledged before me on this day of oely 30, loos/)4 ^�`r by DDUGLAs M. PERRY AND iroNARD E- znxc7csox f , my commission expires Witness my hand and offici t seal. C Notary Public Name and Address of Person Creating Newly Created Legal Description 38-35-106.5, C.R.S.) Escrow# HR70218685 When Recorded Return to: CORYG. URCHILL AND ELIZABETH J_ MILLER Title# K70218685 3160 PIERCE STREET WHEAT RIDGE, CO 80214 Form 96 08/20/04 WDJT1 WARRANTY DEED (Joint Tenants) Printed: duty 29, 2008 {6707585} 2015030278 4/1/2015 9:59 AM PGS 1 $11.00 DFS0.00 Electronically Recorded Jefferson County, CO Faye Griffin, Clerk and Recorder TD1000 N QUITCLAIM �DEED THIS DEED, dated this Gfl� day of ` 'jArc " +^ ' 12015, between ELIZABETH J. CHURCHILL of the County of Jefferson and State of Colorado, grantor(s), and CODY G. CHURCHILL whose legal address is 3160 Pierce Street, Wheat Midge, CO 80214 of the County of Jefferson and State of Colorado, grantee(s): WITNESS, that the grantor(s), for and in consideration of the sum of ($10.00) TEN AND NO1100 DOLLARS, the receipt and sufficiency of which is hereby acknowledged, has remised, released, sold and QLT=AIMED, and by these presents does remise, release, sell and QUITCLAIM, unto the grantee(s), his heirs and assigns forever, all the right, tide, interest, claim and demand which the grantor(s) has in and to the real property, together with improvements, if any, situate, lying and being in the County of Jefferson and State of Colorado, described as follows: THE SOUTH ONE HALF OF LOT 1, AND THE SOUTH ONE HALF OF THE WEST 10 FEET OF LOT 2, HALLER SUBDIVISION, COUNTY OF JEFFERSON, STATE OF COLORADO also known by street and number as: 3160 Pierce Street, Wheat Ridge, CO 80214 TO HAVE AND TO HOLD the same, together with all and singular the appurtenances and privileges thereunto belonging, or in anywise thereunto appertaining, all the estate, right, title, interest and claim whatsoever of the -rantor(s), either in law or equity, to the only proper use, benefit and behoof of the grantee(s), his heirs and assigns forever. The singular number shall include the plural, the plural the singular, and the use of any gender shall be applicable to all genders. IN TNESS WHEREOF, the grantor(s) has executed this deed on the date set forth above. ELIZABETH J. CH CHILL NKA IT ELIZABETH J. MILLER. STATE OF COLORADO J � COUNTY OF yt)a- ie /' ) The foregoing instrument was acknowledged before me this —2 �� day of 2015, by ELIZABETH J. CHURCHILL NKA ELIZABETH J. MILLER. My Commission expires: Wines my h nd a d official seal. LESLIE R. GREGORY NOTARY FU1311C NOTARY O 0 20094075 92 MY c4MMiS610N E%pIRES.tUNE 04, 2e}T QMCLAIM DEED Fitc 5 HTI52420 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: - U) Y r E f U Job Address: 0 P k c r Permit Number: ,.1r ,• , � ` t i ❑ No one available for inspection: Time { AM/PM Re -Inspection required: i%es-) No When corrections have been made, call for re -inspection at 303-234-5933 Date: Inspector: DO NOT REMOVE THIS NOTICE INSPECTION RECORD Inspection online form: http://www.cl.wheatridge.co.us/inspection Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Inspections will not be performed unless this card is posted on the project site Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business day PERMIT: r ADDRESS: W6 rifr�6 S+� JOB CODE: `-i / 12 Foundation Inspections Date Inspector Initials Comments 102 Caissons / Piers 103 Footing / P.E. Letter 104 Foundation Setback Cert. 105 Stem Walls 106 Foundation wall Insulation Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground / Slab Inspections Date Inspector Initials Comments 201 Electrical / Cable/ Conduit 202 Sewer Underground Int. 203 Sewer Underground Ext. 204 Plumbing Underground Int. 205 Plumbing Underground Ext. 206 Water Underground 4. 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'%° 4. 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 o=77 win rrin AMr%iTir%wini ikin lrf-rif%Kir� PERMIT: ADDRESS: JOB CODE: Rough Inspection (continued) Date Inspector Initials Comments 316 Rough Mechanical Residential 317 Rough Mechanical Commercial 318 Boiler / Furnace 319 Hot water tank 320 Drywall screw and Nail 321 Moisture board / shower walls 322 Rough Grading 323 Miscellaneous Final Inspections Date Inspector Initials Comments 402 Gas Meter Release 403 Final Electrical Residential 404 Final Electrical Commercial 405 Final Mechanical Residential 406 Final Mechanical Commercial 407 Final Plumbing Residential 408 Final Plumbing Commercial 409 Final Roof 410 Final Window/Door 411 Land scape/Park/Planning* Inspections from these entities shall be requested one week in advance. *For landscaping and parking inspections please call 303-235-2846 **For ROW and drainage inspections please call 303-235-2861 ***For fire inspections please contact the Fire Protection District for your project. 412 Row/Drainage/Public Works** 413 Flood plain Inspection** 414 Fire Insp. / Fire Protection*** 415 Public Works Final** 416 Storm Water Mgmt.** 417 Zoning Final Inspection* 418 Building Final Inspection Note: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building Inspection does not constitute authorization of occupancy. For Low Voltage permits please be sure that rough inspections are completed by the Fire District and Electrical low voltage by the Building Division. CITYOF WHEAT RIDGE _:�9rBuilding Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: A&9 PoF-- Job Address: :51 E; Permit Number: -,76I'70 ❑ No one available for inspection: Time, :�,7 AM/PM Re -Inspection required: Yes No When corrections have been made, callfor re -inspection at J3/03-234-5933 Date: 11114 //-�- Inspector: '�- /='6 //,-" 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: 306 Z) 3 Job Address: O P plc e T` Permit Number: 2017623 6 ,j 3 ❑ No one available for inspectio Time y L/ AM/PM Re -Inspection required: Yes No When correc ions" have been made, ca for re -inspection at 303-234-5933 Date: / 7 I7 Inspector: 7 - DO NOT REMOVE THIS NOTICE ► ' . City of Wheat Ridge Residential Roofing PERMIT - 201708633 I PERMIT NO: 201708633 ISSUED: 10/26/2017 JOB ADDRESS: 3160 Pierce ST EXPIRES: 10/26/2018 JOB DESCRIPTION: Residential Re -roof to install CertainTeed asphalt shingles - 22.24 sq Pitch = 4/12 *** CONTACTS *** OWNER (303)725-9987 CHURCHILL CODY G SUB (303)719-7663 Chase Johnson 170235 Johnson Construction *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 12,000.00 FEES Total Valuation 0.00 Use Tax 252.00 Permit Fee 236.00 ** TOTAL ** 488.00 *** 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. IV ► A 4 City of Wheat Ridge Residential Roofing PERMIT - 201708633 PERMIT NO: 201708633 ISSUED: 10/26/2017 JOB ADDRESS: 3160 Pierce ST EXPIRES: 10/26/2018 JOB DESCRIPTION: Residential Re -roof to install CertainTeed asphalt shingles - 22.24 sq Pitch = 4/12 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 en7mt. I further attest that I am leally authorized to include all entities named within this document as parties to the work to be P ored and that all ?4 to be per orme,�l is disclosed in this document and/or its' accompan�i� approyed plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and maybe subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building 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 issuantce r 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 co or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dane Lovett 2d70�6 , From: no-reply@ci.wheat ridge.co.us Sent: Wednesday, October 25, 2017 3:04 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 3160 Pierce St Property Owner Name Cody Churchill Property Owner Phone 303-725-9987 Number (enter WITH dashes, eg 303-123-4567) 37 KA a 5 1-6 S 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 cgchurchill@gmail.com Yes Cody C contract.gdf CONTRACTOR INFORMATION Contractor Business Johnson Construction Company Name Contractor's License 170235 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 303-719-7663 Number (enter WITH dashes, eg 303-123-4567) Contractor Address 1745 Shea Center Drive (Primary address of your business) Contractor Email Address chelsea@exteriorsbyjohnson.com Retype Contractor Email chelsea@exteriorsbyjohnson.com Address DESCRIPTION OF WORK TOTAL SQUARES of 22.24 the entire scope of work: Project Value (contract �ry12000 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 r; Pitched roof (2:12 pitch or greater) 38 both? (check all that apply) What is the specific pitch of the PITCHED roof? How many squares are part of the PITCHED roof? Describe the roofing materials for the PITCHED roof. Type of material for the PITCHED roof: Provide any additional detail here on the description of work. (Is this for a house or garage? Etc) 4/12 22.24 r` Certainteed Landmark IR Asphalt home re -roof 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 39 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 Chelsea Moreland Email not displaying correctly? View it in your browser. 40 44 - - .- v /TVW CONSTRUCTION COWANY LLC BBB JOINSON CertainTeW0 PREFERRED Q..,,.....,,...s„y �,.,..,..- CONTRACTOR Corporate Office: 1745 Shea Center Dr. 41 Floor, Highlands Ranch, CO 80129 - Phone 303-719-7663 - Fax 888-859-0135 W W W.ROOFSBYJOHNSON.COM Customer Name: \ Date Property Address: City / State: Billing Address: City / State: Home Phone #: —1 Work Phone #: SPEC1F1!,CAXJ,0NS FOR (PROPERTY REPAIR: Emergency R epairs/Tarps : YEROOFIN YE / NO 0„U�Q%LK, o T e Size o Roofing Material:np i NO Sidin YES NO o Material Color: k is _ o Siding Material: o Valley Material: o Material Color: o Ridge Material: _n GutterYES / NO _ o Ventilation: �/ o u er Size / Mater' 1::,' 1,(i�-I 1'1L(,(1') I o Metal Edging: o Material Color:hi o Chimneyslashings: Interior Damage YEN o Tear Off Yes - Layers o Painting YES 0 o Felt: vT Ice Shield:_�Q�i (A,�(,{1i �� o ,Drywall / Plaster YES 0 o Pitch:1111?1_ Stories: i Skylights # Sizes: Protect Landscaping o” Remove Trash From Gutters & Yard (57 Roll Property With Magnetic Roller G Customer Or Insurance Responsible For Un-Nailable Surfaces (see back side) SPECIAL INSTRUCTIONS * Johnson Construction Company LLC Shall hold in trust any payment received from you until Johnson Construction Company has delivered roofing materials at the site or has performed a majority of the roofing work on your property. * Property Owner is _/ is not _ intending to make payment from proceeds ofa -- -- r• �r�• y +•u caauauy insurance policy. General Contractor: Property Owner or Authorized Representative acknowledges that as a General Contractor Johnson Construction Company LLC is entitled to any applicable Overhead & Profit as determined by Insurance Standards. Insurance / Mortgage Company Note: I hereby authorize the Insurance and / or Mortgage Company listed below to make all checks payable jointly. Terms: This agreement does not obligate the property owner / authorized representative or Johnson Construction Company LLC in anyway unless it is approved by the Insurance Company and agreed upon by Johnson Construction Company LLC. When "price agreeable" is determined it shall become the final contract price of $ IN9. Snd the property owner / authorized representative authorizes Johnson Construction Company LLC to obtain labor and material in accordance with the "price agreement" and the specifications set out herein and on the reverse side hereof to accomplish the project in full. Accepted by Property Owner / Authorized Representative on: Date: am ,,��jj �-Id' Y: Insurance C m an J.C.C. y Mortgage Company: Claim #: Account #: Approx. Date of Service: Date of Completion: General Liability Insurance Provider: Stolly Insurance (p) 800-686-2147 City of Wheat Ridge Residential Mechanic PERMIT - 201601922 PERMIT NO: 201601922 ISSUED: 12/05/2016 JOB ADDRESS: 3160 Pierce ST EXPIRES: 12/05/2017 JOB DESCRIPTION: Install replacement 83% 50K BTU boiler with I zone *** CONTACTS *** OWNER (303)725-9987 CHURCHILL CODY G GC (303)466-4209 Rosalie Cooper 018111 Cooper Heating & Cooling *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 3,845.00 FEES Furnace Replacement 40.00 Total Valuation 0.00 Use Tax 69.21 ** TOTAL ** 109.21 !J * * * COMMENTS * * * *** CONDITIONS *** Both the front and back of this permit are required to be posted on the job site at all times. If the complete permit is not present, inspections WILL NOT be performed.All work shall comply with applicable codes and ordinances and is subject to field inspections. I, by m signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be apermit for, or an approval of, an violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptimerequest((-cci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. 31(00 A -e41 -a 5-4- IN�i6T1O N RECORD Oc�upan�v�rv� (yj 3�L<� 5-C) ktXU INSPECTION REQUEST LINE: (303) 2345933 Inspections will not be performed unless this card is posted on the project site. Call the inspection request line before 11.59 p.m. to receive an inspection the following business day.** Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections I Date Inspector comments Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter tEA Do Not Pour Concrete Prior To Underground/Slab Inspections Date Inspector Initials Electrical Sewer Service Plumbing I Of The Above I comments ._1 ns rlke Ahnve Incnactions Uo NOT Lover unser round or neiowyn-alae vrurK rnvr iv App, --• — --- - Inspector comments Initials Rough Inspections Date Wall Sheathing Mid -Roof Lath / Wall Tie City of sheat kid e 12/06/2016 13:6 CDBA Install replacement Rough Electric' Rough Plumbing/Gas Line Rough Mechanical Rough Framing Insulation Drywall Screw /Nail Final Inspections Final Electrical Final Plumbing Final Mechanical Roof Final Window / Doors Final Building Landscaping & Parking / Planning Dept. ROW & Drainage / Public Works Dept. Fire Inspection / Fire Protection Dist. Inspector CDA013685 AMOUNT Date Initials BPSP 3160 Pierce ST 109.21 APPL/PERMIT NO: 201681922 PAYMENT RECEIVED AMOUNT VS / 5483 109.21 AUTH CODE: 08502D TOTAL 1@9.21 -------------------- ------------------ Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. NOTE. All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy. For low voltage permits - Please be sure that rough inspections are completed from the Fire District and electrical low voltage )y the Building Division. "For Inspection Time Window Requests - Please email ins timere nest ci.wheatrid e.co.us by 8:00 A.M. the day of the inspection with the property address in the subject line of the email. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather FOR OFFICE USE ONLY � 1641 _� � � `- City of 'ge WheatR�d COMMuNiTY DEVELOPMENT Building & Inspection Services Division ao (,co 7500 W. 2e Ave., Wheat Ridge, CO 80033 Plan Review Fae: Office: 303-235-2855 ' Fax: 303-237-8929 Inspection Line: 303-2345933 Building Permit Application be ;610wc8GA4W- Preorrty Owner (please print): �g Maiijrf: (if different than property address) Address: City, State, Zip: Architect/Engineer E -m 0. Contra W: Cooper Heating and Cooling Contractors City License #: 1 I ..,.�:: 720.361.4245 Contra :E -mall Address: lockinney@coopergreenteam.com B� Vis: Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all information on BOTH sides of this form i i I I (Check all t apl ily) C] NEW MM CIAL STRUCT NEW SID [TIAL STRUCTU�2 ❑ELECTRICAL SER�gCE UPGRADE ❑ COMMERCIAL R06FING COM C }ADDITION ❑ RESIDENTIAL ROOFING RES TI A ADDITION ❑ WINDOW REPLACEMENT COM CI ;ACCESSORY ST UCTtVRE (Garage, shed, deck, etc.) ESI ITIJIL ACCESSORY S UCT (Garage, shed, deck, etc.) MEC IC SYSTEM/A►PPL CE RPAIR or REPLACEMENT PLU 1 G YSTEM/APPLREP IR or REPLACMENT ELEC IC SYSTEM] APPUAI ER AIR or REPLACEMENT OTH D P or Sq. Ft/LF s Gallons Amps 1 Other on or cost rnat'rials and labor included in the entire project) UWr4t, V(:V IK SIGNATURE OF! NDER4TANDING AND AGREEMENT I hereby certify t the setback distances p by thin permit application are accurate and do not violate applicable ordinances rules or regulations of a ity f Wheat Ridge or cov , easeipents or restrictions of record; that all measurements shown and alleptic ns made are accurate; that I I La, e rea I and agree to abide by all conditions printed on this application and that I assume full responsibility for co pliance with applicable i y of vVheat Ridge codes and o . for work under any permit issued based on this application; that I am the legal owner or have been au by the legal owner of the ro to perform the described work and am also authorized by the legal owner of any entity included his plication to list that eatF on this) -- i 101 (CONMC710,1) or OBlZF.D REPRES Elul (CONTRACTO T T Building Division Valuation: r ISSUED: 06/01/2010 EXPIRES: 11/28/2010 cedar fence �s cit �r COMMUNITYDEV6LOPMENT Building & Inspection Services Division 7500 W. 29" Ave., Wheat Ridge, CO 80033 Date: t6 )/ T1 Plan # n I ' Permit # OR Office: 303 - 235 -2855 * Fax: 303 - 237 -8929 Inspection Line: 303- 234 -5933 Building Permit Application t?rop,'ertyAddress: f a 1 S T Property Owner (please print): Phone: Mailing Address: (if different than property address) Address: City, State, Zip: Contractor: Contractors City License #: Phone: Lo{ Sub gontrac 7 Electrical: plumbing: Mechanical: City License # City License # City License # n �eSCYiAtiOYt`�D� W.OI'I<c C i t r C e D AR 1? c p bi ['.. c4 o �1 Contract Value: Review Fee (due at time of submittal): Squares BTU's Gallons Amps S $ OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants; easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge . codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity . on this application. CIRCLEONE: ( (CONTRACTOR). or (AUTHORIZED REPR of (OWNER) (CONTRACTOR) PRINT NAME: .+ { ; ^, a p"sF'.w{"^3 SIGNATURE: J `',P "='. ,.__,:. DATE: _ - 1 x,rs ;. r -� � DEP�RTNfEt�1TOS� O)a1L�l � �' t d � u � of _e r f /��✓f/ � Yy u c n rr/ )2eoJ�e�wer � r ✓ /,�+��9f%r � rr i : i ��i �� S� + � s+� ' if i � f �S l �s"v� ���� �� r .. r l 5 � - PCIHLIC WORKS COMP�IENTS ``. r r ras _. : fizb �. � vt +r -' -- :flG,CU�PARr�Y ,!r, n r r vim' x F�RE'DEPAR7tvt[ -1u7� ❑ approved wJ comments Ci duapproyed ti ao rev)e� required ` Bldg Valuation $ r < r 0 Property Line —. . Feet—/. —. _. —. LLI Garage or Carport or Shed a: 6� J � � I 1 � c; a0 ( HOUSE o ', < Side Setback Side Setback Y U i i 0 (._._._. -. -. - - 51DEWALK NORTH I Scale: 7 " =_ List oqu ire footage of ELI. EXISTING and PROP05ED structures located on the property. f .... _........_.._.._.._.._..e..— 'DATE: b� / °/0 �_- .,,._{}.._.._ \ �, .. WW1 ,a low A 1 golf o e s .......... A ~ LL w•°- c~ ~ y C N N C d ~ Q O h a°~ W 5 ~ • _ ~ ~'1 U ~ N, M ~ Ly C y O O c M N U o N m `o ` W U F- O Z Z O U W a N Z ~ L a d FT E o Z r _ Q E L ~ (A a H N G) ~ 9 Q .fl O 13 ~ a ~ a a) E ~ c ~ 0 U N y" } c o a ~ ~ 9 5 m ~ a~ ~ 0 a) U C a) O p. O N z C ti ~ a 0 O ~ U E Q ~ u C: a O i Z t o ~ O u~ m ~ U G t ~ + 0 JGiB~At'3150 PZFRCE S?F E%PIR85: 08/18/2608 . . T~o ANA Rh^PEACE 24 5O. . DSMF3NSIONAL . . . : . - . OWNh"Ft, ~7'120I366-63'.84 JOSH OTT ~ . . G& , 303%456-4161 Semie Reitz 01-9543ReitzRoofing, Inc.. , `~Id'PC7 . . . . . . . . . . . Zf3NT~ tTA. USfi: UA SUbDI'V~~~?~b ~i51.4 . . , . BLOCK/LOT#; D/ . . . ..ESTIMATED.PROJECTVALUATION:4,461.00 . . . . . . . . FEES pe'tmiC ;BEe:~ . 144 . 70 .00 . . 80.30 ~ " . 225.00 Cc~hetzL~t~'„` F~'*MJ8$ MTTST BE 6 IOAIT.ED st~$JA'-Nji) An:gzrrAT, rrrspncTIoNs I3 REPLACEII, A SHBATHING ZNSPECTION WILL SE REQUIRED F hiFelsy tjnE~ify tk8t thpBeCbaGk,dletanceR pcopoeed by thie pe:mit application are acnuxate; anfl do not violate.applicatrle pYqS;i~a.K^~~,qt'i¢,tab arY t+CgtilaCione of the City of.tiheat nidge or covenants, easemente or reatric[ione..of record;[tiaCall m6d4Ntf3bk'l~tYla6bwa, a+id allegatianemadeare accurate; that I have read and agree to abideby allconditione printed on thia apykicYkC'iqn•~nd thaC 2&ReumE fu1lTesDonelbility for compliance with the Wheat Ridge.enildin9 Code (i.&.C)and ailother 41p'ASC0~d2fi41epdtR34gt AidinanCas,fa vaork.under thie permit. Plane eubject to field incpectian. ~ - ~V1~8tl$, xP'1~txA~EOS' . . . . dete . . 1. T¢lo p%FiMI@fGsuee8 ieeueQ ln accoidance with the proviaione eet forth in your applicatioa and ieeubject to the lame of the E0a4tadp aiul.to theZOniIIg Re9ulttione and BuilQing Codes of WheatRidge, Cblorado or any othwxapplicable . 9rd~~e~c,ie 'pt, n~{c ritY. . . . . 2. 7'hf9 gfppYt3i.p68Y1 euplrE 180 dLye fmmChe ieeue.date. Requeata-for an exteaeion muet be received prior to,expiration.dgtq; ,~$ti+UC;.;xlqJon may Le qraxited at thediecretion of the Hullding Official. 3, -#E tWav'pezaU,t e3tglree, a new pesmit may be acquire9 for a fee of one-half the amounY normally requireC, provided no 'CY,549y~'ASVC peen orwill be made in the original plana and epecificationa and eny euepeneion or abandonruent hat 3wt 6XC'4'EQl+~7 cue 417 year:. If Changeahave beea or if suepenaion or abandonment exceede one (1) year, full feea eluli Fie 5rtxd for'.~ 8 n@w De+YOiit. . . . . . : . NowV,tld. o-Y an'y Wdnn4z'attall bedoneeriat will change the natural flow of water caueing a drainage problem. 5. :4oMlr4EO'r~sbs1; noCify the Building Inepector twenty-four (24) houre in advance for all inepectlone anflahall receive urfCt" *QpYbvdl on Snapectiod-Catd beforeproceeding with eucceselve.phaeeR of the job. . 6. Iha TelHdsCR OL a pexwit or tReapp;oval of drawinge and epecificatione ehall not.beconetrued to be apexmit for, nor :.dn appXpVal~bl,,Rnyxlolation oit ieSone of the Luilding codes or any other osdinance,. law, rule Or.Yegulation: Rll plfn :revtev is. siilsi~0. [oectione. . SSgliC;'CWrd C!$.'!-'Mjef SuildiSlg Off' iel. date LINSe (303)234-5933 BUILDING OFFICE: (303)235-2855 l~td',5T 'E I9hb$ SY 3PM ANY BUSINESSDAY FOR INSPfiCTIONTHS FOLLOWING BUSINES5 DAY. .4:. L . . . . . E ~ ~ Y . . . . . . . k~AJ. c(~ . . . . . . ~ .~f00fi'... . . . . . . _ DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number: BUILDING INSPECTION LINE - 303-234-5933 Date: CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 50215 - (303-235-2855) ~~~104 TION Property Owner: -'csh G}} Proper[y Address: 3 IC~ 0 Pi e rc e Phone : 7ac7 36S• G 3 d'</ Contractor License No.: CompanY iRPltz P..,e.G.,ti 'Tv,. . Phone: YG O WN&R/CONTRACTOR SIGNATURE OF i1NDBRSTANDING AND AGRE%M&NT I hearby certify that the setback distances proposed by this peanit applicalion ere accutata, xnd do not violata applicable ordinances, Nles or rogulations af the City of Wheat Ridge or covenanis, eesemenGv ot rnctric4ons of record; thnt all messuremerts showq and allegallons made are accurate; that I have read and agee to abide by afl condilions prirRed on ilus epplications and that I azsume full iesponsibility for compliance with the Wheat Ridge Building Code (O.B.C) and all other applicable V✓heat RiAge Ordinances, for work under this petmit (OWNPRxWMRACTOR).SIGNE +.Ml 7 DATH Description: Y~ar oFF .3 /Ar RvrnoF Cx,l~h dirnensionoi ay~ Construction Value: 4/4/6/ ' Permit Fee: Plan Review Fee: T icr Tax' Total: Electrical License No: Plumbing License No: Mechanical License No: Company Company: Company: Expiration Date: Expirarion Date: Expiration Date: Approval: Approval: Apprwal: (1) 'fhis pemtit was iuued in azcacdarme with the prwisions set forth in yow epplica4on md 'u aubjxt W the kws oC the Staro oF Colondo end W the Zoning RegWatlmu and BuilAing Code of Wheae Ridge, ColoraAo or any oNer applicable ecdwncu of the City. (2) This permit shaLL exp'ue if (A) the work autMnzeA is me commenecd within sixty (60) days Bom usue Mm or (B) the bwlAing aufhociud is svyended oc abendonrd foc a peaod oC 110 Aays. (3) If Ws pemtit expina, a new yuvut may be uquved foz a Cee of ono-Ml( W unoum[ noannlly cequved, ptovided m chsngm M.e been or will be made in Ne oaginsl pleos and specifica4onu and ury sueperuio¢ or ebandonvvcn[ has nat arceWed one (1) year. If c6ariges 1we been or S suspuuion or abmdomnmt escwds one (1) yeaz, fuLL fw ilull be peid fw a new pemsst (0) No work of any mwvec slull be done Nat wiil change the neturei flow of wat¢ causing a dreieage problart (5) Conhactor aha1l notify tlw Building iuspecto[ twuLLy-four (24) hou[s in sdvanw for all irapa4ans snd ahall [ecuve wnuan apprwat on ivspec4on cazd befoie p[ocwdiog with succesxive phasat of thejo6. (6) 12ve ismence ot a pemut w the apyroval ot drawings anA specifica4om shall mt be consWed ro be a pemut for, nor an approval of, ury vialaflon of the provixiom of the building codu or any oNu orEmuncq law, culc wrcgala4on Chief Building Inspector