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3185 Webster Street
City of Wheat Ridge Residential Asbestos Abatement PERMIT - 201901151 PERMIT NO: 201901151 ISSUED: 06/05/2019 JOB ADDRESS: 3185 Webster St EXPIRES: 06/04/2020 JOB DESCRIPTION: Response to asbestos spill due *** CONTACTS *** OWNER (720)329-9669 KAUTZ LISA MICHELLE SUB (720)285-9574 DAN YARMON 190157 TOP NOTCH SOLUTIONS *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 14,887.00 FEES Total Valuation 0.00 Demolition Fee 50.00 ** TOTAL ** 50.00 *** COMMENTS *** *** CONDITIONS *** Work shall comply with 2012 IRC & 2017 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. I, by my signatuVereb st that the work to be perfoed shall comply with all accompanying approved plans and specifications= pcabbuild1 applicable municipal codespolicand that I am the legal owner or have been authorized bythe legal ownrty and am authorzed to obtaithisthe work described and approved in conjunction with this,permrt. I fuI am legally authorized toinclude all entities named within this document as parties to the work to be performed and tbe performed is disclosed in this document and/or its' companying approved plans and specifications. Signature of O or CONTRACTOR (Circle one) Date 1. This permit was is ed based on the information provided in the permit application and accompanying Flans and specifications and is subject to the comp iance 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 pen -nit for, or an approval of, anviolation 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. City Of Wheat dge COMMUNITY DEVELOPMENT Building & Inspection Services 7500 W. 29"' Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(a)ci.wheatridge.co.us FOR OFFICE USE ONLY Date: (J I Plan/Permit a q V I 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: P35 5 UV L5-aek I Property Owner (please print): 1� S� i9 L1 �Z Phone: `�Z�� L - q.9 6q Property Owner Email: _S &A k' Y 4 7 to2sh /cl—ar0 ()e.� 5 , ('©vvA Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: , State, Zi Arch itect/Eng1neer E-mail: Phone: Contractor Name: I T)Q -- N (D17C q 6CLU ]� OA J City of Wheat Ridge License M Contractor E-mail Address: Phone: 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 ,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. 6 E Sq. FULF BTUs Gallons Amps Squares For Solar: KW # of Panels Requires Structural For Commercial Projects Only: Occupancy Type: Construction Type: Occupancy Load: Square Footage: Project Value: (Contract value or the cost of all materials and labor included in the entire project) /y,�?37 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 pro 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 is applicati n. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the appli ion. CIRCLE ONE: (OWNER (CONTRALTO (AUT ORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and las name),: DATE: �S l Printed Name: , // VZ/ZM (9 ' 1 DEPARTMENT USE ONLY ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: Building Division Valuation: All 'L Clear Environmental a- CANS LILTING 11o92 Mallard Ct. Parker, CO 80134 1720-982-1513 Post Abatement Final Clearance Report 3185 Webster St. Wheat Ridge, Co 80033 Prepared for: Top Notch Solutions — Dan Yarmon 3185 Webster St. Wheat Ridge, Co 80033 Performed & Prepared by: Josh Berard All Clear Environmental Consulting 11092 Mallard Ct. Parker, CO 80134 (720) 982-1513 CDPHE Air Monitoring Specialist #23015 CDPHE Asbestos Consulting Firm #24131 Project Number: FC -1127 Inspection Date: May 81h, 2019 This report is for AMS work performed at the above address. Dear Top Notch Solutions, On May 8t", 2019, Mr Josh Berard with All Clear Environmental Consulting performed post abatement final visual & air clearance at 3185 Webster St. The final clearances consist of a visual inspection for dust and debris foIIowed by aggressive air sampling. The clearance consisted of 1 containment. This included the disposal & cleaning of roll off dumpster in driveway of residence. Homeowner created a spill during remodel. Mr Josh Berard CDPHE AMS #23015 performed- a visual inspection following CDPHE guidelines and found no visible dust or debris. Upon completion of the visual inspection, air samples were taken inside of the work area. A total of 5 air samples were taken inside containment. Each of the sampling pumps were ran at 13 liters per minute. A total of 910 liters were sampled from each pump. The air samples were analyzed by Phase Contrast Microscopy (PCM) following the NIOSH 7400 method. All samples must fall below o.o1 f/cc in order to pass final clearance. All Samples were below the limit amount Per Colorado Reg 8 Part B guidelines, the work area is now clear for occupancy Please note: Any suspect asbestos containing material (ACM) remaining should always be assumed to contain asbestos unless determined otherwise. All work performed MUST follow appropriate EPA, CDPHE, OSHA and local government guidelines to protect the employees, occupants and the environment. Josh Berard Air Monitoring Specialist #23015 All Clear Environmental 11092 Mallard Ct. Parker Co 80134 (720) 982-1513 .T(),h(-a)Al1C1ParFC rnm AIHA PAT proficient lab #262896 Sample # Volume (L) #Fields #Fibers Fiber Density f/mm2 Detection Limit f/cc & f/mm2 Fibers/cc 3185 — W — 01 910 100 7 8.92 .003 .004 3185 — W — 02 910 100 6 7.64 .003 .003 3185 — W — 03 910 100 6.5 8.28 .003 .004 3185—W-04 910 100 7.5 9.55 .003 .004 3185 — W — 05 910 100 6.- 8.28 .003 .003 3185 — BL — 06 0 100 1 1.27 7 f/mm2 BDL 3185 — BL — 07 0 100 0 0 7 f/mm2 BDL NIOSH 7400 Method Limit of Detection = 7 f/mm2 for filter area CDPHE (MAAL) Maximum Allowable Asbestos Level .oi f/cc BDL = Below Detection Limit Josh Berard Certification No.: 23015 has met the requirements of 25-7-507, C.R.S. and Air Quality Control Commission Regulation No. 8, Part B, and is hereby certified by the state of Colorado in the following discipline: Air Monitoring Specialist* Issued: May 15, 2018 Expires: May 15, 2019 • This cerrifrcute is valid an& with the possession of a current Division -approved trrtbring course certiJkarion in the discipline specified above. Colonia Deeppaarrttmment of Public fi aM andEnvirumnent ASBESTOS CONSULTING FIRM This certifies that All Clear Environmental Consulting Registration No.: ACF - 24131 has met the registration requirements of 25-7-507. C.R.S. and the Air Quality Control Commission Regulation No. R, Part B. and is hereby authoriatxl to perrorm ashestos consulting activities as required under Regulation No R. Part R, in the state of Colorado. Issued: December 17, 2018 Expires: January 02.2020 f TRAtIV ING 1775 West 55`i' Avenue Denver, CO 90221 303.410.4941 trainingchctom Certifies that Josh Berard / A,eN,-, Aree 1ie,�e,xwa SEAL Has Successfully Completed She 8 Hour Extension Course Titled: NIOSH SBPa (Sampling & Evaluating Airborne Asbestos Dust)' This course fulfills the mandatory onolysist training requirements specified in OSHA`s Asbestos Regulation for Construction & General industries j29CFR1926,1101 & 1910.10011. - Course Date: September 15, 2017 Certificate No.: E17-1636•Nt-CO No. of Hours: 9 Instructor: Brendan Hainsworth •RMS u Mem InitW rursrb s —.W- p2 r:rtwamlan em wYe.mow wae.mew Danaya Benedetto -Training Program Manager M, AM w v r . ko" th 77 *' r '+4q1 �l J i En✓irl�5pec Table of Contents ExecutiveSummary ........................................................................................................ 3 Introduction.....................................................................................................................4 SamplingProtocol........................................................................................................... 5 Summary of Laboratory Results...................................................................................... 7 Conclusion....................................................................................... .... 8 ........................... Appendices Appendix A Certifications Appendix B Photos Page 2 of 9 En lfir:pSpec Executive Summary ➢ EnviroSpec, LLC (EVS) Air Monitoring Specialists (AMS) conducted final visual inspections and a final air clearance within the residential structure located at 3185 Webster Street in Wheat Ridge, Colorado. IIIIUal anal visual InspeCti n, col luded VIII IVlay IY, LU 1 Uy IVII. IVlllillaGl \...IctJV LU did not pass due to remaining visual dust and debris. EVS's AMS Ms. Sheree Thomas -Porter returned May 15, 2019 to conduct another visual inspection. This visual inspection passed, and a final air clearance was conducted. Z Based on final visual insnectinn and analytical results for the final air clearance samples, it is the opinion of EVS that the air quality within the containment meets the Environmental Protection Agency (ENA) and Coiorado Department of Public Health and Environment (CDPHE) regulatory final air clearance standards at the time of this sampling event. Page 3 of 9 En aril:95Pec Introduction EVS's AMS conducted final visual inspections and a final air clearance within the residential structure located at 3185 Webster Street in Wheat Ridge, Colorado. Initial final viGival in-,nPrtinn rnnrliirtP.d nn Mav 14 ?(11q by Mr Mirhaal C;irrntti rim not pass due to remaining visual dust and debris. EVS's AMS Ms. Sheree Thomas -Porter returned May 15, 2019 to conduct another visual inspection. 1 his visual inspection passed, and a final air clearance was conducted. Page 4 of 9 En✓i�1�5pec Sampling Protocol Final visual inspection and final air clearance activities were performed following the removal of asbestos containing material (ACM). Final clearance activities were performed in accordance with the EPA, CDPHE regulations, and the National Institute r r -.-r_`_ _ _ _i � �_ _iii_ iw 1��r.� i� ��r.� -`�- - -1 of Safety an U3 Hearth (fvfvSn� 400 methuca. The final clearance inspection and air sarnpling were conducted by CDPHE certified AMS, Ms. Sheree Thomas -Porter, Certificate #11474. Final air clearance sampling was conducted using aggressive techniques outlined in n u.. n r �� EPA n Hazard � r_ rti i n s iri-. n� Appendix A cl the EPA Asbestos Hazard Emeryency Response Act (AHIE A) reyuiaburr (40 CFR Part 763), and as referenced in CDPHE Reg. 8. Aggressive techniques included the use of a leaf -blower and box fans to agitate the air. Clearance samples were analyzed for airborne fibers by Phase Contrast Microscopy (Pr`IUA ncr Nlr)-q" nnarhnA 7dnn i minn a nncitivo Phacc_rnntrnct mii-rncr•nno crrrn iinnorl with a Walton -Beckett graticule (Type G-22 for `A counting rules'). A quarter -wedge was cut from each sample filter and was examined at a magnification of 400x. Fibers greater than 5 microns in length, with a length -to -width (aspect) ratio equal to or greater than 3:1 were counted. Total fiber counts for each sample filter were divided by their ._____i'.._ __.__._�_ .._i. ..____ �ri__ .___..fie.__. __.___._a.__a, _.__ __._.__ ___._.______� ._ '_._ _r 1uspecuve 5arnple VolurrIes. rhe le5ufurry ccrrcehuaucrr5 were expre55eu frr teriil5 cf total fibers per cubic centimeter of air (fibers/cc). The final air clearance samples were analyzed by an AMS who is deemed proficient for Phase Contrast Microscopy (PCM) analysis under the American Industrial Hygiene Occnniatinn (DIHAI Prnfirionr,%/ Anahitinal Tactinn MATT nrnnram .............. ...... 1. ... .. .1 ............ ....� .. ......)......... . ,..,....Z, ,. ..I I �.... .. �..... ... The EVS AMS conducted a final visual inspection to verify the enclosure did not contain visible dust and debris. After passing the final visual inspection, the AMS collected five (5) PCM final air clearance samples and two (2) field blanks inside the containment. Page 5 of 9 Enpec LJL- Results of the PCM analysis were compared against EPA and CDPHE regulatory standards for final air clearances. The EPA and CDPHE require all final air clearance samples to be equal to, or less than, 0.01 fibers per cubic centimeter (f/cc) under PCM analysis In order to allow ure U01liaininent to be dismantled and cried released for public; access. At the time of the visual inspection, the containment was clean of visible dust and debris and all final air clearance samples were equal to or below 0.01 f/cc. n___ i •n rageU017 'IiArp5pec Summary of Laboratory Results Final air clearance samples were analyzed for airborne fibers by PCM in accordance with the NIOSH 7400 Method. PCM is not asbestos specific because it counts total fibers. Thus, it shows a worst-case scenario because all fibers are counted (carpet, cloth, hair, paper, asbestos, etc.). See table below for analytical results summary. HHL = below Keporung Limit LOU = Limit of Detection Based on final visual inspections and analytical results for the final air clearance _ ._ ._- ._ � - °` ° _ the - ._ �._ : _ ._ _ r r� ir+ that � `�- - -'-- quality - i"- - - - -,�,_ � ��_ - `�_ sar iples, it Is tie uprhnvhh uh Eve that the an quality witniil the containihieiht meters tile, EPA and CDPHE regulatory final air clearance standards at the time of this sampling event. Page 7of9 Summary of PCIVI SamplingResults 3185 Webster Street, Wheat Ridge, Colorado May 15, 2019 — drywall, tape, and joint compound in basement Sample Total Sample Location Average Flow Volume Fibers LOD Result Number Minutes Rate (L) per Field (f/cc 3185- Southeast bedroom 89 14.7 1308 0.002 8.5/100 0.003 Central southwest 3185- 89 14.3 1273 0.002 17/100 0.007 rooms 3185- Northwest bedroom 89 14.3 1273 0.002 10.5/100 0.004 3185- Middle room 90 14.3 1287 0.002 7/100 0.003 31 tib- Lenter Uu 14.3 126t U.UUL 1 U/1 UU U. UU4 3185- Field Blank 0 0 0 0 0 BRL 3185- Field Blank 0 0 0 0 0 BRL HHL = below Keporung Limit LOU = Limit of Detection Based on final visual inspections and analytical results for the final air clearance _ ._ ._- ._ � - °` ° _ the - ._ �._ : _ ._ _ r r� ir+ that � `�- - -'-- quality - i"- - - - -,�,_ � ��_ - `�_ sar iples, it Is tie uprhnvhh uh Eve that the an quality witniil the containihieiht meters tile, EPA and CDPHE regulatory final air clearance standards at the time of this sampling event. Page 7of9 En lfinpspec Conclusion This report was prepared by EVS at the request of and for the sole benefit of the client. The material in this report reflects the best judgment of EVS, in light of the information that was available at the time of preparation. TI_'_ .__ _ _ .t 11_ _ 1.____ 1 _ ♦I_ _ I' -__i I__ LI_ _ _ _--- __.._ _ I h's rupurt Is inu exclusive drIU-I Pre5erii pruperiy UI We Gllunl. In u1e eVerli UI any reuse or publication of any portion of this report, EVS shall not be liable for any damages arising out of such reuse or publication. Any use a third party makes of this report, or any reliance on or decisions to be made on it are the responsibility of such third party. EVS accepts no responsibility for damages, if any suffered, by any third party as a result I- -J 11_ • _ UI UCC:I51UIIS I11aUC U1 aLAIU116 UJKCiI UdbUU U11 11115 repUR. EVS accepts no responsibility and shall not be held liable for m -i -stakes or errors of the laboratories employed to analyze samples or their reported findings either published or verbal. Any contractor or consultant reviewing this report must draw his or her own rrnnt-h minnc rorinMinn fi irthar invactiriatinn nr ramarlintinn rlaamari naraccary No warranty or guarantee, expressed or implied; is made regarding the findings., conclusions or recommendations contained in the report. The limitations presented above supersede the requirements or provisions of all other contacts or scopes of work, implied or otherwise, except those stated or acknowledged herein. Should you have any questions concerning this project, please contact us. Page 8 of 9 EnecFP Regards, Michael Ciccotti, Senior Environmental Scientist; Michael 6a_)envi ro-spec. com Cell: 303.880.5716 Sheree Thomas -Porter, Environmental Specialist Sheree( enviro-spec.com Cell: 720.933.0853 Serina Schenker, Managing Partneri Seri na o-)enviro-spec.com Cell: 303.242.0711 EnviroSpec, LLC 780 Simms Street, Suite 101 Golden, Colorado 80401 Page 9 of 9 En�/ir ` ec Appendix A Certifications ACCLAIM ENVIRONMENTAL S E R V I C E S I N C 7959 Ulster Court, Thomton, Colorado 80602 Tel: 303.424.4647 Fax: 303.432.6669 CERTIFIES THAT SHEREE T -PORTER Has successfully completed the AIR MONITORING SPECIALIST — REFRESHER COURSE This course is approved by the Colorado Department of Public Health and Environment in accordance with the AQCC requirements of Colorado Regulation No. B. Course Date: 01/10/19 Exam Date: NIA Certificate No.: AE19-003-AMS-R 06 Expiration Date: 01/10/20 K. Jay G le sident ACCLAIM ENVIRONMENTAL S —ER V I C E S i N C 7959 Ulster Court, Thomton, Colorado 80602 Tel: 303.424.4647 Fax: 303.432.8669 CERTIFIES THAT MICHAEL CICCOTTI Has successfully completed the AIR MONITORING SPECIALIST — REFRESHER COURSE This course is approved by the Colorado Department of Public Health and Environment in accordance with the AQCC requirements of Colorado Regulation No. 8. Course Date: 01/10/19 Exam Date: NIA, / Certificate No.: AE19-003-AMS-R-05 Expiration Date: 01/10/20 K. Jay Gal LOresident En lliArpSPec Appendix B Photos r_- EnJir.pSpec chambers NAM nam City of Wheat Ridge E -Res. Window Replacement PERMIT - 201900822 PERMIT NO: 201900822 ISSUED: 04/30/2019 JOB ADDRESS: 3185 Webster St EXPIRES: 04/29/2020 JOB DESCRIPTION: Residential window replacement of 16 windows one in bedroom, 2 in master, 2 in office, 2 in bathroom, 1 in kitchen, 1 in family and 1 in living room. and 7 in basement. One door. U -factor .26. *** CONTACTS *** OWNER (720)329-9669 KAUTZ LISA MICHELLE SUB (303)934-4508 Jason Lewis 090396 Lifetime Windows & Siding *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 12,450.00 FEES Window Replacement 50.00 Total Valuation 0.00 Use Tax 261.45 ** TOTAL ** 311.45 *** COMMENTS *** *** CONDITIONS *** Both the front and back of this permit are required to be posted on the job site at all times. If the complete permit is not present, inspections WILL NOT be performed. Work shall comply with 2012 IRC & 2017 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. City of Wheat Ridge i% E -Res. Window Replacement PERMIT - 201900822 PERMIT NO: 201900822 ISSUED: 04/30/2019 JOB ADDRESS: 3185 Webster St EXPIRES: 04/29/2020 JOB DESCRIPTION: Residential window replacement of 16 windows one in bedroom, 2 in master, in office, 2 in bathroom, 1 in kitchen, 1 in family and 1 in living room. and 7 in basement. One door. U -factor .26. I , by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed rs 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 orisinalpermit fee. 1 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 Divrslo 6. The i a e o grantin f a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any appl eco or any 'n rice or regulation of this jurisdiction. Approval of work is subject to Held inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dina Kemp 6L From: no-reply@ci.wheatridge.co.us Sent: Monday, April 29, 2019 3:37 PM To: CommDev Permits Subject: Online Form Submittal: Residential Window/Door Replacement Permit Application Categories: Dina Residential Window/Door Replacement Permit Application This application is exclusively for RESIDENTIAL REPLACEMENT WINDOWS and DOORS - LIKE FOR LIKE ONLY. YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM AND WINDOW/DOOR CUTSHEET (SPEC SHEET) IN ORDER FOR THE PERMIT TO BE PROCESSED. Your Permit will be emailed to the email address provided below once it is processed. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. Is this application for Yes replacement window(s) and/or door(s) like for like? PROPERTY INFORMATION Property Address 3185 Webster Property Owner Name a elo Kautz- Williams Property Owner Phone Number (enter WITH dashes, eg 303-123-4567) Property Owner Email Address Attach Credit Card Authorization Form - **DO NOT ATTACH RANDOM DOCUMENTS" 720-329-9669 sour420diesel@gmail.com 3185 Webster St - CC Form.pdf CONTRACTOR INFORMATION 1 '$3/l -LrS Contractor Business Lifetime Windows and Siding Name Contractor's License 90396 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 303-934-4508 Number (enter WITH dashes, eg 303-123-4567) Contractor Email Address rebecca@lifetimewindowscolorado.com Retype Contractor Email rebecca@lifetimewindowscolorado.com Address DESCRIPTION OF WORK Number of window 16 windows and one door and/or doors being replaced Location of Bedroom 1 , Master 2 , office 2, bath 2, kitchen 1, family 1, LR window(s)/door(s) being door, basement 7 replaced (for example, master bedroom, kitchen, bathroom, etc): What is the u -value of the .26 window(s)/door(s)? City of Wheat Ridge requires the u -value to be .32 or better on windows.. Attach copy of 3185 Webster St - Order.pdf window/door cut sheets showing sizes and u -value Project Value (contract 12,450.00 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work 2 under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have been Yes authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying for Rebecca MacMillan Permit Email not displaying correctly? View it in your browser. OMS Ver. 0002.25.05 (Current) Product availability and pricing subject to change. LINE ITEM QUOTES W33875KAUT W13875KAUT Quote Number: XMUPPRV Architectural Project Number. The following is a schedule of the windows and doors for this project. For additional unit details, please see Line Item Quotes. Additional charges, tax or Terms and Conditions may apply. Detail pricing is per unit. n[.uCe»c»» n»ows As Viewed Frarn The Exteno Entered As: FS FS 671/2" X 36 3/4" Egress Information Width: 1413/64" Height, 33 37/64" Net dear Opening: 3.31 SgFt Performance Information U- Factor. 0.27 Solar Heat Gain Coefficient: 0.21 Visible Light Transmittance,. 0.49 Condensation Resistance:43 CPD Number: MAR -N -26S-01263-00001 ENERGY STAR: N, NC, SC, S esrae®a"b.ataevzw "va�ccrc»..,»oo"n Builrkrli,�r As Viewed From The Exterior Entered As: FS FS 68" X 36 3/4" Egress information Width: 24 21/64" Height: 33 37/64" Net Clear Opening: 3.34 SgFt Performance Information U -Factor. 0.27 Solar Heat Gain Coefficient: 0.21 Visible Light Transmittance: 0.49 Condensation Resistance: 43 CPD Number: MAR -N-265-01263-00001 ENERGY STAR: N, NC, SC, S Ebony Exterior Stone White Interior Infinity Insert Glider Triple Sash - XOX Frame Size 671/2" X 36 3/4" Inside Opening 67 7/8" X 37" Frame Sim Entry Method Is Exterior Frame Sim. Interior Frame Height is 1/2" leu than Exterior Frame Heigh. Left Sash IG - 1 Lite Low E3/ERS Capillary Tube Center Sash IG - 1 Lite Low E3/ERS Capillary Tube Right Sash IG - 1 Lite Low E3/ERS CapillaryTube White Sash Lock & Sash Pull Half Screen Ebony Surround Charcoal Fiberglass Mesh 31/4" Jambs ***Note: Capillary tubes will be added to ALL Low E glass types without Argon. 'Note: Unit Availability and Price Is Subject to change Ebony Exterior Stone White Interior Infinity Insert Glider Triple Sash - XOX Frame Size 68" X 36 3/4" Inside Opening 68 3/8" X 37" Frame Size Entry Method Is Exterior Frame Size. Interior Frame Height is 1/2" less flan Exterior Frame Height. Left Sash IG -1 Lite Inw E3/ERS Capillary Tube Center Sash IG - i Lite Low E3/ERS CapillaryTube Right Sash IG - 2 Lite Low EVERS Capillary Tube White Sash tock & Sash Pull Half Screen Ebony Surround Charcoal Fiberglass Mesh 31/4" Jambs ***Note: Capillary tubes will be added to ALL Low E glass types without Argon. ***Note! Unit Availability and Price is Subject to change OMS Ver. 0002.25.OS (Current) Processed on: 4/10/2019 9:12:01 AM Page 2 of 8 OMS Ver. 0002.25.05 (Current) Product availability and pricing subject to change. INFINITY �m•asaaror "[nor. [.....woo.[ Britt orY As viewed From The Exierii or Entered As: FS FS 68' X 241/2" Egress hxf mwtk n Width:3019/64" Height:2121/64" Net Clear Opening! 4.49 SgFt Performance Information V Factor'. 0.27 Solar Heat Gain Coefficient. 0.21 Visible Ught Transmittance: OA9 Condensation Resistance: 43 CPD Number: MAR -N-265-01263-00001 ENERGY STAR: N, NC, SC, S W13375KAUT WIM75KAUT Quote Number. XMUPPRV Architectural Project Number: Ebony Exterior Stone White Interior Infinity insert Glider - XO Frame Size 68" X 241/2' Inside Opening 68 3/8' X 24 3/4" Frame Size Entry Method Is Exterior From Size. Interior Frame Height is 1/2' less than Exterior Frame Height. Lek Sash IG -1 Lite Low E3/ERS Capillary Tube Right Sash IG -1 Lite Low E3/ERS Capillary Tube White Sash Lock & Sash Pull Half Screen Ebony Surround Charcoal Fiberglass Mesh 31/4' Jambs '"Note: Capillary tubes will be added to ALL Low E glass types without Argon. •"Note: Unit Availability and Price Is Subject to Change Line #4 Mark Unit: OFFICE II' Net Price: —I) h.Q" 1 _ J. EX �e ?� F1 N IT Ebony Exterior .�.b.auxaws Stone White Interior .....[ �.[w, ..woo.. Infinity Insert Glider - XO Brrh or! Frame Size 67 3/4" X 24 5/81 - Inside Opening 681/8" X 24 7/8' Frame Size Entry Method Is Exterior Frame Size. Interior Frame Height Is 1/2" [> lessLen Exterior Frame Height Lek Sash IG • 1 Lite tow E3/ERS AsMewed From The E9den o r CepBaryTube Entered Right Sash FS 67 3/4"" 2 X 24 5/8` IG - 1 Lite Egress Information Low E3/ER S Low E3JERube Width: 3011/64" Height: 2129/64" CapiWhite Net dear Opening: 4.49 SgFt Sash Lock &Sash Pull Performance Information Half Sween U Factor: 0 27 Ebony Surround Solar Heat Gain Coefficient; 0.21 Charcoal Fiberglass Mesh Visible Light Transmittance- 0.49 31/4' Jambs CPD ensationNumber: Resistance: 43 ***Note -Capillary tubes will be added to ALL Low E lass � ry 8 types without Argon. CPD Number. MAR -N-265-01263-00001 'eNote: Unit Availability and Price is Subject to Change ENERGY STAR: N, NC, SC, S rrrrrr�h..aYMM Briltf rG:k As VleweO From The Exterm Entered As: FS FS 513/4' X 36 3/4" OMS Ver. 0002.25.05 (Current) Stone White Interior Infinity Insert Glider - XO Frame Size 513/4" X 36 3/4" Inside Opening 521/8" X 37" Frame Sita Entry Method Is Exterior Frame Size. Interior Frame Height Is 1/2' Mss then Exterior Frame Height Leh Sash IG - lute Low E3/ERS Cap llaryTube Right Sash IG - i Lite Low E3/ERS Capillary Tube White Sash Lock & Sash Put Half Screen Ebony Surround Processed on: 4/10/2019 9:12:01 AM Page 3 of 8 OMS Ver. 0002.25.05 (Current) Product availability and pricing subject to change. Egress Information Width: 2211/64' Height. 33 37/64" Net Clear Opening: 5.17 SqR Performance Information U -Factor: 0.27 Solar Heat Gain Coefficient 0.21 Visible Light Transmittance: 0.49 Condensation Resistance: 43 CPD Number. MAR -N-265-01263.00001 ENERGY STAR: N, NC, SC, S `Mataa�r ! 8Lfl4 I As Viewed From The Exterior Entered As: FS FS 35 3/4' X 24 3/4" Egress information Width -1411/64" Helght:2137/64" Net Clear Opening: 2.12 SgFt Perfat ttnnee Information U -Factor: 0.27 Solar Heat Gain Coefficient 0.21 Visible Light Transmittance: 0.49 Condensation Resistance: 43 CPD Number. MAR-N-265-MZ53-00001 ENERGY STAR: N, NC, SC, S {[�CACCN CNt Y.NOOMf Entered As: FS FS 17 3/4" X 24 3/4" Egress hdormation OMS Ver. 0002.25.05 (Current) W13875KAUT W13875KAUT Quote Number: XMUPPRV Architectural Project Number: Charcoal Fiberglass Mesh 31/4" Jambs ***Note: Capillary tubes will be added to ALL LOW E glass types without Argon. ***Note: Unit Availability and Price Is Subject to Change Ebony Exterior Stone White Interior Infinity Insert Glider - XO Frame Size 35 3/4" X 24 3/4" Inside Opening 361/8" X 25" Frame Stu Entry Method Is Extarlor Frame Size. interior Frame Height Is 1/2" less then Exterior Frame Height. Left Sash IG -1 Ute Low E3/ERS Capillary Tube Right Sash IG -1 Lite Low E3/ERS Capillary Tube White Sash lock & Sash Pull Half Screen Ebony Surround Charcoal Fiberglass Mesh 31/4" Jambs ***Note: Capillary tubes will be added to ALL Low E glass types without Argon. ***Note: Unit Availability and Price Is Subject to Change Stone White Interior Infinity Insert Casement - Right Hand Frame Size 17 3/4" X 24 3/4" Inside Opening 181/8" X 25" IG - i Lite Low E3/ERS CapiharyTube Black Weather Strip White Folding Handle Easy Wash Hinges Interior Full Screen Stone White Surround Charcoal Fiberglass Mesh 31/4" Jambs ***Note- Capillary tubes will be added to ALL tow E glass types without Argon. ***Note: Unit Availability and Price is Subject to Change Processed on: 4/10/2019 9:12:01 AM Page 4 of 8 OMS Ver. 0002.25.05 (Current) Product availability, and pricing subject to change. Width: 7 25/64° Height: 19 IS/16" Net pear Opening: 1.02 SgFt Performance Information U -Factor. . 0.26 Solar Heat Gain Coefficient: 0.2 Visible Light Transmittance: OAS Condensation Resistance: 43 CPO Number: MAR -N-309.00863-00001 ENERGY STAR: N, NC, SC, S Bait for G e r t/ As Mimed From The Exterior Entered As: FS FS 3S 3/4" X 36 3/4" Egress Information Width: 1411/64" Height: 33 37/64" Net pear Opening: 3.30 Sgft Performance Information U Factor: 0.27 Solar Heat Gain Coefficient: 0.21 Vlsb'e Light Transmittance: 0.49 Condensation Resistance: 43 CPD Number: MAR -N-265-01263-00001 ENERGY STAR: N, NC, SC, S �.� MaaYUI •c"a.c."c"..+woo". As Viewed From The Exterior Entered As: FS FS 100' X 48 3/4" Egress hrformstion Width 22 21/64" Height: 45 37/64" Net Clear Opening: 7.07 SgFt Performance Information U -Factor: 0.27 W1387SKAUT W13875KAUT Quote Number: XMUPPRV Architectural Project Number: Ebony Exterior Stone White Interior Infinity Insert Glider - XO Frame Size 35 3/4" X 36 3/4" Inside Opening 361/8" X 37" Frame Size Entry Method Is Exterior Frame Size. Interior Frame Height Is 1/2" less than Exterior Frame HeW Left Sash IG -1 Lite Law E3/ERS CapillaryTube flight Sash IG - i Ute Low E3/ERS Capillarylube White Sash Lock & Sash Pull Half Screen Ebony Surround Charcoal Fiberglass Mesh 31/4" Jambs •'•Note: Capillary tubes will be added to ALL Low E glass types without Argon. ***Note: Unit Availability and Price Is Subject to Change Stone White Interior Infinity Insert Glider Tripe Sash - XOX Frame Size 100" X 48 3/4" inside Opening 1003/8" X 49" Frame Size Entry Method is Exterler Frame Sire. Interior Frame Helgirt Is 1/2" less than Exterior Frame Hoot. Left Sash IG-1Lite Law E3/ERS Capihwy Tube Center Sash IG -1 Lite Law E3/ERS Capillary Tube Right Sash IG - 1 Lite Low E3/ERS Capillary Tube White Sash Lock & Sash Pull OMS Ver. 0002.25.05 (Current) Processed on: 4/10/2019 9:12:01 AM Page 5 of 8 OMS Ver. 0002.25.OS (Current) W13875KAUT Product availability and pricing subject to change. W1387SKAUT Quote Number: XMUPPRV Architectural Project Number: Solar Heat Gain Coefficient: 0.21 Half Screen Visible tight Transmittance: 0.49 Ebony Surround Condensation Resistance: 43 Charcoal Fiberglass Mesh CPO Number: MAR -N-265.01263-00001 3 1/4" lambs ENERGY STAR: N, NC, SC, S '"Note: Capillary tubes will be added to ALL Low E glass types without Argon. ***Note: Unit Availability and Price is Subject to Change �b-At&RM "["UC["[Mt �nNOOri Active Inactive As Viewed From The Exterior Entered As: CN FS 71" X 82" Egress Information Width: 643/8" Height: 781/4" Net Clear Opening: 34.98 SgFt Performance Information U -Factor: 0.27 Solar Heat Gain Coefficient: 0.18 Visible Light Transmittance: 0.42 Condensation Resistance- 62 CPO Number: MAR -N-438-00004-00001 ENERGY STAR: N, NC, SC, S �•.-ssatvar 6rrilr for 4 i r� J As Viewed From The Eaderior Entered As: FS FS 30 3/4" X 161/4" Egress information Width: 12 43/64" Height 13 S/64" Net dear Opening: 1.06 SgFt Performance Information U -Factor: 0.27 Solar Heat Gain Coefficient 0.21 Visible Light Transmittance: 0.49 Condensation Resistance: 42 Stone White Interior Infinity Inswing French Door - XX Left Hand CN 6068 Rough Opening 72" X 821/2" Left Panel IG 1 Lite Tempered Low E3 w/Argon Right Panel IG - 1 Ute Tempered low E3 w/Argon Multi -Point Lode Cambridge Handle Satin Taupe Interior Primary Handle Set Cambridge Hand'e Satin Taupe Keyed Exterior Primary Handle Set Cambridge Handle Satin Taupe Interior Secondary Handle Set Cambridge Handle Satin Taupe Exterior Secondary Handle Set Satin Taupe Adjustable H'nges Swinging Screen Ebony Surround Charcoal Fiberglass Mesh "'Screen/Combo Ship loose Bronze Sill 6 9/16' Jambs Nadi ng Fin •••Note: Unit Availability and Price is Subject to Change Stone White Interior Infinity Insert Glider- XO Frame Size 30 3/4" X 161/4" Inside Opening 311/8" X 161/2" Frame Size Entry Method is Exterior Frame Size. Interior Frame Height is 1/2" less than Exterior Frame Height. Left Sash IG-1Ute Low E3/ERS Right Sash IG -1 Lite Low E3/ERS White Sash Lock & Sash Pull Half Screen Ebony Surround Charcoal Fiberglass Mesh 31/4" lambs `Note: Unit Availability and Price Is Subject to Change OMS Ver. 0002.25.05 (Current) Processed on: 4/10/2019 9:12:01 AM Page 6 of 8 OMS Ver. 0002.25.05 (Current) Product availability and pricing subject to change. CPO Number: MAR -N-265-03515.00001 ENERGY STAR: N, NC, SC, 5 BD �w.taaams "cwi.ea.awr w�weows Aid Is for fife As Viewed From The Exterior Entered As: FS FS 301/2" X 16" Egress IMomwtion Width:1135/64" Height:12 53/64" Net Clear Opening: 1.03 SgFt Performance Information U -Factor: 0.27 Solar Heat Gain Coefficient: 0.21 Visible Light Transmittance: 0.49 Condensation Resistance: 42 CPD Number: MAR -N-265-01515-00001 ENERGY STAR: N, NC, SC, S W1387SKAUT W1387SKAUT Quote Number: XMUPPRV Architectural Project Number: Net Price: Ebony Exterior Stone White Interior Infinity Insert Glider - XO Frame Size 301/2" X 16" Inside Opening 30 7/8" X 161/4" Frame Ske Entry Method is Exterior Frame Size. Interior Frame HeWd Is 1/2" lass than Exterior Frame ttelgM. Left Sash IG -1 Ute Low E3/ERS Right Sash IG -1 Lite Low E3/ERS White Sash Lock & Sash Pull Half Screen Ebony Surround Charcoal Fiberglass Mesh 31/4" Jambs ***Note. Unit Availability and Price is Subject to Change Project Subtotal Net Price: USD 0.000% Sales Tax: USD Project Total Net Price: USD OMS Ver. 0002.25.05 (Current) Processed on: 4/10/2019 9:12:01 AM Page 7 of 9 Date: ' City - . _ - Y6a,�q" Building & Inspection Services Division 7500 W. 29`h Ave., Wheat Ridge, CO 80033 Office, 303-235-2855 * Fax: 303237-8929 Plan Reviewff Fee: Inspection Line: 303-234-5933 Building Permit Application 1 11 1 11 I'll I I I, ''I Imp 1111111111ir � 11!111111'1 1111r,11111111 111111!111!1 i 11111 '111 lill! 111111111111 ill 1111!11 ill 11 ill .. ,... Property Address. IQ" . Property Owner (please print); Phone . Address. Ci!y, State, Phone Complete BOTH sideso NEW COMMERCIAL STRUCTURE Q ELECTRICAL SERVICE UPGRADE NEW RESIDENTIAL STRUCTURE 0 COMMERCIAL ROOFING COMMERCIAL ADDITION 0 RESIDENTIAL ROOFING RESDENTIAL ADDITION 0 WINDOW REPLACEMENT COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT OTHER (Describe) '14 Sq. FtJLF Stu's Gallons Amps Squares Other 3185 lA lP hgft- (9 of l �t INSPECTION RECORD Occupancy /Type INSPECTION REQUEST LINE: (303) 234 -5933 Inspections will not be performed unless this card is posted on the project site. Call the inspection request line before 3:00 p.m. to receive an inspection the following business day. Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Comments Initials Monolithic Slab Reinforcement Caissons Concrete Encased Ground (CEG) Footing /Stemwall P.E. Letter Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground /Slab Inspections Date Inspector Comments Initials Electrical (Underground) Sewer Service (Underground) Water Service (Underground) Plumbing (Below / In -slab) Heating (Below / In -slab) Do Not Cover Underground or Below /In -Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Comments omments Wall Sheathing Roof Sheathing Lath / Wall Tie Rough Electric .. Rough Plumbing Rough Mechanical Gas Piping Do Not Proceed Without Approval Of Above Rough Inspections Rough Framing Insulation Drywall Screw / Nail Final Inspections Date Inspector Comments Initials Final Electrical Final Plumbing s Final Mechanical Roof Final Building / Frame Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking ROW & Drainage / Public Works Dept. inspections call 303 - 235 -2846. For ROW and drainage inspections call 303 - 235 -2861. For fire inspections Fire Inspection / Fire Protection Dist. 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. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground /Slab Inspections Date Inspector Comments Initials Electrical (Underground) Sewer Service (Underground) Water Service (Underground) Plumbing (Below / In -slab) Heating (Below / In -slab) Do Not Cover Underground or Below /In -Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Comments omments Wall Sheathing Roof Sheathing Lath / Wall Tie Rough Electric .. Rough Plumbing Rough Mechanical Gas Piping Do Not Proceed Without Approval Of Above Rough Inspections Rough Framing Insulation Drywall Screw / Nail Final Inspections Date Inspector Comments Initials Final Electrical Final Plumbing s Final Mechanical Roof Final Building / Frame Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking ROW & Drainage / Public Works Dept. inspections call 303 - 235 -2846. For ROW and drainage inspections call 303 - 235 -2861. For fire inspections Fire Inspection / Fire Protection Dist. 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. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather ► i r. . CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office * (303) 237 -8929 Fax INSPECTION NO ICE Inspection Type Job Address /R ide sfer �r Permit Number f' n .,,� L L� � i - c ❑ No one available for inspection Time ? AM(PM) Re- Inspection required: Yes No *When corrections have been made, cal(t re -ir ptq at 234 -5933 Date: f Inspector: DO NOT REMOVE THIS NOTICE " 1 City of Wheat Ridge Residential Plumbing PERMIT - 111001 PERMIT NO: 111001 ISSUED: 08/22/2011 JOB ADDRESS: 3185 WE13STER ST EXPIRES: 08/21/2012 DESCRIPTION: Replace 40 gallon hot water heater * ** CONTACTS * ** owner 303/238 -6898 Carole Browning sub 303/343 -0032 Jeff Metz 02 -1428 DONE SERVICE GROUP, INC ** PARCEL INFO ** ZONE CODE: UA USE: UA SUBDIVISION: 0585 BLOCK /LOT #: 0/ ** FEE SUMMARY ** ESTIMATED PROJECT VALUATION: 1,527.00 FEES Permit Fee 63.90 Total Valuation .00 Use Tax 27.49 ** TOTAL ** 91.39 Conditions: Work shall comply with 2006 IRC & 2005 NEC. Per IRC Sec. R313, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. Carbon Monoxide detectors are required to be installed within fifteen(15) feet outside the entrance to each sleeping room. Subject to field inspection. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all ent i ti med within thr cument as parties to the work to be performed and that all work to be performed is disclosed in this doc ent)an� /omits ccompanying approved plans and specifications. or 1. T is per it was issued based on the information provided in the permit application and accompanying plans and sp 'cations 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. I£ this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re- issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. S. 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 e construed to be a permit for, or an approval of, any violation of an p vi of any appli ode or an dinance or regulation of this jurisdict on. Approval of work is subject specti on. Si atur of Chief Buildrn 0 'cal Date INSPECTION REQUEST ALINE: 303)234 -5933 BUILDING OF CE: (303)235 -2855 REQUESTS MUST BE E BY 3 M ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. 08/22/2011 MON 13:21 Q W � •` R 'o v m Ce (OftP 00 FAX 3033430039 DONE SERVICE GROUP City of Wheat Ridge Building Division 7500 W. 29" Ave., Wheat Ridge, CO 80033 Office: 303 - 235 -2855 * Fax: 303 -235 -2857 inspection Line: 303 - 234 -5933 Building Permit Application �ao1 /oo1 Date: Plan #: Permit #: Property Address: ?,&5 Property Owner (please print): Oos - d,� Zy - .`)YN �r\o, Phone: Mailing Address: (if different than property address) Address: Contractor: o ( 31� -- Contractor License #: oa� 4�� Sub Cbntrdbtorsc Electrical City License #: Plumbing City License #: Mechanical City License #: Company: Company Company: Exp. Date: Exp. Date: Exp. Date: Approval: Approval: Approval: Use of space (description): Construction value: Description Of work: (as calculated per the Building Valuation Data sheet) ^7b CY��,� �` ®� (� Plan Review (due at dme of submittal): $ Sq. FL /L.Ft added: Squares BTU's WC Gallons LAO Amps OWNERICONTRACTOR 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) PRINTNAME: SIGNATURE: Date: state, ;, ♦��4 City of Wheat Ridge Residential Plumbing PERMIT - 102302 PERMIT NO: 102302 ISSUED: 10/01/2010 JOB ADDRESS: 3185 WEBSTER ST EXPIRES: 10/01/2011 DESCRIPTION: Repair 10 of sewer line in yard only * ** CONTACTS * ** owner Carole Browning sub 303/696 -9599 Steve Wakeham 01 -9921 Pipeline Industries, Inc. ** PARCEL INFO ** ZONE CODE: UA SUBDIVISION: 0585 USE: UA BLOCK /LOT #: 0/ ** FEE SUMMARY ** - ESTIMATED PROJECT VALUATION: 2,850.00 FEES Permit Fee 93.35 Total Valuation .00 Use Tax 51.30 ** TOTAL ** 144.65 Conditions: Subject to field inspections. I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or re lations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, an allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and hat assume full responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ri e Ordinances, for work under this permit. Plans subject to field inspection. Signatur ontractor /owner date 1. This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the State of Colorado and to the Zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable ordinances of the City. 2. This permit shall expire 180 days from the issue date. Requests for an extension must be received prior to expiration date. An extension may be granted at the discretion of the Building Official. 3. If this permit expires, a new permit may be acquired for a fee of one -half the amount normally required, provided no changes have been or will be made in the original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes have been or if suspension or abandonment exceeds one (1) year, full fees shall be paid for a new permit. 4. No work of any manner shall be done that will change the natural flow of water causing a drainage problem. 5. Contractor shall notify the Building Inspector twenty -four (24) hours in advance for all inspections and shall receive written approval on inspection card before proceeding with successive phases of the job. 6. The issuance of a permit or the approval 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. All pla re is subject to field inspections. Signs t, hief Building Official date INS CTION 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. `t f , yam h eat LAC Date: COMMUNM DEVELOPMENT - Plan # Building & Inspection Services Division Permit # 7500 W. 29" Ave., Wheat Ridge, CO 80033 Office: 303 - 235 -2855 * Fax: 303 - 237 -8929 Inspection Line: 303 - 234 -5933 Building Permit Application P*4#rty Address: Tye Property Owner (please print): � /e 4 �yp� Phone: Mailing Address: (if different than property address) Address: City, State, Zip: Coptractor: /is)e 1✓(✓ Contractors City License #: Phone: �tyb �ontran #ohs: Electrical: Plumbing: Mechanical: City License # City License # City License # Uescniatlonoftnfork' Fl _ &fe- tzV-�d'l. Contract Value $ 7�8 &9 Review Fee (due at time of submittal): Squares _ZgL_ BTU's Gallons Amps Sq Ft. OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants; easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have mad and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge . codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. CIRCLE ONE: (OWNE NTRACT or (AUTHORIZED REPRESENTATIVE) j (OWNER) (CONTRACTOR) PRINT NAME: L "Ilf (/ SIGNATURE: -� - DATE: a i ? �.�. w,4 i l Bldg Valuation; $ JOB DATE E jL.AJNE INDUSTRIES INC. DATE P.O. Box 370 • Watkins, CO 80137 {l (303) 696- 599 EST " ^ " ^� Fax(303)671-6871 SERVICEMAN INVOICE# oi® 39636 JOB# CALL ORIGIN PO # -JQB1tJ,F.ORMATION' -, - ; BELLING INFORMATION NAME NAME ADD �/`" �_ ADDRESS CITY s ZIP p ( CITY STATE ZIP PHONE PHONE .OE$CRIPTION OF SERVICES- -' ESTIMATE ❑ WARRANTY Terms of Warranty: APPROVAL SIGNATURE COMMENTS: THANK ® SUBTOTAL TAX PLEASE PAY THIS AMOUNT b�J $ � o ITEMS NOT INCLUDED: Landscape, grass, sod, trees, bushes, flowers, plants, fence repair, decorative rock, utility conflicts, private utilities, sprinklers, waterlines, electrical, gas, etc. Not responsible for damage caused by unstable soil, cave -ins or any other complications. TERMS :Job cancellation fees will apply. Invoices are payable -1/2 down and balance upon completion of work performed. Any invoice not paid when due, shall incur interest at the rate of 18% per annum. in the event that it becomes necessary to collect any unpaid balance owed, Pipeline Industries, Inc. shall be entitled to receive all costs of collection, including reasonable attorney fees. Pipeline Industries, Inc. shall be entitled to assert a mechanic's lien for all unpaid materials and labor supplied to building projects pursuant to Colorado law. X SIGNATURE ACCEPTANCE OF INVOICE X SIGNATURE ❑ VISA ❑ M/C ❑ AMEX CARD # EXP APPROVAL # ❑ CASH ❑ CHECK# CHARGE A/R ACCOUNT # C~ q~y Y ~ w 0 w r~ W A in eo W W ::E s m :3 0 0 m n O 7 N S N G N v rn m ~ 3 d a m 0 0 O e~ 7 N '0 A .~i 0 :3 s, C- 0 a a a a (D N fA ~ n .e, .-j ~ ~ ~D c~ r-OL ~ K~ 0 0 (D l ! 0 N ~ ~ C ~ Z rt ~ O ~ 'v ~rn ~m ~ r ~ O W ~ gm L• Z N ~ 'v o m ~ ~ ~ w 0 42 N W N N co N N os ~ N 7 A p ~40 q Wn W OO S ~ N t ~ L~ fD o- (D CD m 3 v a rn 0 A ~ ~ N 'O N n w O 3 ~ C- 0 ~ Q a A N ~ -t c~D n ~ O ~ IJ r'h 0• m ~ N 'a (D 0 rq. W0 0 ~ , ~ N ~ w ~ N N 0 ~ W ~ N v < N ~ 3 0 ~ c z ~ v m m r a ic m m ~ ':k G,! N. gety of Wheat Ridge sidential Mechanic PERMIT - 060022 PERM T NO: 060022 ISSUED: 02/16/2006 JOB DRESS: 3185 WEBSTER ST EXPIRES: 08/16/2007 DESC IPTION: install 90% 80,000 BTU Furnaceremove old unit . CONTACTS gc 303/422-5308 Steve Brandt 02-1365 THE COOLER COMPP.NY owne 303/432-7973 Carole Browning P CEL INFO ZONE CODE: UA USE: UA SUBD VISION: UA BLOCK/LOT#: 0/ F E SUMMARY ESTIMATED PROJECT VALUATION: 2,500.00 FEES Per it Fee 108.30 Tot 1 Valuation .00 wo UTax 45.00 OTAL 153.30 Commients Cily of Wheat Ridye PRESCRI'TIVE 7iRGY CODE BOILERS 1 FURNACES A MINIMUM ' D% AFUE GAS WATER HEATERS A MINIMUM OF.60 kGY FACTOR ELECTRIC WATER NEATERS A MINfMUM OF.9:: EnERGY FACTOR SETBACK THERMOSTAT REQUIRED (EXCEPT HYDRONIC HEAT) R-27 WALLS • R-7tCEILINGS • R-79 CRAWLSPACES I he eby certify thaC Che setback dietances proposed by this permi[ applica[ion are accurate, and do no[ violate applicable oidi ances, rulee or regulationa of the City of Wheat Ridge or covenants, easements or restrictions oE record; that all meas remente shown, and allega[iona made are accurate; that I have read and agree to abide by all conditions printed on this appl cation and that I assume full responsibili[y for compliance with the Whea[ xidge Building Code (I.B.C) and all other ap ab whea Ri e O di c s, for work under this permit. Plans subject to field inspection. ~2 date 1. T is permit was i.esued in accordance with the proviaione aeC for[h in your application and is subjecC m the laws of Che . S ate of Colorado and to the Zoning Regulations and Huilding Codes of WheaC Ridge, Colorado or any other applicable o dinances of the City. 2. T is permit shall. expire if (A) the work authorized is not commenced within six[y (60) daya from issue date or (B) Che b ilding authorized is suspended or abandoned for a period of 180 days. 3. I thia permit expiree, a new permit may be acquired for a fee of one-half the amount normally required, provided no c angea have been or will be made in the original plane and specifications and any evepensiov or abandonment has not e ceeded one (1) year. if changes have been or if suepeneion or abandonmevt exceede one (1) yeaz, full Eees shall b paid for a new permit. 9.N work of any manner shall be done that will change the natural flow of water caueing a drainage problem. 5. C ntractor shall notify the Building Inspector twen[y-four (24) hours in advance for all inspectione and shall receive w itten approval on inspection card before proceeding with successive phases of the job. 6. T e issuance of a permit or the approval of drawings and specificationa shall not be construed to be a permit for, nor a approval of, any violation of the provisiona of the building codes or any other ordinance, law, rule or regula[ion. _~@,wubjecytCTi4,'3dnspections. A 1 plan review aace N RBQUEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855 MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION TFIE FOLLOWING BUSZNESS DAY. COMMWNITY DEVELOPMENT DEPARTMENT Building Permft Number: ~ pf WHEqT,~ gUILDING INSPECTION LINE • 303-234-5933 . -Date: a, CITY OF WHEAT RIDGE ~ 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80033. (303-235•2855) c~CORPO~ . lIFPl.66+LillQN Pxoperty Address: 5~,5' w E/~5 r~' yt S T Conhactox License No.: 23 yb -7 $ Company:7-hG dD o LC /L CU Phone: 3Q3 - Z'~Fs- E pr4 ~ Phone: &)3 - y- J!, 7F 7'~ OWNER/CONTRAGTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I BuUdinsr Deat Valuation Figure: I hereby certify.that the setback distances proposed by this permit application are accurate, and do not violate applirable ordinances, rules or regulallons of the City of Vyllle:$ Wheat Ridge or covenants, easements or restrictions of record; thatall measurements shown, and allegaUons made are accurate; Nat I have read and agrea to abida by all Pemut Fee:$ conditions printed on-this appllcation and that I assume full responsibility for planReviewFee:$ compliance with the Wheat Ridge Building Code (I.B.C) and all other appliwble Wheat Ridge Ordinances, for work undar this permit. Plans subject tol fiei inspectlon. ~ t~c,/~a a,l~ceTF 2-14 -m Total:$ (OWNER)(CONTRACTOR):PRINTED DATE Use of Space (description): Descriptionofwork-~`L~2~~ pD o~ Sq.Pt.added DEPARTMENT USE ONL ZONING COMMENTS: Approval: Zoning: B4ILDING COMMENTS: . Approval: pUeLIC WORKS COMMENTS: Approval: Approval: ~ )RE DEPARTMENT COMMENTS SIC: Sq.Ft.: Watis: Roof: Stories: . Residentiai Units: Electrical License No: Plumbing License No: Mechanical License No: Company: Company: Company: Expiration Date: Expiration Date: Expiration Date: Aoproval• Approval: Approval: (1) ThIs pertnitwas issued in accordance wlth the provisions setforth in your applieation and is subjectto the laws of the State of Coloredo and to Ne ZoninO Reguladons and Building Codes of Wheat Ridge, Coloredo or any other applicable ordinances of cne ciry. (p) This permit shall, expire if (A) the work authorized Is not commenced within siMy (90) days finm 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-half the amount nortnally required, provided no changes have baen orwill be made in the original plans and specifications and anysuspension orabandonment has not exceeded one (1) year. If changes have been or if suspension or abandonment exceeds one (1) year, full fees shall be paid fora new permit (4) No work of any mannar shall be done that will change the natural flow of watar causinga drainage problem. (5) Contractor shall notlfy tha Bufldin9 Inspactor iwenty-four (24) hours In advance for all inspections and shall receive written approval on fnspection eard before proceeding with successiva phases of the Job. (g) The issuance of a permit or the approval of drewings and spaciflcatlons shall not ba construed to be a permit for, nor an approval of, anyviola8on ofthe provislons ofthe 6ullding codes or any other ordinance, iaw, rule or regulation. All plan review Is subJeM to fleid inspections. . Chfef Buildina Official