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HomeMy WebLinkAbout3553 Simms StreetFrom: no-reolvCalci.wheatridae.co.us To: CommDev Permits Subject: Online Form Submittal: PERMIT APPLICATION Residential Window/Door Replacement Date: Friday, April 29, 2022 2:52:46 PM CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Report any suspicious activities to the IT Division. PERMIT APPLICATION Residential Window/Door Replacement 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 3553 Simms St Property Owner Name Kelly Shea Property Owner Phone 303-204-9351 Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email kos.molly@gmail.com Address Attach City of Wheat Shea CC Auth.Ddf Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" CONTRACTOR INFORMATION Contractor Business champion Window co of Denver Name Contractor's License 020146 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 720-974-1403 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email shemans@getchampion.com Address Retype Contractor shemans@getchampion.com Email Address DESCRIPTION OF WORK What is being replaced Windows, Doors Number of window 8 and/or doors being replaced Location of Dining, Kitchen, Utility, Basement window(s)/door(s) being replaced (for example, master bedroom, kitchen, bathroom, etc): What is the u -value of .28 the window(s)/door(s)? City of Wheat Ridge requires the u -value to be .30 or better on windows.. Attach copy of Shea Ddf window/door cut sheets showing sizes and u - value Attach any additional Field not completed. documentation Attach any additional Field not completed. documentation Project Value (contract 12327.00 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 under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have Yes been authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying for Steve Hemans Pe rm it Email not displaying correctly? View it in your browser. A i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office _1�9� INSPECTION NOTICE Inspection Type: Job Address: Permit Number: ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections are complete, schedule re -inspection online. Date: Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: } Job Address: 5 -` Permit Number: C)C) C_ C, U ❑ No one available for inspection: Time I' : t AM/PM Re -Inspection required: Yes No When corrections are complete, schedule re -inspection online. Date:' �1 Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office p INSPECTION NOTICE Inspection Type: !L +rWUC- -\ Job Address: (- Permit Number: O Do b O tom; 0- C/ ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: http://www. cL wheatridge. co. us/inspection Date: Inspector: 1 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: j. Job Address: e , Permit Number: -` ❑ No one available for inspection: Tin<V Re -Inspection required: Ye "When corrections have been made, callot'kre-insx �^ Gge Inspecto"� AM/PM at 303-234-5933 i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Permit Number: RRF . S ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes :IVa When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. uslinspection Date: ' �� ��" Inspector: ' DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division ;(303) 235-2855 Office p i INSPECTION NOTICE t� Inspection Type: 0- ay�" ^r' Job Address: �S `S, ��� m� c, ► Permit Number:y D U o C) fr" ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes When corrections have been made, schedule for re -inspection online at: http://www.ci. wheatridge. co. uslinspection Date: - (b 1 i Inspector: ' DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTQN NOTICE Inspection Type: E � .�� '`� Job Address: Permit Number: ' 2stN cog�p y Z!j MERNEWMATWIMISGJ �.�I;r t►i�if.� ❑ No one available for inspection: Timet Q/PM Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: http://www.ci.wheatridge.co.ueinsp4tion Date: ��lnspO( City of Wheat Ridge Homeowner Interior Remodel PERMIT - 202000424 PERMIT NO: 202000424 ISSUED: 03/05/2020 JOB ADDRESS: 3553 Simms St EXPIRES: 03/05/2021 JOB DESCRIPTION: Kitchen remodel - replace cabinets, countertops, backsplash and flooring; remove door/wall to laundry room; replace exterior doors; build new half wall for laundry plumbing; add can lighting under cabinets; Demolition will include wall to laundry room; homeowner will be doing abatement - 256 sq ft total REVISION: Electrical service change - 200 amps; Added valuation: $2,250.00 *** CONTACTS *** OWNER (303)949-3062 BUTLER ADRIEN K SUB (720)458-8411 SCOTT BERKMAN 080190 CURRENT INSTALLATIONS SUB (303)422-6606 JIM SANDERS 018083 SANDERS & JOHNSON *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 39,350.00 FEES Total Valuation 0.00 Plan Review Fee 384.51 Use Tax 826.35 Permit Fee 614.55 ** TOTAL ** 1,825.41 *** COMMENTS *** *** CONDITIONS *** I, the property owner, by my signature, attest that I currently reside at the project property, intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers. If professionals are hired, those contractors are licensed with the City of Wheat Ridge and are listed on the permit. NOTE: Consultations and inspections will only be performed with the homeowner of record present. All roughs to be done at Framing Inspection. Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections. 41 City of Wheat Ridge Homeowner Interior Remodel PERMIT - 202000424 PERMIT NO: 202000424 ISSUED: 03/05/2020 JOB ADDRESS: 3553 Simms St EXPIRES: 03/05/2021 JOB DESCRIPTION: Kitchen remodel - replace cabinets, countertops, backsplash and flooring; remove door/wall to laundry room; replace exterior doors; build new half wall for laundry plumbing; add can lighting under cabinets; Demolition will include wall to laundry room; homeowner will be doing abatement - 256 sq ft total REVISION: Electrical service change - 200 amps; Added valuation: $2,250.00 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 ermit. 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 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, po plans and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4, No work of any manner shall be performed that shall results in a 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 perm' shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or. ordinanceo. 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 Wheat Ridge O3/l?/2O2O 15:11 C0BA CDAO22494 AHOUNT BPSP 3553 Simms St 7O.25 APPL/P[KMIT NU: 202OOO424 ��H CU0E: 728���3 TOTAL 7O.25 Kimberly Cook ao�,ot�Nau r�V,;�, From: no-reply@ci.wheatridge.co.us Sent: Tuesday, March 17, 2020 2:27 PM To: CommDev Permits Subject: Online Form Submittal: Residential Electrical Service Change/Upgrade Permit Application Categories: Kim Residential Electrical Service Change/Upgrade Permit Application This application is exclusively for RESIDENTIAL ELECTRICAL SERVICE CHANGE OR UPGRADE (200 amps or less). YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN ORDER FOR THE PERMIT TO BE PROCESSED. Your Permit will be emailed to the email address provided below once it is processed. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. Is this application for Yes electrical service change or upgrade - 200 amps or less? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123-4567) Attach Credit Card Authorization Form - **DO NOT ATTACH RANDOM DOCUMENTS** 3553 Simms Street Adrien Butler 303-949-3062 wheatridge cc authorize 001.pdf CONTRACTOR INFORMATION Contractor Business Current Installations Name I Contractor's License 80190 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 720-458-8411 Number (enter WITH dashes, eg 303-123-4567) Contractor Email Address lisa@current-installations.com Retype Contractor Email Address DESCRIPTION OF WORK Is this an electrical service upgrade or change? Number of Amps Location of upgrade/change (garage, house, etc) lisa@current-installations.com Upgrade rme house Provide additional details, homeowner permit #202000424 if needed. Project Value (contract 2,000 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT 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. I understand that work may not begin on this property until a permit has been issued and posted on the property. Yes Yes i 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 Lisa M Patterson Permit Email not displaying correctly? View it in your browser. City of Wh6at -114�d�c COMMUNITY DEVELOPMENT SUBCONTRACTOR AUTHORIZATION FORM Electrical Subcontractor 'i'his form must he completed & signed by the ELEC'TRIC'AL SUBCONTRACTOR performing electrical work on site. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: 3)30 v (General contractor: .5p C'o n S tyv ,-1 S C) (vlGt S 6Q0-qa1-003?,) . llam 4 IKE$] §:JWAIKN 31 W 1 3XION&I 1t u Company Name: L40 e lechi( U Contact Phone It: Wheat Ridge Contractor License #. 190ii l (required field) State License #: -4 )t Master License #: ` Q)^29 PI -No Printed Na of Authorized Agent Signatue u o 'zed Agent Date i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Permit Number: ❑ No one available for inspection: Time ! 'r r' AM/PM Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge.co. uslinspection Date: '' t L I o 3 v Inspector:_ DO NOT REMOVE THIS NOTICE City of W heat j�idge COMMUNITY DEV[LOPMENT SUB -CONTRACTOR AUTHORIZATION FORM This form must be signed by each sub -contractor. This form will not be accepted with missing information. Subcontractor's City of Wheat Ridge License number must be provided in the applicable space.. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address:Permit General Contractor:_ 4z Electrical Sub -Contractor Company Name: State License #: Wheat Ridge License #: Signature of Authorized Agent Plumbing Sub -Contractor Company Name: State License #: Phone #: Master #: (re(luired field) Date Phone #: Master #: Wheat Ridge License #: __ (required field) Signature of Authorized Agent Mechanical Contractor Date Company Name:' ° �ryPhone:_— Wheat Ri��eLi:c:e #:[�[�'zj (required field) S' t e of Au ized Agent Date City of W heat �dgei COMMUNITY DEVELOPMENT SUBCONTRACTOR AUTHORIZATION FORM Electrical Subcontractor This form must be completed & signed by the ELECTRICAL SUBCONTRACTOR performing electrical work on site. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: 5553 'Di MM5 General Contractor: - /-men FORM WILL NOT BE ACCEPTED WITH MISSING INFORMATION Company Name:Gdff��T,�i&_I)A'0►& Contact Phone #:�—��-15*) Wheat Ridge Contractor License #: %0 1 ` 0 (required field) State License #: te'O Master License #: c� Printed Name of Authorized Agent Signature of Authorized Agent Date - City of Wheat Ridge Homeowner Interior Remodel PERMIT - 202000424 PERMIT NO: 202000424 ISSUED: 03/05/2020 JOB ADDRESS: 3553 Simms St EXPIRES: 03/05/2021 JOB DESCRIPTION: Kitchen remodel - replace cabinets, countertops, backsplash and flooring; remove door/wall to laundry room; replace exterior doors; build new half wall for laundry plumbing; add can lighting under cabinets; Demolition will include wall to laundry room; homeowner will be doing abatement - 256 sq ft total *** CONTACTS *** OWNER (303)949-3062 BUTLER ADRIEN K SUB (720)458-8411 SCOTT BERKMAN 080190 CURRENT INSTALLATIONS SUB (303)422-6606 JIM SANDERS 018083 SANDERS & JOHNSON *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 37,100.00 FEES Total Valuation 0.00 Plan Review Fee 384.51 Use Tax 779.10 Permit Fee 591.55 ** TOTAL ** 1,755.16 *** COMMENTS *** *** CONDITIONS *** I, the property owner, by my signature, attest that I currently reside at the project property, intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers. If professionals are hired, those contractors are licensed with the City of Wheat Ridge and are listed on the permit. NOTE: Consultations and inspections will only be performed with the homeowner of record present. All roughs to be done at Framing Inspection. Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections. A r City of Wheat Ridge Homeowner Interior Remodel PERMIT - 202000424 PERMIT NO: 202000424 ISSUED: 03/05/2020 JOB ADDRESS: 3553 Simms St EXPIRES: 03/05/2021 JOB DESCRIPTION: Kitchen remodel - replace cabinets, countertops, backsplash and flooring; remove door/wall to laundry room; replace exterior doors; build new half wall for laundry plumbing; add can lighting under cabinets; Demolition will include wall to laundry room; homeowner will be doing abatement - 256 sq ft total I, by my signature, do hereby attesVA�at the work to be performed shall comply with all accompanyingg approved plans and specifications, applicable building codes, an 1'applicable municipal codes, policies and procedures, and that I,, tl7e legal owner or have been authorized by the legal o perty and am authorized to obtain this permit and perform the work described and approved in conjunction with this,�ppermi st t le ally authorized to include all entities named within this document as parties to the work to be pertor � • l to r ormed is disclosed in this document and/or its' accompanying approved plans and specifications. .3/lil20z0 Sigdature of OWNER or CONTRACTOR (Circle one) Date I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. Thispermit 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 a permit for, or an approval of, any violation of any provision of any _Wlicable code Irimy ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature cif Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of Wheat Ridge Homeowner Interior Remodel PERMIT - 202000424 PERMIT NO: 202000424 ISSUED: 03/05/2020 JOB ADDRESS: 3553 Simms St EXPIRES.. 03/05/2021 JOB DESCRIPTION. Kitchen remodel - replace cabinets, countertops, backsplash and floorings remove door/wall to laundry room; replace exterior doors; build new half wall for laundry plumbing; add can lighting under cabinets Demolition will include wall to laundry room; homeowner will be doing abatement - 256 sq ft total *** CONTACTS *** OWNER (303)949-3062 BUTLER ADRIEN K *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE. UA J Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 J *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 37,100.00 FEES Total Valuation 0.00 Plan Review Fee 384.51 Use Tax 779.10 Permit Fee 591.55 ** TOTAL ** 1,755.16 *** COMMENTS *** *** CONDITIONS *** I, the property owner, by my signature, attest that I currently reside at the project property, intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers. If professionals are hired, those contractors are licensed with the City of Wheat Ridge and are listed on the permit. NOTE: Consultations and inspections will only be performed with the homeowner of record present. All roughs to be done at Framing Inspection. Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections. City of Wheat Ridge Homeowner Interior Remodel PERMTT - 202000424 .Q PERMIT NO: 202000424 ISSUED: 03/05/2020 JOB ADDRESS: 3553 Simms St EXPIRES: 03/05/2021 JOB DESCRIPTION: Kitchen remodel - replace cabinets, countertops, backsplash and flooring; remove door/wall to laundry room; replace exterior doors; build new half wall for laundry plumbing; add can lighting under cabinets; Demolition will include wall to laundry room; homeowner will be doing abatement - 256 sq ft total 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 is disclosed in this document and/or its° accompanying approved plans and specifications. Signature of V ER r CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Budding Official and may be subject to a fee equal to one-half of the 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 Budding Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable code or andinance or re,gillation 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 e W heat Fide ��(, MUNITY DLVELOI MEN f 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: permits .ci.wheatridge.co.us FOR OFFICE USE ONLY Date: n/ Plan/Permit # O �D /r> q)4 Plan Review Fee: t g �/-d. 'S U ►° Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: S-5-1-5,3 '5"n7n4 S 4-re-eI Property Owner (please print):�pQr�i2✓I L�u�f�� Phone: _3e23 -9y2 3� L Property Owner Email: GLr e'� C h Q n otor+�GL 1 f Cv� Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address Citv, State, Zi Architect/Engineer: YZ/d Architect/Engineer E-mail: Contractor Name: 111/A City of Wheat Ridge License #: Contractor E-mail Address: For Plan Review Questions & Comments (please print): Phone: Phone: CONTACT NAME (please print): AGtt'ie-o i�u�1� Phone: 3G3—��J9�3o�2 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. ��;Ch2vt �wtoc(eI bnfS, sLacks i -glace_ d / ' ���/;ances.,Cew�o✓c��/��all /4o lcLkr'ds_Iydors SGdrAt e m11) 6 -Dor). ✓1 E? 0t � I1 tpr iGi(.<v�lf!(� (u lJ�✓i in kr 10/' c,Qll, ��� r�.�ocQel �cZ�S�I;�tiF;nq 3'�.�ciy S�v� �es�C�t��ineF urtd��-✓�wtin t9� GL2mY����iD✓t: �( � ICLrt � roo,,, 4o � /Cvnatlt t�S�vt� Dt�H i iQ l�l.i.i'"d p /J l / CJCOrv� ✓�rG�� 9n5 `� 0 5 0 Dt �Cl1�rd� n� `fa 60 2t j,_IQq t d /"CE/1 13, ;r' ��"l L Sq. Ft./LF 2 �C� 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) $ Z-� , /0 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE. OWNER (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): �J DATE: ozz S/ZOZo Printed Name: Z< 6r 41o_—� ZONING COMMMENTS: Reviewer: BUILDING DEP ENT OMM TS: Reviewer: )Pvu PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CR CONSTRUCTION TYPE: V �J �v Building Division Valuation: W City of `Wh6atI�idge COMMUNITY DEVELOPMENT SUB -CONTRACTOR AUTHORIZATION FORM This form must be signed by each sub -contractor. This form will not be accepted with missing information. Subcontractor's City of Wheat Ridge License number must be provided in the applicable space. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: General Contractor: Electrical Sub -Contractor Company Name: Permit #: Phone #: State License #: Master #: Wheat Ridge License #: (required field) Signature of Authorized Agent Date Company Name: Phone #: State License #: Master #: Wheat Ridge License #: (required field) Signature of Authorized Agent Date Company Name: Phone: Wheat Ridge License #: (required field) Signature of Authorized Agent Date p � City of Wh6atpsid e COMMUN iTY DEVELOPMENT Official Certification of Property Owner Permit THIS IS TO CERTIFY that I, the property owner, by my signature, attest that I currently reside at the project property, or intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers, or, if hiring sub -contractors, list them on the permit. Consultations and inspections will only be performed with the homeowner of record present at the project property. Property Owner(s): Adrien Butler Project Property: 3553 Simms St, Wheat Ridge, CO 80033 Notarized signature of Applicant State of Colorado } County of :SO -Ppm } ss The foregoing instrument was acknowledged by me this �5�4day of F 2020 by ( & ► Ln &Jr1.p r ELIZABETH K KNUDSEN NOTARY PUBLIC STATE OF COLORADO MY COMMISSIOIVIEXPIR S JUNE 24, 2022 My Commission Expires Pe / 2Li /20L2 Nota/Public Property Information Adrien Butler 3553 Sims Street Wheatridge CO 80033 Property Type Residential PH 303-949-3062 Prepared By EnvioCore LLC Asbestos Consulting Firm No. 21660 1685 S. Colorado Blvd Denver, CO 80124 303-GoEnvio (463) 6846 www.goEnvioCore.com info@qoenviocore.com Conducted By John Peralta Asbestos Building Inspector Cert. No. 24339 Inspection Information Inspection Date 02-19-2020 Arrival Time 11:00 AM Report Date 02-21-2020 Inspection # 0220-32 Butler, Adrien Protocols Followed Asbestos AHERA Lab Information ATC Group Services LLC 8985 E Nichols Ave Suite 350, Centennial, CO 80112 303-799-6100 Asbestos NVLAP Cert # 102031 Inspection Report 3553 Sims Street fC:ore ENVIRONMENTAL City of Wheat Ridge Building Divison,�` en )q Core PAGE 1 OF 23 C_ N,'. RCiNMFNr,, N5i%F_-_: 1 it N' Table of Content] Definitions.................................................................................................................................................... 3 KeyTerms.................................................................................................................................................... 3 LimitedInspection Summary .....................................................................................................................4 General................................................................................................................................................................ 4 Asbestos............................................................................................................................................................... 4 Purpose and Scope of Inspection.............................................................................................................4 General................................................................................................................................................................ 4 Asbestos............................................................................................................................................................... 4 Background................................................................................................................................................5 Sampling.....................................................................................................................................................5 Asbestos Results Reporting........................................................................................................................6 Asbestos Inspection Conclusion...............................................................................................................6 Closing......................................................................................................................................................... 7 InspectionPhotos.......................................................................................................................................8 LabResults.................................................................................................................................................10 Inspection Certifications..........................................................................................................................22 P-nv4 ore PAGE 2 OF 23 Definitions 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. b. The terms "Work Activity" shall mean any construction, renovation, remediation, decontamination, cleanup, or other work. Key Terms 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. b. 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 Containina Building Material" or "ACBM" shall mean Asbestos Containnig Materials that has been used for construction or improvement of a building or other structure. Core PAGE 3 OF 23 13. The term "Certified Asbestos Consultina 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. Limited Inspection Summary 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. General 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 env Core PAGE 4 OF 23 FNV . )�..�-N=� i_ n - -iahs representative bulk samples were similar materials, but this does not guarantee that materials of similar appearance are of the same 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. The inspector was called to the subject property by Adrien Butler, Owner. Mr. Butler was concerned about asbestos containing building materials in the affected areas of the building. Per Mr. Butler, suspect asbestos containing building materials to be disturbed in the scope of work include: The affected materials sampled: - Tile - Thin Set Mortar - Texture - Joint Compound The affected areas include: Kitchen - Laundry Room 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. amplin Using methods that are generally accepted in the industry, the Certified Inspector determined that it was necessary to collect 9 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 Aftached Photos (Figure 1 etc.) PAGE 5 OF 23 r;1 v Asbestos Results Reporting Table 1: Table of asbestos samples taken during inspection with lab results. ND = Non Detected, (Asbestos Materials Could became Friable during Renovation J Demolition, If this occurs the friability car. change from Non -Friable o Friable and all state and federal regulation shall be followed) 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 found in the samples analyzed by the laboratory. The affected building materials DO 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 b OF Zs 2HMCEop 3553-BS1-01 To Kitchen - Misc. - Tile & Non- Good 3553 -BSI -02 Backsplash Thin Set Mortar ND N/A N/A Friable Condition 40 N/A 3553-FC1-01 Kitchen & To Laundry Misc. - Tile & ND N/A N/A Non- Good 300 N/A 3553-FC1-02 Room - Floor Thin Set Mortar Friable Condition 3553 -SMI -01 Laundry SM - To Room - Wall gKitchen - , Orangepeel 3% N/A N/A Friable Good Condition 200 3% Chrysotile in Texture 3553 -SMI -03 Wall D Texture 3553 -JCI -01 Laundry To Room, Misc. - Joint 3% N/A N/A Friable Good 100 3% Chrysotile in Texture & 3553 -JCI -02 Kitchen Compound Condition Joint Compound Table 1: Table of asbestos samples taken during inspection with lab results. ND = Non Detected, (Asbestos Materials Could became Friable during Renovation J Demolition, If this occurs the friability car. change from Non -Friable o Friable and all state and federal regulation shall be followed) 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 found in the samples analyzed by the laboratory. The affected building materials DO 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 b OF Zs 2HMCEop 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, John Peralta Certified Inspector EnvioCore LLC, Environmental Consulting Asbestos Building Inspector Cert. No. 24339 env'Core PAGE 7 OF 23 +`.•. 11(JN M E N`Al. R IF i_. 1i0 Figure I - Overview of Address Fiaure 2 - Overview of Kitchen Backsplash Figure 3 -Sample location #I Figure 4 -Sample location #2 Figure 5 - Overview of Laundry Room enykCore PAGE 8 OF 23 Clillrl I I f- _ Figure 6 - Sample location #I Figure 7 -Sample location #2 Figure 9 - Sample location #2 Figure 8 -Sample location #I Figure 10 -Sample location #3 Figure I I -Sample location #I envii -ore PAGE 4 OF 23 Figure 12 -Sample location #2 :STC ANALYTICAL REPORT Prepared for: EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver, CO 80222 Project: 0220-32 3553 Sims Street Order No.: 0030389 Report Date: 02/21/2020 ATC Group Services LLC 8985 E. Nichols Avenue, Suite 350, Centennial. CO 80112 Ph: 303-799-6100 enyWf ore PAGE 10 of 23 8985 E. Nichols Avenue. Suite 350 Centennial, CO 80112 A C Phone +1 303 799 8100 rAkT rFax 1 303 799 3441 www. atc g rou ps a nti c es. c om PLM REPORT SUMMARY NVLAP Lab Code 102031 Customer: AIHA lab Code 1015361536 Chad Moore ATC Job No.: 0220-32 EnvioCore Environmental, LLC Batch No.: 0030389 1685 S. Colorado Blvd. Report Date: 02/21/2020 Denver CO 80222 Sample Date: 02/20/2020 Project: 0220.32 3553 Sims Street Date Analyzed: 02/21/2020 Customer Project No,: Identification: N/A Test Method: 600/R-93/116, 40 CFR, Part 763, Appendix E to Subpart E Page 1 of 4 Client No. Lab No. Sample Description/ Location Asbestos Content 3553-BS1-01 0030389-001 LAYER 1 None Detected Tile -Glass, Clear, 24°C Kitchen- Backsplash 3553-BS1-01 0030389-001 LAYER 2 None Detected Mastic. Tan Kitchen- Backsplash 3553-BS1-01 0030389-001 LAYER 3 None Detected Thin Set Mortar, Off White Kitchen- Backsplash 3553-BS1-02 0030389-002 LAYER 1 None Detected Tile -Glass, Black Kitchen- Backsplash 3553-BS1-02 0030389-002 LAYER 2 None Detected Mastic, Tan Kitchen- Backsplash 3553 -BSI -02 0030389-002 LAYER 3 None Detected Thin Set Mortar, Off White Kitchen- Backsplash 3553-FC1-01 0030389-003 LAYER 1 None Detected Ceramic Tile, Brown, 24`C Kitchen & Laundry Room- Floor 3553-FC1-01 0030389-003 LAYER 2 None Detected Mortar/Thin Set, Gray Kitchen & Laundry Room- Floor These samples were analyzed by layers. Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only if it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) — materials which are friable or may become friable — be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full, and should not be used as a scope of work for abatement without consulting with ATC. )m ore PAGE 11 OF 23 8985 E. Nichols Avenue, Suite 350 Centennial, CO 80112 AVA C Phone -1303 799 6100 kT Fax -1303 799 3441 www.atcgroupseMces.com PLM REPORT SUMMARY NVLAP Lab Code 102031 Customer: AIHA lab Code 1015361536 Chad Moore ATC Job No.: 0220-32 EnvioCore Environmental, LLC Batch No.: 0030389 1685 S. Colorado Blvd. Report Date: 02/21/2020 Denver CO 80222 Sample Date: 02/20/2020 Project: 0220-32 3553 Sims Street Date Analyzed: 02/21/2020 Customer Project No.: Identification: N/A Test Method: 600/R-93/116, 40 GFR, Part 763, Appendix E to Subpart E Page 2 of 4 Client No. Lab No. Sample Description/ Location Asbestos Content 3553-FC1-02 0030389-004 LAYER 1 None Detected Ceramic Tile, Brown, 24`C Kitchen & Laundry Room- Floor 3553-FCI-02 0030389-004 LAYER 2 None Detected Mortar/Thin Set, Gray Kitchen & Laundry Room- Floor 3553-SM1-01 0030389-005 LAYER 1 Chrysotile 3% Paint/Orange Peel Texture, VVdi&el Off White. 24"C Laundry Room- Wall B 3553-SM1-01 0030389-005 LAYER 2 None Detected Drywall, Off V4h rlel Brown Laundry Room- Wall B 3553 -SMI -02 0030389-006 LAYER 1 None Detected Paint/Orange Peel Texture, WfiBe/ ON White, 24°C Kitchen- Wall D 3553-SM1-02 0030389-006 LAYER 2 None Detected Drywall, Off While/ Brown Kitchen- Wall D 3553 -SMI -03 0030389-007 LAYER 1 None Detected Paint/Orange Peel Texture, Mile/ ONVlfiite. 24`C Kitchen- Wall D 3553-SM1-03 0030389-007 LAYER 2 None Detected Drywall, Off While/ Brown Kitchen- Wall D These samples were analyzed by layers- Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only if it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) — materials which are friable or may become friable -- be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE.. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full, and should not be used as a scope of work for abatement without consulting with ATC. I . COf PAGE 12 of 23 r' 8985 E. Nichols Avenue, Suite 350 44TFax Centennial, CO 80112 Phone +1 303 799 6100 Ar -1303 799 3441 iffm atcgroupservices.com Customer: PLM REPORT SUMMARY NVLAP Lab Code 102031 AIHA lab Code 1015361536 Chad Moore ATC Job No.: 0220-32 EnvioCore Environmental, LLC Batch No.: 0030389 1685 S. Colorado Blvd, Report Date: 02121/2020 Denver CO 80222 Sample Date: 02/20/2020 Project: 0220-32 3553 Sims Street Date Analyzed: 02/21/2020 Customer Project No.: Identification: NIA Test Method: 600/R-93/116, 40 GFR, Part 763, Appendix E to Subpart E page 3 of 4 Client No. Lab No. Sample Description/ Location Asbestos Content 3553-JC1-01 0030389-008 LAYER I Chrysotile 3% Paint/Orange Peel Texture, Mitet Off White, 24'C Laundry Room 3553-JC1-01 0030389-008 LAYER 2 None Detected Drywall Tape, Beige Laundry Room 3553 -JCI -01 0030389-008 LAYER 3 Chrysotile 3% Joint Compound, White Note: Drywall Composite: <1% Chrysotile Laundry Room 3553-JC1-01 0030389-008 LAYER 4 None Detected Drywall, Off V\hliite/ Brown Laundry Room 3553-JC1-02 0030389-009 LAYER 1 None Detected Paint/Orange Peel Texture, Mite Kitchen 3553 -JCI -02 0030389-009 LAYER 2 None Detected Drywall Tape, Beige Kitchen 3553-JC1-02 0030389-009 LAYER Chrysotile 3% Joint Compound. White Note: Drywall Composite: <1% Chrysotile Kitchen These samples were analyzed by layers. Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only if it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) -- materials which are friable or may become friable — be further analyzed by pant counting when the results indicate less than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full, and should not be used as a scope ofwork for abatement without consulting with ATC. E!nykCore PAGE 13 OF 23 8985 E. Nichols Avenue, Suite 350 Centennial, CO 80112 Phone *1 303 799 6100 Fax *1 303 799 3441 www.atcgroupseMces.com Client No. Lab No. Sample Description t Location Asbestos Content 3553 -JCI -02 0030389-009 LAYER 4 Drywall, Off White/ Brown Kitchen None Detected These samples were analyzed by layers. Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only if it contains more than one percent asbestos by Calibrated Visual Area Estimation (GVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) — materials which are triable or may become friable — be further analyzed by pant counting when the results indicate ess than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full, and should not be used as a scope of work for abatement without consulting with ATC. env COrE-_' PAGE 14 OF 23 ENVtPD-F_-Al- NSIE=TIGNS PLM REPORT SUMMARY NVLAP Lab Code 102031 Customer: AIHA Lab Code 1015361536 Chad Moore ATC Job No.: 0220-32 EnvioCore Environmental, LLC Batch No.: 0030389 1685 S. Colorado Blvd. Report Date: 02121/2020 Denver CO 80222 Sample Date: 02/20/2020 Project: 0220-32 3553 Sims Street Date Analyzed: 02/2112020 Customer Project No.: Identification: N/A Test Method: 600/R-93/116, 40 CFR, Part 763. Appendix E to Subpart E Page 4 of 4 Client No. Lab No. Sample Description t Location Asbestos Content 3553 -JCI -02 0030389-009 LAYER 4 Drywall, Off White/ Brown Kitchen None Detected These samples were analyzed by layers. Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only if it contains more than one percent asbestos by Calibrated Visual Area Estimation (GVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) — materials which are triable or may become friable — be further analyzed by pant counting when the results indicate ess than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full, and should not be used as a scope of work for abatement without consulting with ATC. env COrE-_' PAGE 14 OF 23 ENVtPD-F_-Al- NSIE=TIGNS 8985 E. Nichols Avenue, Suite 350 Centennial, CO 80112 Phone -1303 799 6100 Fax -1303 799 3441 wwv.atcgroupservi ce s.com PLM Analysis Methodology PLM samples were analyzed utilizing the Environmental Protection Agency's Test Method: Method for the Determination of Asbestos in Building Materials (EPA 600/R-93/116. July, 1993) 40 CFR, Part 763, Appendix E to Subpart E. Reporting Limit <1% Asbestos. Additional treatment and tests may be required to accurately define composition (i.e. ashing. extractions, acetone treatment, and TEM). Unused portions of samples are archived for one year unless client requests special handling. Asbestos content of masticladhesive is separated from total percent asbestos and other materials. Laboratory Equipment Laboratory analysis was accomplished utilizing an Olympus BH -2 polarized light microscope. The microscope is equipped with dispersion staining lenses. Quality Control RTC Group Services is accredited by NVLAP Bulk Asbestos Sample Quality Assurance Program (Lab Code 102031). ATC participates in the NVLAP Bulk Asbestos Sample Quality Assurance Program and maintains an in-house OC/QA program for bulk samples whereby 10% of all submitted samples are reanalyzed and documented in a Quality Control Manual. ATC also participates in a quarterly round robin QC/QA program for bulk samples with several accredited laboratories throughout the United States. Current and past QC/QA program results are available in the laboratory for inspection. Laboratory Personnel Samples were analyzed by Jeff Lomme. Laboratory Director. Mr. Lomme is a professional geologist who has successfully completed the McCrone Institutes's "Advanced Asbestos Identification" Course. Approved Signatory ,dell Lomme f NVLAP LAB CODE 102031-0 The non -detection of asbestos fibers in floor tile by PLM is of itself inconclusive. Confirmation by Transmission Electron Microscope (TEM) is recommended for negative floor tile samples. This report must not be used by the client to claim product endorsements by NVLAP or an agency of the U.S. government. This test reports only to the items stated. Cqre PAGE 15 GF 23 PLM REPORT SUMMARY NVLAP Lab Code 102031 Customer: A(HA Lab Code 1015361536 Chad Moore ATC Job No.: 0220-32 EnvioCore Environmental. LLC Batch No.: 0030389 1685 S. Colorado Blvd. Report Date: 02/21/2020 Denver CO 80222 Sample Date: 02/2012020 Project: 0220-32 3553 Sims Street Date Analyzed: 0 2121 /2 02 0 Customer Project No.: Identification: N/A Test Method: 600/R-93/116, 40 CFR. Part 763, Appendix E to Subpart E Page 1 of 1 PLM Analysis Methodology PLM samples were analyzed utilizing the Environmental Protection Agency's Test Method: Method for the Determination of Asbestos in Building Materials (EPA 600/R-93/116. July, 1993) 40 CFR, Part 763, Appendix E to Subpart E. Reporting Limit <1% Asbestos. Additional treatment and tests may be required to accurately define composition (i.e. ashing. extractions, acetone treatment, and TEM). Unused portions of samples are archived for one year unless client requests special handling. Asbestos content of masticladhesive is separated from total percent asbestos and other materials. Laboratory Equipment Laboratory analysis was accomplished utilizing an Olympus BH -2 polarized light microscope. The microscope is equipped with dispersion staining lenses. Quality Control RTC Group Services is accredited by NVLAP Bulk Asbestos Sample Quality Assurance Program (Lab Code 102031). ATC participates in the NVLAP Bulk Asbestos Sample Quality Assurance Program and maintains an in-house OC/QA program for bulk samples whereby 10% of all submitted samples are reanalyzed and documented in a Quality Control Manual. ATC also participates in a quarterly round robin QC/QA program for bulk samples with several accredited laboratories throughout the United States. Current and past QC/QA program results are available in the laboratory for inspection. Laboratory Personnel Samples were analyzed by Jeff Lomme. Laboratory Director. Mr. Lomme is a professional geologist who has successfully completed the McCrone Institutes's "Advanced Asbestos Identification" Course. Approved Signatory ,dell Lomme f NVLAP LAB CODE 102031-0 The non -detection of asbestos fibers in floor tile by PLM is of itself inconclusive. Confirmation by Transmission Electron Microscope (TEM) is recommended for negative floor tile samples. This report must not be used by the client to claim product endorsements by NVLAP or an agency of the U.S. government. This test reports only to the items stated. Cqre PAGE 15 GF 23 }�({ 8985 East Nichols Avenue, Suite 350 ° , �!t Centennial, Colorado 80112 fill www.cardnoatc.com ENVIRONMENTAL - GEOTECHNICAL BHI LOING SCIENCES - MATERIALS TESTING TEL 303.799.6100 FAX: 303.799.3441 PROJECT INFORMATION ®r -e PAGE 16 OF 23 1... CompanyiCustomer: EnvioCore LLC Project Name: 0220-32 3553 Sinns Street Address: 1685 S. Colorado Blvd. Collection Date: 0219-32 City, ST, Zip Denver CO, 80222 Customer Number/P.O.: Phone/Fax: 303-475-5646 Collection Address: 3553 Sims Street Customer Contact: John Peralta John@goenviocore.co Relinquished By: Date/Time: Re ived By: Date: Time: John Peralta 114 Special Instructions: Sample Type -TAT Sample Number Sample Material Sample Location 1 PLM -24 HR 3553-BS1-01 Misc. - Tile & Thin Set Mortar Kitchen - Backsplash 2 PLM -24 HR 2 3 PLM -24 HR 3553-FC1-01 Misc. - Tile & Thin Set Mortar Kitchen & Laundro=m - Floor 4 PLM -24 HR 2 5 PLM -24 HR 3553-SM1-01 SM - Oran epee) Texture Laundry Room - Waii B 6 PLM -24 HR 2 Kitchen -Wall D 7 PLM -24 HR 3 Kitchen - Wail D $ PLM -24 HR 3553-JC1-01 Misc. - Joint Compound Launda Room 9 PLM -24 HR 2 Kitchen 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 ®r -e PAGE 16 OF 23 1... ABATCH NO. Ar 0030389 ArAT NVLAP Lab Code 102031 AIHA Lab Code 101536 Chad Moore Customer Project No.: EnvioCore Environmental, LLC Description: 0220-32 3553 Sims Street 1685 S. Colorado Blvd. Date Received: 02/20/2020 Denver CO 80222 Date Analyzed: 02/21/2020 Collected: 02/20/2020 Date Reported: 02/21/2020 Collected By: John Peralta Comments: Collection Address: 3553 Sims Street Asbestos Non -Asbestos Lab ID Sample Location! Constituents Constituents Sample # Sample Description M (°!o) 0030389-001 Kitchen- Backsplash None Detected 3553-BS1-01 LAYER 1 Non -Fibrous Material 100% Tile -Glass, Clear, 24°C None Detected Cellulose Fiber (Incom) 5% LAYER 2 Aggregate 15% Mastic, Tan Binder/Filler 80% None Detected Cellulose Fiber (Incom) <1% LAYER 3 Aggregate 65% Thin Set Mortar, Off White Binder/Filler 35% 0030389-002 Kitchen-Backsplash None Detected 3553-BS1-02 LAYER 1 Non -Fibrous Material 100% Tile -Glass, Black None Detected Cellulose Fiber (Incom) 5% LAYER 2 Aggregate 15% Mastic. Tan Binder/Filler 80% None Detected Cellulose Fiber (Incom) 11% LAYER 3 Aggregate 65% Thin Set Mortar, Oft White Binder/Filler 35% 0030389-003 Kitchen & Laundry Room- Floor None Detected 3553-FC1-01 LAYER 1 Aggregate 30% Ceramic Tile, Brown, 24°C Binder/Filler 70% None Detected Cellulose Fiber (Incom) <1% Fibrous Glass (ISO) 5% LAYER 2 Aggregate 60% Mortarrrhin Set, Gray Binder/Filler 35% Analyzed by: f r f anuki. Core PAGE 17 OF 23 E= RDNMEN15IFs- i 10N 5 Reviewed by: 1/a16 Page 1 of 5 Analyzed by: f _,Core PAGE 18 OF 23 _ r -, Reviewed by: Page 2 of 5 BATCH NO. iffAkT 0030389 NVLAP Lab Code 102031 AIHA Lab Code 101536 Chad Moore Customer Project No.: EnviOCore Environmental, LLC Description: 0220-32 3553 Sims Street 1685 S. Colorado Blvd. Date Received: 02/20/2020 Denver CO 80222 Date Analyzed: 02/21/2020 Collected: 02/20/2020 Date Reported: 02/21/2020 Collected By: John Peralta Comments: Collection Address: 3553 Sims Street Asbestos Non -Asbestos Lab ID Sample Location / Constituents Constituents Sample# Sample Description (o/,) told) 0030389-004 Kitchen & Laundry Room- Floor None Detected 3553-FC1-02 LAYER 1 Aggregate 30% Ceramic Tile, Brown, 24'C Binder/Filler 70% None Detected Cellulose Fiber (Incom) <i% Fibrous Glass (ISO) 5% LAYER 2 Aggregate 60% Mortar/Thin Set, Gray Binder/Filler 35% 0030389-005 Laundry Room- Wall B Chrysotile 3% Cellulose Fiber (Incom) 5% Fibrous Glass (ISO) <1 3553-SM1-01 LAYER 1 OBSERVATION SET#1: Carbonates 45% Paint/Orange Peel Texture, White/ Off Wavy Fibers Binder/Filler 47% Mite, 24'C Sign of Elongation (+) Parallel Extinction Non -Pleochroic @ 40x Birefringence (Low) Color: Clear Liquids1.680 Becke Line Used Initial Characterization: Chrysotile OS#1: Para.=1.556, Perp -=1.548 None Detected Cellulose Fiber (Incom) 40% Fibrous Gass (ISO) <1 LAYER 2 Gypsum 60% Drywall, Off White/ Brown 0030389-006 Kitchen- Wall D None Detected Cellulose Fiber (Incom) 10% 3553-SM1-02 LAYER 1 Carbonates 45% Paint/Orange Peel Texture, White/ Off Binder/Filler 45% White, 24'C None Detected Cellulose Fiber (Incom) 40% Fibrous Glass (ISO) <1 LAYER 2 Gypsum 60% Drywall, Off White/ Brown Analyzed by: f _,Core PAGE 18 OF 23 _ r -, Reviewed by: Page 2 of 5 Chad Moore EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver CO 80222 Collected: 02/20/2020 Collected By: John Peralta Collection Address: 3553 Sims Street BATCH NO. 0030389 NVLAP Lab Code 102031 AIHA Lab Code 101536 Customer Project No.: Description: 0220-32 3553 Sims Street Date Received: 02/20/2020 Date Analyzed: 02/21/2020 Date Reported: 02/21/2020 Comments: Asbestos Non -Asbestos Lab ID Sample Location / Constituents Constituents Sample# Sample Description M M 0030389-007 Kitchen- Wall D None Detected 3553-SM1-03 LAYER 1 Paint/Orange Peel Texture, White/ Off \Mite, 24°C None Detected LAYER 2 Drywall, Off White/ Brown Analyzed by: Reviewed by: E!nv , COre PAGE 19 OF 23 ENVIP-AL-AL N==EUTiGN Cellulose Fiber (Incom) 10% Carbonates 45% Binder/Filler 45% Cellulose Fiber (Incom) 40% Fibrous Glass (ISO) <1 Gypsum 60% t Page 3 of 5 #t r BATCH NO. Ar C 0030389 AAV kT NVLAP Lab Code 102031 AIHA Lab Code 101536 Chad Moore EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver CO 80222 Collected: 02/20/2020 Collected By: John Peralta Collection Address: 3553 Sims Street Customer Project No.: Description: Date Received: Date Analyzed: Date Reported: Comments: 0220-32 3553 Sims Street 02/20/2020 02/21/2020 02/21/2020 Asbestos Non -Asbestos Lab ID Sample Location / Constituents Constituents Sample # Sample Description M M 0030389-008 Laundry Room Chrysotile 3% Cellulose Fiber (Incom) 5% Fibrous Glass (ISO) <1 3553 -JCI -01 LAYER 1 OBSERVATION SET#1 Carbonates 45% Paint/Orange Peel Texture, White/ Off Wavy Fibers Binder/Filler 47% VLhite, 24"C Sign of Elongation (+) Parallel Extinction Non -Pleochroic Q 40x Birefringence (Low) Color: Clear liquids. 1.680 Becke Line Used Initial Characterization: Chrysotile OS#1 Para.=1.556, Perp.=1.548 None Detected Cellulose Fiber (Incom) 80% LAYER 2 Organic Matrix 20% Drywall Tape, Beige Chrysotile 3% Cellulose Fiber (Incom) 5% LAYER 3 OBSERVATION SET#1. Aggregate 2% Joint Compound, White Wavy Fibers Carbonates 60% Note: Drywall Composite: <1%Chrysotile Sign of Elongation (+} BinderlFiller 30% Parallel Extinction Non -Pleochroic Q 40x Birefringence (Low) Color: Clear Liquids- 1.680 Becke Line Used Initial Characterization Chrysotile OS#1: Para =1-556, Perp -=1.549 None Detected Cellulose Fiber (Incom) 30% Fibrous Glass (ISO) <1 LAYER 4 Gypsum 70% Drywall, Off White/ Broom Analyzed by: F,:,,.,,. -. . re PAGE 20 OF 23 Reviewed by:*�"T Page 4 of 5 :STC Chad Moore EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver CO 80222 Collected: 02/20/2020 Collected By: John Peralta Collection Address: 3553 Sims Street BATCH NO. 0030389 NVLAP Lab Code 102031 AIHA Lab Code 101536 Customer Project No.: Description: 0220-32 3553 Sims Street Date Received: 02/20/2020 Date Analyzed: 02/21/2020 Date Reported: 02/21/2020 Comments: Asbestos Non -Asbestos Lab ID Sample Location / Constituents Constituents Sample # Sample Description M (%) 0030389-009 Kitchen None Detected 3553-JC1-02 LAYER 1 Paint/Orange Peel Texture, White Analyzed by: None Detected LAYER 2 Drywall Tape, Beige Chrysotile 3% LAYER 3 OBSERVATION SET#1: Joint Compound, White Wavy Fibers Note: Drywall Composite: <1 % Chrysotile Sign of Elongation (+) Parallel Extinction Non -Pleochroic @ 40x Birefringence (Low) Colon Clear Liquids 1.680 Becke Line used Initial Characterization: Chrysotile OS#1: Para =1.556, Perp.=1.549 None Detected LAYER 4 Drywall, Off White/ Brown env i Core PAGE 21 C7; Zs EN. H; -i NME,N--Ai INSPEC2iIGNS Reviewed by: 1/,6 Cellulose Fiber (Incom) 8% Aggregate 2% Perlite 15% Carbonates 401,5 Binder/Filler 35% Cellulose Fiber (Incom) 80% Organic Matrix 20% Cellulose Fiber (Incom) 5% Aggregate 2% Carbonates 60% Binder/Filler 30% Cellulose Fiber (Incom) 30% Fibrous Glass (ISO) <1 Gypsum 70% Page 5 of 5 Inspection Certifications .Co to0 1876 Colorado Department of PublicHealth and Enii6nment ASBESTOS -CONSULTING FIRM s certifies that - enviocbre, LLC Registration No.: ACF - 21660. has met the registration(requirenfents-of 215.7-507, C.R.S. and .the Air Quality Control Commission Regulation N6,.:8,*,,Part Bj and is hereby autho rized toperform asbestos consul& activities aspgpir der'qR'- ula'tioD NO 8,- Part B in the state of Colorado. '-February 14 2019 pr iary-14,2020 Authofted, A P R e prm urve .. ........... 'SE4 ............... Plnyk�ore PAGE 22 OF 23 EN -40 C TIONS v L U(Y) PLA-( W �► mm OZ r� fA N Cx 0A � i m Zo (/ l p2c �� f� v I I I I I N O W I I p 0 O C m I i N O p 5 v r c f I n o � � v O O w C � s N (7 Z D m � � v L U(Y) PLA-( W �► mm OZ r� fA N Cx 0A � i m Zo (/ l p2c �� f� A O z Z N_ I OL civ 01 Wheat Ridge X_ z 0 0 z z 0 O S2 Z Z 0 O O O r O $n w N o I I I I N O 1 I (] a cI m O 1 I O m m O N S m y 0 0 O Z y x v m � g x v r N n D -� rT1 A O z Z N_ I OL civ 01 Wheat Ridge X_ z 0 0 z z 0 O S2 Z Z 0 O O i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: t 4�P►t.-P Permit Number: ❑ No one available for inspection: Timet (A"MIPM Re -Inspection required: Yes .No When corrections have been made, schedule for re -inspection online at: httpYAvww.ci, wheatridge-co. uelnspection Date: Inspect or. DO NOT REMOVE THIS NOTICE I* � I i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: f� e._-C� Job Address:`���� Permit Number: 1 , o--0 ❑ No one available for inspectioTime ! �� �} AM/PM n: Re -inspection required: Yes � When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. uslinspection Date: _° t ? i _ Inspector: 'V7), DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address:.3 S `; 3�r!-- Permit Number: : k5 11 LlNo one available for inspection: Time f� AM/PM Re -Inspection required: Yes 0 When corrections have been made, call for re -inspection at 303-234-5933 Date: L, " '�� ' Inspector: ` y 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: _"< a 11 K pets Job Address: (Y�-f Permit Number: ' (f ❑ No one available for inspection: Time'' Re -Inspection required: Yes(LNo ___, When corrections have been made, Date_ Inspec M at 303-234-5933 i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address:' Permit Number:�� ❑ No one available for inspection: Time[L i SAM/PM Re -Inspection required: (yes.1 No When corrections have been made, call -for re-inspecfio ©3-234-5933 Date:nspe6, E� DO NOT REIVIOVk 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: t Job Address: 3 V '� Permit Number: 1) U \ c, G Q-1 /6 ❑ No one available for inspection: Time t AM/PM Re -Inspection required: Yes fro t.' When corrections have been made, call for re -inspection at 303 -234 - Date: `>�*` Inspector: L- y DO NOT REMOVE THIS NOTICE City of Wheat Ridge Homeowner Interior Remodel PERMIT - 201901043 PERMIT NO: 201901043 ISSUED: 05/22/2019 JOB ADDRESS: 3553 Simms St EXPIRES: 05/21/2020 JOB DESCRIPTION: SWO Bathroom remodel - replace tub, toilet, vanity; replace backerboard; eliminate 2 doors and create new opening; replace exhaust fan and relocate light fixture; Add solar tube; create double vanity - 52 sq ft total *** CONTACTS *** OWNER (303)949-3062 BUTLER ADRIEN *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** Total Valuation Plan Review Fee Use Tax Permit Fee Investigative Fees ** TOTAL ** *** COMMENTS *** ESTIMATED PROJECT VALUATION: FEES 0.00 101.89 147.00 156.75 156.75 562.39 7,000.00 *** 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. Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections. City of Wheat Ridge Homeowner Interior Remodel PERMIT - 201901043 PERMIT NO: 201901043 ISSUED: 05/22/2019 JOB ADDRESS: 3553 Simms St EXPIRES: 05/21/2020 JOB DESCRIPTION: SWO Bathroom remodel - replace tub, toilet, vanity; replace backerboard; eliminate 2 doors and create new opening; replace exhaust fan and relocate light fixture; Add solar tube; create double vanity - 52 sq ft total 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 pennIt. 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 is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date I. This permit was issued based on the infonnation 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 pen -nit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Budding Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a 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 o'rr qny ordinancq gr 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 Ih6atI ,d,�e 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: permits(6ci.wheatridge.co.us FOR OFFICE USE ONLY Date: �1 �n l jq � l Plan/Permit # OJ Plan Review Fee: � p I, S U Building Permit Application *`* Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 3553 Simms Street, Wheat Ridge, CO 80033 Property Owner (please print): Adrien Butler Phone: 3 0 3 - 94 9 - 3 0 62 Property Owner Email: adrienchan@hotmail.com Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: , State, Zip: Architect/Engineer: N/A Architect/Engineer E-mail: Contractor Name: N/A City of Wheat Ridge License #: Contractor E-mail Address: For Plan Review Questions & Comments (please print): Phone: Phone: CONTACT NAME (please print): Addrien Butler Phone: 303-949-3062 CONTACT EMAIL(p/ease print): adrienchan@hotmail.com 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. Bathroom remodel: replace bathtub, toilet, vanity. Replace old sheetrock and backerboard. Eliminate 2 doors (Jack -and -Jill style) and replace with new opening. Replaced exhaust fan and moved surface -mount light fixture. Add solar tube. Add new plumbing for second vanity and move old vanity plumbing to accommodate double vanity. Sq. FULF 52 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) $ 7000 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): 4 L2_ DATE: 5/21/19 Printed Name: Adrien Butler ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT C MMEN : Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: I ILP CONSTRUCTION TYPE: VP (0-P Building Division Valuation: �l City of r Wheat id 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(s): Adrien Butler Project Property: 3553 Simms St, Wheat Ridge, CO 80033 Notarized signature of Applicant State of Colorado j County of aeM_� } ss The foregoing instrument was acknowledged by me this day of (IA 20 by A � r,' e,-, 6,4 FNOTARY ARA D ODEAN TARY PUBLIC E OF COLORADO ID 20164015481 ON EXPIRES APRIL 22, 2020 My Commission Expires/ �20 ?C Notary Public rs. V v � A 4 IF , City of W h cat COMMUNI JY IN ', i I (WINIA1 N I ge APPROVED Review or Code Compliance IaAA, -Z2,19 Plan Marniner Date e Plan : of pw is suame of a P~ or am rftw of plans so w Ifteat" 0 and cwwkftm shall not be a p"mrpr or an QW -W of ony wolobw to OW IY W provisions of the building code or of any My cwd�mwft pwmft pmawwv to vw mtftHty to vwoft or con"I the pw&tu of the &olk*q C*ft Of MW O*wm of dW City sW rot be volt Pr2.��E« SH4 L, C- 00 oD I z- i t2c Zo I -) NJEC IIJ) Z5 A- 7"! A rs. V v � A 4 IF , City of W h cat COMMUNI JY IN ', i I (WINIA1 N I ge APPROVED Review or Code Compliance IaAA, -Z2,19 Plan Marniner Date e Plan : of pw is suame of a P~ or am rftw of plans so w Ifteat" 0 and cwwkftm shall not be a p"mrpr or an QW -W of ony wolobw to OW IY W provisions of the building code or of any My cwd�mwft pwmft pmawwv to vw mtftHty to vwoft or con"I the pw&tu of the &olk*q C*ft Of MW O*wm of dW City sW rot be volt Pr2.��E« SH4 L, C- 00 oD I z- i t2c Zo I -) NJEC IfV 31 C I.? Property Information Adrien Butler 3553 Simms Str Wheat Ridge CO 80033 Property Type Residential Date of Construction 1971 PH 3039493062 Prepared By EnvioCore LLC Asbestos Consulting Firm No. 21660 1685 S. Colorado Blvd Denver, CO 80124 303-GoEnvio (463) 6846 www.aoEnvioCore.com info@aoenviocore.com Conducted By Nick Hopkinson Asbestos Building Inspector Cert. No. 23887 Inspection Information 9-0 Iq 010 q3 Limited Residential Asbestos Renovation Inspection Report Inspection Date Arrival Time 5/21/19 11:30 AM 3553 Simms Str Report Date 5/21/2019 Inspection # 0519-37 Butler, Adrien Protocols Followed Asbestos AHERA env ' rore ENVIRONMENTAL INSPECTIONS Lab Information ATC Group Services LLC 8985 E Nichols Ave Suite 350, Centennial, CO 80112 303-799-6100 Asbestos NVLAP Cert # 102031 en p, PAGE 1 OF 32 EN'J 1r,0 MEN -Al NEPEC TIONS Table of Contents Definitions.................................................................................................................................................... 4 KeyTerms.................................................................................................................................................... 4 LimitedInspection Summary..................................................................................................................... 5 General....................................................................................................................................................................... 5 Asbestos...................................................................................................................................................................... 5 Purpose and Scope of Inspection............................................................................................................. 5 General....................................................................................................................................................................... 5 Asbestos...................................................................................................................................................................... 5 Background................................................................................................................................................ 6 Sampling.....................................................................................................................................................6 AsbestosResults Reporting........................................................................................................................ 7 Asbestos Inspection Conclusion............................................................................................................... 8 Closing......................................................................................................................................................... 9 InspectionPhotos.....................................................................................................................................10 envCore PAGE 2 OF 32 - iEIiME��'Al iNS CECT ❑N� Lab Results kTMAC ANALYTICAL REPORT Prepared for: EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver, CO 80222 Project: 0519-37/Butler Order No.: 0028454 Report Date: 05/21/2019 ATC Group Servkes LLC 8985 E. Nichols Avenue, Suite 350, Centennial, CO 80112 Ph: 303.799.6100 ts.................................................................................................................................................................18 InspectionCertifications..........................................................................................................................31 enVi�Core PAGE 3 OF 32 ENVIRONMENTRL iNcpEC TIONS Definifions 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 Reoort" 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. Key Terms 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 homoaenous 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. Surfacina 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 Containinq 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. envi , Core PAGE 4 OF 32 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. Limited Inspection Summary 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 General 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 env -AL core PAGE 5 OF 32 ENVIRO-AENN_PECT!ON5 representative bulk samples were similar materials, but this does not guarantee that materials of similar appearance are of the same 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 Adrien Butler, Owner. Mr. Butler was concerned about asbestos containing building materials in the affected areas of the building. Per Mr. Butler, suspect asbestos containing building materials to be disturbed in the scope of work include: The affected materials sampled: -Bathroom (Dumpster) The affected areas include: -Drywall -Joint Compound 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. The City of Wheat Ridge shut down the homeowners project as no permit had been pulled. Asbestos Inspection required prior to getting the permit. Samples were secured from the dumpster on site. Sampling Using methods that are generally accepted in the industry, the Certified Inspector determined that it was necessary to collect 8 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.) envCore PAGE 6 OF 32 asbestos Results Reporting Table 1: Table of asbestos samples taken during inspection with lab results. ND = Non Detected, (Asbestos Materials Could become Friable during Renovation / Demolition. It this occurs the hiobility carr cnange from Non -Friable to Friable and all state and federal regulation shall be followed) 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. envi ., Core PAGE 7 OF 32 ENJI,DiJAC%-AL N5AECTiONS f ft 3553-SM1-Ol BATHROOM SM. DRYWALL Significantly 400 HA, 400 To (DUMPSTER) - ROUGH 3% N/A N/A Friable damaged Affected 3% Chrysotile in 3553 -SMI -03 WALL TEXTURE- friable ACM Joint Compound YELLOW surfacing ACM Significantly damaged 400 HA, 400 ND N/A N/A Friable friable Affected Texture surfacing ACM ACM Significantly damaged 400 HA, 400 ND N/A N/A Friable friable Affected Tape surfacing ACM ACM Significantly damaged 400 HA, 400 ND N/A N/A Friable friable Affected Drywall surfacing ACM ACM 3553 -JCI -01 BATHROOM Significantly 30 HA, 25 To (DUMPSTER) JOINT 5% N/A N/A Friable damaged Affected 5% Chrysotile in 3553 -JCI -02 WALL COMPOUND friable ACM Joint Compound surfacingACM Significantly damaged 30 HA, 25 ND N/A N/A Friable friable Affected Texture surfacing ACM ACM Significantly damaged 30 HA, 25 ND N/A N/A Friable friable Affected Drywall surfacing ACM ACM Significantly damaged 30 HA, 25 ND N/A N/A Friable friable Affected Tape surfacing ACM ACM 3553-SM2-01 BATHROOM SM. DRYWALL Significantly HA, 80 To (DUMPSTER) - ORANGE PEEL 3% N/A N/A Friable ed100 Affected 3% Chrysotile in 3553-SM2-03 WALL -WHITE friable ACM Texture surfacing ACM Significantly damaged 100 HA, 80 ND N/A N/A Friable friable Affected Drywall surfacing ACM ACM Table 1: Table of asbestos samples taken during inspection with lab results. ND = Non Detected, (Asbestos Materials Could become Friable during Renovation / Demolition. It this occurs the hiobility carr cnange from Non -Friable to Friable and all state and federal regulation shall be followed) 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. envi ., Core PAGE 7 OF 32 ENJI,DiJAC%-AL N5AECTiONS Asbestos Inspection Conclusion Asbestos containing building materials WERE found in the samples analyzed by the laboratory. The affected building materials DO 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. Based on said analysis, EnvioCore LLC has determined that asbestos containing material has been disturbed in this unit and possibly become airborne. According to CDPHE Regulation 8, the amount of asbestos containing material disturbed has resulted in a MAJOR SPILL. It is required that the disturbance be reported to the Colorado Department of Public Health and Environment and the Colorado Air Pollution Control Division as soon as possible. CDPHE Colorado Environment Release and Incident Reporting Line (24 Hr) • +1 (877) 518-5608 • cdl2he.asbestos@state.co.us envCore PAGE 8 OF 32 ENviV'+G���+tE!-'nl '1_•=ECT G!: `, Closing 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 envi . Core PAGE 9 OF 32 EN✓IRONMCNTAI '3EC T.QN5 Inspection Photos Figure 1 - Overview of House Figure 2- Overview of Dumpsfer envCore PAGE 10 OF 32 Figure 3- Overview of Notification Figure 4- Overview of Dumpster env4Core WAGE 11 OF 32 EUVI�OfIrn EIJ-n� Ns�E[i-C�iS Figure 5- Overview of Dumpster Figure 6- Overview of Bathroom envCore PAGE 12 OF 32 Figure 7- Overview of Bathroom Figure 8- Overview of Address env Core PAGE 13 OF 32 eNviroyrnar; -a� ra=_aeanara Figure 9- Sample location # 1 L •1_ Figure 10- Sample location #2 env'Core PAGE'4 OF 32 ENVII�DfJMEt.'A� Nk 4P Figure I 1- Sample location #3 Figure 12- Sample location #I en : y p, e PAGE 15 OF 32 C."Po k Figure 13- Sample location #2 .PI - SAM Figure 14- Sample location # 1 en: y r, e PAGE 16 OF 32 Figure 15- Sample location #2 Figure 16- Sample location #3 enviorcre WAGE 17 OF 32 ErJ `Y IRClJMEh SAL NSoEC TIC^JS Lab Results ;STC ANALYTICAL REPORT Prepared for: EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver, CO 80222 Project: 0519-37/Butler Order No.: 0028454 Report Date: 05/21/2019 ATC Group Servkes LLC 8985 E. Nichols Avenue. Suite 350. Centennial, CO 80112 Ph: 303-799-6100 envMEh'AL i�ore EN, rio JC:�[17 per, 8985 E. Nichols Avenue, Suite 350 Centennial, CO 80112 AVA C JT Phone +1303 799 6100 Fax +1303 799 3441 www.atcgroupservjces.com These samples were analyzed by layers. Specific layer or component asbestos content is Indicated when relevant. The EPA considers a material to be asbestos containing only if it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) — materials which are friable or may become friable — be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full. and should not be used as a scope of work for abatement without consulting with ATC. envkcore WAGE 19 OF 32 NSPCC sipNS PLM REPORT SUMMARY NVLAP Lab Code 102031 Customer: AIHA lab Code 1015361536 Nick Hopkinson ATC Job No.: EnvioCore Environmental, LLC Batch No.: 0028454 1685 S. Colorado Blvd. Report Date: 05/21/2019 Denver CO 80222 Sample Date: 05/21/2019 Project: 0519-37/Butler Date Analyzed: 05/21/2019 Customer Project No.: 0519.37 Identification: N/A Test Method: 600/R-93/116 Page 1 of 4 Client No. Lab No. Sample Description / Location Asbestos Content 3553-SM1-01 0028454-001 LAYER 1 None Detected Paint/ Texture, Yellows White, 25°C Bathroom, Wag 3553 -SMI -01 0028454-001 LAYER 2 None Detected Drywall Tape, Beige Bathroom, Wag 3553-SM1-01 0028454-001 LAYER 3 Chrysotile 3% Joint Compound, U. Gray Note: Drywall Composite: <1% Chrysotile Bathroom, Wag 3553-SM1-01 0028454001 LAYER 4 None Detected Drywall, Off While/ Brown Note: Chrysotile associated with joint compound Bathroom, Wag 3553 -SMI -02 0028454-002 LAYER 1 None Detected Paint/ Texture, Yellow/ White, 25°C Bathroom, Wag 3553-SM1-02 0028454-002 LAYER 2 None Detected Drywall Tape, Beige Bathroom, Wag 3553-SM1-02 0028454-002 LAYER 3 Chrysotile 3% Joint Compound. Lt. Gray Note: Drywall Composite: <1% Chrysotile Bathroom, Wag These samples were analyzed by layers. Specific layer or component asbestos content is Indicated when relevant. The EPA considers a material to be asbestos containing only if it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) — materials which are friable or may become friable — be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full. and should not be used as a scope of work for abatement without consulting with ATC. envkcore WAGE 19 OF 32 NSPCC sipNS These samples were analyzed by layers. Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only d it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE) EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) — materials which are friable or may become friable — be further analyzed by pant counting when the results indicate less than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not Include point counting unless specifically requested. The results may not be reproduced except in full, and should not be used as a scope of work for abatement without consulting with ATC, enviri core f ACF 20 OF 32 u;�wrnu.��r w—rc*.n, 8985 E. Nichols Avenue, Sub 350 Centennial, CO 80112 AFAkT Phone +1303 799 6100 Fax +1303 799 3441 Affwww. atcgroupseMces.com PLM REPORT SUMMARY NVLAP Lab Code 1020311536 Customer: AIHA Lab Code 101536 Nick Hopkinson ATC Job No.: EnvioCore Environmental, LLC Batch No.: 0028454 1685 S. Colorado Blvd. Report Date: 05/21/2019 Denver CO 80222 Sample Date: 05/21/2019 Project: 0519-37/Butler Dane Analyzed: 05/21/2019 Customer Project No.: 0519.37 Identification: N/A Test Method: 600/R-93/116 Page 2 of 4 Client No. Lab No. Sample Description / Location Asbestos Content 3553-SM1-02 0028454-002 LAYER 4 None Detected Drywall, Off Whilel Brown Note: Chrysotde associated with joint compound Bathroom, Wad 3553 -SMI -03 0028454-003 LAYER 1 None Detected Paint/ Texture, Yellow/ White. 25°C Bathroom, Wag 3553-SM1-03 0028454-003 LAYER 2 None Detected Drywall Tape, Beige Bathroom, Wag 3553 -SMI -03 0028454-003 LAYER 3 Chrysotile 3% Joint Compound, U. Gray Note! Drywall Composite: 0% Chrysotile Bathroom, Wag 3553-SM1-03 0028454-003 LAYER 4 None Detected Drywall, Oft While/ Brown Note: Chrysotile associated with joint compound Bathroom, Wall 3553-JC1-01 0028454-004 LAYER 1 None Detected Paint/ Texture, Yellow/ White, 25'C Bathroom, Wag 3553-JC1-01 0028454-004 LAYER 2 None Detected Drywall Tape, Beige Bathroom, Wag These samples were analyzed by layers. Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only d it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE) EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) — materials which are friable or may become friable — be further analyzed by pant counting when the results indicate less than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not Include point counting unless specifically requested. The results may not be reproduced except in full, and should not be used as a scope of work for abatement without consulting with ATC, enviri core f ACF 20 OF 32 u;�wrnu.��r w—rc*.n, ;STC 8985 E. Nichols Avenue, Suite 350 Centennial, CO 80112 Phone +1303 799 6100 Fax +1303 799 3441 www.atcgroupsen6ces.com These samples were analyzed by layers. Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only if it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) — materials which are liable or may become liable — be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full, and should not be used as a scope of work for abatement wfthout consulting with ATC. env-ALcore PACE 21 OF 32 EN'JIr,O-AE N. NSpCCTiON5 PLM REPORT SUMMARY NVLAP Lab Code 102031 Customer: AIHA Lab Code 1015361536 Nick Hopkinson ATC Job No.: EnvioCore Environmental, LLC Batch No.: 0028454 1685 S. Colorado Blvd. Report Date: 05!21/2019 Denver CO 80222 Sample Date: 05/21/2019 Project: 0519-37/Butler Date Analyzed: 05/21/2019 Customer Project No.: 0519.37 Identification: N/A Test Method: 600/R-93/116 Page 3 of 4 Client No. Lab No. Sample Description/ Location Asbestos Content 3553-JC1-01 0028454-004 LAYER 3 Chrysotile 5% Joint Compound, U. Gray Note: Drywall Composite: 0% Chrysotile Bathroom, Wag 3553-JC1-01 0028454-004 LAYER 4 None Detected Drywall, Oft Whlei Brown Note: Chrysotile associated with joint compound Bathroom, Wag 3553-JC1-02 0028454-005 LAYER 1 Chrysotile 51% Joint Compound, U. Gray, 25°C Note. Drywall Composite: 0% Chrysotile Bathroom, Wag 3553-JC1-02 0028454-005 LAYER 2 None Detected Drywall, OA While/ Brown Note: Chrysotile associated with joint compound Bathroom, Wag 3553-SM2-01 0028454-006 LAYER 1 Chrysotile 3% Paint/Orange Peel Texture, Wide/ Off White, 25`C Bathroom, Ceiling 3553-SM2-01 0028454-006 LAYER 2 None Detected Drywall, Brown/Off White, 23`C Bathroom, Ceiling 3553-SM2-02 0028454-007 LAYER 1 Chrysotile 2% Paint/Orange Peel Texture, While/ OH White, 25`C Bathroom, Ceiling These samples were analyzed by layers. Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only if it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) — materials which are liable or may become liable — be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full, and should not be used as a scope of work for abatement wfthout consulting with ATC. env-ALcore PACE 21 OF 32 EN'JIr,O-AE N. NSpCCTiON5 ;STC 8985 E. Nichols Avenue, Suite 350 Centennial, CO 80112 Phone +1303 799 6100 Fax +1303 799 3441 www.atcgroupseniices.com These samples were analyzed by layers. Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only I it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) -- materials which are friable or may become friable — be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full. and should not be used as a scope of work for abatement without consulting with ATC. envi Core PAC- F 22 OF 32 PLM REPORT SUMMARY NVLAP Lab Code 102031 Customer: AIHA Lab Code 1015361536 Nick Hopkinson ATC Job No.: EnvioCore Environmental, LLC Batch No.: 0028454 1685 S. Colorado Blvd. Report Date: 05/21/2019 Denver CO 80222 Sample Date: 05/21/2019 Project: 0519-37/Butler Date Analyzed: 05/21/2019 Customer Project No.: 0519-37 Identification: N/A Test Method: 600/R-931116 Page 4 of 4 Client No. Lab No. Sample Description/ Location Asbestos Content 3553-SM2-02 0028454-007 LAYER 2 None Detected Drywall, Brown/OfY White, 231C Bathroom, Ceiling 3553-SM2-03 0028454-008 LAYER 1 Chrysotile 3% Paint/Orange Peel Texture, White/ Oft White, 25"C Bathroom, Ceiling 3553-SM2-03 0028454-008 LAYER 2 None Detected Drywall, Brown/Off White, 23°C Bathroom, Ceiling These samples were analyzed by layers. Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only I it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) -- materials which are friable or may become friable — be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full. and should not be used as a scope of work for abatement without consulting with ATC. envi Core PAC- F 22 OF 32 ;STC Customer: Nick Hopkinson EnvioCore Environmental. LLC 1685 S. Colorado Blvd. Denver CO 80222 Project: 0519-37/Butler Customer Project No.: 0519-37 Identification: N/A Test Method: 600/R-93/116 PLM REPORT SUMMARY ATC Job No.: Batch No.: Report Date: Sample Date: Date Analyzed: 0028454 05/21/2019 05/21/2019 05/21/2019 8985 E. Nichols Avenue. Suite 350 Centennial. CO 80112 Phone +1303 799 6100 Fax +1 303 799 3441 wmmatcgroupservices.com NVLAP Lab Code 102031 AIHA Lab Code 101536 Page 1 of 1 PLM Analysis Methodology PLM samples were analyzed utilizing the Environmental Protection Agency's Test Method: Method for the Determination of Asbestos in Building Materials (EPA 600/R-93/116. July, 1993) 40 CFR, Part 763. Appendix E to Subpart E. Reporting Limit <1% Asbestos. Additional treatment and tests may be required to accurately define composition (i.e. ashing. extractions, acetone treatment. and TEM) Unused portions of samples are archived for one year unless client requests special handling Asbestos content of mastic/adhesive is separated from total percent asbestos and other materials. Laboratory Equipment Laboratory analysis was accomplished utilizing an Olympus BH -2 polarized light microscope. The microscope is equipped with dispersion staining lenses Quality Control ATC Group Services is accredited by NVLAP Bulk Asbestos Sample Quality Assurance Program (Lab Code 102031). ATC participates in the NVLAP Bulk Asbestos Sample Quality Assurance Program and maintains an in-house QC/QA program for bulk samples whereby 10% of all submitted samples are reanalyzed and documented in a Quality Control Manual. ATC also participates in a quarterly round robin QC/QA program for bulk samples with several accredited laboratories throughout the United States. Current and past QC/QA program results are available in the laboratory for inspection. Laboratory Personnel Samples were analyzed by Jeff Lomme. Laboratory Director. Mr. Lomme is a professional geologist who has successfully completed the McCrone Institutes's "Advanced Asbestos Identification" Course. n a: Approved Signatory L1 ,dJomme L Ln NVLAP LAB CODE 102031.0 The non -detection of asbestos fibers in floor tile by PLM is of itself inconclusive. Confirmation by Transmission Electron Microscope (TEM) is recommended for negative floor tile samples. This report must not be used by the client to claim product endorsements by NVLAP or an agency of the U.S. government. This test reports only to the items stated envFi core WAGE 23 OF 32 ENVIRONMENTAL N5t'ECTION5 rkTC _ 8985 East Nieltols Avenue, Suite 150 Centennial, (:nlnrado 801 12 C �f TEL: 303.799.6100 ENVIRONMENTAL • GEOTECHNICAL ��.J I FAX: 303.799.3441 BUILDIMO Se1ENCES • MATERIALS TESTING PROJECT INFORMATION Turnaround:2 (tour 24 hour 48 hour 3-5 day Auy 2 Lour TAT ro'ecls received arler will be completed first thing the rollowin ntoruiu Com any/Customer: Enviocore, LLC: Project Name: V1 -0—( Address: 1685 Colorado Blvd Collection nate: :1i i 1 CA Address: Denver. CO 80222 Customer Number/P.O.: -51 - 3 Phone/Fax: 720-473-9044 Collection Address: S55 IVt.v— S Customer Contact: Nick Hopkinson j Special Instruct lou s: Entail: (Vote: Sample collector is responsible for en%toring that all samples have been preserved and prepared to the upprupriule and applicable methodology-. I f package has sustained damage during transit, notify collector and shipper. Turnaround time begins upon receipt of sample (s) by laboratory. ATC will not be responsible for errurs ur omissiumu in calculations fmm inaccuracy of original data. CHAIN OF CUSTODY J % • `llam ,011_ envi , Core PAGE 24 OF 32 —rvv117:11sC _ '' T C`r_ Sa mple Material �.. w W If 8 - © I i0 0 (Vote: Sample collector is responsible for en%toring that all samples have been preserved and prepared to the upprupriule and applicable methodology-. I f package has sustained damage during transit, notify collector and shipper. Turnaround time begins upon receipt of sample (s) by laboratory. ATC will not be responsible for errurs ur omissiumu in calculations fmm inaccuracy of original data. CHAIN OF CUSTODY J % • `llam ,011_ envi , Core PAGE 24 OF 32 —rvv117:11sC _ '' T C`r_ envi , Core PAGE 24 OF 32 —rvv117:11sC _ '' T C`r_ ;STC Nick Hopkinson EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver CO 80222 Collected: 05/21/2019 Collected By: Nick Hopkinson Collection Address: 3553 Simms Street, Wheat Ridge, CO Customer Project No.: 0519-37 Description: 0519-37/Butler Date Received: 05/21/2019 Date Analyzed: 05/21/2019 Date Reported: 05/21/2019 Comments: 2% BATCH NO. 0028454 NVLAP Lab Code 102031 AIHA Lab Code 101536 Lab ID Sample # Sample Location / Sample Description Asbestos Constituents N Non -Asbestos Constituents ("/,(' Aggregate 0028454-001 Bathroom, Wall None Detected Cellulose Fiber (Incom) 2% Binder/Filler 300% Parallel Extinction Fibrous Glass (ISO) <1 3553-SM1-01 LAYER 1 Aggregate 5% Paint/ Texture, Yellow/ Mile, 25°C Carbonates 400% Becke Line Used Binder/Filler 53% Initial Characterization: None Detected Cellulose Fiber (Incom) 85% LAYER 2 Organic Matrix 15% Drywall Tape, Beige Cellulose Fiber (Incom) 30% LAYER 3 Joint Compound, Lt. Gray Note: Drywall Composite: <1 % Chrysotile LAYER 4 Drywa1, ON White/ Brown Note: Chrysotile associated with joint compound Analyzed by: envCore PAGE 25 OF 32 ENVIRONMENTAL INSPECTIONS Chrysotile 3% Cellulose Fiber (Incom) 5% OBSERVATION SET#1: Aggregate 2% Wavy Fibers Carbonates 60% Sign of Elongation (+) Binder/Filler 300% Parallel Extinction Non -Pleochroic Q 40x Birefringence (Low) Color: Clear Liquids: 1.550 Becke Line Used Initial Characterization: Chrysotile OS#1: Para =1.558, Perp.=1.549 DS#1: Para. --Magenta Purple Perp.=Blue None Detected Cellulose Fiber (Incom) 30% Fibrous Glass (ISO) <1 Gypsum 70% Reviewed by: P Page 1 of 6 ;STC Nick Hopkinson EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver CO 80222 Collected: 05/21/2019 Collected By: Nick Hopkinson Collection Address: 3553 Simms Street, Wheat Ridge, CO Customer Project No.: 0519-37 Description: 0519-37/Butler Date Received: 05/21/2019 Date Analyzed: 05/21/2019 Date Reported: 05/21/2019 Comments: 2% BATCH NO. 0028454 NVLAP Lab Code 102031 AIHA Lab Code 101536 Lab ID Sample # Sample Location / Sample Description Asbestos Constituents M Non -Asbestos Constituents M LAYER 3 0028454-002 Bathroom, Wall None Detected Cellulose Fiber (Incom) 2% Carbonates 60% Note: Drywall Composite: <1%Chrysotile Fibrous Glass (ISO) <1 3553-SM1-02 LAYER 1 Parallel Extinction Aggregate 5% Paint/ Texture, Yeflow/ Wtide, 25'C Carbonates 400% Birefringence (Low) Binder/Filler 53% None Detected Cellulose Fiber (Incom) 85% LAYER 2 Becke Line Used Organic Matrix 15% Drywall Tape, Beige Analyzed by: envi , Core PAGE 26 OF 32 �! Reviewed by: vr v' Reviewed Page 2 of 6 Chrysotile 3% Cellulose Fiber (Incom) 5% LAYER 3 OBSERVATION SET#1: Aggregate 2% Joint Compound, Lt. Gray Wavy Fibers Carbonates 60% Note: Drywall Composite: <1%Chrysotile Sign of Elongation (f) Binder/Filler 300.6 Parallel Extinction Non -Pleochroic @ 40x Birefringence (Low) Color: Clear Liquids: 1.550 Becke Line Used Initial Characterization: Chrysotile OS#1: Para =1.558, Perp.=1.549 DS#1: Para.=Magenta Purple Perp.=Blue None Detected Cellulose Fiber (Incom) 2596 Fibrous pass (ISO) <1 LAYER 4 Gypsum 75% Drywall, OH White/ Brown Note: Chrysotile associated with joint compound Analyzed by: envi , Core PAGE 26 OF 32 �! Reviewed by: vr v' Reviewed Page 2 of 6 ;STC Nick Hopkinson EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver CO 80222 Collected: 05/21/2019 Collected By: Nick Hopkinson Collection Address: 3553 Simms Street, Wheat Ridge, CO Customer Project No.: 0519-37 Description: 0519-37/Butler Date Received: 05/21/2019 Date Analyzed: 05/21/2019 Date Reported: 05/21/2019 Comments: 53% BATCH NO. 0028454 NVLAP Lab Code 102031 AIHA Lab Code 101536 Asbestos Non -Asbestos Lab ID Sample Location / Constituents Constituents Sample # Sample Description N (o/,) 0028454-003 Bathroom, Wall 3553-SM1-03 LAYER 1 Paint/ Texture, Yellow/ While, 25°C Analyzed by: t LAYER 2 Drywall Tape, Beige None Detected Cellulose Fiber (Incom) 2% Fibrous Glass (ISO) <1 Aggregate 5% Carbonates 400% Binder/Filler 53% None Detected Cellulose Fiber (Incom) 85% Organic Matrix 150% envi core PAGE 27 OF 32 ENVIRONMENTAL INSPECTION5 Reviewed by:��`+a' Page 3 of 6 Chrysotile 3% Cellulose Fiber (Incom) 5% LAYER 3 OBSERVATION SET#1: Aggregate 2% Joint Compound, Lt, Gray Wavy Fibers Carbonates 600% Note: Drywall Composite: <1%Chrysotile Sign of Elongation (+) Binder/Filler 309/6 Parallel Extinction Non -Pleochroic Q 40x Birefringence (Low) Color: Clear Liquids: 1.550 Becke Cine Used Initial Characterization: Chrysotile OS#1: Para.=1.558, Perp.=1.549 DS#1: Para.=Magenta Purple Perp.=Blue None Detected Cellulose Fiber (Incom) 40°/6 Fibrous Glass (ISO) <1 LAYER 4 Gypsum 600% Drywall, OH White/ Brown Note: Chrysotile associated with joint compound envi core PAGE 27 OF 32 ENVIRONMENTAL INSPECTION5 Reviewed by:��`+a' Page 3 of 6 ;STC Nick Hopkinson EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver CO 80222 Collected: 05/21/2019 Collected By: Nick Hopkinson Collection Address: 3553 Simms Street, Wheat Ridge, CO Customer Project No.: 0519-37 Description: 0519-37/Butler Date Received: 05/21/2019 Date Analyzed: 05/21/2019 Date Reported: 05/21/2019 Comments: 2% BATCH NO. 0028454 NVLAP Lab Code 102031 AIHA Lab Code 101536 Lab ID Sample# Sample Location I Sample Description Asbestos Constituents M Non -Asbestos Constituents M LAYER 3 0028454-004 Bathroom, Wall None Detected Cellulose Fiber (Incom) 2% Binder/Filler 30% Note: Drywall Composite. <1 % Chrysotile Fibrous Glass (ISO) <1 3553-JC1-01 LAYER 1 Parallel Extinction Aggregate 5% Paint/ Texture, Yellow/ V4hde, 25'C Carbonates 40°/6 Birefringence (Low) Binder/Filler 53% None Detected Cellulose Fiber (Incom) 85% LAYER 2 Becke Line Used Organic Matrix 15°x6 Drywall Tape, Beige Analyzed by: t�"— env Core PAGF28OF32 Reviewed by: i �Wlj Page 4 of 6 Chrysotile 596 Cellulose Fiber (Incom) 5% LAYER 3 OBSERVATION SET#1: Carbonates 601% Joint Compound, Lt. Gray Wavy Fibers Binder/Filler 30% Note: Drywall Composite. <1 % Chrysotile Sign of Elongation (+) Parallel Extinction Non -Pleochroic Q 40x Birefringence (Low) Coto: Clear Liquids: 1.550 Becke Line Used Initial Characterization: Chrysotile OS#1: Para?1.558, Perp.=1.549 DS#1: Para.=Magenta Purple Perp.=Blue None Detected Cellulose Fiber (Incom) 30% Fibrous Gass (ISO) <1 LAYER 4 Gypsum 70% Drywall, Off White/ Brown Note: Chrysotile associated with joint compound Analyzed by: t�"— env Core PAGF28OF32 Reviewed by: i �Wlj Page 4 of 6 ;STC Nidi Hopkinson EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver CO 80222 Collected: 05/21/2019 Collected By: Nick Hopkinson Collection Address: 3553 Simms Street, Wheat Ridge, CO Customer Project No.: 0519-37 Description: 0519-37/Butler Date Received: 05/21/2019 Date Analyzed: 05/21/2019 Date Reported: 05/21/2019 Comments: Wavy Fibers BATCH NO. 0028454 NVLAP Lab Code 102031 AHA Lab Code 101536 Asbestos Non -Asbestos Lab ID Sample Location / Constituents Constituents Sample # Sample Description M M 0028454-005 Bathroom, Wall Chrysotile 5% Cellulose Fiber (Incom) 5% 3553 -JCI -02 LAYER 1 OBSERVATION SET#1: Carbonates 60% Joint Compound, Lt. Gray, 25'C Wavy Fibers Birder/Filler 30% Note: Drywall Composite: <1 % Chrysotile Sign of Elongation (+) Birder/Filler 55% Mile, 25'C Parallel Extinction Non -Pleochroic ® 40x Birefrngence (Low) Color: Clear Liquids: 1.680 Becke Line Used Initial Characterization: Chrysotile OS#1: Para =1.558, Perp.=1.549 None Detected Cellulose Fiber (Incom) 40% None Detected Fibrous Glass (ISO) <1 LAYER 2 Gypsum 60% Drywall, OH White/ Brown Gypsum 60% Note: Chrysotile associated with joint compound 0028454-006 Bathroom, Ceiling Chrysotile 3% Cellulose Fiber (Incom) 2% Fibrous Glass (ISO) <1 3553-SM2-01 LAYER 1 OBSERVATION SET#1: Carbonates 40% PaintfOrange Peel Texture, White/ Off Wavy Fibers Birder/Filler 55% Mile, 25'C Sign of Elongation (+) Parallel Extinction Non -Pleochroic @ 40x Birefringence (Low) Color: Clear Liquids: 1.680 Becke Line Used Initial Characterization: Chrysotile OS#1: Para =1.556, Perp.=1.549 None Detected Cellulose Fiber (Incom) 40% Fibrous pass (ISO) <1 LAYER 2 Gypsum 60% Drywall, Brown/OH While, 23'C Analyzed by: Reviewed by: t+ enviCore PAGE 29 OF 32 E.N V iF 01l ISE n'Al IYSpEC Page 5 of 6 ;STC Nick Hopkinson EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver CO 80222 Collected: 05/21/2019 Collected By: Nick Hopkinson Collection Address: 3553 Simms Street, Wheat Ridge, CO Customer Project No.: 0519-37 Description: 0519-37/Butler Date Received: 05/21/2019 Date Analyzed: 05/21/2019 Date Reported: 05/21/2019 Comments: BATCH NO. 0028464 NVLAP Lab Code 102031 AIHA Lab Code 101536 Asbestos Non -Asbestos Lab ID Sample Location 1 Constituents Constituents Sample # Sample Description M (o/,) 0028454-007 Bathroom, Ceiling 3553-SM2-02 LAYER 1 Paint/Orange Peel Texture, White/ OR While, 25°C LAYER 2 Drywall, Brown/OB While, 23°C 0028454-008 Bathroom, Ceiling 3553-SM2-03 LAYER 1 Paint/Orange Peel Texture, White/ Off White, 25°C LAYER 2 Drywall, Brown/Off While, 23`C Analyzed by: envl core PAGE 30 OF 32 Chrysotile 21% OBSERVATION SET#1: Wavy Fibers Sign of Elongation (+) Parallel Extinction Non -Pleochroic ® 40x Birefringence (Low) Color: Clear Liquids: 1.680 Becke Line Used Initial Characterization: Chrysotile OS#1: Para =1.556, Perp.=1.549 None Detected Chrysotile 3% OBSERVATION SET#1: Wavy Fibers Sign of Elongation (+) Parallel Extinction Non -Pleochroic ® 40x Birefringence (Low) Color: Clear Liquids: 1.680 Becke Line Used Initial Characterization: Chrysotile OS#1: Para=1.556, Perp.=1.549 None Detected 1 1t�1 Reviewed by: Cellulose Fiber (Incom) 3% Carbonates 30% Binder/Filler 65% Cellulose Fiber (Incom) 35% Fibrous Glass (ISO) <1 Gypsum 65% Cellulose Fiber (Incom) 2% Fibrous Glass (ISO) <1 Carbonates 40% Binder/Filler 55% Cellulose Fiber (Incom) 40% Fibrous Glass (ISO) 5% Gypsum 60% Page 6 of 6 Inspection certifications c0`0 H �0 1876 Colorado Department Of PublicHealth and Enviroii ent ;ter" ASBESTOS CONSULTING FIRM This certifies that .amu .'. ✓ R. �l •^�, envioCt, LLC - re ;% 'egistration No: ACF = 21660 has met the registration requirements of 25=7-507, C R S and the Air Quality Control Commission Regulation No: 8, Fait % and is hereby authorized to perform asbestos consulting activities as required hider Regulation No 8, Part B, in the state of Colorado. lssued.,�- Febraary 14,"2019 - ✓�f J r ebnwy 14, 2020 f1 s �`ri^`.r'� fiu r .. : - `f f ApCQ gepresentdtive ` r:✓-��•�`ii�'�i'Y. f,/ 1 yr / i`✓ i�'� � � AUth01�LEd` `!rr^fn-^�✓nLji `^ //1"i^ J l ✓i ^ % r SPAT env)Core PAGE 31 OF 32 EN✓IFONIAE, INS SEC TONS Of �' +aa� • + 1876- Colorado e76sColorado Department of Public Health and Emironmcnt ASBESTOS CERTIFICATION* This certifies that Nicholas Hopkinson Certification No.: 23887 has met the requirements of 25-7-507, C.R.S. and Air Quality Control Commission Regulation No. 8, Part B, and is hereby certified by the state of Colorado in the following discipline: Building Inspector* H Aupua 16, 2018 August 30, 21119 • 7001, rrrr(f eato, Is I 01 nnlr with /he twrssesslon of a rtorrent b16-Wion-opprrn•ed /raining raanr rrrriflrnllnn In !hr dA, 1phnr %prrlf ed nhurr. envy ,�•„sE.. _�«. p —.'two t } AvrhmIr o APCD lag MlFfWova • '� sf Al i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: S, rn m 5 S �- Permit Number: c -,AU ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: Inspector: 6F DO NOT REMOVE THIS NOTICE g,20 (a INSPE TION REC INSPECTION ONLINE FORM: http://www.ci.wheatridge.co. /forms.aspx?fid=79 INSPECTION REQUEST LINE: (3 3) 23�59�,3 Inspections will not be performed unless this card is posted on th Call the inspection request line before 11:59 p.m. to receive an in the fol owing Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Initials Comments Pier Concrete Encased Ground (CEG) Occupancy,Type Foundation / P.E. Letter Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Initials Comments Electrical Sewer Service Plumbing Do Not Cover Under round or Below/In-Slab Work Prior To Approval Of The Above In Rough Inspections Date Inspector Wall Sheathing Initials Comments Mid -Roof Lath / Wall Tie Rough Electric Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw/ Nail Final Inspections Date Inspector Initials Landscaping & Parking / Planning Dept. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical Roof / Final Window/Doors Final Building Comments 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 by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather ;RMIT NO: DB ADDRESS: DB DESCRIPTION ** CONTACTS *** City of Wheat Ridge Residential Roofing PERMIT - 201702458 201702458 3553 Simms ST Residential Re - roof to n;tched, 9.2 flat) ISSUED: 06/23/2017 EXPIRES: 06/23/2018 install Laminate asphalt shingles with 36.2 sq. (27 WNER (303)809-9874 DEMMING H FORD 130239 Exceptional Exteriors LLC UB (303)386-4649 Steve Burns ** PARCEL INFO *** USE: UA / Unassigned ONE CODE: UA / Unassigned {UBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / ** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 9,303.40 FEES Cotal Valuation 0.00 195.37 Jse Tax 0.00 ?ermit Fee 195.37 k* TOTAL ** *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved mr�o final inspection, conducted when 25-75 percent of the roof covering is installed, prior approval. Installation of roof sheathing (new or overlay) requires napproved inspection n the entire prior to installation of ANY roof coverings and is require otire roof when spaced or board sheathing with ANY gap exceeding A1% -inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer&€"s installation instructions, whichever is more stringent. In order to pass a final inspectionofrom the elastomeric or similar type roof coverings, a letter of inspection and app rovalmanufacturer&#39;s technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. 3 c D Excepfiiont� 1 Exteriors, LLC *'%r c CONTRACT BBB t Property Oaa�er(s) ` ' C : k - 1)c i, 1 to 1,v (hereinafler, the 'Client' Address t+ S % (hereinafter, the •Premises'} City u '' �� r c ' 1 )-r rldt Stagy G zip ; _> Cel! 7�G'3 t r ` ' `i'�� Other Email 1 f 1A { cu i ,�%i 1 rr l�, Lt :4 r • .'�: ':� SCOPE OF WORK AS APPROVED BY INSURANCE CARRIER a Tear off all layers a Obtain buildN permit as required a Instal 15 Ib. felt, 34 lb. felt or Synthetic Underlayment a Adhere to all local building codes in effect as of install date a Install new pipe lacks, painted to blend a Remove and dispose of all debris created during project a Instal pre -painted eve flashing a Perform magnetic sweep of property in remove base nails a Instal new shingles of your choice a Provide a min. general liability ins. coverage of $1,000,000 a Re -flash all wall abutments and chimneys as needed a Maintain current Worker's Comp. Insurance on crews a Install ice & water shield in all valleys a Provide a 5 year Limited Workmanship Warranty (� �� k'f,'-' I �� AQP) T Oc, /�- Shingle Mfr. v wn, Style Shingle Color � L% Drip Coke 61-d "'t/ "—/ Approximate dates of services t 1 _ Approximate cost of services (Estimated RCV) The above items (knate cost and dates of services) are general estimates based on damages known at the time of conbract being entered. Scope of Work will utomately be perfomed for the RCV total plus any agreed supplements provided by your insurance carrier. Dates are approximate as weft and can be affected by inclement weather, availability of materials, wrraunt of time a lender may take to endorse insurance checks or the amount of time your insurance carver may take to approve the scope and(or payment of services. Upgrades Shingle Upgradey e Felt Ice and Water Ridge fent Wot s Power Vents Platinum Warrant}, $ Upgrade Total $ Estimated Client Payment ResponsUlty Deductible Amount $ Additional Work ("out of Pocket") $ Low Referral Credits Total Estimated Client "Out Of Poc' Deposit Amount $ t 1))0, y>,..Due upon delivery of materials. Customer agrees to have a payment available the day of delivery NOTES LINE ITEMS EXCLUDED FROM CONTRACT (WORK NOT PERFORMED) Additional work auftnzed by the homeowner but not included in the abm desoVbon will be desatbed m a separate addendum (Work Order Cmifimiawn Form). EzoeWnal E4erwrs, LLC and the Owd agree b the terms and conditions set lorttk on both front and back of tfas contract Exceptional Exteriors, LLC (hereinafter "Exceptional Exteriors' and 'EEL') will perform roof replacement and exterior repairs to the Premises for the Client as approved and specified by Client's insurance company (collectively, the "Scope of Work') for the replacement cost value (RCV) of the insurance claim. The only out of oeckwt cost to the Client Is their des .et�and any nor, recoverable depreciation where applicable as well as any agreed costs for any upgrades or additional worts authorized by the Client in writing. Supplemental claims and/or overhead and profit billed by EEL on behalf of the Client and approved by the Client's insurance company for additional work or increases in costs, in addition to this contract shall also be deemed a part of this contract as if contained herein. This contract will become binding upon execution and EEL shall receive all insurance proceeds, including the deductible. Client agrees to provide EEL with all insurance communications, both written and verbal, and to authorize EEL to negotiate with the insurance company on Client's behalf to secure the funds necessary to complete the contracted Scope of Work. EEL shall hold in trust any payment received from the Client until EEL has delivered roofing materials at the Premises or has performed a majority of the roofing work on the promise& 1. All proposals are subject to approval of EEL management. 2. EEL will perform the Scope of Work in accordance with generally accepted roofing and construction guidelines, adhering to local codes in effect at the time of construction. be 3. EEL's standard payment terms are as follows: 50% when material is delivered and 50% when work is completed. Endorse and/or make all checks payable to Exceptional Exteriors, LLC. Any joint checks issued by Client's insurance shadimmediately endorsed and tendered by Client to EEL company s 4. You have the right to rescind this contract and obtain a full refund of any deposit within 72 hours after entering the contract, if you plan to use the proceeds of a property and casualty insurance policy to pay for the roofing work, you may also rescind this contract within 72 hours after you receive written notice form the property and casualty insurer that your claim has been denied in whole or in part. However, EEL is entitled to retain payments or deposits to compensate EEL for roofing work workmanlike manner consistent with standard roofing industry practices, actually performed in a EEL cannot pay, waive, rebate, or promise to pay, waive rebate all or part of any insurance deductible applicable to the Insurance claim for payment for roofing work on your property, 5. To rescind, send by certified mail or Personally deliver a signed and dated Copy of the cancelled contract within 72 hours of contract signing, or 72 hours of written notice of denial of claim from the insurance carrier to the EEL address on this contract. Client may also email a signed and dated copy of the cancelled contract to centectus@exexco.com. B. All excess materials will remain the property of Exceptionsi Exteriors, LLC 7. Client is responsible for timely securing all required Homeowner s Association approvals of the roofin B. EEL shall not be liable for failure of performance due to labor controversies, strike fire,hail weather, acts of God, inability to obtain material from usual sources, or any other circumstances beyond EEL's control. g products and colons), 9. EEL shall not be responsible for any leaks or water damage below the roof line or any damage caused by excessive wind, ice or hail during the period of the warranty. 10. Replacement of code required materlals/upgrades not covered In Client's Insurance i a labor and material basis, policy will be additionally charged to Client on 11. EEL will not be held responsible for slight scratching or denting of gutters, oil droplets In the driveway, hairiine fractures in concrete, or damage to plants or shrubbery. Furthermore. EEL will not be or fallen crown molding or fascia, or interior dam t hold responsible far exterior damages such as broken 12. EEL's liability coverage insurer Alliance Insurance q end ��� plahanno �t rock or nail pops, 13. This contract and all attachments hereto represent the entire co^tceran« contact McEwen 72p g3g-3411 contracts between the Client and EEL. tween parties• and supersede 811 prior written or oral 14. This contract cannot be changed, modified or terminated by any other contract unless the same is in Rorty against whom enforcement of the change, modification or termination is sought writing and signed by the 15. This contract shall be binding upon the parties and their ts• H any one ntatives and or more of the provisions Contained n this contract for anyPermitted heirs, legal re respect such invalidity, illegality or unenforceability shalt not affect any of the other hold invalid, bgal or unenforceable leinsany construed as if such invalid, illegal or unenforceable provision had never been contained herein.ems' and this contract shall be 1, reser I here: any ma acco^1v, yocumer Isbursed 'Idly re9t their ret You, 17. An account is past due when more than thirty (30) days have passed after the roofing work was completed. If an account is past due by 60 days a late charge of $120 will occur. If an account goes to into collections, Client shall pay EEL interest at twenty- one (21 %) percent per annum for all past due accounts. N Client does not pay all sums when due under this contract to EEL, then Client agrees to pay all costs and fees incurred by EEL for its collection, Including reasonable attorney fees and costs. EEL reserves the right to place a mechanics lien on Client's property for any default in the timely payment of amounts due under this contract. . Client shall pay EEL interest at twenty-one (21%) percent per annum for all accounts 90 days past due. 18, the parties waive the right to a jury trial in any action or proceeding based upon or related to any aspect of the transaction in connection with this contract, or any document executed or delivered in connection with such transaction. 19. Venue for any legal action brought pursuant to or involving this contract shall be in the City and County of Denver, State of Coborado, or any other location mutually agreeable to the parties. 20. Ail attachments to this contract shall be part of this contract and are incorporated herein by this reference. 21. it is the Client's sole responsibility to provide a safe -keeping area for all pets. EEL shall not be responsible for gates left open during or after its work. 22. After Client has paid all sums due under this contract, the inspection will be called in to the city/county/municipality and Client will receive a five (5) year Workmanship Warranty for the roof and one (1) year for all other work. EEL must be notified of all Warranty claims within five days of the discovery. Exceptional Exteriors, LLC 3679 S. Huron Street, Suite 402 - Englewood, CO 80110 Phone: 303-386-4649 E-mail: coin -YwY -o_c�m Client Signature Date Z°t I Exception LLC Representative Date �_�Y� i _) C • il,, lam � r- Printed Name Printed Name F, City of Wheat Ridge Residential Roofing PERMIT - 201702458 PERMIT NO: 201702458 ISSUED: 06/23/2017 JOB ADDRESS: 3553 Simms ST EXPIRES: , 06/23/2018 JOB DESCRIPTION: Residential Re -roof to install Laminate asphalt shingles with 36,2 sq. (27 pitched, 9.2 flat) *** CONTACTS *** OWNER (303)809-9874 DEMMING H FORD SUB (303)386-4649 Steve Burns 130239 Exceptional Exteriors LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 9,303.40 FEES Total Valuation 0.00 Use Tax 195.37 Permit Fee 0.00 ** TOTAL ** 195.37 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding A;�-inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturera€T"s installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer&#39;s technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. City of Wheat Ridge Residential Roofing PERMIT - 201702458 PERMIT NO: 201702458 ISSUED: 06/23/2017 JOB ADDRESS: 3553 Simms ST EXPIRES: 06/23/2018 JOB DESCRIPTION: Residential Re -roof to install Laminate asphalt shingles with 36.2 sq. (27 pitched, 9.2 flat) 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 leggally authorized to include all entities named within this document as parties to the work to be performed and that all work to.be.pertormed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER?r CONTRACTOR (Circle one) Date 1, This perni�t w,as issued based on the information provided in the permit application and accompanying dans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, po plans 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 and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change, of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all 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 b construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any ordinancetegul on f 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@ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. Antoinette Kulick - � 6,-� 4 (:; "/-' From: no-reply@ci.wheatridge.co.us Sent: Tuesday, June 13, 2017 3:33 PM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. Permits are currently being processed within 3-5 business days, subject to change based on volume. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall./The Building Division will be open from 7:30-10:30 a.m., Monday through F day 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 Property Owner Name Property Owner Phone Number Property Owner Email Address 3553 N. Simms St. H. Demming 3038099874 fdemming47@gmail.com It 1955.3') Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. CONTRACTOR INFORMATION Contractor Name Contractor's License Number (for the City of Wheat Ridge) Contractor Phone Number Exceptional Exteriors 130239 3033864649 Contractor Email Address permits@exexco.com (permit pick-up instructions will be sent to this email) Retype Contractor Email permits@exexco.com Address DESCRIPTION OF WORK Are you re -decking the No roof? Description of Roofing Laminate/Asphalt Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 27 material selected above? Does any portion of the Yes property include a flat roof? If yes, how many squares 9.2 on the flat roof? 2 TOTAL SQUARES of all roofing material for this project Provide additional detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract value or cost of ALL materials and labor) 27 Pitch 4/12, no separate garage 72s&- 8303 , G - SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that this Yes application is NOT a permit. I understand I will be contacted by the City to pay for and pick up the permit for this property. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have been Yes authorized by the legal owner of the property to submit this application and to perform the work described above. Name of Applicant Rob Juenger Email not displaying correctly? View it in your browser. 3 EZ I •Drees to have a Paymerrt a�Flable -t Oliorc c 6Xt-r LLC �, • 1 rear p� SC ar (hereinafter the Client • nsl all la OPE OF Wo (h+- /ns�nt5lb. felt 301. RKAS E 4o her �Srrr+ses7 • Inst ewNeia� b Borgnmet� APPROVE flail _ �' _ ' Reser r �n d paj�eve #ash � � end U went O 3Y I"'JRANNC � � u` ogles E • l ► a// wal//�,,,°�f Your 9 0011 Obi CARRIER '� , ghi e Ace$ watersh?v�d alln ' Ys as . ovet emit as r uirad u `4 Atfr alleys need A$ and di �in8 Codes. wry S � ed Provide rr'�e °f audebris in effect as of ia* CIIns (K Stye dab vl% � • P Intain grn�9W o � i�q to ftiect ro�rerl a 5 Year oers s. covefa9e o f 'ose Wads rn r i le color �� �( rn>ted Vy sh � on $ "� 711e of y 3eNi{ alb Lt of agoto �. ehe a �a a uenddates x+t,ef st of 'oin�ae' � �fseal (Esnrated RC� f� 778 rare Men, �n?er a tek-� air ah 4afa�ba1 k pafpvesk�n pp,�e Shing fP PmuBGyesoroQv+deeb�,� tirr� �n of Ric+�e ven PgrQde Vp9rpd�s �brpa�ntofse., 14770 a / OW 8 Qa1e��8n�d. 1 y e ve ias pjaf`n''m jyu�' ° r encs Pell> Ice Polll er s er 1000a' W01k l `�+n � a'�►+a�,,,r x'01 kel- 4-4 ald $ roil asf8d G 110nf "put�pori_... ay.. teril .)ops 836-: remec ,1.0 is to ,,,Q reser ,Ygw+.a, A ans Iteret nereptn- A i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Alt AA S Permit Number: ❑ No one available forrYes n: Time AM/PM Re -Inspection requireNo When corrections have been made, call for re-inspedtidn at 3`03-234-5933 Date: Z ! ! Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: '3 S'S 3 .S Permit Number: 2.D ��% ® - 'IT*- 11v',fL f'1/c; L/� ❑ No one available for inspection: TimQX, AM/PM Re -Inspection required: Yes o When corrections have been made, call for re-inVc�lon303-234-5933 Date:Inspector: �� DO NOT REMOV -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: Ar 0 Job Address: 3 %�� 1 Nt /LA .$ Permit Number: 2 d 7 p 2 e-1 ❑ No one available for inspection.: Time r!� .� AM/PM Re -Inspection required: Yes �N - When corrections have been made, call for reins` fion at 303-234-5933 Date: Inspector: / �',L I ®O NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division r (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: )QD P Job Address: --�S _l Yn,�,L5 Permit Number: 2UY7 U � ❑ No one available for inspection: Time! (i��ft�i AM'IPM Re -Inspection required: Yes N0) When corrections have been made, call for re -inspection at 303-234-5933 Date: 74/!/ /7 Inspector: T U �ON(51,1fir. DO NOT REMOVE THIS NOTICE City of, at d g( - FOR OFFICE USE ONLY Date: PlanlPermit # 2 c> Lo I ii1';•! 1 1 ii IN 1!! 1 1 1 1 1 .1 it" ---- - v Property Address: 3553 Simms St Wheat Ridge, 80033 I Ford Dernming Property Owner (please print), Phone: 303±�� Property Owner Email: not availab Address: Same as Above Contractor, Thd at Home Services, Inc —1 Electrical: WR City License # Plumbing: Phone: 1-855-712-8899 Complete all information on BOTH sides of this form Elm 0 NEW COMMERCIAL STRUCTURE Q ELECTRICAL SERVICE UPGRADE [I NEW RESIDENTIAL STRUCTURE 0 COMMERCIAL ROOFING COMMERCIAL ADDITION RESIDENTIAL ROOFING RESDENTIAL ADDITION WINDOW REPLACEMENT i r COMMERCIAL y yi STRUCTURE i a# shed, deck, RESIDENTIAL ACCESSORYSTRUCTURE *.i. shed, deck,.« MECHANICAL SYSTEM/APPLIANCE REPAIR i 1M. # REPLACEMENT PLUMBING SYSTEM/APPLIANCE i Ib ti or • ! A ELECTRICAL SYSTEM/APPLIANCE i•11 1Y i 8 or REPLACEMENT ■ y OTHERKI #` ♦ # (For ALL projects, please provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage existing condition and proposed new condition, appliance size and efficiency, type and of .' to be used: 'A'eplace (4) windows. Like for like in existing openings. U -value =.32 max Sq. FtAF __._,� ------ ..__. Amapa ____ Squares ---11—-1-1---- ------ -.._.­---------' Other EF fl, �A! Ifl C5, In 10 In In In CI iA In Ir, In In lf V7 V1, VI te� In V�; "In Ic Ic cz It" z 44 LL, � a IV. L3 01 cl C i tv of W,66 -at cd], --y' 1;NlT'ND[-VF1,0PMFNT FOR OFFICE USE I� Planer nit, 0 IJ�D-76 Plan Review Fee. 11; , 11111111�111;11111 111111 11111!!11 �ililill 1111111111111 I� 11 11 um= Iii-liTri :r!JJJ �l'J �I JJI 11 11 Jill!" 1 11 Jill I I i 1!1� 1 11 ill I 0,1roperty Address. 3553 Simms St Wheat Ridge, CID 80033 Property Owner (please prinfl: Ford Demming Phone- 303-809-9874 Address: Same as Above City, State, ' Architect/Engin _ftrN/A Contractor: Thd at Home Services, Inc Contractor E-mail Address: copermits@gmail.com City License # Plumbing: WR City License# a= - VAT 7 IM7 " re'le * P 11-1 City License # Mechanical: WIR, City License # Complete all information on BOTH sides of this form El NEW COMMERCIAL iwy STRUCTURE • I. a SERVICE UPGRADE ADDITIONNEW RESIDENTIAL STRUCTURE Q COMMERCIAL ROOFING COMMERCIAL y� RESIDENTIALROOFING ENTIAL ADDITION R] WINDOW REPLACEMENT COMMERCIAL y !r STRUCTURE RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT E] PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ELECTRICAL i A MfFtREPAIR MAb oREPLACEMENT IIF y OTHER (De amount(For ALL projects, please provide a detailed description of work to be performed, including current use of areas, of materials to be •,• Replace ( 4 ) windows, like for like in existing openings. U-value=.32 max Sq. FULF ___ Stu's Gallons Amps _.,._ _... e ._ _w . _ .. _e_..._ squares _. �._._ �...__..._...___ ___ ter il I Em Cl ICI lc� ria N3 t to 0- 4 ot, OV ok *71 21 4d I 40 z tr e, f-4 ria to 0- 4 *71 11;59 P- I FOR OFMCE USE ONLY Cit,y of W he at e m L)NiTN' DEVELOPMENT M planMenzlit # 1) 1111111111111,111�111111111111;1111111111111111jr 1117� . III 0 * . z - * �iroperty Address. 3553 Simms St Wheat Ridge, CO 80033 Propel wner (please prino: Ford Demmin2 - ph 303-809-9874 Prope!j y Owner Email: not available 1111 ppi � 1� 11 j i� �� ip pill Address: Same as Above City, State, Zip: T rUJIM Phone: Contracto d at Home Services, Inc mmum Phone. 303-360-0126 x 8642 Contractor E-mail Address: copermitsCa)gmail.com Plumbing: WR City Ucense Mechanical: U/2- Citv License # Complete all information on BOTH sides of this form i I Im 11111 1 Sq. FtA.F Stu's Gallons • 113 1 WIN I Ili III I iiiiiiiiii "I I � I I I I I 1 1 CIRCLE ONE: (OWNER) (CONTRACTOR) ar (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Jules Landis I - ERIn NAME: SIGNATLT",: DATE: R is r4 fA C, CI 00 4A iA toq az (A vi 44 EA I R vi I R iA iA I- R I R I R I � 00 x 49 to cl, 40 u 4d 9 a os 46 t:s 40 40 co ;J6 C4 I ca ra ei is r4 fA C, CI 00 4A iA toq az (A vi 44 EA I R vi I R iA iA I- R I R I R I � 00 x 49 to cl, 40 u 4d 9 a os 46 t:s 40 40 co ;J6 C4 I ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: &Qt~ Vii; Pei l Job Address: ~r , X711 z F $J Permit Number: (D 1 7., ❑ No one available for inspection: Time AM/PM Re-Inspection required: Yes No When corrections have been me e, cal r re-inspection at 303-234-5933 Date: `c } 'v f Inspector.~I ' r DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 235 -2857 Fax INSPECTION NOTICE Inspection Type: 4t_sit Job Address: �5_�55 Permit Number: relI34r/ r ❑ No one available for inspection: Time AM PM Re- Inspection required: j °` No When corrections have been made, call for re- inspection at 303 - 2345933 Date: 4 '7l-f�`z Inspector: DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line J (303) 235 -2855 Office • (303) 235 -2857 Fax INSPECTION NOTICE Inspection Type: OK d:1•,rw ~ Job Address: rZ 7, �4. Permit Number: oa f 30ff ❑ No one available for inspection: Time LWO 'AWPM Re- Inspection required: VesNo When corrections have been made, call for re- inspection at 303 - 2345933 Date: �� I r Inspector. DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE �� Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 235 -2857 Fax INSPECTION NOTICE Inspection Type: <O�Tri6 Job Address: a5S 7 5ir�r s r Permit Number: r -2 �//-4 v 772 EE ❑ No one available for inspection: Time : sus" AM /PM Re- Inspection required: , Yes _ No "When corrections have been made, call for re- Inspection at 303- 234 -5933 Date: inspecto DO NOT REMOVE THIS NOTICE 19-Aug-2009 12:06 PM ASPEN 3037457363 112 ~mw 1300 S Potomac St. Suite 152 Aurora, CO 80012 (877) 784-7663 otncB 1 V (303) 752-5232 Fax LO-ITIR-AC_TING ShC,( L\LU.INC: IN NAIL M^ MLA ' RL'•RPQFINCL WIND u. h I~11LllM t)M•{.V\~:L To: TOWN OF WHEATRIDGE From: Kevin Krickbaum Attn: Building Dept. Pages: 4 , Fax: (303) 237-8929 Fax: (303) 752-5232 Phone: (303) 235-2855 Phone: 214 405-3194 Re: Permit Amendment Date: 8/19/09 Job Name: permit#091394 3553 N.Simms Street 19-Aug-2009 1206 PM ASPEN 3037457363 vµ e K ~I.wG wT ~ r /J'C r In.~ .T ~ ~ ~ 3 / ~1 3553 .c~ .Sr/,~~slS"r~~~ l1 ~~ragr a~i~' SL+s~'S'h'~rS "I'n)'~riw~T pAr 9- /Vf l ~j~ ! w S/~CG! iOw Ow 60 '0 11 qJ . / O~s~~'' ~ / ! )/G~~cI S Gm~-s ~ ✓µL 1 cO r. VK\ ~/•L ~~/LJ~ 2 r1Y BIOS 36 y 2/2 -)0p ZI 1 41 City of Wheat Ridge ~rr ►J Faxed Roof Permit PERMIT - 091394 PERMIT NO: 091394 ISSUED: 08/18/2009 JOB. ADDRESS: 3553 SIMMS ST : EXPIRES: 02/14/2010 DESCRIPTION: Reroof. ,28 sqs.. CONTACTS owner 303/467-1332 Catherine Demming sub 866/948-0933 Chris. Nussbeck 09-0168 ASI Contracting PARCEL INFO ZONE :CODE:: UA.. USE: UA 'SUBDIVISION: 0680 BLOCK/LOT#: 0/ **FEE SUMMARY ESTIMATED PROJECT VALUATION: --.6,440.00. FEES Permit Fee 181.10 Total Valuation .00 L~6 ~.)•4 Use. Tax 115.92. , **TOTAL 297.02 `.Conditions:. r- Both front and back.. of permit need to be posted on job site. If one or the other is not present, : INSPECTION WILL NOT. BE PERFORMED.. 6 nail. installation mid-roof. inspection required.. Board sheathing ..spaced more thana 1/2 of an inch apart requires plywood overlay on entire roof. Ice and water shield required from -:eave`edge to 2'inside exterior ..walls. 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 regulations of the City of Wheat Ridge or covenants,. easements or restrictions of record; that all Iy. 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 . r' ap icable Wh at "d a Ord,, nces, for work under this permit. Plans subject to field inspection. ~Y ~n G, 6ignature of contractor/owner date x 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 r" 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 maybe 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. g:, 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. yr All plan review is s eject to field inspections. c r Signature of Chi 1:111,1 ; ing Official date INSPECTION HQ ST LINE: (303)234-5933 - BUILDING OFFICE:-.(303)235-2855 ~~REQUESTS ST BE MADE BY 3PM. ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. FOUNDATIONINSPECTIONS DATE = INSPECTOR INITIALS COMMENTS: ootings/Caissons temwall / (CEG) Concrete Ground einforcing or Monolithic eatherproof / French Drain Sewer Service Lines Water Service Lines POUR NO CONCRETE' UNTIL ABOVE HAS BEEN SIGNED CONCRETE SLAB FLOOR - Electrical (Underground) Plumbing (Underground) Heating (Underground) 'D,O N OT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ROUGHS Sheathing Lath / Wall tie Mid-Roof Electrical Service v; Rough Electric ' : z i% =RoughPlumbing _ . . Gas Piping e-. Rough Mechanical ABOVE INSPECTIONS TO BE _SIGNED(PRIOR`TI Framing ' Insulation Drywall Screw FINALS - Electrical X y X Plumbing . Mechanical ' ~U~" e Roof X2 Final f Fire Department, : s » ' ainage SPEC andscapingSNOUL LL ITEW 4jST,BE COMPLETED AND APPROVED BY PLANK/NG.AI E* TE OF OGC'UPANCY. -I,b' ISSUED. INAC INSPECTION BYITHE $U1L'ij CER ntt h _ ` ' OFA CERTIFICA.TEEOF OCCUPANCY: NOR PERM OCCUPANCY NOT'PER"MITTED UNTIL GERTIFI PROTECT THIS CARD-FROM .THE WEATHER 11,-Aug-2009 02:04 PM ASPEN 3037457363 `~1I .Y City of " x 7heat CommuNITY DvELovv Office; 303-235-2855 " Fax.-303-237-45929 Inspection Line: 303-234-5933 Facsimile Building Permit Application 1 MM _ Property owner (please Mailing Address: (if different than Address; oe pate: D Perm/t 'za_azl! 2/2 Phone: (303) 51(®7-1332 =am: XS.L eawIv-611-AL4 ~&C. Contractor License Q 901Gf1 Phone: Su) 9q?-oqa 9 iomnanv ame: License Expiration Date: Trade/Profession; Approval: Use f e ace descrl Bon): G5~ O owe'v CorK CwIef je 3o y.- J✓ Plan Review (due stoma of aubmfflal): $ 8q. FL/L.Pt added: Squares Zg BTU's Gallons Ampa OWNER1cONTRACTORSIGNATURE 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 aggree to abide byy all conditions printed an this application and4hat I assume full reeponalblitty for compliance with the Wheat Ridge Building Code (I.B,G) and all other applicable Wheat Ridge Ordinances, for work unreerthis permit. Plans subjeo d inspection. C/RLCEONE:: (OWNER) TRACTO or PERSONAL.REPRES Of tER) (CONTRATOR) EM NAME: 4 kk4 SC O~O(10~, a SIGNATURE; Date: Bldg Valuation: Credit Card Pay~t nt: Use gredit card listed on file/IS~t ~`~7-0f Print name: - SclcoAoe Signature; ( ~ ~w~co~~+-r■nu e~~+~e■~ CITY OF WHEAT RIDGE Building Inspection Division Y-OOOOO (303) 234-5933 Inspection line (303) 235-2855 Office ' (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: N,nh, Job Address/Permit Number: M f'? `IfIe?C366.o' i No one available for inspection: Time 12L// ANY M Re-Inspection requiredr Yes `.When corrections have been made, call for re-inspection at 303-234-5933 Date: "7-~•{~~ Inspector: 2 DO NOT REMOVE THIS NOTICE t, CITY OF WHEAT RIDGE Building Inspection Division / (303) 234-5933 Inspection line (303)-235-2855 Office ' (303) 235-2857 Fax INSPECTION NOTICES Inspection Type:r Job Address/Permit Number: c = S~ ,.F s I,' ❑ No one available for inspection: Time OPM Re-Inspection required: Yes No When corrections have been made, call for re-inspection at 303-234-5933 Date: 7/ /9 Inspector: ~t DO NOT REMOVE THIS NOTIC rz II ♦ i CITY OF WHEAT RIDGE Building Inspection Division I (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE ~ ~svsd~t'Gr r~.l; `r ~Y_YSX®~idICJ't3,QC .lis?s%r~/c% fs~ fpJ1d~i~ ~~n:9i { f-s$-Til~ ❑ No one available for inspection: Time AM/PM Re-Inspection required: Yes >No «o "When corrections have been made, call for re-inspection at 303-234-5933 Date: ,,,/zAo Z Inspector: 47;„ r_ DO NOT REMOVE THIS NOTICE Inspection Type: 6,4d l ng~~ Job Address: 5 <-F c c <T Permit Number: 6g44_X z All i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: d : L d~eoF Job Address: _ X553 a4rr~ as s s r Permit Number: C~ vo y9' is i 4 i G iF i l` t; ❑ No one available for inspection: Time AM/PM Re-Inspection required: ~-No When corrections have been made, call for re-inspection at 303-234-5933 Date: eZ Inspector: DO NOT REMOVE THIS NOTICE a City of Wheat Ridge Building Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855" Fax: 303-235-2857 Inspection Line: 303-234-5933 Building Permit Application Date: t6i Plan Permit Property Address. 5z5 )%JW(t s S?L Property Owner (please print): Mailing Address: (if different than property Address: Phone: City, State, Zip: . Contractor: Contractor License ),3 ) ?3 Phone: 3 6 ~ - &6 -&&,L/ .7 Sub' Contractors: Electrical City License Plumbing City License Mechanical City License Company: Company Company: Exp. Date: Exp. Date: Exp. Date: Approval: Approval: p Approval: Use of space (description): 30 d0-M enSr p,r ii Construction Value: s 317 p p 1 a e> Description of work: i ~A G6 a / (as calculated per the Building Valuation Data sheet) J Plan Review (due at time of submittal): $ Sq. Ft./L.Ft added: Squares BTU's Gallons Amps OWNERICONTRACTOR 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 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. CIRCCE ONE:: (OI`WNER)`_ (~C_ONT~SRACT6O/R) or PERSONAL REPRESEN VE of (OWNER) (CONTRATOR) PRINT NAME: Jyn-skn (.0®6C. SIGNATURE: Date: '1 (40 01K 3 O m ~ ~ ~ ~ O ~ c o ~ A m o m N Q7 (D R a_ ~ c, ~ 3 0 ry 0 O d n o a~ ~(D ~ O A ~ wo • < 0 0 7 w C 1, A ~ L ~ Q (D r i°o(~o 0 3 ay m ~a a O 3 O D ,N F. m C) co E; < a o :r O U) N C O Y ~ c ~ 3 CL O A ~ , N (D m D A ~ m N (Dq 10 Of O 7 < n C r 0 v I 4 - z T o ~ N * ~ v v m N » > ~ ~ ~ Z ~ D 0 m ~ 3 C) m m ~ DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : 10345 % BUILDING INSPECTION LINE - 303-234-5933 CITY OF WHEAT RIDGE Date : 4/7/00 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 - (303-235-2855) Property Owner: Property Address : 3553 SIMMS ST Phone : 467-1333 Contractor License No. : 17152 Company : Precise Plumbing Phone : 534 0881 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I Ihereby certify that the setback distanees proposed by this permR application are accurate, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrietions of reeord; that all measurements shown, and allegations made are accurete; that I have read and agree to abide by all conditions printed on this epplication, and that I assume fullresponsibiliN for compliance wRh the Wheat Ridge Building Code (U.B.C.) and all other applicable Wheat ttidge ordinances, for work under this permk. (OWNER)(CONTR4CTOR) Description : Replace hot water heater Construction Value : $309.00 Permit Fee : $23.50 Plan Review Fee : $0.00 Use Tax : $0.00 Total: $23.50 Use: Electrical License No : Company : Plumbing License No : Company: Mechanical License No : Company: Expiration Date : Expiration Date : Expiration Date : Approval : ApprovaL' Approval : (1) This permit was issuetl in accortlance wkh the provisions set forlh in yopur application and is subeM to the laws of the State of Colorado and to the Zoning Regulations antl Building. Code of Wheat Ridge, Colo2tlo or any other applicable ordinances of e City. (2) abThis anEOrned fo a a l "pire of 2 the days.~ authorizeC is nol commencetl wRhin sixty (60) tlays from issue tlate or (B) the building authorizetl is suspended or (3) If Nis permit expires, a new permit may be acquiretl for a fee of one-half the amount nortnalry require4 provided no changes have been or will he made in the original plans and speafcations and any suspension or abantlonment has not exceeded one (1) year. If changes are matle or if suspension or abandonment exceetls one (7) year, full tees shall be paid for a new permiL (4) No work of any manner shall be tlone that will change Me natu2l Bow of water wusin8 a tlreinage problem. (5) Conireclor shall notiry the Building Inspector twenty-four (24) hours in atlvance for all inspectlons and shall receive written approval on inspaction cartl before proceetliing wtth successive phases of the lob. (s) The issuance of a permR or the approval of drawin9s antl specifptions shall not be canstruetl to be a pertnit fOr, nor an approval of, any violation of Ne provisions of the builtling cotles or any other ordinance, law, rule or regulation. Chief Building Inspector DEPARTMENT 01: PLANNING AND DEVELOPMENT Building Permit Number : BUILDING iN8PECTION DNISION - 235-2856 . CITY OF WHEAT RIDGE • Date : 7500 WEST 29TH AVENUE WHEAT RIDGE. CO 80215 Property Owner: Fa~~~°°"n%" ~ • . Property Address : 3 5 S 3 S~'~r'n s t , Phone : YC %/3 3 3 Convactor License No. 7/ S-~Z Company : Pr s cis '00/.p, <i~ y.2;; C-- Phone tr/ OWNER/CONTRACTOR SICaNATURE OF UNDERSTANDING AND AGREEMENT I neraby certiy tnac me sMadk aisnncss proposw oy mis psmmt apprcation an uarats. arq Ao na vroiats aopuabN orownom nun a mpwuons of tfN Ciry d W"st RIOpr w wvwmro. easemama a rsstnpions o! nmetl: tlyt aY meatasivernana snown. ano alNpauons rmaois aro aceuraa: mat I nsvr tsao ane ro atilde ey ar maloons ornra an tlW spprntion. ana mat 1 auurrr Wq b oonqrlnoo wwh tlw YN~t RWp~ &dtlkg CoOt (U.B.C.) ana an atlw apprabN IM io!z ammac br ur work qwM"s pomrt (OVAERxconrrRAcroR) COOS1NCf10D V81YQ : 9O P - Permit Fee : z :1 SO Uae Tax:.C0w,-s PcLOj•rs row: 23 5n . DEEC(Iption: /'~V/ct /fv4 4i^ J PT•t0'< .!C'e/' i4~•c ~'o.~ BUILDING DEPARTMENT USE ONLY I Approval: Zoning : APProval ~ V Approval: Occupancy : Wails Roof : SWries : Residential Units : Electncat License No : Plumbmg License No : Mechanical License No : Company: Company: Company: Expiration Date : Expiradon Date : ExpiraBon Date : Approval : Approval : Approval : ~ : Pltn's'Rdqutrsd= I : Firhs ROgutred." ; t) ilus pamut wai owa0 YI aCCaWnp wmf Oia provaqni fM krm n yopy appbnppn aro O tUq~et b 01~ IM~ W 11N SUb W CdOqOO sn0 b IM Zd~vp ;Z7 RpWauons ano Bwbug Coe~ of WMSt Rqq~. Cadaoo a aM oow/ soqraOM orovunps W 1eu Cily. This o~rmn snan axove d fAl ma wwa aummsoo n ro, mmmWioea wnwn wT' (60) e+Ys han mw Wu a f8I IM EwNUq auuaraw s tu+wWO a aovwonao ror a pwqa a 720 aaya iI mu oermrt eiam. a new wmvt m+Y oe aoaum b a M d oM-Nn IM urwwrt nommM nauraG. povqw ro dunges new Own a wo Ee nrW n aq . ag~W pana srw ue06neons ana anY auoWtqn a swrqonnrm nas na expwea one (1) Yow. p Cwqn wn mwo a d wnpwMqn a suwqomwK excsws ona 111 rw. Wx Nn uW w wn br a nw ownn. (4) No wWk o( inY manfla/ fMiY Ot OOn! QNt Mr/ ffNnW M Ilatlual Mw W watM tlYLllq 7 0pY1s9@ 0MWMn. 'S) Ca+uaaor snsn noury me Budaug insowa iwM+ryaour (xs) noua n awann ror aa mipKOOna vq uiu reelN r,mwn gppromi on ngp@mon nra pNa~ Woc~aau^9 wnn suaessrve dusaf ol me p0. ~6) TT! ufuinC! O( a Demvt M Ne i0W0"aI pf pfiwNlqs in0 SDqGdCOnt Sllill nOt Do mnSVt1lp m pe i pORM (p/. Ilp/ an mpapyel W, illy rqIi00110( M DIOWqfI{ ot me Dunomq mues or any otner oramarrs. uw. ru:e a reqwavon. Chief Budtlinq Inspecror - For Mayor THIS PERMIT VAUD ONLY WHEN SIGNED HY THE CHIEFBUILD(NG INSPECTOR ANO'NUYOR CALL: 2345973 24 HOURS PRIOR TO INSPECTION DEPARTMENT OF COMMUNITY OEVELOPMENT 7500 WEST 29tn AvENUE BUILDING INSPECTION DIVISION 237-6944 ExT. 255 P.O, eox 63e CITY OF WHEAT RIDGE, COLO. PERMIT Nq~91/117341 THIS PERMIT VALID ON~Y WHEN SIGNED BY THE CHiEf BUILDING INSPECTOR AND RECEIPTED BELOW. APPUCATION FOR MISCELLANEOUS PERu IT ~ JOB ADDRESS ~j l . OWNER CONTRACTOR h ADDRESS ADDRESS PHONE ZIP CODE DO _ CITY " ZIPCODE CONTRACTPRI E $T//PO PHONE LICENSE NO. DATE _J- / 9"i / 1. TYPE Ground❑ Woll❑ Proleotingo 2. MATERIAI ~ S q D Fats SIGNS 3. ILLUMINATION Ya❑ Noo T s Y~ Tofal SQuan FaN 4 SET BACN FROM PROPERTY LINE 5 . Eleef Psrmit No. (SDecify which ia fron}) ❑ E ~ W cl E] Zons_ Approved,Zone Inspeeta 1. TYPE SolidO M Disappraed on TAOn 80% ODen❑ Looi Thon BO% O en FENCES ? MATERIAL p 3, SET BACK FROM PROPERTY LINE N $ H~~OM (Specity whieh is tront) ❑ g ❑ W ❑ Z0^*- AOMaW,Zons Inspgeta psapprovad ' ' 'OT HER J ~ 8. L DRAW SKETCH OR SHOW BEIOW, THE FENCE,SIGN,OR OTHER STRUCTURE.GIV{Nu p157ANCE5 FROM pRppERTY LINES. (SETBACKS OR PROJECTIONS INCWDED) J INSPECTION TICKET JOB ADDRESS L DATE: 1,~2- O BLDG. PERMITM l 3 V;' PERMITM BLDG. CONTR. J STREET NAME SMOW DIS7ANCES FROM THE MAIN BUILDING TPADJOINING HOUSES, STF SUBCONTRqCTOR DISTANCE TO PROPERTY LINES, NOT MAXIMUM OR AVERAGE DISTA DATE INSP. l APPLICATION FOR PLUMBING; ELEC n/ THIS APPLICATION WILL BECOME A PERMIT TO PERFORM THE INDICATE 7YPE OF INSP. PERMIT WILL EXPIRE 180 DAYS FROM THE DATE OF I' ELECTRICAL PERMI7 PLUM8INC INSPECTION MADE STATE LICENSE N0. SiATE LICENSE NO 1AIINM1M WIRE UNDERSIZE B IILEGAL lp REMARKS ' ,v_✓ BSM 1 ON. TEMPORARY METER WASH BOWI. - NEW SERVICE - AMPS BATH TUB CHAN6E SERVICE-AMPS SHOWER _ LIGHTIN6 $INK W.R. FORM 6.19 HEATING GARBAGE DISP POWER SUB-CIFCUITS WATER HEATER UTIUTY(RANGE, DISPoSER, ETC ) AUTO. WASHER I FIXTURES DISH WASHER _ WIRING MOTOFtS d CONTROLS FLOpR DRAW SIGNS URINAI ELEVATOR TRANSFORMERS 9 RECTFIERS SEWERS ADDITION TO OI.D WORK OTHER MOTORS OVER I HP TOTAL FI%TURES REMARKS 1 MreDy ocNnowledqe tnot this aDplico- PERMIT FEE NOT VALID UNLESS RECEIPT! tion u torrect and understand tnot I USE TAX connor Srart tnis project unrii tnis ovvr- totion it opproved. I shall comply with TOTAL FEE $ / c tM lows o1 the Stafe o( Colorodo and to / the Zoninp Repulntions ond Buildinp AppROVED J Code of the Cify ot WAeot RidQe. Any E91SkppRO'p'E'D- ~ _d ky, 1-6 02 sp I violarion of tne above terme wiil cause im di t CHIEF BUILDI INSPECTOR, City of Wheaf Ridqe me a e revocahon ot fnls ermi ~ - CALL 237-8944 EXT. 255 24 HOURS IN ADVANCE 1 iean &pna~ur Da}e Issued FOR INSPECTIONS ~ i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office p INSPECTION NOTICE Inspection Type: !L +rWUC- -\ Job Address: (- Permit Number: O Do b O tom; 0- C/ ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: http://www. cL wheatridge. co. us/inspection Date: Inspector: 1 DO NOT REMOVE THIS NOTICE