HomeMy WebLinkAbout3662 Simms StreetPERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION
City of Wheat Ridge
Residential Roofing PERMIT - 201702812 �-
201702812
3662 Simms ST
Residential reroof
4/12 pitch
ISSUED: 06/28/2017
EXPIRES: 06/28/2018
Install asphalt shingles, 27 squares 130 mph lifetime
*** CONTACTS ***
OWNER (303)870-3282 CHRISTENSEN ANDREA G
SUB (303)756-7663 Ty Correy 090134 Advanced Exteriors, Inc.
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,800.00
FEES
Total Valuation 0.00
Use Tax 226.80
Permit Fee 220.15
** TOTAL ** 446.95
*** 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€rms installation
instructions, whichever is more stringent. In order to pass a final inspection of
elastomeric or similar type roof coverings, a letter of inspection and approval from the
manufacturer's technical representative stating that "the application of the roof at
(project address) has been applied in accordance with the installation instruction for
(roof material brand name) roof covering" is required to be on site at the time of final
inspection.
�1 0J7 �(
3C��()-S)�' y" 'INSPECTION ECORD
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/forms.aspx?fid=79
INSPECTION REQUEST LINE: (303) 234-5933
OcciTanc //y Type
6 /
Inspections will not be performed unless this card is posted on the project site.
**Request an inspection before 11:59 p.m. (midnight) to receive an inspection the following business day.**
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections Date Inspector Comments
Initials
Pier
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground/Slab Inspections
Date Inspector
Initials
Comments
Electrical
Sewer Service
Plumbing
Do Not Cover Under round or Below/In-Slab Work Prior To Approval Of The Above Inspections
Rough Inspections Date
Inspector
Initials
Comments
Wall Sheathing
Mid -Roof 7, 1-7
Lath / Wall Tie
Rough Electric "
Rough Plumbing/Gas Line
Rough Mechanical
Rough Framing
Rough Grading
Insulation
Drywall Screw / Nail
Final Inspections
Date
Inspector
Initials
Comments
Landscaping & Parking / Planning Dept.
Inspections from these entities should be requested
one week in advance. For landscaping and parking
inspections call 303-235-2846. For ROW and drainage
inspections call 303-235-2861. For fire inspections
contact the Fire Protection District for your project.
ROW & Drainage / Public Works Dept.
Floodplain Inspection (if applicable)
Fire Inspection / Fire Protection Dist.
Final Electrical
Final Plumbing
Final Mechanical
Roof
Final Window/Doors
Final Building
NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate
of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy.
'For low voltage permits — Please be sure that rough inspections are completed from the Fire District and electrical low voltage
by the Building Division.
Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued
Protect This Card From The Weather
i CITY OF WHEAT RIDGE
- Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address:
Permit Number: 0/7Q
r
❑ No one available for inspection: Time AI /PM
Re -Inspection required: Yes No)
When corrections have been made, call for re -inspection at 303-234-5933
Date: �, /747 Inspector: 36w(:7/4&?
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: l -e- rl�rS��
Permit Number: _ 01 1102 FIZ
❑ No one available for inspection: Time -AM/PM
Re -Inspection required: Yes No�
When corrections hav been made, call for re -inspection at 303-234-5933
Date: Inspector:
DO NOT REMOVE THIS NOTICE
09/29/16
Or Current Owner/Occupant
SAILSBERY ARCHIE D
3662 SIMMS ST
WHEAT RIDGE CO 80033
Regarding Permit: 201500248; Replace 50 if of water line in yard only.
3662 Simms ST, Wheat Ridge, CO 80033-5334
Dear PERMIT HOLDER:
Our Records indicate that the above noted permit was issued on 02/19/15. Our last
inspection related to that permit was on 02/23/15.
The permit expired as of 02/19/16
Please contact our office within one week from the date of this letter to update us on the
status of this permit, or call for a final inspection on the property. You may call
303-234-5933 or request inspections online at www.ci.wheatridge.co.us. Information needed
are permit number, property address, type of inspection and date to be inspected.
If the permit is not extended before October 31, 2016, the permit will become void.
If you do not contact this office, and wish to resume work at a later date, you will be
required to submit a new permit application, drawings with appropriate code edition
information and pay applicable fees. Incomplete or inactive permits may be reported to
agencies such as Jefferson County Assessor, title companies, etc., and could affect future
transactions related to this property.
Thank you for your cooperation concerning this matter. If we can answer any questions,
please don't hesitate to contact us at 303-235-2855, option 7.
Sincerely,
Wheat Ridge Building Division Staff
NIXIE 808 5E 1 0011/07/16
RETURN TO
SENDER
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City of Wheat Ridge
a Resid. Windows/Doors PERMIT - 201601538
PERMIT NO: 201601538 ISSUED: 10/03/2016
JOB ADDRESS: 3662 Simms ST EXPIRES: 10/03/2017
JOB DESCRIPTION: Replace 4 vinyl windows - like for like - U value = .28
*** CONTACTS ***
OWNER (303)870-3282 CHRISTENSEN ANDREA G
GC (303)375-0745 Paul Bonow 020146 Champion Windows of Denver
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: /
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 2,419.00
FEES
Window Replacement 122.57 e�
Total Valuation 0.00
Use Tax 43.54
** TOTAL ** 166.11
*** COMMENTS ***
*** CONDITIONS ***
Windows shall comply with all applicable codes, have a .32 or better U -factor and shall be
safety glazing if within a tub enclosure, less than 18 inches above the floor or within 24
inches of a vertical edge of a door.
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 le ally authorized to include all entities named within this document as parties to the work to be
performed and that all work to be per
is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
I . This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
sub3ect 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 original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4• No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granti�dinance
it shall not be construed to be a permit for, or an approval of, any violation of any provision of any
applicable code or aio gulati of this jurisdiction. Approval of work is subject to field inspection.
/0/C3//&
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
3��s)►�msS+
INSPECTION RECORD occupancy/Type
uAJA , 2 INSPECTION REQUEST LINE: (303) 234-5933
Inspections will not be performed unless this card is posted on the project site.
Call the inspection request line before 11:59 p.m. to receive an inspection the following business day.**
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections Date Inspector Comments
Initials
Pier
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground/Slab Inspections Date Inspector Comments
Initials
Electrical
Sewer Service
Plumbing
Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections
Inspector rf,mman+a
Rough Inspections
Date
Initials
PAYMENT RELLIV D MUM
VS / 6183 166.11
AUTH CODL: 874352
TOTAL 166.11
----------------------------------------
Wall Sheathing
Final Plumbing
Mid -Roof
Final Mechanical
Lath / Wall Tie
Roof
Rough Electric
Final Window / Doors
Rough Plumbing/Gas Line
Final Building
Rough Mechanical
Landscaping & Parking / Planning Dept.
Rough Framing
ROW & Drainage / Public Works Dept.
Insulation
MOTE: 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.
Drywall Screw / Nail
City of Wheat Ridge
10/83/2016 11:44 CDkP
Replace 4 vinyl wind
CDBO13768 AMOUNT
EPSP 3662 Sims ST 166.11
APPL/PERMIT NO: 201681538
Final Inspections
Date
Inspector
Initials
PAYMENT RELLIV D MUM
VS / 6183 166.11
AUTH CODL: 874352
TOTAL 166.11
----------------------------------------
Final Electrical
Final Plumbing
Final Mechanical
Roof
Final Window / Doors
Final Building
Landscaping & Parking / Planning Dept.
Inspections from these entities should be requested
one week in advance. For landscaping and parking
inspections call 303-235-2846. For ROW and drainage
inspections call 303-235-2861. For fire inspections
contact the Fire Protection District for your project.
ROW & Drainage / Public Works Dept.
Fire Inspection / Fire Protection Dist.
MOTE: 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 r -11C L.11 R, �•• •� 4y�
by the Building Division.
"For Inspection Time Window Requests — Please email insl)timerequest(a�ci wheatrid_ e.co.us by 8:00 A.M. the day of the
inspection with the property address in the subject line of the email.
Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued
Protect This Card From The Weather
City Of
W heat jge
COMMUNITY DEVELOPMENT
Building & Inspection Services Division
7500 W. 2911 Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(a)ci.wheatridge.co.us
r
CE USE ONLY
0/
Plan/Permit #
I.00
Plan Review Fee:
Building Permit Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address: 3662 Simms St
Property Owner (please print): Andrea Christensen Phone: 303-870-3282
Property Owner Email:
Mailing Address: (if different than property address)
Address: 3662 Simms St
City, State, Zip: Wheat Ridge, CO 80033
Architect/Engineer E-mail: Phone:
Contractor: Champion Windows
Contractors City License #: 20146
Contractor E-mail Address: kparkman@getchampion.com
Sub Contractors:
Phone: 303-375-0745
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub:
City License #
Other City Licensed Sub:
City License #
Complete all information on BOTH sides of this form
Description of work: (Check all that apply)
❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE
❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING
❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING
(�
RESIDENTIAL ADDITION X WINDOW REPLACEMENT
❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ OTHER (Describe)
(For ALL projects, please provide a detailed description of work to be performed, including current use of areas,
proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and
amount of materials to be used, etc.)
replacing 4 vinyl windows - same size opening & no structural changes
Sq. Ft./LF Btu's
Amps
Squares
Gallons
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$ 2419.00
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 1 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.
CIRCLEONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REP— ENTATIVE) of (OWNER) (CONTRACTOR)
Electronic Signature (first and last name): Kim Parkmani A& DATE:
I understand that checking this box, that I acknowledge that this constitutes a legal signature.
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
Building Division Valuation: $
l'�r Isre'll. eJ
CHAMPION WINDOWS of DENVER
HOUSE DIAGRAM
6 j
10000 East 45th Avenue
t
3
NEOEnglis
DENVER, CO. 80238
303 375-0745
Measure Date: Measured B
Order Date: verified BY:
Andrea Christensen 3150002926
-- .LEGEND
W I White I T I Ten I ADB I Adobe I BR Brick Red I BRZBronze EO Eme ald Green I CG I Cottage
ORDER CODE LEGEND:
Gray C;Colonial Oak DO
Derk Oak CH Che ry
DH Double Hung72P.0
DH -0 Double Hung O3P
2P 2 -Panel
2 -Panel Oriel
3 -Penal
3P.E 3 -Panel Equal Lite
HP
PW F
AW
Hopper
Pix Window Frame Only
Awning12LC
1LC-R
1CL-L
1 -Lite Csmt w/ right Vent
1 -Ute Csml w/ left Vent
2 -Lite Csmt
3LC 3 -Lite Casement
4LC -Lite Casement
15LC 5 -Lite Casement I
GW Garden Window
2PE 2 Panel Egress
SHE Sn i Hung Egress
WINDOW
SCUEua
I GLASS
#
LOC
INSIDE MSRMT
W X
OUTSIDE MSRMT
W X
STYLE
CLR
ORDER SIZE
X H
FULL
YIN
GRIDS
OBS
TP
COMMENTS
STYLE
LOC
LOC
LOC
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SHOP INSTRUCTIONS
CHAMPION WINDOW MFG.
D NFRC 820CI Series
Foarn Enhanced Vinyl Frame
Double Glaze - Low -E ' Argon Gas
National Fanestmtbn CHW-A-7
Rating Council'
® Double Hung Window With Grids
8 mmm11
ENERGY PERFORMANCE RATINGS_
U -Factor (U.S./I.P.) Soler Heat Gain Coefficient
01.28 0.19
I ADDITIONAL PERFORMANCE RATINGS 1
Visible Transmittance I Condensation Resistance
0.44 I 54
danufac'urcr stipulates t est theses sting, conform to applicable N;RC procedures for Qelnrmir Ing wh a pr:1r c,
perform -rice NFRC ratings am d•iturmined lom a fixed sal of environmental conditions and a specllic p odurl s'ze.
N RC r : nut recommrnd any product and does not warrant the suitability of any product for any s ,1CIA use.
Corsufl manufacturer's literature fur other product podonrunce Information. www.nfrc.org
eeer.ene+ , r.• �
CHAMPION WINDOW MFG.
8200 Series
NHRc
I
Foam Enhanced Vinyl Frame
Double Glaze, Low -E a Argon Gas
Na ���ee�tig ;on
cHw-a-e I
1�
Slider Window With Grids
ENERGY
PERFORMANCE RATINGS
U -Factor (U.S./I.P.)
Solar Heat Gain Coefficient
0.28
0.19
ADDITIONAL PERFORMANCE
RATINGS
Vlsible Transmittance
Condensation Resistance
0.43
57
r stipulates that these ratings conto rm to appliabta NFRC procedures for determinInp whoa product
. NFRC ratings are determined for a fixed set of environmental condltlons and a &pod c product size.
not recommend any product end does not warrant the sultebllily of any pad; 3 for any epeclnc use.
oneull manufaclurers Nterature for other product performance Information, vww.nirc.erg
L
CHAMPION WINDOW MFG.
D NFRC 820CI Series
Foarn Enhanced Vinyl Frame
Double Glaze - Low -E ' Argon Gas
National Fanestmtbn CHW-A-7
Rating Council'
® Double Hung Window With Grids
8 mmm11
ENERGY PERFORMANCE RATINGS_
U -Factor (U.S./I.P.) Soler Heat Gain Coefficient
01.28 0.19
I ADDITIONAL PERFORMANCE RATINGS 1
Visible Transmittance I Condensation Resistance
0.44 I 54
danufac'urcr stipulates t est theses sting, conform to applicable N;RC procedures for Qelnrmir Ing wh a pr:1r c,
perform -rice NFRC ratings am d•iturmined lom a fixed sal of environmental conditions and a specllic p odurl s'ze.
N RC r : nut recommrnd any product and does not warrant the suitability of any product for any s ,1CIA use.
Corsufl manufacturer's literature fur other product podonrunce Information. www.nfrc.org
eeer.ene+ , r.• �
CHAMPION WINDOW MFG.
8200 Series
NFRC
Foam Enhanced Vinyl Frame
Double Glaze . Low -E - Argon Gas
National Fenestration
Rating Courtdl'
CHW-A-8
®
Slider Window
ENERGY PERFORMANCE RATINGS
U -Factor (U.S./I.P.)
Solar Heat Gain Coefficient
0.28
0.21
ADDITIONAL PERFORMANCE
RATINGS
Visible Transmittance
Condensation Resistance
0.49
57
Manufacturer stipulates that thea ratings conform to eppifssble NFRC procedures for determining whole product
performance. NFRC ratings are determined for a fixed set of environment&] condlIlons and a specific product size.
NFRC does not recommend arty product and does not warrant the suitability of arty product for any spedflc use.
Consult manufacturers Iheraluto for other product performance information. wwwnfrc,or;
CHAMPION WINDOW MFG.
8200 Series
NFRC
Foam Enhanced Vinyl Frame
Double Glaze ' Low -E ' Argon Gas
National Fenestration
Ratlnp Council'
CHIN -A-7
Double Hung Window
®
ENERGY
PERFORMANCE RATINGS
U -Factor (U.S./I.P.)
Solar Heat Gain Coefficient
0.28
0.21
ADDITIONAL PERFORMANCE
RATINGS
Visible Transmittance
Condensation Resistance
0.50
54
Manulaclursr stipulates that these ratings conform to applicable NFRC procedures lot determining whole product
performance. NFRC ratings are determined for a fixed set of environmental conditions and a specific product size
NFRC does not recommend any product and does not warrant the sultabillry of any product forany specific use
Consult manufacturer's literature for other product performance information, www.ntm.org
Certificate of Completion
Building Division
7500 W 29TH AVE
WHEAT RIDGE CO 80033-8001
R
Stipulations: Interior Remodel of lst Floor and Basement.
Remove and Install Walls per Drawing, Add
Floating Walls in Basement and Move Bathroom
Walls. Repair/Replace Existing Deck.
This certificate verifies that the building constructed and/or
the use proposed of the building and/or premises, under the
above permit number and on property described below, does comply
with the Wheat Ridge Building Code and development standards of
the zone district in which it is located and may be occupied.
All other licensing requirements for the City must be met.
I
Owner: CAMERON COOK
3662 SIMMS ST
WHEAT RIDGE CO 80033
Contractor: Tyson Frank
3270 ALLISON ST
WHEAT RIDGE CO 80033-5949
For the Following Purpose: Residential Remodel
Editions NO change shall be made in the USE of
Co Editions
ICC/2014 NEC this building without prior notice
— 2006 ICC/2011 NEC and a new Certificate Of Completion
— 2006 ICC/2005,NEC from the City of Wheat Ridge.
Other
C ie Bu 9o �r— Z—o—n- I —ng— —Aa 7in 1 s t r a 'to r
CERTIFICATE MUST BE POSTED BY FRONT DOOR OF
COMMERCIAL OCCUPANCIES
► A i City of Wheat Ridge
Residential Remodel PERMIT - 201500523
PERMIT NO: 201500523 ISSUED: 04/20/2015
JOB ADDRESS: 3662 Simms ST EXPIRES: 04/19/2016
JOB DESCRIPTION: Interior remodel of 1st floor and basement. Remove and install walls per
drawing, add floating walls in basement and move bathroom walls.
Repair/replace existing deck.
*** CONTACTS ***
OWNER (720)299-9029 CAMERON COOK
GC (720)312-5349 Tyson Frank 100126 T.F. Remodeling and Repair LTD
SUB (720)985-9403 Ryan Campbell 130007 Final Phase Electric, LLC
SUB (303)278-4946 Paul Scarberry 140135 Peek's Plumbing & Mech. LLC
SUB (303)798-7436 Dan Kelley 021898 Southglenn Htg & A/C Inc.
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: /
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 145,980.13
FEES PAID
Total Valuation 0.00
Plan Review Fee 928.69
Use Tax 2,627.64
Permit Fee 1,428.75
** TOTAL ** 4,985.08
*** COMMENTS ***
*** CONDITIONS ***
KC: Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2014 NEC and
all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections.
A 41 City of Wheat Ridge
Residential Remodel PERMIT - 201500523
PERMIT NO: 201500523 ISSUED: 04/20/2015
JOB ADDRESS: 3662 Simms ST EXPIRES: 04/19/2016
JOB DESCRIPTION: Interior remodel of 1st floor and basement. Remove and install walls per
drawing, add floating walls in basement and move bathroom walls.
Repair/replace existing deck.
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 no
e legal owner or have been authorized
by, rt
the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this -perm. I further attest that I ate lelly authorized to include all entities named within this document as parties to the work to be
performed and that all wor t -be perfetmed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2, This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and maybe subject to a fee equal to one-half of the originalppermit 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.
q. 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 permithall not be construed to be a permit for, or an approval of, any violation of any provision of any
applicable code or any ordinance o; tgulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official r " Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
FOR OFFICE USE ONLY
1 I City of Date:
"r. Wheat i e
I OMMUNITY DEVELOPMENT "
Plan/Permit #
Building & Inspection Services Division L�XI Sf�
7500 W. 291h Ave., Wheat Ridge, CO 80033 Plan Review Fee:
Office: 303-235-2855 * F2x: 303-237-8929
Inspection Line: 303-234-5933
Building Permit Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address: k�k'_ j'ucS
Property Owner (please print): dc -t Phone:
Property Owner Email: <<C uu,L
Mailing Address: (if different than property address)
Address: � 7 (� s 3, I'4, 1( y c-,
City, State, Zip: Li /0- {"^ t Cy d--*(.iJ-�
Architect/Engineer:
Architect/Engineer E-mail:
Phone:
Contractor: / Y SL."
Contractors City License #: C)c 1 Z!o Phone:
Contractor E-mail Address:� d �(y DI , bow)
Sub Contractors:
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub:
City License #
Other City Licensed Sub:
City License #
Complete all information on BOTH sides of this form
Description of work: (Check all that apply)
❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE
NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING
COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING
RESIDENTIAL ADDITION ❑ WINDOW REPLACEMENT
COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
ELECTRICAL SYSTEMIAPPLIANCE REPAIR or REPLACEMENT
OTHER (Describe) ' L 1- f !'c' AQS K S}, 3 Ctt t (L
(For ALL projects, please provide'a detailed description of work to be performed, including current use of areas,
proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and
amount of materials to be used, etc.) I t\ r I
Sq. Ft./LF
Amps
l:,L,31i71c 9t*4-/&,w.
Btu's
Squares
cow /y
Gallons
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
u:' LV, c= C,
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.
CIRCLE ONE. (OWNER (CONTRACTOR) Lr (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
PRINT NAME: 6 SIGNATURE: DATE:
ZONING COMMMENTS:,+ -4/ Q•14
Reviewer :SLrr/
BUILDING DEPARTMENT COMMENTS.
Reviewer
PUBLIC WORKS COMMENTS
Reviewer
PROOF OF SUBMISSION FORMS
Fire Department ❑ Received
Water District ❑ Received
Sanitation District ❑ Received
❑ Not Required
❑ Not Required
❑ Not Required
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION
Building Division Valuation: $
P
rte•
a
am
U`1
1
G �n
CoC0
0RAp
Wheat 5idge Building Depart►nent
p roved
OrFICIAL A E
Validity of permit: The issuance of a permit or approval of plans, spKifications
and computations shall not be a permit for, or an approval of. any vw don to
any of the provisions of the building code or of any City ordinances.
Permits presuming to give authority to violate or cancel the provisions of the
Building codes or other ordinances of the City shall not be valid.
APPROVED
Subject to Field Inspections
Wheat Ridge Building Dept.
Sign ...........Plan Checker
Work shall comply with the
following codes: 2012 IRC, 2012
IECC & 2014 NEC.
Required guards shall not be less
than 36" in height and shall not have
openings greater than 4".
v +
06"s
BY:
rE:
CG`•` sNTS
FOR OFFICE USE ONLY
City of
Wh6atlk
COMMUNi,Ty DEVELOPMENT plawpermlt# 1,
Building & Inspection Services Division
7500 W.29"' Ave., Wheat Ridge, CO 80033 Plan Review :
Office: 303-235-2855 * Fax: 303-237-5929
Inspection Line: 303-234-5933
Building er it Application
* , Plaaee complete all highlighted smas on both sid of this form. incomplete applications may not be processed.
Property Address.
Propoq Owner (please print).
Property Owner Email p^ CALI
Address: 4� kvg
Arc FtactJ n i+ er Eail i . Phone..
r
Contractors City License Phone*
Contractor E-mail Addrew
Sub Contr ctors-.,."�(�,
Electrical: s k, Plumbing: f e e.s
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 #
► :;1 + t
0 NEW COMMERCIAL STRUCTURE ELECTRICALSERVICE UPGRADE
STRUCTURENEW RESIDENTIAL STRUCTURE COMMERCIAL ROOFING
COMMERCIAL ADDITION RESIDENTIAL ROOFING
RESDENTIAL ADDITION WINDOW REPLACEMENT
COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
RESIDENTIAL ACCESSORY shed, deck,
MECHANICAL SYSTEM/APPLIANCE REPAIR
o REPLACEMENT
n.
.,LUMBING SYSTEM/APPLIANCE REPAIR ,
ELECTRICAL SYSTT/APP�IANCE REPAIR or REPLACE ENT
& r.
nount of materials to be used, etc.)
Sq. FULF Y a. Stu"a
Amps Square
Gallons
Other
Environmental Development and Training CAI
2100 W Littleton BlvdSuite 225
Littleton, Colorado 80120
Phone 303-638-3778
Cameron Cook
Mortgage Broker
Residential/Commercial
Unibell Financial Inc.
550 S. Wadsworth Blvd. Suite #301
Lakewood, Co 80226
RE: 3662 Pierce Street in Lakewood Colorado. Project Completion and Clearance report for
Sub -Trigger level operations and maintenance trimming of small areas of wall and ceiling
material to facilitate and minimize the potential for asbestos disturbance during future planned
renovation activities, in conjunction with sub -Trigger level, minor spill response visual and
clearance testing related to decontamination of interior due to historic renovation activities. No
Further Action is required at site as of Planned construction pathway on 4/14/2015.
Task I - Field Work:
Project Scope of Work Conducted during Air Monitoring:
1. Contractor conducted abaternent according to applicable sub -trigger level EPA, Colorado
Regulation 8, and OSFIA containment in:
OSHA: required containment systent, and negative pressure vysteni.
2. Completion of final inspections and air monitoring.
2.0 SAMPLE COLLECTION METHODS
EDTACM LLC used Nl0S1-1 method 7400,40 CFR 763 AHERA and 0SF[A 29CFR 9010
methodology during activities to support abatement activity:
M
ENVIRONMENTAL AIR SAMPLES ADJACENT TO THE WORK AREA:
Environmental sampling was conducted post abatement activity. The air samples
were collected on 25 min cassettes with 0.8u filters and analyzed by R2 Analytical
according to NIOSIA method 7400. All environmental samples were less than or
equal to 0.01 Ucc (fibers per cubic centimeter of air sampled). No fiber
concentrations were observed in excess of the 0SlJA 29CFR 9010 or the CF1Pl-1E
Allowable Asbestos Level (MAAL),
FINAL AIR SAMPLES:
Clearance air sampling was conducted according to Colorado Regulation 8. All of the
clearance samples collected within the work area were less than 0.01 F/CC, (fibers per
Cubic Centimeter. No concentrations were observed in excess of the Maximum
Allowable Asbestos Level (MAAL).
3.0 CONCLUSIONS
Based on observations during the site visit, and the laboratory analytical results, EDT LLC ACM
concludes the following:
All Environmental and Final work Area or Clearance Air samples collected outside
and inside the regulated work area clearance criteria indicated; fiber concentrations
less than or equal to 0.01 f/cc (fibers per cubic centimeter of air sampled). No fiber
concentrations were observed in excess of the Maximum Allowable Asbestos Level
(MAAL) per CDPI--[E.
Based on sampling and analysis results attached, no further action is recommended or required
for this phase of the project for the impacted areas. As additional abatement items are addressed
environmental and clearance air monitoring should be performed according to Colorado and
EPA Regulations.
us
4.0 LIMITATIONS
Environmental Development and Training ACM LLC prepared this report, for the
exclusive and present use of Cameron Cook and My Father's Business. This report
addresses certain physical characteristics of the site with regards to the release or
presence of asbestos in limited, client determined, areas only. These services were
performed in a manner consistent with practices common in the environmental health
profession. The information and conclusions provided herein are valid only with respect
to the specific locations and analytes investigated at the time this report was prepared.
The findings, conclusions, and recommendations presented here are based on information
available at the time the site was evaluated.
In the event of any reuse or publication of any portion of this report, Environmental
Development and Training ACM LLC shall not be liable for damages arising out or such
reuse of publication. Any reuse a third party makes of this report, or any reliance on or
decisions made are the responsibility of such third party. Environmental Development
and Training ACM LLC accepts no responsibility for damages, if any, suffered by any
third party as the result of decisions made or actions taken based on this report.
ik. 7urd"
Kris Thomas Wilson
President
Environmental Development and Training ACM LLC
Environmental Development and Training A LLC
2100 W Littleton blvd Suite 225
Littleton, Colorado 80120
Phone 303-638-3778
Bob Regan
303-210-1349
5177 South Ventura Way
Centennial, CO 80015
BDI, -- Below Detection Limit
AMA Laboratory Certijkation
#156492
Colorado Laboratoty Cert�fication
414903
R`' Analytical Job amber
R3662015-1
Client
.36 52:X'=1
Client Project Number
3662DX-1
Date,' Time Logged In
04/1 !2015Cq),, 1550 It rs
Ar aosis Due
2 Hour Rush
Analysis Requested
ATIOSH 7400 A -Rules
I f/MMI
f/ce & f/MM2
f/ce
R-21Sara ple #
122 LAB ID Volt meLL) ffields LFibersEjg�lie ltd
Retection Linift
Fiber Concentration
X t- L -0 I
BL -1
0 too 0
XI -131,02
13L-2
0 100 0
-
XI-CLR-03
3662C 1 -3
632 too 3,5 OM3
0.003 RDL
X1 -CLL -04
3662CI-4
632 100 4,O 0.004
0.004 BDL
X I -CLR-05
3662C -5
632 100 10 UO3
0.003 BDL
XI-CLR-06
366201-6
632 too 10 0.003
0.003 BDL
XI-CLR-07
36620 1 -7
632 100 3.5 OM3
0.003 BDL
BDI, -- Below Detection Limit
Environmental Development and Training ACM LLC.
2100 W. Littleton Blvd Suite 225
Littleton, Colorado 80120
Phone 303-638-3778, Fax 303-374-2755
Email: edtacmllc@icloud.com
Cameron Cook
Mortgage Broker
Residential/Commercial
Unibell Financial Inc.
550 South Wadsworth BLVD Suite #301
Lakewood, CO. 80266
RE: Asbestos Sampling — 3662 Simms Street in Lakewood, Colorado
COME=
Limited, construction specific Asbestos assessment of predominant building
materials at 3662 Simms Street in Wheat Ridge, Colorado. Sampling included a
partial, historic renovated area., and focused on predominant material of Planned
construction pathway of 4/11/2015.
The asbestos survey will be completed by an Environmental Protection Agency (EPA)
accredited AIJERA and Colorado State certified Asbestos Building Inspector. The
inspector will perform the physical assessment of suspect materials, plan and organize the
building inspection; identify and map homogeneous areas and functional spaces; assess
the condition and potential for future damage to friable materials; and collect samples.
A minimum of three samples will be collected from each readily visible and accessible
homogeneous area, in accordance with EPA National Emissions Standards for Hazardous
Air Pollutants (NESHAPS) and the Occupational Safety and Health Administration's
(OSHA) regulation 29 CFR 1926.1101.
Sampling will follow the 3-5-7 rule under RHEA, specifying the collection of -
3 samples of surfacing materials less than 3,000 square feet in size.
5 samples of surfacing materials between 1,000 and 5,000 square feet in size; and
7 san-tples of surfacing materials greater than 5,000 square feet in size.
Fewer samples may be collected at inspector's discretion of miscellaneous materials, and
material in small patch areas.
Additional samples may still need to be collected during demolition if hidden areas are
revealed and materials are encountered that were not sampled earlier, A cost estimate for
collection of samples from materials discovered during demolition.
The samples will be submitted to Reservoirs, under proper chain -of -custody procedures,
for analysis of asbestos content on a Rush Same Day turn -around time. Reservoirs is an
American Industrial Hygiene Association (AIHA) accredited laboratory and participates
in the National Voluntary Laboratory Accreditation Program (NVLAP).
A minimum of three samples of a material is needed to categorize that material as non -
asbestos -containing. As a cost saving procedure, and as specified by the asbestos
inspector, the samples will be analyzed progressively. (If the first sample of a
material is analyzed and contains asbestos, then the subsequent samples are not analyzed,
since the material must be categorized as asbestos-coritaining.) Samples with layers will
not be analyzed progressively.
If less than or equal to ten percent of • is detected in a friable Sample, then the
sample must be pointed -counted, including samples with re sults less than one percent.
Point -counting is a systematic laboratory technique which can more accurately quantity
the percent of asbestos. Friable material and non -friable material that could be rendered
ffiable during renovation activities are �required to be point -counted by Colorado
Regulation No. 8.
Task 1: Inspection.
Inspection Activities. Completion and field review of Statement of Work (SOW) related
to destructive and non-destructive sampling of homogeneous building materials is limited
to client specified specific small area locations planned for limited renovation. Building
samples will be analyzed per building based on EPA requirements, with a maximum of 3
to 7 samples per and at client request limited to specific homogeneous small scale
planned renovation areas. Additional sample of specific units will be required to fully
characterize all suspect materials within units, and unit wall and ceiling cavities.
6 - INSPECTION COVER SHEET
Date, description, and location of additions/renovations for this building e.g., new structural additions
or application of surfacing material or fireproofing insulation.
1968, partially renovated historically, date of renovation unknown ,hoofing Assumed ACM until tested and
proven otherwise.
Type of heating system. Fin Tub, originally installed
Has any part of the heating system, including boiler(s), hot water pipes, water heater, etc., been
renovated or replaced? Yes I X] No
Provide date, description and location of heating system renovations/replacements for this building:
Currently under going renovation of damaged Tube, no insulation on fin Tube.
7 - ROOMIFUNCTIONAL SPACE ASSESSMENT*
Type of Material: [ X]Surfacing [ ]Thermal [ X ]Miscellaneous
Textured Drywall Tape and Compound
Partial Cover Wall and Ceiling
Flooring System Remnant: Non -ACM floor adhesive over drywall texture and compound over spray
Roofing: Assumed
Material: [ X]Friahle ( XINon-Friable
All sam led materials, exclrcdin non friable fluorin and roofin .materials
Description:
Textured drywall tape and mud wall -board system, Partial coverage.
Non ACM floar#n over d II rtexture overspra,li , rool'in -Assumed
un
Amount of Material.
Non ACM floor adhesive over
drywall texture over spray
1200 SF Walls and cefling:Percent of
Area: 15% main level, 20% in
Wall and ceiling textured basement or on floor Homogeneous Area.
drywall, 800 S. living area
Flooring 2floor space.
0%
Attic insulation 900 SF
Roofing: Approximately
approx. 1800 SF
Powder dust or debris present? Yes, Minor
Spill due to historic renovation
Is this material in a supply or return air plenum? No, NA no plenum
Note the extent or spread of damage over large areas or large percentages of the homogeneous area:
latedu
Rooml Functional Space Assessment continued on next page
ZEMM
[X I High - Workers in vicinity more than
once/week or material is in a public area
accessible to building occupants (e.g., hallway or
auditorium)
[ ] Moderate - Workers in vicinity once/month -
once/week or material is in a room/office
accessible to building occupants
[ I Low - Workers in vicinity less than once/month
or material is visible but not within reach of
Note the potential for disturbance of the material:
Potential for disturbance is High
Comments:
1. Repair, and Minor spill of historically
disturbed Drywall will require abatement
by ALL sampled materials damaged.
Cleanup or continuing removal will
require at minimum: OSHA Class I trained
workers using OSHA Class I work
practices. Larger Removal of material
over 32 SF will require a Colorado GAC
and Emissions Permit.
1. Damaged/Significantly damaged TSI 5. ACBM with potential for damage -
2. Damaged friable SURFACING ACBM _X & ACBM with potential for significant damage
3. Significantly damaged friable SURFACING ACBM 7. Any remaining friable ACBM or friable suspected
4. Damaged or significantly damaged friable ACBM
miscellaneous ACBM
Reason for classification: Grater than 25 SF Drywall rendered friable -OSHA Class I
Preventative measures _b might eliminate he reasonable likelihood of undamaged ACBM from
su which
becoming
significantly
fir t
e gn an y damaged
Do not disturb. Repair and or abatement by qualified contractors only. If accidental damage, planned
maintenance renovation or repair of damaged areas only by qualified contractors are performed use
appropriate engineering controls with certified asbestos abatement workers
Copy of inspectors accreditation certificate sVgested, but not required by EPA
Homogeneous mogeneous ArealRulk Sample Summary continued on next page
ASBESTOS INSPECTION REPORT
EXECUTIVE SUMMARY:
This inspection for asbestos containing building materials (ABCMs) was conducted in
accordance with the Asbestos Hazard Emergency Response Act AHE RA 40 CFR Part 763 and
the Occupational Safety and Health Administration (OSHA) 29 CFR 1926. 110 1, The suspect
ACBM defined within this study includes surfacing and finishing components of the floors, walls
and ceilings, then -nal systems insulation on piping, and heating ventilation and air condition
systems (HVAC) and any miscellaneous suspect material encountered. A visual and tactile
inspection of suspect ACBM was performed throughout the building. Samples were collected
randomly of each suspect ACBM, The Environmental Protection Agency (EPA) and the
Colorado department of Public Health and Environment (CDPHE) recognize building materials
that contains greater than one -percent asbestos to be an ACBM,
UEM
This Scope of Work was performed by, Mr. Kris Wilson of EDT ACM LUC, EPA and
State of Colorado Certified Asbestos Building Inspector.
ACBM SAMPLE FINDINGS
A total of 9 samples were collected from 3 identified homogenous areas of friable or nan-
friable in friable condition materials. Of the 9 samples collected, the Drywall texture and
compound contained greater than 1% asbestos. None of the other samples contained
greater than 1% asbestos by PLM analysis. The texture overspray under the non -ACM
flooring adhesive was confirmed to contain leas than 1,% asbestos, and is to be managed as
an OSHA regulated material, one material, the roofing material, is assumed asbestos until
sampled and analyzed.
LEAD BASED PAINT INSPECTION
Ma Iffimoulkrogm
be managed and tracked as part of an Asbestos Operations and Maintenance plan per EPA
AHERA and Colorado Regulation Number 8 part B.
***It should be noted building materials not previously analyzed during this inspection must be
assumed asbestos, until tested and proven otherwise, Any material not identified that will be
impacted by renovation /remodel activities must be removed in accordance with 40 CFR 763
AHERA and the State of Colorado Regulation 8 Part B and OSHA.
Please contact me if you have any qUCStiOD related to this project,
2i4f 7 M*104V
Kris Thomas Wilson
President
Inspector #4663
Environmental Development and Training (,I LLC':
2 100 W. Littleton Blvd Sune 225
Littleton, Colorado
LIMITATIONS
Environmental Development and Training ACM LLC prepared this report, for the exclusive and
present use of Cameron Cook. This report addresses certain physical characteristics of the site
with regards to the release or presence of asbestos in limited, client determined, areas only.
These services were performed in a mariner consistent with practices common in the
environmental health profession. The info nation and conclusions provided herein are valid only
with respect to the specific locations and analytes investigated at the time this report was
prepared. The findings, conclusions, and recommendations presented here are based on
information available at the time the site was evaluated.
In the event of any reuse or publication of any portion of this report, Environmental
Development and Training ACM LLC shall not be liable for damages arising out or such reuse
of publication. Any reuse a third party makes of this report, or any reliance on or decisions made
are the responsibility of such third party. Environmental Development and Training ACM LLC
accepts no responsibility for damages, if any, suffered by any third party as the result of
decisions made or actions taken based on this report.
Environmental Development and Training A CM LLC
2100 W. Littleton Blvd Suite 225
Littleton, Colorado 80120
Phone 303-638-3778
Cameron Cook
Mortgage up
Broker
Residential/Commercial
Unibell Financial Inc.
550 S. Wadsworth Blvd. Suite #301
Lakewood, Co 80226
CC: Jose Pinedaja
My Fathers Business
RE: 3662 Simms Street, in Lakewood Colorado. Project Completion and Clearance report for
Sub -Trigger level operations and maintenance trimming of small areas of wall and ceiling
material to facilitate and minimize the potential for asbestos disturbance during future planned
renovation activities, in conjunction with sub -Trigger level, minor spill response visual and
clearance testing related to decontamination of interior due to historic renovation activities. No
Further Action is required at site as of Planned construction pathway on 4/14/2015.
Task 1 - Field Work:
Project Scope of Work Conducted during Air Monitoring:
1. Contractor conducted abatement according to applicable sub -trigger level EPA, Colorado
Regulation 8, and OSHA containment in:
OSHA: required containment #,stem, and negative pressure system.
2. Completion of final inspections and air monitoring.
2.0 SAMPLE COLLECTION METHODS
EDT ACM LLC used NIOSH method 7400, 40 CFR 763 All ERA and OSHA 29CFR 9010
methodology during activities to support abatement activity:
Eff
ENVIRONMENTAL AIR SAMPLES ADJACENT TO THE WORK AREA:
Environmental sampling was conducted post abatement activity. The air samples
were collected on 25 min, cassettes with 0.8u filters and analyzed by R2 Analytical
according to NIOSH method 7400. All environmental samples were, less than or
gqgal to 0.01 f/cc (fibers per cubic centimeter of air sampled). No fiber
concentrations were observed in excess of the OSHA 29CFR, 9010 or the Cl- PHE
Allowable Asbestos Level (MAAL).
FINAL AIR SAMPLES:
Clearance air sampling was conducted according to Colorado Regulation 8. All of the
clearance samples collected within the work area were less than 0.01 FICC, (fibers per
Cubic Centimeter. No concentrations were observed in excess of the Maximum
Allowable Asbestos Level (MAAL).
3.0 CONCLUSIONS
Based on observations during the site visit, and the laboratory analytical results, EDT LLC ACM
concludes the following:
All Environmental and Final work Area or Clearance Air samples collected outside
and inside the regulated work area clearance criteria indicated; fiber concentrations
less than or equal to 0.01 f/cc (fibers per cubic centimeter of air sampled). No fiber
concentrations were observed in excess of the Maximum Allowable Asbestos Level
(MAAL) per CDPHE.
Based on sampling and analysis results attached, no further action is recommended or required
for this phase of the project for the impacted areas. As additional abatement items are addressed
environmental and clearance air monitoring should be performed according to Colorado and
EPA Regulations.
HN
4.0 LIMITATIONS
Environmental Development and Training ACM LLC prepared this report, for the
exclusive and present use of Cameron Cook and My Father's Business. This report
addresses certain physical characteristics of the site with regards to the release or
presence of asbestos in limited, client determined, areas only. These services were
performed in a mariner consistent with practices common in the environmental health
profession. The information and conclusions provided herein are valid only with respect
to the specific locations and analytes investigated at the time this report was prepared.
The findings, conclusions, and recommendations presented here are based on information
available at the time the site was evaluated.
In the event of any reuse or publication of any portion of this report, Environmental
Development and Training ACM LLC shall not be liable for damages arising out or such
reuse of publication. Any reuse a third party makes of this report, or any reliance on or
decisions made are the responsibility of such third party. Environmental Development
and Training ACM L1,C accepts no responsibility for damages, if any, suffered by any
third party as the result of decisions made or actions taken based on this report.
Kris Thomas Wilson
President
Environmental Development and Training ACM LLC
Environmental Develolwizent and.Training ACU LLC,
2100 W Littleton Blvd Suite 225
Littleton, Colorado 80120
Phone 303-638-3778
Bob Regan
303-210-1349
5177 South Ventura Way
Centennial, CO 80015
X I -CLR-05
XI-CLR-06
BDL -- Below Detection Limit
3662CI-5 632
36620-6 632
3662CI-7 632
100
AIIIA Laboratoty Certification
9-15649.7
100
Colorado Laboratory Certification
#14903
100
R2 Ana4ylical A)bAlumber
83662015-1
Client
3662X-1
Client Project Number
3662DX-1
Datel Time Logged In
041141-7015@1550 Alm
A nalvsis Due
2 Hour Rush
Analysis Requested
NIOSH 7400 A -Rules
f/mmf/cc
& f/mm'
f/ce
R2 Sample 4
R2 LAB ID YqtMg(L) Fields #Fibers Fiber Density
Detection Limit
Fiber ConcentraLjo_n
XI -BL -OI
BL -1 0 100 0
XI -BI.., -02
BL -2 0 100 0
-
XI-CLR-03
36620I-3 632 100 3,5 0.003
0.003 BDL
XI-CLR-04
3662C1-4 632 100 4,0 0,004
0.004 BDL
X I -CLR-05
XI-CLR-06
BDL -- Below Detection Limit
3662CI-5 632
36620-6 632
3662CI-7 632
100
10
0.003
100
3,0
0,003
100
15
0.003
0.003 BDL
0,003 BDL
0.003 BDL
Reservorrs Enwronmental, Inc Effective January 1, 2015
Reservows Environmental QA Manual T kQAWLabkReservws Environmental QA Manuardoc
ti,'L
REI LA13RE MrV13
-WPP""- _qL 1r -q E vironinental, Inc.
6MRWIM, JIMX;f.WA
Laboratory Report:
Project Description:
2100 W, Littleton Blvd., Suite 225
Littleton CO 80120
3668
3668
Reservoirs Environmental, Inc, is an analytical laboratory accredited for the analysis of Industrial Hygiene and
Environmental matrices by the National Voluntary Laboratory Accreditation Program (NVLAP), Lab Code 101896-0
for Transmission Electron Microscopy (TEM) and Polarized Light Microscopy (PLM) analysis and the American
Industrial Hygiene Association (AIHA), Lab ID 101533 - Accreditation Certificate #480 for Phase Contrast
Microscopy (PCM) analysis. This laboratory is currently proficient in both Proficiency Testing and PAT programs
respectively.
Reservoirs Environmental, Inc. has analyzed the following samples for asbestos content as per your request, The
analysis has been completed in general accordance with the appropriate methodology as stated in the attached
analysis table, The results have been submitted to your office,
RES 317214-1 is the job number assigned to this study. This report is considered highly confidential
and the sole property of the customer, Reservoirs Environmental, Inc, will not discuss any part of this study with
personnel other than those of the client, The results described in this report only apply to the samples analyzed,
US. Government. This report shall not be reproduced except in full, without written approval from Reservoirs
Environmental, Inc, Samples will be disposed of after sixty days unless longer storage is requested. If you have any
questions about this report, please feet free to call 303-964-1986,
Sincerely,
Jeanne Spencer
President
P, 303.%4-19W
F 303-477-4275
5801 Logan Street, Suite 100 Denver, CO 80216
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Teto,ri. Lead. Pain-tTesting
344.0 Youngl.-'ield St., #1,1313
Wlieatl'Zidge, C,0 80033
Billl"O:
("'ook
Inspection Location:
Now= Cameron Cook
Addivss: 3662 SiMMS,
Uty, State, Alp:\,033
Desrip
ction:
INVOICE
Date: April 1,0, 2015
11rilloice 041,01,50742
For:
Leadl-Based Paint'I'esting
An Wei% exteHor lead inspectiori ixas conduicted by Micl-iael M,, McCarty of Teton laad
PaintTesting at 3662 SMIMS Met in Wheat FUdge AM& on April 10� 2015� AH interior
sn"'A cxtericw assays an A inwHor and exWrWr compment; testedrecorded negative readings
fk-the pw(mce of Parl -hased IBM,
A myAw remiNg is an anny re �rs t 1.0, rNwh is an way eqwd to ov
�,kniount: $�lywo
PRE -RENOVATION FORM
This frarrtn rrt ay be used by renovation firms to cdrtcrst en, c.cari Phan e with the r" edpral
lr+e re>rsnvs.r,c.r crdttk.atit7r grad rt novation, wi as;r; and p it i rift s a c:latiurts.
tcl p nt Confirmation
aerphfet Receipt
J 1 have ret,eived <a r-urry of the lead hazard information pamphlet infCauninr, tett, ot, the
potential rrslt of the Ie id hazard exposure from renovation aachvlty to be ga rforrneed in nay
riwelling unit I received this parnpWet before the work began.
Panted Narne of Owner rfs�r€rt
signatut or Owner aCwuP, a'' Sign'Mur Dale
Renovator's Seib Certification Option (fol tenant -occupied llin s only)
Instruct ons to 6te,',ovalor; If the kad hazard information pamphlet wa A cae!(sv re c= but t ,erary
s€gnature was not ca's.tiainabip you may check the apprropfirat'e box helow.
Declined , cp riif -h a- 1 have m ati ,'t tfoot d faith effort to defi er ths'' I m'd fare}rwt inf')°n)'Pion
par phlet to tate ental tal dwelfing unit listed l"}elowv Ra, ° ads date and tiara€, indicated and that ,I're
rs� vcap rr �g ell aq v..c °xip�t tta h&acatira'taattnn of se�eipt„ 8 issrt9aers o rtify trial l h ave= left d copy
of the parnphit t ar 0�e uinit Wth the oc(c€para.
Unavailable for Signature, 2 certify that I have rfaacde a good fenth effort to dpHvey the least
h axard anlcormation parnpiAtn to the rental dwelling unit €lstt.d below and that the occupant,
wras ra,avtiarfat)ie ro sign the confirmation of receipt, l further eertif~y that i have Wt a copy of
I pampl-ilet gat the await by s#aaancf it under €he cfdt'at or b y tfal( an hour p arnphlet was iefta
Printed d tVa Ce of P rsnn reit .fit€nq t oiivE ry w Mtge* a ¢ d Orlil if y, m
Signature eai Perser Certifying Lead Pamphlet t Delivef yK
Unit Address
Note Regarding Mailing Option Asan kattprnaativ e to dehver y in person, You May rn ail the
lead hazard information paoaThiet to tha* ov mcr;3i d/or €a v aEat, P sgy+rrt lel Must bP rasarilt d bat
least sevc n Hays before renovation, Mailing mrist bo doc oln rated by <a cerjficas,e of marlin
from the pest ofa,cee,
IX.,NI") PAINT IN'SPEC1,710N REPORT
RETOWr NUMBER.,
INSPE(TION FOR:
PEIRFORMED Xl',,,
INSTRUMENT TYIAE4
ACAJON
04103:507,742
"AM,
A
t
C0 80031"ll
Niton
X-If-'Tvlpc, Arialvzf.,,,r
S uunbci-.
'l is report has been produced in accordancc %,vitb accepted
,,cgnxidelines. 'rixe cotitained withii-t are accurate to
the hest of oxw kcno-vvk�jgct.
SICYNED,
M 'hvi�.d Nic
Cerifflied Lead Assesscw
St- "Oneat Ridgk- CO
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♦ 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: Ag, ,9
i.�/Sd6eTera,� �G
Job Address:
Permit Number: 6
>) Aov:, 0*, r Ae7 . 4- 729 ' 4Z3 5
Vr �cGr rC rfd T€' . 144224Z i wx—/L,.�g
�.�r - up iae�J
❑ No one available for inspection: Time AM /PM
Re- Inspection required:, No r
* When corrections have been made, caff for re- inspection at 303 - 2345933
Date: & 1�1J c? Inspector jr.rs,
DO NOT REMOVE THIS NOTICE
A 4 CITY OF WHEAT RIDGE
-13"wlding Inspection Division
i (303) 234 -5933 Inspection line
(303) 235 -2855 Office • (303) 235 -2857 Fax
INSPECTION NOTICE
Inspection Type: Mi l aF�_
Job Address:
Permit Number:
❑ No one available for inspection: Time AM /PM
Re- Inspection required: Yes No
'When corrections have been made, calf for re- inspection at 303 - 2345933
Date ;„ . -LQ Inspector:
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
,r4000
Residential Roofing PERMIT - 091432
PERMIT NO:: 091432 ISSUED: 08/19/2009
JOB ADDRESS: 3662 SIMMS ST EXPIRES: 02/15/2010
DESCRIPTION: Reroof 28 sqs
CONTACTS
owner 303/422-0166 Art'Sailsberg
sub - 918/260-9435 Matthew.. Hibbs 09-.0189 Roof It Roofing LLC.
PARCEL INFO
ZONE CODE: UA USE: UA
SUBDIVISION: 0680 BLOCK/LOT#: 0:/
FEE SUMMARY ESTIMATED.: PROJECT VALUATION: 9,150,00
FEES
_.Permit Fee.. 235.70
Total`Valuation .00
Use Tax 164.70-`~~` )
TOTAL 400.40 "
Conditions:
6 nail installation & mid-roof -inspectionrequired. Board sheathing spaced more
than 'a 1/2 of an inch apart `requires plywood overlay on entire roof. Ice and
water shield required from eave edge to 2' inside exterior walls.
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
measurements : shown, and allegations made are. accurate; that I have read and agree to abide by all conditions 'printed on this
application and that Iassume full responsibility for compliance with the Wheat Ridge. Building Code :(I.B.C)-and all other
applica le heat:Rid Ordinances, for work under this permit. Plans subject to field inspection.
2 -0q
Signature o contractor/owner
1. This permit was issued in accordance with the provisions set forth in your. application. and is subject to the laws of the
State of Colorado and to the Zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable
ordinances of the City.
2. This permit shall expire 180 days from the 'issue date. Requests for an extension must be received prior to expiration
date. An extension may be granted at the discretion of the Building Official.
3. If this. permit expires, a new permit may be acquired for a fee of one-half the amount normally required, provided no
changes. have been or will be made in the original plans and specifications. and any suspension or. abandonments has not
exceeded : one (1) year. If changes have been or . if suspension or abandonment exceeds one (1) year, full fees shall
be ;paid . for. a new permit.
4. No work of any manner shall be done that will change the natural flow of water causing a drainage :problem.
5. Contractor shall notify. the Building Inspector twenty-.four (24) hours in advance for all inspections and 'shall receive'
written approval on inspection card before proceeding with successive phases of the :job.
6 The issuance of a permit. or the approval : of drawings. and specifications shall not be 'construed to be a permit for, nor
an approval of, an v'olation of the provisions of the building codes or any other ordinance, law, rule or regulation.
All plan r ie 1 ub7 ect to field inspections.
0
Signature of ief uilding Official date
INSPECTION :REQUEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855 REQUESTS MUST BE MADE BY. 3PM. ANY BUSINESS DAY FOR, INSPECTION THE FOLLOWING. BUSINESS DAY.-
~oF W"E T ~e City of Wheat Ridge Building Division
m 7500 W. 29th Ave., Wheat Ridge, CO 80033
_ Office: 303-235-2855 * Fax: 303-237-8929
°OCOrxP°° inspection Line: 303-234-5933
Building Permit Application
Property Address: (3 vvt ms 5
Property Owner (please print): `-g
Phone: 3Q. -tizz-6166
Mailing Address: (if different than property address)
Address: S~A vr, p-
City, State, Zip:
Contractor: jNtA- l~er~ CPS coq, 3RJ- &Yv+rEt-d-d"
Contractor License Oq-(9 1 LJ Phone: (919) 260 - S L(3S
Sub Contractors:
Electrical City License Plumbing City License Mechanical City License
Company: Company Company:
Exp. Date:
Exp.
Date:
Exp. Date:
Approval:
Approval:
Approval:
Use of space (description):
dLSi'!L`
Construction Value: $ i SL7
Description of work: kt
4io f 1 ~t'i M4Vq z
1up.4-S
(as calculated per the Building Valuation Data sheet)
bo,V, o ti w,~ C,;.AS
i,`~ fp,.l i o `j r
Plan Review (due at time of submittal): $
Sq. Ft./L.Ft added: Squares 9- O BTU's Gallons Amps
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 the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
under this permit. Plans subject to fie d ins ection.
CIRLCE ONE:: (OWNER) (CONTRACTOR or PERSONAL REPRES T/A E of (OWNER) (CONTRATOR)
PRINT NAME: f Qtl 1 ` SIGNATURE: >f ' ~l - Date:
Date: 08 ( H I Uq
Plan
Permit
'I Valuation: $ 1
APPLICATION FOR MI;
JOB qDDRESS SI f`r'\ m S
CONTRACTOR y
S7500 WEST 29tn Av~NUE DEPARTMENT OF GOMMUNITY DEVELOPMENT
ADDRESS _
CITY
PHONE
237-6944 EXT. 255 P.o. eox s3e BUILDING INSPECTION DIVISION PERMIT N0.
CITY OF WHEAT RIDGE, COLO. M91#17403
THIS PERMIT VAUD ONLY WHEN SIGNED BY THE CHiEF BUILDING INSPECTOR AND RECEIPTED BELOW.
OWNER
PHONE T,-Ja-O
1. TYPE
Groune
ZIP CODE _
LICENSE NO.
CONTRACT PRICE $
DATE
ZIP CODE~
WoIIL,J ProiecfinpU 0}hp
2. MATERIAL 5 w D Fooe
3. ILLUMINATION Yas❑ No❑ Typs Tofol Squore Feat
4 SET BACK FROM PROPERTY LME N_ S_ E_ yy E~~tPQmil No.
2ons__ ADDroved,2onalnapeefor
(Spstifywhichitfronl) n n ('1 I"1
.,.n.. V.e~
L TYPE Solid Mon Thon BO% ODanO Loss Thon BO% Open
FENCES ? MATERIAL
3. SET BACK FROM PROPERTY LINE N~_
S- E- W Zons_. ApprwW,2one Impeeta
(Specity whicA if front) ❑ ❑ ❑ ❑ Disapprowd
OTHER 12.
3.
DRAW SKETCH OR SHOW BELOW, THE FENCE,SIGN,OR OTHER STRUCTURE,GIVIhv" DISTANCES FROM PROPERTY LINES.
(SETBACNS OR PROJECTIONS INCWDED)
~
SPECIFY NORTN
STREET NAME
SHOW DISTANCES FROM THE MAIN BUILDING T6ADJOINING HpUSES, STREETS, AND PROPERTY LINES; ON IRREGULAR LOTS, SiIOW LEAST
DISTANCE TO PROPERTY LINES, NOT MAxIMUM OR AVERAGE DISTANCE.
APPLICATION FOR PLUMBING; ELECTRICAL; MECHANICAL PERMIT
THIS APPLICATION WILL BECOME A PERMITTO PERFORM THE INDICATED WORK ONLY l1PON VALIDATION BY THE BUILDING INSPECTION DIVISION.
PERMIT WILL EXPIHE 180 DAYS FROM THE DATE OF ISSUANCE IF WORK IS NOT STARTEO WITHIN THAT TIME.
ELFCTRICAI oFar,niT
-
rLumoirv3 rtHMIT
MECHANICAL PERMIT
STATE LICENSE N0.
STATE LICENSE NO
ALUMINUMWIpEUNDERSIZE81LlEGAL
FLOOR
BSM IST 2ND 3RD 4
NO
'
TH
N0. Fl£L:CiNaOne GpyqlRoppns ElxSolor
WATER CIASET
TEMPORARY METER
WASH BOWL
FORCED AIR - BTU
NEW SERVICE - AMPS
BATH TUB
MpT WATER BTU
CHANGE SERVICE - AMPS
SHOWER
STEAM - BTU
IIGHTING
AIR CONDITIONING-BTU
HEATING
SINN
OTHER
GARBACE DISP
POWER SUB-CIFCWTS
WATER HEATER
REFRIGERATION SVSTEM
UTILI7Y(RANGE,DISPO5ER,ETC.)
AUTO.WASHER
Refri sronf Group
FIXTURES
DISH WASMER
Pumtlt Chor e
WIRING
MOTORS 8 CONTROLS
FLOOR DRAIN
AUTOMATIC SPRINKIER SYSTEM
SIGNS
URINAL
ELEVATOR
TRANSFORMERS 9 RECTFIERS
SEWERS
ADDITION TO OLD WORK
OTHER
MOTORS OVER I HP
TOTAL FIXTURES
I hsreby ocknowledqa thot this appiica-
m iE torrect ond undersfond ihof I
nnof simt thie projecf until fhie oppli-
ion is opproved. I sholl comply wifh
lowe of the State o! Colorado and to
Zonina ReQulationa ond Buildinp
olthe City ot Wneat Ridqe. Any
ion o( the above ferme wdl couse
iat~frev otion o( t~is permif
/I
PERMIT FEE
USE TAX
TOTAL FEE
APPROVEC
96APPROVEE
CHIEF BUILDII
City of Wheat Ridqe
Date Issued
NOT VALID UNLESS F
,~/Y Sd~Lr1
1 /L--i/
F7f ?h
CAIL 237-8944 EXT. 255
24 HOURS IN ADVANCE
FORINSPECTIONS