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HomeMy WebLinkAbout4675 Robb Streetypy ROg6 s+, INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Occupancy/Type f'kF . 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 Wall Sheathing Concrete Encased Ground (CEG) Foundation / P.E. Letter Mid -Roof 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 Rough Inspections Date Inspector Initials Comments Wall Sheathing 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 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. 'r Final Electrical Final Plumbing A LL �00F07omlf Final Mechanical R 9 litrV Roof r u IPPD_AX'r SreV l C Final Window/Doors Final Building la 1-)(2.5- .S NOTE: 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 The City of Wheat Ridge Third Party Form Property Address eo;h S,-�- – Pyle, Permit Number ZR)-?o3Z 51 Permit Issued Date "7.5- Zall Owner Information Property Owner Information PAI EJWk a C IF Property Owner Address Inspector Information Inspection Company Construction Support Services, inc Inspector Name Richard Boon Inspector Contact info. 303-221-1559 Inspector Statement and Acknowledgement * I hearby acknowledge the roof I am inspecting is 6/12 or over all roofs that are under 6/12 must be inspected by the City of Wheat Ridge Buiding Dept. * I hearby acknowledge the roofing system for the referenced building has been insl and found to be in compliance with the minimum requirements of the 2012 IRC and IBC as well as all City of Wheat Ridge Policies and Procedure and Manufacturer's recommendations and specifications. Inspector: Richard A. Boon, Date: f- *1 hearby acknowledge that I am the owner of the building referenced above and I g my consent for the listed third -party inspection company to perform my roof inspecti in lieu of the City of Wheat Rid a BuildinDivision inspection. R Propery Owner/ Agent: —P , Date: VV; This original document as well as the roofing check list, must be submitted to the C1 Building Offical within seven days of the final inspection. Drop off in person Permit counter 2nd floor 7500 W. 29th Ave Wheat Ridge CO 80033 Drafted Date: 7/26/17 Submit via Email Kcook(a).ci.wheatridge.co.us Please add note to reverse side The City of Wheat Ridge Inspection Check List notes Mid -Roof Property Address 7;' Rpyl ex Permit Number Permit Issued Date Roof Inspection Pass FAIL Date of Inspection: 8-2-17 Structural roof components x Verify that no more than 2 layers of shingles exist x Flashing for roof and walls If new sheathing is installed verify that it is listed in the permit description (Valuation must be adjusted) Verify sheathing nail pattern ( See policy & Proceedures) x Crickets and saddles where needed x Verify B vent must have boot same gauge as pipe x Verify vent caps x Verify no flashings are damaged or rusted x Step flashing shall be min. of 8x8 piece per shingle Verify scuppers allow for proper drainage x Ice and water shield 2' in heated wall spaces x Underlayments must follow 2012 IRC / 2012 IBC x Verify roof slope for proper drainage x Dripedge shall have min of 2" overlap x Dripedge should extend down min 2" past roof deck x Dripedge shall be mechanicaly fastened 12" OC 90 LB roll roofing shall not be applied to roof slopes less than 2:12 slope: Exception, detached garages, patios, carports, open on three sides with min. slope of 1:12 Modified Bitumen, EPDM, TPO min slope 1/4:12 slope Above roof insulation R-25 NOTES 4 Companj Construction Support Se Inspector signature: / 1111irl 1 Property Address Permit Number Permit Issue Date Roof Inspection Pass Fail Company Name: Inspector signature: Date of Inspection: The City of Wheat Ridge Inspection Check List notes Final Roof lfw - /,\ q� 75- Wfhh 5,1— Structural roof components Verify that no more than 2 layers of shingles exist Flashing for roof and walls If new sheathing is installed verify that it is listed in the permit description (Valuation must be adjusted) Verify sheahing nail pattern ( See policy & Proceedures) Crickets and saddles where needed Verify B vent must have boot same gauge as pipe Verify vent caps Verify no flashings are damaged or rusted Step flashing shall be min. of 4x4 piece per shingle Verify scuppers allow for proper drainage Ice and water shield 2' in heated wall spaces Underlayments must follow 2012 IRC / 2012 IBC Verify roof slope for proper drainage Dripedge shall have min of 2" overlap Dripedge should extend down min 2" past roof deck Dripedge shall be mechanicaly fastened 12" OC 90 LB roll roofing shall not be applied to roof slopes less than 2:12 slope: Exception, detached garages, patios, carports, open on three sides with min. slope of 1:12 Modified Bitumen, EPDM, TPO min slope 1/4:12 slope Above roof insulation R-25 Below roof residential R-38 Below roof commercial R-32 Notes -k- 1 , 1- �e'vV-4s 1* � i i CITY OF WHEAT RIDGE _:�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: }P0� Job Address: 467SU�� S% _Permit Number: 2 G r7o-3-z,M LJ No one available for inspection: Timey'& • l i AM/PM Re -Inspection required: When corrections have been made, call for re -inspection at 303 -234 - Date: - 03 -234 - Date:. �� l Inspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge r Residential Roofing PERMIT - 201703259 PERMIT NO: 201703259 ISSUED: 07/05/2017 JOB ADDRESS: 4675 Robb ST EXPIRES: 07/05/2018 JOB DESCRIPTION: Residential Re -roof to install Lifetime Laminated CertainTeed Burnt Sienna asphalt shingles - 37 sq. (36 sq. pitched / 1 sq. flat) *** CONTACTS *** OWNER 303-521-0889 ALICE DATEMA SUB (303)663-5615 Joel/Channa Speckman 080141 All In One Contractors *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: UA / Unassigned BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 13,748.47 FEES Total Valuation 0.00 Use Tax 288.72 930 Permit Fee 267.70 ** TOTAL ** 556.42 *** 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 one half 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 installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. z City of Wheat Ridge r Residential Roofing PERMIT - 201703259 PERMIT NO: 201703259 ISSUED: 07/05/2017 JOB ADDRESS: 4675 Robb ST EXPIRES: 07/05/2018 JOB DESCRIPTION: Residential Re -roof to install Lifetime Laminated CertainTeed Burnt Sienna asphalt shingles - 37 sq. (36 sq. pitched / 1 sq. flat) 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_permrt. I further attest that I am legally authorized to include alI entities named within this document as parties to the work to be performed and that all wor)�t�be perf"ormed is dis losed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or ONTRACTO�(Circle one) Date 1. This permit was issued base irt6rmation provided in the permit application and accompanying pplans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees 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 be construed to be a permit for, or an approval of, an violation of any provision of any applicable r any ordinance or regulula��tio��n of this jurisdiction. Approval of work is subject to f any 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 insptimerequestgei.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. Kimberly Cook 2,01703 zfq From: no-reply@ci.wheatri dge.co.us Sent: Thursday, June 22, 2017 10:30 AM 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 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 Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes residential roof? How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address 4675 Robb Street Wheat Ridge, Colorado 80033 Property Owner Name Alice Datema Property Owner Phone 3035210889 Number Property Owner Email adate45@earthlink.net Address 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 All In One Contractor's License 080141 Number (for the City of Wheat Ridge) Contractor Phone 8175659922 Number Contractor Email Address verticalorders@gmail.com Retype Contractor Email Address DESCRIPTION OF WORK Are you re -decking the roof? Description of Roofing Material Select Type of Material: If "Other" is selected above, describe here: verticalorders@gmail.com No / Lifetime Laminated Certainteed Burnt Sienna Asphalt Field not completed. How many squares of the 36 material selected above? / Does any portion of the Yes / property include a flat roof? If yes, how many squares 1 on the flat roof? TOTAL SQUARES of all 37/ roofing material for this project Provide additional detail House, 4/12 Pitch here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract D48.4 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 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 Brandon Pask Email not displaying correctly? View it in your browser. 3 ONE STORY ACCESS ® Yes ® No PITCH 4/12 TEAR OFF and haul away 1 layers of existing shingles. ® DECKING — Remove and replace decking, as needed, for $50 per sheet extra. RE -DECK - Remove and replace all decking © UNDERLAYMENT - We will install Synthetic SHINGLES — CertainTeed Landmark Laminate (Brand & Style) F] INSTALL (yr) 3 -Tab (color) P1 INSTALL LT (yr) Dimensional Burnt Sienna (color) RIDGE - a3 -Tab Ridge [] Matching Hip & Ridge ❑ High Profile Ridge FLASHING - We will replace flashing as needed. VALLEYS & PENETRATIONS — Install ice & water shield. ✓❑ PIPES - Install & paint 4 1 1/Z' 1 2" 1 3' _4" lead stacks e METAL EDGE ® Keep or P1 Replace all White (color). VENTILATION ® Install 1 Cardinal Solar Power Vents 20 Watt Black _ wind turbines _ low profiles _ power vents _ LF Ridgevent Detached Garage [:] Shed ❑ Patio Covering ❑ Other Install squares of ALUM SEAMLESS GUTTER -See Gutter Diagram & Notes ANY CURRENT LEAKS? [:] Yes ®No If so please explain below ANY INTERIOR DAMAGE? ® Yes [;�11\lo If so please explain below (Please provide photos of leaks & Interior damage) ANY AREAS EXCLUDED FROM WARRANTY? ®Yes ®No Please describe •• • Mclean roof, gutters, and jobsite Q 25 Point Inspection ®Collect Payment N Haul off excess material 01 Sweep site with magnet ISSUANCE OF • Q 2 Year workmanship[:] -Other ROOFING: All roof work including remove and install laminate shingles, underlayment, drip edge, flashings, ventilation, and Ice&Water shield GUTTERS: MISCELLAN UPGRADES: Free cardinal vent due to postcard mailer UPGRADE AMT: 0.00 P1 WILL DO JOB FOR INSURANCE PROCEEDS OR CASH CONTRACT AMOUNT $ Original RCV Amount $ 16049.92 + 'This may not be final contract price and does not include upgrades or any supplements paid by insurance company. ✓ Does the first insurance check need to be signed by the mortgage company? ®YES ®NO ® Already Signed ✓ Homeowner has read and understands the "What to Expect' insert and all pages and terms of this contract? DYES R NO Material Placement: Where motorhome sits Special Instructions: Inform tenants EARLY! Protect landscapinq- Company's Surety and Liability Insurer Information Insurer: Gemini Insurance Company Address: 7233 East Butherus Drive City, State, Zip Code: Scottsdale, AZ 85260-240 Phone Number: (480) 951-0905 ACCEPTANCE OF TERMS Customer's signature below signifies acceptance of all terms and conditions set forth in this Agreement �"AA 6/9/17 6/9/17 Customer Sigrfdtrre 4 Date Project Manager nature Date Page 1 CUSTOMER NAME: Alice Datema (rental) GUTTER DIAGRAM Rear Left NONE JOBADDRESS: 4665 Robb St Front GUTTERS 5" 6" DOWNSPOUTS P12X3 ®3X4 COLOR INSURANCE PAID FOR: ®FULL REPLACEMENT ®PARTIAL REPLACEMENT GUARDS Yes[] Nat GUTTERS & DOWNSPOUTS (TOTAL LF INS. PAID) GUTTER LF TO BE SUPPLEMENTED 0 GUTTERS & DOWNSPOUTS (ACTUAL LF - FULL HOUSE) TOTAL # OF DOWNSPOUTS 1STORY 2STORY Right INSURANCE PAID PARTIAL, BUT OWNER WANTS FULL & AGREES TO PAY DIFFERENCE IF INSURANCE WILL NOT ®Yes ®NO NOTES: Page 2 Alice Datema (rental)ALL All in One noted the following items that were not included in your insurer's repair estimate. Permit, O&P 19 -PAYMENT is due upon roof completion. Amount of 1:t PAYMENT $12,370.48 $ 1,481.15 "Out of Pocket Expense" included in 1st PAYMENT FINAL PAYMENT is due upon receipt from insurance or 30 days after job completion, whichever is sooner. Amount of FINAL PAYMENT*** $2,118.61 —1 understand all applicable supplements and/or general contractor overhead & profit paid by insurance company will be owed in addition to this amount. Additional payments sent by insurance for depreciation/supe menta will also be due upon receipt. RIGHT OF CANCELLATION PURSUANT TO FEDERAL REGULATION AND COL. REV. STAT. § 5-3-403: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. , RIGHT OF CANCELLATION PURSUANT TO COL. REV. ST. § 6-22-104: YOU, THE BUYER, MAY CANCEL THIS AGREEMENT AT ANY TIME WITHIN 72 HOURS AFTER YOU HAVE BEEN NOTIFIED THAT YOUR INSURER HAS DENIED YOUR CLAIM TO PAY FOR THE GOODS AND SERVICES TO BE PROVIDED UNDER THIS AGREEMENT. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Company shall hold in trust any payment from Customer until Company has delivered the materials to your property or has performed a majority of the work on the property. By signing this Agreement you agree that you have also been provided notice of this right to cancel orally in addition to the writing contained herein. ACCEPTANCE OF TERMS Custo er's signature below signifies acceptance of all terms and ditionsOrth in this Agreement. _ 6/9/17 6/9/17 Customer Signature Date Project Mall -ger Signature Date Page 3 WORK NOTCOMPLETING 1. IST INSURANCE CHECK (ACV Less Deductible) INSURANCE SECTION DESCRIPTION OF WORK NOT COMPLETING ITEM #'s NOT ACV NOT DEP NOT Other structures R&R storage shed 15 NON-RECOVERABLE DEPRECIATION – ARE COMPLETING 635.96 Front Elevation R&R gutter/downspouts 12 6. 205.02 Rear Elevation R&R gutter/downspouts 13 53.10 120.60 Left Elevation R&R gutter/downspouts 14 35.40 80.40 Contract start date: 6/9/17 'Estimated Job Completion Date' shall be on or before 180 days after the 'Contract Start Date' Line 7 Line 8 19 -PAYMENT is due upon roof completion. Amount of 1:t PAYMENT $12,370.48 $ 1,481.15 "Out of Pocket Expense" included in 1st PAYMENT FINAL PAYMENT is due upon receipt from insurance or 30 days after job completion, whichever is sooner. Amount of FINAL PAYMENT*** $2,118.61 —1 understand all applicable supplements and/or general contractor overhead & profit paid by insurance company will be owed in addition to this amount. Additional payments sent by insurance for depreciation/supe menta will also be due upon receipt. RIGHT OF CANCELLATION PURSUANT TO FEDERAL REGULATION AND COL. REV. STAT. § 5-3-403: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. , RIGHT OF CANCELLATION PURSUANT TO COL. REV. ST. § 6-22-104: YOU, THE BUYER, MAY CANCEL THIS AGREEMENT AT ANY TIME WITHIN 72 HOURS AFTER YOU HAVE BEEN NOTIFIED THAT YOUR INSURER HAS DENIED YOUR CLAIM TO PAY FOR THE GOODS AND SERVICES TO BE PROVIDED UNDER THIS AGREEMENT. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Company shall hold in trust any payment from Customer until Company has delivered the materials to your property or has performed a majority of the work on the property. By signing this Agreement you agree that you have also been provided notice of this right to cancel orally in addition to the writing contained herein. ACCEPTANCE OF TERMS Custo er's signature below signifies acceptance of all terms and ditionsOrth in this Agreement. _ 6/9/17 6/9/17 Customer Signature Date Project Mall -ger Signature Date Page 3 BALANCE DETAIL 1. IST INSURANCE CHECK (ACV Less Deductible) 10,889.33 2. INITIAL RECOVERABLE DEPRECIATION 3,160.59 3. NON-RECOVERABLE DEPRECIATION – NOT COMPLETING 0.00 4. NON-RECOVERABLE DEPRECIATION – ARE COMPLETING 0.00 5. PROPERTY OWNER DEDUCTIBLE 2,000.00 6. UPGRADES / ADDITIONAL WORK 0,00 7. WORK NOT COMPLETING (ACV Value) (518.85) 8. WORK NOT COMPLETING (Depreciation) 9. TOTAL OWED TO ALL IN ONE*** $ 14;489.09 19 -PAYMENT is due upon roof completion. Amount of 1:t PAYMENT $12,370.48 $ 1,481.15 "Out of Pocket Expense" included in 1st PAYMENT FINAL PAYMENT is due upon receipt from insurance or 30 days after job completion, whichever is sooner. Amount of FINAL PAYMENT*** $2,118.61 —1 understand all applicable supplements and/or general contractor overhead & profit paid by insurance company will be owed in addition to this amount. Additional payments sent by insurance for depreciation/supe menta will also be due upon receipt. RIGHT OF CANCELLATION PURSUANT TO FEDERAL REGULATION AND COL. REV. STAT. § 5-3-403: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. , RIGHT OF CANCELLATION PURSUANT TO COL. REV. ST. § 6-22-104: YOU, THE BUYER, MAY CANCEL THIS AGREEMENT AT ANY TIME WITHIN 72 HOURS AFTER YOU HAVE BEEN NOTIFIED THAT YOUR INSURER HAS DENIED YOUR CLAIM TO PAY FOR THE GOODS AND SERVICES TO BE PROVIDED UNDER THIS AGREEMENT. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Company shall hold in trust any payment from Customer until Company has delivered the materials to your property or has performed a majority of the work on the property. By signing this Agreement you agree that you have also been provided notice of this right to cancel orally in addition to the writing contained herein. ACCEPTANCE OF TERMS Custo er's signature below signifies acceptance of all terms and ditionsOrth in this Agreement. _ 6/9/17 6/9/17 Customer Signature Date Project Mall -ger Signature Date Page 3 ADDITIONAL TERMS AND CONDITIONS This agreement, including the additional terms and conditions on the reverse side and any agreement executed in writing pursuant thereto (this "Agreement"), is entered into between Storm Operations of America LLC ("Company"), and the property owner(s) or property owner's representative(s) set forth on the opposite side of this Agreement ("Customer"), for the purpose of replacing or repairing Customer's property that was damaged. 1. Approval / General Contractor. Customer hereby certifies that Customer is the owner of the property described herein and authorizes Company to obtain labor and materials to accomplish the replacement or repair in accordance with the Agreement This Agreement is subject to the credit and pricing approval of Company. Customer acknowledges that Company is a general contractor and as such will be entitled to 10% overhead and 10% profit, as allowed by Customer's insurance company and state standards. 2. Agreed Price. The full amount of all monies as specified by the agreed upon price ("Agreed Prie) does not include any extras such as carpentry repairs or other repairs not speed in this Agreement that may be necessary to complete the repair or replacement process as required by local building codes or to cosmetically satisfy Customer. 3. Materials. All materials provided by Company will he standard stock materials, unless otherwise specified, and will match existing materials within reasonable tolerance as to color, texture, design, etc. Notwithstanding the foregoing, other products and materials may be substituted for equivalent products due to availability. Customer understands that there is a 2 -day minimum charge for all drying, water extraction and dehumidification equipment provided by Company. All excess materials remain the property of Company. 4. Access to Property. The prices and terms of Company's estimate and this Agreement are based upon completion of the work during normal working hours, and Customer agrees to provide Company access to Customer's property as required for completion of the work. Customer will he responsible if any interruption of Company's work results from Customer's failure to provide reasonable access or due to the acts or negligence of others not under Company's direction. Company shall not be responsible for damages arising from delay due to inclement weather, strikes, fires, accidents, delays in shipments or delivery of materials, or any causes beyond Company's reasonable control. Customer agrees that Customer's telephone, electricity and water will be made available to Company's personnel during the course of the work. Customer will also furnish at its expense, single phase, 220 -volt, 50 -amp electrical service. Company shall not be responsible for protection of Customer's property, except to provide that protection which is specifically called for under the specifications provided by this Agreement Customer also agrees to remove, store and/or protect personal property during Company's work. Customer will manage and be responsible for protection of vehicles and property exposed to damage by Company's work 5. Job Completion / Past Due Amounts. Job completion shall be the date on which Company's work is substantially finished (as distinguished from the date of Customer's acceptance thereof) or the date of Company's last item of work at the property, whichever is earlier. Customer's failure to make prompt payment shall entitle Company, on forty-eight hours (48) hours' written notice, to stop work The Agreed Price shall be increased by Company's reasonable costs to stop the project and/or resume work In the event Customer chooses not to pay for a part of the work, an individual line item, or a trade, Customer releases Company of its obligations for the performance of that component with regard to the integrity of the building system as a whole. Customer agrees to pay a service charge of 8% per annum or the maximum amount allowed by law, whichever is less, on all balances 30 days or more past due. Customer also agrees to pay for all collection costs, including employee time and expense and all attorneys' fees and costs Company incurs in either collection of and/or protection of its interests in Customer's past due account or performance of this Agreement. 6. Insurance / Mortgage Company. Customer hereby authorizes its insurance and/or mortgage company listed on the front of this Agreement to pay Company directly for all work and materials provided by Company to accomplish Customer's replacement or repair. Customer further directs its insurer and/or mortgagee to include Company as a payee on all checks or drafts now or hereafter payable for such loss. Company reserves the right to supplement Customer's insurance and/or mortgage company price for increases in the scope of work and/or documented price increases. Customer agrees to allow these supplements to be paid directly to Company. Company makes no representations or warranties regarding Customer's insurance coverage or if Customer's insurer will pay for all or any of the work to be performed by Company under this Agreement Customer agrees to pay Company in full for all work performed by Company under this Agreement, regardless of Customer's insurance coverage. Customer also agrees to pay Company directly for all amounts, despite depreciation or deductibles, and to also pay for additional work not covered by Customer's insurer and that said amounts must be paid beforejob completion. In the event Customer breaches this Agreement, Customer agrees to pay Company: a) in full, on a time and materials basis, for all work and materials provided by Company as of the date of such breach; and b) a consulting fee equal to 20% of the total cost of work and materials provided by Company as of the date of such breach, which fee represents the industry standard for reasonable profit and overhead and is not a penalty. Company and its authorized representatives are NOT acting as public adjusters. 7. Limited Warranty. A written limited warranty may be offered on workmanship and materials provided pursuant to this Agreement on the terms and conditions reflected in any written limited warranty materials provided at the time of sale. If Company is not paid in full in accordance with this Agreement, all such warranties are null and void. 8. Hazardous Materials / Mold. Nothing contained in this Agreement shall be construed to require Company to determine the presence or absence of any hazardous materials or asbestos -containing materials affecting the property or to require Company to remove or protect such materials. In the event that Company learns of the presence of such materials on Customer's property, Company reserves the right to immediately stop work and negotiate a change order for such additional work as may be required. In addition, this Agreement does not include, unless expressly specified, any mold abatement, removal or cleaning. If mold is found existing on the Customer's property, any cost to abate, remove or clean shall be paid by Customer as an additional cost Any warranty provided herein excludes the cost to abate, remove or clean any mold on Customer's property. 9. Liability. Company is not responsible for damage or loss caused in whole or in part by: the acts or omissions of other parties, trades or contractors; lightning, gale force winds (+50 m.p.h.), hailstorms, ice damage, ice damns (caused by thawing and freezing of ice, water or snow) hurricanes, tornados, floods, earthquakes or other unusual phenomena of the elements; structural settlement; failure, movement, cracking or excess deflection of the roof deck; defects or failure of materials used as a roof substrate over which Company's roofing material is applied; faulty condition of parapet walls, copings, chimneys, skylights, vents, supports or other parts of the building; vapor condensation beneath the roof; penetrations for pitch boxes; erosion, cracking and porosity of mortar and brick; dry rot; stoppage of roof drains and gutters; penetration of the roof from beneath by rising fasteners of any type; inadequate drainage, slope or other conditions beyond the control of Company which cause ponding or standing water, termites or other insects; rodents or other animals; fire; or harmful chemicals, oils, acids and the like that come into contact with Customer's roof and cause a leak or otherwise damage C ustomer's roof. If Customer's roof fails to maintain a watertight condition because of damage by reason of any of the foregoing, any applicable written limited warranty shall immediately become null and void for the balance of its term. Company accepts no liability to indemnify or hold Customer harmless for claims or damages to persons or property, except to the extent that such damage occurs during performance of Company's work and are the direct result of Company's error or omission. Notwithstanding the foregoing, Company shall not be responsible for damages to any area of the property upon which Company's work has not been completed nor is Company responsible for slight scratching or denting of gutters, oil droplets in driveways, hairline fractures in concrete, damage to flowers or landscaping, or minor broken branches on trees, plants or shrubbery. In no event shall Company be responsible for any type of damage resulting from vibrations, including, but not limited to, interior drywall damage, nail pops or disconnection of chimneys, flues, air ducts, ventilation shafts, exhaust vents, fumace vents or sewer vents. Company is not responsible for damaged electrical, cable, A/C, or plumbing lines installed within 6 inches of the roofline. Customer understands and agrees that Company shall have no responsibility for damages of any kind to persons or property occurring after job completion. 10. Hold Harmless. Customer agrees to hold Company harmless in connection with the work described herein and that Customer's maximum recourse shall be, and Company's maximum liability under this Agreement shall be limited to, the amount Company billed to Customer. Customer understands and acknowledges that Company does not warrant or guarantee previous workmanship or pre-existing materials, nor any materials or labor not originally provided by Company. Company shall not be responsible for latent defects in materials and accessories supplied. Company shall not be responsible for rework required as a result of the acts or errors of others. 11. PRE -LIEN NOTICE: COMPANY HEREBY PROVIDES NOTIFICATION THAT ANY PERSON OR COMPANY SUPPLYING LABOR OR MATERIAL FOR THIS IMPROVEMENT TO YOUR PROPERTY MAY FILE A LIEN AGAINST YOUR PROPERTY IF THAT PERSON OR COMPANY IS NOT PAID FOR THE CONTRIBUTIONS. Upon default in payment, a lien will be placed on the property and charges will be added from the date of substantial completion at the maximum rate allowed by law. 12. Insurance Deductible. If Customer plans to use the proceeds of an insurance policy to pay for any of the work under this Agreement, Company shall not pay, waive, rebate or promise to pay, waive or rebate all or part of any insurance deductible applicable to the insurance claim for payment for the work under this Agreement 13. Miscellaneous. This Agreement constitutes the entire agreement and understanding of Company and Customer relating to all of the subject matter hereof, and supersedes all prior agreements, arrangements and understandings, written or oral between the parties concerning such subject matter. ANY REPRESENTATION, STATEMENTS, OR OTHER COMMUNICATIONS NOT WRITTEN IN THIS AGREEMENT, OR MADE IN WRITING PURSUANT THERETO, ARE AGREED TO BE INVALID AND NOT RELIED ON BY EITHER PARTY AND DO NOT SURVIVE THE EXECUTION OF THIS AGREEMENT. This Agreement is subject to the laws of the state in which it has been signed and executed. Customer shall not assign this Agreement without the prior written consent of the Company. Other than as permitted herein or as permitted by applicable law, this Agreement cannot be canceled or amended without written mutual agreement of both parties. Company and Customer intend and agree that if a court of competent jurisdiction determines that the scope of any provision of this Agreement is too broad to be enforced as written, the court should reform such provision(s) to such narrower scope as it determines to be enforceable. Company and Customer further agree that if any provision of this Agreement is determined to be unenforceable for any reason, and such provision cannot be reformed by the court as anticipated above, such provision shall be deemed separate and severable and the unenforceability of any such provision shall not invalidate or render unenforceable any of the remaining provisions hereof. THE TERMS IN THIS AGREEMENT ARE SPECIFICALLY AGREED TO AND INCORPORATED HEREIN. Toll Free: 888.794.5226 I Fax: 888.255.6732 I www.stormoperations.com CLAIM #: 001728618 INSURANCE CO: USAA INSURED: Alice Datema (rental) ADDRESS: 4665 Robb St CITY/STATE/ZIP: Wheat Ridge, CO 80033 INSURANCE WAIVER AUTHORIZATION AND WAIVER OF CONFIDENTIALITY If insurance is involved in the funding of this Contract in any amount the Customer authorizes and expressly agrees to direct USAA Insurance Company in writing to pay Storm Operations of America LLC solely and directly for any Services Storm Operations of America LLC furnishes to the Project under this Contract that are covered and funded by Customer's Insurance Company, including any and all supplements and/or supplemental Services additionally covered and funded by Customer's Insurance Company. Therefore, Customer hereby appoints Storm Operations of America LLC as attorney-in-fact, authorizing Storm Operations of America LLC to communicate directly with Customer's Insurance Company to discuss Storm Operations of America LLC's scope of work/ costs for the Services, including, any and all estimates and/or supplements to Storm Operations of America LLC's scope of work/costs for the Services before, during, or after the Project. Customer further appoints Storm Operations of America LLC as attorney-in-fact, authorizing Storm Operations of America LLC to endorse Customer's name on and deposit any and all checks or drafts issued by its Insurance Company to Customer, whether solely or jointly as payment for Storm Operations of America LLC's Services. ACCEPTANCE OF TERMS Customer's signature below signifies acceptance of all terms and conditions set forth in this Agreement 6/9/17 Customer Signature Date Page 9 ATTENTION NO VERBAL AGREEMENTS All work we are completing must be IN WRITING on the contract. CHANGE ORDERS Any changes in scope after a contract is signed must be filled out on a change order. SUPPLEMENTS Sometimes we bill the insurance company for additional money called a supplement. This money will be due to us in addition to the regular contract amount. READ OUR TERMS In circumstances that are beyond our control and not the result of negligence, we will not be held responsible. Drywall nail pops from vibrations and damage to utility lines placed too close to the roof deck are just a few of these types of examples. 6/9/17 Customer Signature Date Page 10 6/9/17 Project Manager Signature Date Dat,: 6/9/17 Attn: Claims Department RE: Selection of Contractor Insured: Alice Datema (rental) Claim Number: 001728618 Address: 4665 Robb St Wheat Ridge, CO 80033 To whom it may concern: This letter is to inform you I selected Storm Operations of America LLC as my general contractor of choice to complete repairs to my residence. I have selected Storm Operations of America LLC because they provide an additional layer of supervision over the work instead of relying on the word of a roofing company. In addition, they have agreed to coordinate the work between the various trades to minimize my inconvenience throughout the restoration process. By using a general contractor I am able to avoid wasted time and effort, on my part, in getting prices from several different specialty contractors; and then getting contractors to show up when they are scheduled to bid or do the work. Working with them also saves me the worry of having different specialty contractors taking my deposits without doing the work (a real concern for me), also in determining what to do if I cannot find someone to do the work items for the offered settlement prices. Storm Operations has agreed to bid the work using their subcontractors, including 20% for overhead & profit since they are a General Contractor. Sincerely, Ln W Q L CL O L a OL N J-� 0 V) ra LD fu Of O ■o L E a 0 0 L A I'- t L 0 cn Z Q Q W J �9 E 0 0 oma �cT aLL�3 <10o oZ 0 iIF z ~ r o Wf3a 0 z z 0 ���g a z a o z s a ow 'o i p a � 0 t-5ma _ c O oro � o C s0 NOTICE OF CANCELLATION 6/9/17 You may CANCEL this transaction, without any Penalty or Obligation, within THREE BUSINESS DAYS from the above date. If you cancel, any property traded in, any payments made by you under the contract or sale, and any negotiable instrument executed by you will be returned within 10 BUSINESS DAYS following receipt by the seller of your cancellation notice, and any security interest arising out of the transaction will be cancelled. If you cancel, you must make available to the seller at your residence, in substantially as good condition as when received, any property delivered to you under this contract or sale, or you may, if you wish, comply with the instructions of the seller regarding the return shipment of the property at the seller's expense and risk. If you do make the property available to the seller and the seller does not pick up such property within 20 days of the date of your Notice of Cancellation, you may retain or dispose of the property without further obligation. If you fail to make the property available to the seller, or if you agree to return the property to the seller and fail to do so, then you remain liable for performance of all obligations under the contract. To cancel this transaction, mail or deliver a signed and dated copy of this Cancellation Notice or any other written notice, or send a telegram, to Storm Operations of America LLC at 9830 W. 59th Place Arvada, CO 80004 NOT LATER THAN MIDNIGHT OF THE THIRD BUSINESS DAY FROM THE ABOVE DATE. I HEREBY CANCEL THIS TRANSACTION. BUYER'S SIGNATURE Alice Datema (rental) BUYER'S PRINTED NAME 6/9/17 DATE NOTICE OF CANCELLATION 6/9/17 You may CANCEL this transaction, without any Penalty or Obligation, within THREE BUSINESS DAYS from the above date. If you cancel, any property traded in, any payments made by you under the contract or sale, and any negotiable instrument executed by you will be returned within 10 BUSINESS DAYS following receipt by the seller of your cancellation notice, and any security interest arising out of the transaction will be cancelled. If you cancel, you must make available to the seller at your residence, in substantially as good condition as when received, any property delivered to you under this contract or sale, or you may, if you wish, comply with the instructions of the seller regarding the return shipment of the property at the seller's expense and risk. If you do make the property available to the seller and the seller does not pick up such property within 20 days of the date of your Notice of Cancellation, you may retain or dispose of the property without further obligation. If you fail to make the property available to the seller, or if you agree to return the property to the seller and fail to do so, then you remain liable for performance of all obligations under the contract. To cancel this transaction, mail or deliver a signed and dated copy of this Cancellation Notice or any other written notice, or send a telegram, to Storm Operations of America LLC at 9830 W. 59th Place Arvada, CO 80004 NOT LATER THAN MIDNIGHT OF THE THIRD BUSINESS DAY FROM THE ABOVE DATE. I HEREBY CANCEL THIS TRANSACTION. 6/9/17 BUYER'S SIGNATURE DATE Alice Datema (rental) BUYER'S PRINTED NAME NOTICE OF CANCELLATION If you are notified by your insurer that all or any part of the claim or Agreement is not a covered loss under the insurance policy, you may cancel the Agreement by mailing, emailing or delivering a signed and dated copy of this cancellation notice or any other written notice to Storm Operations of America LLC at 9830 W. 59th Place Arvada, CO 80004 any time within 72 hours after you have received such notice from your insurer. Even if you timely deliver this Notice of Cancellation, the contractor may still retain all payments or deposits made by you to compensate contractor for roofing work actually performed in a workmanlike manner consistent with standard roofing industry practices, to an extent necessary to compensate the contractor for the actual work performed. If you cancel, any payments made by you under the Agreement, other than those excepted in the prior sentence, will be returned to you within 10 days following receipt by the contractor of your cancellation notice. I HEREBY CANCEL THIS TRANSACTION. 6/9/17 Date Insured's Signature Alice Datema (renta Insured's Printed Name NOTICE OF CANCELLATION If you are notified by your insurer that all or any part of the claim or Agreement is not a covered loss under the insurance policy, you may cancel the Agreement by mailing, emailing or delivering a signed and dated copy of this cancellation notice or any other written notice to Storm Operations of America LLC at 9830 W. 59th Place Arvada, CO 80004 any time within 72 hours after you have received such notice from your insurer. Even if you timely deliver this Notice of Cancellation, the contractor may still retain all payments or deposits made by you to compensate contractor for roofing work actually performed in a workmanlike manner consistent with standard roofing industry practices, to an extent necessary to compensate the contractor for the actual work performed. If you cancel, any payments made by you under the Agreement, other than those excepted in the prior sentence, will be returned to you within 10 days following receipt by the contractor of your cancellation notice. I HEREBY CANCEL THIS TRANSACTION. 6/9/17 Date Insured's Signature Alice Datema (rental) Insured's Printed Name ,.-t, w.� -11 �.. U.W,A V"""" 7 Ctv" 1(l�Ut3l1tL 11�111t Kegarding the l iSAA Rental f rum nCe Remi Pr°pertY Ins Vra Regarding the USAA claim on 05/08/2017 USAA Clams <547d2vlxk3c5�alms uses cOm From: daim on 05/08/2017 To: adate45(8pearthlink net properly insurance Subj� Regarding the USAA Rental per: Jun 1, 2017 8 18 AM --'� F Attachments: RFy`GFD IA E TIM T iQH �- NM to Y address book" ro enure de"WWY to roar . D USAA SECURITY ZON 0 Awe ivq Claim Message USAA 0 enifr+ta USAA` view Accounts I Privacy Promise I Contact Us Dear Colonel Datema, This correspondence is regarding the following USAA claim: Reference *: 001728618-636 Policyholder: Alice Datema Attached is a copy of the repair estimate. Thank you. provide documentation, you can attach You may reply to this message. If you need top medical, financial or documents to Y° identifiable reformation sent by emailur email. We cannot guarantee the of any other personalty Email Delivery Criteria ase make sure it meets the following criteria: To ensure delivery of your email, pie The size of the message can't exceed 30 MB. These attachments are supported:.bmp, •Jpe, •jpeg, JP9, and .xlsx. Individual attachments must not exceed 7 MB. o Include no more than 10 attachments. f, Attachments can't be password protected. Sincerely, i Maria O Pattison Central Region pdf, .doc, .dooc, .xis http://webmail.earthlink, net/wam/printable.jsp?msgid=51280&x=-1506519262 6/1/2017 insured: Property' I tome: Worley A USAA Service Provider PO SOX 33490 San Antonio, TX 78265 800-531-8722 5/18/2017 DATEMA. COL ALICE. 4665 ROBB ST WI TEAT RIDGE. CO 80033 4645 R013B ST WIIEAT RIDGE CO 80033 Claim Rep.: John Foy Estimator. John Foy Member Number: 001728618 Policy Number: 00 172861818 1A Type of Loss: I tail Cause of Loss: Other Coverage Dwelling Other Structures Date Contacted: 5/9/2017 6:48 PM Date of Loss: 5/8/2017 Date Inspected: 5/13/2017 3:30 PM Date Est. Completed: 5/18/2017 6:19 PM Price List: CODE8X MAY 17 Restoration/Service/Remodel Line Item Total Material Sales Tax Replacement Cost Value Less Depreciation Actual Cash Value Less Deductible Net Claim Total Recoverable Depreciation Net Claim If Depreciation is Recovered John Foy 0901119c9aa41469 Cell: (303) 521-0889 E-mail: adate45ed carthlink.net Business: (919) 801-8426 Business: (919) 801-8426 UR Number: 636 Deductible Policy LImit 52,000.00 $360,000.00 $0.00 $36,000.00 Date Received: 5/9/2017 Date Entered: 5/9/2017 3:51 PM Summary for Dwelling �USAA ConfldantW 14,650.25 386.36 $15,036.61 (2.496.68) $12,539.93 (2.000.00) $10,539.93 2,496.68 $13,036.61 insure,!: DATEMA. COL ALICE env em: 4665 ROBB ST Date Inspected: WHEAT RIDGE, CO 80033 ,tome: 4645 ROBB ST WHEAT RIDGE, CO 80033 Claim Rep.: John Foy Worley 5/18/2017 Cell: (303) 521-0889 E-mail: adatWeaearthlink.net Business: (919) 801-8426 Estimator. John Foy Business: (919) 801-8426 Member Number. flail 618 flaPolicy Number. 001728618/81A UR Number: 636 [�pc of Loss: 1isi1 Cause of Loss: Other Coverage Dwelling Other Structures Date Contacted: 5/9/2017 6:48 PM Date of Loss: 5/8/2017 Date Inspected: 5/13/2017 3:30 PM Date Est. Completed: 5/18/2017 6:19 PM PriceList: C0DE8X_MAY 17 RcstordtiOn/Service/Remodel Linc Itcm Total Material Sales Tax Replacement Cost Value Less Depreciation Actual Cash Value Net Claim Total Recoverable Depreciation Net Claim if Depreciation is Recovered L19c9aa41469 Deductible Policy Limit $2,000.00 $360,000.00 $0.00 $36.000.00 Date Received: 5/9/2017 Date Entered: 5/9/2017 3:51 PM Summary for Other Structures John Foy uSAA ConM; wl Page: 3 976.04 37.27 S1,01331 (663.91) 5349.40 $349.40 663.91 $1,01331 `r f3A ITAIA, COL. ALICL•: 1 a �4 "'�,,,e:�,.$E.,,�..rrirll�s:.=•,� :.+.i<rlri.�:a.:i5ri_::;.t5+%ak? Worley DA 1'E MA`COL_ALICE 1 Source - Geomai Roof Source - Geomni Roof Datems Roof 3512.54 Surface Arca 337.18 Total Perimeter Length 5/1 &r" 17 35.13 Number of Squares 119.18 Total Ridge Length Pagr.F CAT SEL DESCRIPTION AC V CALC QTY UNIT PRICE RCV DEPREC. 1. RF'G ARMV> Remove Tear ot3`: haul and dispose of comp• shingles -Laminated 1,723.22 2. RFG SQ -1.5 33.63 SQ 51-10 1,725.22 (0.00) 3005 SQ -1.3 Laminated - comp. shingle rfg. - w/out felt (1.23333) 6,166,67 3' C' 37.00 SQ 200.00 7,400.00 FELT15 33.63-10.11 Roofing felt - 15 !b. 658.32 164.58) 493.74 4. RFG 23.52 SQ 27.99 IWS 337* 3 Ice& water shield 1,011.00 SF 1.63 1.668.15 278.03) 1,390.12 5. RFG DRIP Drip edge (95.37) 572.25 P 337.18 LF 1.98 667.62 6. RFG FLPIPE Flashing - pipe Jack (2438) 146 27 5 5.00 EA 34.13 170.63 7. RFG VENTT Roof vent - turtle type - Metal 215.01 S 5.00 EA 50.17 250.85 (35.84) 8. RFG VENTEC8 R&R Rain cap - 8" 3 3.00 EA 52.04 156.12 (20.47) 135.63 9. I1 VC VENTCP5 Furnace vent - rain cap and storm collar. 5" 2 2.00 EA 66.01 132.02 (26.40) 1 OS.b2 10. RFG DISIIRS Digital satellite system - Detach & reset 3 3.00 EA 36.26 108.78 (0.00) 108 78 11. AWN PCDK-- R&R Patio Cover - Roof panels only - No load 79.14+72.60 151.74 SF 6.06 919.55 (138.34) 781.21 Totals: Datema Roof 13,857.28 2,016.74 11,840.54 Front Elevation CAT SEL DESCRIPTION CALC QTY UNIT PRICE 12. SFG RCV DEPREC. LUTA R&R Gutter/ downspout - aluminum - up to 5" 51 51.00 LF 5.79 295.29 L19c9aa41469 UMA CMWM-tW (205.02) ACV 90.27 Worley blA. COL ALIT k Sr` I ti 20l ° fate CONTINUED - Front Elevation (':41' SEL DESCRIPTIONA('` CALL RCV DEPRt_C:. __ ... ____._— QTY UNIT PRICE Down spouse 10. gutter 41 295.29 205.O2 90.27 1 otals: Front Elevation Right Elevation CAI' SEL DESCRIPTION DEPREC. ACV CALL QTY UNIT PRICE RCV No storm related damage noted to this elevation during inspection 0.00 0.000.00 Totals-- Right Elevation Rear Elevation CAT SEL DESCRIPTION DEPREC. ACV CALC QTY UNIT PRICE RCV 13, SFG GUTA R&R Gutter / downspout - aluminum - up to 5" 30 30.00 LF 5.79 173.70 (120.60) 53.10 Down spouts 30, gutter 73 Totals: Rear Elevation 173.70 120.60 53.10 Left Elevation CAT SEL DESCRIPTION CALC QTY UNIT PRICE RCV DEPREC. ACV 14. SFG GUTA R&R Gutter / downspout - aluminum - up to 5" 20 20.00 LF 5.79 115.80 (80.40) 35.40 Down spouts 20, gutter 30 Totals: Left Elevation 115.80 80.40 35.40 0901119c9aa41469 CAT SEL Small shed Worley Other Structures 96.19 Surface Arra 39.29 Total Perimeter Lcngth DESCRIPTION 14,442.07 5/18/2017 Page: 8 2,422.76 12,01931 0.96 Number of Squares 27.81 Total Ridge Length CALC QTY UNIT PRICE RCV DEPREC. ACV 15. XST SI iEDMG R&R Storage shed - Metal - Gable type - 10'x 8' (0.00) 208.18 i 1.00 EA 976.04 976.04 (635.96) 340.08 Totals: Small shed 916.04 635.% 340.08 Total: Other Structures 916,04 635.% 340.08 Total: Source - Geomnl Roof 15,418.11 3,058.72 12,35939 Labor Minimums Applied CAT SEL DESCRIPTION CALC QTY UNIT PRICE RCV DEPREC. ACV 16. HVC MN -A Heat, vent, & air cond. labor minimum 1 1.00 EA 208.18 208.18 (0.00) 208.18 Totals: Labor Minimums Applied 208.18 0.00 208.18 Line Item Totals: DATEMA COL ALICEI 15,62619 3,058.72 12,56757 901119c9aa41469 USAAZ—� at}�` ails ttt Ftwu arra `w will Ares Sc Area ty",c0 Tacal Ridge Length coverage p%tihnic Strvct= Term 901119c9aa41469 Worley 0.00 SF Ceiling 0.00 SY Flooring 0.00 SF Short Wall 0.00 Total Area 0.00 Exterior Perimeter of Walls 36.09 Number of Squares 0.00 Total Hip Length Item Total % 14,650.25 93.75% 976.04 6.25% 15,62619 100.00% USAA coe�tid-tW 5/18/2017 0.00 SF Walls and Ceiling 0.00 LF Floor Perimeter 0.00 LF Ceii. Perimeter 0.00 Interior Wall Area 674.36 Total Perimeter Length Page; 9 ACV Total % 12,539.93 97.29% 349.40 2.71% 12,889.33 100.00% ,.(;L ALICE ,. rr�o,ste: VA.l MA`COL AL10E1 ,00" C - Geomni Roof Cres: Source - Geomni Roof Datema Roof Coverage: Dwelling Front Elevation Coverage: Dwelling Rear Elevation Coverage: Dwelling Left Elevation Coverage: Dwelling Area Subtotal: Source - Geomni Roof Coverage: Dwelling Area: Other Structures Small shed Coverage: Other Structures Area Subtotal• Other Structures Coverage: Other Structures Area Subtotal: Source - Geomni Roof Coverage: Dwelling Coverage: Other Structures Labor Minimums Applied Coverage: Dwelling Worley 5/18/2017 Page: 10 Recap by Room Subtotal of Areas Coverage: Dwelling 93.75% = Coverage: Other Structures 6.25% = Total L901119a9aa41469 15,626.29 100.00% 14,650.25 976.04 100.00% 15,626.29 13,857.28 88.68% 100.00% = 13,857.28 295.29 1.89'/0 100.00% = 295.29 173.70 1.11% 100.00% = 173.70 115.80 0.74% 100.00% = 115.80 14,442.07 92.42% 100.000/0 = 14,442.07 976.04 6.25% 100.00% = 976.04 976.04 6.25% 100.00% = 976.04 15,418.11 98.67% 93.67% = 14,442.07 6.33% = 976.04 208.18 133% 100,00% = 208.18 Subtotal of Areas Coverage: Dwelling 93.75% = Coverage: Other Structures 6.25% = Total L901119a9aa41469 15,626.29 100.00% 14,650.25 976.04 100.00% 15,626.29 f Worley cap by Category with Depreciation s I>� G PATIO COVERS ACV 13834 F telling L 100.w". = VENT �►DITIONING 10,953.71 486,02 ening N6 co- (a),i OO.OQ'/. _ POOFING coverage Dwelling(, a7 I00.w". = 50FF IT, FASCIA, is GUTTER ' Coverage: Dwelling (a 100.00°/. = EXTERIOR St ther Coverage:tructum 100.00'/. = Subtotal %I,terial Sales Tax Coverage: Dwelling � 9t .2(P`. Coverage: Other Structures 8.80'/. Total RCV 919.55 919.55 340.20 340.20 12.805.71 12.805.71 594.79 584.79 976.04 976.04 15,626.29 423.63 386.36 37.27 16,049.92 5 1t0017 Page I Deprec. ACV 13834 781.21 26.40 313.80 1,852.00 10,953.71 486,02 17&77 635.96 340.08 3,058.72 2,367.57 101.87 321.76 3,160.59 12,88933 FREQUENTLY ASKED QUESTIONS claim process• if there is any conflict between these answers and the policy. The FAQ's and answers below will be helpful in the your policy controls. Please read your policy. How is my initial Dwelling Payment determined? mens am generally based on the coat to repair or�tace Subject to the applicable deductible and policy conditions, Dwelling pay uses When the cost to repair or rep the damaged property with similar construction and for the same use on the fs rot (� actuai cash value of the Toes), and the damaged dwelling exceeds $5000. USAA will paya� on of �Pl�e claim up balance (recoverable depreciation) when the reps/ How do 1 collect the recoverable depreciation.' Value, to receive additional amounts (recover p(recoverable Where initial payment for Dwelling loss is in the amount of Actual Cash property. When u depreciation), you must complete the actual repair or replacement of the damaged Part of the propr� and necessarily incurred to policy will y the coveted additional amount You actually replacement is actually completed, the po cY d addittut cost of your claim (our cost). In no case will USAA but not to exceed the approved rep repair or replace the property. repairs less Your Policy pay more than the total amount of the actual reps Why is the check made out to me sad someonecelse (po�r ims °because Wearcyiuired to include theiname on payment to I f your check incl the name of your mortpi The check must be presented to them for their endorsementprior you. per the mortgage clause on your policy. returned without payment. Please contact us if the our bank for payment. Incomplete endorsements will result in the check being is incorrect so that we may update that information and issue a correct payment to you. mortgagee information to repair or replace my damaged Property using the some material? of constnuction What if I'm not going P air or replace the damaged building part with a different material ar type Please contact us if you choose tooror repair differing from the original estimate could affect any replacett�nt cost claim from what is on our estimate. Replacement you art otherwise eligible What if my contractor's estimate is different from USAA's estimate'. usr►t► c� 0901119c9aa41469 ,.«t,.,,wcutllall.eahmilnk.net/wam/printable jsp?msgid=51280&x=-1506519262 6/1/2017 ` COMMUNITY DEVELOPMENT DEPARTMENT BUILDING INSPECTION LINE - (303-2545983) CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80033 - (303-235-2855) Building Permit Number Date 76255 9/23/2003 Property Owner: ALICE DATEMA Property Address : 4675 ROBB ST Contractor License No. : 18464 Company : B& F Heating & A/C Phone : 431-4178 Phone : 431 8914 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certi(y that the setback distances proposed by this permil application are accurate, and do not violate applicable ordinances, rules or regulalions of the City of W heat Ridge or covenants, easements or restridions of record; that all measurements shown, and allegations made are accurete; lhat 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 (U.B.C.) and all other applicable W heat Ridge ordinances, for work under this permit. (OWNER)(CONTRACTOR) Description : INSTALL 80,000 BTU'S FURNACE Construction Value : $2.199.00 Permit Fee : $108.30 Plan Review Fee : $0.00 Use Tax : $0.00 Total: $108.30 Use: mo BUILDING DEPARTMENT USE ONLY ~oningc R,~Lfie4ts;, SIC : Sq. Ft. : ~ Approval: Zoning : Bi414iin06mrnen#s:; Approval: R,ublie,W.arks`dorhinen3s: i Approval: Occupancy : Walls : Roof : Stories : Residential Units : Electrical License No : 17875 Plumbing License No : Mechanical License No : Company :Coffman Electric, Inc Company : Company : Expiration Date : 2/28/2005 Approval : OK/KS Expiration Date : Expiration Date : Approval : Approval : (1) This permit was issued in accordance with the provisions set forth in yopur application and is subject to the laws of the State of Coloredo and to the Zoning Regulations and Building Code of Wheat Ridge, Coloredo or any other applicable ordinances of the City. (2) This pertnit shall expire it (A) the work authorized is not commenced within sinty (60) days from issue date or (B) the builtling authonze0 is suspentled or abandoned tor a period of 120 days. (3) If this permit ezpires, a new permit may be acquired !or a fee of one-half the amount nortnally 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 are matle or if suspension or abandonment ezceeds one (1) year, full (ees 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 prohlem. (5) Contrador shall notify the Building InsDector hventy-four (24) houre in advance for all inspections and shall receive written approval on inspection card before pmceediing with successive phases of the job. (6) The issuance of a pertnit or the approval of drdwings and specifcations shall not be construed to be a permit for, nor an approval of, any violation ot the provisio o he buildin odes or any other ordinance, law, rule or regulation. I Chi uilding In ctor Please sign Terms and Conditions on reverse side of page. BUILDING INSPECTION DIVISION - 235-2855 ~ ""l"'"'y rei lrin rvumoer : CITY OF WHE4T RIDGE Date : 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 AppLICATIo N PropertyOwner: 0~1ce CJQlt'ynA Property Address : L~ 6-1CJ 0) h b S4-,~-e e ~ Phone : Contractor License No. : lg7 l' l, ~31 ~j78 ~07 Company :B,1 r N PC~fi nc~ ( I c~.1 jj# (~c~ I/ n~ Pnone :.303 113 /PL7 1/-/ OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AGREEMENT 1 hereby certify that the setback distances proposed by this permit application arc accurate, and do not violate appliwble ordinances, rules or rcgulatione ot the City of Wheat Ridge or covenants, easements or restridions ot rccord; that all measurcments shown, anO allegations made are accurete; that I have read and agree to abide by all conditions printed on this application, and that I assume full responsibili for compiunce with the Wheat Ridge Building Cotle (U.B.C.) and all other applicabie Whe idge ordinanas, for work untler this pe R. (OWNER)(CONTRACTOR) SIGNE ~ Qn t~.-i~ d-- pA~ Q3 Description : C-Q- F4 Approval: Zoning : Approval: Approval: Occupancy : Walls Construction Value Permit Fee : Use Tax: Total : Use BUILDING DEPARTMENT USE ONLY Roof : Stories Electricai License No : 17F71~ piumbing License No : Company ./~o 1~f3Y)a,nn C'C-~J'; C, Company : Expiration Date : Expiration Date : Approval : Approval: SIC Sq. Ft. : Residential Units : Mechanical License No : Company : Expiration Date : Approval: (1) Thls pertnit was issued In acoorduice wIN the provWons sel foM in yopur R aDdicatbn and ia supeet to Me 101y of Ne State of Colonao an0 to the 2oning egulations antl Building CoOe ol VMeat RiOqe. ColomEO or arry oNer ap0lieaDle ortlinarlcas of Me Ciry. (2) This permit shall expirc tt(A) Me work aulfqnzed iy not cpmmenceE wi~in aixty (80) aDantloneA for a perqC pl 120 Oaya days hom issw tlete a(B) Me Duiltlinp authonzcd ia suspenEeE or . (3) If this permil expircs. a new permit may Oe ecquiretl /or a fee ol one-hal! the amount rarmelly repuiRy, prorfaed rw Uanpea have Oeen or will De maCe in the ongmal pians aiw speciRmtlona arM arry suspansbn «aDantlonment nas not sxceedep one (t) year. It charpes ve maae a il suspenabn w abanCOnment ezceetls one (t) year, NII leea ihall 6e peiA Ior a naw pamil, (a) No wOrk of arry nynnm'hap pa dpne yNt wi0 ayrqe Uw nsNnl flpw a Wetaf nuainq a Cl2inege pfOdem. (5) Convaaa ahan noUy the BuiWirp Inapecta twanry-lour (yq houn in aEvanca ror ail mspectbna anE ahall receive writlen appmval on inspaction wrd Detore praeeCling with succaasiva pAaxs ot tM' (6) ine issuance d a pemiil or py appro,ial ~oe'~rax~i~ys anC speU6ea6ona slwll no{ pe consvuetl to pe a of the OuiWinp wCes a ary oMer orUinanq. lyw. niy amyulaGOn. 7~t for. w an approval ol. arry violation ol the piovisiqns V Chief Building Inspector