HomeMy WebLinkAbout7809 W. 38th Avenuei CITY OF WHEAT RIDGE
Building Inspection Division
r (303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: c_, ~ L ~ L~ , ~✓I
r ~
Job Address: &j ..5 71A /6o
Permit Number: x745 5
r41
!t~,Ul~ u~nl✓o✓
4
El No one available for inspection: Time t` PM
Re-Inspection required: Yes No
When corrections have been made, call for re-inspection at 303-234-5933
Date: a' l) Inspector:,
DO NOT REMOVE THIS NOTICE
ADDRESS:
~oF"'"EtT~o City of Wheat Ridge Building Division
m 7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
°Otoa"o° Inspection Line: 303-234-5933
Date: G I.
Plan
Permit 0
Building Permit Application
Property Address; Ty i (Itj
Property Owner (please print)/~~ C',EEEC~ "t?~I' LGC Phone 3S ~U
Mailing Address: (if different than property address)
City, State, Zip: (fo U(jv? d
Contractor
Contractor License eo / 010 Phone:-30,j oZc 8 'z S-<
Sub Contractors:
Electrical City License Plumbing City License Mechanical City License
Company: Company Company: >k4l✓F- C,-J,
Exp. Date: Exp. Date: Exp. Date:
Approval: Approval: Approval:
Use of space (description):, 6~6;e Construction Value: $ h✓~ fur
D6Sc19ptlon Of*Ork - (as calculated per the Building Valuation Data sheet)
S~f/T-V A.4T7- ,ere,, J.4,v?O- X 5 /417d r% erA; 2e*e Plan Review (due at time of submittal): $
Sq. FL/L.Ft added: Squares BTU's Gallons Amps
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distance's proposed by this permit application are accurate, and do not violate applicable ordinances,
rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and
allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full
responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge. Ordinances,. for work
under this permit. Plans subject to field inspection.
CIRLCE ONE:: (OWNER) ((CONTRALTO or PERSONAL REPRE TATIVE ff (0 (CONTRATOR)
PRINT NAME: {f'/C. G. '?-NE/ZOi✓6' SIGNATURE: Z~ Date:
r
Bldg Valuation: $
7500 West 29th Avenue
Wheat Ridge, Colorado 80033
303/235-2846 Fax: 303/235-2857
May 24, 2005
To Whom It May Concern:
The City of
Wheat Ridge
tim
Please let this letter serve as zoning and use confirmation for property located in the City of
Wheat Ridge at 7809 W. 38`a Avenue.
Zoning classification code: The zoning on the property is Planned Commercial Development
(PCD).
Property owner's name: Jefferson County assesses property taxes for all properties within the
City of Wheat Ridge. Pursuant to the Jefferson County Assessor's records, on May 24, 2005, the
property owner of 7809 W. 3e Avenue is reflected as Baxter Healthcare Corp., 2009 Chenault
Drive, Suite 100, Carrollton, Texas, 75006. The Jefferson County Assessor records show the
property owner of 3800 Zephyr Street as Clear Creek MOB, LLC. This information may or may
not be up to date. Security Title Guaranty Co. indicates Clear Creek MOB, LLC is the current
property owner.
Address of the property: The property known as Lot 2, Zephyr Medical Commons, Phase 4
Subdivision is addressed as 7809 W. 3e Avenue, Wheat Ridge, Colorado, 80033. The Jefferson
County Assessors records reflect an address of 3800 Zephyr Street. Their information is in the
process of being updated to show the correct address.
Type of permitted useluse in conformance with classification: Permitted uses within the
Zephyr Medical Commons Planned Development are general office uses with an emphasis on
medical offices. The Clear Creek Ambulatory Surgery Center is in conformance with the
permitted uses in the approved planned development plan.
Copy of conditions or restrictions on use, including setback and height restrictions and
parking requirements: The site plan for Clear Creek MOB was approved as an administrative
amendment to the original Zephyr Medical Commons planned development plan. The approved
site plan is consistent with all minimum development parameters of the underlying Zephyr
Medical Commons planned development plan. These development parameters include setbacks,
height and parking.
If you have any questions or need further clarification, do not hesitate to contact me at 303-235-
2848.
Sincerely,
Meredith Reckert, AICP
Senior Planner
~:~a~
~r- C~ _.k
Am.~ ~tolory SurgiCa. Ce-,jt, rr
7809 West 38t" Ave
Wheat Ridge, CO 80033
Permit # 16926
( ~ 9zG
Medical Inc.
CAloon
CAL GAS & VACUUM SPECIALISTS
16124 Foster Overland Park KS 66085
Telephone: (913) 681-6548
FAX: (913) 681-8878
E-Mail: almoon@moonmedical.com
-7 go q w ~)g`~ ~ .
MEDICAL GAS & VACUUM
REPORT
Clear Creek Ambulatory Surgery Center
Wheat Ridge, CO
February 2005
Moon Medical Inc / Medical Gas & Vacuum Certification
4c~an ~d1ca~ 1nC.
"MEDICAL GAS & VACUUM SPECIAUSTS
_
"•6^L4 Fo:'e~Orerl~wc Vwk. K4ob.0V5le;ephar,e: (9131681-6548
FAX: 1913)681-8378
INSTALLER TESTING AFFIDAVIT
Certificate of Installation of the Medical Gas Piping Systems
Facility: Clear Creek Ambulatory Surgery Center / Wheat Ridge CO
Contractor: Trinity Mechanical
This is to certify that through periodic observation during construction and by
documentation, tests and certification records the referenced medical gas piping
system has been installed in accordance with the National Fire Protection
Association / NFPA-99C Gas and Vacuum Systems 2002 Edition for Health Care
Facilities Chapter 5(#5.1.12.2) as indicated below.
1. Written documentation certifying that all installed piping materials comply with the requirements of
sections Chapter 5 (#5.1.12.2)
2. Verification that the brazing filler metals and installations procedures specified was used according
to chapter 5.
3. Written documentation that installers and brazers have been trained and tested for proper
installation methods for medical gas pipe.
4. Written documentation that the 24-hour standing pressure test, at 20 percent above the normal
operating line pressure listed in section 5.1.12.2 was performed.
5. Labeling of the medical gas tubing with gas content, operating pressures directional arrows and
color-coding.
Copies of all required documentation, test and certification records have been made part of the
facility's permanent records.
I certify all statements contained herein are true and correct.
Installer Signature:..... . ~ ..............................Date: ~°~.-O~ 01
~dical, Inc.
`SPECIAUSTSj
16..24 Fo7`er. t)verlz;rWParis. KS 66085
ii3?i'n)8?-E3'i^.fi
F,4X 913 ~ `i£ 1-88 78
aimaan~r~moonmeciic.a! t;flm
Oxygen Analyzer: Ceramatec SIN FE0195-5361 MAX02 OM-25A I Calibrated Dec. 01, 2004 & before used.
Nitrous Oxide: Geotech SINN0016 Medigas FP991 Calibrated Dec. 01, 2004 & before used.
Nitrogen Analyzer: Ceramatec SIN FE0195-5361 MAX02 OM-25A I Dec. 01, 2004 & before used.
C02 Analyzer: Geotech S/NN0016 Medigas FP991 Dec. 01, 2004 & before used.
+ TRI I Austin TX I Test Tubes
+ Certified Medical Testing I Murrieta, CA I Bag Samples
CO Analyzer: Geotech SINN0016 Medigas FP991 Dec. 01, 2004 & before used.
+ TRI I Austin TX I Test Tubes
+ Certified Medical Testing I Murrieta, CA I Bag Samples
CO Analyzer: Med-Con Model A332 SINA332-18 l Dec. 01, 2004 & before used.
Gas Mixture: TRI / Austin TX I Test Tubes
+ Certified Medical Testing I Murrieta, CA I Bag Samples
Dew Point: Ohmic Instrument SIN 1272 Airline Meter #AMM-151 Dec. 01, 2004 & before used.
Particulate Sampling: Oahu's SIN A-9887 Model #AS120-S21 Calibrated on Site
Vacuum: Dwyer Gauges S/N 7112-G30 Vacuum Gauge 1 Dec. 01, 2004
Halogenated Hydrocarbon: TRI I Austin TX I Test Tubes
+ Certified Medical Testing 1 Murrieta, CA I Bag Samples
Hydrocarbon as Methane: TRI I Austin TX I Test Tubes
+ Certified Medical Testing / Murrieta, CA / Bag Samples
Foxboro Miran 203 CA111 SIN 002141 Calibrated and Zero on Site
Equipment
Pressure Gauges: Meriam Instruments SIN MPH08001 Merigauge #39001 Dec. 01, 2004
Flow Meter: Dwyer S/N S08L RMC-121 I Dec. 01, 2004
NOTES:
Medical ~c.
CALoon
GAS & VACUUM SPECIALISTS
16124 Foster, Overland Park, KS 66085
Telephone: (913) 681-6548
FAX: (913) 681-8878
E-Mail: almoon@moonmedical.com
Facility: Clear Creek Ambulatory Center / Wheat Ridge, CO
Purchase Order Number: Trinity Mechanical
Contact: John Vonfeldt
This reflects the services described in the Medical Gas Distribution System Inspection
Agreement ("Agreement"). The agreement states that verification of installed Medical Gas
Piping Equipment shali be made to help determine that the recommendations of the National
Fire Protection Association (NFPA 99) Standards for Health Care Facilities, 2002 Edition, were
followed. Gas System Performance Criteria and Testing NFPA 99C Chapter 5
• Cross-Connection Test. All medical gases and vacuum shall be reduced to atmospheric pressure. All sources of test gas from all of the
medical gas systems, with the exception of the one to be checked, shall be disconneded. Each individual station outlets/inlets shall be
checked to determine that test gas is being dispensed only from the outlets being tested. That the gas delivered at the outlet is that shown
on the outlet label and that the proper conneding fittings are checked against their labels and latch valves.
• Gas & Vacuum Warning Test. All medical gases and vacuum shall be tested for alarms. All source equipment shall be tested for iYs
performed per 4-3.5.3. Each individual warning alarm shall be checked to determine that an audible and noncancellable visual signal is
indicated if the pressures increase or decrease in pressure by 20 percent and if the medical vacuum decrease to 12 hg.
• Valve Test. That the valves installed in each medical gas and vacuum piping system shall be tested to verify proper operation. Zone valve
boxes shall be labeled for the rooms or areas controlied.
. Outlet Flow Test. That all medical gases and vacuum shall be tested for flow. Oxygen, medical air, nitrous oxide shall deliver 3.5 SCFM
with pressure drop of no more than 5 psig and static pressure of 50 psig 0/+5. Nitrogen outlets shall deliver 5. SCFM with pressure drop of no
more than 5 psig and static pressure of 160 psig. Medical vacuum shall deliver 3. SCFM without reducing vacuum pressure below 12 in. Hg
at an adjacent station inlet and maintain a vacuum of 12 in of inercury (hg) at the station inlet farthest away from the central vacuum source.
• Piping Purge Test. In order to remove any traces of particulate matter, a heary, intermittent purging of the pipeline shall be pertormed.
Purge shall product no discoloration in a white cloth and the test gas used during the previous tests shall be removed from the piping
systems.
• Mediwl Gases Concentretion Test. Each pressure gas source and outlet shall be analyzed for concentration of gas, by volume with
instrument designed to measure the specific gas dispensed. Ouygen 99 plus percent, Nitrous Oxide 99 plus percent, Nitrogen Less than 1
percent ouygen, and Medical Air 19.5 to 23.5 percent oxygen.
This inspection was performed on the date noted and was found to be in compliance with the conditions Iisted above.
A ilo4niloA rennr} lie4inn 4he arenc mr1fIIM flllNY1S l:IIPCI(PfI IA AHACIIP.fI }3S 0840 Y/I OP tF11S B4r2BITI@nt.
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Carbon Dioxide
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February 07, 2005
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61 to to to
CXoon Medical ~c.
AL GAS & VACUUM SPECIALISTS
16124 Foster Overland Park, KS 66085
Telephone: (913) 681-6548
FAX: (913) 681-8878
E-Mail: moonmedicalinc(a)cs.com
MEDICAL VACUUM PUMP TEST REPORT
Facili
Clear Creek Ambulato Center
Ci , State
Wheat Rid e, CO
Confi uration
Du lex
HP
5
Area Served
Hos ital / Center
Date
Februa 07, 2005
Location
178
Ins ector s
AI Moon CMGV #002
Manufacturer
Air Tech
T e of Pum
D Vane
Model #
#439 Job 208-3-60
Serial #
SCSKRA102SCANNFPA
YES
NO
Is the system dedicated to Medical use?
0
Is the pump located separately from manifold locations?
Q
Are isolation valves installed on each pump and drip legs7
0
Are check valves installed on each pump?
El
Are flex connectors installed on each pump?
Q
Is system fed by emergency power system? Verified by whom?
p
Is each pump provided with separate disconnect, overload?
C~f
Are there two control transformers?
Cd
Is there an automatic alternator?
0
Are running time approximately equal?
0
Does the receiver have a three-valve bypass installed?
~
Does the receiver have a drain?
~
Does the receiver have a pressure gauge?
0
Is the receiver corrosion resistant?
0
Is the receiver ASME labeled?
Q
is there a properly installed source valve?
Q
Is it properly labeled?
~
High/low pressure alarm activates master alarms?
~
Main gauge visible from standing position?
~
Medical Vacuum demand check valve installed in gauge/switch?
0
Does the lag alarm activate master alarms?
2
Is the exhaust outside?
0
Is the exhaust 10 feet from any door, window or opening?
0
Is the exhaust turned down and screened?
0
Is the exhaust run with copper, galvanized or stainless steel?
Q
Is it wired to local alarm?
2
.l Inc.
eC~1Ca
CAto.onM
L AS & VACUUM SPECIAL~STS
16124 Foster Overland Park, KS 66085
Telephone: (913) 651-6548
FP,X: (913) 681-8878
E-Mail: moonmedicalinc(~a cs.com
MEDICAL GAS MANIFOLD
TEST REPORT
Facili
Clear Creek Ambulato Center
Ci , State
Wheat Rid e, CO
Confi uration
Automatic
Tank #
2X2
Area Served
Hos ital / Center
Date
Februa 07, 2005
Location
Bottle Stora e Rm. 176
Ins ector s
AI Moon CMGV #002
Manufacturer
Allied Healthcare
T e of Unit
Nitrous Oxide
Model #
86-63-2100 #3000
Serial #
200406020001
YES
NO
Verity automatic alternation?
Q
Shut-Off Valve Per Header Bar?
0
Shut-Off Valve Main Line?
0
Warning Light?
121
Is system fed by emergency power system? Verified by whom?
[JJ
Duai Line Regulators?
0
Relief Valves To The Outside (except medical air)?
0
Is it properly labeled?
0
Noleaks Detected?
0
Area Posted ( No Smoking
0
Enclosed With Locking Entry?
0
Interior Location Vented?
0
Free From Flammable Liquids and Gases?
O
Electric Switch and Outlets Above 1.5 Meters (5 Feet)?
0
Cylinders Are Individuaily Chained or Secured?
0
Area Is Not Exposed To Temperatures Above 54.4 C(130 F)?
0
Area is Not Exposed To Temperatures Below -7 C(20 F)? (Nitrous Oxide and
Carbon Dioxide
Q
High/low pressure alarm activates master alarms?
0
Main gauge visibie from standing position?
Q
Medical Gas demand check valve installed in gauge/switch?
p
Is the exhaust turned down and screened?
L~f
Is the exhaust run with copper, galvanized or stainless steel?
[JJ
PSIG
Pressure Main Line
50
C!*oon
MedicalEIALIS1nc.
CAL GAS & VACUUM SPTS
16124 Foster Overland Park. KS 66085
Telephone: (913) 681-6548
FAX: (913) 681-8878
E-Mail: moonmedicalincCaDcs.com
MEDICAL GAS MANIFOLD
TEST REPORT
Facili
Clear Creek Ambulato Center
Ci , State
Wheat Rid e, CO
Confi uration
Automatic
Tank #
2X2
Area Served
Hos ital / Center
Date
Februa 07, 2005
Location
Bottle Stora e Rm. 176
Ins ector s
AI Moon CMGV #002
Manufacturer
Allied Healthcare
T e of Unit
Medical Air
Model #
86-64-2100 #3000
Serial #
200406023002
YES
NO
Verity automatic alternation?
p
Shut-Off Valve Per Header Bar?
[✓7
Shut-Off Valve Main Line?
LJ(
Warning Light?
[rJ
Is system fed by emergency power system? Verified by whom?
0
Duai Line Regulators?
0
Relief Valves To The Outside (except medical air)?
0
Is it properly labeled?
No leaks Detected?
0
Area Posted ( No Smoking
~
Enclosed With Locking Entry?
0
Interior Location Vented?
Q
Free From Flammable Liquids and Gases?
Q
Electric Switch and Outlets Above 1.5 Meters (5 Feet)?
[J(
Cylinders Are Individually Chained or Secured?
Q
Area Is Not Exposed To Temperatures Above 54.4 C(130 F)?
Q
Area Is {Jot Exposed To Temperatures Below -7 C(20 F)? (Nitrous Oxide and
Carbon Dioxide
0
High/low pressure alarm activates master alarms?
B
Main gauge visibie from standing position?
p
Medical Gas demand check valve installed in gauge/switch?
0
Is the exhaust turned down and screened?
Q
is the exhaust run with copper, gaivanized or stainless steei?
Q
PSIG
Pressure Main Line
50
~c.
C)ftoo.nM.ed.iqa1
ALISTS
16924 Foster OverlandPark, KS 66085
Telephone: (913) 681-6548
FAX: (913) 681-8878
E-Mail: moonmedicalinc(a)cs.com
MEDICAL GAS MANIFOLD
TEST REPORT
Facili
Clear Creek Ambuiato Center
Ci , State
Wheat Rid e, CO
Confi uration
Automatic
Tank #
2X2
Area Served
Hos ital / Center
Date
Februa 07, 2005
Location
Bottle Stora e Rm. 176
Ins ector s
AI Moon CMGV #002
Manufacturer
Allied Healthcare
T e of Unit
Carbon Dioxide
Model #
86-65-2100 #3000
Serial #
200406028002
YES
NO
Verity automatic alternation?
0
Shut-Off Valve Per Header Bar?
~
Shut-Off Valve Main Line?
Q
Warning Light?
✓Q
Is system fed by emergency power system? Verified by whom?
p
Dual Line Regulators?
~
Relief Vaives To The Outside (except medical air)?
0
Is it properly labeled?
0
No leaks Detected?
C~I
Area Posted ( No Smoking
L~(
Enclosed With Locking Entry?
0
Interior Location Vented?
~
Free From Ffammable Liquids and Gases?
Q
Electric Switch and Outlets Above 1.5 Meters (5 Feet)?
Q
Cylinders Are Individually Chained or Secured?
Area Is Not Exposed To Temperatures Above 54.4 C(130 F)?
0
Area Is Not Exposed To Temperatures Below -7 C(20 F)? (Nitrous Oxide and
Carbon Dioxide
0
High/low pressure alarm activates master alarms?
0
Main gauge visible from standing position?
61
Medical Gas demand check valve installed in gaugelswitch?
0
Is the exhaust turned down and screened?
0
Is the exhaust run with copper, galvanized or stainless steel?
Q
PSIG
Pressure Main Line
50
MeC~1Ca.l Inc.
CAoon
AL GAS & VACUUM SPECIALISTS
16124 Foster Overland Park, KS 66085
Telephone: (913) 681-6548
FAX: (913) 689-8878
E-Mail: moonmedicalinc(d)cs.com
MEDICAL GAS MANIFOLD
TEST REPORT
Facili
Clear Creek Ambulato Center
Ci , State
Wheat Rid e, CO
Confi uration
Automatic
Tank #
1 X 1 Li uid Reserve C linders 4
Area Served
Hos ital / Center
Date
Februa 07, 2005
Location
Bottle Stora e Rm. 176
Ins ector s
Ai Moon CMGV #002
Manufacturer
Victor
T e of Unit
O en
Model #
VM1100
Serial #
FL01906
YES
NO
Verity automatic alternation?
Q
Shut-Off Valve Per Header Bar?
~
Shut-Off Valve Main Line?
Q
Warning Light?
Q(
Is system fed by emergency power system? Verified by whom?
0
Dual Line Regulators?
0
Relief Vaives To The Outside (except medical air)?
0
Is it properly labeled?
0
No leaks Detected?
~
Area Posted ( No Smoking
~
Enclosed With Locking Entry?
0
Interior Location Vented?
0
Free From Flamma6le Liquids and Gases?
0
Electric Switch and Outlets Above 1.5 Meters (5 Feet)?
Q
Cylinders Are Individually Chained or Secured?
0
Area Is Not Exposed To Temperatures Above 54.4 C(130 F)?
0
Area Is Not Exposed To Temperatures Below -7 C(20 F)? (Nitrous Oxide and
Carbon Dioxide
0
High/low pressure alarm activates master alarms?
0
Main gauge visible from standing position?
0
Medical Gas demand check valve installed in gauge/switch?
0
Is the exhaust turned down and sCreened?
p
Is the exhaust run with copper, galvanized or stainless steel?
~
PSIG
Pressure Main Line
54
AA- ( aG~,c,
ISOT.ROL
SYSTEMS L
Medical Division of Bender Inc.
OverSi%tyYear5of 6tpetiencevMMElectricalSa/eyProducts
ACKNOWLEDGEMENT
EQUIPMENC CEECKOUT
This leuer shall serve as evidence that the Lsotated Power Systems havs been tested by a Certified Fadory
Technician for compliance with the requirements of Article 517 of the National Electrical Code, NFPA 99
Siandard for Iiealth Care Facilities, and the Project SpecificaYions.
Results will be forwarded to the ISOTROL factory for compliance review by theu engineers. Insurance
requirements prolribit us &om distributing copies of test resuits, which have not been previewed by the
factory. Verbal comments on the results of diese tests are not binding.
Hospitsl or Facility: G464we csPEEK /t5c Test Date: / iPaaos
City/ State/ Cowrty: GvHe-.+T- re.D6-1- / co /
Room ID
0.-f p,e Z' o~e 3'
oit' ¢
Purchase Order Sales Order
3 ZS4~v Z9o8 fifl
Z / 7 40 7
Tested by:
MAcK
fi4 L~5e- f/
(prznt aame)
(sign aame)
W1t718S5:
pfGd-
crLjOry
(pllRrJ[l7JR¢)
Y
~i-~-~
- (sigrr manze)
Title:
Fola,••=~
Company:
E 1«t.: c-
Training Provided :
❑ Yes
;gNo
Reason : N0A14
Notes :
For questions or teclmical information, piease contact ISOTROL SYSTEMS
xgv a- innm
ISOTROL SYSTEMS . 700 Fox Chase . Coatesville. PA 1932D. ToA-free: (800) 8334834 • Fax: (670) 383-7100
GROUNDED TECHNOLOGIES
1 N C O RP O R A T E D
4 1 6ci;u
AUTOMATIC TRANSFER SWITCH
TEST REPORT (ZENITH)
CLIENT:
JOB NUMBER:
Clear Creek
-
LOCATION:
ENGINEER:
DATE:
Wheatrid e, CO
Thom Cook
02/04105
SWRCHGEAR DESIGNATION: ATS DESIGNATION:
ASSET NUMBER(S):
CALIBRATION DATE(S):
NORMAL SOURCE: EMERGENCY SOURCE:
NORMAL CIRCUR BREAKER SIZE:
EMERGENCY CIRCUR BREAKER SIZE:
480
480
400
400
MANUFACTURER: MODEL/ CAT NO.:
SERIAL NUMBER:
VOLTAGE:
GE Zenith
ZG4SA04044-7
1444018
480/277
ORAWINGNUMBER: GENERATOR MANUFACTURER/kW:
AMPERES:
GENER4LAPPEARANCE:
CAT
400
A
IN
SPE
CTION
CHECK POINT
couortiorv rvores
CHECK POINT
.coxortioN Nohs
WORKING SPACE
A
LUBRICATION
N
CONDUCTOR IDENTIFICATION
A
MAIN CONTACTS
N
INDICATING LAMPS
A
ARCING CONTACTS
A
DIRTACCUMULATION
A
ANCHORAGE
A
TIGHTNESS OF CONNECTIONS
A
OTHER
CO
NTRO
LPANEL
AS FOUND
AS I
EFT
DESCRIPTON
ACC.
RANGE
SE777NG
VALUE
MFG.TOL.
VALUE
MFG.TOL
7HANSFER TO EMERGENCY TIME DELAY
t SEC
1 SEC
REfRANSFER TO NORMAL TIME DELP.Y
30 MIN
30 MIN
ENGINE COOLDOWN TIME DELAY
5 MIN
5 MIN
ENGINE START DELAY
3 SEC
1 SEC
OELAY TR4NSRION TIME DELAY
in hase
in hase
PHASE RELP:Y UNDER VOLTAGE DROPOUT
$0%
80%
YHASE RELAY UNDERVOL7AGE PICKUP
90%
90%
PHASE RELAY UNDER FREQUENCY PICKUP
95%
95%
PHASE RELAY UNDERFREQUENCY DROPOUT
90%
90%
EMERGENCY SOURCE UNDERVOLTAGE DO
80%
80%
EMERGENCYSOURCEUNDERVOLTACaEPU
90%
90%
EMERGENCYSOURCE UNDER FREQUENCY PU
95%
95%
EMERGENCY SOURCE UNDER FREQUENCY DO
90~
90%
•
UESCRIPTION
OPERATION
NO7ES
TRANSFER TEST
successfully initialetl & completed transter test via "Fast TesY' and "standartl tesP' key on CP
BYPASS TIME DELAY
Vefifietl ail hypass of TD's
GENSET ENGINE STARTING CIRCUR
Verifietl gen set slart dreuit is working pmpeAy. Also verified automatic bypass of re-transfer TD is
working when normal power is available antl gen set Fails. ATS successfully transferretl immediately to
nortnal werb assin re-transfer
rnFasuxvnexrsra~r~ VOLTS
AMPS
CONTACTRESIS
TANCE mn
ATMNNPoIECONDULTORS R-N B
-N C-N R-B
BC GA / 8
C P B
C N
NORMAL
EMERGENCY
NOTES
Eme en transfertest: 6.3seconds
x CONDITION A-ACCEPTABLE
R-NEEDS REPAIR, REPLACEMENT ORADJUSTMENT GCORRECTED WA-NOTACCEPTABLE
GROUNDED TECHNOLOGIES
I N C O R P O H A T E D
AUTOMATIC TRANSFER SWITCH
TEST REPORT (ZENITH)
CLIENT:
Clear Creek
JOB NUMBER:
-
LOCATION:
Wheatrid e, CO
ENGINEER:
Thom Cook
DA7E:
02/04105
SWITCHGEAR DESIGNATION: ATS DESIGNATION:
ASSET NUMBER(S):
CALIBRATION DATE(S):
NORMAL SOURCE: EMERGENCY SOURCE:
480 480
MANUFACTURER: MODEL/CAT NO.:
GE Zenith ZG4SA04044-7
NORMAL CIRCUfT BREAKER SIZE:
250
DA
SERIALNUMBER:
1443186
EMERGENCY CIRCUR BREAKER SIZE:
250
VOLTAGE:
480/277
DRAWINGNUMBER: GENERATOR MANUFACTURER/kW:
CAT
INSPE
CHECK POINT corvomoN
AMPERES:
400
CT[ON
CHECK POINT
GENER4LAPPEARANCE:
A
.coxomoN rvores
WORKING SPACE
A
LUBRICATION
A
CONDUCTOR IDENTIFICATION
A
MAIN CONTACTS
A
INDICATING LAMPS
A
ARCING CONTACTS
A
DIRTACCUMULATION
A
ANCHORAGE
A
TIGHTNESS OF CONNECTIONS
A
•
OTHER
PANEL
AS FOUND
AS L
EhT
DESCRIPTION
ACC.
RANGE
SET7ING
VALUE
MFG.TOL.
VALUE
MFG.TOL
7RANSFER TO EMERGENCY TIME DELAY
t SEC
t SEC
RETRANSFER TO NORMAL TIME DELAY
30 MIN
29 MIN
ENGINE COOLDOWN TIME DELAY
5 MIN
5 MIN
ENGINE START DELAY
3 SEC
t SEC
DELAY TRANSITION TIME DEL4Y
in hase
in hase
PHASE RELAY UNDER VOLTAGE DROPOUT
80%
80%
PfIASERELAYUNDERVOLTAGE PICKUP
90%
90%
PHASE RELAY UNDER FREQUENCY PICKUP
95%
95%
PHASE RELAY UNDER FREQUENCY DROPOUT
90%
90%
EMERGENCY SOURCE UNDERVOLTAGE DO
80%
80%
EMERGENCY SOURCE UNDER VOLTAGE PU
90%
90%
EMERGENCYSOURCE UNDER FREQUENCY PU
95%
95%
EMERGENCYSOURCEUNDERFREQUENCYDO
90%
90%
DESCRIPTION
•
O
PERATION
N07ES
TRANSFER TEST
successWlly inNatetl
& completetl transfe
r tes[ via "Nas[ TesP' and "sfandard tesY' key on CP
BYPASS TIME DELAY
Verified all bypass of TD's
GENSET ENGINE STARTMG CIftCUIT
Verified gen set siart cifcuit is worCing propedy. Also verifietl auromatic bypass of re-transfer TD is
worlcing when nortnal povrer is available antl gen se[ fails. ATS successfully transferted immediatety to
normal ggbMLkVj
assin re-transfer
weasuxuexrsru~rv VOLTS
AMPS
CONTACTRESIST
ANCE ma
ATWJNPoIECOHWCfOPS q-N
B-N C-N R-B
BC
CA A B
C A B
C N
NORMAL
EMERGENCY
Eme en transfer test: 6.3 seconds
NOTES
*CONDITION A-ACCEPTABLE
R-NEEDSREPAIR,REPLACEMENTORAWUSTMENT GCORRECTED N/A-NOTACCEPTABLE
GROUNDED
P N' C O
TECHNOLOGIES
R' P' O R A 7 E 6
AUTOMATIC TRANSFER SWITCH
TEST REPORT (ZENITH)
CLIENT:
JOB NUMBER:
Clear Creek
-
LOCATION:
ENGINEER:
DATE:
Wheatrid e, CO
Thom Cook
02/04/05
SWfTCHGEAR DESIGNATION:
ATS DESIGNATION:
ASSET NUMBER(S):
CALIBRATION DATE(S):
NORMAL SOURCE:
EMERGENCY SOURCE: NORMAL CIRCUR BREAKER SIZE:
EMERGENCY CIRCUIT BREAKER SIZE:
480
480 60
60
D•
MANUFACTURER:
MODEL/ CAT NO.: SERIAL NUMBER
VOLTAGE:
GE Zenith
ZG2SA00844-7 1443715
480/277
DRAWINGNUMBER: GENERATOR MANUFACTURER/kW:
AMPERES:
GENERALAPPEARANCE:
CAT
80
A
INSPE
CTION
CHECK POINT
.conomox rvo
CHECK POINT
.couonnx xons
WORKING SPACE
A
LUBRICATION
A
CONDUCTOR IDENTIFICATION
A
MAIN CONTACTS
P.
INDICATING LAMPS
A
ARCING CONTACTS
A
DIRTACCUMULATION
A
ANCHORAGE
A
TiGHTNESS OFCONNECTIONS
A
OTHER
CONTRO
LPANEL
AS FOUND
AS L
EF7
DESCRIPTON
ACC.
RANGE
SETfING
VALUE
MFG. TOL.
VALUE
MFG.70L
TRANSFER TO EMERGENCY 71ME DELAY
7 SEC
1 SEC
RETRANSFER TO NORMAL TIME DELAY
30 MIN
28 MIN
ENGINE COOLDOWN TIME DELAY
5 MIN
5 MIN
ENGINE START DELAY
3 SEC
1 SEC
DELAY 7R4NSITION TIME DELAY
in hase
in hase
PHASE RELAY UNDER VOLTAGE DROPOUT
80%
80%
PfIASERELAYUNDERVOLTAGE PICKUP
90%
90%
PHASE RELAY UNDER FREQUENCY PICKUP
95%
95°h
PHASE RELAY UNDER FREQUENCY DROPOUT
90°/u
90%
EMERGENCY SOURCE UNDERVOLTAGE DO
80%
80%
EMERGENCY SOURCE UNDER VOLTAGE PU
90%
90%
EMERGENCVSOURCE UNDER FREQUENCY PU
95%
95%
EMERGENCYSOURCEUNDERFREQUENCYDO
90%
90%
•
DESCRIPTION
O
PERATION
NOTES
TRANSFER TEST
successfully initiatetl & completed transfer test via "Fast TesC and "shandard tesC' key on CP
BYPASS TIME DELAY
Verified all bypass of TD's
GEN-SET ENGINE STARTING CIRCUR
Verified gen set start circuit is working propeAy. Nso verified autanaBC bypass of re-transfer TD is
working when normal power is available and 9en setfails. ATS su
ccessfullytransferretl immetliatelyto
normal vrerb assin re-Vansfer
xeasuxemexreraxex VOLTS
NYIPS
CONTACTRESIS
TANCE ma
ATMMWPoLECONOULRORB A-N
8-N C-N N-B BC G/ R B
C A B
C N
NORMAL
EMERGENCY
NOTES
Eme en transfer test: 6.3 seconds. Normal feeder CB tri ed on re-transfer. The EC Riviera will set u
the Instantaneous settin to avoid tri in
the CB.
xCONDITION A-ACCEPTABLE
R-NEEDSREPAIR,REPLACEMENTORAWUSTMENT
GCORRECTED WA-NOTACCEPTABLE
i ~ qzk
WAGNER EQUIPMENT CO.
POWER SYSTEMS
START-UP TEST REPORT
DATE: January 11, 2005
CUSTOMER: Tumer Logistics
Clear Creek ASC
EQUIPMENT: Cat 3456 Standby pkg. gen set S/N CBM00192
Site Rated at 300kW Standby
TABLE OF CONTENTS
1) FACTORY GENERATOR TEST REPORTS
2) EMCP 11+ TEST REPORT
3) 4 HR. LOAD TEST REPORT
4) ENGINE DELNERY REPORTS
f1Gy°
CATERPILLAR~
0.8 POWER FACTOR GENERATOR SET TEST REPORT
Customer. E255 WAGNER EQ
Engine Modei: 3456 Test Date: 19-AUG-2004 Engine SIN: 7WG02188
S.O. BDWBL Generator SIN: CBM00192 Rating: 300EKW
No Load Generator Set High idle
Average Voltage
Line to Line Voltages
Full Load Rated Speed
Rated Genset Power
Observed Genset Power
Rated Frequency
Average Voltage
Line to Line Voitages
Average Line Current
Line Currents
Power Factor
Tested WITH PAN I X I
1800 RPM
486 V
486 V
479 V
484 V
1500 RPM.
300 KW
299.1 KW
60 HZ
484 VOITS
484 VOLTS
477 VOITS
482 VOLTS
445 AMPS
443 AMPS
441 AMPS
443 AMPS
0.8
Tested WITHOUT FAN I I
Thepurpose of the attacbed report is ro usure that the generaror set m qucsaon has been fzctory tesled
a[ 0.8 power factor. I[ is a sumrtary of the bazic parameters on every 5~mtor set manuTactuted by Ca[erpillar.
lfiis report is not a guaantee of site perfortrence.
The following is an explanation ofthe pammeter found on the repoit:
812312004
GRIFPIN
pOWER
SYSTEMS
Generator Set - Sready state speed of the generator set at no load with the govemor spad setting adjusted to nm at synchronous speed at full laad.
High Idle
Avetage Voltage - The published or mted genemtor set voltage- Shis vulq8e is set during the generzmr set test at no Ioad and Culi load.
Line To Line - 7'he individual phase voltages.
Voltages
Average Curtent - Cument 6iaz results when the gmwator se[ is at rated voltage and at the tat load.
Power Factor - Cosine of the pfiase angle betweai the voltage and the cumnt. It cm alw be defined as the real power (KW) divided by the apparentpower
(KVA).
Ratmg - The nominal electricai power mting. Rating are based on SAE 11349 sundard condiuons and also apply to LSO 3406/1, DIN 6271, BS 5514 and
ISO 8528.
Observed Power- 7'his is the electrical power produced by the generntor set during the full Ioad tesc Observed power, by no means, reflects maximum power
capability. .
3LO438 TEST DATA COORDINATOR
WAGNER POWER SYSTEMS
EMCP II PLUS TEST REPORT
SHOP TEST _ SITE TEST X, DATEQLo2_ 200J~
JOB [:Iect/' C-feek 4mb4daj"ory TESTED BY ~
CUSTOMER ?crn PANEL TYPE HRS.
w/o No. 5AM61aa25 MODEL No.
ENGiNEnnooeL/ sM 7GU60e2189 GENMODEL/SM SR96J69M(,O/fj,
OP5-0 SETPOINTS FACTORY CHANGE VERIFY
POO'I- FUEL SOLENOID TYPE 0
P002-uNrrs sHOVUN p Fo
POOSSHUTDOWN OVERRIDE POR ENGINE PAULT O
POO4-SHUIDOWN OVERRIDE FOR SENSOR PAULT D
POOS-COOLANT LOSS SENSOR
I
POOF)SHUTDOWN OVERRIUE FOR COOUINT LOSS
- 0
POOTSYSTEM VOLTAGE
0
POOS-N!A
POOJ-RING GEAR TEETH
I 13
PO'I O-ENGINE OVERSPEED
21 a8
PO'I'I-CRANK TERMINATE SPEED
900
PO'I 2-0IL STEP SPEED
1360
PO'I S-LOP SHUTDOWN AT RATED SPEED
3
~
POI 44LOPSHU7DOWNATIDLESPEED
-
PO'I S-HIGH WATER TEMP. SHUTDONM
.225
PO'I G-LQW WATER TEMP. ALARM
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PO'IT-TOTAL CYCLE CRANK TIME
~
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CATERPILLAR DEALER . ~ . ~ .
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rvaci6n yajustes.
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19C 3l
FAN rEST REpoRT
j~~IBalancin,9'
AIM OUTLET
TEST REpoxT
System: ~ .
JEDI Balancing Es ~POxT
Project: Clear Creek Ambulatory Center System: RTU-3 Supply
Area Served
Outlet
No Plan Actual AK
Desi
: VEL
gn
CFM
Fina1
VEL CPM
Final
MIN HEAT
~
Notes
FPB-3-6
1
CD
CD
;
200
205
2
CD
CD
165
170
TOTAL
365
>
375
SO
380
6'Y0.75
FPB-3-7
1
CD
CD
250
?
250
2
CD
CD
250 ;
255
TOTAL
500
(
505
80
580
6"70.95
FPB-3-8
1
CD
CD
225
I
220
i 2
CD
CD
225
'
225
TOTAL
450 :
;
445
80
530
li 6"/0.60
JEDI CZICIl'IC2,1 TEST REPORT
Project: Clear Creek Ambulatory Center System: RTU-3 Supply
~ Outlet Dcsign Fiual Final ~
Area Served Notes
No Plan Acriiat AK i V~.L CFM VEL CFM AiI HEAT
. , .
VAV-3-1 1 SWR SWR 250 : 255
2 SWR SWR 250 250
3 CD GD 125 125
4 CD CD 225 230
TOTAL 850 860 150 150 R"/138
VAV-3-2
1
CD
CD
325
320
2
CD
CD
325
130
3
CD
CD
600
&
600
TOTAL
1250
1250
200
200 i~
12'Y1.37
VAV-3-3
1
CD
CD
225
230
75
75 ;
4"/1.44
VAV-3-4
1
CD
CD
300 :
310
2
CD
CD
300 .
290
TOTAL
600
600
75
75 :
811/131
VAV-3-5
1
CD
CD
200
200
2
CD
CD
130
;
130
3
CD
CD
130
~
135
=4
CD
CD
130
130
5
CD
CD
80
:
7i
TOTAL
670
'
670
li0
150
' 8"70.82
U7VIT TOTAL
7C>3~
Remarks:
eJTEDIBalancin VALVE TEST REPORT
Project: Clear Creek Ambulatoiy Center System: Heating Water
Balance
Design
Measw~ed
Station
Valve
Si''e
~,,pM
Design D/P
D/p
Fiual
D/P
Finai
GPM
Balance
Valve ,
FPB-1-1
GRISWOLD
3.8CV
71
50%
FPB-1-2
GRISWOLD
3.8CV
4.
71
50%
FPB-1-3
GRISWOLD
3.SCV
71
50%
FPB-1-4
GRISWOLD
3.8CV
S
71
75%
FPB-1-5
GRISWOLD
1.6CV
28
7j%
FPB-1-6
GRISWOLD
0.72CV
12
qp%
FPB-2-1
GRISWOLD
1.6CV
1.8
40
50%
FPB-2-2
GRISWOLD
1_6CV
1.4
24
jp%
PPB-2-3
GRISWOLD
1.6CV
1.1
15
100°/n
FPB-2-4
GRISWOLD
0]2CV
0.5
12
100%
FPB-2-5
GRISWOLD
0.72CV
0.8
31
lpp%
FPB-3-1
GRISWOLD
1.6CV
3.4
142
gp%
FPB-3-2
GRISWOLD
1.6CV
13
21
50%
FPB-3-3
GRIS\VOLD
1.6CV
1.1
24
50"/0
FPB-3-5
GRISWOLD
0.72CV
0.5
12
50%
FPB-3-6
GRiSWOLD
0.34CV
OS
56
9pn/o
FPB-3-7
GRiSWOLD
0.34CV
0.5
56
50%
FPB-3-8
GRISWOLD
0. 3,4CV
0.5
56
50°/u
TOTAL
;4.9 `
Remarks:
eIEDI (Yl[j cZn VALVE TEST REPORT
Project: Clear Creek Ambtzlatory Center System: Heating Water
Reinarks: (1) Stuck (2) No coiiho] valve. (3) No Flow.
WAGNER EQUiPMEI~i i C~.
pOWcR SYSTEMS
START-UP TEST REPORT
DATE: JanuarY 11, ZOtlS
rj)gTOMER: Tumer Logistics
- Cieaz Creek ASC
[12utPMENT: Cat 3456 Standby Pk9. 9en set SIN CBM00192
Site Rated at 300kW StandbY
TABLE OF CONTENTS
1) FACTORY GENERATOR TEST REPORTS
2) EMCP !i+ TEST REPORT
3) 4 FiR. LOAD TES7' REPORT
4) ENGINE DELIVERY REPOR7'S
~pya 38
WERTILLNW
0.8 POWER FACTOR GENERATOR SET TEST RFPORT
eustomer. E255 WAGWicR EQ
Engine Modeh $456 Test Date: 19-AUG-2004 Engiae SIN: 7.WG02988
BDWBL GeneretorSlN: CBMOM92 Rating: 300EKW
S.O.
No Load Generator Set High idle 1800 RPM
Avera9e Vutta9e 486 V
Une to Une Volbges 486 V
479 Y
984 V
Fuil Load Rated Speed 1800 RPM'
Rated Genset Power 300 KW
Obsmed G¢nset Power 299_1 KW
Rated Frequency 60 NZ
pverage Vottage 484 VOITS
Une to Une Voltages 484 VOLTS
477 VOLTS
482 dOITS
Average Line Current 445 11NIPS
Une CurreMs 443 AMPS
441 AMPS
443 AMPS ~ 133UED
Power Factor 0'8 ~~0~
Tested WITH FAN ~ X ~ Tested WITHOUT FAN ~ I Gw~N
PovY~e ~
srss~uts
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MProt7q'.
TEST DATA COORDINATOR
3fA438
WAGNER POWER SYSTEMS
EMGP 11 PLUS TEST REPOKT
SHOP TEST _ SITE TEST ~ DATE OL=Z2- 200 r
JOB Glfal' Greefi~ Qmbc~al`?~~ Gt.n~"'~ TESTED BY &v~'f ~
CUSTOlIRFR Ticrn L~ ftGS
PANEL TYPE HRS.
wro No. 54 6r a.ag
ENGINE n+ooQIs0.3-f/'15d 71,'~60 198
RAODEL No.
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GROUNDED TECHNOLOGIES
r N c a a r o a a r e a
AUTOMATIC TRANSFER SWITCH
TEST REPORT (ZENITH)
CLIENT:
JOB NUMBER:
Clear Creek
-
JCATION:
ENGINEER:
DATE:
.
Wheatrid e, CO
Thom Cook
02l04105
SWRCHGEAR OESIGNATION: ATS DESIGNATION:
ASSET NUMBER(S):
CALIBRATION DATE(S):
NORMAL SOURCE: EMERGENCY SOURCE: NORMAL CIRCUIT BREAKER SIZE:
EMERGENCY CIRCUfT BREAKER SIZE:
480
480 400
400
D•
MANUFACTURER: MODEL/ CAT NO.: SERiAL NUMBER:
VOLTAGE:
GE Zenith
I 1444018
ZG4SA04044-7
480/277
ORAWINGNUMBER: GENERATOR MANUFACTURER/kW:
AMPERES:
GENERP.LAPPEARANCE:
CAT
400
A
INSPE
CTION
CHECK POINT
.corvomox r+ons
CHECK POINT
.cw+omorv xohs
WORKING SPACE
A
LUBRICATION
A
CONDUCTOR IDENTIFICATION
A
MAIN COMACTS
A
INDICATING LAMPS
A
ARCING CONTAC7S
A
DIRTACCUMULATION
A
ANCHORAGE
A
TIGHTNESS OF CONNECTIONS
A OTHER
CONTROLPANEL
AS FOUND
AS L
EFT
DESCRIP710N
ACC. RANGE SETiING VALUE
MFG.TOL
VALUE
MFG.TOL
IRANSFER TO EMERGENCYTIME DELAV
1 SEC
1 SEC
REfRANSFER TO NORMAL TIME DELAY
30 MIN
30 MIN
ENGINE COOLDOWN TIME DELAY
5 MIN
5 MIN
ENGINE START DELAY
3 SEC
1 SEC
"RAY TRANSITION TIME DELAY
in hase
in hase
~ASE RELAY UNDER VOLTAGE DROPOUT
80%
gp%
PHASERELAY[1NDERVOLTAGE P[CKUP
gp%
90%
PHASE REIAY UNDER FREQUENCY PICKUP
95%
95%
PHASE RELAY UNDER FREQUENCY DROPOUT
90%
90%
EMERGENCVSOURCEUNDERVOLTAGEDO
Bp%
BO%
EMERGENCY SOURCE UNDER VOLTAGE PU
90%
90%
EMERGENCYSOURCE UNDERFREQUENCVPU
95%
95°~
EMERGENCY SOURCE UNDER FREQUENCY DO
yp%
90°k
•
UESCRIPTION
O
PERATION
NOTES
TRANSFER TEST
successfully initiated 8 compleled transfer [es[ via "fas[ TesY' and "sfantlartl tesY' key on CP
BYPASS TIME DELAY
Verified all bypass of TD's
GENSET ENGINE STARTING CIRCUIT
Verified gen set siart dreuit is working propedy. Also verifietl automatic bypass of re-transfer TD is
working when nortnal power is available antl gen set fails. ATS successfully transferred immediately to
nortnal werb assin re-transfer
ypLID
AMPS
CONTACTRESIS
TANCE mtt
M~RUA.rMIUI
A B
C N
RTMNNPOIECON.YCTOR3 A-N B
-N C-N F-8 BC CA A B
C
NORMAL
EMERGENCY
NOTFS
Eme en transfer test: 6.3 seconds
. cnn,ror1nn1 a_ar.r.FaraaiF
R-NEEDSREPAIR. REPLACEMENT OR ADJUSTMENT
GCORRECTED _ WA-NOTACCEPTABLE
GROUNDED TECHNOLOGIES
1 N C O RP O R A T E D
AUTOMATIC TRANSFER SWITCH
TEST REPORT (ZENITH)
CLIENT:
Clear Creek
JOB NUMBER:
-
JCATION:
Wheatrid e, CO
ENGINEER:
Thom Cook
DATE:
02104/05
SWITCHGEAR DESIGNATION: ATS DESIGNATION:
ASSET NUMBER(S):
CALIBRATION DATE(S):
NORMAL SOURCE: EMERGENCY SOURCE:
480 480
MANUFACTURER: MODEL/CATNO.:
GE Zenith ZG4SA04044-7
NORMAL CIRCUfT BREAKER SIZE:
250
DATA
SERIALNUMBER:
1443186
EMERGENCY CIRCUIT BREAKER SIZE
250
VOLTAGE:
480/277
DRAWING NUMBER: GENERATOR MANUFACTURER/kW:
CAT
AMPERES:
400
GENERALAPPEARANCE:
A
CHECKPOINT
.m,uomorv nores
CHECKPOINT
.mruomorv
rvmEs
WORKING SPACE
A
LUBRICATION
A
CONDUCTOR IDEMfIFICATION
A
MAIN CONTACTS
A
INOICATING LAMPS
A
ARCING CONTACTS
A
DIRTACCUMULATION
A
ANCHORAGE
A
TIGHTNESS OF CONNECTIONS
A
CON
OTHER
TROLPANEL
AS FOUND
AS L
EFT
DESCRIP710N
ACC.
RANGE
SETTING
VALUE
MFG 70L
VALUE
MFG. TOL
TRANSFER TO EMERGENCY TIME DELAY
1 SEC
1 SEC
REfRANSFER TO NORMAL TIME DELAY
30 MIN
29 MIN
ENGINE COOLDOWN TIME DELAY
5 MIN
5 MIN
ENGINE START DELAY
3 SEC
1 SEC
^~LAY TRANSfTION TIME DELAY
in hase
in hase
,ASE RELAY UNDER VOLTAGE DROPOUT
80%
80%
PHASE RELAY UNDERVOLTAGE PICKW
90%
90°h
PHASE RELAY UNDER FREQUENCY PICKUP
95%
95%
PHASE RELAY UNDER FREQUENCY DROPOUT
90%
90%
EMERGENCY SOURCE UNDERVOLTAGE DO
80°h
80%
EMERGENCY SOURCE UNDER VOLTAGE PU
90%
90%
EMERGENCYSOURCE UNDER FREQUENCY PU
95%
95%
EMERGENCYSOURCEUNDERfREQUENCYOO
90%
90°k
DESCRIPTION
•
O
PERATION
NO7ES
TRANSFER TEST
successFUlly initiatetl
& completetl transfe
r test via'Yast Tesl" antl "sfandartl tesY' key on CP
BYPASS TIME DELAY
Verified all bypass of TD's
GENSEf ENGINE STARTING CIRCUIT
Venfietl gen sel start circui[ is woilcing propeily. Also venfied automatic bypass of re-Vansfer TD is
woAting when nortnal power is available and gen set Fails. ATS successfully transferretl immediately [o
normal erb assin re-transFer
MFnsuxeMw~sra~ VOLTS
NTMNNPoIECONDIILTOR3 q-N
B-N FN R-B
AINPS
6C GA B B
CONTACiRESISTANCE ma
C P B C N
NORMAL
EMERGENCY
Eme en transfer test: 6.3 seconds
•
* CONDITION A ACCEPTABLE
R-NEEDS REPAIR, REPLACEMENT OR ADJUSTMENT GCORRECTED WA-NOT ACCEPTABLE
GROUNDED TECHNOLOGIES
f N C O RP O R R T E D
AUTOMATIC TRANSFER SWITCH
TEST REPORT (ZENITH)
CLIENT:
JOB NUMBER:
Clear Creek
-
JCATION:
ENGINEER:
DATE:
Wheatrid e, CO
Thom Cook
02/04/05
SWffCHGEAR DESIGNATION:
ATS OESIGNATION:
ASSET NUMBER(S):
CALIBRA710N DATE(S):
NORMALSOURCE:
EMERGENCYSOURCE: NORMALCIRCURBREAKERS¢E:
EMERGENCYCIRCUliBREAKERSIZE:
480
480 60
60
MANUFACTURER:
MODEL/CATNO.: SERIALNUMBER:
VOLTAGE:
GE Zenith
ZG2SA00844-7 1443715
480/277
DRAWING NUMBER: GENERATOR MANUFACTURER/kW:
AMPERES:
GENERALAPPEARANCE:
CAT
80
A
INSPE
CTION
CHECK POINT
coxomox xores
CHECK POINT
.coNOrtrorv uo~s
WORKING SPACE
A
LUBRICATION
A
CONDUCTOR IOENTIFICATION
A
MAIN CONTACTS
A
INDICATING LAMPS
A
ARCING CONTAC7S
A
DIRTACCUMULATION
A
ANCHORAGE
A
TIGHTNESS OF CONNECTIONS
A
OTHER
CONTRO
LPANEL
AS FOUND
AS L
EFT
DESCRIPTION
ACC.
RANGE
SETfMG
VALUE
MFG.TOL.
VALUE
MFG.TOL.
TRANSFER TO EMERGENCY TIME DELP.Y
1 SEC
1 SEC
REfRANSFERTO NORMAL TIME DELAY
30 MIN
28 MIN
ENGINE COOLDOWN 71ME DEL4V
5 MIN
5 MIN
ENGINE START DELAY
3 SEC
t SEC
^RAY TRANSITION TIME DELAY
in hase
in hase
WSE RELAY UNDER VOLTAGE DROPOUT
80°h
80%
PHASE RELAY UNDERVOLTAGE PICKUP
90%
90°h
PHASE RELAY UNDER FREQUENCY PICKUP
95%
95%
PHASE RELAY UNDER FREQUENCY DROPOUT
90%
90%
EMERGENCY SOURCE UNDERVOLTAGE DO
80%
80%
EMERGENCY SOURCE UNDER VOLTAGE PU
90%
90%
EMERGENCVSOURCE UNDER FREQUENCY PU
95%
95%
EMERGENCYSOURCEUNDERFREQUENCY00
90%
90%
OPERATIONAL
DESCRIPTION
O
PERATION
NOTES
TRANSFER TEST
successfully initia[ed & completed transfe
r test via "fast TesP' and "shantlard tesP' key on CP
BYPASS TIME DELAY
Verifietl all bypass of TD's
GENSET ENGINE STARTING CIRCUfT
Verified gen set start circuit is working properiy. Also verified automa0c bypass of re-Vansfer 7D is
worlting when nortnal povrer is available antl gen set fails. ATS successfully transferred immediately to
normal Qgver in re-transfer
wEssuaewemsrmcEx VOLTS
AMPS
CONTACTRESISTANCE mtz
pTMNNPoLECONDIIClOIS q-N
B-N FN A-B BC Ul i1 B
C A B C N
NORMAL
EMERGENCY
•
Emer en transfer test: 6.3 seconds. Nortnal feeder CB tried on re-trensfer. The EC Riviera wiil set u
the InstaManeous settin to avoid tri in
the CB.
~CONDITION AACCEP7ABLE
R-NEEDS REPAIR, REPLACEMENT OR ADJUSTMENT
GCORRECTED N/A-NOTACCEPTABLE
ISOT.ROL ~L
SYSTEMS
Medicai Division of Bender !nc.
Over SIMy Yearo M experience wtth Electrical Safety Products
ACKNOWLEDGEMENT
. EQUIPMENT CHECKOUT
1his letter shall serve as evidence ihat the Isolated Power Systems have been tested by a Certified Factory
Teclmician for compiiance with the requi*e*neuts of Article'517 of the National Electrical Code, NFPA 99
Standard for Heaith Care Facilities, and the Project 5pecifications.
Resuks will be forwarded to the ISOTROL factory for compliance review by their engineers. Insurance
reqvirements prolubit us from distributing copies of test results, wluch have not been previewed by the
factory. Verbal comments on the resu]ts of these tests are not binding.
HospitaiorFacility: ciYZ-EX~ //5c TestDate: / 141i.lzaos-
City/ State/County: WHeAT lcp l
Room ID c9,e Z_; oIP 3 a O,-f 5t
Purchase Order Sales Order 3 Zs*v Z9a8 44 ~ / 7 40 7
Tested by:
Mfti2,E'
.<i4 ~~SG h/
(print nume)
(sign mmw)
Witness:
B~en~
Grejbrv
(printname)
(sign mmne)
Title:
Fola.•~.a~
Company:
R•:v,-c'aL
Training Provided :
0 Yes
IgNo
Reason: NONL- i2Bc~✓4STfa6 D/C f1.P.PfJn/rrE~,
Notes :
For questions or technical information, please contact IS03'ROLSYSI'EMS
Rev 4-12003
ISOTROL SYSTEMS . 700 Fox Chase . Coatesville, PA 19320 • TolFfree: (800) 833-6634 • Fax: (610) 363-7100
Yi ~~~MT~M~II~RP"7 • 5~1~~ ' ~ • ~ • ~
• , TeN~tasa3-9e~s+#Oa-a33~8~4+~Fax:b~o.~~6~7?oR : ~ . ,
~ " y~awasazrA~sl~~n. ~ . • ,
:n'' „ . . . , ~ , .'y ,~{,i: r . • ,•y,';.
, . n ; ~ •
' . .
~ Thursday, February 10, 2005
Dave Kiein
Riviera Electric
~ 5001 S. Zuni Street
I Littleton, CO 80120
I
. • nv. rar~ • r. aico
- JS~~~ i ~'~'~S 4
Reference: Fest Reports for Clear Creek ASC SO 17407
Dear Dave:
Enclosed are the test reports for the above referenced hospital.
If you have any questions or need furtfier information, please fet me know.
Thanks,
Linda 7orres
Marketing & Product Sales
ec:GE Supply
- l IIU%L.u`f.'f II[1 LQ:Ik'".+l[CGO::~J
nv.rvv r.cico
isorROL ~
SYSTEMS ~
Medicai Division of Sender Inc.
Certificate of Acceptance
awarded to
Clear Creek ASC
Go GE Supply
425 Quivas Street
Denver, CO 80204
The Isolatad Power Systems installed in the following locations:
OR #1 (Pane1 12668), 2(Panel 12655), 3(Panel 12656), &
4(PaneJ 12657) fully comply with NFPA 70, Articfe 517 of
the National Eiedrical Code and NFPA 99, Standard for Heafth
Care Facilifies
Thursday, February 10, 2005
arcel Treenbla
.T ~ Over Slxry Year9 M Experienos wilh Electrical Setery ProduGs
(50'ff20I. Systems • 700 Fox Chase • CoatO5vi110, PA 19320 . Ph: (8QU) 8394834 . Fsx: (610) 3BSq700
. . . . •i•w~rn~ rcavacrtn
no.rbe r.aiee
ISOTROL
SYSTEMS Aw
Medicai Division of Bender Inc.
Guarantee-Warranty Agreement
•ance: Glear Creek ASC
IOL SY37EMS Job SO 17407
laner. GE Supply Co
zmer's P.O. 325402908AA
'ZOL SYSTEMS does hereby warrarn and guarantee that all equipment supplied
its job-contract with GE 5upply Co of Denver, Cp - and supptied to end
nTear Creek ASC - to be free from defeds of workmanship and material
)eriod of three years from the date of shipment 11/17104 on material other than
aolation Monitor (LIM), which has a five yearwarranty from date of shipment.
ther agree we vqill, at our own expense, repair or replace, at our option, all such
als which become defective and/or inopera6le during the period covered by ourwaRanty.
Thursday, February 10, 2005
MarcelTremb ~--OvarSizryYearsafExperiencewlNEleariwlSsfetyProducts -
'.07ROL Systems . 700 Fox cryase. Coatesville, PA 19320 . ph: (800) 833-883a • Fex; (610) as3-7100
r.4~[ts
'r`tnav :"n tt~LFS`[M i pOWER$ERUE ~ pHq•E ryp, :5M 510 1747 Feb. 10 2005 01:53pM P02
isoTROL ~
" sYSTEMS ~
Mecrical Dlvlsion ot Bender Ine.
' owiaayr:.nauaFxac.wimeftlfkaa.i.A,fteaws
ACKNUWLEDGEIIENT
CQU1PblENT G7)ECICOUT
7'his ledet shall serve aa evidence that the isotatsd Power 6ystcros lwva 6een tated Ay a(:mtified Factory
Techniciqn for wmpEisnce with thc n:qniromenu of Aniclc 517 of the Natianal Llteuiwl Codk NFPA 99
SwnWard for NeaMi Cazc raciliti6p, nnd Ihe Pmject Spccifiwtions.
ltesuhs will be forwarded to We ICpTROi. fselory for complianc:4 rcvinw by their engiacers. )rsurd»ce
rMireinenta proinbit iw from distribating wpies of tnst resuRs, wuich hsve noi bcon prcviewed by iIle
factory, Vciiral coqimcnrs on tfic resuhs eflhosc tcms ore not biading.
'Hospital rn• Facithy: e c64F Tedt Aate: ho /7~ o
City / Stdte / GountY: cv N6tT R/ibGg- / 40 l ~DJbGrt'S_... . Room I17 W: _OR Qir z•, oR 3_~_pMej
PurchaeOrder#/SalesOrder#: _3tS¢o29080101 f i
Tcstedby:
fA/-ESCN
(~wintnamel
Z8~~~
(tfgh nnmR)
W1tDC5~~
. O.f^'~ GrcTry
(prinl~rnmr~
(5iO 710111P.)
TILl61
~ei6MR.~
Campeny:
liaining Provided : ❑ Yes PINo
Reason : rayE fta 6/6srf (I n.e
Nous: r._~........._.
Fa quutions or tcchnical infonnuion, plcaac contact 350'rnt)1. SYS7l:MS
iuv 4 - MAiw
I607R0L 6Y67FM5 • 7f10 Fox Chqu - Cpilb{vllls, PA 19320*7oN-hN: (MJ 8334834 • Fea: (Oi 0) 30Y110G
hV.'(6b P.5/p8
, ~ISOl.A7Ep PaWER PANEL CHECKOUT
' LEqKqOEIFAULT CURREIt1' MEASUREMENTS AND 07NEA OATA FOR 1-PHASE PANEL
' JOB NAME
:
REEK ASC
ROOM or O.R. ID
OR 1
, • CUSTOME:
R
PLY
ff
SERIAL # PANEULIM:
12658 0409558866
' P.O.
325402908AA
DA7E
d1/91005
S.O.
TESTED BY;
M. FALESCH
OVERALL Current Readin s
Branch Circuit Condition;
Test Coadition:
Amme(er Readin - Microam eres
Exceottorl(9hS!!~flMUre
airCUits, all CBZ~ i~ ON
AB loads swjtched OFF inCudiing X-Ray
310
329
osfion
Vie'"'ers.
AP CB, in oN position
AII loads switched OFF including
380
387
su icaUather fi Ms and X.R viewers.
This is the penel leakage induding the
g
12
AII CB, in oPF position
J
conhibutian af the transfortner. Also see
L
foofiote 2.
INDIVIDUAI.
Branch G?rcuft Gurrent
Reatlin s
Circuit #
Type of Load
Load Sw
itch OFF
Load S
witch ON
Switch Tv
ae
L1
L2
L1
L2
1-P
2-p
1
RECEPTACLES
54
59
2
RECEPTAGLES
45
46
3
RECCPTACLES
52
55
4
RECEPTACLES
39
42
5
RECEPTACLES
53
55
6
FtEC@PTACLES
67
59
7
RECEPTACLES
51
73
8
8
RECEPTACLES
SURGICAL LIGHTS
54
36
56
43
36
43
10
11
RECEPTACLES
SURGICAL LIGHTS
39
33
42
34
33
34
12
RECEPTACLES
18
20
13
FILM VIEWER
60
45
47
71
14
SPARE
15
RECEPTACLES
41
43
16
SPARE
s. le 6,
Mft
z uM
s
x-Ra viawar
d
8
Sil~ 7Mher nta
,I
~
~
e
Fimd eawwnem
J
70
Reee Yade
y
y
'
16
5 ra
•
r..
Ssfe/Hazard Lam s
Pass
Fafl
LIM Readin mA
0.3
Tesfiute Switch
Pass
Fail
LIM Tri ed Point mA
5.0
Remolelndlcators
Pass
Faif
N/A Field-Wiri ColarCode
Pase Fail
Fiel -Wirin Wire Type
XHMW
Field-Wirin Gau e
qp
kVA: 10
Prima
Volts: 10
Prima No•Load Amps- 2,84
Seconda Voits: 127
~ Must 6e Iess than 600 µ4 and 1040 pA, rcspeaivepr, tor 120 V and 208 V Isolated Power Penels. Vvhsn passing ortailip8 a penel, tl+e type
o(Ioad switch - ons- OrtwO-pote-xrill be Wken inin aaount, Tt1e 1eaKage/lault wlrpnt cOnVi6utian of laads contfolled 4y one-Pcle syitehes
will 6e suhtRct9d ff0(Il these feadltlga. (t is ryiphly reCpmmOnded that tnesB 1-ppl! 5witches 6e convertotl to 2-pole switeheS,
2 teave the LIM CB 111 l11e OFF pasltloq. fe--d or prytedetl 6y ofher meaqs, opert the conneGion(s) 6apvoen the ltM and the rofaronee
6us.
a The CB is ON aNy fnr tha drcuk undRr test It is then tumed OFF. The 2-pole load swRch st the equipment is altemataly OFF, ON. & OFF,
A An X-Ray panel wlll ahen heve a utiuh 1ee0-ing muitiple rerepqGes that are eleetrically Interlocaed sa fhat only one raeeptade is
enargjzed. Seled 6y bial-and-etror the recepWcb thet prvduces fhe latgedt reatlings.
° Erbes requlrqd where there is s d mafk
e Sartfe o0ntlitian as 1° row o( "OVERACL CUROfIt Readings" Rev 4-212003
150TROC SySteRls o 700 Fes Ch25e v COBtesville, pq 19320 9 Ph: (800) 639-8834 t Fac (fitO) 389-7100
~v~ai~LVVJ 11'Jtnll R1YILRM
no.ree r.bize
TFSTING OF EXPOSEp FIXEp ELECTRICAL EQUIpMENT WITH CONDUC711/E SURFACE9
Voiiage Measurements
Jf]8 NAME:
CIEAR CREEK ASC
ROOM or OR
OFt t
CUS70MER:
G.E. SUPPLY
PANEL SERIAL
12658
P
O
#
325
.
.
4029U8AA -
DA7E:
01/17/2005
S,O.
17407
TESTED BY:
M
FALESOH
.
#
FIXED ELEC
oFSCRirT10N
7RICAL EQUIPMENT
REFERENCE EQUIPN1ENf
GND LOCA710N LOCATION
VOLTAGE
MEpSI1REMENT
my
REMAHfcs
7
iPS PANEL
N
E
3
X
W
N
E
S
X
W
(Sm Note ry
2
FILM VIEWER
X
X
3
SURGiCAL LIGHTB
X
CEILING MOUNTED
4
SURGICAI LfGHTS
X
CEILING MOUNTED
5
GASlEIECT BOOM
X
J
CEILING MOUNTED
Nctet: EYC4PthceplaMSOfwiringtleviCes.
Note 2 q reterence pant, in aeycenEing order of choiee, can be: s) Tha refirenee (irouna eus In the Isoraeed power Panel, b) A yrounding
Point, ln ar near the room uqder teat, that Is electficaly remote Som tOCeptscles, e,g„ an a0.metal cold.evater plpe, Cr c) The
groundine wrrtact of areesptaela thet ia ppwered from a tliHerent branch eircWt hom the receptaqe vnder test.
Noq9: TherearenotestinprequiremeMgforexisqp6comatructian,
Noto 4: Must intarpoae frepuen"haping networfc betweert meaaurfng poiM an0 vcitrneRer
NoU 5: Chadc Manc 4 means s 20 mV tor NEW consiruaion, Also applies m pottion of an elecMcel system that hss been ropaired,
rep12ced, or auered.
Rev 4 , ?J2003
ISOTROL Systems • 700 Fox Chase . CoetesWlle, pq 19320 . ph: (BOa) 833-6834 . Far. (810) 383-7100
I - 1 1.1VV, 11•Jlnll RYV1LRh
NV.'(bb P.7/ZB
TESTING JF RECEPTACLES IN PATIENT CARE AREAS
Impedance Measurements
JOB iviaME:
CLEAR CREEKASC
ROOM or OR
OR 1 Pa e 1 of 2
CUSTOMER:
G.E. Sl1PpLY
PANEL SEFtIAI
12658
P.O.
325402908AA
DATE:
01111f2006
S.O.
17407
TESTED BY;
M. FAt,ESCH
RECEPTACLE
TYPir-
RATIN
RESISTANC
Ptm51CALINTEGR
POLAFUTYO
ttEMqRKS
NORTH #1
D75-B
B
~
OK
NORTH 02
D/S-e
B
J
oK
NORTH 03
D/S-B
B
J
~
OK
NORTH #4
D/S-B
B
J
~
OK
EAST#1
DIS-B
B
OK
EAST #2
D/S•B
8
OK
EAsT #s
o/s-a
a
J
J
oK
EASTit4
D!S-B
6
J
OK
SOUTH #1
D/S-B
B
J
OK
SOUTH#2
D(S-B
B
J
OK
souTM #3
ars-a
a
J
~I
ox
SOUTH #4
D/S-B
B
J
OK
SOUTH #5
Dfs-B
e
OK
SOUTH #6
D!S-B
B
~
OK
SOUTH #7
0/S-B
B
+l
J
OK
WEST#1
D/S-B
B
OK
WEST#2
D!S-B
B
OK
WEST#3
D!S-B
8
~I
J
OK
WEST#4
D/S-8
B
,I
J
OK
'Refers to locadon such as N(orth) wall, some I.O. etc.
2DIS-B =*pupleX StraighGBlatle S/S-B a Single Strafght-Blade S1T-L o Single 7wisbLodc
"A =:-2P3W, 15A, 125V, NEMA 5-15R B=:>2P3W, 20A 725V, NEMA 5-20R C=;~2P3W, 20A 125V, NEMA L5-20,
Twist-Lock D o 3P4W, 20A, 5#250V, NEMA L16-20, Twist-Lock E=*3P4W, 30A, 30250V, NEMA L15-30, TwiSt-
Lock F=~ 2P3W, 80A, 250V, X-Ray, Twist-Lack
'Check Mark d means 5 0.1 ohm OK far R54V construcfion. Atso applies to portion of an electripi system that has
been repaired, replaced, or aitered
$ Check Mark 4 means confirmed by visual inspection as being GOOD, Other comments under ReMAxics
6 Enter either °OK" or"Reversed". Coneetion by contractor required if entry is "Reversed".
Rev 4 - 2/2003
ISOIRQL Sy5tOrt16 a 700 FoX Ch2S0 • COBt29ville, PA 19320 • Ph: (50) 833{834. Fax (610) 383d700
rLO.1I.CGGJ 11•J1M1'I KlV1LRM
nV.'(bb N.tl/Ctl
TESTiNG OF kECEPTACLES IN PATIENT CARE ARE/s►S
Impedance Measutements
JoB NRfyE:
CLEAR CREEK ASC
'
ROOM or OR
OR 1 Pa e 2 of 2
CUSTqMER:
G.E. SUPPLY
PANEL SERIAL
12658
P.O. # :
325402908AA
DATE:
01 /'17 /2005
S.O.
17407
TESTED BY:
M. FALESCH
RECEP7ACLEI.D,
TYPB
RATING
RESISTANCE
FWSICALINTEGRITY3
P0LAR1
REMARKS
800M 01
D/S-8
8
J
d
OK
BOOM 42
0f8-B
e
J
J
OK
BOOM#3
57/5-B
8
J
OK
BOOM 114
D/5-8
8
OK
BOOM #5
D/S-B
8
J
OK
BOOM #6
D/S-B
B
+1
OK
BOOM#7
DIS-B
B
OK
600M #B
D/S-B
B
J
OK
900M#9
DIS-B
B
OK
BOOM #10
5/S-8
8
J
J
OK
BOOM#11
S/S-B
e
-4
OK
eooM #12
sis-s
e
J
d
ox
900M#13
S!S-B
B
OK
BOOM #14
S/S-B
B
J
+I
OK
BOOM #15
S/S-B
B
J
OK
CEILING#1
S/T-L
B
J
OK
'Refere to location sueh as N(orth) wall, sorrle I.D. etc.
2O/5-8 a DUpiex Straight-81ade S!^rB e Singfe Strdight-Blade S1T-L =:.Single 7wist-l.oCk
''A ~*2P3W, 15A, f25V, NEMA 5-15R 8=:-2P3W, 2QA 125V, NEMA 5-2aR C q 2P3W, 20A 125V, NEMA L5-20,
Twist-Look D=:o3P4W, 20A, 3p250V, NEMA L15-20, Twist-Lock E=:>3P4W, 30A, 30250V, NEMA L15-30, Twist-
Lock F=~ 2P3W, 6DA, 250V, X-Ray, 1Wist-Lock
`Check Mark J means 0.1 ohm QK for NEW construction. Also applies to portion of an electrica7 system that has
been repaired, replaced, vr aitered
5 Chack Mark q means canfirmed by visual inspectian as being GOOD. Othar comments wder rterowRUs
6 Enter eithef "OK" or "Reversed", Correction by crontractor required if enSry is "Reversed".
ReV 4 - 2l2003
ISOTROL 5ySt8((16 * 700 FoX ChdSe • C08M9Ville, PA T93Z0 - ME (800) 833-6834 • Fafc (610) 383-7100
rc.~.ia.cr.rew ai•.~ani'i ~cavacran nv.~w .~.~v
ISOLATED POWER PANEL CHECKOUT
LeerAGFJFqULT Cl1RRENT MEASUREMENTS AND OTNER GATA fOR 1.PHASE PANEL
JOB NAME: ff3254O29 REEKASC ROOh1 or O.R. ID
CUSTOMER: FLi' SERIAL#PANEIlLIM:
P.O. 8AA DATE:
S.O.TESTED BY:
I 10409558920
005
ESCH
FAL
OVERAt,L Current Readin s
Ammeter Readin - Microam eres
8ranch Circuit Condition:
Test Condition:
1
L2
L
Exceativr lighZng f~e
circuits
all CB s in ON
Ali IOads switehed OFf induding X-Ray
275
254
,
osition
V1ewers
Afl CB, in ON position
AlI laad5 SwitChad OFF Induding
364
316
su icei/other li hts and X-R viewers.
This is the panel leakage including the
10
12
All CBa in OFF posftion
conhibution of the trensformer, Also see
fo0tnote 2.
INDIYIDUAL B
Gircuit # Type of Loa
ronoh Cirouit Current
Load SWitch OFF
Readin s
Load Switch ON Swikh Tvpe
L1
L2
L1
L2
1
-P
2
-P
1
RECEPTACLES
41
45
2
RECEPTACLES
33
33
L-i
3
RECEPTACLES
42
43
4
RECEPTACLES
48
48
5
RECEPTACLES
42
44
8
RECEPTACLES
63
61
7
RHCEPTACCES
42
43
8
RECEPTACLES
33
33
9
SURGICAL UGHTS
47
50
47
50
10
RECEPTACLES
32
34
11
SUROICAL LIGHTS
39
43
39
43
12
13
'14
RECEPTACLES
FILM VlEWER
SPARE
16
68
17
48
55
70
15
RECEPTACLES
48
46
16
SPARE
Sam En
2
LIM
e
xa vkwer
4
8
Su ie9UOtlwf A hte
J
J
J
B
FiMed LKMPMWt
-7
4
1
'1
10
Reeearaue
J
J
13 6,
•
10
& agI
SafelHazardLam s
Pass
Fall
UMReadin mA
U.3
TesUMute SWitch
Pass
Fai! ❑
LIM Tri etl Point ma
S.q
Rematelndicators
Pass
Fail
N/AZ
Field-Wirin CalofCade
Pass Feq
Feld-wrin Nfrce Type
XHHW
Field-Winn Ga 8
12
kVA: 10
Pr(ma
VoRs: 211
Prima
NaLoadAm s: 3.07
Seconda Volts, 129
I Must be b6s tAan 600 pA and 1040 Wl, respeqiv¢y, far 120 V and 208 Y ianiated Power Panela. W hen passtng or taiiiqg a panal, tha type
of load SWItCh-one-af hwo-R918- Will he tdkon IMp account TI1e leekeqelFautteuROnt COntnbutlon of lpad5 C9Rtrolied by otle~pole sWItCh25
wiq he subtraded from these read'mgs. It Is Ilighty+eeQm(neadod that these 1-pob swimhes Oe converred ro 2-pae switches,
Z Leave Ihe LIM CB in the OFF r r`'~on. ff TuseO or prateded by othei means, open the eonneclien(s) petween the LIM and the rotaiance
hns.
a lT1e CB is ON only fa the dtCUk under test, It Is tlien tumed OFF. The Z-pole ioaE switqt atthe aqulptlteM I5 altfmatey OFF, ON, & OFF.
4 M X.Ray panel v+Ill oR9n MOVa a eircuR kediry mulfiple mcepWcfes that are eleRfically interlodced 6o Glat anly ane reCeptacle i5
enargfzed. Select by tdal-andercaf the recepmcle that produaos the larges[ ieadings.
5 Enmes required whero there is a J mark
6 Same wntlitlon as 7row M"OVERALL Current Readir.gs" Rev 4-212003
IS07RO1. Sysrems . 700 Far Chase . Castesville, pq 1 932q • Ph: (800) 83M834 • Fax (810) 383•7100
fL011GOUJ 11'Jlnl'I R1V1CRn IYU'rbb r. ibzCtl
TESTING QF EXPOSER F!XED ELECTRICAI. EQUIFMENT 1MIFH CONDUCTIVE SOURFACES
Vottage Measurements
JOB NAME:
CLEqR CREEK ASC
ROOM Of OR
OR 2
CUSTOMER:
G.E. SUPPLY
PANEL SERIAL
12655
P.O. A
3254Q2906AA
DA7E:
01l1112005
8.0.
17407
7ESTED BY:
M. FALESCM
FlXED ELEC
TRICAL EOUIPMeNT
vOLTAGE
#
DfiSCR{pT10N
REFERETlCE
GND LOCATION
EQUIPIWENT
LoCATlON
MEA3UREMENT
mV
REMARKS
N
E
5
W
N
E
5
W
(See bOL'B 5)
f
IPS PANEL
X
X
~
2
FILM VIEWER
X
X
3
SURGICAL LIGHTS
X
-1
CEILING MOUNTED
4
SURGICAL LIGHTS
X
J
CEILING MOUNTED
5
GAS/ELECT 800M
X
q
CEILING MOUN7ED
ote 1: Exoeptfaceplates of wiriqg device&. NoEe 2: A rotemnce poiM, in desrarldln9 ottler of qiWCe, pn be: a) The referencs ground bus in Ne Isalated Pcww Panel, h) A groyncftng
poirrt, in or nearthe room untler tast, that Is eledrically remota from reaepfacles, a.g., an all•matal cvld-water piPe, ar c) The
grounding wnhaA of a racepqcb that ic powered from a dmerent branch drwk frorn Me reueptaele undertesc
No08 3; 7tiere sre no Eesting reqplremenm for exiatinp aonsWdion,
Note 4: Must Interpose (requenry-shaping network he[ween meaSUring peiM end wftmetsl
Note 5: Check Mark q ineana 5 20 mV faf NEW consttuelion. Also applka to portion otan electrisal system that has heen repsired,
replaced, ar aRered. Rev 4 -212G03
ISOTROL Sy9tems • 700 FOX Chese • CvawS'vflle, PR 19320 - Ph: (800) 839$834 a Kex: (610) 383-7100
r~o. u. wo~ aa•oinn Ravicrtn IYV.lbb Y.11/Gtl
TES?'ING C?F RECEPTACLES INJ PATIENT CARE AREAS
Impedance Measurements
JOB NAME:
CUSTOMER:
P.O. # ;
S.O.
CLEAR CREEK ASC
ROOM a
G.E. SUPPLY
PA►dEl. ;
325402906HA
DATE;
77407
TESTca
rOROR2 Pa e1of2
iERIAI 12655
01/17/2005
8Y; M. FALESCH
RECEp7ACLEI.D,
TYPE
RAT1N
RESISTANC
PHYSICALlNTEGRITY
POLARI
REMARKS
NORTH #1
D/S-B
S
OK
NORTH #2
DIS-B
e
J
OK
NORTH #3
D/S-B
B
J
J
OK
NORTH #4
D/S-B
B
OK
NORTH 95
D/S-B
6
J
OK
NORTH #6
D1S-8
B
J
~
OK
NORTH #7
D!S-B
B
d
OK
EAST#1
Dls-a
a
J
J
OK
EAS7 #2
p/S-B
B
d
J
OK
EAST#3
D(S-B
B
OK
EpST #4
D/S-B
B
+J
~
OK
SOUTH X1
D/S-e
B
OK
SOUTH #2
D/SB
B
~
OK
SOU7H #3
DIS-e
e
~
J
OK
SOUTH #4
D1S-0
B
J
OK
WES7#1
D!S-B
8
J
J
OK
wES7 #2
D/S-B
B
OK
WES7#3
D/S-B
e
J
J
OK
WEST#4
D/S-B
B
J
OK
'Refers m Iocation such as N(orth) wail, some I.D. efc.
4D1S-B a Duplex 5tralghi-Blade S/S-B 7* Single Straight-Blade S!'!'-L a Singla Twist-I.ock
'9A =*2P3W, 15A, 125V, NEMA 5-15R B=*2P3W, 20A 125V, NEulq $-20R C~ 2P3W, 20A 125V, NEMA L5-20,
Twist-Lpck D a 3PAW, 20A, 3¢250V, NEMA 115..20, Twist-Lcck Eq 3P4W, 30A, 31250V, NEMA L15-30, Twlst-
L.ock F=* 2P3W, 60A, 250V, X-Ray, Twist-Lock
°Check Matk q means 5 0.1 ohr11 OK for NEW construcdon. Also applies to portion of an etectricai system that has
been repaired, replaced, or altered
S Check Mark d means confirmed by visual inspecdon as being GOOD. Other comments under ReNwrtKs
° Enter either "OK" or"Reversed"_ Corzection by contravtor required H entry is "Reversetl°.
Rev 4 - 212003
tSOTRO(. Systems.700 FacCheae. Castesvllle, PA 10320 . Ph; (800) 8336834 • Fax; (fi10) 583-7700
♦a•acnii rtlvacRn 1`N•fbu r.1C, Ltl
TESTING OF RECEPTACLES IN PATIENT CARE AREAS
impedance Measurements
dOB NAME:
CLEAR CREEK ASC
ROOM or OR
OR 2 Pa e 2 oF2
CUSTOMER:
G.E. SUPPLY
PANEL S~RIAL
12655
P.O.
32fi402906AA
DATE:
01 H 1l2005
S.O.
17407
TESTEO BY:
M. FALESCH
RECEP7ACLE 60,
TYP
RAiING
RESISTANC
PHYSICAL IN7EGRITY
POLARITY
REMARI44
sooM
Dls-a
e
J
J
oK
BOOM #2
D/S-9
B
OK
BOOM #3
D/S-B
B
J
OK
BOOM #4
D1S-5
B
J
OK
BOOM #5
D/S-B
B
OK
BOOM #B
D/3-B
B
OK
eQOM #7
D/3-6
B
OK
BOOM #8
D!S-B
B
J
J
OK
800M #9
DJS-B
B
~
OK
BOOM #10
S/S-B
B
"N071'ET lir'oTALLED
800M #11
SB-B
8
J
°NOT YET INSTALLEO
$OOM #12
S/S-B
B
°NOT YET INSTALLED
BOOM#13
S/S-B
B
"NOTYETIN3TALLEO
800M#14
S/S-8
B
"NOTYETlNSTALLED
. BOOM #15
S/S-B
B
' IUOT yET lNSTALLEO
ceiuNG91
sR-L
e
d
~
oK
'Refers to locaflon such as N(orth) wall, some J.D. ete.
2D/S-B o Duplez Straight Blade S!S-B e Single Straight-Rldde SIT-L Single Twist-Loek
"A =2,zaaw, 15A, 12bV, NEMA 5-15R B=>2P3W, 20A 125V, NEMA 5-20R C=~-2p3W, 20A 125V, NEMA L5-20,
TWfSbtxk 0=~.3P4W, 20A, 3¢i250V, NEMA L15-20, TwiSFlodc E=3P4W, 30A, 425pV, NEMA L15-30, TWist
l.odc F=5~ 2133W, 60A, 250V, X-Ray, 'Iwist-Lock
°Check Mark J means !5 0.1 ohm OK for NEW construction. Also applies in portion of an electrical system that has
been repaired, replaced, or altered
S Check Mark J means canfirmad by visuai inspee!ion as being GoOD. Other comments under ReMntaKs
6 Enter either "OK" or "Reversed". CorrecGon by crontractor required if entry is "Reversed".
Rev 4 - 212003
ISOYROL Syseems . 700 Fox Cnsse • Boa»sa71e, F:. 79320 • Ph: (eooy 8336834 • Faz: (670) 383,7100
~u.aa.~w,~ ia•xrn~ rtivacrtn IMV.fOYI 1'.1.7/Ctl
ISOLATED POWER PANEL CHECKOUT
LEAKAGEIPAULT CURRENT MEA9UREMENTS ANO 077iER 00.TA FOR 7.PXASE PANEL
JOB N,vdAE:
CLEP~Fi CREEK ASC
ROOM or O.R. !h
CUSFOMER:
G.C. SUPPLY
SEF2IAL # PAN~LfLIM:
56861
P•d.
325402908AA
DATE:
mt
S.Q.
174W
TESTEO eY:
OVERALL Current Readin s
Braneh Clrouit Condition:
TesE Condition:
Arnmeter Readin - Microam eres
L1
L2
Exce for Itghting fjMutO
dreuit3
all C~=s in ON
All batls swiiChad OFF inpfuding X-Ray
. 258
265
,
osition
V1eW8rs'
All G8, in ON posidon
All loads switched OFp including
343
294
au iCelfothaNi hts and X-R viewers.
T111S ie the panal leakege including the
8
13
All 08. in OFF position
ccntn'bution vf the hansformef. Also see
faotnote 2.
INDNIDUAL B
ranch Ciroutt Cutrent
Readin s
Cireujt #
Type of Loa
Load Switch OFF
Load Switch ON
5
witeh Tvpe
L1
LZ
L1
L2
1
-
P
2
-P
1
RECEPTACLES
34
38
2
RECBPTACLES
36
37
3
RECEPTACLES
33
37
4
ftECEPTACLES
40
42
6
RECEPTACLES
33
36
6
RECEPTACLES
58
82
7
RECEPTACLES
33
36
B
RECEP7ACLES
54
57
9
SURGICAlLIGH7S
38
44
10
RECEPTAGLES
37
42
11
SURGICAL LIGHTS
27
31
F
12
RECEPTACLES
15
2D
13
FII,M VEINER
60
45
447
70
14
SPARE
15
RECEPTACLES
51
SS
76
SPARE
Sam
z
uM
J
•
5
k viewsr
J
J
❑
8
Su IraVetlw f hW
J
~
e
FpreO ul menl
J
lD
Reee faqe
J
.
1
S re
&afelHazard Lam s
Pass
Fai! ~
LIM Readin
mA
02
TesVMute SWitcA
Pass
F9il
LIM T ap Point mA
5.0
Remote Intlicators
Pess
Fail WA ~
Field-wrin
olor Cede
Pess Fafl
Ffeld-wrin Wire T e
XHHW
Field-Witi~
Gau e
12
kVA: 10
Prima
Vo1ts: 210 Prima
N~j ad Am
: 225
Sacronda Volts: 121
7YW C: tlrenClt w7lBS only,' IIgAt C0/IV01!@B alltl pX[UfBS f0 CB u75(alled /at6f (FUtufe OR).
I MuSt De less than 600 µA and 1040 pA, respsetively, tor 720 V and 208 V laolated Pmyer Paneis. When passln8 orlalling e panel, the type
at I070 avlitch - ane- or hva-e0lo - vhll de taken jnto axouM. Tho kakage/fauR anent contributlon pt bads cwiholled by one.pole awilclies
will qe su6traeted froryi lh9ae re80ings. k is highty WAmmended tha[Oese 1-pole sWNclle9 be conveded to 2pa(e swpd7es.
Z Lgave the LIM Ce~;c t`s OFF position. H fused ar protlIXed 6y other meens, open the ecNleetion(s) hehveen the LIM and the referepee
6us.
9 The CB Is ON OnlyFor the cirwit un{1er (eaG It i5 then tumetl pFF, ?f1e 2-p010 loed swRch at the equipmBM IS 6ftOmetely OFF, ON, 8 OFF.
° Arl X-RaY Panei wi14 Otten haVe a Circuk feeding rnyNlple receptaGes lhst are electdplly IntorloCkBtl 90 thet pnly One rmptaqp 16
energized. Select by triaFand-arror the reeeptaclethat producas the iargest readtngs.
d Entiies reqMred whero there 's a J mark
e Same wnddion as t~ rew of'OVERALL Currem Reaaings^ Rev4 - 212003
ISOTROL Syst9f11S • 700 Fox Chase • CaaMSVille, PA 19320 • ph; (800) 8336934. Fa7c (610) 363-7100
I-a..~w.i, .x.rn~ ~..r.u.~, nv.(oer r.awco
TE571NO 6F EXPpSED FIXED ELECTRICAL EQUIPMENT WITH CONDUi:TIbE SURFACES
Voitage Measurements
JOB NAME: CLEAR CREEK ASC ROO-wi ar OR OR 3
CUSTOMER: G.E. SUPPLY PANEL SERIAL 12656
DATE: 0111112005
P.O. 325402908AA 11
8.0. # 17407 TESTEp BY: M.FALESCH
FUCED EL6C7RICAL EQUIPMENT yOLTAGE
RFFERENCE EQUIPMENT MEASUREMENT REMARKg
# DESCRIPTION GNp LOCp710N LOCATON mV
N E S W N E S W (See Note 6)
1 IP3 PANEI. X X -4
2 FILMVIEWER X X
Note t: ExceptfacepIates of wiring deviees.
Nole 2 A referance palnR M dasCanding ordef ct ehoir2, cen 6e; a) ThB felbronce gryund 6us in tha Isolatotl Power Panel, b) A graunding
voim, in or near the room underlest, mat ia etseqicallY romote fram receptaciaa, a.g., an alHnetai ccid-water poe, nrc) The
yraunding eon}act of a recept9clE lhat is powered from a AiHereM 6raheh chcuR from the reaeptsde under test,
Note 3:There are no tesdrtg vquirements Por eYislfng aonstruetion.
Note A; Must tntelpos0 kequanry-shaping nehvork bebveen measuring po1M end vollmeler Note 5: Che+ic Mark 4 mBana 5 20 mV Por NEW conatruetbn. Alao appliea M poAien ef an eledftl eystem that has heen repahed.
fryH000d, Or ellercd.
Rev4-2RW3
ISpTROL System6 v 700 Fox Chase . CoaiesuSie, PA 19320 • pA: (800) 8336834 . Fax; (610) 985-7100
r~o.ii.c~ 11•JLMI'i rtivtcrtH ryU.(bb r.iaied
TESTtNG OF RECEPTACLES fN PA?'!ENT CARE AREAS
Impedance INeasurzments
J08 NAME
:
EAR CREEK ASC
ROOM or OR
OR 3
CUSTOMER:
E. SUPPLY
P
PANEL SERIAL
12656
P.O.
3325402908AA
OATE:
Ot/11/2005
407
TESTED BY:
M. FALESCN
RECEPTACLELD.
TYP
-RATI-N-dr
RESt3TAN
PNYSICAL INTEG
POLpp
REMARKS
NORTH #1
D/S-B
B
J
OK
NORTH #2
D/S-8
6
J
OK
NORTH #3
D/S-B
B
J
J
OK
NORTH #4
DIS-B
B
J
OK
EAST#1
D/9-B
B
J
J
OK
EAST92
D/S-S
e
OK
EasT#s
DIS-B
B
J
J
oK
_EAST#4
%
D!5-B
B
J
OK
SOGTH #1
DIS-B
8
J
OK
SOUTH #Z
DIS-B
B
~
OK
SOUTH #3
Q/S-B
B
J
J
OK
SOUTH #4
D/S-B
B
J
OK
SOUTH #5
D/5-B
6
J
OK
SOUTH #6
D/S.B
8
J
J
OK
SOUTH #7
D/S-B
B
J
J
OK
wEST#I
Dis-B
e
J
J
o~c
WEST#2
D/S-B
B
J
~I
pK
WEST#3
D/5-B
B
OK
WEST#4
D/S-B
B
J
d
OK
CEILING;~7
Sff-L
B
J
~1
OK
'ReFers to Iocatiop such as N(orth) wall, some 1.0, etc.
'D/S-B e* Duplex Straght-elade S/S-B Single Straight-elatle S/T-L = Single Twist Lock
3A =:~2P3W, 15A, 125V, NEMA 5-15R B=:-2p3W, ZOR 126V, NEMq 5-20R G q 2P3W, 20A 725V, NENtA L5-20,
7wist.Lock D=~3P4W, 20A, 3~Z50V~ Nr:MA L15-20, Twist-Lock E=>3P4W, 30A, 3~ZSOV, NEMq L15-30, TxisF
Lock F= 2P3W, BOA, 25OV, X-Ray, YWist-Lock
°Cheek Mark 4 means { 0.1 ahm OK for NEW construction. Also applies to portion of an electrioal system that has
baen repaired, replaced, or aftered
S Check Mark ti means confirmed bv isuat inspection as being GOOD. Other eomments under tteMuwcs
° Enter either "OK" or "Reversed". Correchon by wntractor required if entry is "Reversed".
ReV 4 - 2l2003
1SOTROL Systems. 700 Fmc Chase • CoatesvlNe, PA 19320. P6: (800) 833.8834 . FaM: (810) 383-7100
ran.aa.c~n aa•acnri rttvacrtn ryU.(bb 11.16/Gtl ISOLATED POWER PANEL CHECKOUT
IFAKA6filFAUtT CUi1RENT MEASUREMFNTS ANO DTNER DA7A FOR /-PHASE PANEL
, JOB NAME:
CRE.EK ASC
ROOM or O.R. !D
OR 4
CUSTOMER:
PPLY
g
SERIAL # PANEULINI:
12657 040955 928
P.O.
3254029l
a1/'11l2005
TESTED BY:
M. FALESCH
OVERALL Curzent Readin s
Brdnch Cirouit Conditton:
Test Condition:
Ammetar Readin - Miaoam eres
ExeP for lightin9 fiXe
circuits, ati CBZ, in ON
All l~ds switched OFF inciuding X•Ray
201
94
osition
°1BwBB•
All cB: in ON position
All loads swjtched OFF includin8
252
277
su ical/other ii hts and X-R viewers,
This is tfle panal leakage iflclutling the
TO
10
AlI CB, in OFF pos8ion
contnbudon of the transformer, qlso see
1- 1
foWnote 2.
1NONIDUAL 8
rench Cifcuit Current
Reatlin s
Circuit#
Type of Loa
Load Swimtt OFF
Load Slruitvh ON
Switch Tv
De
L1
L2
L1
L2
1-P
2.P
1
RECEPTACLES
28
26
2
RECEPTACLES
28
28
3
RECEPTACLES
25
24
'
4
RECEPTACLES
43
39
8
RECEPTACLES
27
24
6
RECEPTACLFS
59
56
7
RECEPTACLES
28
26
❑
8
RECEPTACLES
28
26
9
SURGICAL LIGHTS
38
40
14
RECEPTACLES
30
29
11
SURGICAL LIGHTS
29
30
❑
12
RECEPTACLES
15
16
13
PILM VIEWER
45
74
77
52
114
SPARE
15
RECEPTACLE5
48
53
16
SPARE
Snm e En
pies
Z
~
J
5
X•W viawer
~
8
S ImYMOmI Is
J
J
~
e
Fl.eG ui e'n
J
~
70
U9
lRece
J
'
16
S Bre
.
' Must be less than 600 pq and 10an Wa, respealvely, for 120 V ana 200 v Isolated Paver Palels. Whan pessiny or fa1iri8 a penel, the type
ot load WItCh -one- or Mro-pale will ba taken Into accaunt. The IeekagelFauk afr9nt confipuHop of baES wnirolled hy one-pola switches
will be 6uWaeled troM th95e readiqgs, h IS higNiy reeomrttenCetl that these p-pole 9witches b9 convert0d t4 2-poks sv!dches.
Z Leava the LIM CB in th.e OFP posdion. if fu6e0 or pmteMtl by otller means, open the conneetian(s) belWaOn the LIM and the rof8fence
bue.
3 The CB is ON on/y kr the Wrcult yntler test n is tMn Wmed OFF. The 2,poie load swltqh at the equipment Is alternatefy OFp, ory, & OFF,
4 An X-Ray penel wiil oftea have a circuit feading muitiple racepWUes thrt am eleatrlcely interincked so that only mne mcepbqa is
eneigizad SeieU by 4riaW nd-error the recsptaCle thet praduces the lafga5t miuringa.
6 Entetes required wryem there ia a J matk
SamO COndition as 1' mw of"OVERALL Cument Readings• Rev 4 .2{2003
1SOTROL Systems . 700 Fnx cifase • C;atasviNe, PA 19320 . Ph: (600) 833-saa4 . Fax: (610) 3p3-71 00
rcn.ai.cnuo ii - ~orn'i rtaviamn 'w.roG r.arIco
TESTING QF EXPOSEp FIXED ELECTIi1CAL EQIJIPMENT WITH CONDUGTIVIE SURFACES
Voltage Measurements
JOB NAME:
CLEAR CREEK ASC
ROOM or OR
OR 4
CUSTOMER:
G.E,SUPPLY
PANELSERIAL
126fi7
P1O,
325402908AA
DATE:
011112008
S.O.
17407
TESTED BY:
M. FALESCH
#
FlX@D ELEC
OESCRIPTION
TRICAL EQUIPMENT
REFERENCE EpU1PMENT
GNO LOCATION LOCATION
VOLTAGE
MEASUREMENT
my
REAAARKS
N
E
5
W
N
E
S
yy
(3ee Note 5)
t
IPS PANEL
X
X
~
2
FiLM vtEWER
x
X
Nots1: ExaeptfaceplatesotwirinBdeNxs.
Note 2; A reWience point, in dascantlinq oNer o} cnolce, csn Ee: a) 7'he reterence ground bua in tha Isolated Power Panel, b) A praunding
pant in pr nsar tM room underteat, that is etaeWcaly remate lrom reoeptaclas, e.g., an all-metei wM-meror pipe, ar e) The
grounding wrnad of e recephde thet is pawerod Nom a different breneh dreuit from the rocxptacle undet teet
Nate 3: There aro nu tasting requUements for existing eonstrudion.
Nate 6: Must interpose frequencyahepjng natwork betwaen measuring point and vollmeter Note 5: Chetk Merk ~ meana 5 20 mV for NM wnshuciian. AISO dppfles to pottian af an eleetricai systam Nat hu peon repaitetl,
repiaced, or elcemd.
Rev d - 2I2003
ISOTROL Sysfema • 700 Fax Cpase • Coafesvllle, PA 19320. Ph; (800) 833•6894 • Fax (610) 383-7700
fLOr11, GW✓ 11'JJmI R1Y1LRn
I w.rov r.aa, cv
TESTIRIG OF RECEPTACLES IN PATtENT CARE AREAS
Impedance Measurememts
JOB NAME:
CLEAR CREEK R3C
ROOM or OR
OR a
CUSTOMER:
G.E. SUPPI.Y
PANEL SERIAL
12657
P.O. # :
325402908AA
DATE:
O111112006
B.O.
17407
TESTED BY:
M. FALESCN
IiECBPTACLEIA.
TYPE
RATIN
RESISTArvC
PHYSICALINTEGRITY
'OLnftRV
REAqnRKS
NORTH #1
D/S-B
B
J
J
OK
NORTH #2
D/5-8
e
OK
NORTti #3
O/S-B
B
J
J
OK
NORTM#4
D/S-B
B
~
OK
NORTH #5
D/S-B
B
OK
NORTM 7F8
D/S-B
8
J
+l
OK
NORTH07
D/S-B
B
7-
4
OK
EAST #1
D(S-B
B
J
OK
EAST #2
DB-B
B
OK
EAST#3
D/S-B
B
d
J
OK
T#4
D/S-B
B
OK
SOUTH #1
B
J
pK
SOllTH #2
B
OK
SoUTH #3
E
B
d
J
OK
SOU7H #4
D/S-B
H
OK
WE9T?~1
8
OK
WEST#2
D/S-B
8
4
+1
OK
WEST#3
D/S-B
9
J
OK
WEST#4
D/&B
B
~
J
OK
CEILING#1
SR-L
B
OK
'Refere to locatfon such ae N(vrih) wall, same I.D. etc.
zD/S-B =Duplex 9traight-Blade S!9-1211---*Single Straight Blatle S/T-L o Single Tvist Lock
'3/4 0 2P3W, 15A, 125V, NEMA 5-15R B=5~2P3W, 20A 126V, NEMA 5-20R C a 2P3W, 20A 125V, NEMA L5-20,
Twist-Lock 0-~,3P4W, 20A, 425oV, NEMA L15-20, Twist-Lock E=*3P4W, 30R, 3¢250V, NEMA L".5-30, Twist-
Lock F=:, 2P3W, BOA, 250V, X-Ray, Twist Lock
'Check Mark d means <O.t ohm OK for NEW ransWCtlon. Also appiies to portion of an elecVical system that hae
been repaired, reptaced, or altered
5 Check Mark d means confirtned hy visual inspecfiqn as being GOOD. Other commenta under REMARKs
g Enter either "OK" or"Reversed". Corcestion by contractor repuired if entry is "Reversed".
Rev 4 - 2/2003
tSCTROI Systems .:GC Fax CheSe • caatssvllte, PA 19320 . rh: (800) 8334834 • Fax (sto) 3637100
rc.o.aa.ceiei~ 11•0aMri tcavtu[w
iW,ren 1-1.i7iee
ISOV01 .SySt@fI1S Medical Division of Bender inc.
SUBMITTAL DRAWINGS
&
BILL OF MATERIAL
FOR
S0174p7
Customer: GE Supply Company
Representative: Y.umen Power
CLEAR CREEK ASC
700 Fwc Chase
Coatesville, PA 19320
Tel.: 610-383-9655
Toll Free: 500-833-6834
Fw 610-383-7100
ar2512ooa 1
i rcc.u.c~o uaanri R1VILRH IYV.lOO r.cnica
ISOtfQl SySt@1175 Medical Division of Sender Inc.
$017407
CLEAR CREEK ASC
SURMITTAL DRAWINGS & BILL OF MA7ERIAL
TABLE OF CONTE!:TS
i Bill of Material S017407
~ IPP-10BA1-G2l16P16-BF Elevation Drawing .....................................446 1325 R2
~ IPP-10BAt-G2/16P15-BF Wiring Diagram . 442 1186 R4
BENDER Series LIM2000, 1 Phase Line 1SOlaEian Monitor ....................Data sheet
' 1 Phase ►sotation Transfortner Data sheet
arzsrzooa 2
rcn.ai.cvcr,.~ u•.~.~nn rtava~r~n n~.rou r.ci~co
ISQtrO) .5Y$t@RiS Medical Division nf Bender In0.
7w+#: s017407-GearcmcYasc
C1t570mCr. GE SupPIY C°mPw4'
P.O.#:325402908AA
3u6mitM& August 25, 2004
Reprcsmrative: I.ymrn Power
Item Qry, Description
1.0 4 ISOI,AT'ED PpWER PAN'EL
#lush-mounted 14 GA galvamized steel backbpx, 41" x 24" x S" (HxWxD),
14 GA, Type 304 staintess stcel &ont trim w! # 4 brushed finish, 43" x 26" (TixW),
with door w/ hidden hingas and keyed flush ]ock over tueaicer panel.
EaCh panel containing:
1 kVA, 208 V-120 V, I Ph, 60 T-Tz isolation transformer,
1 60A, 2P, GE, Type TFIQC, Main circuit breaker,
1 Load center w/ provision far 16, 2P, GE, Type THQP
plug-on circuit breakers, w/ dead&ont - 16 positions,
2 In-line fuge,s for LIM cizcuit,
16 20A, 2P, Type THQP, plug~On, branch circvit brealcer,
1 LTIvf2000,1 Ph, Line Isolation Monitor (W, w/digitaVanalog dispiay,
1 Tteference ground bus w/ 20 connections.
ISOTitOL type TPP-108A1-G2l161P16-gF
2.0 1 CHECKOLTT SERVICE
Certified testing 6y qualifiod ISOTROL Systems technician, including
complete inspec6on of the Isolated Power Systems mearioned 'ut this submittal.
C6eckout includes written records, certification aad meeGng with hospital
medical and maiatenance staff to explain operation of equipment and the
need for periodic testing and logging test resiilu.
Checknat must 6e ordetcd from factory, otherwise t4o Certitcate of
Acecptance ou the installation and a Limited Warranfy (5 year LIM &
3 Year Traasformer) of the Isolated Povyer Systems wffl not bc issned. NO'Y'E: Minimunt of 30 days reqnired to notify Checkout Technician
It no tification is tess tLaa 30 days thero will be additioaal clearges.
Aecepted by
Date :
Signature
8251'2004 g
T
~L6.11.CtlGD 11•J3~'1 R1YICRM
nv.I oo r.ccl cv
PLAN
i
~
1
r ----_'_--i
1 f
- - '_^d
f1r__- -J1
I il I I
I II
I II ~
I II I '
I II ~
~
~-------___-i
s
.
i 1
J
-
-
~
,o
r--~
-
-
0
9
~
p I a •
J
e:-.a6
4
o i ~
p r~
a o
O Q
$
Q
0'
~
r-A
,s
FRdNT
1 S/S FRONTTAIM
2 BACKBOX, GAI.VANiZEO STEEL
3 BACKPLATE
4 BACIfPIATE MOUNTING BRACKET
5 TRANSFORMERSHELF
6 TRANSfiqRMER SHELF
MOUNTiNG BRACKET
7 HFiEAKER dEADfRONT
, 8 STAINLESS 3TEEL DOOR vy/LOCK
9 LJM FUSES
10 GRCUIT BREAKER, MAIN, 2P
77 CIRCUIT BREAKER, BRANQH, 2P
12 LORD CENTER
s prawing is Ihe propeAy of 6ENDER Medlcdl Fwdu
2
;
19 ISOIATIONTRANSFORMER,1Ph.
KVA RATING: ~ v KVA
PRIMARY VOLTAGE 2() J? V
SECONDAAY VOLTAGE; 1+Z d V
FREqUENCY:Co Q_HZ
14 LINEISOLATIONMONITOR, 1 Ph.
15 CANNECTOR PIATE, !IM
16 GROUND BUS
Elevatlon Diawing
ISOlatetl Ppwef Panel
Flusn mamt.tph., s..yoKVn,
uM Fuses, Ie cEPs
fi
1
4461325
VIEW A - A
I
I
I
ii
~
~
~
I
I
rco.ia.coo.r ♦t•oanri narac.r~n
jiv.roo r.co, co
INCOMItvC,
POWER
L1 L2
,
3
5 _
7
9
ti
13
15
'1 LIM FUSES / - O A
2 UM FUSES DISCONNECT
3 LOAD CEN7ER
d GRCUIT BREAKER, MAIN, 2P
CQa A
6 CIRCUIT BREAKER, 6RANCH, 2P
# f~/(e - %ZoA
T1
aqy&
GROUND
2 2 ~
TQ SYSTEM
GROUND
4
FtEMpTE
~ 9
y
*
ICATQR
INDICAT07FI
plES
t
2p00
8
ReQui~edl
MEfERE
D
10
~EON~.Y
72
~
g
PANEL
PANEL
GFOUND
RROUND
14
i8
6 ISOLATION TRANSFORMER,1Ph.
KVA RATING: I Q KVA
PFiMARY VOLTAGE; Zfd V
SECONDARY VOLTAGE: 120 V
FREQUENCY: kO HZ
7 LINE ISOWON MONITOR, lPh
8 CONNECTOR PLA'fE, L1M
9 GR04NQBUS
• NOTES:
t. Typa XHHW wire wlTh a dlelectrfc conshant ot lese then 3.6 3. Slze of ap wnduGOrs shell ba in eccordance With ell UL. NEC,
is recommanded for ell branch cirwltfiQla wiring. NFPA and 8tale Fire Marhsan iaquirsrnerrts.
2. Aolarity ahell he obsened in elI instances. 4. q9 remom Indlcetion circuipy sryell he low voltaQe and vAA ri4t
fiis Orewing te the property qf sET+rt]EA Medcal Proaucw Group. conmuute Ieakege to the syspem.
FEV. DA7E NAME JATE Juy 22, 1998 (SOTROL~ ~ Wiring Oieeram S~~ Not to soale
DR4WN L, GinvlAN ~Y~~k~K Isotated PowerPanel SHE'ET 1 c! 1
CHK'ED D. LO86 ?~Fa~awoo 1Ph..3..37.6KVA, O~~~y p~p.
4 70/17/03 LG MP'VED ~Tiz~1~0 vM luses. 16 085 4421186
~~GL1~Sl~GVVJ 11'J"'~1"11'1 R1Y1CR1'1
, ' , . LiOOlatlprt MonitQr
' • , • , ;;fP~~. ~ . e and 76ree phase 5ystems
, ' ~ . . . ,
I iM2ooapiusTm . . • ~ ~ ~
. ,,...~_,.~.m,...._.~~_._~..~...~..u.....~,.~.~ „
I I
4,437"' 3.250"
■ Less than 35 microempere I,IM hazard currerrt
■ No iMerterence with eleeMCel equipment
■ Speclal phase-bcking cirouitry
for uftimate stability 8nd repeatabitity
■ Voltage-free SPOT contact for eMernat alarm
■ Pravision for remote indicetors
• Internal overload protection with autometic reset
• Easy to clean rugged lexan front foil
■ Digitel displey 8 analog bar greph
■ Autometic self celibration and seif check
■ Audjple alarm volume is adjystable vis manu
■ Load Monitor[ng aveilable
■ RS485 communicadon port avallable
ProductDescription
The tine Isotation Monitor (Llfu) detads the totel (eakd8e
impedance to ground in an Isolated (ungroupdad) AC power
system. Based on this Infprmation, the maximum Totaf HazaTd
CyrreM (TMC) is detertnined and displayed on dig)ta) dispiay
and LEO 6af 9raph.
The CIM is avapable faroperation in 50 M 80 Hz systems with AC
voltages 100to240v.ThesupplyvoltagefartheLlMistskenfrom
the system to ba monjtoretl. Two separate ground Conneafions are prov(ded. Each gtaund
nlust be wired Individually to the RBferenCe Grourtding Bus. A
break in either eonnection will cause the LtM to alarm.
The BENAER LIM2000p1us*M Series Line IsolatioR Monitar
meets or eXceeds aN applicabie 11,S, and Canadlan
specificatiqns. It comolies with NEC qrticle 517, NFPA 99,
UL9022, CSAZ32.2 and is recogoizad uoder U! flle no. E8117e9
and CSA file no. LR60783-3.
nv.ron r.crico
BENDER. ~ .
. .•a-.-::; , ,
Medic2lProdyctsGraup ~
7100cr~..,~_~
8.500" - ~ 2.450"
I
p -r
4.100" 3756"
x a•.. wpwr• I •
1
i
-
Qi~ensionDfegram (inch)
I
2.qso^
im-E t
~ 5,328" --.4
Operational I nfortnation
Usually, ihel2 w71 6e a diNerent irylpedapce between each
Isolated conductor and ground, Thus, thera wiil be a diHerent
current flcwitlg thfaugh a person maklrlg physicel contaq
betoveen any one ofthe isolated canducrors and ground, The LIM
(unctian is to calculate and display the Vue maximum value of
theTotal Hazard Current(rHC). The BENDER LIM axomplishes
this using a patentQd measurement technique.
The 7HC is displayed on a seven segment digital dispiay and a
6ar graph. Normally, the greep "SAFE" LEO fs Illytninated, th0
tlispiay shows e low leakege v4lue and the bar greph is in the
non.elarm, Or safe, green znne. THC levels wilf increase as
addiflOna) loads are connected to the system and/orwhen a Ijne-
tagrnund fauR has suddenfy ocauRetl or is Slowly developing.
There is a uisual and audible alartn when the THC exeeeds the
UM semng of either 2rriq or 5mA. Relay autput cpntacts are
availahle which can be wired into a circuit to trigger sn external
alaim.
Thevisualafarm,red"HAZARD"LED ramainsllluminatedTOrtrye
duration oftpefautt. The aud"hle alarrp can, bowevef, be sitenced
by pushin8 the "MUTE" button at any time, at the diseretion of
personnet in the Wcfnity of the IIM. Whan the FMUTE" 6utton js
aetivated, the amher I.ED in the mute button is iRuminated to
indipte a muted condiNon.
AdivatethetesthuitontochecktheClMaperetion. Makingthistast
does not adtl W the hazard cu(fBnt of a systam in ectual use, nor
daes the test Indude the effect of the line.to-greund stray
impadance of the System.
The LIM h83 pravis!ons fer connacting vne or more Remote
Indicatcrs, with or without analag or 6lyital display met6r. A
Remote Ineicator dupiicates the L1M audibie and vlsipie 2!e!.*n
signais.
SpeeifkeGons ana qMa Ndata subJect m ehange~without noSice. P'ae '
~~r n ~w .~t ~e~ Mwi~~. . ~a • ~ + vr
. ,w.~,..~.~~arwv~ M~mr:~.a..mr~:n~t • Lt0{LgT
fLD~11~GCIVJ '11~JY1'lll.' RLYILICI't
• • ~i~~a~~wv~~~w~.nnn~w~
LIM2000pIw~"'8 LIM2000p1
Rateq j~sy~etlon vokage
Insulayon olaas in acc. W UL1022
DieleetMc vahage-witpstanC test
R8f2d s9NjCe ~j1~g
Ratad malne wlrage af v~
w.~'I`+~wa,af~ n ~ wx~--nru~~.
us-1CB
300 V
1500 V
~~NOY01ls O~~t1011
t00V - 120VAC I
200V•240VAC iph~
200V - 240VPG ~ph.
Frequeney renge ot Vw
6a m 60 Hz (H. 5%
~
~Pe~'dting renge MVk
95 to 7TO~h M rsted
voRage
Mac pOwcr cpn6umptian
12,5 VA
CA
Measurln9 urrrent
max. zo un
dS~~,itor ha~aM currene
max, 35 µ4
Min, intemal tmpedance st sw60 Hz
4.7 Meg S1
NolDinal re6ponsB ve,.e
5 mA pt0ngea6~e t0 2 mA
R05pansp (pf~a~C9
7.9 tn 2{ttA ar 4.8 t0 5 InA
Respo~se letardatlon
a q seC.
4E9panse hyetereSi6 ~
20°k af ro4pOnSB Velue
Output conWd assemblies
one vokage.Bee SpDT eor~taCt
one 12 V DC, 200 mA max
Remote IndiceWroutPut
enelog antl digital tlispfay
IndicatOf qu~ut
Rated contact Voltege
250 VI24WC
iinake Cepacity
bA /1G 4A OC
BreaR cap3c;ty
~ezavocanaurx=o
aa,
SWliching 71M (24~ V AC / s0 Hz)
70° eycles
OperationllMde
continuous
LIM avedoetl prateotlon
bufR-in lhertnel overload with
Ambient t8mpe2lure
auWmaNe rgsgt
.
wllen a0oroting
+32°F tc+722°F
0°C W *50°C
Nhen stored
-13°F W riSB°F
-25°C (0+70°C
Mau~ingorientatfpp
e~y -
Cort~eator
75 pin Mo1ex lype 03-09-2152
Weght
epproz. 1.53 16
I,1M2000pIUSTMConneator Plate
Rated jngulauon vattage
Ca61e le~gth
Tery~inelSMP
Con~ector
Mat6 conductor size
MovMing otkntatian
Weight
300 V
20' (0,5m)
i B terminals
15 pM Mo(ax
12 AWG
by screws
approx 0.44 Ib
Physical Dstails
fhe UM ta lesatryan 2-7R` tleep. Cu4outneedadfM newpanel maunt~ng
is T x 47NG (•0; 7/32ry. Cutou! needed for fqtloffi Panel mau~ing
is 5-38' x 3•1la" (i0; 1/32~, Muuntlrig hcies are pn 4" antl 6•~/2'
cen~~s.
A75pIryfOmaleMObxcal~lfeabris6udtpt(pthebadc ottrye LIM2CppplupTM,
A~nneuor pWce assemhly with t5^ qbie ana 1s-pin ma~e Mo~ex
eonnector is ava(la4te tn facllitete freld wiring.
The;udlble alafm Sound Ievel adustment is av2peble vW menu
rv~.~nv~, rn .c~ica •
~:•fn;7•,.~ .
' '~'~r0~ I.I~~~i
T9 UM2pU0plus"'
(Conqecror NswOe
aom mating enu)
O O Q
l3 OG~emn
O °O tiJ MK2000
m- M. "n I.IM ReR~ota
0~° ~ To fuses or IndlratorTe~mNaic
~ qmcK~~.anNO etfCUithmaker
70 17 12 12 ~ 670
an xrnx ac COnneeted to
sewnd~ry0i I ~ ~ ~
~ r.~n iw fsolatlon ~ ~ 4
7hanckrtner1 i ~ i
i ~I i
~ p i ii ~
~ ~ I I I
~ ~I i
u
+~a~ ~ i i i
4t•Mar ~ I I I
N• exm ~ I I I
w+--- -i- - u i
KpNC ~ ~
N7/Cq~moq j
FYNO I i j
5TM° i I
~p~_ _T~~_j_~aJ
~ ~
WON
I I
0 ~~J
~ e ~ -
ConnectorPlma P~6fenceprounC
Med¢I!P 892075700
(N teM fi+nclla~ wilh FG1 !C) thtee Phase SYStem
f8) ootlonaiforsYatnmmuGn9 (festPoxdanna~a~rd~aple)
Wfrtng Diagram
Legend to Wiring piagram
Lt, L2;
To se~ondary of Isola~ion T~anstormer.
RemmmenCed i~~lne tuses
72V oc Cam.
: Corr~mon cOnnecdon ot extemal RemoU Indicstor
Safe:
^Safe" Ilght connection of 8M8ma1 Ren10t2lndieatOr
HazarQ:
"MazaM' light cpnneetton of externel Remote tqd~cator
tN~. M+:
EtRema~ mq meter (a00 yA)
RI1:
Test butip~ Sovrce
RQ.
Loeai 8~ system muNng from LIM antl Remate
InEincor
K7MC:
NC wMac[ of the alerm relay Ki
K1/Comrnan;
Common eantact ol the aiarm rolay K7
K1M0:
NOWndcto/thealarmfeleyKl
GND2,
UMGND:
~
Grountl wnnections, iione Is intenuptod LIM
~
~ will alarm
1.3lTest
RelnoEe °PesY' functien or Cpnne~tio~ ~31~ Mree
phase systems
SP~ificationa and other deta subJect fo chanae withaut natice, vw.sas
.«.,R:
' ~ LO. 11. CGGO 11 • i]4M'I' IS1 V LLICM ~ '
• , ~ . a ' • t , ~ ,
, ~ . . ' .
• ~ . _ i . .
~ . .,~~...--.T..,. .r.........a,..n-,..e....~ ~..e--.r.~..........w-~.,......,.~~p..---,....
Optiona! Load Monitortn9 Functlonantl RS485SBrial
CommunicaGon InteKAco
The bad monltoring feature provides the a6iljty ta mupiMr the
percentage of load used on the secondary ot the isolation
tfansfofmar. 9yTeeding one leg ofthe sewnderywires ftom the
trertsformerthraugh a curtenl transfarMer and setting the LIM
to ihe aecrondary amperage a( the isolation trdnstofiner. The
I.IM aelcutates the pereentdge of load being usad. When the
isolatfon transformef approaches Bp% of fated powef, a
Nashing yeilow LED Illuminates. When 100% af power is
achieved, a flashfng yellow LED illuminates as wetl as an
audible alarm,
The R5405 wmm4nication outputfeature provides the ahliity
to downloed Gurrept information from the I,IM ta e Parsanal
Date Assistant (PDP) or pefsonai computer, The information
availabl6 is the Current milliamp reaqing on try6 LIM, the
Ndnsfoqner load pereent2ge, and the alerM status.
~
Nxuee.~.r1 ar
xapwarl.W. c.rrux
c
n
W N ~
~
~j pMrCYt14
~~~f ~YXLLYnMI
~0
wY
MMOq..u ~
Gc~W0.~
O
Connectians required in single phase syatems using
MK20U0C-G1 Remote IndicatorwloveAoad Indicetor.
, Add@ianal corlnectlans requirad In Single Phesa systems
using MK2000CP-G1 Metered Remota IndiCatorwlOvedoad
Indlptor & TesY bulton.
Note:'TEST"funct{opfrcm RertiotelndicAtor is notavaifab7e
for 3 phese systams. t,3f'TEST' conneetion is used ss L3
in 3 phase systems. Overloasd option requhes ihree (3)
Current Transformers, (L1, L2, & L3), in 3 phase sysfems.
Additlenalconnectiansrequifedfor"SystemsMuting"pption.
- Conneclions required fot "RS485 Interlaee'.
" I`N.tbl~^T.CO/GO ,
Bf. NO ~ E a~:~ ~
<r.:.-:;...... ;.a.,•
'Medcai Pmdurts Group
:..m.....
Orderine Inferma}inn
7ype
Artic►e No.
100-120V,1Ph
92075001
100-120V,7Ph*
92075002
200-24GV,1ph
92075003
200-240V,1Ph'
92075OD4
200-240V,3Ph`
92075005
•UM with Load Monitoring
0
~
~
~
Load Monitoring S R5485 Connector Plate
K2 f Common:
OverloeQ Indkator an MK20DOC-G7
K2lNC:
NCCOntaclofthe9larmrelayK2
K2 I NO:
Ov9t109tl Intlica(Ot On Mf(2000C-G7
131. 1St,
251, 252,
381, 3S2'
To Current 7}ansformer (C1)
COMeetjon5
A, 8,
Shleld: RS485 Cemmunicotian
Spect5ratIons and other tl9ta aubJect (p char ge withouf notice. P+p= ~ ~da
~
-~ea« ..............a~.ve...,..m-...~...~....~
w-a.~-.,.~...m,~..._.
~
I
i
i
• r~o.u.cvv.~ ta•~ru'~ navacrtn 9\V.foG~ -,.J'.C(/Ctl
• •i • • 1 . ~ .
• ~ ~ ~ ' .
• . ~ ~~~~.~'alrw~a~•~+~wM.-mmf.ny<r ~~n.~~-~.~-~w..~~ryn~ n~~~ ~ ~~~.r ...v~n• ~.~r ~s~v~.~..~w~n.• • . ~n.yr~~ •
Diaptay
1. Amber THC setting LEDs
tndjcates tha current "THC" setting
2. "TEST bulton
cryecks functlons af ihe LIM
3. Grean "SAFE" LED
bright uniess LIM is in alartn mode
4. LEDApalog Barf3raph
dlsplays Total Hazard Current
5, Toial Harard Currenj
Req LED Displey
displays Total ►iazard Current
8. Red "Nazard" LED
indicetes "7HC">SmA (2mA)
7. Amber "MUTE" LED huKOn
silences atarm 6uzzer
8. ARtbCr "Trapsfomler Loed" LEO
indicates transfortner load
• over 9D% (optional)
9. Tran(ormer Loed (TL)
Retl LED Display
crisplays transtormer load (optionaq
NOTE;
!f you have any questions or need further
assjstance, please call us ustng our toff-
iree number. (800) 356-4286.
~j ra ~ (Q~
sAFE -r ~ . i. ,fil14 NALU7D
rMiliIlf:?7111j, A
I e
D+2 +4 5 e 7 1 inq
N05% /AIl,-.• .1 % o>eox
~ ~ ~ \ 00
ErconCodes Listing
ER
1,0
Ground error LIM•GNDor GND intertupted
ER
2.0
AD eonveRer caiibrdtjon falled; herdware feped arror
ER
3.0
Measuring ckCUft test f0iled; hardware mistake.
ER
4.0
Tolerance behveen actual syst¢m voffage and caliprated system
voltage has been increasCd
ER
4.5
Tolerance between actual signal voltage end cafi6rated system
volt8ga has 660n inefCdSed
ER
5.0
Hardware defect mfssjng system trigger
ER
6.0
Progrem sequence interrupted; EMI 1Meriarence
ER
6.5
Program sequence interfupted; stack point indication too high
ER
Error in the current medsunng arcuitry
'
Standards
Our Address
The BENDER LIM2000plusT"' Serfes Line lsolation Manitor meets or
BENDER MEptCAL PRODUCTS
exceeds alI appliceble U.S, and Canadan specificetinns. It compCas with NEC
700 Fox Chase
Art(Ge 517, NFPA 99, 11L7022, C$A 232.2 8n3 is UL and CSA tetogp¢ad.
Coatesville, PA 19320
Phone: 800,956.4266
3afety Instruetions
610-383-8200
~ Electrfcalequlpmentshalloniy6einsfalledbyqualifiedpersonnei
Fax: 610-383-7t00
in aonsideratian of Ute appiieabfe safery regulations.
E-mail: medical@bender.org
FLGEo
.w...5....`.+-..w......~
specifieetions antl other data aubject to ohange witho~ nofir.e, mesu~
,........•,~..-__T . ...w,..~......~..,..m~.~....-.~..,.....~..~..........n.r..e.-.........,
rco.aa.cw.~ u•arrn'i ntvuRn
~Y/~TR
. ~V~N'6~OM •'~,...•i~
SYSTEMS lsqt~tior~
Me¢1c~IpivisiOnofHend'gcMa. . • ~
} ~ . . ,
~
siormers
~e• ~ v~.~.~. ~ . ~.~~~~~.nnY~wu~Mev+,~e~r'n+.Ya - - tir..rvnrt~~
Transformer Dimensicn Diagram
kVA
A
B
3.0
14.0
13.25
.5
5,0
14.0
15.0
.5
7.5
16.0
15,0
C
125
10.0
14.0
14,0
6.0
.5
15.0
15.0
15.0
9
2D.0
16.0
18.75
0
25,0
16.0
i6.75
75
Technica! Data
kVA
Leakage current •
NoiCe
%
%
Wt.
120V
208-277V
d6
fmp.
Reg.
Lb.
ge~.
~c.
3•0
72
18
25
3.75
3.0
65
5.0
20
30
25
3.60
2.8
85
7.3
22.5
33.5
30
3.50
2.6
110
10
25
37
35
4.10
2.6
170
16
30
40
35
4.10
2.6
170
ZO
~
' 44
40
4.00
3.0
260
25
34
51
40
4.00
3.0
320
•Maximum Leakage CurrerK (Micro anps)
~yv. ron ~ • r.cnito
~~~EY' ..R~`..~ .
Mediral Proluots Group ,
5ingle Phase Low Profile
Protiuct Description
These transformers provide ext2mely Iqw
noise and low leakage. pess than 50
microamps.) This makes them partlcularly
suitable far use in Isoleted Pawer Systems,
Such systems find wide usage in uitieal care
areas as ORs, ICUs, CCUs, ex. where an
extra layer pf electrical safety js desirable.
Suggested technical speoWlcations
• SinglB phase, 50 or 60 Hz, with primary and
secondary voltages as indicated an the contract
drewings.
• Class H fated insulation
• Electrostatic shield between primary and
secondary wfndings grounded to enclqsure.
• Electrostatjc shield designed in a way to
prevent direct shortjng of primary to secondary
windings, and reduce the coupling of harfnonic
distortions between primary and secondary
circuits.
• Core and coils isofated from enclosurq hy
means of suitabta vibration dampening system.
, ToWI leakage cunentto ground from
transformer secondary winding in corttPliance
with UL1047, tables 30.1 and 302 and CSA
zazz.
• Maximum sound level of transformer. 25 de
for units 6KVA of less, 30d8 fir 7.5KVA, 35d6
Tor 10 - 75KVA units.
• TempereWre rise limitetl to 115 degree C
a bove ambient under full foad cond@ions,
• Transformer UL and CSA recognized as a
component, atthe voltages, amperages and
KVA rdtirsgs required.
I501ROLSYS7EM5/BENUERMEOtCqL pRppUCTg Contact factory forinformaliortonthree
700 Fox Chase phasetransformers
Coalesvnle, PA 19320
Phone: 800•633-8634 800-356-4266 CO 610-383-9655 610-383-9200 F~ 810-383-7100 Recognized
~ E-mail: iaotrol@bender.org medlcal@bellderorg &pec'rfleations and oMer data subjec! W change withoW notica. ~ Ly
, r,........ ..W.~ ..~.r.,....e....+m..,~,~,-,,..:....r.v~a.~.._.~~~........~W..,.~r...-.,...~._,.....~..w..,....w.z;za .5~,.
Dimensjan Table pnensal
INTERNATIONAL CONTROLS SYSTEMS INC.
Certification Regarding
Jeron Provider 620 Nurse call System
Ttris Certification States that the following Nurse Ca11 Devices have been tested and are
worldng properly.
CODE BLUE, PATIENT STATION &
DOME LIGHT
REC 1
CODE BLUE, PATIENT STATtON &
DOME LIGHT
RE(] 2
CODE BLUE, PATMNT STATION 8c
DOME LIGHT
CODE BLUE, PATIENT STATION &
DOME LIGHT
REC 3
REC 4
~
CODE BLUE, PATMNT STATION &
DOME LIGHT
REC S
CODE BLUE, PATIENT STATION &
DOME LIGHT
- REC (
CODE BLUE, PATIINC STATION &
DOME LIGHT
RE(,' 'J
CODE BLUE, PAITLNT STATION &
DOME LIGHT
RE(,' $
Toilet Switch & Dome Light
Pjt(,"j'
Toilet Swi[ch & Dome Light
RCTL
Toilet Switch & Dome Light
RCSH
CODE BLUE
RCCB
pAT1SNT STATION & DOME LIGHT
SD 1
-
PATIENT STATION & DOME LIGHT
SD 2
PA'ITENT STAITON c@ DOME LIGHT
SD 3
PATIEN'1' STATION & DOME LIGHT
SD 4
PAT1IIdTSTA1TON&DOMELI4HT
SD:S
Toilet Switch & Dovie Ligfit
SDTj,- .
ppTtENTSTATION&DOMELIGHT
PRE1
PATTfiNP STAT[ON & DOME LIGHT
PREz
PATWNT STATION & DOME LIGHT
PRE3.
.
PATIENT 5TATION & DOME LIGHT
. PjjE.. 4 . .
PA'fIEN'P~STAT(ON& DOMELIGE3T
PRE5.
PATMNT STATION DOME LIGHT
pRE 6.
PATIE,NT STATION & DOME LIGHT
'
Pj~
Toilet Switch .@ Deme LigM
PR'j'j,
CODE BLUE
PRCB
CODE B L U E & DOME LIGHT
. OR I
CODE BLUE & DOME LIGHT
OR 2
CODfiBLUE&DOMELIGHT
QR3
1300 S. Inca Street • Denver, CO 80223 • (303) 778-0884 Fax (303) 733-6105
/f A i
CODfi BLUE & DOME LIGHT
oR 4
CODE BLUE & DOME LIGHT
(_1R S
CODE BLUE, PATIENT STATION &
DOME LIGHT
181
MASTER
NURSE STATION
Facility Name , GZi4^ liKW~
Business Name -1;4,lvgY-
Date
a~t~j ~a.S BY (~i~ !~//l✓
Name TitleofAuthorizedRepmsentative
Av~~
' SignaWre of Aut6orized Representative
International Controls 3ystems INC.
"f «9 ( d~rd
Name and Title of ICS Representative ~
. ~
Sigaaaue of ICS Representative
Date 2-1"3--K
JEDI Balancing
Project: Clear Creek Ambulatory Center System/LJnit:
Manufactiser
MC UAY
Model
RPS030CLW
Serial
FBOU04050099900
Ratin
12000 CFM 0.75" ESP
Thermal
Thermals
AIR APPARATUS
TEST REPORT
RTU-1
.
~ .
~
Amufachser
A.O.SMITEI
Motor HP
RP.M.
5
1760
Phase
Frame
3
S184T
S.F.
T e
1.15
MOGB
Volts
Am s
230/460
13.6/6.8
~ c
Motor Sheave
AK66H
MotorBore
AX 1 1/8"
Fan Sheave
AK109H
Fan Bore
H X 1 7/16"
No. Belts
1
Bek Size
A73
VFD1160
Remazks: Fan read with VFD ai 60 HZ. Grill read out total is 9375 CFM.
JEDI Balancing
Project: Ciear Creen Ambulatory Center System/[Jnit:
Manufachser
MCQUAY
Model
RPSOISCSW
Serial
FBOU04040100100
Ra '
7100 CFM 2.0" ESP
Min Outside Air Re .
1500 CFM 21°/n
VFD
CFM
6600
Outside Air
1550
Retum Air
5050
AIR APPARATUS
TEST REPORT
RTU-2
Manufachirer
BALDOR
Mntor FIP
R.P.M.
7.5
1760
Phase
Frame
3
213T
S.F.
T e
1.15
NG
Volts
Am s
230/460
20.0/10.0
Motor SHeaue
BK85H
Motor Bore
H X 1 3/8"
Fan Sheave
1B5V80
Fan Bore
B X 1 15/16"
No. Belts
1
Belt Size
B47
Fan RPM
1765
Volts
VFD-460
Am s
VFD-7.8
JII
oRt
Filter
-010"
-025"
Cool
-0.25"
-0.45"
Fan
-0.45"
1.85"
Filter
1.85"
1.80"
Heat
1.80"
1.55"
Remazks: Duct static maintaining 0.84" with all VAV's and F'PB's calling for ma2ciwn cooling. Duct stadc set
point is 2.0". Set point of 2.2" is nceded to satisfy low box. Summation- 7225 Computer Actual-
6600
JEDI Balancing
Project: Clear Creek Ambulatory Center System/Unit:
Manufadurer
MINEt MMIM
MC UAY
Model
RPSOISCSW
Serial
FBOU04040100100
Ratin
6500 CFM 0.75" ESP
VF'D
4660
AIR APPARATUS
TEST REPCRT
RTU-2
Manufacturer
: ~
BALDOR
Motor HI'
RP.M.
2
1725
PLase
Frame
3
145T
S.F.
Type
1.15
NG
Voks
Am s
200-230/460
5.7-5.4/2.7
q
Motor Sheave
AK39A
Motor Bore
H X 7/8"
Fan Sheave
AK99H
Faa Bore
H X 17/16"
No. Belu
1
Belt Size
A67
VFD-22
In
Remazks: Fan read out with VFD at 60HZ. Fan is movmg 4860 CFAS by grilt read out.
JEDI Balancing
Project: Clear C:eek Ambulatory Center System/Unit:
Manufactiser
.
MC UAY
Model
RPS025CLW
Serial
FBOU05060100000
Ratin
11000 CFM 2.0" ESP
Min Outside Air R.
1100 CFM 10%
ADNSTABLE
a~ -
CFM
8145
Outside Air
1115
Retiun Air
7030
AIR APPARATUS
TES i REPORT
RTU-3
Manufacpser
A.O. SMITH
Motor HP
RP.M.
15
1770
Phase
Frame
3
S254T
S.F.
T e
1.15
MOGB
Volts
Am s
230/460
37.8/18.9
Motor Sheaue
~i
3B5V60
Motor Bore
B X 1 5/8"
Fan Sheave
3BSV46
Fan Bore
B X 1 15/16"
No. Belts
3
Belt Size
BX38
Fan iiPM
1890
Volts
385-385-387
Am s
11.7-113-11.5
-0.29„
Remazks: Unit finalled with all VAV's calling for maacium cooling and unit mamtainiug 1.70".
JEDI Balancing FAN TEST REPORT
Project: Clear Creek Ambulatory Center
Fan Number
- - -
F-1
F-2
s;r
Manufacturer
GRr?FNuF.CK
GREENHECK
Model
GB-101-4-X
GB-081-6-X
Serial
04H19036
04H18963
Ratin
400 CFM 0.375" SP
200 CFM 0.375" SP
Manufacturer
MARATHON
MARATFION
MotorFIP R.P.M.
1/4
1725
1/6
1725
Phase Frame
1
48Z
1
48Z
S.F. T e
135
SS
135
SS
Voks Am s
115
5.0
115
3.6
k,
MotorSheave Bore
1VP30
1/2"
VP25
1/2"
Fan Sheave Bore
AK40
3/4"
AK39
3/4"
No. Belts Size
1
3L210
1
3L180
Manufacteuer Model
NONE
NONE
Iustalled 1'hermals
Ratin Am s
Required Thermal
Ratin (Am s
S)
Fan Motor
Fan
Motor
Fan
Motor
CFM
Volts
410
121
205
121
RPM
Am s
1095
4.5
1040
3.5
SP.In
SP.Out
NAC
ATMOS
~
NAC
ATMOS
Rematks: A= 7.5" X 7.5" = 0.39 Sq.Ft R= 513 FPM F= 528 FPM1205CFM
JEDIBalancing FAN TEST REPORT
Project: Clear Creek Ambulatory Center
Fan Number
F3
F-4
S
Manufactiser
GREENfIECK
GREENHECK
Model
GB-141-0-X
GB-1414-X
Serial
04H19213
04H19214
P.atin
1100 CFM 0.50"
SP
725 CFM 0.50"
SP
Manufacturer
MARATHON
MARATHON
Motor HP RP.M.
1/4
1725
1/4
1725
Phase Frame
I
48Z
1
48Z
S.F. T e
1.35
SS
135
SS
Volts Am s
115
5.0
115
5.0
MotorSheave Bore
1VP30
1/2"
1VP30
1/2"
Fan Sheave Bore
AK40
3/4"
OK40
3/4"
No. Belts Size
1 3L210
1
31,200
MaunfacWrer Mudel
NONE
NONE
Instatted Thermats
Ra' Am s
Required Thermal
Ratin Am s
Fan Motor
Fan Motor
Fan Motor
CFM
Volts
1045
121
760
121
RPM
Am s
1110
5.0
925
4.4
SP.In
SP.Out
NAC
ATMOS
NAC
ATMOS
Remazks:
JEDI Balancing FAv TEST REPOxT
Project: Clear Creek Ambulatory Center
Fan Number
F-5
F-6
Ivfanufacturer
GREENIIECK
GREENHECK
Model
GB-081-6-X
GB-1804-X
Seria1
04H18964
041119240
IRating
250 CFM 0.375"
SP
1600 CFM 0375" SP
Manufacturer
MARATHON
MAItATHON
MotorHP
RP.M.
1/6
1725
1/4
1725
Phase
Frame
1
48Z
1
48Z
S.F.
T
135
SS
135
SS
Volts
Anips
115
3.6
115
5.0
MotorSheave
Bore
VP25
1/2"
1VP30
1/2"
Fan Sheave
Bore
AK39
3/4"
AK66
3/4"
No. BeTts
Size
1
3LI80
1
3L250
Manufachuer
Model
NONE
NONE
Instslled Therruals
Ratin Am s
Required Thermal
Ratin Am s
Fan
Motor
Fan Motor
Fan Motor
CFM
Volts
260
121
1605
121
RPM
Am s
1065
3.6
765
4.7
SP.In
SF.Out
NAC
ATMOS
NAC
ATMOS
Remazks:
JEDI BaLancing
FAN TEST REPORT
Project: Clear Creek Ambulatory Center
Fan Ntmiber
`
F-7
F-8
y A
_
Manufac[urer
GREENHECK
1
Model
GB-1014-%
Serial
041-30780
P,atin
250 CFM 0.375" SP
~.c
Manufacturer
MARATHON
MotorHP RP.M.
1/4 1725
Phase Frame
1 48Z
S.F. T e
135 SS
Volts Am s
115 5.0
£
a
Motor Sheave Bore
VP30 1/2"
Fan Sheave Bore
AK40 3/4"
No. Belts Size
1 3L210
Nlanufacbser Model
NONE
Installed Thermals
Ratin Am s
R uired Thermal
Ratin s)
k
Fan Motor
Fan Motor
Fan
Motor
CFM
Volts
305
121
RPM
Am s
810
4.0
SP.In
SP.Out
NAC
ATMOS
Remarks: (1) In tenaut finish. Fan nof installed yet. A=42" x 8" = 233 Sq.Ft. R=129 FPM F=132 FPM
Required CFM &om gFossing station flow rating.
JEDI Balancing FAN TEST REPORT
Project: Clear Creek Ambulatory Center
FanNumber
CUH-1
CUFI-2
- -
Manufach¢er
MESTEK
MESTEK
Model
RW-1120-03
RW-1120-08
Serial
10/06/04
10/20/04
ga'
275 CFM
1025 CFM
Manufacturer
G.E.
G.E.(1
MotorHP
R.P.M.
1115
1050
1/10-1/15 1050-1050
Phase
Frame
I
NG
1-1 NG-NG
S.F.
T e
1
NG
NG-NG NG-NG
Volts
Am s
115
0.78
115-115 134-0.78
Motor Sheave
Bore
DIRECT DRIVE
DIRECT DRIVE
Fan Sheave
Bore
No. Belts
Size
Manufacturer
Model
BUILT IN
BUII,T IN
Installed Thermals
Ra ' Am s
Re ' ed Thermal
Ratin s
Fan Motor
Fan Motor
Fan Motor
CFM
Volts
285
121
1020
119
RPM
Am s
DIRECT DRNE
09
DIItECT DRIVE
1.1-0.7
SP.In
SP.Out
ATMOS
NAC
A3'MOS
NAC
Remarks: (1) Hes 2 motors.
JEl)I Balancing FAN TEST REPORT
Project: Clear Creek Ambulatory Center
FanNumber
UH-1
'
iJH-2
Manufacturer
BEACON/MORRIS
STERLING
Model
HB-108a
HS-048
Serial
H0491574001001
P04526865001001
Itatin
150 CFM
520 CFM
„3?
Manufaclurer
MORRILL
IVIARA1T30N
Motor HP
RP.M.
9 WATTS 1550
1/6
1140
Phase
Frame
1 NG
1
NG
S.F.
Type
1 NG
1
NG
Voks
Am s
115 0.53
115
3.7
s
Motor Sheave
Bore
DIRECT DItIVE
DIRECT DRIVE
Fan Sheave
Bore
No. Belts
Size
Manuficturer
Model
NONE
NONE
Installed Thermals
Ra ' Am s
Re nired Thermal
Ftatiu Am s)
Fan
Motor
Fan Motor
Fan Motor
CFM
Volts
160
118
530
119
RPM
s
DIRECT DRIVE
0.5
DIRECT DRIVE
3.5
SP. in
SP. Out
ATMOS
ATMOS
, ATMOS
ATMOS
Remazks:
JEDI Balanc,ing FArr TEST REPOxT
Project: Clear Creek Ambulatory Center
Fan Number
iJH-3
-
Manufachuer
STERLING
Model
HS-204
Seria1
H0449100003001
Ratin
2600 CFM
• -
-
r.
Manufacturer
FASCO
Motor I3P R.P.M.
s
s
1/3
1140
Phase Frame
1
NG
S.F. Type
1
NG
Volts Am s
115
4.5
Motor Sheaue Bore
DII2ECT DRNE
Fan Sheave Bore
No. Belts Size
Manufachuer Model
NONE
Installed Thermals
Ratin Am s)
Re uired Thermal
RaAn s)
.
.
c~..
Fan Motor
Fan Motor
Fan
Motor
CFM
Voks
2575
117
RPM
Am s
DIItECT DRIVE
43
SP.In
SP.Out
ATMOS
ATMOS
Remarks:
JEDI Balancing
PUMI' TEST REPORT
Project: Clear Creek Ambulatory Center
Pump Identification
P-1
P'2
Manufacwser
B& G
B& G
~
Model
1514; 2BC 8.25" IMP
1510; 2BC 8.75" IlVIP
M
gerial
2005
2005
P
e
BASEMOUNT
BASEMOUNT
gatm
150
GPM 75 Ft. I3d
150
GPM 75 Ft. Hd
Manufachuer
A.O. SMITH
A.O. SMITH
Y
0
Motor HP
RP M.
7.5
1760
7.5
1760
0
Phase
Frame
3
S213T
3
S213T
R
S.F.
Type
1.15
SCE
1.15
SCE
Volts
Am s
230/460
.
19.2/9.6
_ m
230/460
w
19.2/9.6
.
Mamifacturer
.
r
,o
S UARE D
S UARE D
►S
Model
85025C025
85025C025
T
Instaued Thermal
ADNSTABLE
ADNSTABLE
A
R
gatin Am S
6-18
6-18
E
Re ' ed Them
Rac;n am 5
R
'Fhermals set at:
SET 9.6
SET 9.6
~
Pum OffPtessiae
12.5
PSI 29 Ft. Hd
12.5
PSI 29 Ft. Hd
M
E
Valve Shut Differential
35.9
PSI 83 Ft. Bd
36.3
PSI 84 Ft. Hd
S
Valve en Differential
30.5
PSI 70 Ft. Hd
31.5
PSI 73 Ft. Hd
U
VaIve en G.P.M.
155
152
R
Indicated Valve S '
E
D
. .
.1 e
.
~
.
._n. _
...n,
..,r:.,H . n_.
Dischar e Pressise
,
0
.
.
_
PSI Ft. Hd
0
PSI Ft. Hd
F
Sucrion Pressure
0
PSI Ft Hd
0
PSI Ft. Hd
Pressure Differential
0
PSI Ft. Hd
0
PSI Ft. Hd
N
G.P.M.
A
L
vol,~
Ams
xemarks:
JEDI Balancing
PUMP TEST REPGt2T
Project: Clear Creek Ambulatory Center
Pump Identification
P-3
P-4
Manufactuuer
B Bc G
B& G
U
Model
60 2 X 5.25 4.125"
IIvIP
60 2 X 5.25 4.125"
IMP
Serial
2005
2005
P
Type
1NLINE
INLINE
Ra '
20
GPM 15
Ft. Hd
20
GPM 15
Ft. Hd
Manufacturer
B& G
B& G
Y
0
Motor EiP
RP.M.
3/4
1725
3/4
1725
Phase
Frame
1
56Z
1
56Z
O
R
S.F.
T e
1.25
SC
1.25
SC
Voks
Am s
115/208-230
7.2/3.8-3.6
115/208-230
7.2/3.8-3.6
ivianufacdrer
S UARE D
S UARE D
Model
8536SA011
8536SA011
TA
Ivstalled Thermal
1. B12.8
1. B12.8
g
Rating (nm 5
Re uired Therms
E
R
Ratn nm s>
Thermals set at:
~
Pum OffPressiae
20.1
PSI
46 Ft. Hd
203
PSI
47 Ft. FId
M
F,
Valve Shut Differential
7.5
PSI
17 Ft. Hd
7.4
PSI
17 Ft. Hd
Va1ve en Differential
5.4
PSI
12 Ft. Hd
53
PSI
12 Ft. Ad
S
U
Valve en G.P.M.
21.9
222
R
Indicated Valve Settin
20% OPEN
20% OPEN
E
D
Dischaz e Pressure
222
PSI
51 Ft. Hd
22.4
PSI
52 Ft. Hd
F
Suction Pressure
15.8
PSI
36 Ft. Hd
16
PSI
37 Ft Hd
Pressure Differential
6.5
PSI
15 Ft. Hd
6.4
PSI
IS Ft. Hd
N
G.P.M.
20.1
20.1
A
L
voies
120
119
s
5.2
4.9
Remarks:
JEDI Balancing E T~ oRT
;
Project: Clear Creek Ambulatory Center System: RTU-1 Supply
Area Served
ouflet
' Desi
gn
Final
Final
N
t
~
No
Plan
Actual
AK
_ VEL
CFM
VEL
CFM
MIN
I-IEAT
o
es
FPB-11
1
CD
CD
290
280
2
CD
CD
290
295
3
CD
CD
290
300
4
CD
CD
290
290
5
CD
CD
290
290
6
CD
CD
290
285
TOTAL
1740
1740
1740
1740
12"/1.11
FPB-1-2
1
CD
CD
290
300
2
CD
CD
290
305
3
CD
CD
290
300
4
CD
CD
290
285
5
CD
CD
290
290
6
CD
CD
290
TOTAL
1740
1740
1740
12"/1.09
FPB-1-3
1
2
CD
CD
CD
CD
K
290
290
F
3
CD
CD
290
4
CD
CD
290
5
CD
CD
290
6
CD
CD
290
TOTAI,
1740
1750
1740
1740
12"/1.10
icemar":
JEDI Balancing
Project: Clear Creek Atnbulatory Center
AIR OUTLET
TEST REPORT
System: RTU-1 Supply
Area Served
outlet
Desi
ga
Fi
Final
Not
No
Plan
Actuat
AK
CFM
_
VEI.
CFM
MIN
HEAT
es
FPB-14
1
CD
CD
!
290
~
300
2
CD
CD
290
290
3
CD
CD
2S'J
E
295
4
CD
CD
290
'
295
5
CD
CD
290
285
6
CD
CD
290
300
TOTAL
1740
1765
1740
1740
12"11.01
FPB-1-5
1
CD
CD
100
105
2
CD
CD
300
300
3
CD
CD
400
410
4
CD
CD
125
125
TOTAL
925
940
525
925
811/1.01
FPB-1-6
1
CD
CD
200
195
100
200
6"/1.10
VAV-1-1
1
CD
CD
§
175 .
165
2
CD
CD
50
50
3
CD
CD
50
55
4
CD
CD
150
155
5
CD
CD
250
250
6
CD
CD
275
265
TOTAL
950
940
375
375
10"1134
VAV-1-2
1
CD
CD
800
810
100
100
10'Y1.26
a
s
Remarks;
JEDI Balancing
Project: Clear Creek Ambulatory Center
AIR OUTLET
TEST REPORT
System: RTIJ-1 Supply
Area Served ~
~~et f
Desi
gn ~
Final
Final
Notes
No
Plan
Actual
AK
VEL
_
CFM
. .
VEL
CFM
, .
MIN
HEAT ~
_ _
VAV-1-3
.
1
_
CD
.
CD
250
260
-
2
CD
CD
250
255
-
3
CD
CD
250 `
245
4
CD
CD
75
75
TOTAL
825
.
835
325
325
10"/135
VAV-14
1
CD
CD
500
1
VAV-1-5
1
CD
CD
175
175
2
CD
CD
125
125
3
CD
CD
275
270
TOTAL
575
570
200
200
8"/121
VAV-1-6
1
CD
CD
250
270
2
CD
CD
250
255
3
CD
CD
250
250
4
CD
CD
~
250
240
TOTAL
1000
1015
1000
1000
10"/1.09
VAV-1-7
1
CD
CD
500
495
50
50
8"/1.13
VAV-1-8
1
CD
CD
100
95
2
CD
CD
300
310
3
CD
CD
400
395
TOTAL
800
806
475
475
' 8"/1.10
iJNIT TOTAL
13,535
13,590
I
-
r
-
J
-
.
-
-
I
-
Remarks: (1) Grill not installed. Duct Capped. Install later.
JEDI Balancing
Project: Clear Creek Ambulatory Center
d ;
Outlet
Design f
EFi
nal
r
Notes
Area Serve
;
No
Plan
Actual
AK
VEL
CFM ,
CFM
_
VEL
.
CFM
_
.
RTU-1 Ret~sn '
I
SW
SW
500
510
2
CD
CD
200
205
3
CD
CD
^00
860
4
CD
CD
250
260
5
CD
CD
600
0
1
6
CD
CD
400
405
7
SW
SW
675
680
8
SW
SW
~
650
655
9
CD
CD
675
670
10
CD
CD
675
675
11
SW
SW
675
690
12
SW
SW
675
680
13
CD
CD
675
680
14
CD
CD
300
295
41
15
CD
CD
400 ~
390
16
CD
CD
675 '
705
" 17
SW
SW
400
410
18
CD
CD
200
200
19
SW
SW
400
405
TOTAL
9925
9375
a
s
aTu OUTLET
TEST REFORT
System: RTU-1 Return
Remazks: (1) Grill not installed.
JEDI Bulaneing
Project: Clear Creek Ambulatory Cenier
AIR OUTLET
TFST REPORT
System: RTU-2 Supply
d az
A
S
outlet a
Desi
gn `
Fina1
Final
Notes
erve
rea
No
Plan
Actual
_
AK
_
VEL
_ - -
CFM
. VEL
CFM
MIN
HEAT .
. , .
FPB-2-1
_ _
1
.
CD
.
.
CD
.
.
225
230
2
CD
CD
225 i
235
3
CD
CD
225 '
220
4
CD
CD
225
225
5
CD
CD
225
230
TOTAL
1125
1140
625
1025
12"/0.82
FPB-2-2
1
CD
CD
100
100
2
CD
CD
200
195
3
CD
CD
200
205
4
CD
CD
200
200
5
CD
CD
200
205
TOTAL
900
905
450
800
8"/1.12
FPB-2-3
1
CD
CD
225
230
2
CD
CD
275
265
TOTAL
500
495
350
600
8"/0.94
FPB-24
1
CD
CD
300
300
125
225
6"/0.92
FPB-2-5
1
CD
CD
1
1
225
220
2
CD
CD
100
100
3
CD
CD
225
225
TOTAL
'
550
545
250
450
8"70.95
Remarks:
JEDI Balancing
Project: Clear Creek Ambulatory Center
ATR OUTLET
TEST REt ORT
System: RTU-2 Supply
S
d
A
Outlet
Desi
gn
F
Final
Notes
rea
erve
Plan
Actual
AK
VEL
CFM
VEL
CFM
MIN
HEAT
VAV-2-1
r
CD
CD
475
480
2
CD
CD
325
330
CD
CD
150
145
4
CD
CD
125
120
5
CD
CD
75
75
TOTAL
1150
"
1150
300
300
12"/1.48
VAV-2-2
1
CD
CD
75
80
2
CD
CD
150
145
3
CD
CD
75
75
4
CD
CD
175
170
5
CD
CD
75
80
6
CD
CD
75
80
TOTAL
625
630
200
200
8"/1.30
VAV-2-3
1
CD
CD
125
0
1
2
CD
CD
275
305
3
CD
CD
100
110
4
CD
CD
125
.
135
5
CD
CD
100
115
6
CD
CD
100
115
7
CD
CD
100
105
S
CD
CD
100
110
~
9
CD
CD
100
110
10
CD
CD
100
115
TOTAL
1225
1220
500
500
12"/1.20
,
,
Remarks: (1) Grill not instalfed. Set VAV for total flow and propo.-ci'oned at that flow.
JEDIBalancing ~s ROUTLET
EPORT
,
Project: Clear Creek Axnbulatory Center System: RTU-2 Supply
ed °
A
S
r
Outlet 1
Desi
gn
Final
Final
Notes
rea
e
v
-
No
Plan
Actual
AK
.
VEL
CFM
VEL
CFM
.
MIN
HEAT
_ ~
-
_ .
VAV-24
.
1
-
CD
-
CD
.
75
80
.
.
2
CD
CD
75
75
3
CD
CD
100 '
95
4 CD CD 100 105
TOTAL 350 355 200 200 6"/1.04
VAV-Z-S 1 CD CD 325 315
2 CD CD 175 175
I iJNIT TOTAL
JEDI Balancir 14IR OUTLF,T
g TEST REPORT
;
Project: Clear Creek Ambulatory Center System: RTU-2 Return
d '
S
OuUet
Design
Final
t
Notes
erve
Area
No
Plan
Actuat
AK +
VEL
- -
CFM
VEL
CFM
-
VEL
-
CFM -
_
.
RT[J-2 Rehun
~
1
_
CD
.
CD
-
150 ,
570
(2
2
CD
CD
475
405
'
3
CD
CD
350
0
1
4
CD
CD
700
580
~
5
CD
CD
75
60
6
CD
CD
75
65
7
CD
CD
775
625
8
CD
CD
775
630
9
CD
CD
1050
0
1
10
CD
CD
100
85
11
CD
CD
100
85
12
CD
CD
375
315
13
CD
CD
475
400
14
CD
CD
340
280
15
CD
CD
340
285
16
CD
CD
340
275
TOTAL
6495
_
4660
k
P
Remarks: (1) Grill not mstalled Not hooked up to duct. (2) No damper.
JEDI.~alancing m~ ~OUTLET
pORT
;
Project: Clear Creek Ambulatory Genter System: RTU-3 Supply
Served ~
A
Outlet
Desi
gn
Final
Final
Notes
rea
No
Plan
Actual
AK
_
VEL
_
CFM .
_
VEL
.
CFM
MIN
_ .
HF.AT
.
.
.
_ .
FPB-3-1
_
I
.
SW
SW
_
735
.
.
.
. . .
.
1)
2
SW
SW
735 _
-
3
SW
SW
735
TOTAL
2205
1200
2700
14"
FPB-3-2
1
SLOT
SLOT
150
150
2
SLOT
SLOT
150
155
3
SLOT
SLOT
150
160
4
SLOT
SLOT
150
165
TOTAL
600
630
450
900
8"/1.02
FPB-3-3
1
CD
CD
100
100
2
CD
CD
100
105
3
SLOT
SLOT
200
210
4
SLOT
SLOT
200
200
5
SLOT
SLOT
200
195
6
SLOT
SLOT
200
205
7
SLOT
SLOT
200
200
ry 8
SLOT
SLOT
200
210
TOTAL
1400
1425
500
1000
12"10.96
FPB-3-5
1
SW
SW
650
645
100
200
8
8"/0.92
5
~
~
Remarks: (1) Low airIlow. Cannot Balance.
JEDI Balanci;tg
Project: Clear Creek Ambulatory Center
AIR OUTT ,ET
TEST REPORT
System: RTU-3 Supply
Area Served `
Ouflet
Desi
gn
~ Final
Final
'
Notes
-
No
Plan
Ac[ual
AK
VEI.
CFM
VF.I,
CFM
bIlN
HEAT
FPB-3-6
I
CD
CD
200
205
2
CD
CD
165
170
TOTAL
365
375
80
380
6'Y0.75
FPB3-7
1
CD
CD
250
250
,
2
CD
CD
250
.
255
TOTAL
500
505
80
580
6"10:95
FPB-3-8
I
CD
CD
225
220
2
CD
CD
225
225
TOTAL
450
445
80
530
6"/0.60
F
R
~
s
T
i
~
2
9
H
Remarks:
JEDI Balancing
Project: Clear Greek Ambulatory Center
AIR OUTLET
TEST REPORT
System: RTLT-3 Supply
d ?
A
S
Outlet ~
Desi
gn
Final
Final
Notes
.
rea
erve
No
Plan
Actual
AK
-
VEL
-
CFM
VFS,
-
CFM
MIN
IIEAT
. ,
.
VAV-3-1
_
1
SWR
.
SWR
.
250
255
2
SWR
SWR
250
250
3
CD
CD
125
125
4
CD
CD
225
230
e
TOTAL
850
860
150
150
8"/138
VAV-3-2
1
CD
CD
325
320
2
CD
CD
325
330
3
CD
CD
600
600
TOTAL
1250
1250
200
200
12"/137
VAV-3-3
1
CD
CD
225
230
75
75
4"/1.44
VAV-3-4
1
CD
CD
300
310
2
CD
CD
300
290
TOTAL
600
600
75
75
8"/1.31
VAV-3-5
1
CD
CD
200
200
2
CD
CD
130
,
130
3
CD
CD
130
135
4
CD
CD
130
130
5
CD
CD
80
75
TOTAL
~
670
~
670
150
150
8"/0.82
iJNIT TOTAL
9765
7635
~
G
Remarks:
JEDI Balanc~ng
Project: Clear Creek Ambulatory Center
AIR OU'I'T ET
TEST REPORT
System: Exhauts
S
d
A
outlet `
Desi
gn
Final
Notes
rea
erve
No
Plan
Actual
AK
VEL
CFM
-
VEL
- -
CFM
VEL
CFM
F-1
1
~
ER
ER
100
105
2
ER
ER
300
305
TOTAL
400 :
'
410
F-3
1
ER
EB
125
120
2
ER
ER
350
335
3
ER
ER
125
120
4
ER
ER
75
70
5
ER
ER
75
70
TOTAL
6
ER
ER
~
350
1100
330
1045
F-4
1
ER
ER
125
120
2
ER
ER
125
130
3
ER
ER
100 ;
b
105
4
ER
ER
100
-
105
5
ER
ER
100
95
6
ER
ER
100
105
7
ER
ER
100
100
TOTAL
750
760
EF-8
I
ER
ER
50 ,
(1)
2
ER
ER
80
3
ER
ER
25
4
ER
ER
115 '
TOTAL
270
i
~
Remarks: (1) rannot installed
JEDI Balancing VALVE TEST REPORT
Project: Clear Creek Ambulatory Center System: Heating Water
D
i
Measured
Station
RTU-1 ~
V~Vee
GffiSWOLD
Size
19.8CV
es
gn
GPM
13.4
Design D/P
18
D/P
Final
D/P
Final
GPM
Balance
Valve
50%
RTU-2
GRISWOLD
9.OCV
7.6
22
50%
RT[J-3
GRISWOLD
9ACV
11.5
18
50%
CI7fi-1
GRISWOLD
1.6CV
1.8
40
50%
CF.TH-2
GRISWOLD
7.OCV
6.1
27
50%
UH-1
GRISWOLD
1.6CV
1.9
50
500/o
UH-2
GRISWOLD
3.8CV
2.5
19
50010
IJFi-3
GRISWOLD
19.8CV
14.5
22
50010
FI'R-1 SOUTH
GRISWOLD
0.72CV
2.1
200
100%
FTR 1 WEST
GRISWOLD
0.72CV
2.1
200
100%
~
Remazks:
JEDI Balancing
VALVE TEST REPORT
Project: Clear Creek Ambulatory Center System: Heatiag Water
Measured
Station
Balance
Valve
_
S~
D~
Final
D/F
Final
GPM
Balance
Valve
VAV-1-1
GffiSWOLD
1.6CV
100% 1
VAV-1-2
GRISWOLD
~.72CV
t
50%
VAV-1-3
GRISWOLD
0.72CV
100%
VAV-1-4
GRISWOLD
092CV
50°/ 1
VAV-1-5
GRISWOLD
0.72CV
50% 1
VAV-1-6
GffiSWOLD
3.8CV
2A4
7
1000/.1)
VAV-I-8
GRISWOLD
1.6CV
13
21
100%
VAV-2-1
GffiSWOLD
0.72CV
0.7
24
100%
VAV-2-2
GRiSWOLD
0.72CV
0.5
12
50%
VAV-2-3
GRISWOLD
1.6CV
12
17
50%
VAV-2-4
GRISWOLD
0.72CV
0.5
12
100%
VAV-2-5
GRISWOLD
0.72CV
0.5
12
50%
VAV-3-1
GRISWOLD
0.72CV
0.5
12
0% 3
VAV3-2
GRISWOLD
0.72CV
0.5
12
0%(2
VAV-3-3
GRISWOLD
0.72CV
0.5 ~
12
70%
VAV3-4
GRISWOLD
0.72CV
0.5
12
75%
VAV-3-5
GRISWOLD
034CV
0.5
56
60%
TOTAL
13
Remazks: (1) Stuck. (2) No control valve. (3) No Flow.
VALVE TEST REPORT
JEDI Balancing
Project: Clear Creek Ambulatory Center System: Heating Water
y
Measured
Starion
. ..F,.a.
FPB-1-1
B~a°ce
Valve
GRISWOLD
S~
. rF-~.
3.8CV
Design
GPM
4.8
, Design D/P
71
D/P
Final
D/P
Final
GPM
Balance
Valve
50%
FPB-1-2
GRISWOLD
3.8CV
4.8
71
50%
FPB-1-3
GRISWOLD
3.8CV
4.8
71
50%
FPB-14
GRISWOLD
3.8CV
4.8
71
75%
FPB-1-5
GRISWOLD
1.6CV
1.5
28
75%
FPB-1-6
GRISWOLD
092CV
0.5
12
500/o
FPB-2-1
GRISWOLD
1.6CV
1.8
40
50010
FPB-2-2
GRISWOLD
1.6CV
1.4
24
50%
FPB-2-3
GRISWOLD
1.6CV
1.1
15
1000/o
FPB-2-4
GRISWOLD
0.72CV
0.5
12
100%
FPB-2-5
GRISWOLD
0.72CV
0.8
31
100%
FPB3-1
GRISWOLD
1.6CV
3.4
142
50%
FPB3-2
GRISWOLD
1.6CV
13
21
500/o
FPB-3-3
CfRISWOLD
1.6CV
1.4
24
50%
FPB-3-5
GRISWOLD
0.72CV
0.5
12
50%
FPB-3-6
GRISWOLD
034CV
0.5
56
50%
FPB3-7
GRISWOLD
0.34CV
0.5
56
50%
FPB-3-8
GRISWOLD
034CV
0.5
56
50%
TOTAL
34.9
R
~
Remarks:
JEDI Balancing
Project: Cleaz Creek Ambulatory Center
Location:
VELGR TD
TRAVERSE REPORT
syscem: x-FU-i suPply
Air Temp. (F):
DUCT
SIZE: 40" X 14" SQ.FT.: 3.89
REQiTIItED
FPM: CFM:
INITIAL MEASUREMENT
FPM: 1662 CFM: 6465
Number of Readings: 18
. ,
y
1 2 4 5
STATIC PRESSURES
Initial: 0.62" Final:
6 7 8 9
Final CFM by Fan Law #2:
10 11 12 13 14 15
1
3270
2760
[22
1959
2900
3112
2
2304
107
1355
1449
2626
3
1140
0
0
569
627
1690
4
5
6
7
8
9
10
11
12
13
14
15
NOTE: All measurements are correc{ed £or altitude and temperature.. Velgrid is 12"X12" with 16 averaging points.
Remazks:
JEDIBalancing
Froject: Cleaz rreek Ambulatory Center System:
I,pcafint1;
VELGRID
'!'RAVERSE REPORT
RTU-1
Air Temp. (F):
DUCT
SIZE: 28 X 14" SQ.FT.: 2.72
REQUIItED
FPM: CFM:
INITIAL MEASUREMENT
FPM: 1973 CFM: 5365
Number of Readings: 16
_Ya_.__ . _`%.~.'"E~Ss:~ , a.. 'Y' :
r~N V°+1 2 3 4 5
STATIC PRESSURES
Initial: 1.05" Final:
: A "~a,_ :3s~Jk'. .'..a3.w.n,"`
6 7 8 9
Final CFM by Fan Law #2:
:w° -"¢f~?' ..z..
10 11 12 13 14 15
1
1963
1905
1897
1962
2169
2
1759
1843
2047
2205
1759
3
1694
2059
2103
2268
1919
4
5
6
7
8
9
10
11
12
13
14
15
NOTE: All measurements are corrected for attitude and temperattse. Velgrid is 12"X12" with 16 aveiaging poinu.
Remazks:
~
j oon 1Vledical
~ MEDICAL GAS & VACUUM SPECIAUSTS
16124 Foster Overland Park KS 66085
Telephone: (913) 681-5548
FAX: (913) 681-8878
E=Mail: almoon@moonmedicai.com
MEDICAL GAS & VACUUM
REPORT
Clear Creek Ambulatory Surgery Center
Wheat Ridge, CO.
February 2005
Moon Medical Inc / Medical Gas & Vacuum Certification
Q61ED24 4I1 ICAL GAS CUU SPECIALISTFoster Overland Park: KS 66085
Telephone: (913) 689-6548
FAX: (913) 681-8878
INSTALLER TESTING AFFIDAVIT
Certificate of Installation of the Medical Ga's Piping Systems
Facility: Clear Creek Ambulatory Surgery Center / Wheat Ridge CO
Contractor: Trinity Mechanical
This is to certify that through periodic observation during construction and by
documentation, tests and certification records the referenced medical gas piping
system has been installed in accordance with the National Fire Protection
Association / NFPA-99C Gas and Vacuum Systems 2002 Edition for Health Care
Facilities Chapter 5(#5.1.12.2) as indicated below.
1. W ritten documentation certifying that all installed piping materials comply with the requirements of
sections Chapter 5 (#5.1.12.2)
2. Verification that the brazing filler metals and installations procedures specified was used according
to chapter 5.
3. Written documentation that installers and brazers have been trained and tested for proper
installation methods for medical gas pipe.
4. Written documentation that the 24-hour standing pressure test, at 20 percent above the normal
operating line pressure listed in section 5.1.12.2 was performed.
5. Labeling of the medical gas tubing with gas content, operating pressures directional arrows and
color-coding.
Copies of all required documentation, test and certification records have been made part of the
facility's permanent records.
I certify all statements contained herein are true and correct.
Installer Signature:~„l,/,6, ..................................Date: d,~-pP; ~7s"
*r4 oanAS & V SPECI A i~IeACUUM .~.cain c.
Foster, Overland Park, KS 66085
Telephone: (913) 681-6548
FAX: (913) 681-8878
almaon@moonmedical.com
Oxygen Analyzer: Ceramatec SIN FE0195-5361 MAX02 OM-25A 1 Calibrated Dec. 01, 2004 R before used.
Nitrous Oxide; Geotech SINN0016 Medigas FP991 Calibrated Dec. 01, 2004 S before used.
Nitrogen Analyzer: Ceramatec SIN FE0195-5361 MAX02 OM-25A I Dec, 01, 2004 & before used.
C02 Analyzer: Geotech SINN0016 Medigas FP991 pec. 01, 2004 & before used.
+TRI I Austin TX I Test Tubes
+ Certified Medical Testing I Murrieta, CA 1 Bag Samples
CO Analyzer: Geotech SINN0016 Medigas FP99 / Dec. 01, 2004 & before used.
+ TRI I Austin TX I Test Tubes
+ Certified Medical Testing I Murrieta, CA I Bag Samples
CO Analyzer: Med-Con Model A332 SINA332-18 / Dec. 01, 2004 & before used.
Gas Mixture: TRI 1 Austin TX / Test Tubes
+ Certified Medical Testing I Murrieta, CA 1 Bag Samples
Dew Point: Ohmic Instrument SIN 1272 Airline Meter #AMM-151 Dec. 01, 2004 & before used.
Particulate Sampling: Oahu's SIN A-9887 Model #AS120-S2 1 Calibrated on Site
Vacuum: Dwyer Gauges S/N 7112-G39 Vacuum Gauge 1 Dec. 01, 2004
Halogenated Hydrocarbon: TRI I Austin TX I Test Tubes
+ Certified Medical Testing 1 Murrieta, CA 1 Bag Samples
Hydrocarbon as Methane: TRI I Austin TX I Test Tubes
+ Certified Medical Testing I Murrieta, CA I Bag Samples
Foxboro Miran 203 CA111 SIN 002141 Calibrated and Zero on Site
Equipment
Pressure Gauges; Meriam Instruments SIN MPH08001 Merigauge #39001 Dec. 01, 2004
Flow Meter: Dwyer SIN S08L RMC-121 / Dec. 01, 2004
NOTES:
Medical ~c.
C*oon
CAL GAS & VACUUM SPECIALISTS
16124 Foster, Overland Park, KS 66085
Telephone: (913) 681-6548
FAX: (913) 681-8878
E-Mail: almoon@moonmedical.com
Facitity: Clea* Creek Ambulatory Center / Wheat Ridge, CO
Purchase Order Number: Trinity Mechanical
Contact: John Vonfeldt
This reflects the services described in the Medicai Gas Distribution System Inspection
Agreement ("Agreement"). The agreement states that verification of installed Medical Gas
Piping Equipment shall be made to help determine that the recommendations of the National
Fire Protection Association (NFPA 99) Standards for Health Gare Facilities, 2002 Edition, were
followed. Gas System Performance Criteria and Testing NFPA 99C Chapter 5
. Cross-Connection Test. All medical gases and vacuum shall be 2duced to atmosp`aric pressure. AIl sources of test gas from all of the
medical gas systems, with the exception of the one to be checked, shall be disconnected. Each individual station outiets/inlets shall be
checked to detertnine that test gas is being dispensed only from the outlets being tested. That the gas delivered at the outlet is that shown
on the outlet label and that the proper connecting fittings are checked against their Iabels and latch valves.
• Gas & Vacuum Warning Test All mediral gases and vacuum shall be tested for alarms. All source equipment shall be tested for 8's
performed per 43.5.3. Each individual waming alertn shall be checked to determine that an audible and noncancellable visual signal is
indicated'rf the p2ssures increase or decrease in pressure by 20 percent and if the medical vacuum decrease to 12 hg.
• Valve Test That the valves instailed in each medical gas and vacuum piping system shall be tested to verity proper operation. Zane valve
boxes shall be labeled for the rooms or areas controlled.
• Outlet Flow Test That all medical gases and vacuum shail 6e tested for flow. Oxygen, medical air, nitrous mcide shall deliver 3.5 SCFM
with pressure drop of no more than 5 psig and static pressure of 50 psig 0/+5. Nitrogen outlets shall deliver 5. SCFM with pressure drop of no
more than 5 psig and static pressure of 160 psig. Medical vaeuum shall tleliver 3. SCFM wRhout reducing vacuum pressure below 12 in. Hg
at an adjacent station inlet and maintain a vacuum of 12 in of inercury (hg) at the station inlet farthest away from the centrzl vacuum source.
• Piping Purge Test. In order to remove any treces of particulate matter, a heavy, intermittent purging of the pipeline shall be pertortned.
Purge shall product no discoloration in a white cloth and the test gas used during the previous tests shall be removed from the piping
systems.
• Medical Gases Concentration 7est. EacFt pressure gas source and outlet shall be analyzed for concentration of gas, by volume with
instrumant desjgned to measure the specific gas dispensed. Ouygen 99 plus percent, Nitrous Oxide 99 plus percent, Nitrogen Less than 1
percent oxygen, and Medical Air 79.5 to 23.5 percent mcygen. This inspection was perFormed on the date noted and was found to be in compliance with the conditions listed above.
A detailed report listina the areas and/or rooms checked is attached as oaeP 217 nf tnis anraor„on+
O en
Medical Air
Vacuum/WAGD
Nitrous Oaide
Carbon Dioxide
f~J
0
Q
Q
~
Febniary 07, 2005 1
A1 Moon CMGV #002
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Medical ~c.
C*oon
CAL GAS & VACUUM SPEC~ALISTS
16124 Foster Overland Park, KS 66085
Telephone: (913) 681-6548
FAX: (913) 681-8878
E-Mail: moonmedicalinc(a)cs.com
MEDICAL VACUUM PUMP TEST REPORT
Facili
Clear Creek Ambulato Center
Ci , State
Wheat Rid e, CO
Confi uration
Du lex
HP
5
Area Served
Hos ital / Center
Date
Februa 07, 2005
Location
178
Ins ector s
AI Moon CMGV #002
Manufacturer
Air Tech
T e of Pum
D Vane
Modei #
#439 Job 208-3-60
Seriai #
SCSKRA102SCANNFPA
YES
NO
Is the system dedicated to Medical use?
Is the pump located separately from manifold locations?
Q
Are isotation valves installed on each pump and drip legs?
Are check valves instailed on each pump?
E]
Are flex conrtectors instalied on each pump?
~
Is system fed by emergency power system? Verified by whom?
p
Is each pump provided with separate disconnect, overload?
Q
Are there two control transformers?
Is there an automatic alternator?
Q
Are running time approximately equal?
p
Does the receiver have a three-valve bypass installed?
0
Does the receiver have a drain?
Does the receiver have a pressure gauge?
p
Is the receiver corrosion resistant?
p
Is the receiver ASME labeled?
Is there a properly installed source valve?
p
Is it properly laheled?
Q
High/low pressure alarm activates master alarms?
p
Main gauge visible from standing position?
p
Medical Vacuum demand check valve installed in gauge/switch?
~
Does the lag alarm activate master alarms?
~
Is the exhaust outside?
Q
Is the exhaust 10 feet from any door, window or opening?
0
Is the exhaust turned down and screened?
~
Is the exhaust run with copper, galvanized or stainiess steel?
Q
Is it wired to local alarm?
0
1Viedical~e.
C)~to.on
& VACUUM SPECIALISTS
16124 Foster Overland Park, KS 66085
Telephone: (913) 681-6548
FAX: (913) 681-8878
E-Mail: moonmedicalinc(")a.cs.com
MEDICAL GAS MANIFOLD
TEST REPORT
Facili
Clear Creek Ambulato Center
Ci , State
Wheat Rid e, CO
Confi uraYion
Automatic
Tank #
2X2
Area Served
Hos ital / Center
Date
Februa 07, 2005
Location
Bottle Stora e Rm. 176
Ins ector s
AI Moon CMGV #002
Manufacturer
Allied Healthcare
T e of Unit
Nitrous Oxide
Model #
86-63-2100 #3000
Serial #
200406020001
YES
NO
Verity automatic alternation?
p
Shut-Off Vaive Per Header BaR
0
Shut-Off Vaive Main Line?
0
Warning LighY?
~
IS system fed by emergency power system? Verified by whom?
Q
Dual Line Regulators?
~
Relief Valves To The Outside (except medical air)?
p
Is it properiy labeled?
0
No leaks Detected?
0
Area Posted ( No Smoking
0
Enclosed With Locking Entry?
~
Interior Location Vented?
~J(
Free From Flammable Liquids and Gases?
~
Electric Switch and putlets Above 1.5 Meters (5 Feet)?
Q
Cylinders Are Individuaily Chained or Secured?
p
Area Is Not Ecposed To Temperatures Above 54.4 C(130 F)?
[J(
Area IS Not Exposed To Temperatures Below -7 C(20 F)? (Nitrous Oxide and
Carbon Dioxide
[J(
High/low pressure alarm activates master alarms?
Q
Main gauge visible from standing position?
p
Medical Gas demand check valve installed in gauge/switch?
0
Is the exhaust turned down and screened?
0
Is the exhaust run with copper, gaivanized or stainless steei?
Q
PSIG
Pressure Main Line
50
CXoon Medical rnc.
AL GAS & VACUUM SPECIALISTS
16124 Foster Overland Park, KS 66085
Telephone: (913) 681-6548
FAX: (913) 681-8878
E-Mail: moonmedicalincCa)cs.com
MEDICAL GAS MANIIFOLD
TEST REPORT
Facili
Clear Creek Ambulato Center
Ci , State
Wheat Ri e, CO
Confi uration
Automatic
Tank #
2X2
Area Served
Hos ital / Center
Date
Februa 07, 2005
Loca6on
Bottle Stora e Rm. 176
Ins ector s
AI Moon CMGV #002
Manufacturer
Allied Healthcare
T e of Unit
Medical Air
Model #
86-64-2100 #3000
Serial #
200406023002
YES
NO
Verity automatic alternation?
C!
t-Off Valve Per Header Bar?
0
Off Valve Main Line?
R
~
Warning Light?
C~(
Is system fed by emergency power system? Verified by whom?
C~f
Dual Line Regulators?
0
Retief Vaives To The Outside (except medical air)?
Q
Is it properly labeled?
I~J
Noleaks Detected?
0
Area Posted (No Smoking
0
Enclosed With Locking Entry?
Ef
Interior Location Vented?
0
Free From Flammable Liquids and Gases?
G~J
Electric Switch and Outlets Rbove 1.5 Meters (5 Feet)?
~
Cylinders Are Individually Chained or Secured?
[~7
Area Is Not Exposed To Temperatures Above 54.4 C(130 F)?
[JJ
Area Is Not Exposed To Temperatures Below -7 C(20 F)? (Nitrous Oxide and
Carbon Dioxide
0
Migh/low pressure alarm aCtivates master alarms?
Main gauge visible from standing position?
0
Medical Gas demand check valve installed in gauge/switch?
p
Is the exhaust tumed down and screened?
~
Is the exhaust run with copper, galvanized or stainless sYeel?
0
PSIG
PreSSUre Main Line
60
~Iedical~c.
C*-oon
CAL GAS & VACUUM SPECIAIiSTS
16124 Foster Overland Park, KS 66085
Telephone: (913) 681-6548
FAX: (913) 681-8878
E-Maii: moonmedicalincacs.com
MEDICAL GAS MANIFOLD
TEST REPORT
Facili
Ciear Creek Ambulato Center
Ci , State
Wheat Rid e, CO
Confi uration
Automatic
Tank #
2X2
Area Served
Hos ital / Center
Date
Februa 07, 2005
Location
Bott1e Stora e Rm. 176
Ins ector s
AI Moon CMGV #002
Manufacturer
Allied Healthcare
T e of Unit
Carbon Dioxide
Model #
86-65-2100 #3000
Serial #
200406028002
YES
NO
Verity automatic altemation?
Q
Shut-Off Valve Per Header Bai?
R(
Shut-Off Valve Main Line?
0
Warning Light?
Q
Is system fed by emergency power system7 Verified by whom?
~
Duai Line Regulators?
0
Relief Valves To 7he Outside (except medical air)?
m
Is it properly labeled?
0
No leaks Detected?
Q
Area Posted ( No Smoking
EI
Enclosed With Locking Entry?
0
Interior Location Vented?
El
Free From Flammable Liquids and Gases?
0
Electric Switch and Outlets Above 1.5 Meters (5 Feet)?
0
Cylinders Are Individually Chained or Secured?
Ef
Area Is Not Exposed To Temperatures Above 54.4 C(130 F)?
0
Area Is Not Exposed To Temperatures Below -7 C(20 F)? (Nitrous Oxide and
Carbon Dioxide
[JJ
High/low pressure alarm activates master alarms?
p
Main gauge visible from standing position?
C~I
Medicai Gas demand check vaive installed in gauge/switch?
p
Is the exhaust tumed down and screened?
Q
Is the ezhaust run with copper, galvanized or stainless steel?
0
PSIG
Pressure Main Line
50
C) jqon.Medica1i4,c,
,ECAL GAUUM SPECIALIS
16124 Foster Overiand Park, KS 66085
Telephone: (913) 681-6548
FAX: (913) 681-8878
E-Mail: moonmedicalincCc~cs.com
MEDICAL GAS MANI;FOLD
TEST REPORT
FaCili
Clear Creek Ambulato Center
Ci , State
Wheat Rid e, CO
Confi uration
Automatic
Tank #
1 X 1 Li uid Reserve C linders 4
Area Served
Hos ital / Center
Date
Februa 07, 2005
Location
Bottie Stora e Rm. 176
tns ector s
AI Moon CMGV #002
Manufacturer
Victor
T e of Unit
O en
Model #
VM1100
Serial #
FL01906
YES
NO
Verity automatic alternation?
[~7
Shut-Off Valve Per Header Bar7
Q
Shut-Off Valve Main Line?
Q
Waming Light?
p
Is system fed by emergency power system? Verified by whom?
0
Dual Line Regulators?
Q
Relief Valves To The Outside (except medical air)?
~
Is it properry labeled?
H
No leaks Detected?
C~f
Area Posted ( No Smoking
C~1
Enclosed With Locking Entry?
C~(
interior Location Vented?
0
Free From Flammable Liquids and Gases?
0
Electric Switch and Outlets Above 1.5 Meters (5 Feet)?
[JJ
Cylinders Are Individually Chained or Secured?
0
Area Is Not Exposed Fo Temperatures Above 54.4 C(130 F)?
p
Area Is Not Exposed To Temperatures Below -7 C(20 F)? (Nitrous Oxide and
Carbon Dioxide
Q
High/low pressure alarm activates master alarms?
0
Main gauge visible from standing position?
0
Medical Gas demand check valve instailed in gauge/switch?
Is the exhaust turned down and screened?
~
Is the exhaust run with copper, galvanized or stainless steel?
0
PSIG
Pressure Main Line
54
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7500 West 29th Avenue The City of
Wheat Ridge, Colorado 80033 Wheat
Telephone 303/235-2846 Ridge
May 16, 2005
COURTESY ADDRESS NOTIFICATION
NOTIFICATION is hereby given that the following address has been assigned to the property/properties as
indicated below:
PROPERTY OWNER(S): Wheat Ridge Medical Properties LLC 7821 W. 38`~ Ave. Wheat Ridge, CO 80033
Clear Creek MOB LLC ] O55 Auraria Pkv Ste. 300, Denver, CO 80204
OLD ADDRESS: Phase 4:7809 W. 38~' Ave. Wheat Ridee, CO 80033 (new buildine)
NEW ADDRESS(ES): 7809 W 38'h Avenue Suite 100 Wheat Ridge, CO 80033 (core space)
7809 W. 38`h Avenue, Suite 200, Wheat Ridge, CO 80033 (Dc EnQen's office)
SUBDIVISION: Zephvr Medical Commons LOT(s) 2 BLOCK
NOTES: See attached site plan and official address notiTcation dated May 5, 2004.
AUTHORIZED BY: DATE:
DISTRIBUTION:
1. Property Owner
2. Jefferson CounTy Assessor, ATTN: Data Control, 100 Jefferson County Parkway, Golden, 80419
3. Jefferson County Mapping, ATTN: Addressing, 100 Jefferson County Parkway, Golden, 80419
4. U.S. Post Office, 4210 Wadsworth Blvd., Wheat Ridge, 80033
5. Xcel Energy, ATTN: Correspondence, P.O. Box 840, Denver, 80201
6. Qwest Communications, Attn: Shirley Campbell, 12121 Grant Street, Room 601, Thomton, CO 80241
7. Comcast, Attn: Jon Alvino, 6793 W. Canyon Ave., 413C, Littleton, CO 80128
8. WaterDistrict: WheatRidQe
9. Sanitation District: Wheat RidQe
10. Fire District: Wheat Rid¢e
11. Wheat Ridge Planning Division
12. Wheat Ridge Building Division
13. Wheat Ridge Police Department
14. Log File
15. Other.
NOTE: Please notify all other parties concerned.
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Wheat Ridge, Colorado 80033
303/235-2846
Ridge
NOTIFICATION is hereby given tfiat the following address has been assigned to the property/propeRies as
indicated betow:
PROPERT'P OWNER(S): Wheat Ridge Medical Prooerties LLC 7821 W 38' Ave Wheat Rid¢e. CO 80033
Clear Creek MOB LLC 1055 Auraria Pkv. Ste. 300 Denver. CO 80204
OLD ADDRESS(ES): 3800 Zenhvr Dr Wheat Ridee CO 80033
NEW ADDRESS(ES): Phase 3• 7821 W 38m Ave Wheat Ridae CO 80033 (existine buildin¢)
Phase 4• 7809 W 38' Ave Wheat Rid¢e CO 80033 (new oroposed buildin¢)
SUBDIVISION: Zej)hvr Medical Commons LOT(s) 2 BLOCK _
NOTES: See attached site plan.
AUTfIORIZED BY: DATE: S- 5~v y
DISTRIBUTION:
1. Property Owner
2. Jefferson Counry Assessor, ATTN: Data Control, 100 Jefferson Counry Parkway, Golden, 80419
3. Jefferson Counry Mapping, AT'IN: Addressing, 100 Jefferson CounTy Parkway, Golden, 80419
4. U.S. Post Office, 4210 Wadsworth Blvd., Wheat Ridge, 8003
5. Xcel Energy, ATTN: Correspondence, P.O. Box 840, Denver, 80201
6. Qwest Communications, Attn: Shirley Campbell, 12121 Grant Street, Room 601, Thomton, CO 80241
7. Comcast, Attn: Jon Alvino, 6793 W. Canyon Ave., #13C, Littleton, CO 80128
8. Water District: Wheat Rid e
9. Sanitation District: Wheat Rid¢e
10. Fire District: Wheat Ridge
11. Wheat Ridge Planning Division
12. Wheat Ridge Building Division
13. Wheat Ridge Police Department
14. Log Fite
15. Other.
NOTE: Please notify all other parties concerned.
ADDRESS MAP UPDATED BY:
"The Garnation City"
The City of
Wheat
DATE:
OFFICIAI. ADDRESS NOTIFICATION
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1 of 5
7500 West 29th Avenue The City of
Wheat Ridge, Colorado 80033 Wheat
Telephone 303/235-2846 Ridge
May 5, 2004
OFFICIAL ADDRESS NOTIFICATION
NOTIFICATION is hereby given that the following address has been assigned to the property/properties as
indicated below:
PROPERTY OWNER(S): Wheat Ridee Medical Prouerties LLC 7821 W 38'" Ave Wheat RidQe. CO 80033
Cleaz Creek MOB LLC 1055 Auraria Pkv. Ste 300 Denver. CO 80204
OLD ADDRESS(ES): 3800 Zenhvr Dr Wheat Ridge CO 80033
NEW ADDRESS(ES): Phase 37 7821 W 38' Ave Wheat Ridee CO 80033 (existine buildin¢)
Phase 47 7809 W 38' Ave Wheat Ridee CO 80033 (new nronosed buildine)
SUBDIVISION: Zeohvr Medical Commons LOT(s) 2 BLOCK
NOTES: See attached site plan.
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AUTHORIZED BY: DATE: S- 5-v
IV
DISTRIBUTION:
1. Property Owner
2. Jefferson County Assessor, ATTN: Data Control, 100 Jefferson County Parkway, Golden, 80419
3. Jefferson County Mapping, A7"CN: Addressing, 100 Jefferson County Parkway, Golden, 80419
4. U.S. Post Office, 4210 Wadsworth Blvd., Wheat Ridge, 8003
5. Xcel Energy, A1"TN: Correspondence, P.O. Box 840, Denver, 80201
6. Qwest Communications, Attn: Shirley Campbell, 12121 Grant Street, Room 601, Thomton, CO 80241
7. Comcast, Attn: Jon Alvino, 6793 W. Canyon Ave., #13C, Littleton, CO 80128
8. Water District: Wheat Ridge
9. 5anitation District: Wheat RidQe
90. Fire District: VJheat Rid¢e
11. Wheat Ridge Planning Division
12. Wheat Ridge Building Division
13. Wheat Ridge Police Department
14. Log File
15. Other. _
NOTE: Please notify all other parties concemed.
ADDRESS MAP UPDATED BY: DATE:
"The Carnation City"
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COMMUNITYDEVELOPMENT DEPARTMENT Building Permit Number: 78239
, BUILDING INSPECTION LINE - (303-234-5933)
Date : 1110/2005
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
Property Owner. CLEAR CREEK AMBULATORY
: Property Address : 7809 W 38TH AVE
Phone :
Contractor License No. ; 21665
Company : Riviere Electric
Phone : 937-9300
bWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Valuation : $10,700.00
. l hereby certify that the setbackdistances proposed by this permit application are accurate, and
. PBfftllt F82 :$253.90
do not violate applicable ordinances, rules or regWations of the City of Wheat Ridge or .
'covenants, easements or restrictions of record; that all measurements shown, and allegations
Plan RevieW Fee :.$165.04
made are accurate;that I haveread and agree to abide by all conditions printed on this
~ $192
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application, and that I assume full responsibility for compliance with the Wheat Ridge Building
.
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Code(U.B.C)antl all other applirable Wheat Ridge ordiaances, forwork underthis permit
..(OWNER)(CONTRACTOR)SIGNED
DATE
TOYeI : `$611.54
;
Use :
Description : 1NSTALL NEW FIRE ALARM SYSTEM INCLUDING HORN, STROBE AND PULL STATIONS
Electricaf License No : 21665 Plumbing License No : Mechanical LicenseNo :
Company:RivieraElectric, 'Company: Company;"
Expiration Date : 2/28/2005
~ Approval : OK/KS Expiration Date : Expiration Date :
' APProval Approval .
(1) . 7his permit was issued idaccordance with the provisions set forth in yopur application anH is subjec[ to the laws of the State of Colorado and to the Zoning _
~ Regulationsand euilding Code of Wheat Ridge..Colorado or anyother applicable ordinances of the City. .(2) 7his'permit shall expire if (A) the workztithorized is not commenced within sirzly (60) days from issue date or (B) the building authorized is suspended or.
abandoned for a period of 120 days
(3) If this permit expires, a new permit may be acquired for a fee of one-ttalf the amount nortnaltyrequired; provided no changes have been orwill be made in the
-'original plans antl specifcations and anysuspension or abandonment has not exceeded one (1) year. If changes are made or if suspension orabandonment .
exceeds one (1) year, full fees shall be paid for a new pertnit . " . (4) . No work of any mannershall be done thatwill change the naturel flow of water causing a dreinage problem..
, (5) . Contrector shall notifythe$uilding Inspectorhventy-four (24) hours in advance for all inspections and shall receive written approval on inspection.caN before . .
' pmceediingwithsuccessivepfiasesofthejob. (6) The issuance of a permit or the wv.aLof drewings and specifications shail.not be construed to be a percnit for, nor an approval of, anyviolation of the -provisions Ek idin . pedes inance;law,-ruleorregulatioa iei ding I~tor
` Please sign Terms and Conditions on reverse side of page.
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ADDRESSC
A Certificate of Occupancy 1 Completion
has been requested for:
PURPOSE OF STRUCTURE: /22 OY3
Building Department Approva
Remarks: I A I
Zoning Approval:
Remarks:
3- -7- Z-OS
Pubiic Works Approvah d,e 3lS~oS
Remarks:
Fire Marshall Approval:
(if Applicable)
Sanita4ion District Api
(if Appiicable)
Remarks:
Water District Approval:
(If Applicable)
Remarks:
Turner
Clear Creek Ambulatory Surgery Center
7809 W. 38th Ave.
Wheat Ridge, CO 80033
Phone:303-940-3776
Fax: 303-9404845
Address
Gerald H. Phipps, Inc.
P.O. Box 40387
1530 W. 13'h Ave.
Denver, CO 80204
December 28, 2004
RE: Clear Creek ASC Tenant Space
To Whom It May Concern:
Please be advised the building permit #18037 for "Tenant Space" at the Clear Creek
Ambulatory Surgery Center located at 7809 West 38'` Ave. Wheat Ridge, CO 80033 will
be transferred over to Gerald H Phipps, Inc.
Furthermore, This contractor and all iYs subcontractors must submit proof of general
liability insurance to Turner Construction Company with "Tumer Covstruction" listed as
additionally insured. Levels of insurance shall be the following:
Automotive Liability, Bodily Injury and Property Damage $ 1,000,000
General Liability, Bodily Injury and Property Damage $ 3.000,000
Worker's Compensation Insurance Statutory Level
Submit certificates to our main office at 1873 S. Bellaire St. Suite 1200 Denver, CO
80222. Evidence of insurance must be submitted prior to commencement of your scope
of work. If you have any questions feel free to contact me at 303-419-6751
"I'hank you,
Bryo Casper
Project Manager
C.C. Development Solutions Cnoup
1055 Auraria Pazkway, Suite 300
Denver, CO 80204
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A Certificate of Occupancy / Completion
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ADDRESS: 1 D Oq W. ~D ~ f'CI/v-~
PURPOSE OF STRUCTURE:
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STOP WORK ORDER
YOU ARE HEREBY ORDERED TO STOP WORK LOCATED AT
79 o q vJ , rz~, v~
BY ORDER OF THE CITY OF WHEAT RIDGE BUILDING DEPARTMENT
FOR THE FOLLOWING REASON(S):
H 0-t \Y~)o •r hi.`, rS
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This notice may be removed ONLY by
THE CITY OF WHEAT RIDGE BUILDING DEPARTMENT !
Date: 2-.- d-S~" Building inspector 4~~
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COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
Job Address: W a-
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When corrections have been made, call for re-inspection at
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DO NOT REMOVE THIS NOTICE
COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
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DO NOT REMOVE THIS NOTICE
COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
Job Address: 9 (3 9 W 36~
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DO NOT REMOVE THIS NOTICE
When corrections have been made, call for re-inspection at
303-234-5933.
COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
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DO NOT REMOVE THIS NOTICE
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COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
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COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
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COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
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DO NOT REMOVE THIS NOTICE
COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
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DO NOT REMOVE THIS NOTICE
COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
Job Address: '1 9 03 G 3$~=
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Date: 2~~~
Inspector
DO NOT REMOVE THIS NOTICE
COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
Job Address: $0 w f::!
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When corrections have been made, call for re-inspection at
303-234-5933.
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DO NOT REMOVE THIS NOTICE
COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
Job Address: 1 g0 9 w
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When corrections have been made, call for re-inspection at
303-234-5933.
COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
Job Address: 9 09 w 36t7
1!M- 2 c,'L' w-' - C\ 1'J-a UoYJ I
When corrections have been made, call for re-inspection at
303-234-5933.
Inspector
DO NOT REMOVE THIS NOTICE
COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
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Job Address: ~j g 0 °I W c3 9-
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When corrections have been made, call for re-inspection at
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Inspector
DO NOT REMOVE THIS NOTICE
BovLnLrz Associ.ares, INC.
Robext G. Owens III, AIA
Ctaig D. Mulford, AIA
NovemUer 24, 2004
ArcGitetFUre + Inderios De.rigv
Meredith Reckert
City of Wheat Ridge Community Development Deparrinent
7500 West 29'h Avenue Wheat Ridge, Colorado 80033
RE: Cleaz Creek ASC
Wheat Ridge, CO
Boulder Associates Project No. 03938.00
Deax Ms. Reckext,
Nicholas J. RehnUecg, AIA
Timotli}' C. Boexs, AIA
n
~ ~r~4'~
I am writing this letter to introduce to you flie design of a proposed flagpole for the subject project wluch
the owner is requesting to be instalied on their property on the south side of the building.
This flagpole shall be a clear, anodized tapered pole, 35' maxirnum height including base and beacon, with
an internal halyard, an all-weather U.S. flag, possibly an all-weather State flag, and a 360° flagpole beacon.
The proposed products and sketches are attached. Please review tlvs infoimarion and norify me if you see any issues with the above items which may not
adhere to city regularions or which may cause concern when we submit for the Certificate of Occupancy for
this project.
Your attenrion to this issue is very much appreciated.
V ery Truly Yours,
BOULDER ASSOCIATES ARCHITECTS
_~~A7.T=
Jon A. Tuckes
Associate
cc: 03938.00 (4)
Alan Main, Development Soluuons Gxoup
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4747 Table hlesa Dxive Suite 202 Bouldec, Colorado 50305 Teleplione 303.499.7795 I^acsimile 303.499.7767
2015 J Street Suite 205 Sauramen[o, Califoraia 95814 Tetephone 916.492.6796 PacsimiLe 916.492.8798
- www.boulcierassociates.com
/EXISTIN6 VEGETATIG
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CLEAR CREEK AMBULATORY SURGERY CENTER
BOULDER ASSOCIATES
Archirecnue + Incecior Desiga
4747 Table Mesa Drive, Suice 202
Bouldec, CO 80303
(303) 499-7795 Facsimiie(303)499-7767
Dare:
24 Nov. 2004
Sheec Number.
Projecc Number.
03q38.00
D[awnBy:
DJP -
I of 2
BrAGON LIGHT.
5EE ATTAGHED SPEUFIGATIONS FOR
MANU"rAGNRERS AND MODELS.
PROVIDE ELEGTRIGAL SERVIGE AS
REQUIRED.
GLEAR ANODIZED ALUM.
TAPERED W/EXTERNAL
~-HALYARD
2"ELASTOMERIG SEALANT
AND FLASHING GOLLAR PER
NANUFAGNRER'S
REGOMMENDATION
GOM?AGTED SOIL
~ 2 TI'c5 AT TOP
- GONGRETE FOUNDATION
. I I I- 36" DIAMETER
PVG FOUNDATION TUBE
PER MANUFAGTURER'S
. . REGOMMENDA710N.
hELDED STEEL PLATE II-I I°' • = GENTERIN6 WEDGES
5 VERT.
84
STEEL LI6HTNIN6 GROUND II I "Q~ I= EQUALLY SPAGED
SPIKE NELD=D TO'rLAie
I I I . I I-I3_0" I I I- #4 GL05ED TIES
i i-I I - - I I I- AT 12" O.G.
POLE SHALL BE 30' HIGH. ALL REBAR MIN.
SEE ATTAGHED SPEUFIGATIONS FOR FORMWORK/EARTH
MANUFAGTU12ER5 AND MODELS.
AI.I A1.23/8.' = 1 -0.
CLEAR CREEK AMBULATORY SURGERY CENTER
I~ B O U L D E R AS S O C I A T E S Dare: 2'' Ncv. 200-^. I Sheet Number.
i Acchi[ecmre + Incecior Design A
' 4747 Table Mesa Dcive, Sui[e 202 Project Number. OJG3o.00
I~ Bouldec, CO 80303
(303) 499-7795 Facsimile (303) 499-7167 Dcawn By: -GA 2 oP 2
American Flagpole - Choosing the Right Flagpole
Page 1 of 1
Tuesday, November 02, 2004 home < flagpole basics < choosing the i
[prini
~Home
~ About American Flagpole
News
Product Releases Mission & Vision
History
~ Flagpole Basics
Flagpole Dictionary
Plag Etiquette Choosing the Right Pole
Frequently Asked Questions
Wind Chart Information
Installation Instrudions
~ Flagpole Catalog
Flagpole Accessories
Specify Your Own Flagpole
t Custom Capabilities
~ Stocking Locations
k General Information
Care & Maintenance
Warranty
Terms and Conditions
Credit Application
~ Contact Us
Choosing the Right Flagpole
Flagpole Types
To assist in selecting the right flagpole for your installation, we've
pictured below the basic flagpole types. For standard
specifications, a description of options and product listing click on
the photos below to go to our on-line Flagpole Catalog. All
standard flagpoles are engineered to meet wind speed
requirements per NAAMM's latest standards on wind speed
specified for your area.
.e_~
Exkern3l
IntLrna[
9utrlyyCr
Vertic5l.
Nauiic2l
CUur
H3lyard
Haly3rd
LV3I[ Mas[nt
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Foundation Methods
Once a decision has been made on the type of fiagpole, determine
the method of installing the foundation. Setting the pole into the
ground (Ground Set) is the standard foundation method, or fasten
the pole to a concrete pad (Shoe Base). Other types of flagpoles
require a wall mount
Finish Options
American Flagpole offers satin aluminum, achieved by rotary
sanding as a standard finish. See Finish 0 tp ions for a list of
optional finishes available, including Thermoset Powder Paint and
Anodized finishes.
Experienced In-House Design and Engineering
American Flagpole also offers Custom Capabilities, for unique
aluminum tapered products and simulators such as spires and
accessories.
Back to Flagpole Basics
Terms of Uses I Prrvacy Policy
Oc 2004 American Flagpole. AII Ri9ht5 Reserved.
http://www.americanflagpole.com/choosing.asp 11/2/2004
American Flagpole
`
Page 1 of 1
"
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Monday, November 01, 2004
home < I
[prini
> Home
i, About American Flagpale
News
Product Releases
Mission & Vision
History
ii~ Flagpole Basics
Flagpole Dictionary
Flag Etiquette
Choosing the Right Pole
i Contact Us Standard Finishes
Frequently Asked Questions
Wind Chart Information
Installation Instructions
P Flagpole Catalog
FJagpole Ac[essories
Specify Your Own Flagpole
> Custom Capabilities
v Stocking Locations
P General Information
Care & Maintenance
Warranty
Terms and Conditions
Credit Application
Aluminum: Directional sanded satin aluminum finish
Thermoset Power Paint: Lightly textured, the outdoor life of our
Thermoset powder coating has a Guaranteed Color Uniformity
rating of 15-plus years by the National Association of Architectural
Metal Manufacturers Metal Finishes Manual. Specialty colors are
virtually unlimited.
Anodized: Available in Clear, Light eronze, Medium Bronze and
Black. See anodized d_isclaimer.
Ag.Li9ht Beonzo dGMetl.um Oran;n A[7-Dirk Ornn=p AE~101
Anodlztd Anodizetl Anoeixed nnudl
Special Note: "Please note these are photographic reproductions
of available finishes. There will be minor production variations.
Contact factory for samples."
See our Finish Warrantv on factory-applied Thermoset Powder
Paint coatings, a guarantee against damage due to normal
climatic conditions for up to five years from the date of shipment.
Terms of Uses I Privacy Policy
O 2004 American Flagpole. Ali Rights Reserved
http://www.americanflagpole.com/FinishOptions.asp 11/1/2004
n?-suina
AluminUm
Ainerican Flagpole
---i
I
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PR1.,:. JU! ;;L •7 .i. ie:G;lI c~.
a
Tuesday, November 02, 2004 home < Ragpole Catalog < i
[prini
~Home
~ About American Fiagpole
News
Product Releases
Mission & Vision
History
t Flagpole Basics
Flagpole Dictionary
Flag Etiquette
Choosing the Right Pole
Frequently Asked Questions
Wind Chart Information
Installation Instructions
t Flagpole Catalog
Flagpole Accessories
Specify Your Own Flagpofe
~ Custom Capabilities
~ Stocking Locations
~ General Information
Care & Maintenance
Warranty
Terms and Conditions
Credit Application
j Contact Us
Page 1 of 2
Foundations
Ground Set: Our standard
foundation method offers the
support and is the most economical
foundation choice.
*Foundation size will vary with soil
conditions.
Ex osed Hei ht
A
B
20' 0"
2' 6"
24"
3
25' 0"
3' 0"
24"
3
0' 0"
3
' 6"
24"
3
' 0" "
0"
40' 0"
4' 6"
36"
4
45' 0"
5' 0"
36"
4
50' 0"
5' 6"
42"
4
55' 0"
6' 0"
42"
4
60' 0"
6' 6"
42"
4
65' 0°
7' 0"
42"
4
70' 0"
7' 6"
42"
6
75' 0"
8' 0"
42"
6
80' 0"
8' 6"
48"
7
*Su ested dimensions
Shoe Base: Used when an aboveground installation is more
feasible; mounting on a column, a building's flat surface (like a
roof) or a buiiding's support structure (steel beam).
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Tube
Dia.
A
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C
D
Bolt
Dia.
golt Circle Dia.
4"
7 1/2'
3'
9/16'
2'
3/4'
6 1/2"-8'
5"
7 1/2'
3'
9/16'
2'
3/4'
7 1/2"-8'
6"
9 3/4'
3 1/2'
11/16'
2 3/4'
1'
911-10'
7"
10 1/2'
3 11/16'
11/16'
2 3/4'
1'
10"-11'
8"
11 1/4'
3 15/16'
13/16'
2 3/4'
1'
11"-12'
9"
13'
4 1/4'
7/8'
2 3/4'
1'
13"-14'
10"
14'
4 7/8'
1'
3 3/4'
1'
14"-15'
12"
17'
8'
1 3/8'
3 3/4'
11/4'
16°-18'
~
http://www.americanflagpole.com/Foundations.asp 11/2/2004
a-' t
~ F L A G P O L E
PRIDE. QUALITY. TRADITION.
SF-ftCoN LllrFfT,
Exposed
Height
(Nom.)
rotol
~
`m
m
E
0
~
Taper ~
Length
(Nom.)
~ABV9$lE--~fBBuu~'
Holyord, Sfoinless Steel Airoroff Coble.
`Two Snophooks, Swive% Chrome Ploted Bronze.
` Beaded Roller S/ing
With Plostic Covered Counterweight.
Topered Alum. Tube
"G" Ecse Wol% Alloy 6063-T6
Sotin Ground Finish
Flush Access Door with Cylinder Lock and
Continuous Piono Hinge, ond o Manuolly Operoted
Winch Hoving o Removoble Hondle and Positive
Locking of Any Position.
Butt Diometer 4•16~ Spun Alum. Col%r
(Coulk Col%r Perimeterby lnstol%r)
f- Grade
Concrete (by lnstoller) B
ogI oeptn Cement or Woterproof Compound (by installer)
y Ground Sleeve Ass'y (16 Go. Corrugated Stee% Golv.)
~
Ory Sond (b)l lnstallerJ
1}„ /
Steel Wedges, Shop Welded, Equolly Spoced at 90'
/ 3 16" Steel Base Plate Welded to Sleeve
Lightning Spike 6'k6"k3176" Steel Support Plote
(3/4" Steel~
"Amencan Flagpole will accept no responsibility for any color varia[ions of anotlized poles.
Customer P.O. 03938.00
Factory Order
Pole Sections: ~
Date: 11/2/2004
Quantity: 1
Finish: Anodize, Clear
Customer Name: Jon Tucker
Project Name: Clear Creek ASC
Architect Name: Boulder Associates
q
30 ft.
B '
3 ft.
C
33 ft.
D
13'-9 in.
E;
6in.
F
3.5 in.
G
.188 in.
Specification DocumenY Page 1 of 2
Rmeriean Flagpole Specifications
Section 10350 - Plagpoles
Part 1 - General
1.1 SUMMARY/DESCRIPTION
A. Scope of Section: Provide aluminum flagpole(s) as shown on drawing and as specified herein; with
components as needed for a complete installation.
B. Related Sections: Division 3 section °Cast-in-Place Concrete° for concrete footings for flagpoles.
1.2 PERFORMANCE REQUIREMENTS:
A. Structurai Performance: Provide flagpoles capable of withstanding the effects of wind loads as
determined according to NAAMM FP 1001-97, "Guide Specifications for Design of Metal Flagpoles" or to
specified wind speed, whichever is more stringent.
B. Base flagpole design on maximum standard size nylon flag suitable for use with pole or flag size
indicated, whichever is more stringent.
1.3 SUBMITTALS: A. Product Data: For each type of flagpole required, submit manufacturer's technical data and standard
installation instructions.
B. Shop Drawings: Show general layout, jointing, anchorage, support systerns, and accessories.
C. Samples: Finish samples for each finished metal used on flagpoles, as may be required.
1.4 QUALITY ASSURANCE:
A. Source: Obtain each flagpole as a complete unit from American Flagpole, including fittings,
accessories, bases, and anchorage devices.
5 DELIVERY, STORAGE, AND HANDLING:
A. General: Spiral wrap flagpoles with a heavy Kreft paper or other lightweight wrapping and enclose in
a hard fiber tube or other protective means. Store bare flagpoles in a dry location, protected from the
weather and moisture, as recommended by the manufacturer.
B. Ship to project site in one piece or as specified. If more than one piece is necessary, prov(de snug
fitting precision joints with self-aligning, internai splicing sleeve arrangements for weather tight, hairline
field joints.
Part 2 - Products
2.1 MANUPACTURER
A. Manufacturer, subject to compliance with requirements, shall be:
American Fiagpole
26252 Hillman Highway
Abingdon, VA 24210
1.800.368.7171 (telephone)
1.276.676.3090 (fax)
http://www.americanflagpole.com
2.2 PLAGPOLE TYPE AND CONSTRUCTION:
A. Aluminum Flagpole Construction, Fabricate from seamless, extruded tubing complying with ASTM B
221, alloy 6063-T6, having a tensile strength not less than 30,000 psi with a yield point of 25,000 psi.
Heat treat after fabrication to comply with ASTM B 597, temper T6.
1. Provide cone-tapered flagpoles, per manufacturer's standard rate of taper.
B. Assembly Construction: Int. WJ Winch Groundset fla9pole, 30 ft. nominal mounting height, with a
minimum base wall thickness of 0.188 in., and a 6 in, butt diameter. Ship to project site in 1 piece.
2.3 MOUNTING
http://www.americanflagpole.com/SpecDoc.asp?CN=IWVJ30D61-AA&label=IWW 11/2/2004
Specification Document
Page 2 of 2
A. Poundation Tube: Galvanized corrugated steel foundation tube, .0635 inch [16 Gauge] (1.6 mm)
minimum wall thickness, sized to suit flagpole and installation. Provide with 3/16 inch (4.8 mm) steel
bottom plate and steel centering wedges ail welded togethec Furnish with 3/16" inch (4.8mm) support
plate, 3/4 inch (19 mm) diameter X 18" long steel ground (lightning) spike, all welded construction.
2.4 FITTINGS .
F. Internal Halyard Truck Assembiy With Hood for Cable: Cast aluminum non-fouling revolving with
single pulley mounted inside hood, stainless steel roller bearings, threaded spindle for attachment to top
of pole, and bronze exit bushing for cable.
Provided with stainless steel ball bearings.
J. Internal Halyard, Winch System: 1/8" (3mm) stainless steel aircraft cable with plastic coated
counterweight and beaded sling assembly. Manually operated mechanical winch having automatic brake
system and operated with a removable hand crank. Winch shail be concealed inside the flagpole behind
a flush access door havin9 a cylinder lock and continuous piano hinge.
K. Halyard Flag Snaps: Provide 2 swivel snap hooks per halyard as follows:
1. Chrome plated bronze
0. Collar: Manufacturer's standard spun aluminum flash collar to match flagpole.
2.5 MISCELLANEOUS MATERIALS
A. Concrete: Comply with requirements of Division 3 Section "Cast in Place Concrete".
2.6 PINISHES
A. Metal Finishes, General: Comply with NAAMM's "Metal Finishes Manual for Architectural and Metal
Products" for recommendations for applying and designating finishes.
B. Aluminum: Finish designations prefixed by AA conform to the system established by the Aluminum
Association for designating aluminum finishes.
2. Clear Anodized Finish: AA M32-C22-A41
PAl2T 3 - EXECUTION
3.1 PREPARATION
A. Excavation: For foundations, excavate to neat clean lines in undisturbed soil. Remove loose soil and
foreign matter from excavation and moisten earth before piacing concrete.
B. Provide torms where required due to unstable soil conditions and for perimeter of flagpole base at
grade. Secure forms, foundation tube, fiberglass sleeve, or anchor bolts in position, braced to prevent
displacement during concreting.
C. Place concrete immediately after mixing. Compact concrete in place by using vibrators. Moist-cure
exposed concrete for not less than 7 days or use a non-staining curing compound.
D. Trowel exposed concrete surfaces to a smooth, dense finish, free of trowel marks and uniform in
texture and appearance. Provide positive slope for water runoff to base perimeter
2 PLAGPOLE INSTALLATION
A. General: Install flagpoles where shown and according to shop drawings and manufacturer's written
instructions.
B. Foundation-Tube Installation: Install fiagpole in foundation tube, seated on bottom piate between
steel centering wedges. Plumb fla9pole and install hardwood wedges to secure flagpole in place. Place
and compact sand in foundation tube and remove hardwood wedges. Seal top of foundation tube with a
2-inch (50 mm) layer of elastometric sealant and cover with flashing collar.
END OP SECTION 10350
http://www.americanflagpole.com/SpecDoc.asp?CN=IWW30D61-AA&Iabe1=IWW 11/2/2004
Frorn:DEVELOPh4Eh1T SOLUTIONS GROUP 303 893 0251
flagpole beacon
FI.AGYOT,E BEACOTVTm
The new and exciting way to lighi
your flags at night.
. Minimize light pollution
• Beacon tums mth flag
. Made in the U.S. of the highest
qualiry matezials
• Low power, unlike spotlights
11/10/2004 11:59 #968 P.003/004
Flapolewazehouse.com is a
member of these organizations
LE'E D
UARK-SKY
. 8" SPUN ALUMINUM GOLD ANODIZED BALL
• 2" X 4" OPTICALLY CLEAR POLYCARBONATE LENS MIRROR
POLISHED REFLECTOR
• REFLECTOR ANGLES ILLUMINATE ENTIRE FLAG
• 400-WATT LIGHT SOCKET • 20 / 35 / SO WATT HALOGEN BIILB (WATTAGE DEPENDENT ON
FLAG 51ZE) [RATEp 2000 HOUR]
• 20 AMP ROTARY CONTACT (BRUSHLESS TYPE)
r FULLY GROUNDED OPERATION
• ALL PLBC7TtICAT.. COIvIPONENTS UL T..ISTQA
• ELECTRICAL CABLE IS STRAIN RELIEVED; WATER, OIL, OZONE,
T.TV, ANll ABRASTON RESTSTANT
• ALL ELECTRICAL CONNECTIONS ARE WATSR RESISTANT
• OPTIONAL ON Q DUSK / OFF Q DAWN SWiTCH AVAILABLE
• BULBS AVAILABLE IN XE~+(SOFT BLUE LIGHT) AND
FTAT,OGYN (SIiIGHT Wt-IITB LTGHT)
• BULH CHANOINQ INSTRUCTIONS 1NCLLJDEA
• REPLACEMfiNT BULBS, SPARE SCREWS AND INSTRUCTIONS
AVAILABLH F1tOM TFTE FLAG COMPANY,INC.
• USE OF HIGHER WATTAGE BULBS WILL VOID ALL WARRANTY
• OT-3 TftUCK
Page 1 of 1
hrr..•//..~.~,.,. fl~l..,..ie......e7,...,re "..,ifl.,..,..,.tet,e,,....,, k~ 7 . i i ii nMnnn
From:DEVELOPMENT SOLUTIOPlS GROUP 303 893 0251 11/10/2004 11:59 #968 P.004/004
flagpole beacon Page 1 of 2
Answers To Flag Pole Beacon Questions
Q: What is the parpose U£'xhe Flagpole IIesconTM 7
A: The purpose nf The Flagpole SeacozarM ts to reduce light pollution and light tresspass while lalumina#ing the flag accox
flag regulations. (return to questions)
Q; How muc1i of the Flag does Flagpole Beacom''"" 1iglit?
A; A.x•ound 75% uf the flag when flying. Around 25% of the flag when draped. (return to questions)
Q: F1ow do isumens work?
A: Lumens is how brlght the light is at 1 square yard ureu at u certain distance. (return to questions)
Q: Do all Flanpole Bexcons''"T require st truck?
A: Yes, the Cam Systetn also requires an adaptor. (return to questions)
Q: no al] The F1agpole BeaeonaT"' require A transformer?
A; No - just the Xenon 12 vott bulb system. (return !o questions)
Q; W9i1 The Flagpule BeaconTM witlistnnd tlxe vibraY4an caused by h'rgh winds?
A: Yes - the Xenon will withstand more vibration than the Halogen. (ietum to que5tiorlS)
Q: Wi13 texnperature affect The Flagpole BeaconTM ?
A: Temperature wSl[ not affect Tlie Flagpole Beacon'rM. (return to questions)
Q: What is the turn around tixne eo receive The Flagpole BeaconTM 7
A: Exeh Flagpole BeaconTM fis custom made. Please atlow 4 to 6 weeks Yor delivery due to the large demand, (return to qu
E2: Can The Ftagpole [3eaconTM be used witli th.e Sanner'Pole System or a telescopipg po1e7A: Yes - The Flagpole Beacon
be used with both and also wifb wood, steel and fiberglass poles. (return to quest[ons)
Q: What is the difFerence between a 359 Yruok aizd a 360 truck7
A: The 360 truc[c turns continaously and the 359 ta'irck makes a 359 degree turn and stops. (retum fo quesfiions)
Q: What is tNe dif'ference in the brighniess between a xenon bnlb and a habgen bu16Y
A: '['he xenon bulb is a softer, bluish light that gives enough light to show proper respect to the Fkag. The halogen is a whi
brighter bulb with the brightness vaz'ying depending on bulb wattage.(rCtUrn fo quastions)
Q: What is the life expectancy of tLe a:enun light?
A: 'J'he life expectancy is approximately 10,000 hours. (return to que5tions)
Q. Whnt is the iife expectancy of the halogen iiglit?
A: The life expectancy is approxlzzaately 2,000 hours if handled properly. (retum fo questions)
Q: Can x halogen tight be convertee} to a aenon light?
A: XE can be changed, but with some difPculty. (return to questions)
Q; What !s the transformer cnsing made of?
A: "xhe casing ts a sealed all weather plastic casfng that can be burled directly. (PetuYtt t0 qUeBtions)
Q; Can the wires be burietl without a condnlt?
A,; A conduit is highly recommended but not necessary for the 360I2evolving Beacon. It is necessary for the 359 Revolvin
Seacon, (return to queskions)
Q: Does The P'Eagpole BeaconTM qualify f'or bark SkIe5?
Ac Yes; The Flagpole BeaconTM does meet Dark Sktes requl1•ements for down llghting and energy efficiency. (return to qu
u.~._.n______. n..........~,._...._„w,..,... ,,,..,,..n,,.,.......s,,,. 1 1 nn/~nnn
COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
Job Address: 7$ 0 9 W~ 3 8~ 1'~v-)~'
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When corrections have been made, call for re-inspection at
303-234-5933.
a-
Inspector
DO NOT REMOVE THIS NOTICE
vuo w. .
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COMMUNITY DEVELOPMENT DEPT.
Inspection Services Division
(303) 235-2855
Correction Notice
Job Address: 6°I w
~oofi~r~s
'~CS V~!\ +
DO NOT REMOVE THIS NOTICE
When corrections have been made, call for re-inspection at
303-234-5933.
COMMUNITY DEVELOPMENT DEPT.
~ m Inspection Services Division
(303) 235-2855
~oZoRpo° Correction Notice
~
Job Address: ~ [Y 6 9 w
\A~fto Lt`,S
~ -C~ 'j \\L~'4
,
When corrections have been made, call for re-inspection at
303-234-5933.
1 l - 2,-o
Inspector
DO NOT REMOVE THIS NOTICE
B O O L D E A A S S O C I A T E S, I N C.
Archzterture + L:terior De.rign
Robect G. Oweas III, dIA
Craig D. btulfocd, AI:1
October 13, 2004
Meiedith Reckert
City of Wheat Ridge Community Development Department
7500 West 29" Avenue
Wheat Ridge, Colorado 80033
RE: Clear Creek ASC
Wheat Ridge, CO
Boulder Associates Pxoject No. 03938.00
Deaz bis. Reckext,
Nicholas J. Rehnbecg, AIA
Timothy C. Boexs, AIA
/
/
After seveial conversations with you on the telephone I wanted to follow up with a letter stating what I
pexceive as our ageement regardinJ the 6'-0" height restrictiou of the emergency geucrator und trash
enclosure fox the above refereuced project.
As discussed, the enelosure wall height was designed per city restrietions to be 6'-0" tall. The emergency
geneiator, due to the requiied capaciry for emecgency power and tlic required souild attenuotioii to mufilc
the sound transmission of the operating generator, is 26'-0" ]on, 6y 3'-6° widc by 12'-0" t.ilL Thc
enclosure footprint was revised to accommodate this size and in the process hvo parking spaces Nczre
deleted in the noxtheast lot. As pxeviously discussed with you this Nvi1L not be an issue as we are sril I
providing 11 moxe spaces than are required. However, as discussed, me woidd atso like to iimrease the
enclosure wall height to 8'-0" tall to provide more of a visual screen for the generator. We fed tl~~t
extending the wall to12'-0" tall would be aestheUCally uupleasing and tUat ai18'-0" tall enclosura wall
would be an acceptable compromise providing the u7ost effective screen of the emergency genera[oc.
Due to the tight construction time frame for this project, and realizing that we liave Uecn trndiiag phone
messages for over a week now, we are going to proceed with this understanding and install flie enclosure
wall to a height of 8'-0". Please contact me immediately if you have any concerns with the above stated
posirion. The last thing any of us want is to have this issue noted as noncompliant when we are ready to
pull our Cert+_ficate of Oceupancy. Your attention to this issue is very much appreciated.
Very Txuly Yours,
BOULDER ASSOCIATES ARCHITECTS
jon A. n cker
Associate 4747 Table Mesa Diive Suite 202 Boulder, Colocado 80305 Telephone 303.499.7795 I'acsimile 303.499.7767
2015 J Stxeet Suice 205 Sacramenro, California 95814 "1'elephone 916.492.8796 Pacsimile 976.492.8798
www.boulderassociatcs.com
Page 2
cc: 03938.00 (4)
Alan Main, Development Solutions Gxoup
Bryon Caspex, Turnex Construcdon
Nick Rehnbexg, Boulder Associates
09/22iR004 15:18 FAR 3034997767 BOULDER ASSOCIATESa 001/003
Robcrt G. Owcns [II, :V;\
Craig D. hlulford,:1IA
TRANSMITTAL
Nicholas J. RehnUcrg, .11,1
'Cimoth}' C. 13ocr,, :1IA
TB.fE
WE TRANSb4IT
Bou1.[) rx Acsoc.t,kzLs,INr_.
fL'tGiterhu-e + Interior Detigir
❑HEREWITHVIA: AFAX ( 3 )'PAGESINCLIIDINGTRAuSM1TTAL ❑HARDCOPYTOFOLLOW
TH1S IS TRANSbIITTED TO YOU
❑ FOR APPROVAL ❑ FOA YOUR USH ~ ~~FOR 1'OUR RE49GW ❑ AS REQUESTED
NO.OFCOPIES
DATE
DESCRIPTIOV/RF,MARKS
ACTIONCODE
1
8/11/04
Enclosureforemer enc enerator
Meredith Please review the attached sheets showing the revised
enclosure size. We lose two arkin s aces but we are still 11
over the required numbec My may concem is the max height of
the wall is at 6'-0" er ci re uirements. The enerator itself
Is 12'-6" tall. We would like to better hide the generator. Please
advise on ossibili of waivin 6'-0" wall hei ht. Thanks Jon
?~statwl Also, please eility of adding one flagpole for US
ossi r orate fla below.
R cc~ iBMIT F Ill1 U(1T RIY[I!PMIT F 2Ffl I
R\11T FOR FILES
~
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IF ENCLOSURES aRE NOCOOaP
.~i~ ~1
~OPY TO \1'ITH ENCI.OSLRt9AP. .
INDLY 7KIDTIFY US
d"
Jon Tucker
NO~dcpR~P° \bypcro~°g\ve ~
a y~y ~~,~o9to~oi o~ne
#'3? 7'abic Alcsn Driec Suitc 2NF'Re7g~~~'f:olorado 80305 'fclcphonc i03.999.'?95 I^aesimilc 303A99J7G?
wv: w.bouldcrns.nciatcs.cum
Wheat Ridge CO
Wheat Ridge, CO 80033
FAX NUMBER PHONGNU.318ER PAOlECT7Yl;M6ER
03938.00
303-235-2857 303-235-2846
09/22/9004 15:19 FA% 3034997767 BOULDER ASSOCIATES
Roozioos
03,738-.00 (7 v)
DESIGN BUTLD
BOULDER ASSCICIAT'ES & TURNEI2 CONSTRUC"a"ION
Project: C}ear Creek Ambitlaforl, Surgerv. Center AFOIICO No. 024
Location: Wheat Rid6e CO Date: 09-20-04
Referenee Sheets: Al.l, A1.2
Scope: Revise Emergency Generator enclosure.
Architectural:
1) Revise emergency ggenerator enclosm-e as indicated on the attached sketch.
2) Gate to emereency generator to be 12'-0". Coordinate wiYh the steel supplier.
3) Loading area and parking space #9 to be 4" concrete. This item is related to and
required by the owner's switch to liquid oxygen as revised in AFO 019. Price this
revision with AFO 019.
4) Coordinate the deletion of 2 parking spaces with the city inspector. I have
verbally notified the planning department of this change and since we have more
than the required amotmt of parking overall this will not be an issue with them.
Issued By: ~
JonlTucker
Areliitect's Project Manager
09/22/9004 15:20 FA% 3034997767
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10/13/2004 14:31 FA% 3034997767 BOi1LDER ASSOCIATES
B O U L D E R A S S O C I A T E S, I N C.
ArcGitecFure + Interior Design
Robext G. Owens III, AIA
Craig D. Mnlfoid, AIA
TRAN5MITTAL
V icholas Rehnberg, AIA
Timoth}' C. Roeis, AIA
ID oovoos
Meredith Reckert October 13, 2004 2:29 PM
Ciry ofR'heat Ridge Communiry PROICCTN.4I.M
Dmelopment Dept.
7500 R@st 29'" Ave.
WTeaz Aidge, CO 3fA33
Wheat Ridge, CO
rAXI.'UMffiER PHONENUbBER PROICCTNL7vIDF.R
303-235-2857 03938.00
. WE TRANSMIT
❑ HEREIViTH VLI: @00 FAX ( 3) PAGLS Itr'CLUDING 17UNSMRTAL ❑ HARD COPY TO rOLLON
THIS IS TRANSMITTED TO YOU
❑FORAPPROVAL ❑iOR1'OURUSE ❑FORYOLRLAEViLW ❑ASREQUESTED
IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US
COPY TO WI'7gLNCLOSURE ❑ FILE CODE
(04)
E3 SHOPDRAIVINGDIVISION
❑
Jon
4747 Table Mesa Dcive Svite 302 Bouldex, Colocado 80305 Telephosse 303.499.7795 Facsimile 303.499.7767
www. bouldernssocia[es.wm
10/13/2004 14:31 FA% 3034997767 BOULDER ASSOCIATES . U002/003
Boui.ni1, K Assocf A 'res_Ivc.
AribrleUru-e + [itierror Derige
Robcrt G. Owens I[I, .ll,\
Cxaig ll. \4ulford, AIA
Octobes 13, 2004
Meredith Reckert
Ciry of Wheat Ridge Covmiunity Development Department
7500 West 29" Avenue
lVheat Ridge, Colorado 80033
RE: Clear Creek ASC
Wheat Ridge, CO
Bouldex .`lssociates Project No. 03938.00
Dear \Is. Reckert,
Nicholas J. Rehnberg,,1I,1
Timoehy C. Bocn, ,\IA
After several conversations with you on the teleplione I wanted to follow ttp witlt a letter statin-, whnt i
perceive as our agreement reemdine fhc 6'-0" hei ght restrietion of thc emcrgency eener:uor.ind tr.eh
enclosi¢e for tlie above referenced pruject.
As discussed, the enclostire wall hei-hl w:as desigoed pzr city restrinions to be 6'-0" tall. T6e emzrecncy
generator, due to the required capacity for emzrgency pover and the required sound anenuation to mui ile
the somid transmission of the operaiin., eeneinror, is 2G-0" lon~ by R'-G' Xvidr bv 1?'-0" talL 7hc
enelosure footprint was revised m aeeominodate ihis size and in the process nk-o purl;in" sparr> \ccsc
deleted in tlie nortlieast lot. As preX-iously diseusscd k-it6 you this xxill noi bc :m i;sue as Xve are suil
proaiding 11 more spaces than are reqiiired. FioiNcver, as di,cussrd. ~ve kWuld al.n like lo incre:i>e Ihe
eneiosure wall heiglrt to 8'-0" tall to provide more of a aisual sren for the -uncr:iinr. A1`c f",9 U;-u
extending the wall to 12'-0" tall im-onld be aesthetically unpleasing and that an 3'-0" tall enclosure ~kall
woidd be ati acceptable compromise providing the most effective screen of ihe emergency ,eoemtor.
Due to tlie tieht construction Cime frame for Ihis project, ancl rcalizin" thot Nee have heen u.idin" k'hone
messages for over a week now, we are going to proceed with tliis undzrstandina and install tlle endoswc
watl to a height of 3'-0". Please contact me immediately if you have any conceins mith the abuee stated
position. 1'he last thing any of us want is to have dhis issue noted as noncompliant wlien we are ready to
pull our Certificate of Occupancg.
Your attention to this issue is very much appreciated.
Verv Truly Youxs,
BOULllER ASSOCLkTES _1RCHITECTS
~
Jo«.~ ckerj~
_lssociare +747 'I'able \Icsa Drivc Snite 202 Houldcr, Culorado 80305 1'elephone 303.499.7795 Vaesimile 3D3.J99.;'6',
2075 1 Street tiuite 205 $nciamento, Culitornia 95871 'Celephone 916.492.8796 Focsimile 976A93.8793
wm
~w.Uouldcraa ociam..com
10/13/2004 14:32 FA% 3034997767 BOULDER ASSOCIATES [M003/003
Page 2
03938.00 (4)
Alan Mavi, Development Solutions Group
Bry-on Caspex, Tumer Consnuction
Nick Rehnbexg, Boulder Associates
Turner
Clear Creek Ambulatory Surgery Center
7509 W. 38~' Ave.
Wheat Ridge, CO 80033
Phone:303-940-3776
Fax: 303-9404845
ADDRESS:
City of Wheat Ridge
7500 W. 296" Ave
Wheat Ridge, CO 80033
Attn: Kristy Shutto
June 16, 2004
RE: Cleaz Creek Ambulatory Surgery Center
Ms. Shutto,
In regazds to the building permit #16926 issued to Tumer Constnxction Company for the
above mentioned project The construcrion value of 2,394,000 is the total of all labor,
material and supervision costs, which includes a11 subcontractors and suppliers who will
be working on this project under contract to Turuer Conshuction Company.
If you have any further questions regarding this project feel free to give me a call at
303-940-3776.
Thank you,
Bryon Casper
Project Manager
~
~
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Engineering & Surveying, LLC
Niii
April 2, 2004
Ms. Kristy Shutto, Building Department Seoretary
City of W heat Ridge
7500 W est 29th Avenue
Wheat Ridge, CO 80033
Re: Zephyr Medical Commons (Phase IV), Lot 2
7809 W. 38th Ave.
Certificate of Sewer Service Availability
Dear: Kristy:
This letter is in response to your request for confirmation of the availability of sanitary sewer
service for the above project.
The subject lot at the address referenced above is entirely within the boundary and service area
of the W heat Ridge Sanitation District (W RSD). Treatment of sewage generated within the
Wheat Ridge Sanitation District is provided by the Metro Wastewater Reclamation District
(Metro). W heat Ridge Sanitation District facilities in this area consist of an 8 inch sanitary sewer
main within 38`h Avenue. Our records show an 8 inch private sewer main within this area
running toward the north and connecting to an 8 inch W RSD sewer main in W. 39`" .Avenue. It is
not clear if the owner of the subject lot is requesting to tap into the private sewer rnain.
Correspondence dated August 12, 1998 (attached), from Mr. Ken Brown, then-District Engineer,
to Mr. Reid Gamberg of DRG & Associates, indicates that the private sewer main is to be
dedicated to the W FiSD before additional taps are approved. This dedication is to include a
sewer main easement to the W RSD for access and maintenance. Moreover, if the owner of
subject properry is requesting to tap the private sewer main, their at,ility to connect a sewer
service line may be limited by the rights of the present owner of the private sewer main.
This parcel is subject to the assessment of both W heat Ridge Sanitation District and Metro tap
charges. The subdividers and/or developers may be required to extend sewer lines to their
project sites and/or share in the cost of providing additionai capacity to serve their projects.
in 2w{{'.'LfOii, yGE; SiiOUlu ~'i2 awarG'il lat ilie Cisirici reGuires approvaf ot pians for sewer main
extensions, service connections, determination and payment of tap fees, as weil as inspection of
construction by the DistricYs Engineer.
Very truly yours,
HCL Engineerin & Surv ying, LLC
~ "
Robert
R. Ga r~el, P. .
District Engi er
Wheat Ridge Sanitation District
RRG/rg
cc: 9570 Kings[on Ct, Suite 310 • Englewood, CO 80112 • Phone (303) 773-1605 • Fax (303) 773-3297
www.hclenginecring.com
Msr 08 04 o7s58s 1
bS/0l/20D4 16:49 FAI SAi499TT67 HOSRD6& ASSOCIATES (~06]I00~~
/.L-aac yo,,e 4, ~ .~o3a3S-~fr5'~-
C7TY OY WS6'AtHIDOW
esRratcwa~ oawwTraAYM sewsseMMvics svea.►sum
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NmolDIWiCY: WHBAT AZqGE t4ATER DIST&ICT Lyyprapprpflpftw& Na.
OkRqw9RViaAvalibb ()WNa BArvlaeNefAr+dYYle
C1ve~1f orCmtl~Y:. NaFar.
2009
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vn• i cn.rr wrnv nr inA ~rovmo~nn.wI m.i a crM.~,
xooemAppuaot abw"4&ooW*.vi9aaueNwenwkLoatdu.cXd4o.sedpeaer+ue
Duhietor AgxY ay➢lying wrviea,
bs~m=L
Ta AiL
C O' N 8 U ~ T A N T S
% August 12, 1998
Mr. Reid Gamberg q .p~ (O /_.24 d{',•
DRG 8c Asaociates, Inc• ~ ~ 0
755 Par[et St., Suite 138 ~y
i,akewood, CQ 90215
ge: Zephyr Medical Commons - Fixmro Count
•7845 W. 38°i Ave.
'Pa/
pear r. Gamberg:
[n our capAeity as Engineers for the'Wheat RidBe Sanitatinn District, we have reviewed the plumbing
nlana xa4!isb yro wAimittod for the abova-roferenced oroject, and have calculated the sewer service tay
Eees as follows:
Whnt Ridge Uuttation Di4trict
6 SEES 0 $490= $2,940.40 (Wheat Ridgc Sadmaon District)
1 Ys" water Tap = 12 SFRE
12 SPRE 0 $1320.00 = $15,840.00 (Metro Wastewatea District)
Pixture Court = 120.00
Insputtion Fee = 90.00
~ Total $18,990.00
The tap faas are due and payable prior ro the coanec[ion of any fixtures to the sorvice lite facilides•
The inspeaion can be scheduled hy contacring the Disaict Engiaeer a[ 740-8900
Please note thst the 8-inch sanitary+ sewer m which tlais tap is scheduled W be connected is shown in the
DisricYs rxords as being a private main. By defioition in the Disirid's Itules and ReguleUons. & four
"private" ~cyonnec[edto the prate ~in without ouPissuing a wnnec pecautt tor the
build~88 aro a{readY
abovo-referenced Proposcd Phase ehree buildin6.
Review of the Disu'tec's records uidicate Hrat so date, tap tees have oniy been phid ior the buitding(s ) ac
3865 Zephyr Steeet:
Accordingly, prior to approvat of additional sanitary sewer taps, the District is requjrin8 d►e following:
prior to approval of additional samtary sewer taPs to the District's facilities:
• Proof of paymen[ of the sanitary sewer qp fas for existiag buildings within the complea
od►er tltan 3885 Zephyc street:
• Conveyance of the private main to du Ais[tia inclusivc of proof of its strucWra►.
bydraulic and alignment integrity, sttisfutory maintenance, and proof of ownecship.
. Conveyanee of an aeceptable easemem allowing the aistrict access for the puzposa of
maincenanee and operation of the main.
~
74100 Easf Unlon Avenue. SuMe 500 •Donvx. Cobrado 00237 •Phone: (303) 740-9900 Fw: (908) 740-E034
Ai
~
Cf the above wndidoas can bo ma, you wiil be abie to peticioo to the Distric[ to accept dte sanitaF7'
aewer main for ownership and ubtain approval of the additional tap m the main subject m ic's rules and
regulations.
If you have any questions in this regard please cli1 us.
Very truly yours,
TranSyetems Corporation Consultants
t:),Ze~ 4~~
Williaat K. Brown, P.E. . -
E41huK .or zhe Wheat .Tidga 5anira:ion Uistr+ct
cc: District OfRce
Barry Hudson
~
~
COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number : 16952
BUILDING INSPECTION LINE -(305-234-5933) Date : 4114/2004
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
Property Owner: CLEAR CREEK MOB
Property Address : 7809 W 38TH AVE
Contractor License No. : 21902
Phone : 753-9600
Company : Turner Construction Co. Phone : 753-9600
OWNER/CONTRACTOR SIGNATURE OF UNDER'STANDING AND AGREEMENT
I hereby certiTy that the setback distances proposed by this permit application are accurate, and
do not violate applicable ordinances, rules or regulations of the Ciry 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 lhat I assume full responsibility for compliance w heat Ridge Building
Code (U.B.C.) and all other applirable Whea 'dge ordinan , f ork under this permit.
(OWNER)(CONTRACTOR) SIGNED ~ DATE~
907
Construction Value :
$140.00
Permit Fee :
$30.55
Plan Review Fee :
$0.00
Use Tax:
$1_68
Gl Total:
$32.23
Description : CONTRUCTION TRAILER & 6' CHAINLINK CONSTRUCTION FENCE.
bza
BUILDING DEPARTMENT USE ONLY
, SIC : Sq. Ft: :
Approval : MR 4/14/04
Zoning: PCD ~Oesa~~~n~'actorip~e~s~1'VQt,:
Ielind"~,C~; apAroved o~~ctin Ponsible for
ELEC. BY SEPARATE PEF~d!'fCilY is ~~ot ar'd req m~rO9c'nerts a`~,' '~r~
Approval : SUbmitted q, responsib/e o de~,°'lOPn' c, Pcr,
b a errors res ithin the p~~~ `Or rn`cc~:r.a ,
PP Wiing fro S c tc
A roval:
'na~ L, ;7y.°ez r,;,,'
Occupancy : Walls : Roof : Stories : Residentiai Units :''0j - '
Electrical License No : Plumbing License No : Mechanical License No :
Company: Company: Company:
Expiration Date : Expiration Date : Expiration Date :
Approval : Approval : Approval :
(i) This pertnil was issued in accordance with the provisions set foAh in }ropur application and is su6ject to the laws of the State of Coloratlo and to the Zoning
Regulations and Building Code of Wheat RidBe, Colorado or anyother applicable ordinances of the City.
(2) This permit shall expire if (A) the work authonzed is not commenced within sizly (60) days from issue date or (B) the building authorized is suspended or
abandoned for a penod of 120 days. (3) If this pertnit 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
onginal plans and specifications and any suspension or abandonment has not exceeded one (1) year. If chan9es are made 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 d2inage problem. (5) Contrector shall notifythe Building Inspectortwenty-four (24)'hours in advance for all inspec[ions and shall receive wririen approval on inspection card before
proceediing with successive phases of ihe job. (6) The i anceggg((( or the
~qyq~o I of drawin s and specifications shall not be consirued to be a permit for, nor an approval of, any violation of the
prou ~~~~~slfr/an~ther ordinance, law, rule or regulation.e bCl e
Chief Building inspector
Please sign Terms and Conditions on reverse side of page.
a~ w~EqT COMMiTNITY DEVELOPMENT DEPARTMENT Building Pemvt tv'umber:
1 v BUILDING INSPECTION LINE - 303-234-5933 Date:
° CITY OF WHEAT RIDGE
u 7$00 WEST 29TH AVEA'UE
WHEAT RIDGE, CO 80033 - (303-235-2855)
y~7~y
C~C ORP~~
r 3r yy~P9s~ F y~.,yl4A~TdjlA9V
Property Owner. C 6CWR C.f~CJ7K ///~i6Q
ProperryAddress: 7,?,,j? G~,esS~ ep 7S lfv,5:
Contractor License No.:
corrq)any:
O\l'!TfR/COR'1"RAC70R SIGFATURE OF UFDERSTANDING AttD AGREEMER7
1 hcreby ccrtify that the sctback disunca proposcd by this permit application are accurstc,
and do no1 violau appticablc ordinanca, rula or rcgulations of [ht Ciry o( Whcat Ridgc or
covrnants, cascrtrcnu or restrictions of rxord; thai all measuremcnis shown, and allcgations
madc arc accurate; that 1 have read and agcc to abidc by all conditions primed on this
appliwtion and that I usumc fuil }csponsibiliry for compliance with thc Whcal Ridge
Building Code (U.B.C) and all othcr applicablc Whpt Ridge Ordinanca, t'or work unda
this pertniL .
(O)N'NERxCONTRAC70R):SIGNED DA7E
Phone :
Phone:,TaS- JS,?-
Construction Value:$ I%D
Permit Fee:$
Plan Review Fee:$
Use Tax:$
Total:$
(OVRJER)(COhTRACfOA): PR7I.TFA DATE
DESCRIPTION: Cn "f-"" ' C~-
C-(`ti ~
BUILDING DEPARTMENT USE ONLY
L~ SIC: Sq.FC:
ZONING COMMENTS:
Approval:
Zoning:
BUILDIN6 COMMENTS:
Approval:
Pueuc Wowcs CoMMeNis: App7oval:
Occupancy: Walls: Roof: Stories: Residential Uniu:
Electricai License No: Plumbing License No: Mechanical License No:
Company: Company. Company:
Expiration Date: Expuation Date: Expuation Date:
ApprovaL - Approval: Ayproval:
(1) ThISPCTIIIIM'15(55YWN'1CCOIYINCCN'IUIUKPryViSjppj$et (OldIIOyOW]PpLCyOOOypaLjSybjKIw tLCIiW50IUKStlUOfCOIOI]AOLIdIpILCIpOlnB
Regu4oons 1W Bui)ding Coda of R'hot Ridge, Cobredo m my wher app&ayk ordinanccs of Lhe Ciry.
This permit shall enpirt if(A) dhe wark aulhoe¢ed is nwt commmced wifiin sury (60) dnys fiqn issue dau m lBJ the building 2ul6orized is susyrndcd ur
abandonM fm a yeriod of 720 days. -
(3) ]f thu prnnit expircc, a new pemiil my be acquired fw a fa ofom-Lalf the amuum nwmally roquirtd, Pruvided no <hanges have bttn w wi0 be made
in Ihe origmal pluis and syaifications and my suspention m abandonmem hm od exceeded wrc (7) yeu. If cfianges tuve bern or if suspnuion or
abandonmem cxcee& oM (1) yor, fuP ka sha0 be paid for a new yenniL
(4) No work of any manna slull be done that will cbaoge thc nanval M. of xvur nuvng a dninage probkm.
(3) Contrxbr shail nod(y fie Bulding lmpecm twrnty-tuur (24) hours iv Wiantt fm all inspec6ons mW shall receiv<vrinrn appmvil on imyecuon <vd
befae procadiny witL succcssive yluuv of the job'
(6) The iuuantt of a pennit or 1M appmwl of Mwings vd syecifinom sha0 m pc conswed ta pe a ycrmit fw. nar an approvil of, my viplation of de
provisions of Ne buiWing codcs w my otFtt ordinaott, hw, ruk or rtgu66ao.
Chief Building Inspector
~
PR4POSED CU ! RB & GUTTER EXfSTING ~ - ! - ~ -
STORM SEWER
EXISTING CUR ' B dt GUTTER ~ ~
EXISTING SANITARY SEWER MANHOLE SIDEWALK
EXISTING STORM
SEWER MANHOLE PR4PERTY UNE
EXlSTlNG FIRE HYDRANT ~
~ EXISTING WATER LINE ~ a~araw i
EXISTING INLET ' ~
PROPOSED W ATER LlNE ;
WATER VALVE pd ; ~ :
EXISTING SAN iTr~ s~wER ~ ~ GRAPHIC SC
~P~ ALE Lt, GUR6 ;
~ ao ~ ~ PROPpSED 5ANiTARY SEWER
CATCH CURB CC ' 1 ~ ,
i
( IN FEET )
1 fneh = 20 it.
e ~ ~
BEGfN CURB & GUTTER
' SAWCU ' T & REMOVE 60.86 CURB
TIE INTO EXISTIN M G ~
EXISTING 12 FES p ~ EXISTING 12 HDPE _ ■ I ~
} _ ~ ~ ~ _._a_ ~ ~ - ~ _ _ ~
~ ~ ~ ~ _ ~ ~ _t , a t
i ' " f'` ~ ~ 8 UTlLITY EASEMENT LANDSCAPING
_.4..,. o - ~ , 4
~ ~ . i ~
~ ~
~ ° EXO~TIN ~ , I ~ G INLET W/ ORIFICE
I ~ I ~ ~ ,
i ° ( i ~ ~ ~ ~ ~ I 1 ~ , f
~ . ASPH ~ I~ ~A i ALT - t° ~ PAVEMENT
a~• ! ~ ~ . ,
° . ~ t~ ` TR - 6 ~ , , ~ ANS
~ ~ R' ti , FORMER ~ 76.07 ll -
o { 4' x 15.26 ( ~ Y ~
~ EXISTI G " ~ TRASH 3 1-v,
WATER~ M IN ~ ~ ~ 4 EXISTING 6"HDPE ~ ~
~ p~. , ° ~ ~i ui , ~ ~ ~ , ~
p , , 4 ERGENC a " ~ ~ NERAT ~ . ~ _a.
~ 4 WALK ~ ~ . . _ ~
i _ 29.6 ~ ~t + ~ , LANp ~ 8.94 , ~
D CURB AND GUTIER REMOVAI ~ Z 36.90 EXISTING ~ SCAPING 7 96 , ~ t
~ 4 a 1 TIE INTO EXISTING , 4 WALK ~ ~ BUiLDING ~ ~ ~
~ EXISTING 12" DRAfN 12~60'
15.53' 3' WALK (L=13')
~
„ _ « ~ ~ I 2 2N~ EXPANSION ~ ~c ~Ni WATER SERVICE W y
~ 2 90' BEND N .
Q 6 90 8EN0
2" WATER METER
= SE~ DET~RIL SHEET 4 " ~ ) 6 D.I.P. FIREI.f~JE i' ~
~ » » _ „ SEE DETAII SHEET 4 , Exisr~~c t ) PHASE 4 BUIL 6 HDPE 2l~ 2 R QSI M r
i I ~ „ _ TF - 5~45.80 ~ s ; ~ 6 x 2J¢ WATER SERVICE TEE
~ ~ „ 8.44 I 9Q (SEE DETA1l SHEET 4
0 ~ 4 r i
~ G ' ~ ~ ~ ° ~ 41. ~ i
EXISTING 6" a ~ v N ;E~iD CURB ~ p ~ WATER MAIN 6 D.I.P. F ' ~n RELOCATE 6 WATER MAIN [r y.
._..r ~ ` ~ n ~E~ ^ ~ ~ WATER CONSTRUCTION PLAN~ i
E ~ BEGIN CUR N~ GAS METER ! ~ ~ B & U _ ~ wv ~ ~ 5.38~ Z ~ ._.m. „ 25.4, ~ ~ ~ S WCUT & REMOVE t74.08 ~ 6 PVC SA~! ~ ~
_ _ ~ARY SE R ~ T!E INTO EXi~ _ .
~ , LANDSCAP ' _ ~____r ~ _ ~ ~ 9 ING
_ ~ ~ ~ ~~y/.~. ~ ~ ~ e ~ 6 ~4 _ ~ ~
zEP ~ _ » ~ H YR 4~ BEGIN 6 WATER MAIN RELOCATION ` ~ R, - , _ .W . . ,
ABANOON EXISTING 6" PIPE . _ _ ~ ~ . ,
' ~ _ 10 MIN. SEPARATION 50 . WATER~A'SE1viEi~ " "E)(~
~ . ~ ~MI ORM MANHQLE „ „ y~~. , 6 TE APPROX. 8" M .4
AIN I~dV 37A9 ~ . TIE 6° HYDRANT ~ ~ _ I , s. ~ ~ ~
! ~ 1 nip ~Nro ~xrs~nN ~x~s~~c ~ ~ "„.„.-4. ~ n t , ~ ~X~ r . . 'i
1Y4 GAa~ LINE r-~-- - TING 6 HDPE ;-.-9~6;~_ , ._.m. ~
P R XC~EL E r » ~ ~ ' - ~ - NERG AS-BUILT, 29 EC- 6 x 6 TEE AND 1 ~ ; ~ / ~ R8, ,
~ L CATI~N T~O~_,, FIELD VERIFIED ~ ~q y~ ~r EXISTING 12 DRAIN ~ ~.g ~ ` I I KICKBLOCK_.~_ ~ IS~UNC~.Sl~II ,AQ,.Y .~9,Nklt~l.E.~..,. ~ ~
RIM 44 ~ (S DE7AIL SHEET 4) t~ LANDSCAPING ~ , .O6
INV IN S ~ _ ~ . ~ R~. I ( ) 34 1 ~
INV OUT ~ , ~ ,,26. N 4.81 ~ ~ ~
~ .
~ ~ I , I ! € ~ 3~
I ; ~ .
+ 4 ~ I ~ i ~ ± . 1 t ! .
~ j ~ ~ ~ x
1 ~ ~ .
! , I RFMOVE
~ ~ ~i ; EkISTI ¢ , 1 r ,:,~r,.,` F < NG ~ ~ ~ ~ p A ~ . ~ ~ t~~ ~ ~ ASPHALT
~..1
t ; ~ F '
:
, ~ ~
~ o EXISTING II
BUILDING ~o
EXISTING ; ; i ~
BUILDIN~ ' ~ i
1=
i" ~ ~
(j ~SPHALT ~ ~ e ~ ~ li'! r~a~rr~,e-.ir •
rnYGMGIV I ~ ' I ' CI ( ~
r'' •
~ ✓ O~ 'g 3 Avenue I
Whea i , t Ridge, Colorado i
. ~ ~ 0 mmm ..e. . ~....e. ~ ~ MM MOM =No UMJ
M ~ . ..,W.... ..y..,,. .....o.,, . ~
~ .d...._ ~ ~ L&O ~ 22.00'
~
L LANDSCAPING
0_ 0 0 _.e.... ~ _ ._._e ~j w... a,.. '
p A.._,. a._ ~ ~ ~ . _ _ . ~ ~
~
~
SINGi.E FAMILY R ES
EXISTING UTIIiTIES NOTE: - ,
FCCALL UTILITY NOTIFICAT(ON N CENTER OF COLORADO Exi
STING UTILITIES SHOWN ARE R£PRODUCED FR4M UTILITY
~ 0 MAPS AND/OR APPARENT SURFACE EVIDENCE, THESE ~
800-922-1987 IOCATIONS & E LEVATIONS SHOULD 8E CONSIDERED ~ ~
L9LI. 2 8U511~ESS DAYS 3N ADVANCE APPROXIMATE ONIY. CONTRACTOR iS RESPONSiBI 1. ALL DlMENSIONS REFERE BEFORE YOU DIG GRA E FOR FIELD
, DE, OR EXCAVATE VERIFICATION OF UTILITY LOCAT10NS AND ELEVAT! UNIESS 4THER~ISE NOTED. FOR THE MARICING OF UNQER{~20UND ONS. NOTIFY ENGINEER IMiMEDiATELY OF ANY DISCREPANCIES WHICH
MEMBER UTILITlES. MAY AFFECT CONSTRUCTION Of lMPROVEMENTS SHOWN HER
EON. ~
B 0 U L D E R A s s o I
~ -
rc itec ture + nteri
~
~
COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number : 76923
BUILDING INSPECTION LINE -(503-234-5933) Date : 4110/2004
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
Property Owner. CLEAR CREEK MOB LLC
Properiy Address : 7809 W 38TH AVE Phone : 313-893-0250
Contractor License No. : 21665
Company : Riviera Electric Phone : 937-9300
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 restriclions of record; that all measurements shown, and allegations
made are accu2te; that I have read and agree to abide by all conditions printed on this
appliration, and that I assume full responsibility for compliance with the Wheat Ridge Building
Code (U.B.C J and all other applicable W heat Ridge ordiryAnces, for work under this permit.
(OWNER)(CONTRACTOR) SIGNED / DATE "9 aS!
.
Description : TEMP METER AND TEMP OFFICE TRAILER HOOKUP
mo
BUILDING DEPARTMENT USE ONLY
ffigrffiQ~ e , SIC : Sq. Ft. :
k7
Approval:
Zoning :
~Gurrj~~
Approval:
ub i`, ;or ~ u en~
Approval :
Occupancy : WaIIs : Roof : Stories : Residential Units :
Electrical License No : 21665 Plumbing License No : Mechanical License No :
Company : Riviera Electric Company : Company :
Expiration Date : 2/28/2005
Approval : OKIKS Expiration Date : Expiration Date :
Approval : Approval :
(1) This pemit was issued in accordance with the provisions set foAh in yopur application and is subject to the laws of the State of Colorado and to the Zoning
Regulations and Building Code of Wheat Ridge, Coloredo or anyother applicable ordinances of the City.
(2) This pemit shall expire if (A) the work authonzed is not commenced wilhin sixty (60) days from issue date or (B) the building authorized is suspended or
abandoned for a period of 720 days.
(3) If this pemit expires, a new pemit may be acquired for a fee of one-half the amount nortnally required, provided no changes have been orwill be made in the
- original plans and specifcations and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspension or abandonment
exceeds one (1) year, full fees shall be paid for a new pertnit . .
(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 Inspectorhvenry-four (24) hours in advance for all inspections and shall receive wntten appmval on inspection card before
proceediingwithsuccessivephasesofthejob. (6) The issuance of a pemit orthe approval of drawings and specifications shall not be cons[rued to be a permitfor, nor an approval of, anyviolation of the
pmvisions of the buildinAg ,co'des or an~jther ordinance, law, rule or regulation. VI/eea$ Kit~e
Chief Building Inspector
Construction Value :
$2,500.00
Permit Fee :
$108.30
Plan Review Fee :
$0.00
Use Tax :
$30.00
Total:
$138.30
Use :
Please sign Terms and Conditions on reverse side of page.
a~ wNF4r COMMUNITY DEVELOPMENT DEPARTMENT Building Pemut Number:
, c BUILDING INSPECTION LINE - 303-234-5933 Date:
° CITY OF WHEAT RIDGE
V 7500 WEST 29TH AVEA'UE
p~~ ORPQ~ WHEAT RIDGE, CO 80033 -(3y03-23j5-j2¢85y5~y)
9iPH 's~yy~p~~
i"$a~l ~.?~1 d 41A4 V
PropertyOwner: ClP_qx Creek YVi08 I.LC De.ve/orment Svlwt,i,n 5rouP 1-(.d.
ProperryAddress: ip55 ,gorariaPw-kWay S+3oo Danuer,CD 8oa.af Phone:~303~ g93-d~v
ContractorLicenseido.: gawwxq~ ~~J
& q ~
Company: Riuier[~6lec,riC U~l rPhone:(3o3) q37-9306
ON'ItER/COK"I"RACTOR SIGNATURE OF tiRDER$7ANDING MD AGREEMEtf7
1 hereby cMify thai the sctback distanca proposed by this peririit application are accurzte,
and do not vioiate applicablc ordinanca, rula or regulaUOns of [he Ciry of Whwt Ridge or
<ovrnanis, wscmrnu or rcstrictions ofrxord; that ail rt~easurrnxnts shown, and allegations
madc arc aceuau; that 1 have read and agrcc to abidc by all conditions printcd on this
application and that 1 azsume fuil responmbiliry for compliance with thc Whp1 Ridge
Building Code (U.B.C) and ail otHer appiicablc Whcat Aidge Ordinances, for work unda
this pertnit. .
10NRJERy,CONTRAC70R):SIGNEDDATE q'9"U
!
(ON'NER)(CON7RACTOR): PRII.7ED DpTE
Construction Value:$ 2~5oa
PermitFee:$ I08,30
Plan Review Fee:$
UseTax:$ -3a,00
Total:$
13S,3o
DESCRIPTION: %en~~ O ~~'iGe %rq~~e~,
~
BUILDING DEPARTMENT USE ONLY
SIC: Sq.Ft.:
ZONING COMMENTS Approval:
Zoning:
BUILDIN6 COMMENTS:
ApprovaL
PVDUC WORI(S COMMENTS:
Approval:
Occupancy: Walls: Roof: Stories: Residenrial Uniu:
Electrical License No: Plumbing License No: Mechanical License No:
Company: CouipanY Company:
Expiration Date: Expiration Date: Expiraeon Date:
Approval: Approval: Approval: (7) Thu permit was issued in accordantt with Uie ptovjsj,,, fonfi io your appticarioo aod is subjw a i6e 6ws of ihe Sute otCobndo and w 6e Zoning
Regulations and Building Codcs o( Wha1 Ridge, Cobredo w any othw applicabk ordinanca of th<Ciry.
This pemiit shall ezpirt if(A) i6e work amhorized is rwt commrnced wirhio sury (60) dayy frvm issue dmc m(B) the bwlding 3utM1orized is suryended or
abandoned frn a yeriod of 120 days:
(3) if thu permit expim, a new pmnif may be xqwred for a fa of om-Lalf ihe unqmi normilly reqwred, provided no changet have ban w will be made
in t6e wigiTui plens and syecifxations and any suyyrnswo or ayaodonment has na uceeded oM (7) yor. If cLanges have ban or if susynuion w
abandonment exceeds moe (1) ynr, fu➢ ftts sha0 be paid for a new pcfmii
(4) No work of any manrcr shail bc done dwt wifl chaoge the nyquy ibw of wvur caming a dnimge pmbkm.
(i) Cmtracw shali nwufy ihs Bulding lnryetmr tweoty.four (21) Iwun io advance fa ill inryeruons md s1u0 receire wnaeo appmwl on inryeeuon card
bcfrne Vraeedin8 wiih successiv<p6a}es of thejab.
(6) ibe issuaoce of a pennit w Ibe appmwl of Mwings and specificatiwu s6a11 nw1 be mnstrued b be a pemnit fw, oor an ayprovil of, any violation of fie
pm%isions of the bui{ding codes or any odw ordinaoce, 6w, ruk or rcguhuon.
Chief Building Inspecror
WHEAT RIDGE FIRE PROTECTION DISTRICT
PO BOX 507 • 3880 UPHAM STREET • WNEAT RIDGE, COLORADO 800340507
303-403-5900 • FAX303-940-0350 • WWW.WRFIRE.ORG
January 29, 2004
To: Darin Morgan
Chief Building Admiuistrator
City of Wheat Ridge
Wheat Ridge, Co.
80033
76W P.
Subject: Approval of Building Plans for Cleaz Creek Surgery Center, 38 & Zephyr St.,
Wheat Ridge, Co., 80033
Dear Darin,
After a review of the building plans for Clear Creek Surgery Center located at 38 &
Zephyr, I am submitting the following comments and requirements for this particular project:
Provide complete plans for fire sprinkler system for building. Plans must be approved prior
to installation and will require a fire department pernut.
2. Provide complete plans for 6re main into building. Fire main will require a fire department
pernut prior to installation.
Provide complete plans for fire alarm system for project. Fire alaim system must be
addressable. Plans must be approved prior to installation and will require a fire department
pernrit.
4. Issues and or items not addressed at tlris time witl be addressed as need arises.
If there are any questions conceming this project, I can be contacted at 303-403-5902, or
Pager nusnber 303-687-7336. Thank you for your help and consideration regarding this matter.
Respectfully,
4:~oberts
F.M., W.R.F.P.D.
COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number : 76926
BUILDING INSPECTION LINE -(305-234-5953) Date : 4/9/2004
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
Property Owner: CLEAR CREEK MOB, LLC
Property Address : 7809 W 38TH AVE
Contractor License No. : 21902
Phone :
Company : Turner Construction Ca Phone : 753-9600
OWNER/CONTR4CTOR 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 Ciry of Wheat Ridge or
covenants, easements or restrictions of record; that all measurements shown, and allegations
made are accurate; ihat I have read and agree to abide by all conditions printed on this
appliration, and that I assume full responsibility for compliance with the Wheat Ridge Building
Code (U.B.C.) and all other applicable WheatWv ordinances, for work under this permit.
(OW NER)(CONTRACTOR)
Description : MEDICAL OFFICE BUILDING
Construction Value : $2,394,000.00
Permit Fee : $13,915.45
Pian Review Fee : $9,045.04
Use Tax : $28,728.00
Total: $51,688.49
Use :
L173QZJ
l
GOICa a-
nin9rQ1
Approval : MR
Zoning :
Approval : DM
Approval : DFB
Occupancy: Walls
BUILDING DEPARTMENT USE ONLY
sIC: p[ease*4eF.:
OK TO ISSUE. 3112104 Qivnet/ Contmctor is responsible for loeafleS PTOp'
t~q ~d cpnshuctin~ iinpro~ cmentsment standao
apptoved plan et,d Teqa'~e3 develop
'fhe City is not *:s;~o;lsible tior inaccuraW informa
3111/04 ~bmitted i=r~~ Fl~ set and any
ecrors resulting from inaccurate information.
PLEASE SEE ATTACHED SHEETS.
Roof : Stories : 1 Residential Units :
Electrical License No : 21665
Company : Riviera Electric
Expiration Date : 2/28/2005
Approval : OKIKS
Plumbing License No :21910
Company :Trinity Mechanical, Inc.
Expiration Date : 3/31/2005
Approval : OK/KS
Mechanicai License No : 21910
Company : Trinity Mechanical, lnc.
Expiration Date : 3/31/2005
Approval : OK/KS
(1) This pertnit was issued in accordance with the provisions set forth in yopur application and is subject to ihe laws of ihe STate of Colorado and to the Zoning Regulations and Building Code of Wheat Ridge, Colorado or any other applicable ordinances of the City.
(2) This pertnit shall expire if (A) ihe work authonzad is not commenced within sixly (60) days from issue date or (B) the builtling authorized is suspended or
abandoned for a period of 120 days. (3) If this pertnit expires, a new pertnit may be acquired for a fee of onc half the amount nortnally requiretl, provided no changes have been or will be made in the
original plans and specifcations and any suspension or abandonment has not exceeded one (1) year. If changes are.made or if suspension or abandonment
exceetls one (7) year, full fees shall be paid for anew pertnit. (4) No work of any manner shall be done that will chan9e the natural Flow of water causing a d2inage problem.
(5) Contractor shall notifythe Building Inspectortwenty-four (24) hours in advance for all inspedions and shall receive written approval on inspection card before
proceediing with successive phases of the job.
(6) The issy~ nce of p i r the ap val of drawings and specifcations shall not be construed to be a pertnit for, nor an approval of, any violation of the
provisloisDUt~~u Iiotle~ohg ordinance, law, rule or regulation. L GD [LG
Chief Building Inspector
Please sign Terms and Conditions on reverse side of page.
4A09 COMMUNI7Y DEVEIOPMENT DEPARTMENT Building Permit Number.
TION LINE- (303•234•5933) Date:
F WRIDGE
CITY O
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 •(303•235•2855)
APPLICATION
Property Uvner: ~--~--C-
Property Address: Phone :
Contractor License No.: ~
Company: ('c,. ~.~9s ~o v. c~ b.\ C-'-v.I Phone: 3O -3~-
OWNEfUCA1tT3UCT0A SIGNANRE OF UNDERSTANqNG AND AGREEMENT
I hereby ce.tily ihat the setbadc dstances ProWsed by this pertnit apprcation are aaurate, and do not valale
applicabie oNinances, rules a reguWtiors of the Ciry d Wheat RiOge w covenants, easements m restric5ons ol Construction V alue: S Z,3~4; d
remrd; that aA rtrzsuremenls shown, and allegaGans matle are accurate; ihat I have reatl and agree to abide by permit Fee: $ l 3;~J--~
all corqNOns pinled on this application and that I asswne NII respons3ili.y lor mmpl"iance wiU Lhe wheat Ritlge P~~ Review Fee:
Buifdirg Code (U.B.C) an0 ali oNe1 applicaMe Wheat Ri e Ordi es. fw work urroe~ Lha pemut
L1Se TdJC: So a
(rnvn_rxncawr~cTO~ swNeo --~~Fre i 13~0~1 ZZ°
(OWNERNCONiRACTOR): PRkITEO {"'Q-S~ ~ oxTEYlS1Q Total Fee:
DESCRIPTION: •
Np Ccl
BUILDING DEPARTMENT USE ONLY
SIC:
Approval:
Zoning:
41EMT5:
APProval.(31'~-
Approval:
-u I~
Electrical L+cense No: a~ l(lQ- Plumbing License No: Mechaniwl License No:
Company~`Q~`~. CompanY:- ~kyiyl.~t (k9-2i~ Company.'`-\"✓`e'I-0..
'
Expiration Date: Expiration Date: Expiration Date:
Approval: Approval: ApProval:
nh o." w,s wme m scwaMc..rn me woMim• •r ionn M row appkam aW i. weMa m me i..n w me stm a eow,ao ma ro me zanwy a.yurems
aMBuilBnp[adudWAUlRdis.tdaadoorrryaMappfoDNwdnanasdtMGry.
(2) TAMDwA1dWwpinN(A)tMwarAMAOriudNmd camrncWrMhM+6lyiwldry+hombweertt a(B)tMMildn9wjdOrixWnwspwMed«abw4omdlarapwbd d 110 Arys.
(3) f IWDowAt extilsse.iMwVMaiaaj'bacqiWMaIMdMlhillthe aowMawmg7rsqWYb.DmmdW lqchrqnhme bMMIAEe (NdlMMe pipMY
plrs and ; 'N ; -1 s aod a" wspenaoe aaE+ndonmrA hs uai nce" on, f117m- IF donqq Tm bwn a[ seWmabn or aDandonnrR nctsN om (7)
Yor. 10 fia " M Vabd tor s uw vensilt.
44) NoworkMae)muner " WOOee tlulwadwnqlMnaeralMwolwmwouWMYa drai^aPWobhen.
(S) CMbi00r iTli wWI kM billiS^O tiWKtorr UMV'kw R4) AOWf YI WnRU M i1 MpKlbns ioO iAill IMre waMlM apprdeil OC NtyWfpe CiN bAme
porwBnp+MA wwsdw isea dfM JoA (6) 1M itwaen d a DrwAt a IEe +OVe+al d B+Mrp rb sytlfintiont shal aal b conatruW lo De a Dernift Iw. rwr an +7Prm'al M. any violation o! Ne Wwebns M
Ne WYdlilwda n sy oMr adnana.law. rvN a npWaGm.
Chlef
COMMUNI7Y DEYELOPM N EPARTMENT 5uild inA_Fermit Number:
~rL2;::6INSPE£iION NE (303•2345933) Oate:
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENU
WHEAT RIDGE, CO 80033 - (303•235•2855)
APPUCATION
PropeRy owr,er ~ lc~-i G e~k N\cj~s , L-Lr--
Property Address: je~~ ~y i- Phone :
Contracior Ucense No.: ~ c~
Company: 5'~ v, c e.% Ct...v.~ Q"y Fhone:
l
pWNER/LONiMCTOR 51GNATURE OF UNDERSTANqNG AND AGRfEYEM
1 nereny ce.ti7 mat n,e semack aislances woD~d M mis perma apvk~bai are aaurate. ana ao noi vawle
ypplii~yple ol{uiynces, rules a regulatiors ol the Cgy d Wheal Rdge a ~ enants, easemenis or resUi-~,.,bns of Construction V alue: 5
reaW: Nat a1 measurements sMwn. ard aAega6au ma0e are aaurate: that I have rea0 3n0 agree 10 aDde by Permi t Fee: l5t-
ap prqibpny priMeC on N"s appGCaCOn arnd liat I aswme fu6 respons.y lo: compliance with C~e NTeal R;Nge Plan Review Fee: ~
Buiding CoOe (U-B.C) antl all otlim app6caMe Wtieat R~ e Ord~ , Ior wonk under fhis ~:m2 i ,
LSCT3X:
(OWNERAC<7N;RAC%OR). SIGNEO ✓ ~ja7E
jpNTiEfiMCONTiUCTOft):VRINTED DA7E1 Tota]Fee: ~Sl,bc+o~
DESCRIPTION:
0
. ~R~.
BU1lDING DEPARTMENT USE ONLY
SIC: I~r~~ ,Sq.Ft.:
V II ` :
2a+ew Caw[xrS:
APProvaC
Zoning:
euKowc caireMrs:
Approval:
AlE~r'A C.vt~~u~2.~S STf!-wL/~ ~ S6C-s,v,t-r~s `
waucwaascausxn: N - - ~
Ayproval:
Electrical L'+cense No: Plumbing License No: Mechanical ticense No:
Company: Company: Company:
Expintion Date: Expiration Date: Expintion Date:
ppproval: Approval: Approval:
~7~ TEM prmll hw~d M smwd~ea ~i1! IM pori~ienf an bM b row apy0caum and N suD}~q In qt bn d tEr Shte d Cobndo arM ~o th<Zai~y Rpu4GOns
. ' a0&iWMCo6nMWlulRNy4,CWasdoaairyatlwappiWNadamnadUeCllr.
(t~ ibM Orwl " expIn Y W WwerY wtlwrl»d h iwl cammmicW wMA4 rMY (M) GM han bw, Mb a(8) IM biiry stlwri:od b auapeMtl a aDrWenM br a
prbd d 7M arys, (3) 9 UM Vewl awine, aewVr" M M aryuiM fer a ir d enMa tlhr swwal wnnYy nPiVM. Pa'WM no dsann Man br vW M mA& M V e aipMW
plrn aW spodkOm +^A aq imsfemsim aabridwmra Aa wol uWW am (1) Yw. V Wnyq Lm bme a II suNm+b+ a aDailimmewit uc«h em (t)
Yw. N fia aRi b►+b la s sw yrei
{q NewMd+eYsrwNibdwtlalWdiaep MeaeralAwdtiYW ousinpadrainap podra
(5) Laibado/ dd wtry 1M 9101BP'/ 111101,60er b"ll`iar Q1) li~ I. adraect br al AmpeGMS rM " nnir6 rMr appmal w YuWcbm Wd Wlore
qecwd~y+tl ssussM N+~ MtMkk
m 7M iswuc~ d a V~ > IM+Ppn'al d trwbp~ aM spodkaOOns Aal nal b wnwwd to De a VwmN la, nor an +oP~Y ol, anr riobuon W Nr W"+iona d
ON OYW*lO WOq> Y7 EIM OlalillCe.IT1.lW G/lpldibMl.
Chief Building Inspedor
o~ W"E4r COMMUNITY DEVELOPMENT DEPARTMENT Building Permil Number:
, ,z,T10N LINE - (303-234-5933) Date:
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
CO~~ppO~ WHEAT RIDGE, CO 80033 -(303-235•2855) ~n
APPLICATION ~g 7
---OM9 G,r, e
Property Owner. LL-C-- V~j
Property Address: IPhone:
Contractor license No.: ~
Company: Phone:ci'
Mt_ l~ v~ v~e.srn-~ 303 -~-134 - G~11 ~
OWNEfUCONiRALTOR SIGNANRE OF UHDERSTANDIHG AND AGREENENT
1 hereby ceAify Nat the setbadc distances pmposed by Nis permil application are accurate, antl do not violate
applicaDle obinances, rules w reguWtiors ot the Giry of 4Jheat R'bge or covenants, easemenls or resVictions ol
recDrd: that all measu2ments shOwn, and ailegalron5 m2tle are aau2te; Nat I have reaE and agree to abitle by
all coMiOOns piinted on ths applicaUOn and that I assume lull responsibiliry for complarice wiN Ue Wheal Ridge
Building Code (U.B.C) and ali other applirable Wheat R~~q ~e O/rdbr work under iha pertnA.
(OWNER)tCONTRFCTOR)- SIGNED ATE I I 3/
(OwNEft)(COMRACTOR): PRINTED - av DATEk /1 ~ O
Construction Value: S0
Permit Fee: $ t 3 i9 (S
Plan Review Fee: S q~ &k-S
Use Tax: S Zg 7za,
Total Fee: $'51
,
DESCRIPTION: • , ~
BUILOING DEPARTMENT USE ONLY
i SIC:
,~ns: k \
ApProval:
Zoning ~
Approval:
RIBLIC WONIlS COMMENTS:
Approval:
Electricall
Company:
Expiration Date:
Approval:
~Y--
vvai;S^DUi. ~JileS:
Plumbing License No:
Company:
Expiretion Date:
Approval:
~.Ft~:
i;esid'cri i~oi 'v'n:;s
MechanicalLicense No:
Company:
Expira6on Date:
Approval:
(i) 7bq ppmR waf Iasuad N accordana wtA the prm'lalms se11M6 in yeur+pVksbm aM h sub)cd to the lawi W the Stah ol CobnOO and ta Mt Zoning Repubtians
md Bu{Idn9 Codn o1NTW RidW. Cdondo w anr aMr appFnDk or&nanca dMe CMy.
(7) Thb pamit Md eapin M(A) the wMi Mhorlxed la nwl commene9d wphin strty (60) dsyf hom bwe dale w (B) the buiWng authorhed N wapendsd a abandoned /w a
prbd d 120 dryt
(J) tl Uh Vwni aVkn. a nnr ➢m* mY b acVWrsd M a fa ol nns-LaII the amount normaBY nW6M, pevidtl m Uan9n hare 6ean a will be msde in the ariylnY
dvs ua +v.Waabm• ma .y wwm;an «.w~ammem eu not u«ed.a on. (1) rw. r dwpa nm ew a x suwension a an.raonm.rt uc.ew m. (i)
yer.lutlfaa sAaC W Wk lor a aw DrmN.
41) No roA ot aay mennr ahad Oe done tlul w1W danW the nahrtal Mr ol wriw autNY a dnMye poWan
(5) p~oc..~dmy nshoM mi w~aar.. vhuu d ~newK+« ~«~n-~~ R4) nwn m,arance rw .a MspWlons ma aAm rscWe w,IWn aypwal on wpactlon wa b.f«e
(6) The IswaMe d a pwnit a the approval d trmrAnqs and sperMcations shal ad be conWUed to be s pamil fa. na an apporal of, anY vidatlon ol the pravisbns ol
me euaaxro Wan or mr an.aam.n«, ia,+, rat a nowmm.
Chief Building Inspector
PLRNNING & PW Fax:3032352857
~t< Transmit Conf_Raport 4-V
P 1 Rpr 9 2004 15:53
C D.0.7 ] C Check condition of remote Fax. ] C 993034242280 7
city of Wheat Ridge
Fax TransM"IttOl
Da'rE:
Name:
Organixation:
Fax:
Phone:
Frdm:
Department:
7500 West 29th Avenue * Wheat Ridge, CO 80033
Planning: Phone # (303) 235-2846
Public Works: Phone # (303) 235-2861
Building Department Phone # (303) 235-285
Fax; Phone # (303) 235-2 7
~
Kris Shutto- Bufldin D~ t. S~cr a
Planning p Building Dept. j4 Public Works
o Contractors License Ap,pl. o Fee Schedule I
Q Ctass 1&2 ,License Appl. Q Building Permit Application
a EIectrical KOther;
a Contractor.License Renewal
# of Pages: (Includ9na cover paae) ~
Comments: eed.• c7 co ze o cnree jj su„"...-.. .
License ❑ Ca ies a State lectrical Contractors & nscers Lice es
Q ertf cate o Insurance ~
LPrc
Messaee:
city of Wheat Ridge
Fax Transmittzkl
7500 West 29th Avenue *
Planning:
Public Works
Building Depnrtment
Fax:
DATE:
Nnme:
Orgnnization:
Fax:
Phone:
~ 1 -oy
~u~~TG s
Wheat Ridge, CO 80033
Phone # (303) 235-2846
Phone # (303) 235-2861
Phone # (303) 235-2855
Phone # (303) 235-2857
From: Kristy Shutto- Buildina Dep4 Secre4arv
Department: Planning ❑ Building Dept. X Public Works ❑
Sub ject: o Contractors License Appl.
o Class 1&2 License Appl.
o Electrical
o Contractor License Renewal
oFee Schedule
OBuildingPermit Application
KOther:
# of Pages: (Including cover paae)
~o
Comments: Need• oCopies ofthree (3) current citv licenses o Copv ofMaster Plumber
License o Copies ofState Electrical Contractors & Masters Licenses
Original to follow in the mail ❑ Yes "o
rGi---J ~ 2 CL l GFR~2~' T0~2. fU S. ~-'-C r v v< < ~
From:DEVELOPMENT SOLUTIONS GROUP 303 893 0251
FAX
To:
From;
Date:
RE:
Na ot Pagse (Incl. Cwerk v 2;
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TWi. te& d*%ft*R" MtwrLA OsAl A"
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NOTE: This facsimNe wmmunlradon may conlain CONFIDEN7IAL INFORMATION which is iniended
oMy for the use of the Addfessee(s) named e6ove. If you are not the intended tecipient of fhis
ammunkatlon, afhe emp(oyee or agent responalble Por delNedng ft to me intended reciptent, yau are
hereby notlfied that any dissemine6on Or Copying of tlfls eommun/cadon may be sMcdy pmhPotled. H
you have iecelved lhis communica6or+ !n ermr, p/eese noUfy us lmmedlately by ieplying fo fhis
communication and discardfng it
04J07/2004 09:46 #461 P.001/005
DEVELOPMENT
SOLUTION9~
G80UP ~
6~. • ~A•~r+..~
1055 Aurada Paek+rey, Suhe 300
Derner, Coloredo 80204
ph. 303-8830250 Fex 303-883-0257
From:DEVELOPMENT SOLUTIONS GROUP 303 893 0251 04/07/2004 09:46 #461 P.002/005
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be4vdeit Gesald W. Tcmlinaoa d/b/e, Tom2j.haon & Company and Maxion
R. Tomlinevn, pastiee of'she.fir4t party and'.WheaY Rydge Sani-
tation Dlstrict, aI quasi-municipal corporation of the State of
-.COloradc, party Qf,the aecond part,WITNE89ETHa^
, Thnt the said paTtieb of thefiYat part, £or and in con-
sideration o£ the.~aum oE One Dollar and oehes good and valuable
eonsidesation to aeSd partiea in hand'paid by party 4£ the aecond
pazt, the recolpc whergo€ 14, hezeDy cenfeas'td and acknovledged „
•ha"ve'cjYkrtted, Sez9ein48, 9c13~• conveyed, aselgned and set ovez,.
and by these, presente 9o.9zana,,ba=gain',;eall,, convey,, aaeign
~ and, set'over,qnto parey o`E.the aecon8'pent e11 of the fo7lawing ,
d Vco
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desCxibedprvQerty sitvate in the Cdunty of Jeffexson, State of , .
~ C Coloxado,'.'to-wits " • g`,~ . ' - ' .
A sbrip uf laod lying,5 'feeE eithAr aide ofi a line, eaid,atYip to_, .jy . bauaed aeanon-exclusiva.eaaemenC for an 8 inch diameter vieificd •
' clay pipe aewer. lirje•,'.said lina lying.in the £ast one-half vf the '
southWe9t one-quaxtes, of the aoutheast one-quarter of the 9ouCh- ~ ' •
weet.one-quarte4'oP 8eetion23,Tamehip 3 5outh, Ranqg 69 Weet
o£ the @th FtS.t~te~Mexiflian,_ Countp of JeEfereon, 6tnte of Coloradoi-
'b2ing mose, particularly deaaribed ae .followa:, ' -
Heginpin9 at,tkiil southwest coarier oP said ee5t one-helf of'the
southweat ane-quaelar.oF the southCast'one-quartez of the southwest " . ane-qnasterp'LiianceN 00907'45°E a dlstance of 30.00,feet 'to a,.
point on.ihe nozth4tjg4,tkjhe nf.Way line oi Weet 38th Avenue,. saidpoint 6eing..t'hq,Cameaa the eputheaet Cosriez ef the ➢chert .
-'SubBioiaion ae:;,'epord48; in Plafi 8qok 14 on Pag2 59 in the OE£ice a£ the C1eYk anQRecos3er of aaiq"Jc££erson eounty; tAence 9 090
. 59,1511 E along saYd''noxtiierly right oF wny line of Weat 38th -
AvBnue e'distanee oY 159.5 feee Cb tlie True Point af Beginning; 'thence N. 00007'65'E aleng a'7:ine and said 5' feet eithez eide b.f .i
' 6aid'llne, a di'9tahc'E nP 63L;42~feat.to a point oE CezmineeiOn
ae eentezyine•of Wdet 3,9~hAvenne, said line and eaid 5£eet eSther•
entizely within a 50 Poct non-exclusive
. wster, lY~Se(eaeement.g'ranted eo the whene Ridge water Dietsict -aqd
15 feet,west0zly, 0£'n.6'inchcast' iron.water maiA. Lying 15„Eeet"
wqae. o£_tteeasterly lim,it of ea}d `rion-exclueive watex line easetncnt_',_
. . ' . , .
. ,,TOGBTAEA with.alY,atid'yingyl@z•the appurtenaneQS, sights snd eaeementa, therevnto ,bel'onc~-ing, or isr ;etnyyise appeztaining, - and .a'il . ' ` . . of theeetiate~,•right; n~eieBt, q1alm,and demand wkiatBOeVen:
' oE aaid~pqsties'of. tN6 £itati'p8rt Gither 'in 1ew ox'in eqvity,'of
' . in and:YO the'.abo've'b3sgained.pr6ioiaea and appurtienances. . , -
~ TO HAVB AND'TD'SOLA.the aama,Eoget7iez WiYh sll and~singular.
~ the agpurtena.nce4'sad grivllegea.ihereunto bplongingoa.inanywdse.
,.thereunto a~ppeitaining,.andl aTL ehi;asta'te, i'ight,title, interesY , •
~end c1almwhaEsoaVer oi.'the.,aaidpeztiiee7o£ thQ-iirat gast eiChez
in law or'equity..LO'-tha onl-y_propei•.g'pe; benefit an$.bohnoE dt~
its:-suceassor . a':and" asaigna' Eo;ev
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:hezeunb6;'se4^theiz- hande;'and seals_,~hs..day"ah8 yeq,i;fixs~;above~ : ' ;Ij' ~
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From:DEVELOPMENT SOLUTIONS GROUP 303 893 0251 04107/2004 09:47 #461 P.003/005
~ 8TAT6 OP - COLOAADO.~)..'
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. . . COUDITY OE J£FFERSON~ , . , . : . . . ~ . ~ . .
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The fore ding inaEsumept' wa's acknowleBged beEore me thia a3`-:
~ dey 09 19.76 'hy.Ge;ald.W.-TOmlineon d/b/a Tomlinsdn
~ • 5, Compan and,Marion K. Tomlinaaag~ i.~ ~
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My' commiffiion expixes:, My gppIdssjon expi~es Augpst 6, 137;,
' WITNE6S my hnnd,~aricts~o.fficial •seal,' . ' . • - . , ~ „ ,
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From:DEVELOPMENT SOLUTIONS GROUP 303 893 0251 04/07/2004 09:48 #461 P.004/005
779676.1..i;;r,ar,is 1-,h11(y o6 °.r7~3.82siKi;,
:c_c!~ olJefFCr:rPSi!~~b° ~G• P4.6I: 4 iq
` 7 "g-96'76 ' ,:~,:o,eoa m 2841 807 . r•.Fis9rserrr"
,
" THY6 INDENTqRH, made Lhia h7~' cIay o€•~_, 1976, by , • 'and Detveen GeTald w. Tomlin9on d%4/a Tomlinsaq A Company and Metion '
R. Tomlinson, Past}es o£ the Firat paxt, and Whedt Ridge 5anitation oistrict, a quasi-munieipal cozporation,' of the County of Jeffezson, 'Siate of Colosado, 8arty ob the,5econd Phrts ' , .
SVITNE55ETH,that fez arid in consideration of the sum 04 ONE DOI.LAR ($1.00) arid other,good and valuable cdneidezations in hand .
paid to the Pamtiea of the Fisst Pazty by the Pa;ty of the Second Part, , i the receipt of whieh ie hexc7iy acknowled9ed, eaid 2arties ot the Yi_st , Paze does hereby gzant, bargain,~ae7,1, convey end wazxanc to tne .
Party of the Second Part'y, i1s aucceseoce and esaigna forevez, a right-
oi-uay and easemer.t under end,a'crose the following de6czibed lae8,• situate in the County of Jef.fexaon and 6tate vf ColoYado, to-vit: .
~
A
A atrip of land lyi.ng'Sfezt aither aide of a line, eaid atrip to
be uaed as , a non-exclusive easement foz an B inch diemeter vitified
clay pipe'sewex line, said line'lying in the East one-hal£ o£ the
southwes't,one-quaxter of tha,southeast one-qu6=teS oP the -south-
. weet one-quastes oE section 23, Townehip d south, Range 69 West of
the 6th Pzime Mexidhn, CounCy af.Je££eison, 6tate of Colorado; :
hcing more particulasly degcxibed aQ follpws:,
8eginning at the southwest aazneY cY said eest one-half of the
sovth.aesi one-quaxEez o4 the scutheast one-quartex of the southwese
;j
ane-quartez; thence N.0007'45" E a distanee of 30.00 feet to a.
point on the nostherly sighi of way line of west 39th Avenue,
eaid point being the same aa the southeest oosner of the L'chert '
Sukdivision ae iecerfled in Plat Book14 on Page 56 in the,Of41ce. .
of.the'C1'erksnd RecozdeY of said JaEfe=son CounCy; thenee,9 B9°'
.
59"15" E.along said hoztherly right oE way line of west 38th ,
I
Abenue a distance o£-159,5 feet to the True Point oP Beqinning;';
'
a'line and said 5 Feet either side of
thence N 00°07.'45"Ealon4
.
aaid lirie, a dieCance. of 631,42 fee~ to a point of tezmination
at centierlihe of Weat39th Avenue, saifl line and said 5£eet eiehez
_
eide of 'said li.n'e-liea:antixely within a 50 fdot nen-excTusive
'
water line, easement gianted to the Wheat RidgetAteL DiatTiCt and
.
15 feet westetly'olt a6inch.oast iron water main lying 15 feet
.
west oP the eastaz3y limi6 oE said non-exclusive watez line eaeement,
. It is-underss.ood that the susface of the land will be,returned
to iY6"original condition anathat any damage eaused to adjacent .
ldr.d'oS str.uctutes esihe resdle oE sanitaxy sewzr line conatxuction .
~
.
5econd Yast. •
ar.rriaintenance will b~ paid'by,the Party of the
,
, • . . . ,
' TOGEfitER wiili the r}ghe Co'-Che eaid Pasty o£ the 9econB-Pase '
'
.
,,.ytesuece6sozs and assigns, top],ace, maintein, inapect,.xepair,~
Teplace, oz add td.said 3ewez.lina or aeweY linas, ae the Secdnd .
, •
Party 6ha11 determlhe, and„tRe Second Party ahall have the right of
'
,
.ingxees an8 egress to and over•the'aLOVe deeCxibed pLemiaes at any.
end a11 time6 Por the puspose cE =epniting,.senewing, replaeingt oY
addirg to'aaid eeNer 1Lne, And,fos:doing anything necessaxy oz uaefal
oz convenitns Por the.easement ha'rein gsante8, Logether with the..
psivilege of xsPyacii,gat any Yime ony or 911 of sY.e seti+ez Lines
•
conatzueted underrsaid land.
Tha~Partfee oftheFizat.PaFt~axpreaaly reserve the aight tp '
'
;
s'.
use'Lhe, afozed'eaerilied,easement -fos 'the installation ol cther utili-tie
"
.
and
such as "power.]inea,;telep'hone ~lipis•,,.arid drainsge faeil'itiea
• gtoSided, that th'e g.zrsCPaxbies 9#t21L; not' esect O=constsuct any,,.
•
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From:DEVELOPMENT SOLUTIONS GROUP 303 893 0251 04/07/2004 09:48 #461 P.005/005
, . . . .
, : - zs4x sos.
• • .
building or improvements exceot fencee ovez oi• upon aaid ].anda.
~ The pmovielonsHeYeo£ 9hq11 Sr.u=e io the benetit of and bind ;
j successoxs and aseigna of the respeetioe parties hesetp and all
~ cover.ants ahall apply to and run,With the land.
ZN FIITNES5 wHEREOB~.rhe Pazties o4 the~Fi=st Part have set .
their hande, and,eeale the day end year fizst abova wriktin., .
•
, . ~ ceoxge W. momlinson d/b/a
Tomlinaon S Company.'
. • ~ ~ . Mnzyon x. Tomlinavn .
i ~ STATE 'OF COI.ORADO
) as.
' COSJ2yTY OF TEFF$RSON
. ~ The Eazegoing.instxument wes anknowledge9 before me this
day oE , 1976 by,George W. Tomlinson d/b/a 'tomlinson~.
~ s Campany an 'Marion A: Tomlinson.
~ My commission, expi=es: Ky. Opmmission expir¢s Aupust 6, ISJ.;
~wi~rNeSS My hand and eLficial sea1.
~ . . ' . '
~ . " . . ~ • Natfty Pub ic " ~ . . .
- ~ • ~ . ~ , ~,:u•~...~...~.. ' ' ~ ~ ~
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. . ' ' . ~ . ' ' . -.n. ~...t~~: . . . . i . . . v.~Lt•: ....:f9.:.slt~.'i'~
APR-02-2004 FRI 03:33 PM HCL ENGINEERING FAX N0, 3037733297
■ ■ o■ 9570 Kingston Court, Suite 310
■ E■ ~ ~ ■ Englewood, CO 80112
■ ll (303) 773-1605
■ Engineering & Surveying, LLC 0 {303} 773-3297 FAX
FAX TRANSMfTTAL
Qate: Aprll 2, 2004
Ta Kristy Sbutto
Company: City of Wheet Ridge
Fax 303 235-2857 (ph 303 235-2855)
From: Randy GabNel
Company:
Phone
RE: Zephyr Medicat
P. 01
Number of Pages Including Cover Sheet 5
Original to be sent separately? Yes No x
Comments: Kristy, Letter of Sewer Availibility.
Thanks
APR-02-2004 FRI 03:33 PM HCL ENGINEERING FAS N0, 3037733297 P. 02
~ ~ ~ n MCL woom
00 Engineering & Surveying,LGC am
0
April 2, 2004
Ms. Kristy Shutto, Building Department Secretary
Cily of W heat Ridge
7500 W est 29"Avenue
W heat Ridge. CO 80033
Re: Zephyr Medical Commons (Phase IV), Lot 2
7809 W. 38'h Ave.
Certificate of Sewer Service Availability
Dear: Kristy:
0
This letter is in response to your request for confirmation of the availability of sanitary sewer
service for the above project.
The subject lot at the address referenced above is entirely within the boundary and service area
of the Wheat Ridge Sanitation District (WRSD). Treatment of sewage generated within the
W heat Ridge Sanitation District is provided by the Metro Wastewaler ReclamaUOn District
(Metro). W heat Ridge Sanitation District facilities in this area consist of an 8 inch sanitary sewer
main within 38'" Avenue. Our records show an 8 inch private sewer main within this area
running toward the north and connecting to an 8 inch WRSD sewer main in W. 39'" Avenus. it is
not clear if the owner of the subject lot is requesting to tap into the private sewer main.
Correspondence dated August 12, 1998 (attached), from Mr. Ken Brown, then-District Engineer,
to Mr. Reid Gamberg of DRG 8 Associates, indicates that the private sewer main is to be
dedicated to the 4VRSD before additional taps are approved. This dedication is to include a
sewer main easement to the WRSD for access and maintenance. Moreover, if the owner of
subject property is requesting to tap the private sewer main, their ability to connect a sewer
service line may be limited by the rights of the preseM owner of the private sewer main.
This parcel is subject to the assessment of both W heat Ridge Sanitation District and Metro tap
charges. The subdividers and/or developers may be required to extend sewer lines to their
project sites and/or share in the cost of providing additional capaciiy to sarve their projects.
In addition, you should be aware that the Distdct requires approval of plans for sewer main
extensions, service conneCtions, determination and payment of tap fees, aS well as inspection of
construction by the DistricYs Engineer.
Very truly yours,
HCL Engineerin & Surv ying, LLC
Robert R. Ga iel, P, .
District Engi er
Wheat Ridqe Sanitation Disirict
RRG/rg
cc: IS rFc
9570 Ki[tgsWn Ct., Stiitc 310 . Frtglewood, CO 80112 • Phone (303) 773-1605 • Fax (303) 7733297
vvww.hclengineering.com
APR-02-2004 FRI 03:33 PM HCL ENGINEERING FAX N0. 3037733297 P. 03
Mar 0a 04 07468a
o0i9912e04 10:43 FK 7044q?707
EGMM A88QCIL768
4186u00 r. a
~Q.L.Afd~t4 F~r6L ~G~+76 ~3+~.~?r`~~f5~'
caYwasswrsmitas
cmcnlsa~waaR..u~►~ste~vK! Avnawfnm
?7~1DIrtm tdim&4 F•h&e 6l~i~t~YelYdeli_
pmwR9adeeAlfi" OOwWMnlaNeoAw401s
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w.rsa
NladDypiq~ nE~iT PID(~ (~TEA DIBTR'LCC Cyyr'p/oyP4Zy
aiRMmMqrAWYDH . OWSISfyNy}wAr&LY
' Camenri o[l:~A1. rtf~ur
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xaamApplimt A~Id!nsv~crplootb~Mnr4wl~tQusOadiawdpdy8~
DYmstas A~IroY WD17~L ~s.
~
,APR-02-2004 FRI 03;34 PM HCL ENGINEERING
r Aa;uat 12. l999
~
Mr. Raid Ounb"g
DRti dc Aaocbuee, Ine.
755 pu(et St., 9uite 138
lsioewood, CO B0215
~
T
FAH N0. 3037733297 P. 04
~ oL '~^TJNOT!V ~
y9
Re: Ze" Medial Cortwaue - Fiuoae Com
r1910 W. 38+' Ava.
~ ~54mr/im M:
u, aa upeeitr wbgioeen tor ft whaa xidge sand►aaon Aiauia, we deve reviewea 14e phunaing
pIwr w" ym ps*usbd for tlfe i6ovo-re{prcqeed omject, ord Ivve cwlaUUte4 tAe NIW so►vice tap
fea a tollows:
*hut %1{e uritadwn Dlstrld
6 SNB 0 $490= 52,910.0D (917W Ridsa Sanitildoa DirRiU)
iW' WaGdt Tap m 12 SFRB
iZ SFRB a $1320.00 = f15,84U.00 (blenro Wauewaoer Dlurld)
Futwts Cwnt = 120.00
lemeabn Fee ~ 90.00
~
~
Tatat $18,990.00
'!be tap faa are due and payabie pdor m the comecxbn of any fixaree to 0e aervice If1le fycilida-
'!Ue impeabt► ean be sebedulod bY wnaain8 ft Disnia Bngiaeer u 740-6900
PleM mk 9W the 8-ineh aNntY sewer to witich lhis ap ia scheduled w be mmclad ic eFawn in IErc
Ditrkt'a recads Y bedqQ r private main. HY Winidou im dio Dleaict'c Rulee aod 1Wlaiooe. s
"printe" main na oNy pmvl4e service w wle bWldim. The plaoo eubmiuad bdkue thu feut
buiWioga are tlreedy cmmected ta tla privau win whlwut our ieauing a wneeWon Pefmic for thc
dovo-ieftaced ProPwd Phm tbfw b'ilft.
Revkw oT tlie CilxAct'a rewrds mdkate mu m aem, rap tcES navo oNY been paid ior dho buitdRWa) n
3585 7.eplqrt Saed-
AecoMitWy, pior mappmvai Qf addiUonil sasdis[y 9ewer tape, dw Aistriet it ttquQing dre foUoaing:
pcior rc appmval of additiotwl sanitary aewer aps to the Dis4aet's faclihies:
Rvof of paymeru of the wNtety aewer ap fea for exbdng WkHnp wUhnf de wmPkx
odrr dma 1R8s ?•sphyr Stiect:
Cosmme of qw prirare ma[a to dm Diurict inclutive of pcoof af io ttnmtuial.
hydnWie sad di9uoant uMeBrih'. Mdfacxory owintenom, and ptoof of oamns6ip.
Caa►veyraee oP sa aeceprtable eaeeueem dlowlna de Diaria aaaa for fie poryoec of
miJncamrKe aad operation of the main.
7800 eoM uryon Arenw. 8uleo bw • oenvar. ceWaao 80237 • rneeh: (304) 740eooo r=: cHM 740ev34
APR-02-2004 FRI 03:34 PM HCL ENGINEERING FRH N0. 3037733297 P. 05
'
~
tbe above conmliom can be met, You wlll be tDlt w peeitioa to the D'muicc OD aceept tlro stnihry
scwror eesia for owmrddp ead obtaln appmval of dx addftional up to dw roain sublQCt m it'e rulee oad
regnluJore.
lf you nave sny queetio,re (n mis regard pleaae eau us.
Very auty yoUK,
1tanSyaqac CotporBtWn Coneulmate
WilNrm K. &own,.P-E. , M
n4pw kr dit WhEat Ridpe SenlatiisA DiYtt+ce .
ec: DistrictOfFlte
Bury Hudsn
6
A
~
~
PLRNNING & PW
P.1
Fax:3032352857
4<4< Transmit Conf_Report 41<
Rpr 2 2004 17:28
Location Mode Start Time Page Result Note
93034997767 NORMAL 41 2,17:28 3'07" 6 0 K
Cifiy Qf V1fhea# Ridge
Fax TranSmittal
7500 West 29h Avenue • Wheat Ridge, Coiorada 80033
Planning:
(303) 235-2846
Building:
(303) 235-2855
Eagineering:
(303) 235-2851
FAX:
(303) 235-2857
Web Site:
www.ci.wheatrid e.co.us
DATE " 2-- v
Name:
Organiza#ion:
Fax:
Phona:
/L
From:
Division:
Subject:
# of Pages:
3U'3 ~ y r- ~--~IP'*
Planning ~ euitding 0 . Engineering ❑
Comments:
City of Wheat Ridge
Fax Transmittal
7500 West 29h Avenue
Planning:
Building:
Engineering:
FAX:
Web Site:
. Wheat Ridge, Colorado 80033
(303) 235-2846
(303) 235-2855
(303) 235-2861
(303) 235-2857
www.ci.wheatridge.co.us
DATE L/ - Z- C)y
Name:
Organization:
Fax: 3U - 7 `Z r- -1-
Phone:
From: Wrvzd " )(--Z'~
Division: Planning ~ Building ❑ Engineering ❑
Subject:
# of Pages: (Includinq cover page)
Comments:
Original to follow in the mail ❑ Yes O~No
APR-02-2004 FRI 03:33 PM HCL ENGINEERING FAX N0, 3037733297
A■ M Olln 8570 Kingston Court, Suiie 310
■ m■ r• ■ Englewood, CO 80112
■ ■ 41 ~ (303) 773-1605
■ Engineering & Surveying, LLC ■(303) 773-3297 FAX
FAX TRANSMITfAL
Date: Apri12, 2004
To: Kristy Sbutto
Company: City of Wheat Ridge
Fax 303 235-2857 (ph 303 235-2855)
From: Randy Gabriel
Company:
Phone
RE: Zephyr Medicai
P. 01
Number of Pages Including Cover Sheet 8
Original to be sent separately? Yes No x
Comments: KrisiY. Letter of Sewer Availibility.
Thenks
A,PR-02-2004 FRI 03:33 PM HCL ENGINEERING FAX N0. 3037733297 P. 02
Nr ma MCL Noma
00 Engineering $ Sucveying,LLC am
0
April 2, 2004
Ms. Kristy Shutto, Building Deparlment Secretary
City of W heat Ridge
7500 West 29"' Avenue
Wheat Ridge, CO 80033
Re: Zephyr Medical Commons (Phase IV), Lot 2
7809 W. 38'h Ave.
Certificate of Sewer Service Availabiliiy
Dear. Krisry:
a
This letter is in response to your request for confirmation of the availability of sanitary sewer
service for the above projecl
The subject lot at the address referenced above is entirely within the boundary and service area
of the W heat Ridge Sanitation District (W R5D). Treatment of sewage generated within the
W heat Ridge Sanitation District is provided by the Metro Wastewater Aeclamation District
(Metro). Wheat Ridge Sanitation pistrict facilities in this area consist of an 8 inch sanitary sewer
main within 38°i Avenue. Our records show an 8 inch private sewer main within this area
running toward the north and connecqng to an 8 inch WRSD sewer main in W. 390, Avenue. It is
not clear if the owner of the subject lot is requesting to tap into the private sewer main.
Correspondence dated August 12, 1998 (attaehed), from Mr. Ken Brown, then-District Engineer,
to Mr. Reid Gamberg of DRG & Associates, indiCates that the private sewer main is to be
dedicated to the WASD betore additional taps are approved. This dedication is to include a
sewer main easement to the W RSD for access and maintenance. Moreover, if the owner of
subject property is requesting to tap the private sewer main, their abllity to connect a sewer
service line may be limited by the rights of the preseM owner of the private sewer main.
This parcel is subject to the assessment of both Wheat Ridge Sanitation District and Metro tap
charges. The subdividers andJor developers may be required to exiend sewer lines to their
project sites and/or share in the cost of providing additional capaciiy to serve their projects:
In addi6on, you shou►d be aware that the District requires approval of plans for sewer main
extensions, service connections, determination and payment of tap fees, as well as inspection of
construciion bythe DistricYs Engineer.
Very truly yours,
HCL Engineerin & Surv ying, LLC
Aobert R. G iel, P.
District Engi er
Wheat Ridge Sanitation Dislrict
ARGIrg
cc: ~.a
95701Cu7bton (x., Suik 310 • Englewood, CO 80112 - Phone (303) 773-1605 • Pax (303) 7733297
www.hclengneering.com
APR-02-2004 FRI 03:93 PM HCL ENGINEERING FA8 N0. 3037733297 P. 03
Mar Oa 04 07o68•
Oi/sV2004 FAi 1HMf'!7E!
!W[OBP A880CILTR4
418saiar. ]
~2.1e'a'tl- vtk.yd -&r.L -76 ?43~.~.s-~frs~
c~rii' ~aaR~►.T~mbt
C~iG'[!C4'~Y19~.Al~R~iR~iVlCi 1YA3~1Q.li'Y
Ii~1DWm11(4&&4 Ri~LQ ~Q .
riidrf Npl~lr~eltlt~
(7SwwlenlaA~aiW~ I)tw~i~vlaKxA~N~lle
~1~1Mnd A~ . ~
~ AT~~
Nsdnwlon rnn 7V DletBSec cybwr'Wi'C7wmdt1a
l*wywMviiAM1hbU ()Awe eMMftNUA"0*Y
2004
ar+•a rn.rT wms nr Me ~...smwv+n.ve.. n, 0 nmk~~
~~~Y~/D1s~os~ ~aotb~f~d~at~ia~atliar4~dprli~r8r
APR-02-2004 FRI 03:34 PM HCl ENGINEERING
~ AUSW 12. 1M
Mr. Raid Ounbws
DRCi dc AuoelStee, Iae.
755 pu[d St., 9uite 138
i,akeavood, Cp 80215
~
FAH N0, 3037733297 P. 04
7~r4N1~5i1~ At
a oti a u L ~ /1 N T. s
y9
Re: Zep4Y~ Medlal Caeenam - Ffmae Coun[
r18lS W. 38~ Ava.
~ ~~~n:
w our ewpw* agrghma ror ft whaa Ridge sula[ian Dia[ri«, wc bwe neviewea ma phanblas
piau w" ytv wirmitoed for tlfe abwe-referaoud orojec[, ard have ukuUted Ike SNve; eervk.e t+p
feet a tollm:
VYhnt lthlV BseWtloa DWrld
6 SPB 41 $M= $2.916.00 (WdM &idp Sa"kid°n Diqcitt)
1%' Wa00t Tap - 12 SFRB
IZ SP88@ $1320.00 = $15,840.00 (Meoco W+uew&oer D1ut1a)
P'u[pus Caunt = 120.00
Ieweetlon Fce ~ 90.00
~
Tatoi 518.990.00
The up fea are due aod payable prlor co the mroiealon of ai►y fimua ro ft xrvice We ficiflda-
ihe io*gct4on Cin be scfiedukd by wntacting the Diudct P.agiaeer u 7446900
Plem tpte 6in the 84Wch dniqtY sewer m whioh " tap u acboduled to be eooaeGod ic eFwwn in ihe
uilsia', recoias Y betoa 4 peivm moiu. Br aetidtlon ia d,e nbuid's Rula na xejulakw. s
"pcinee" mMn aa a* pwt* servia m aie bnitding. '1Le pbm wAmYeod YdfcM Snc fbur
6uddio¢ ue dtddy con00Cted W tlfs privale wuo wiCw4t ou[ ieNU1g a eomeedon petmit tor qw
atwvsiafamc,ed PWoocd Phm thra bWft6.
Hevkw o( tlie tihuicCa racoeds mdicate fhae m ave, np teea have oNY bax paid ior ft euiidRtg(s'1 u
3d83 2"1p7 Streot-
Auordin*, pdw oo appuoval of o0ditlonH sardnry sewer twe, dw Distriet ie tequaiog the foUoaing:
prica to approval of additiotrl aonlfary sewer nps to the Dis4ict's fadtltia:
Avcf of PaYmmu of tho wnlr+tY tewer ap fea for e"ng bugdinp wUhin dx wmPtex
alfier eboa 3R8S T.epiryr Sneot:
Couveyroce o[ the pdvere mda w the Dioa3a inelucive ot pmoP af ih anxlucal.
lq*mulie and+lip=W iMaY*. u"CWY uamtenow, md Qmof of owrotship.
Canveyaoce oP aa exepuDte aaeealMn WowlnQ dha Diarica aaess for dfe pu►pore of
mdmmnce and opaation ot dhe aiein.
i~
~
7400 Eol Unlo+Avenue. BuMe b00 • oenwe. cowraeo 80237 • rMa+r. tl0.11 7104000 Par. 41W1 74"934
APR-02-2004 FRI 03:34 PM HCL ENGINEERING FAH N0, 3037733297 P. 05
A
K dw ibove conaion can be met, You wlll be iD1c co paition to dx D'arlci to weept m~,a~clhrul~er ud
~
ww~er msia fa owneahip ud obtaUn apgrovil of the additioml up to d~s macn wbkCt
regnlu3om-
lf You ►wve anY 9uestim in mis rejard plmre ait w.
Yery uu4' YOUn.
1YaSYmm cOlP°mtin Coneul=u
~4`
W1Wm K. BrownIP•8•
$wbw tar dk WheAt Ridpe SinltsciisA Diucia
s: Dist[ia OlRee
Barry Hudsn
6
~
~
WHEAT RIDGE FIRE PROTECTION DISTRICT
PO BOX 507 • 3880 UPHAM STREET • WHEAT RIDGE, COLORADO 800340507
303-403-5900 • FAX303-940-0350 • WWW.WRFIRE.ORG
January 29; 2004
To: Darin Morgan
Chief Buitding Admixiistrator
Gity of Wheat Ridge
Wheat Ridge, Co.
$0033
Subject: Approval of Building P1ans for Clear Creek Surgery Gentec, 3 S& Zephyr St.,
Wheat Ridge, Co.; 80033
T3ear Darin,
After a review of the building plans for Clear Creek Surgery Genter Iocated at 38 &
Zephyr, T am submitting-the fallowing comments and requirements for this particular project:
Y. Provide complete plans for fire sprinkler system for building. Plans must be apprQVed prior
to installation and will requue a fire department permit.
2. Provide cqmplete plans for fire main inta building. Fire main wilY require a fire Eiepartment
pernut prior to installation.
Provide compTete pians far fue alarm spstem'foF project. Fire alarm system must be
addressable. Plans must be approved prior to installation and will require a fire department
pernut.
4_ Issues and or items no[ addressed at tliis time will be addressed as need arises,
If there are any questions concerning ttus praject, I can be contacted at 303-403-5902, or
Fager number 303-687-7336. Thank you for yQUr hetp and consideration regarding this matter.
Respectfully,
ave Roberts
F.M., W.R.F.P.D.
ApPlication Date; f -I 3-O 4 i -7-tSO Permi! No.
Wheat Ridge Fire Protection District I
P.O. Box 507 8 3880 Upham Street • Wheat Ridge, Colorado 80034-0507 S
303-403-5900 Office • 363-940-0350 Fax • www.wrfrre.org rn
a
formaYi n ~ 5(te Informatlon ~
Name; v:a-r ~ns a.k (~;z Addr e ss:r
Agent:~i .r~Sa.r1 i~ ~ 1a-i C-Z
~G~ur'~QrT ~
Addrez: 'S < - c.sq m , v~ \Z~o eusiness: G aac' C-t
15a.ui-57CO $0-E22 Contact: «u\ aav~ py
Phone: 2pb - CS Phone:
i aftA the a6ove iMormatlon to be accurate, I have reeelved and raWewed the inspaetlon Compliance and the Fee Schedu[e. This permit is the 1n
pmperty of the Whea[ Rldpe Rre RoLOefan DIsvIR and G Issued subjeL M mnditions eoMained herein. Upon any faiiure of any condiLon induding
hllure ot daenna ol any parmk paymenq this perncle Ia aubjea m Immedialc revoeation and Fhe permit must be relumed upon demand m a ~
representatlve oi the Wheet Ridpe 5m Proteetion oisGiU.
Slgnature af Appllcant: ~
s N
NOTICE: If construction is sarted prior to the issuance of a permit, THREE (3) tlmes the nortnal tee wfll be assessed. ~
INSPECffON BY FIRE PROTECTION DIStRICf REQUIRFA? Ig YE5 ❑ NO rn
pqsC fhiSypJmhm e cor~;arou, y/xe Repuz4~cgwr~insDectionsa minimum oftfrree days M advance at3034033902.
TYPE OF PERMIT
FORMULA (me fce shedule sheet)
FEES
Tank Inspection
Na. of Tanks=
Review Alarm System Plans
S stem Value=
Review Sprinider System Plans
System Value=
Revlew Mlsc. Sysbem Plans
System Value= 141 ooa. ~
Review Building Pians
Valuadon=
Spectial Handling or Use Plans
ValuaNon=
TOTAL FEES DUE
'0
ov
0
Date Paid
Amt Pald
,
Method
Q'
inwals
-4
R[
n
bO Total eldg. ❑ lU4eration
New ❑ Partial ❑ Other: h~l
Field Inspections and Dates: 0
Z
Hydrostatic Tests and Dates:
v
cdmmem'S: d7l' 1 ,.r.'TS{7mD S 1rJ rr.e.uA; wif4otr...},7' ~
ul
~
~
FlRE PROTECTION DISTRICf AVPROVAL IS REQUIRED PRIOR TO THE ISSUANCE OF TFiIS PERMIT. ry
❑ APPROVED AS SUBMITTED C~
~It CONDITIONALLY APPROVED (SEE Gomment5.) ~
DATE
FINAL APPROVAL
ev
ou
m
Date Paltl
~
AmG Paid
~
Method
Inilials
oATE
-q
b'd BbOI'°N laH1S[a HIj 300A 03HM Wd00:6 ti001 '0E''4W
city of Wheat Ridge
Fax TransmittOl
7500 West 29th Avenue *
Planning:
Public Works:
Building Department
Fax:
DATE:
Name:
Organization:
Fax:
Phone:
From:
Department:
,
Wheat Ridge, CO 80033
Phone # (303) 235-2846
Phone # (303) 235-2861
Phone # (303) 235-2855
Phone # (303) 235-2857 -
i
'Vjarck Ib, 2oo4
Planning ❑ Building Dept.
Sub ject: o Contractors License Appl.
o Class 1&2 License Appl.
oElectrical
a Contractor License Renewal
r
Public Works ❑
oFee Schedule
oBuildingPermit Application
% i.
# of Pages: (Includina cover paae) 2-
Comments: Need• D Copies oJthree (3) current citv licenses o Copv of Master Plumber
License o Col2ies ofState Electrical Contractors & Masters Licenses
o Certi zcate oflnsurance
-T'~X L5 ls rn er a s bep n Sent lo _9,-rn,u4 is
--VAa.ttik slaL.
Original to follow in the maii ❑ Yes P(No
7500 West 29th Avenue WheQt Ridge, CO 80033
Planning: Phone # (303) 235-2846
Public Works: Phane # (303) 235-2861
Building Depari'ment Phone # (303) 235-2$55
Fax: Phone # (303) 235-2857
DATE:
Name:
Organization:
Fax:
Phone:
From:
Department;
_March Ito, 2=4-
Kris Shutto- Buildin De t. Sacreta
plnnning ❑ Building Dept. ~ Public Works ~
! 5ub ject: D Contractors License Appl.
a Class 1&2 License Appl.
oEdectrical
; a Contractor Z,icense Renewal
,.w-
Li Fee Schedude aBuildingPermit .9pplication ,
% i 1.- e _ , e, ~
# of Pages: (i..ncludin4 cover oaae) 2--
Comment5; /Vpe~d oCaPies ojthree (3} current citvTicenses oConv ofMaster Plurnber
L{ceyse o Co,pies of State Electrical Contractors & Masters Zicenses
t7 Certi cate o Insurance
A 0* Z ..Mi 80:Sti`9T/£ ltiMON NOlldlINHS ?JM
aIoN Ijnsad a6pd amtl lipiS aPoW U0I12301
80:SL b00L 9S JpW
,k>I< ...iadaZ~!] - z~u oD iW s u1e...il >j<>j<
ZS8LS£Z£0£~Xp~
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Md 2 9NINNd~d
Original to follow in the mail ❑Yes g(No
arnistdpt W~"4 R+ sEwM rxby;m,.t sCptiC rOEMft xn.
Scwee Servira Avatia6la Scwcr Servica NotAvdln'h1C ,
[ammments cr Condirions• '
, I herebY cettlty that svaiiab* oCsavke ii aa b+Umftd above. i S[gvannsafAathorizadAgent . Aan .
7affeaon Cmity BesRh Dtpaztmant P SHPTIG~
Aneborized Siyqrwtnae Datc
. WATER
Nameof7?i6taacT: WHEAT RIAGE wAT£R DZ51'RrC2' CO[uxadvWellPe~[TNo.
(Awatars«viceA,railablo ()waar sftviraNwwvailsbm d2004
COAnIW~SOTCOfftElStptlS' Nt7NF.
d18t'8 8 Qf 5C{~'1GE76 88 L11l1CGTEdYj10V0.
~ ~~Y ~MFIRCH SipamnofAuthorizcdAgent Ieffeesea Casmty 8va@h Dep~ (YP WBLL)
AuiBartz~d 9iga~uro N 0* T Ih ,0 ZS :Si ` T T/£ '1HW21ON NOlldlINdS ?JM
aIoN jInsa~ a6ed awtl ePoW U0I1230~
LS:ST b00L LZ JpW
,k* '4-...i0 daZy - z~u aD ?W su~e...i1 7k>[<
ZS8ZS~Z£O~:xe~
T 'd
md '8 9NINNtild
F WHEqT
O
y P~
ti a
~
c~ m
c~C OR P~O
Inspection Services Division
Buildinm Plan Review Comments
Address:
78dT
-~WW 381" Avenue
O,tvuer: Clear Creek MOB Contractor•: Turner Construction
Project: New 14,000 sq ft MOB Occnpxncy: I-1.2 / B Valuation: $2,394,000
llxtc;: February 11, 2004
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
/ - ~v
Provide photometric plan for site and building lighting / l./
Trash enclosure walls cannot exceed 6'-0" in height, change detail A1.2-1, 2.
Openings in one-hour walls are to be protected by one-hour fire resistive assemblies. UBC 302.3
Mechanical room 174 is to be separated from the remaining building by one-hour fire resistive
construction. UBC 302.5
Correct specification book reference at door schedule to 08711 per specification manual.
Door schedule - no detail 9/A8.4 on sheet A8.4.
Why install a 4'-0" door at 112B when all doors accessing area are only 3'-0" doors? Change door 121
if proposed as a gurney entrance and exit.
Provide a copy of the soils report referenced on structural documents.
Detail A4.5(2) - provide minimum seven inches toe clearance from wall to center of ladder rung per
OSHA 1910.27(b)(7)(iii).
Provide a supplementary grounding electrotle at light pole detail. NEC 250.54
Provide an enlarged mechanical room, mezzanine electrical plan and electrical room plan to verify
clearances to disconnects and switchgear.
Please make these additions or corrections to the submittal and resubmit for review, if you have any
questions please contact me at 303-235-2853.
TheYo
Da0
Codes Ad ini trator
~Nx
Mar. 2004 4:18PM WHEAT RIDGE FIRE DISTRICT No, 0869 P. 2
VYHEAT RIDGE FIRE PROTECTION DISTRICT
PO BOX 507 • 3850 UPHwM STtxEEf • WHEAT RIDGE, Co1.o[x.4Do 80034.0507
303e3038900 • FAX 303-940-0350 • wvVW.WRFIRE.ORG
Tanuary 29, 2004
To: Darin Morgan
Chief Building Administrator
City of Wheat Ridge
Wheat Ridge, Co.
80033
Subject: Approval ofBuilding Plans for Clear Creek Surgery Center, 38 & Zephyr St.,
Wheat Ridge, Co., 80033
Dear Barin,
After a review of the building pIans for Glear Creek Surgery Center located at 38 &
Zephyr, T am submitting the fnllowing comments and requ?rements for t7us particular pmject:
1. Provide complete pians for fire spriukler system for building. Plans must be approved prior
to installation and will require a fire department perntit.
2. Provide complete p3m for fire main iuto biuiding. Fire main will require a fire departmenc
pemrit prior #o instailation.
Pravede compleYe plans for fire alami system fos project. Fire alarm system must be
addressabie. Plaus must he approved prinr to installation and will require a fire department
pertniY.
4. Issues and or items not addressed at this time w'sll be addressed as need arises.
If there are any questions concerning tbis project, F can he contacted at 303-403-5902, or
Pager muuber 303-687-7336. Thank you for your heip and consideration regarding tiris matter.
ResPectfuuY,
ave Roberts
F.M, W,ILF.P:D.
DEPARTMENT OF PUBLIC WORKS
REVIEW FEE STRUCTURE FOR BUILDING PERMIT APPLICATION
Date: 3 _0~5 --oLI
Applicant: ~W~G~' Phone #
30 3 - 7S3 -'Ya7
Location of Construction: _7 cJ 3 84'% fF v~~~~
i
Purpose of Construction: ~~E.~,e c.esEx 14. D. /3 . Building Permit Value: 3~~49^
Single Family Commercial
Multi-Family
DEVELOPMENT REVIEW FEES
Developmen[ Review Processing Fee:
$100.00
$ /0 0• 00
(for document processing)
Single Family Residence Review Fee:
$50.00
$
(for review of applicable technical documems)
CommerciaUMulti-Family Review Fee:
•(for review of eaisting technical documents)
$100.00
$
•(for review of technical documents for construc[ion in
Right-of-Way, Final Dninage Repocl, and Erosion Control Plan)
$500.00
$ SOU,. 00
CDOT Access Pernilt Fee:
$1 ~ 00
$
(for docmnent appliqtion and processing)
~
Traffic Impact Study Re«ew Fee:
$100.00
$
(for document review• and processing)
Flood Plain Variance Review Fee: -
(for docuincntreNicHaud processing)
C1ass I Application:
$300.00
$
Class I Publication/Notice
N/A
Class II Application
$750.00
$
Class II Publication/Notice
$90.00
$
TOTAL REVIEW FEES (due ai time of building pemut issuance): $ 600• o0
PLEASE NOTE THAT IN ADDITION TO TfE ABOVE FEES, TI-IERE WII.L BE ADDITIONAL LICENSING AND
PERMITTING FEES REQUIltED FOR CONSTRUCTION OF IMPROVEMENTS WITfIIN PUBLIC RIGHT-0F-WAY.
Signature of Applicant Date
0.c 06'03
oF "'r~y T
DEPARTMENT OF PUBtIC WORKS
BUILDING PERMIT APPLiCATION REVIEW
Date: 3`ZS~O N' cOL oRA
Location: 7805 GJ. 3,9-4"" /-FvE.rJU~ ~GoT Zt 02e7°1-hve
Atteation: Building Department
I have reviewed the attached materials submitted ia application for approval of a /YIc7~«~i2 OFFic~ /3ui~.D i.✓6
at the above referenccd address. Please rwtc the summary comments below.
1. ✓ goundary Closure: ✓ OK _ Not OK; refer to stipulations.
2. ✓ - Drainage:
a. Drainage plan and report needed _
b. Drainage plan not needed .
c. Lot drainage/grading to be reviewed by Building Division _
d. Site drainagdgading provisions have been reviewed and are:
✓OK Not OK; refer to sUpulations.
3. ✓ NPDES Permit Required: _ Yes _AZ No
4. ~V
Public Improvements:
a. strxt paving needed: Yes
~ No
b. curb and gutter needed: Yes
L,~ No
c. sidewalk nuded: Yes
✓ No
.
d. sveet lights needed: Yes
✓ No
e. storm sewer needed: Yes
~C No
f. letter o( credit required: _ Yes
✓No
If a letter of credit is requued, for what improvements?
42~1A
Amount of letter of crediC NIA
5. ✓
Subdivision Agreement required:
Ycs
✓ No
6. ✓
Development Covenant rtquired:
_
Yes
i No
If Yu, for
7. ✓
Traffic impact analysis and report required:
Yes
✓ No
8. ✓
State Highway Access Pemtit needed:
Yes
~C No
9. -~G
New roadway or alley R.O.W. dedication recommended:
_
Yes
✓ No
If yes, what is recomnxnded?
10. ✓
Al] existing dedicated roadways/alleys mcet the standards of the City: V~ Yes
_ No
If no, which do not and what i5 requested:
,✓Ifl
II. ✓ APPROVAL: 7'he Public Works Department has reviewed this request and hercby gives its approval,
subjxt to the above and/or attached stipulations.
Signarure David F. Brossman, P.L.S. Dare
12.A(f1 NO APPROVAL: 7'he Public Works Department has reviewed this requcst and dces not give iu approval
for the reasons staud:
Signarure David F. Brossman. P.L.S. Date
13.Stipulations anached: _ Yes ✓ No
14. ✓ Summary Comments: Anv damage to the czistine Pubtic Imorovements as a result of this construction is to
be revaired to meet Citv standards bv the Pamit Aaolicant orior to the issuance of the Catificate of
Occuoanev. A Drainaee Certification Letter is required vrior to the issuance of the Certificate of Ocwpancv.
Cfly oE 14heat
Departrnertc
DEPARTMENT OF PUBLIC WORKS (303) 235-2861
7500 WEST 29T" AVENUE WHEAT RIDGE, CO 80033 FAX (303) 235-2857
LETTER OF NOTMCATION FOR PUBLIC IMPROVEMENTS RESTORATION
DATED !✓l~ CW ZS ZDD V ADDRESS 790 5/.J • 384"` A vgj 0E
Dear Contractor:
In conjunction with the approval of the building permit application for the above referenced address, this
letter is to inform you that all exisung public improvements located along the frontage of said address
shall be restored, (if damaged from related construction) to an acceptable condition, as determined by
City of Wheat Ridge Public Works Department, and prior to the issuance of a Certificate of Occupancy.
Prior to any construction commencing, the City's representative wil] conduct an onsite inspection to
deternune the existing condition(s) of the public improvements at this address.
If you have any questions, please contact me at 303-235-2864.
Sincerely,
David F. Brossman, P.L.S.
Development Review Engineer
Cc: File
Rev 4/03
APPLICATION FOR GRADING / FILL PERMIT
APPLICANTS NAME:
APPLICANT'S ADDRESS:
ADDRESS OF FILL:
7..3 S4ltrlV
(Immac cRy, su , zip)
Zv, ~X ~
~
1 N.O
DATE OF APPLICATION:
3-ZS
All permits shatl be applied for through the Public Works Department. An approved pemvt is effective for a
period of one (1) yeaz from date of issue and may be renewed. All fees shall be in accordance with those fees
established by the Uniform Building Code or other applicable City adopted Resolutions or Ordinances.
Note: All public improvemenu, when consbucted, shall be maintained (by the respective individual(s) andlor
company responsible for the construction of that public and/or private improvement in the respective
development) on a daily basu, or as needed, such that they are free of mud and other construction debris
tracking from the site. Faiiwe to comply with this reguirement will result in the enforcement ojArticle III,
Specified Nuisances, Section 15-16 (4) of the City of Wheat Ridge Code of Laws.
MINOR EXCAVATION AND FII.L PERNLITS
1-50 Cubic Yards: No pemtit is requ"ued for dumping or excavation of earth materials, which do not exceed
50 cubic yards, provided, however, that any fill deposited is on natural terrain of less than three (3) horizonta(
to one (1) vertical slope, or such fill is less than three (3) feet in depth and is not intended to support pernianent
suvctures, and in addiuon, such fill or excavation dces not obsuvct or otherwise adversely affect any
drainageways. Should any of the above standazds be exceeded, or a drainage way be affected, a permit shall be
requ'ued under the guidelines for No. 2.
2. 51-500 Cubic Yards: Dumping or excavadon of earth materials not exceeding 500 cubic yazds may be
allowed with a pemvt approved by the City Engineer. All applications are to be submitted on the appropriate
completed application form and shall be accompanied by the appropriate fee and sketch plan indicating the
following infonna[ion before the permit will be issued.
A. Location and dimensions of all property boundaries and structures on the site..
B. L.ocation and extent of areas to be filled and/or excavated.
C. L.ocadon of existing and proposed drainageways, imgation ditches, etc., and indication of how and where
historic run-off will be maintained on and ttuough the site.
D. Cross-secUOn area to be filled and/or excavated indica6ng original stope, new slope and depth of fill.
E. Statement that indicates the proposed use or purpose for said fill or excavation.
F. RelaUve elevation of adjacent properties.
G. Erosion control plan showing placement of control devices such as hay bales, etc.
3. 501-20,000 Cubic Yards: Operations in which earth material fill or excavation exceeds 500 cubic yazds, but
dces not exceed 20,000 cubic yards, may be allowed by a pemvt issued by the Ciry Engineer after review of
an application and supporting information. The following information shall be submitted with the required
application form:
A. A site plan, prepazed and signed by a Colorado registered professional engineer, at a scale of no less than
1 inch to twenty feet (1:20) which i1lusVates the following:
B. Location and dimensions of all property boundaries and structures on the site.
C. Location and extent of areas to be filled and/or excavated.
D. Location of existing waterways and drainage courses indicating any changes. (for a site containing an
established irrigation ditch, a letter of approval from the appropriate ditch company shall be required).
E. Location of existing and proposed points of ingress.
F. Location and extent of existing vegetation, proposed changes in such vegetation and methods of
rehabilitation on site vegetation afrer earthwork operadons are complete.
G. Erosion control plan.
H. Cttading plan with existing (dashed lines) and proposed (solid lines) ground contours with contour
intervals of 2 feet and spot elevations.
1. At least two cross sections (east to west and north to south) through the site showing depth of fili and/or
excavation.
J. A drainage report may be required if site runoff chazacteristics aze changed.
K. Relative elevations of adjacent properties and strucmres.
L. Statement of purpose of intended fill and/or excavation.
4. Performance Standards: The following provisions shall apply to all Minor Excavauon and Fill Pemvts:
A. Rehabilitation: Within thirty (30) days afrer cessation of filling and/or excavation, rehabilitation for the
site shall have been completed in accordance with the approved plans. Rehabilitation shall consist of
leveling, grading, landscaping or any combination thereof to minimize potential erosion and be acceptable
to the City Engineer.
B. Debris: Debris and/or contaminants shall not be used except with the approval of the City Engineer.
"For the purpose of this Section, the term debris shall have the same meaning as the terms "gazbage, trash
or junk" as defined in the Wheat Ridge Code of Laws, Section 1511."
In no case shal] debris or contaminates idenlified or classified as hazardous waste by local, state or federal
agencies be used as fill in any fill areas within the City of Wheat Ridge.
C. Excavation and/or fill azeas shall be graded to facilitate weed control until final gades are set and site
rehabilitabon and use occur (must be leveled with side slopes not to exceed 3 to 1).
5. Pemut Fees*
50 cubic yards or less
51 to 100 cubic yards
lOlto 1000 cubic yards
for the fust 100 cy
plus for each additional 100 cy or
fraction thereof
1001 to 10,000 cubic yards for the
first 1000 cubic yards
plus, for each additional 1000 cy
or fraction thereof
10,000 cubic yards or over
*VJheat Ridge Code of Laws Section 5-76.
$10.00
$ I5.00
$15.00 _x
$ 5.00
$60.00
$ 4.45
$100.00
po
TOTAL $ S'
All pemvts shall be applied for prior to fill deposition or excavation opemtions begin. Any pemvt applied for
afrer cutting or filling opentions on site aze in progress shall be subject to a double fee and other penalties as
prescribed by Wheat Ridge Code of Laws, Section 26-1004. Any Fill requested under this permit within the100
year flood zone MiJST COMPLY WITH WfEAT RIDGE CODE OF LAWS, SECTION 26-801, FLOOD
PLAIN ZONING ORDINANCE.
I HEREBY ACKNOWLEDGE THAT THIS APPLICATION IS CORRECT AND UNDERSTAND THAT 1
CANNOT START TffiS PROJECT UNTIL THIS APPLICATION IS APPROVED. I SHALL COMPLY WITH
THE LAWS OF THE STATE OF COLORADO AND WITH THE ZOPIING REGULATIONS AND BUILDING
CODE OF THE CITY OF WHEAT RIDGE. ANY VIOLATION OF THE ABOVE TERMS WILL CAUSE
IMMEDIATE REVOCATION OF THIS PERMIT AND COMMENCEMENT OF ENFORCEMENT
PROCEEDINGS BY THE CITY OF WHEAT RIDGE. THIS APPROVED PERMIT WILL BE KEPT IN MY
POSSESSION OR PERMANENTLY ON THE JOB SITE.
APPLICANT:
Applic nYs Signature
Owner's Signature (if different ihan above)
CITY OF WHEAT RIDGE:
Rev. 17J03
k!
Approval Date
B O U L D F . R A S S O C A T E E S, I N C.
Arcbitecdure + Inteo-ior Derigrr
Robert G. Owens III, AIA
Craig D. Mulford, AIA
Maxch 9, 2004
Darin Moxgan
Ciry Of Wheat Ridge
7500 W. 29th Ave.
Wheat Ridge, CO 80033
Re: Clear Cxeek Ambulatory Suxgeiy Centex
7809 W. 38th Avenue
'Wheat Ridge, CO
Bouldex Associates Project No. 03938.00
Deax Nix. Moxgan,
Nicholas J. Rehobecg, AIA
Timothy C. Bcecs, AIA
The following responses to the Bu$ding Pexmit Comments are submitted fox youx xeview:
Public Woxks Comments - Need to include the aoss-section views A-A, B-B, GC as shown on
Sheet C-3.
These sections have been included on Sheet G3 ar reguerted.
Community Development Depaztment Comments
1. Pex the owner's xequest, the pxopexty will be addxessed as 7809 W. 38th Avenue.
The documentr bave been nvi red to rbow the correct addrerr.
2. It is my understanding that the site plan is being modified to shift the cuxb line for the
interior drive running adjacent to the west side of the structuxe to the east. All sheets
showing site unpxovements need to be xeplaced (G2, C-3, L-1, Ir3, A1.1).
All appropriate rheetr have been revired to indicate a 2'-0"shift to the eart of the above-mentioned curb in
order to keep the exirting water line in place ar it exz rtc Thi r har been coordinated with tbe City of Wbeat
Afdge Water Dirtrict. The exact location of tbe exirting water line rhadl be field verified and the curb
location adjurted appmpnately.
3. On sheet L1, all quantities appear to be adequate. However, the altexed site plan is not
xeflected which will afEect landscaped coverage and material quanriries. The tables should be
modified to be consistent with the new site plan.
The tabler have been madzfied on SheetLl ta matcb The new rite plan revzriona.
4. On sheet Ll, all sheet hees adjacent to 38" Avenue, must be a muumum of 3" in caliper.
SheetLl has been revised aaordingly.
4747 Table Mcsa Urivc Suiu 202 Boulder, Coloiado 80305 Telephoce 303.499.7795 Pacsimilc 303.499.7767
2015 J Street Suite 205 Saccamento, California 95874 "Pelephone 916.492.8796 Facsimile 976.492.8798
www.boulderassociates.com
Page 2
5. On sheet Ll, in table labeled °Landscape Requirements", first category (overall landscape area),
the requued and provided column headings appear to be transposed.
The overalllanclrcape reguirementr have been revised according to rite plan revirionr and an indicated on
Sheet L7.
6. On Sheets Ll and Al.l, a breakdown of living versus non-living landscaped coverage should be
added. The non-living coverage cannot exceed 20% of the total landscaped area. Coverage by
living materials should be estixnated using the projected growth after two full growing seasons.
Coverage by k'ving materials har beex calczelated and adjurted and ir indecated on Sheet L9.
7. All signage must be sepaxately pexmitted (sheet A12)
Thir ir noted ar a requirement and a deferred submittal on SbeetA0.1 andA12.
8. On sheet A1.2, maxunuxnheight of lighting standards must be shown.
An 18'-0"maxzmnm beightforligbting rtandardr har been indicated on SbeetAl.2.
9. On sheet A3.1, wall mounted lighting standazds must be shown.
Tbe wall mounted digbt rtandarcdr are indicated ox SbeetA3.1. ~
Building Plan Review Comments ~
1. Provide photomehic plan for site and building lighting.
See the attacbed letter of rerponre from tbe electncal engineer, Gordon, Gumeron andArroczater, Inc.
2. Trash enclosure walls cannot exceed 6'-0" in height, change detail A1.2-1, 2.
The detailr have been revised accordingl
y.
3. Openings in one-houx walls axe to be protected by one-houx fixe xesistive assemblies. UBC
302.3.
The openingr have been revised to 60 min. door arremblies..
4. Mechanical xoom 174 is to be sepacated from the xemauung buIlding by one-hour fire
xesistive construction. UBC 302.5.
A ane hour wall bar been indicated around Mech. Bm. 974.
5. Correct specification book reference at door schedule to 08711 per specification manual.
The Door Scbedule har been revired accordingly.
6. Door schedule- no detail9/A8.4 on sheet A8.4.
Detail9/A8.4 war midabeled ar 101A8.4 and har nom been deleted ru the daar en guertion war revised
from a rdida'ng alumenum door to a rwinging aluminum door. See the revi red Door Schedule .
7. Why install a 4'-0" door at 112B when all doors accessing azea are only 3'-0" doors? Change
door 121 if proposed as a gumey entrance and exit.
Page 3
Door 112B ir a 4'-0 ° door ba red on preference due to the trac ure at tbe doar. It ir not required for uae ar
agurney exit. Door 121 ir required ar part of tbe occupancy reparation, not argurney egrerr.
8. Provide a copy of the soils report referenced on structural documents.
Tbe Geotecbrrical Bepart ir included in the Praject Manual under the Divzrion `7nformation Available to
Biddert".
9. Detail A4.5(2) - pxovide miniinum seven inches toe clearance fxom wall to center of laddex
rung per OSHA 1910.27(b)(7)(iu).
Detail2/A4.5 har been revired accardingly.
10. Provide a supplementary grounding eleclrode at light pole detail. NEC 250.54.
See tbe attacbed letter of rerponre from tbe electrical engineer, Gardon, Gumeson andArrociater, Inc.
11. Provide an enlarged mechanical room, mezzanine elechical plan electrical room plan to verify
clearances to disconnects and switchgear.
See tbe attached letter of rerpanse fmm the mechanical and electrical engineer, Gordon, Gumeron and
Associatey Inc.
Fire Pxotection District Comments
1. Provide complete plans for fire sprinkler system for building. Plans must be approved prior to
installation and will require a£ue deparhnent permit.
The fire rprinklerplan.r, wben completed, rball be rubme#ed for permet axd reviewprior to in rtallntian. Tbzr
bcu been noted on SbeetA0.1 under Deferred Submittals.
2. Provide complete plans for fire main into building. Fire main will require a£ue department permit
prior to installation.
The fzre mainplanr, when campleted, rbadl be rubmittedforpermit and reveenprior to inrtallateon. Thir har
been noted on SheetA0.1 under Deferred Submittalr.
3. Provide complete plans for fire alarm system for project. Fire alarm system must be addressable.
Plans must be approved prior to installation and will require a fire department permit.
The fire alarm planr, wben compdeted, rhall be rubmitted farpermet and review prior ta inrtallah'on. Thir
bar been noted on SheetA0.1 under Deferred Submzttalr.
4. Issues and or items not addressed at this time will be addressed as need arises.
Understood
Attached with this lettex please find the Building Pexmit response items as listed:
- Thxee (3) sets of originally submitted "marked up" dxawings xetumed.
- Two (2) sets of originally submitted Structiual Calculations xeturned. No xevisions.
- Two (2) sets of originally submitted Pxoject Manuals xetuxned. No revisions.
Page 4
Original Plan Review Comments retumed.
Thxee (3) sets of xevised drawings, stamped and signed.
One (1) set of Addendum No. 1. Note: Addendum No. 1 provided for refexence only, the
revisions have been indicated on the xevised drawings.
"Ihe xevised drawings have a fmal xevision date of Delta 3 ox Delta 4- Mazch 5, 2004.
Please xeview these resubmitted items and do not hesitate to call should you have any questions or
furthex comments.
Very Truly Youxs,
BOULDER ASSOCIATES ARCHITECTS
~
fnTucke
J
cc: 03938.00 (4)
Bryon Caspex,Tuxner Construction
Alan Main, Development Solutions Gxoup
. . , MRR. 9.2004'.2: 57PM:,. GORDON GUMESON- _ N0.229 P,2i3 ` Gordnn, Gumeaqn and Assoclates, Inc. ' ' ' ConsUltl~g EA~ineers '
Marck 9, 2004 .
' . ' . . i9 • in,.:eiu . ' . • ',I.
• . - ~NTr,Jon Tucker , ; . . .
. Bouider.,Associates Architects
. 4747•Tabl@ Iviesa Drive;'Snite 2027.1
. , ' . . . ~ ' ,
. , . • Boulder, CQlorado 8D303 "
, . . RE: Cletti CTeek -A.C$ , , • : ' :
. , . . Plan"T{eview Comments ; ' . . . . . .
GG,AA 03093 . ' ' ' • •
' Dear Yon: • • _ , i • . ,
. . . , . ~ , " .
. • 'T spok,e yyith Darin Morgau; Whear.I,tlflge Codes.Adminisirator, this'-morning to dS'SCUSS his`
cOmments on.tha'memq datedFebruary 11, 2004„ itwas agzeed that_GGA•eould-simply Feply to •:.'uie CommenES' in, written fotm, provided the issues 'wers addreSSed duYing constructioq. Tke' '
- followiiqg response shall-ba included with.rlie re ~sub.rnittal totkie•$uilding bepartment. •
commen@ Number ' GGA Respnnse ' ' , . . .
' - . 1• The' photometric plan is included With 'rhe • re-submitted'docnmant'S dat'ed ; : . .
, Maroh 5, 2004. . ' . . , 10 Tl}e 5ife lighting poles wi11 lie gzounded as indicated on 77e,tairs 10 and 11
shoWn oit Sheet E0:3, 'Addinonaily, Specification Section 16,450; 'Article .
, • 3.15 states a#6'supplemeqtal grounding conductor is required at metal poles
. , swpporting outdoor fixtures. - , . . ' '
'Electrieal eqnipment shall be installed as required to, meet NEG clearances, OuF Spacifcation 5ection 160I0, Article 3.08•B and,Secrion 16170, Article .
3,10-C address tliis issue. • ,
' Tf, you have any other issues, plaasa.contact me at 303-409-6545 Eo cIiscuss:
'Very . yourg ' . • • , ,
ORTt9 ~ 1S N AND ASSQCIAtES . ' .
7e e D, • dreIl '
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WHEAT RIDGE, CO
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WHEAT RIDGE, CO
B O U L D E R A S S O C I A T E S Daze: I I FEBRUARY 2004 Sheet Numba:
Architecnue + Interioi Design
4747TableMarDrive,Suia202 ProjecrNumber. 00938.00 I/~ ~ I~~~.~
BouWa, CA 80303 r~
(303)499-7795 Pecsimilr(303)499-7767 I DrmnBy: 5. LAICA
CLEAR CREEK ASC ADDENDUM NO. 1, ITEM 10
HW SET: 1 (SECTION 08411)
DOOR 201
EACH OPENING TO HAVE:
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HW SET:33 (SECTION08711)
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WI-IEAT RIDGE, CO
B O U L D E R 1A S S O C I A T E S Daze: I i FEBRUARY 2004
Acchicanur+ Interiot Desigu
4747 Table Mca Dcive, Suice 202 i Project Numbe~: 00938.00
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Daze: 11 FEBRUARY 2004
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WHEAT RIDGE, CO
B O U L D S R A 3 S O C I A T E S
Dare: 11 FEBRUARY 2004
Shat Numlxr.
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Aichitectum + Iacerioc Design
4747 Table Maa Drive; Suiu 202 Pmjett Numher. 00938.00
Boulda, CA 80303
(303) 499-7795 Pscsimile(303)499-776i DtawnBy. S.LAIGO
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CLEAR CREEK AMBULATORY SURGERY CENTER
WHEAT RIDGE, CO
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B O U L D E R A S'S O C I A T H S Due: I I FEBRUARY 2004 Shat Number.
Architecture + Iaterioc Iksign
4747 Table Mesa Drive, Suice 202 Pmjecx Number. 00938.00 ~ I i~~~
Boulder, CO 80303
(303) 499-7795 Farsimile(303)499-7767 DrawnBy. 5. LAIGO
64 REGORDS
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CLEAR CREEK AMBULATORY SURGERY CENTER
WHEAT RIDGE, CO
B O U L D E R EA S S O C I A T E S Due: 11 FEBRUARY 2004 Sheet NumhK:
Aahitecnue + Inttrior Iksig¢ .
4747 Table Maa Drive, Suiu 202 Project Number. 00138.00 ~ I~~~
Bouldec, CO 80303
(303) 499-7795 Pacsimile (303) 499-7767 Drawn By. 5. LAIGO
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CLEAR CREEK AMBULATORY SURGERY CENTER
WHEAT RIDGE, CO
B O U L D E R A S S O C I A T E S Daze: I I FEBRUARY 2004 Sheet Numbec:
Atthiteccuce + Interioc Design
4747 Table Mm Drive, Suite 202 I, Pmjecc Numbet: 00938.00
Bouldu,C080303
(303) 499-7795 Pacsimile (303)499-7767 DrawnBy: 5. LAIGO
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CLEAR CREEK AMBULATORY SURGERY CENTER
WHEAT RIDGE, CO
B O U L D E R A S S O C I A T E S Due: II FEBRUARY 2004 SheetNumber.
Acchitemue + tnurioc Design .
4747 Table Meaa ]hive, Suite 202 Pmject Number: 00938.00
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(303) 499-7195 Pacsimile(303)499-7767 DrawaBy. 5. LAIGO
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ie2 vsrietn~ cvr-s ~s.i exr-i nrr-i Rtr-i ~rr-i um-~ . ALI. BASE GAEIPE'f5 N&t1'IGAL 511~ALEi) TO 9E PI.AM-I, ttU.E55 ND'f~ OhERW15E.
ALL GOUtIEi2TOP5 AND BAf~5P1~ TO BE P1AM-2 U~B.E~f NOTti7 O11~N65E - 2, ALL INTERlOR 5URFAGES OF G~iVORK TO ~ YF&tE hBAMIt~ ALL E~'05L~ -
INT8ti0R5 OF Gfv~B~RJC TO HE PLAM-I U~E.55 NOT~ Oi}&FYU~k. ~as ca+w.wunc~ ucc~r xc. ca+. re-i ~r_~ ~.i _ I GOl/~ D~7'AIL _
~lsJ a~ ~to~r usn~ o~ r~~,v.s uyr~ iDi o n~rs
~ ~~iw~+sc+~u~,GO~N.TSPELIfIGATtON5. - -
. - sr~rrn~ . IMNbr MtUr1Y0 Wt
_ - .aa FY~i~h aoh.ao~
a~srNtna~
.
B 0 U L D E R S S 0 C I A T E S I
, r~ e,
Arcbitecture + I nterior Dcrign
'
' - TONOJE i0 DI$G HARGE
~ - + GANOPY
DRAIN AT GRAD
(33 SEATS)
PROVIDE SPLA~iH BLOGK.
ABOV SEE PLUMBING. I
AU10MAiIG
DDLE
MATIG
DOOR PADDLE I
~
2 ~
i IOOB -
DOOR PA DLE
I I
REGESSED A81 I i UNIT ~
I VE
HEATER PE ME A42 ~
GEN
~ VE
- ~
V -
A4.6 II A 6
ABOVE
LO
Y
I
pp
II
_
_
-
^o I
I
-
- -
- -
- -
~
ABOVE
281_`
I
-
~
A43
EN i RY P1.AN
A2.2 I/4"_ I-_0"
CLEAR CREEK AMBULATORY SURGERY CENTER
WHEAT RIDGE, CO
B O U L D E R A S S-0 C I. A T E S
Dace: I I FEBRUARY 2004
Sheec Number.
Atc6itecnue + Intetio[ Iksign
4747 Table Meaa Duve, Suiu 202
Projar Numlxr. 00q38.00
Bouldec, CA 80303
(303) 499-7795 Pazsimile (303) 499-7767
1 Dnwn Bp 5. LAIGO
CLEAR CREEK ASC ADDENDUM NO. 1, ITEM 28
HW SET: 3 (SECTION 08411)
DOOR 100A
EACH OPENING TO HAVE:
2
EA
PIVOT SET
7215
626
IVE
2
EA
INTERMEDIATE PIVOT
7215 INT
626
NE
1
EA
PANIC DEVICE
3547A-EO
626
VON
1
EA
P.Sr1IC DEVICE
3547A-NL-OP
626
VON
1
EA
RiM CYI,INDER
FURNISHED BY SECTION 08711
2
EA
OFFSET DOOR PIILL
8190 - 2- O
630
IVE
1
EA
ASTRAGAL
DOORMANUFACTURER'S STANDARD
BYO
2
EA
CONCEALED CLOSER
5030 X ST-2714
689
LCN
2
EA
OVERHEAD STOP
100SCJ
630
GLY
1
SET
WEATHERSTRIP
DOOR MANUFACTURERS STANDARD
BYO
2
EA
DOOR SWEEP
3452CNB X DOOR WIDTH
AL
PEM
1
EA
THRESHOLD
272A X DOOR WIDTH (OR AS DETAILED)
AL
PEM
1
EA
POWER TRANSFER
EPT-10
689
VON
1
EA
AUTO OPERATOR
4822 X 4820-18G
689
LCN
2
EA
WALL PLATE SWTTCH
7910-956
GRY
LCN
HW SET: 4 (SECTION 08411)
DOOR 100B
EACH OPENING TO HAVE:
2
EA
PIVOT SET
7215
626
NE
2
EA
INTERN4EDIATE PIVOT
7215 INT
626
NE
1
EA
PANIC DEVICE
3547A-EO
626
VON
1
EA
PATIIC DEVICE
3547A-NL-OP
626
VON
1
EA
RIM CYLINDER
FURNISHED BY SECTION 08711
2
EA
OFFSET DOOR PULL
8190 - 2- O
630
NE
1
EA
ASTRAGAL
DOORMANiJFACTURER'S STANDARD
BYO
2
EA
CONCEALED CLOSER
5030 X ST-2714
689
LCN
2
EA
OVERHEAD STOP
100SCJ
630
GLY
1
SET
WEATHERSTRIP
DOOR MANiJFACTURERS STANDARD
BYO
1
EA
POWER TRANSFER
EPT-10
689
VON
1
EA
AUTO OPERATOR
4822 X 4820-18G
689
LCN
2
EA
WALL PLATE SWITCH
7910-956
GRY
LCN
l I/2" ALUMINUM GURTAIN V1ALL
I" INS. 01-A55 (NP.)
NO SHADES
O
>
~
~
~
~
N
PLOOR LINE
LL
J
~
~
~
ry
N
N
m
N
N
N
~
N
N
~
N
~
~
~
N
~O
N
3'-4 3/4" 2 I/2" 4'-4 I/2" 2 4'-4 I/2" 2 I/2" 3'-5 3/4"
I I 4 7`7
~
O
~ ~ IOOA
r
O
15
12
8'-II I/2" 2 I/2" ~-5 3/4"
1 I/2" ALUMINUM GURTAIN WALL VIF VIF
I" W5. 6LA55 (ttPJ
NO SHADES
0 LD rrPe t'All
A82 I/4"= I'_O"
CLEAR CREEK AMBULATORY SURGERY CENTER
WHEAT RIDGE, CO
15
O
~
B O U L D E R A S S O C I A T E S Dae: I I FEBRUARY 2004 Sheet Number.
Architernur+ Iatedot Design . .
4747 Table Maa Drive, Stite 202 Projat Number. 00938.00 j~
Bouldec, C0 80303 Jl~ I ` 2
(303) 499-7795 Paaimile(303)499-7767 ~ DrawnBp. 5. LAICA
4 I/2" ALUMINUM STOREFRONT _qI/4" GLA55
ROLLER SHADES
N
C)
~
O
~
~
q
A5.1
l
4 I/2" ALUMINUM STOREFRONT
I/4" GLA55
ROLLER SHADES
O
4-_7 41_8"
7
5
3.4 iooe
v
ry
~
~
q_01
NPes "M~~ $ "N"~
K~J
-A8.2 I/4"= I'-0"
CLEAR CREEK AMBULATORY SURGERY CENTER
WHEAT RIDGE, CO
B O U L D E R A S S O C I A T B S Daze: 11 FEBRUARY 2004 Sheet Number.
A[chi[ecNtr r Intttiot Daign
4747 Table Maa Drive, Suice 202 Pmjett Number. 00938.00 ~ I~~ Q
Boulder, CO 80303
(303) 499-7795 Facsimile(303)499-7767 DrawnBy: S. LAICA
] ~R• MEru 5na5
6' MfTP1 5M5 0 16'
W FOIL FAGm RI9 BA'
SiF81LBE F£R SIRUG
Q 1REhiED BLOLKING -
SYfElmm ~TIG LEILINS
PROJIOE PDDIT011AL 3
51W ~IN6 TO flR2 PJr
VNLL N.L PFOJrID OPFNIN'a
NLMIWM WINDOW
I
1 1
1
1 1
PREFINLILD MEiAL
LM HA~11N6
PALY PDIIERID 51l15LE ~Y
RDGF I£hBRANE WER iAfERED
RI61D IIWIAiION AT I/4' PfR FCOT -
N4' iHIGK AT LOW POIH151 _
1
'
3'-II'
PP.EFIIO~ ~AL-
FALIAVRPP
PAINIED GYP. BD ~It OJER
MEfPL 5R9 FRPMIN4
\ WALL SEGTION ,4T 0I911
n4,1 in•= r-o,
IY WILDIN6 PME20vER
I I
5/9' 6YP. SHEANING
~ I ~
b' METAL SMlS o I6' OL.
. I ~
ly/ FOIL FAGfp W9 6A7 IN`JJLATION
TO.51lETGEQ W.l~E
I
I
I
I
I
I
I
Q
2
I
I
I
PFEfINISHEpMErAL
I
I
GAP FLnSNINz
51ff1.11,9E
SRCknRP1 I
I
I
FLEXIBLE FLh5HIN6 W
~
N£fF5e34'OG.
II I
~
~
PREFINISHED METPL BD.51~.
GWNiERFL45NIN6
1
~
~1
1
~ ~
r
7
~
ao it
iw
iia' TMicK
L~
I
I
I
I
FA5GIA
I
I
PAIMED6YP.9DWFFItOVER
MEfqL SMJ FFAMINZ
51B' GYP. PA.
35/8'METPL
Tlf)5
2 WALL SEGTION AT TOILET ROOMS
I
nai in'= r-o•
CLEAR CREEK AMBULATORY SURGERY CENTER
WHEAT RIDGE, CO
B O U L D S R A S 5 O C I A T E S Ihce: I I FEBRUARY 2004 Sheec Numbn:
Acchicettute + Intetior Dgiga
4747 Table Maa Drive, Suice 202 Projat Numlxr. 00938.00
BoWda,CO 80303
(303) 499-7795 Paaimile (303)499-7767 DrawnBp. 5. LAIGo
5/8" GYP. BD. OVER
~ I /8" METAL STUD
TREATED WOOD 5LOGKIN6
SINGLE PLY ROOF MEMBRANE
I LAP OVER BLOGKING
2
METAL SND HEADER TO SPAN
I AGRO55 BEAMS
5/8"TREATED PLYWOOD
~ RIGID INS. OVER METAL DEGK
~
~
O
B.O. METAL PRAMIN6 ~L
. aEV. +9_g.
6" METAL SND FRAMING
I . 518" GYP. SOFFIT BD. OVER
118" FURRING GHANNELS OVER
- 4" METAL SND FRAMING BAGKER ROD AND SEALANT . 4 5/8" 6 I/4" "I V2'
7/8" FURRING GHANNELS
HEAD DE-TA1 L
A8.3
i i/z°= i'-o'
CLEAR CREEK AMBULATORY SURGERY CENTER
WHEAT RIDGE, CO
B O U L D E R tA S S O C I A T E S Daze: 11 FEBRUARY 2004 ~ Shat Number.
A¢hitecnue + Inarioi Ikuga
4747 Table Mar Dtive; Suim 202 ~ Project Numher. 00938.00
Boulder, CO 80303
(303) 499-7195 Yacsimile (303) 499-7767 DrawnBy. 5. LAIGO
T
0
6" METAL SND HEADER -
ORIENT VERTIGALLY .
4 I ~ R
OR ENT H R NONTALDLY
I /
~ Al B.0.5ND5
ELEV. W~_8.
5/8" GYP. BD. OVER
4" MEiAL SND FRAMING
5 318" k I/4~ I/41 5 318"
HEAD Dr=TAI L
A8.3
i i/2"= i'-o"
CLEAR CREEK AMBULATORY SURGERY CENTER
WHEAT RIDGE, CO
B O U L D E R A S S O C I A T E S Daze: 11 FEBRUARY 2004 Shett Numba:
. elichi[ecnue + In[enoc Iksign
4747 Table Mesa Drive, Suim 202 Projett Numbw. 00938.00 I_~ O~
Boulda, CO 80303
(303)499•7795 Pazsimile(303)499-7767 DrawnBy. S.LAIGO ~
y STEEL BEAMS PER STRllGT.
FULLY ADHERED SINGLE PLY
ROOF MEMBRANE OVER I/4"
i DENS DEGK OVER I I/2" METAL DEGK
LAP MEMBRANE OVER FASGIA
NV G N7 GLEAET~RIP EDGE
STEEL NBE PER 5TRUGNR4L
TREATED BLOGKING
PREFINISHED MEiAL FASGIA
BEV. t.O.S'fgL
EL9_9•
- B.O. 5ND NEADEWFRAMIN6 il
ELEV. t9_g•
3
4 5/8"
PTD 5/8" GYP SOFFIT BD. OVER "I/8"
FURRING GHANNELS OVER 4" METAL 5ND
2_8"
b" ME7AL SND HEADER TO SPAN OVER W4 BEAMS
I
6"METAL SNDS
I
I 5/8" METAL SNDS
-
l/8" FURRING GHANNELS
HEAD DETAI L
A8.3
i i/z"= i'-o"
CLEAR CREEK AMBULATORY SURGERY CENTER
WHEAT RIDGE, CO
B O U L D E R !A S S O C I A T E S I Dam: 11 FEBRUARY 2004 Sheet Numbee
Aichitecnue + Interiot Design 4741 Table Mesa Drive, Suice 202 Project Number. - 00938.00
Houldec, CO 80303 A~ I-~ O
(303) 499-7795 Pscsimile(303)499-7767 DrawaBy: S.LAIGO
io
A93
2
. REGLOGATE MED.GA\
. . ~ . -TYRIGAL ~
. ~
-
~
r~
N
q3 nP: OPERATING ROOM #2
166 10'-0"
O
rj-~~ O.R. - RGP
I A2.1 I/4"= I'-0"
CLEAR CREEK AMBULATORY SURGERY CENTER
WHEAT RIDGE, CO
B O U L D E R pl S S O C I A T E S Daze: I I FEBRUARY 2004 Shett Number.
. Aichitectuce + Interiot Daign .
4747 Table Diaa Drive, Sviu202 Projett Number: 00938.00 A:;) I~55
Boulder, CO 80303
(303)499•7795 Faaimile (303)499-7767 ~ DnwnBy. 5. LAIGo
ADDENDUM NO. 1
Clear CreekAmbulaton Suxgeny Center
Wheat Ridge, Coloxado
Boulder ilssociates Pxoject No. 03938.00
ISSUED TO: Tuxner Consuvcdon
DATE: February 11, 2004
BY: Bouldes ilssociates ilrchitects
4747 Table Mesa Drive, Suite 202
Bouldex, Coloxado 80305
This Addendum foxms a part of the Contract Documents and modifies the oxiginal documents dated
January 12, 2004, with a xevision date of 26 Jan. 04. Attached coxsesponding sketches are labeled, for
example, AD1 (Addendum No. 1) -10 (Item #10), with xevisions to che oxiginal documents clouded
and noted with a delta 2.
DRAWINGS / SPECIFICATIONS
1. REVISE east side main xooE dxain and canopy dxain dischaxges at Gxid 8 as shown on
Sheets Al.l and A22 to a single combined dischazge as noted on Sheet P2113. See also
xevisions stated in RFI #1 attached.
2. RELOCATE gas metex and associated landscaping and resoute gas piping as indicated
in RFI #2 attached.
3. REVISE typical extexior wall note to read "15# Bldg. Paper over'/z" exterior gxade
gypsum sheathing oves 6" metal studs @ 16" o.c.". See RFI #3 attached.
4. CI.ARIFICATION: See the shop dxawing xequirement for metal studs as stated on RFI
#4 attached.
5. Pxovide monument sign foundadon xeinfoxcing as indicated in RFI #5 attached.
6. Pxovide thickened slab on gtade and reinfozcing as indicated in RFI #6 attached. See
also J.C. Baux Addendum attached.
7. Pxovide construction joint as indicated in RFI #7 attached. See also J.C.Baur addendum
attached.
8. Provide a $1,200.00 allowance for light fi.cture BB-2. The exact light fiatuxe type will
need to be cooxclinated with the City of Wheat Ridge and the cost adjusted accoxdingly.
They have not been forthcoming with the fiYture type zequired other than to state
"Victorian Acorn Style Pedestrian" light See also RFI #8 attached.
9. REVISE funsh specification for the ICU dooxs as indicated in the attached RFI #9
attached.
10. REVISE Dooxs 161A, 18213, and 201 in floor plan to match Doors as desaibed in the
Door Schedule. REVISED floox plan sketch attached. REVISE hardware gxoups fox
these dooTS as indicated on attached schedule. Door 161A shall use F3~~l Set 34 (added
to Secuon 08711). Doox 182B shall use HW Set 33 (added to Secuon 08711). Doox
201 shall use FIV' Sec 1(revised in Secuon 08411). REVISE Type L fxame as indicated
on a[tached sketch. See also xevisions scated in RFI #10 attached.
11. DELETE the vextical sunscreen shown on wall secuon 2/A4.41ocated at the southwest
wall of Waiting 101. REVISED Details 3/A4.4 and 14/i183 axe attached.
12. DELETE equipment 127 Monitox/IV Caxt from the Equipment Schedule.
13. DELETE zoof dxain leadex chases as shown on Sheets A2.1 and A2.2 in xoom Equip.
167, and in Futuxe Tenant space. Roof dcain leadezs aze xouted in the plenum space and
are dischazged at esteriox walls pex the Piumbing sheets.
14. The dnnking fountains as specified do not requixe a wall carxiage oT a thickened wall.
REVISE die wall at the drinking fountains to 35/8" metal studs pex Detail 2/A7.1.
15. All Film Illumuiatoxs 105 on the Equipment Schedule aze to be surface mounted units.
16. Microwave 120 shall be a non-vented unit at all locations.
17. Contractox to provide bacl:ing for the TV bracket at all Television/TV bracket 143
locations.
18. REVISE Shower 147 as shown on die attached sketches. t1DD wall mounted lavatory
as indicated. Recess slab on grade 2" in Showes 147. Slope to dxain. See also revisions
by Goxdon, Gumeson and Associates attached. REVISE finishes as indicated on the
attached Room Finish Schedule. REVISE Door 147 as indicated on die attached Doox
Schedule.
19. ADD sink in Clean/Work Stex$e Storage 169 as shown on the attached sketch. Revise
interior elevarions as indicated. See also sevisions by Gordon, Gumeson and Associates
attached.
20. REVISE south wall of Men's Lockex 179A to a 3 5/8" stud wall. See attached sketch.
21. RELOCATE sink in Nurse 125 as shown on attached sketch. Revise mtenox elevations
as indicated. See also xevisions by Goxdon, Gumeson and Associates attached.
22. REVISE west wall of Nourish. 135 to a 6" stud wall to accommodate an elecuical
panel. See attached ske[ch.
23. Undexslab perimeter 2" EPS insulation as indicated on wall secrions to be 2'-0" wide.
24. REVISE intexiox elevations 3/A6.1, 32/t16.1, 35/A6.1, 37/A6.1, 64/A6?, and 65/i16.2
as indicated on the attached sketches. REVISE detail 18/A7.2 as indicated on the
attached sketch.
25. REVISE blinds at window type K and X-9 as shown on the attached sketches.
26. REVISE Room Fuush Schedule and Materials List as indicated on the attached
schedules. Revisions indude coorclination corxecdons of xoom names on the schedule
with xoom names as shoxvn on the plans, and the addiuon of HB-2 on the Materials
List.
27. DELETE lightning protection spstem fxom the scope of work on the project.
28. REVISE Dooxs 100t1 and 100B 2o aluminum manual swing doors with automauc push
button opecatozs. See the revised floor plan attached indicating doox paddie locarions.
REVISE haxdwaxe groups for these dooxs as indicated on the attached schedule. Door
100A shall use FIW Set 3(Revised in Secnon 08411). Door 100B shall use HW Set 4
(Revised in Section 08411). REVISE window fxame types A, M, and N as indicated on
the attached sketches.
29. The "Additional Pxovisions/Scope oE Work" insexted at the end oE Section 15010 -
Basic Mechanical Requuements shall also be inserted at die end of Secdon 16010 -
Basic Electrical Requirements.
30. REVISE Details 1/A4.7, 2/A4.7, 5/A83, 7/A8.3, and 8/A8.3 as indicated on the
attached sketches.
31. CLAffiFICATION: All field brick (Brick #1) to have a nominal size of 4"CU. s S"L. x 2
2/3"H. All jumbo brick (Brick #2, #3, #4) to have a nominal size of 4"W. x S"L. s
4"H., except soldiex couxse (Bzick #2) to have a nominal size of 4"W. x 12"L. x 4"H.
32. REVISE room COATS 110 to COATS 101A and Door 110 to Door 101A. See the
attached Room Fuush Schedule and Door Schedule.
33. RELOCATE ceiling medical gas oudets in OR's as indicated on the attached sketch.
34. REVISE bowl type light fvYture shown on Sheet A9.1 at the east and west ends oE
Coxridox 151 to a downlight type fisture as indicated on Sheet E11A.
35. DELE'I`E reEexences to details 1/A93 and 10/A93 shoxvn on Sheet A9.1 in Men's
Lockex 179A and Women's Lockex 180A.
ADDITIONAL CONSULTANT ITEMS
1. Make mechanical, plumbing, and electrical xevisions as noted on the attached Addendum
Number 1 from GoTdon, Gumeson and Associates dated February 11, 2004, with xevisions
clouded and noted with a delta 2. Note addirional revisions showing addition of sink in
Clean/Woxk SterIle Stoxage 169 shown on the attached 8 Ys" x 11' dTawings PA1.9 and
PA1.10.
2. Make structurai revisions as noted on the attached drawrings Xl through X6 and 51.0, S2.0,
SSA from J.C. Baur and Associates dated 2/11/04, with xevisions douded and noted with a
delta 2.
3. RE: Cold Formed Fxaming Scheduie on Sheet 54.0:
"At openings widex dian 8'-0" with bzick veneex as the extexiox wall surface, use 600 T200-
68 (14 gage) track at the sill (condiuon 4 of the schedule)."
NfISCELLANIOUS INFORMATION
1. Atcached for xefexence purposes are RFI #1 thxough RFI #10 from Tuxner Construcuon
Company and Boulder Associates' written xesponses.
2. No substitutions of products ox equipment have been approved to date.
END OF ADDENDUM NO. 1
ADDENDUM NIJMBER 1
TO DRAWIlVGS AND SPECIFICATIONS
PROJECT: CLEAR CREEK AMBULATORY SURGERY CENTER
7821 38'" STREET
WHEAT RIDGE, COLORADO
PROJECT NUMBER: 03093
ENGINEER: GORDON, GUMESON AND ASSOCIATES, INC.
4725 SOUTH MONACO STREET, SUITE 200
DENVER, COLORADO 80237
DATE:
FEBRUARY 11, 2004
The Drawings, Specifications, and Contract Documents on the project are modified, corrected,
supplemented, and/or superseded as of Februazy 11, 2004, as hereinafrer described.
The following additions, deletions, changes, and information shall become a part of and modify all work
shown or described in the drawings and project manual dated 7anuary 28, 2004.
Bidders shall make any necessary adjustrnents in their bid on account of this addendum. It will be
construed that each bidder's proposal is submitted with tull knowledge of all modifications and
supplemental data specified herewith.
1. Sheet M21A, Operating Room #1 (168), Operating Room #2 (166), Operating Room #3 (157), and
Operating Room (155): Provide local wall mounted, digital humidity and temperamre indication.
Humidity in %RH, Temperamre Deg. F.
2. Sheet M3.lA, North of Gridline 2-13: modify piping iunning north/south per MAl.l.
3. Sheet M3.1A, South of Door to Bulk Storage (177): modify piping mnning north/south per MAl.l.
1. Sheet P0.1, Plumbing Schedules
a. Add WATER SOFTENER UNIT SCHEDULE as indicated on the attached 8-1/2" x 11" drawing
PAi.l.
b. Revise AIR COMPRESSOR SCHEDULE as indicated on the attached 8-1/2" x 11" drawing
PA1.2. GGA #{03093 - 1 - 02/11/04
c. Revise MEDICAL GAS ALARM PANEL SCAEDULE as indicated on the attached 8-1/2° x
11" drawing PA1.3.
d. Revise ZONE VALVE BOX SCHEDULE as indicated on the attached 8-1/2" x 11" drawing
PAl.4.
e. Revise MEDICAL GAS MANIFOLD SCHEDULE as indicated on the attached 8-1/2" x 11
drawing PA1.5.
2. Sheet Pl.l, Under Slab Plumbing Plan
a. Revise building waste and vent to accommodate new lavatory, relocated sink, and new shower as
indicated on the attached 8-1/2" x 11° drawing PA1.6.
3, Sheet P2.1A, Plumbing Plan, refer to full size drawing for revisions.
4. Sheet P2.1B, Plumbing Plan, revise sink designation as indicated on the attached 8-1/2" x 11°
drawing PA1.7.
5. Sheet P4.1, Plumbing Details
a. Delete Reverse Osmosis Piping Detail.
b. Revise Air Compressor Detail as indicated on the attached 8-1/2" x 11" drawing PA1.8.
1. Sheet E0.1, Electrical Legend and Schedules
a. Revised load, feeders and breaker size to air compressor. Added air dryer.
b. Removed WTP-1 and added WS-1.
2. Sheet E0.2, Electrical One-Line Diagram and Schedules
a. Revised drawing note for sound attenuation of generator enclosure.
3. Sheet E0.3, Electrical Details
a. Revised "Roof Mounted Receptacie Detail" and "Television Oudet Raceway Detail".
4. Sheet E0.5, Panelboard Schedules
a. Edited loads per revised equipment schedules.
b. Added panelboard schedule for future panel "FH", added circuit breaker for temporary lighting in
future space.
GGA #03093 - 2 - 02/11/04
5. Sheet E2.1A, North Power and Systems Floor Plan
a. Refer to drawings for floor plan revisions.
6. Sheet E2.113, South Power and Systems Floor Plan
a. Refer to drawings for floor plan revisions.
7. Sheet E3.113, South Lighting Floor Plan
a. Added temporary lighting and switching.
1. Section 15440, Plumbing Fixtures and Trun, Article 2.7, Shower, add the following:
B. SH-2
l. Walls and floor by General Contractor.
2. Symmons Temptrol 25-300-B30-X pressure balancing brass body valve with
bronze and stainless steel trim, integral stops, adjustable hot water lunit stop,
ADA compliant lever handle, hand held shower head willi 2.5 GPM aerator,
in-line vacuum breaker, 30" adjusting bar, 5' flexible metal hose, arm and
wall flange.
3. ?ay R. Smith Figure 2005, round cast iron body with flashing collar, 6°
round iuckel bronze adjustable strainer head widi secured hole grate, bottom
waste outlet flashing clamp.
2. Section 15440, Plumbing Fixtures and Trim, Article 2.8, Sink, add the following:
F. S-6
1. Elkay #LR1517, 18 gauge type 304 stainless steel, 15" x 17.5" O.D. single
compartment, 7-1/2" deep, self-rimming, ledge back, thoroughly sound
deadened, three hole punching for faucet.
Trim: Type 5
3. Section 15440, Plumbing Fixtures and Trun, Article 2.8, Sink, Paragraph G, Item 2, SS-1, revise
item 2 to the following:
2. Zurn Z85700, wall mounted knee action mixing valve with cast altuninum
wall bracket, stirrup controlled, straight stops and 1/2" male union outlet.
Pipe tempered water only to valve.
4. Section 15440, Plumbing Fixtures and Trun, Article 2.9, Sink Trim, Paragraph C, Item 1, Type 3,
add "hand held spray and hose" to faucet description.
GGA #03093 - 3 - 02/11/04
5. Section 15440, Plumbing Fixtures and Trun, Article 2.9, Sink Trun, Pazagraph D, Type 4, revise
"Baz Sink" description to "Hand Wash Sink".
6. Section 15440, Plumbing Fixtures and Trim, Article 2.9, Sink Trim, Paragraph D, Type 4, add the
following:
2. 3-1/2" diameter stainless steel basket rype strainer with mbber seat stopper
and 1-1/2" outlet.
3. 1-1/2" 17 gauge tubular brass unionjoint P-trap with cleanout, waste to wall,
wall escutcheon, 3/4" Y-connection for dishwasher waste, where indicated
on drawings.
4. Flex supply pipes, compression type loose key stops, wall escutcheons.
7. SecUOn 15440, Plumbing Fixtures and Trim, Article 2.9, Sink Trun, add the following:
E. Type 5
1. American Standard, Model 2770.732, center set baz faucet, 12" x 6"
gooseneck with metal lever handles.
2. 3-1/2" diameter stainless steel basket rype strainer with rubber seat stopper
and 1-1/2° outlet.
3. 1-1/2" 17 gauge tubular brass unionjoint P-trap with cleanout, waste to wall,
wall escutcheon, 3/4" Y-connection for dishwasher waste, where indicated
on drawings.
4. Flex supply pipes, compression type loose key stops, wall escutcheons.
8. Section 15440, Plumbing Fixtures and Trim, Article 2.10, Bed Pan Washer, revise model number to
Zurn Z87302-EVB-HK-SE-SH3., spray hose with angled self-closing valve and insulated handle.
1. Secuon 16210, Engine Generator Set, Article 1.2, Paragraph A, Item 31, add the foliowing:
"(minimum 70 db at 25 feet.)
2. Section 16210, Engine Generator Set, Article 2.2, Paragraph A, Item 1 and Item 2, revise as follows:
1. Kilowatts: 225
2. Kilovolt Amperes: 280
3. Section 16250, Automatic Transfer, Article 2.2, Paragraph A, Item i, sub-item b, revise as follows:
b. ATS-Q: 250 Amperes
END OF ADDENDUM NO. 1
GGA #03093 - 4 - 02/11/04
O O
~ DDC DDC ~
` WATER I ' ~ ~ i
II, : ENTRY VICE B-2 - ~
TMEGHANIGAL- L - I ~ PB- '
Il4 ' ~
B-1 -1 10 4" 9
3rO
4" HR ~
I ' ~2
3n HRS
3 Z
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r--~~ T -73" : 4„ HR
9 ;
- J 12
UH-3
SPRINKLE~ DEGONTAMINATION
173 I11
-
3~4UH 1
~ HRHS-►-
~ L
I
1 1 PARTIAL NORTH MECHANICAL PIPING FLOOR PLAN
M3.tA scni.e i/a' = i'-o'
'I
~i
~
I~
1- .
1 r3/4" i
PROJECT NAME: SHEE_ TITLE:
Clear Creek Ambuiatory Partial North Mechanical
Sur er Center Pi in Floor Plan
GORDON, GUME50N AND ASSOCIATES, INC PROJECT NUMBER:ll DATE: DRAWING N0.
4725 SOUTH MONACO STREET, SUffE 200 BA '~03938.00 / GGA n03093 02- 11-04
DENVER, COLORADO 80237 REFERENCE DRAWING(S): SCALE: MAI.1
(303) 779-1222 FAX: (303) 694-9144 M3.1A 1/4" = t'-0"
S:Uabs~2003103093WCADDRA`M03093M3.1 A_FIrM0l.dwg, 02170104 0325:14 PM, jkh
AUTOMATIC WATER SOFTENER
PEAIC FLOW RATE
COMINIJOUS RO
RESIN TANK
SYAIBOL
MFR
l~ODEL
GPM
P~
GPM
7PD
BACKWASH
GPM
NUI~BER
SIZE
Tf
PSI
-
MAT
9• Dw'
WS-7
CUWGAN -
SMS-61
20
25
15
15
2.0
2
42' HIGH
FlBEF
I t. /DJUSTABLE MEiER INft1AiED REGENERATION SYSTEM.
2. F1EC: 120/1.
AUTOMATIC WATER SOFTENER
COMINUOUS FLDW RATE
RESIN TANK
BRINE TANK
pp
BACKWASH
tqNK
SRE
7'pNK
VOLUME
REMARKS
GPM
PSI
GpM
NUMBER
SIZE
MATERtAL
(Las)
75
15
2
0
2
9~ DLk
"
FlBFRGLASS
18• Dik
'
POLYET1iYl.EN
250
TM'IN ALlFRNAi1NG
.
42
HIGH
38
HIGH
SYSTEM
PROJECT NAME: SHEEf TITLE:
Clear Creek Ambulatory Plumbing Legend
Sur er Center Plumbin Sc~iedules
PROJECT NUMBER: DATE: DRAWING N0.
GDRD_ON; GUMESON AND ASSOGIA'fES, INC BA #03938.00 / GGA 7#03093 02-11-04
4725 SOUfH MONACO StREEf, SUffE 200 0 A11 1
DEtdVER, COLORP,DO 80237 REFERENCE DRAWING(S): SCALE:
(303) 779-7222 FAX: (303) 694-9144 P0.1 NONE
I AIR COMPRESSOR SCHEDULE
SYMBOL
IYPE
MFR
MODEL
COMPRNo. ESSORS
CONFlGURAl10N
CpppARy
RPM
0 175 PSIG
AC-1 .
RECIPROCATING
2-STAGE
CHAAIPION
60CAW15V
7
VERRCAL
TANK MOUNTED
5.4
565
1. PRONDE REFRIGERAiED AIR DRYER AD_i.
AIR COMPRESSOR SCHEDULE
~
CONFlGURAiION
RPM
HP
ELEC
RECENER
REMARKS
~
COMPRESSORS
~~5 SIG
~oN
>
1
VERTICAL
5.4
565
1.5
115/1
60
1
~
TANK MOUNiED
PROJECT NAME: ~n~L] ~"'-a;
Clear Creek Ambulatory Piumbing Legend
Sur er Center Plumbin Sc~iedules
GORDON, GUMESON AND ASSOCiATES, INC PROJECT NUMBER: DATE: DR.4WING N0.
BA #03938.00 / GGA ~03093 02-11-04
4725 SOUTH MONACO STf2EET, SUrrE zoo PA1.2
DENVER, CDLORADO 80237 REFERENCE DRAWWG(S): SCALE:
(303) 779-1222 FAX: (303) 694-9144 P0.1 NONE
S:\J.^.bs~2C••-A4:30?3W':ACCFA1M93G33P0.1 _>chP6l:jwy, 9:J11I04 1v:42:55 AM. JIb
MmICAI GAS ALARM PANEL SCHEDULE
u+En uN P
wSM uAR
~C
RELkRKS
gyy~
µqp~y ~yp
IMNIFIXD
R~ET'E IN
R6QA'E
STSfEAi P51/Ng
-
CFIFNGEOVER
USE
LO'N
CWN(:E
SIAVE PANELS
PRFA SFXVID
GSS SEIAACE
G4S SERVICE
GAS SfWE
G1S SERJC
GAS SETMCE
pXy'a
OXYGEN
NR. 0%IDE
Mm. aR
OXYGEN
OXYGEN
Nm OXIDE
-
OR
Mm R
1151
/
MFA
OXI~E
~
VACUUM
VACWAI
C02
C02
pXYGFN
OXYGQ!
~-2
~
ARFA
Mm. aR
NR.OXIDE
OXYGEN
OXYGEN
Mm. AIR
NR. OXIDE
-
VPLUUN
715/1
~
VACWM
C02
~ 2 2
PROJECT NAME: SHEEf TITLE:
Clear Creek Ambulatory Plumbing Legend
Sur er Center Plumbin Sc~iedules
GORDON, GUMESON AND: ASSOCIATES, WC PROJECT NUMBER: DATE: DRAWING vo.
4725 SOUTH MONACO SiREET, SUITE 200 BA ~03938.00 / GGA ~03093 02-11-04 1
DENVER, COLORADO 80237 REFERENCE DR,qWING(S): SCALE: PA
(303) 779-1222 FAX: (303) 694-9144 P0.1 NONE
ZONE VALVE BOX SCHEDULE
vaLvE sIzF
, iNCHEs
m.+BOL
uooa
OZ
IA4
NZO
VAC
CO?
2 cwc6
ao~,wcs
2
zva_i
77-82-1108
7/2
7/2
7/2
1-1/4
1/2
(4) 0-100 PSIG
O.R /1
77-83-1007
(7) 0-30 HG
-ZVB_2
77-82-1108
1/2
7/2
7-1/4 .
1/2
(4) 0-100 P516
O.R 12
77-83-1007
1
(i) 6-30 HG
ZVB_3
77-82-1108
1/2
7/2
1/2
7-1/4
1/2
(4) 6-700 PSIG
O.R. JS
77-83-1007
(1) 0-30 HG
77-82-1108
1/2
7/2
7/2
1-1/4
1/2
(4) 0-700 PSIG
O.R #4 .
[
77-&3-1001
(1) 0-30 HG
ZVB-5
77-82-1106
7/2
.
.
7
.
. (1) 0-100 PSIG
PROCEIDURE RIA.
.
(1) 0-30 HG
ZVH-6
77-82-7109
3/4
F'S
(1(1) 0-30 HGIG
RECOVF1iY
Z4B-7
77-02-1109
3/4
.
.
1_1/4
.
(i) 0-700 PSIG
(1) 0-30 H6
PRE-OP
1. EQUIPAIFNT SCHmUIE BASm ON CHEIAEfRON.
NAME:
Creek Ambulatory
rv Center
GORDON; GUMESON AND ASSOCIATES,
4725 SOUiH lAONACO STREEf, SUfTE 200
OENVER, COLORADO 80237
(303) 779-1222 FAX: (303) 594-9144
SHEEf TITLE:
Plumbing Legend
Plumbin ScFiedules
PROJECT NUMBER: DATE:
BA #03938.00 / GGA #03093 02-17-04
REFERENCE DRAWING(S): SCALE:
P0.1 NONE
No.
RA1.4
S:\1^.LsL9C~3\03:?3V,'JACCFAlM~i3033PJ.1 ~chP01:Jwq.,•U11/v410:42:36AM.JI6
~ MEDICAL GAS MANIFOLD SCHEDULE
SriBOL
56MCE
N0.
CNNDERS
N0.
WUID DE14AR5
COMROL
PANEL
HEWER
CONFlWM710N
IAOUMING
FlAOR/WPLL
~
DEI.Nflit
PP~RE
6
-
LC'9
- I
FOR USE WfIH
X
G
H
710/1
275 p$IG K
L7
11q.1-1
O
Y
E
-
2
IXA
STAG6fRE➢
WN.L
55
c
VALVE OEWMS
wrmruL ouu
MG11-2
IAmM.LL P1R
3+3
-
FliM2
WALL
110/1
55
Pit65, REG.
SrqGGM
30-70 PS1G
I~~ D~
YGAI-3
NffR0115 OXIOE
2+2
-
FliAl2
Wp1.L
110/1
55
PRESS flEG.
2
S7AGGM
30--70 P9C
INiERWLL OI1FL
I.N;A1-4
CARBON DpXIOE
2+2
-
FHAYL
W~
110/1
160
PR6S PEC.
nAGGM
30-70
e~c
1. EQUIPMENf SCHEWLE BASm oN W6IFRN INNOVATOR.
2 HEMEtt TO INCWDE 24' FLFXI6LE SiP1NtESS $fEF1 PIGfAILS Wflfi CHECN VPLVES.
3. %YOnDE CfLJNOER SUPPORIS PQt NFPA 99 REOIIIRQIQIIS
PROJECT NAME: SHEET TITLE:
Cleac Creek Ambulatory Piumbing Legend
Suraerv Center Plumbinq ScFiedules
GORDON; GUMESON: AND ASSOCIATES INC PROJECT NUMBER: DATE: DR4WING N0.
4725 SOUTH MONACO STREET, SU(iE 200 BA #03938.00 / GGA #03093 02-11-04
DENVER, COLORADO 80237 REFERENCE DRAWING(S): SCALE: PA1.5
(303) 779-1222 FAX: (303) 694-9744 130.1 NONE
a:lJ.^.bs~2G]34~3]33W':ACGFAW\L3033P].1 SchP0l:Jwy,,]iJ11D41,-r4__SAM..JIb
TOLET
pEfAVFAY
h IPflIYATO
Z"W
4 UP~
'w uP
J WCC
2"W
T06ET
145
~
4"W UP
rz , vwvnro
E~~"Y
; EE
2"V UP
4"W UP
TO WCO
2"W UP
' 2"W UP
~
' PELOVWM IBI
14
r l PPLO'QiY 11
^
r~
"
2
~4
4~
~wvmr
8
4 W UP
~w.we 2"V UP
15~ 4"W UP
4"FCO
; stR„Y 2^w ui
I~
UP
UP 2"w
I L «I~i
REW9YEAY
~W U ll9
UP
4"
l Z-V~ UP;
! I r2"
T
,z7 4"W UP
4~ 0 WC
:r42 I P "oY
11 k_ 114i r-
~
ILJ 2"w uPJ
MNSE
W IIP_
II U - jl
^
2nW ~
m I -
HALLWAY
BI
~
-,(l'~----,fl~----t,fl~-----,Il~---
PROJECT NAME: SHEEf TITLE:
Clear Creek Ambulatory Underground Plumbing Plan
Sur er - Center
GORDON, GUMESON: AND RSSOCIATES, INC PROJECT NUMBER: DA7E: DRAWING N0.
4725 SOUTH MONACO SiREET, SU(TE 200 BA #03938.00 / GGA 7#03093 02-11-04
rA1.6
DEN4ER, COLORADO 80237 REFERENCE DRAWING(5): SCALE: p
(303) 779-1222 FAX: (303) 694-9144 p1,0 1/8" = 1'-0"
S:IJ^bsk003\03093V+GACCFA`MG3033P1 A_Flry ]i:hxy. D'V 1 1/94 1 r.3i:43 AM. JIb
PROJECT NAME: SHEET TITLE:
Clear Creek Ambulatory North Piumbing
Suc er Center Floor Plan
GORDON, GUNIESON AND AS50CIATES INC PROJECT NUMBER: DATE: DRAWING N0.
+ BA ~03938.00 / GGA #03093 02-11-04
4725 SOUT}i MONACO STf2EEf, SUffE 200 ~~1.7
DENVER, COLORADO 80237 REFERENCE DRAWING(S): SCALE:
(303) 779-1222 FAX: (303) 694-9144 P2.18 1/8'=1'-0"
S:4J^.bs~003h3~P.3V+':ACGFAIM.]3]33P2.16_FIrP]_ dw~, 0'J71/0401:1?:53 PIA. JIb
, I NOTE: IXiEND ALL DRAINS FULL SIZE.TO
DISCHARGE ABOVE FLOOR DRAIN.
AIR INTAKE (SEE PLANS FOR SIZES).--~,
Fl.IXIBLE CONNECfION--~I
BP1L VALVE (Bl'-PASS
TAGGED NORMALLY CLOSED) Fr~
NLL SIZE
BY-PASS
RACK ON WALL /
PR6SURE
~ GAUGES (IYP.) FlFXIBLE -
7q~pq W/GAUGE COCK CONNECTION.
I DISCHARGE 3/4' DRAIN-
PRUNION (IYPI ~ TO Fl.OOR DRAIN
REGUtAl1NG VALVE
SET A 125 P.S.I.
' ~ IF
AD-1
HANKINSON HPR5, 715/1, 0.72 kw, FlLTERS:
ItdfEGRAL GRADE 9 FlLTER 0.1 ~IICRDN
(992 BULK WAiER. 3 MICRON IAAX, pARTICUtATE
PAAf1CUlAiE), 5 SCFM 0 100' F 0.008 ppm OIL REMOVAL INLEi AIR, 100' F SANRAiED, FlN. Fl.OOR 100' f NABIINT, 38' F DEWPOIM
1s AIR CO
P4.1 NOT TO SCALE
O
rPRESSURE REIJff
VALVE
AC
TANK DRAIN
VALYE
VI6RATION
, ~ISOLATORS
PIPING DETAIL
CONCREfE
ARCH.
PROJECT NAME: SHEEf TITLE:
Clear Creek Ambulatory Piumbing Details
Sur er Cen#er
GORDON, GUMESON AND ASSOCIATES INC PROJECT NUMBER: DATE: DRAWING N0.
~ BA #03938A0 / GGA ~03093 02-11-04
4725 SOUTH MONACO STREEf, sUrTE zoo pA1:g.
DENVER, COLORADO 80237 REFERENCc DRAWING(S): SCALE:
(303) 779-1222 FAX: (303) 694-9144 P4.1 NONE
5:\J.^.bs\2r~]3\03r33U':AC6FAW4]3093P4.7_GtlPO1:Jwy.0iJ11/06 vL20:35 PM. Jlb
FEB.11.20045:06PM GORDON GUMESON N0.978 P.2i3
PROJECT NAME: Wlttl 111Lt:
Clear Creek Ambulatory Underground Plumbing Plan
Suraerv Center
GORDON,. GUMESON AND ASSQClATES, INC
4725 SOUM MONACO SfREF.T, SUfTE 200 6A ~3938.00 J GGp #03093 -02-11-04
pENVER, COLORApO 80237 REF~RENCE DRAWING(S): SCAI-E: PA1•9
(303) 77s-12Z2 FAX: (303) 594-9144 P1A
s:UOLe~t003W3038a.:AW qAWto3ossp~.o_Flrpal.awy, ae/i1104945730 PM, JN
FEB.11.2004 5:06PM GORDON GUMESON
rN 1n~
STEAM
GENERATOR
36
2n ~
- 6"
CLEAN / WORK
STERILE STORAGE
169
3EG1N 1/4" PER Ff. SLOpE
' ~ 5
?_16" i -
~
~
~
5
~
~
~
~
~
(
I
~L
I
-~~11 -
~
ANESTH. .
13 15 i 65
27
nP.s
`
•D-
N0.978 P.3i3
1--i
' /I 1606
JANITOR
17
E)
G
I I
~
~
~ I
WOM~N'S LOCKEF
EQUIPMEN i R
16Z
EQUIPMF-NT
^ 163 ~
I1Y+r1Vi"
L~-r
Clear Creek Ambulatory
SurQerv Center
I G.ORDON, GUA+IESON AND ASSOCIATES;
(303) 779-1272 F/+X: (303) 894-9144North Plumbing Flaor Plan
4725 SOLRM MONACOSTREET, SUf1E 200
~ENVER, COtARADO 80237
PROJECT NUMOER: DATE: DRAWING NC
BA #03938.00 / GGA #03093 02-11-04
REFERENCE DR,4WING(5): SCALE: PA1.10
P2.1A 1/4" = 1'-0"
S:Wnha1c063103u39Wr~pGCAAVJ~R3~33Pi.1A~hP~1 ~1wg, J'v71/~405;09:45 PM,JI~
MEDICAL EQUIPMENT SCH
EDULE
I awa~c~
na _J
wMa
00~-M
ca~M
MMU
~r
os~ra~ W I
M I Fu
wM= I
FEM
HWxr
IEMM
wo
~
116
UL7RASONIC CIEANEFt
15.0
115
20A2G
CDPL
+44" PfF ~
NFNA 5-20R
I
1
3
1178
NR COMPRESSOR I1 1 2I
1.4 Za.O
115
30AZG I
01L
+IS' PFF
J-BO%
~ 117C
NR ORYER (FOR 1178) I
0.1 1.0
115
20A2G
01L
+18" PFF
J-BOX
3
~
c u i
i i
117r,
i
i
n
120A MICROWAVE 1.1 92 I ~Z~ 22A26OiL [I ' NEMh 5-20R
1208 MICROWAVE 120 ~ 20A26 BL +6f"[~ ~ NE4A 5-20R
111A GCC9ICGG~Tl1G 1 7 15/1 190 ~ 9pA9C ~ p1AA' A[G 1JplA 9_9AG
SCFlEDULE
VP-1
VACUUM PUMP I(2) 5 I 13.5 I 37.5 I 208 I 3 50A7G
I OL I
60A7P
~N R
Z
WS-1
WATER II 0.5 4.3 I 115 I 1 I 20A2G
01L
SMTO I
2
SOFlENER
GENERly. NOTES:
A.
VERIfY ABOVE SCHEDULED INFORAIA➢ON WfIH OMSION 15 CONRWCiOR ANO SUBIA
l1TPLS. NOTIF( ENGINEER OF
M1NY DEVIATIONS FROM iHE ABOVE SCHEDUlEO INFORAIA➢ON PRIOR TO ftOUGN-IN.
COOROINATE LOCFTIONS OF
POINiS OF CONNECTION WIiH DIVISION 15 PRIOR TO ROUGH-IN.
PROJECT NAME:
Clear Creek Ambulatory
Sur er Center
GORDON, GUMESON AND ASSOCIATES,
4725 SOUTH MONACO STREEr, SUITE 200
DENVER, COLOR4D0 80237 (303) 779-1222 FAX: (303) 694-9144
FXFY
SHEEf TITLE:
Eiectrical Legend and Schedules
PROJECT NUMBER: OATE: DRAWING N0. BA #03938.00 / GGA 7#03093 02-11-04
REFERENCE DRAWING(S): SCALE: EA1.1
E0.1 1/8" = 7'-0°
DRAWING NOTES
Ol EXTERNAI GROUND-FAULT ALARM REIAY AND SENSOR (fl'PICAL OF 3). REL4YS
SHALL ALARM AT COMMON INDICATOR LAMP AT REMOTE ENGINE-GENERATOR
ANNUNCIATOR PANEL AND AT INDIVIDUAL INDICATOR LAMPS AT GENERATOR
CONTROL PANEL.
O2 PANELBOARD FOR FUTURE TENANT. LOCATED IN FUTURE TENANT SPACE.
480/277V, 34, 4W, 25KAIC, 42 POLE.
O3 WEATHER PROOF ENCLOSURE SHALL BE SOUND ATTENUATED TO A MAXIMUM OF
70db AT 25 FEET OR AS REQUIRED TO COMPLY WITH ARTICLE 12 OF THE
REVISED COLORADO STATUTES AND THE AUTHORIIY HAVING JURISDICTION.
E-MON CORPORATION (OR EQUIVALENT) CAT #480400 KIT ELECTRONIC
KWH/DEMAND MEfER WITH (3) SPLIT-CORE CURRENT SENSORS. LOCATE IN
MHiN ELECTRICAL ROOM.
OS INTERNALLY-MOUNTED SQUARE D NSS MODULE.
O6 FURNISHED BY OTHERS FOR INSTAILATION BY DIVISION 16 CONTRACTOR. REFER
TO SPECIFICATIONS FOR EXACT REQUIREMENTS.
18
~ ~P 3
i GP
A ~
T-DiL
500A3P
ENCLOSED
BREAKER
I
1-- -1
~
^
o~
~
o n
N I ~ I
J C~
~
o n
- - ~J
tC ~
I~
PANEL
D1L
lO
500 3 MCE I SEPARATELY
~ ~ ENCLOSED
BRKR (TYP.) -
225 kW, 280 kVA, 0.8 pf, 480Y/277V
WEATHERPROOF HOUSING
O
PROJECT NAME: SHEET TITLE: Clear Creek Ambulatory Eiectrical One-Line Diagram
Sur er Genter and Schedules
GORDON; GUMESON AND ASSOCIATES, INC PROJECT NUMBER: DATE: DRAWING N0.
BA ,'~03938.00 / GGA #03093 02_11_04
4725 SOUTH NONACO STREEf, SUITE 200 11 EA1.Z.
DENVER, COLORADO 80237 REFERENCE DRAWING(S): SCALE:
(303) 779-1222 FAX: (303) 694-9144 E0.2 1/8" = 1'-0"
DETAIL NOTES
Oj RECEPTACLE IN NEMA 3R ENCLOSURE. ENCLOSURE
SHALL REMAIN WEATHERPROOf WHEN RECEPTACLE IS
O1 IN USE.
~ I O 3/4" RIGID STEEL CONDUIT
i I O3 ROOF
~ ~ 5 O4 FLASHING z
OS 1-5/8" GALVANIZED UNISTRUT SUPPORT, 12" ABOVE
~ FINISHED ROOF TO BOTTOM OF RECEPTACL .
6
GENERAL NOTES
1. RECEPTACLE MAY BE MOUNTED TO ROOF70P EQUIPMENT
OR EQUIPMENT SUPPORTS IN LIEU OF SUPPORT SHOWN
IF NEC ANS UMC REQUIREMENTS ARE MAINTAINED AND
SUCH MOUNTING IS ACCEPTABIE TO ROOFfOP
EQUIPMENT MANUFACTURER.
7 ~ ROOF MOUNTED
E0.3 NOT TO SCALE
INSULATED ~ 3/4"C WITH
THROAT PULL CORD
BUSHING
STUBBED INTO ACCESSIBIE
CORRIDOR CEILING SPACE
3/4"C (WITH PULL CORD) FOR N
CONTROLS - AT PATIENT ROOMS
144 & 146 ONLY
4 TELEVISION OUTLET RACEWAY DETAIL
Q.3 Nor ro scaLE
PROJECT NAME: SHEET TITLE:
Clear Creek Ambulatory Electrical Detaiis
Sur er Center
' GORDON, GUMESON AND ASSOCiATES, INC PROJECT NUMBER: DATE: DRAWING N0.
, 4725 SOUTH MONACO STREEf, SUITE 200 BA $03938.00 / GGA '~03093 02-11-04 i q
i DENVER, COLORADO 80237 REFERENCE ORAWING(S): SCALE: EA I.J
(303) 779-1222 FAX: (303) 694-9144 E0.3 1/8" = 1'-0"
D1L
IYNUF: SQU0.9E 0 7YPE NWO V/PN/N': 209Y/120V, 3 PHASE. 4%1RE
A BUS: fiW A ML6: 5W N BUS: NLL CB15: NLL
NG 22000 ENCI NQIA i NMG: NAFACE
NOiES: NOiES:
TO7AL
CIRCIIR
POlES
dRCUR
TODL
CRIP710N
BflKR
BRKR
OESCRIP7ION
Z
9
A
P
A
I ~ 1
1 0 ~
I
1
I A 2
20
I
700
F-I
118, 1075
200
40
1
3 8 4
20
I
1375
F-4, F-3
ryg
7375
20
7
5 C 6
20
I
1375
F-4. F-5
1a9
2000
20
1
7 A 8
10
I
1575
FPB-1-1, `rP8-1-2
12p4
1100
20
1
9 B 10
10
I
1575
FPB-I-S, FPB-I-4 -
137A
1400
20
7
II C 12
40
1
1375
FPB-1-5. FPB-2-5
121A
2125
20
I
ll A 14
YO
I
1375
FPB-4-7. FPB-2-2
110
500
20
I
15 6 ib
20
I
0
SPME
131& 1778 '
1500
20
I
17 C 18
20
1
4
SPME
EYM-1
2060
30
19 A 20
20
1
0
SPME
2
2060
B 22
20
I
0
SPIRE
1 ~
50 I
0
1
47 C 24
20
I
0
SPME
A 26
0
SPACE
RCPF SIIE SIGNACE
180
20
1
27 B 28
0
SPACE
R(Ph ROOF
360
20
I
29 C JO
0
SPACE
SPME
0
20
I
31 A 72
0
SPICE
SPME
0
20
I
33 9 34
0
SP1GE
SAME
0
20
I
35 C 76
20
I
500
SIiE 11GF1lING CONTACTOR
SPACE
0
37 AM
100
6560
PANF1 'OL'
SPM,E
0
79 B 40
45150
"
SPACE
0
41 C 12
31
520
p
SF A SF
400
17269
PNIEt 'Bl"
0
SF B SF
19095
0
SF C SF
.
3
20496
LOAD
SUMMAR
Y
LiG
LTG
FCP!
MOTOR
MOTOR
O7HER
El£Gi
KRG1
NISC
SIIB-
AIE0.S
ftWD
INC
FL/H
UtGA
OiHEfl
HFAT
EOUIP
lOID
TOTPL
LAN
LWD
TOTIL
707N: A
11.2
13.9
6.0
1.4
37.3
15.7
(0) B
12.1
5.1
10.2
2.1
29.1
.
29.4
C
13.9
7.0
I
71.2
.I
32.1
32.2
TO1A
37.1
45.9
27.4
4.5
94.9
94.9
PF S
100
95
100
~ 80
80
140
100
100
100
80~
100
TOTNL A ~
11.2
4.1
6.0
2.4
76.8
36.8
(KVA) 8 I
121
6.7
102
2.1
30.6
70.6
C
I3.9
8.8
11.3
d
}].9
33.9
iOiIL
37.1
32.4
27.4
4.5
I
101.4
101.4
NEC FKTORS:
~
.
-<15f M/A
10
ISf M/A O (S)
IW
NSik =QNO I(VA
0
7N0 kVA O (x)
0
>PREV M/A 0 (S)
SO
I
O7HQ1 F
125
115
100
1 25
100
100
100
1D0
I00
125
100
NEC A
7.1
1
17.1
fi.0
2.4
~
7P7
727
10i/L 8
I
7.7
1
6.J
142
2.1
I
26.2
16.2
(kVA) C
i
B.B
I
j
8.8
II2
.1
I
P8.9
28.9
i0T0.
~
I 23.5
1
I324
R4
, 4.5
87.8
87.8
PfYSE A-B B-C A-C
I P/NEL
I laPS FER A B C
NINIUUN PNIEL
81lINCE (S): 80 91 AB
I PF (R): 94
j PHASE 272b 2187 2407
WGAGO': 2726
PROJECT NAME: SHEET TITLE:
C1ear Creek Ambulatory Panelboard Schedules
Sur er Center
GORDON, GUMESON AND ASSOCIATES, INC PROJECT NUMBER: DATE: DRAWING No.
BA ~03938.00 / GGA #03093 02-11-04
4725 SOUTH MONACO STREEf, SUITE 200 EA1.4
DENVER, COLORADO 80237 REFERENCE DRAWING(S): SCALE:
.(303) 779-1222 FAX: (303) 094-9144 E0.5 1/8" = 1'--0"
F}i
NINUF: SqUPRE 0
IYPE
NWO
V/%1/Y!: 208Y/14P/, 3 PWSE, 4 b1RE
A BIIS: /W Ml0
N BUS:
NLL
G BUS: NLL
.
NQ 25000
QICI
NEAIA i
YMG: SURF/LE
N016: ~
NOiFS:
Q
2
TOTAL
CIRCUR
POl6
GRCIIR
tOLLL
DESCRIFIION
&tN(i -
BRKN
OESCRIPIION
p
A
P
0
A
P
A
1QAP lTG
260
20
1
I A 2
0
SPACE
SPACE
0
3 8 4
0
SPACE
SPACE
o
5 C 6
u
SPACE .
SPACE
0
7 A 8
0 '
SPACE
SPACE
0
9 B 10
0
4'ACE
SPACE
0
11 C 12
0
PICE
SPACE
0
13 A 74
0
SPACE
SPACE
0
15 B 16
-
0
S°ICE
SPACE
0
17 C IB
0
SPACE
SPACE
0
19 A 40
0
SPACE
SPACE
0
21 8 12
0
SPACE
SPACE
0
23 C 21
0
SPACE
SPACE
0
45 A 26
0
SPACE
SPACE
o
27 8 28
0
SPACE
SPACE .
0
29 C 30
0
SPACE
SPACE '
0
31 A 32
0
SPACE
SPACE
0
37 B 34
0
SPACE
SPACE
0
35 C 36
0
SPACE
SPACE
0
37 A 39
0 -
SPACE
SPACE
0
39 B IO
0
SPACE
SPACE
0
41 C. 44
a
SPACE
LOAD
SUMMAR
Y
liG
LiG
ftCPi
NOTOR
MOTOR
OhIFA
F1£CT I
NRCH
IlISC
SUB-
YFIS
RMVD
INC I
FL/HiD
lACST I
O1NER
HEAT .
EOUIP
LOIO
iOiN.
LND
LOM
TOTAL
TOTAL A
.1
.7
.3
(MN) B
C
.
TOTAL
.3
.7
. 3
PF S
100
95
100
&7
90
100
100
100
100
90
100
TOTAI: A
.3
.7
.7
(NVA) B
C
TOTAL
.7
.3
3
NEC FIG70RS:
=<iSf NVA
10
IST M/A 0 (S)
100
>ISfB =<7N0 NVA
0
1ND k!A 0 (S)
.
0
>PREV NVA 0 (S)
50
I
ORiER S
125
IPS
100
PS
100
100
100
100
100
125
100
NEC A
}
I
I
]
TOTN 8
~KVA)C
I
.7
.7
3
A-B B-C
A-C
PPNEL
P5 PQt A B C
A4
MINIWIIN PNIEL
t(X)
0 100
0
I
PF (S):
100
I PFUSE: 1.7
AVPIGIY:
2.7
PROJECT NAME:
SHEET TITLE:
Clear Creek Ambulatory
Panelboard Schedules
Sur er Center
PROJECr NUMBER:
DATE:
DRAWING No.
GORDON, GUMESON AND
ASSOCIA
TES,
INC
BA #03938
00 / GGA #03093
04
02
4725 SOUTH MONACO STREET
SUITE 200
.
-11-
G
,
EA'1:J
DENVER, COLORADO 80237
REFERENCE DRAWING(S):
SCALE:
(303) 779-1222 FAX: (303) 694-9144
E0.5 "
1/8" = 1'-0"
BL-6
VP
1178
117C
WS-1
PROJECT NAME: SHEET TITLE:
Clear Creek Ambulatory North Power and Systems
Suroerv Cerrter Floor Fian
GORDON; GUMESON: AND ASSOCIATES,
4725 SOl1TH MONACO STREET, SUITE 200
DENVER, COLORA00 80237
(303) 779-1222 FAX: (303) 694-9144
PROJECT NUMBER: DATE:
BA #03938.00 / GGA #03093 02-11-04
REFERENCE DRAWING(S): SCALE:
E2.1A 1X„ _ V o,.
No.
EA1.6
PUMP AL-2F 7
UA ' 46
4 DS 8 I j +9 °~l
I 4¢ +18" 133A 143B ~ BL-4
+48° ~ P 46 RECOVERY N EP T011
I AL-32 CUH-1 C
#1 (PRIVATE)
CDPL-4'4,46
~ 48 146 8L-44(48 O
2 140 TP °
OO DL
PB-2-
VESTIBULE
182 +44"
2$ L AL-8 r 11 DL
8
4 ~ +44" 0 /
2 ~
I ~
13 ~ EP N
GFCI
BL-46 ~
2
113
+7 WER
lrJcn 2 ! 4 I I 1477 T 'T-CDPL" CDPL"
AL-26
26 "T-D1L" T
"DiH° LECTRICAL ,
2 175 j
H',T-LSL" '7-OL° i 2
SH'0 n
~ 0 tL ~
~
°LSI.° "QH°
PROJECT NAME: SHEE7 TITLE:
Clear Creek Ambulatory North Power and Systems
Sur er Center Floor Plan
PROJECT NUMBER: DATE: DRAWING N0.
GORDON, GUMESON AND ASSOCIATES; INC gq #03938.00 / GGA $03093 02_104
-0ENVER, COLORAOOC8023REEf, SUITE 200 REFERENCE DRAWING(S): SCALE: EA1.7
(303) 779-1222 FAX: (303) 694-9144 E2.1A 1/8" = 1'-0"
L~ +48"Ak{o 4 -~-1
4 i
e+44
2
" OR1" i 10 i
II 2 ~ 104A O S 14,16
12 I ~
O 1p +72
~ O O 1-1A ~
~ 103A O CB
OSA O Y +481
I 1038 O
10 I
o +7F
0
O S O I
OOPERATING
tOtA ROOM #t I
i l08 i
J
2
10
@)104B O Z
O ° P~s
4 O 108C ~
~
o ~
+4 103C
N 103D O 1086 6 6
CB
p 105-18 0 0
12 ;
I 12 O S j! OO
~14,16 OPERATING
~
ROOM tt2 1018
COR2" 166 I~
,I I
PROJECT NAME: SHEE7 TITLE
Clear Creek Ambulatory North Power and Systems
Sur er Center Floor Plan
GORDON, GUMESON• AND ASSOCIATES, INC PROJECT NUMBER: DATE: DRAWING N0.
. 4725 SOUTH MONACO STREET, SUITE 200 BA ~03938.00 / GGA ~03093 02-11-04
DENVER, COLORA00 80237 REFERENCE DRAWING(S): SCALE: EA1.H
(303) 779-1222 FAX: (303) 694-9144 E2.1A 1/8" = V-0"
+48
~
'3
~
)1088 6
f108C1
103E
4 r-~
~CB
0
*104C
S 1I4,16
~ 12
105-1C
O 12
3
Q 103F CB
10
OPERATING
ROOM #3
157
I ~Wi4,io ROOM tt4 0101D . I~ I,~47
PROJECT NAME: SHEET TITLE:
Clear Creek Ambulat`ory North Power and Sys#ems
Sur er Center Floor Plan
GORDON; GUMESON AND ASSOCIATES, INC PROJECT NUMBER: DATE: DRAWING vo.
4725 SOUTH MONACO STREEf, SUITE 200 BA ~03938.00 / GGA ~03093 02-11-04
DENVER, COLORADO 80237 REFERENCE DRAWING(S): SCALE: EA1 (1
.J(303) 779-1222 fAX: (303) 694-9144 E2.1A 1/8" = 11-0"
U
DRAWING NOTES CONT'D
O9 JUNCTION BOX FOR DOOR OPENER PUSH PLATE. REFER TO ARCHITECTURAL
PLANS FO C tk~CZ 10 R UI M TS FIN C N N L TI N. Z
10 PROVIDE CEILWG-MOUNTED 20A TWIST-IOCK RECEPTACLE AND PLUG (HU88EL
2315 AND 2313 OR APPROVED EQUIVALENT) WITH 4' "SO" CORD TO SUSPENDED
DUPLEX RECEPTACLE. VERIFY LENGTH OF CORD WITH OWNER PRIOR TO
ORDERING.
11 SOOA ENCLOSED BREAKER, SQUARE D, FOR SECONDARY FEEDERS FROM
TRANSFORMER 'T-D1L":
DE
1.
~ I '
N 127
+4 ~ STEP DN.
1231A_ 1068 ' 131
4 o BL-56
142A
45 4 ~ ~JCA I , pL<
59
57 +44' I r ,
~ 'b ~
NUR ~ Z
~ i
125 ' ,
OL<
~ . o
3 ~ BL-56
. ~ _I _J I
i .
PROJECT NAME: SHEEf TITLE:
Clear Creek Ambulatory North Power and Systems
Sur er Center Floor Plan
GORDON, GUMESON. AND ASSOCIATES, INC PROJECT NUMBER: DATE: 1 DRAWING Na
4725 SOUiH MONACO STREEi; SUITE 200 BA #03938.00 / GGA #03093 02-11-04
DENVER, COLORADO 80237 REFERENCE DRAWING(S): SCALE: EA1.1Q
(303) 779-1222 FAX: (303) 694-9144 E2.1A 1/8" = 1'-0"
UL I 1 i 7j'v!
)
BL-26
i
:1L1'ATION
113
VESTIBULE
112
os
CORRIDOR
110
BL-2C
PROJECT NAME: SHEET TITLE
Clear Creek Ambulatory South Power and: Systems
Sur er Center Floor Pfan
GORDON, GUMESON AND ASSOCIATES, INC PROJECT NUMBER: DATE: DRAWWG N0.
4725 SOUTH MONACO STREEf, SUITE 200 BA '~03938.00 / GGA ~03093 02-11-04
DENVER, COLORADO 80237 REFERENCE DRAWING(S): SCALE: EA1.11
(303) 779-1222 FAX: (303) 694-9144 E21B 1/8" = i'-0°
N
N
FU T U E T EPACE 5FI ONTECT
B OCCUPANCY
2
S3
~
~G
❑
II
D1H-1I1 :
D1H-11
$
N
i
I
N
i
FUTURE T
~
B OC
~
,
~
i
i
N
~
;
i
j
i
i
PROJECT NAME:
Ciear Creek Ambulatory
SHEET TITLE:
South Lighting
Sur er Center
Floor Plan
GORDON, GUMESON AND ASSOCIATES, INC
PROJECT NuMeER:
BA ~{03935.00 / GGA $03093
onre:
0P_1t_04
oRnwiNC No.
4725 SOUTH MONACO STREET, SUITE 200
1~1
DENVER, COLOR,4D0 80237
REFERENCE DRAWING(S):
SCALE:
EA1.
IG
(303) 779-1222 FAX: (303) 694-9144
E3.16
1/8" = 1 '-0"
3/4" BASE PL.
ON 1 "f NON-
SHRINK GROUT
116V COL. & BASE PL.
1 1/2~ 3/4"4 ANCHOR BOLTS W/
~,P 2" STD HOOK AND 8"
EMBED.INTO CONCRETE
/(4 REQ'D EA. PL.)
•
~ a t COLUMN
~ & FOOTING
~ i
C COL. & BASE PL--{
CONC. CAP - SEE 3/S3.0-
~
16"xt6" MINIMUM PILASTER
W/(4) #6 VERT. DOWELS
W/STD. HOOK IN f00TING
AND #4 TIES AT 12" O.C.
DETAIL MINIMUM) 6/S3.p IMILAR TO
M J
U
~
i STEEL COLUMN - SEE
i ROOF FRAMING PLAN
a
■~i
° .i'. .
M
<
ed
0
SLAB ON GRADE
- SEE PLAN
SEE PLAN
~
~f
FOOTING REINF.
- SEE FOOTING
SCHEDULE
z
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'~11-II1--~~' SOIL, OR RECOMPACTED
FOOTING PLAN DIMENSIONS ON-SITE OR IMPORTED
SEE FOOTING SCHEDULE STRUCTURAL FILL SOILS
- SEE SOILS REPORT
TYP. FOUNDATION DETAIL - nP'CAL
, OTES
1. AT : INTERIOR COLUM7V ON ~ 1'-0»
! GRID "
USE 1 ° THICK BASEPIATES.
,2. AT GRID WTERSECTION C-5, USE
' 4 - 1"0 ANCHOR BOLTS.
0. ANCHOR BOLTS TO BE A307, TYPICAL U.N.O;`
q CONSULTING ENGINEERS
~~I J.. C. B HU R 2551 31 st STREET 8030
J~~. BC. [~5,.~OCI~iTES, INC. - PROJECT N0~ 030851
CLEAR
CREEK SURGERY
DETAIL
2/S3.0
DATE:
2/11/04
X ~
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SCALE:
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PROJECT N0. 03085
DATE:
2~11~04
SCALE:
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.
.
. & ASSOCIATES, INC.
BOULDER, CO
PROJECT N0.
80301
03085
DATE:
2/11/04
X
~
SCALE:
3/4"=1'-0°
02/12/2064 16:00 303-415-1070 J.C. BAUR & ASSOC. PAGE 02/02
J(S~JI J C..BAU1R CONSULTING ENGINEERS
• 2551 31st STREEf
& ASSOCIATES, INC. PBOULDER ROJECT' o°. oaoss'
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DATE: 2/1 1 /04
NOT TO SCALE
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3. ALL INTERIOR COLUIJMS SHAII BE rS5z5xJ/16, TYP~GAL UNLE55 NOiED OTHERwiSE.
4. ALL WIND COlUMNS SHALL 8E T56~3x3/Ifi, A%IS PERPENDICUtAR TO WALL, TYPICAL. CONNECiION 70 8EAN5 70 BE ttPICAI PER i/549. 5. 70P Of SiEEL BEW~15 PERPENDICULAR TO JOIStS SHALI BE
I15'-0", irPICAI UNLESS NOTEO OTHEFWiSE TnUS; (f2 i f2"). 6, i0P OF S1EEL BEAMS PARALLEI i0 J015i5 SHAIL MATCH TFtE
80TfpA! OP METAL OECK AT THE ROOF SIOPE TOP pF STEEL Ai SUGH BEAMS lS TO BE i~5'-2 t/Z" AT THE BNLDiNG PERIh1ETER.
7. SEE OETA~L 7/S4A fOR FRAMtNG AROUNO RDOF aENETRAT10N5. ~p~„ ~ m COOR~INATE LOCAiION AND 512E5 WItH ARCNITECTURAI ANO B,m Stp, PIPE a o
~ ~.3 2 MECHANICAI ORAWINCS. yy/fiKEO 8726,~~~ p '-8' 1 i'-8" 8. COLUMNS ARE TO BE CENiEqEO ON CRi~ MtERSECnONS - (T.0.5. ~ ~ U 1YPICAL UNlESS NOiED OTt1ERWi5E.
9. ROOF ~ECK SHALI BE VUICRAFT 1,58, 20 CAGE ME1Al DECN, W6y15 ~ U UNLE55 NOTEO OiHERWiSE. SEE OEip1L 6/Sd.O FOR FASTENING Wbr15 °1• p REOUIqEUENT5. ~'6z9 r.•+'"""~ s ' ~
t9, iN01CAiES TrPICaI BEAM 80itOM vLyNGE BRACiNG W~ W~ ' H wgxg0 5 giµ o, LOCpT10N5. SEE DEIAIL d/54.0. ,f^-~ r-~- W6x2a f 2.D 54.0
i1. BEAMS N~T LA6ELE0 ON PUN ARE t0 8E W8~i4 '"'""`G~-. f ~ ~ u°• - S.A . A r^-'- f ~S qx a a i ~ b P U R9 N y,~ ~,,m.g u, m N „ e w 6x t 5 W, B, ~x15.~+' J P p N X ~,2,;LEFr361EKi. 5,F9§~1,~T'F9AI..~BE~pG~NG., 6EYALI N r""°"p~ ~~w~~ • ~i3.~EXT6Ri0R WluLS ARE t0 BE FRM1E~ Wi~H A COlO-FORNfD~NEiAL~'~ SiM' a.O.S, o~09 ~ ~ x m W6x9 ~ m ~n
Y ~ SND WALL SYStEM, WALL SYS7EA1. INCWOiNG MEMBER SQES ANO 4 v a 6~y"' w6x9 ~ CDNNECnONS, aRf i0 BE DE9CNED Bv tHE C0~0-FORNED SUPPUER. ~ L ~ W5v~5 ° N i b ~ H c
j SHOP DRAwINCS hIUSi BE SUBA11ifE~ PER REQUiRENENiS Of tHE 5 2. 0 5 4. 1 t A c y W 1~ ' T~^""`~ o SPECIFlCA7tONS. REPRESENtAi1VE St2E5 ANO CONNECTIONS ARE w8x ~ 6 .M~ ~~k W5x9 h."' ~ 75 ; Y.6 A - { PftON~E~ FOR PRiC~NG PURPOSES ItV DFiAiI 72/Sa.O. SFE ~ YySk W6x
SPEGIFICATION SECDON 05400 AN~ DE~NL i2/54.0 FOR AOQ~TIONAL? Ir~ ~ W6r~ ~z` t~~ i~D~
14`~qQ F'-~Eb ONttNCt`~,"~~L4~3`Kt"Ii-'iLLY~~REQUIRED AROUNO ENLIRE ~,enY~'4~ C ~ S • ~ ~ ) ~ ~o m ~ IMOICATES NOMENi ~ W6'~5 r10 ~ w ~ PERIME7ER OF BUILDING ANO Ai AL6 ROOF EDGES. UNlESS NOiE~ Pz 3 ~ CONNECi10N - ttP. W8 ~6 ~BRICH $UPPORL LS~V,) COL. ki5 a pTHERWISE. WELO TO JOISiS ANO BEAq15 WITH 3/18" FlLLEi WEID ~pxgx3(~6 H ~f - SEE OE[AIL 17 54,0 ~ P~~` P, ° ~
~ {SipGGER 2-t2 At CONTINUOUS EOGES). BUTf WELO BOiH LEGS ~ LSaxnst/1 - COORD. aUN iHAOUG " / g"0 S~ -~E ~ +S ~ LOCATION ~ ELEVATpN SI~`5 ~ 10 EASTERN p WIflXE4 q^~ y~ G pF ANCLE TOGETH6R Ai JOl~7T5. 'Y ~ wE~~ftN y Q,S. = j26~ NS i C~. .p Pl?E GDL. 'a
^ C6xs 2~~iQ 15. AifACH COlO-FORI~EO WALL S1U05 TG ROOF SiAUCiUAE WiiH 7 W/ARCH. DWGS. d p5E A.4 vERtiCN. SI.iP CDNNECiiON - ttaiCq~. Fl, PR04i0E DECK BEARING ;S6M6+~/ 9^ g~~qg~-9°1 ~ W~rIXED 8 GSeii.5 CONT. 16. V£R11CAL BRICK GON7ROL JOiN75 ARE t0 BE LOCATEO NO MORE ~ ANCLE SiM. 74 iHAT 8 ag, =~~9 t~~~' < ~;.q,5. ° 12~ ~8~ g'..8' - TYP~ N~1UND
iHAN 25'-6" ON CENTER. .4 OF OE7Nl 4/S4A ~ g'-8'~ PERIAIEtER OF ROOF t7. L.SV) - 1NOiCATES IONG SiOE OF iS MEAIBER i5 VERiiCAL, i ~5 4, q" g'`8'~ ~ ~ ~ ~S.S.V,) - 1NOICATES SHORT SIDE OF TS AIEMBER IS 4ER11CAl. 8 ~ ~ 4-p~ ~ 3ti-8"
1.5YI.10 A7EiAl 0@CK W/2" 1b.,OP,E,NrWE6r$AF+ls15L~86H3GM'4~.,BF~,F.~q..µA~,U~„AEGmfdM€~Y4~j]QNS. ~ g ZD ~ ~ NORMAL WEIGH CONCRETE ~'T9,'qT CONNEC71dN5 FROA1 TS BEAMS YO 8"0 PIpE AT ~ENTRY WAY, CUT'1 y I3 p 11
N {iOTAL THICHN S= 3 1/2") TUBE i0 FIT pN~ WEI.D ALL AROUNO TO PIPE WITH 3/i6° FlUEi, } 4 / k WW.F. 6x6 W1.4xWL~ E 30. AT CONNECTIONS FROM TS-f0-i5 MENBERS, WElO AU. AROUNO e w/ L3.5~3~t/4~ EOGE ANCLE WITH 3/16" FILIET - iYP1CAl, U.N.O. l_ 1~0 T
py si~ nu co~uMNS u~eE~o ns "cnNOaY co~u~Ns~ oN Pu,~ ~e ro sE ~ WEST CANOPY FRAMING PLAN ~ NIGH ROOF FRAMING P(.AN CB~8.2 i TS6x4x3/76~ ttFICAL UNLESS NOlEO OTHERWiSE. ~ ~ ~PpN N0tE5~, f/6" = i'-0
22 AT CANOPY ON CRip "U NEAR CRIO "13", EXTEN~ TS BEAM iHROUCH~ t, I, SEE 'RDOf FRPMING PLAN", iHIS SHEET, FOR PLpN NOTES. TS COLUAINS ip 51JPPOR PtAN NOiES~ , TNtS SHEE7, FOR P~L~~ ~ T OUiRiG4ER BEAAIS, r-~~"~°''-'"~~''•~ y i. SEE ROOF FANdiNG aLAN" AN NOiES. ~ ~ .~h_„r._,~~_,..,.r..,,,-_.~4~.h....~•.w,-- 2, 8"fl P1PE WLUAINS ARE TO HA4E PIXED BASES - SEE 9ISJ.0. RDOF BEAhAS A80VE NOt SHOWN, SEE RWF FRAMING PtAN. ~
R 3. A7 ALL CONDIilONS WNERE T5fOx2 OR TSfixfi RUN TNROUCHg 3, SEE SHEEf SSA FOfl IATERPl BRACING ELEVATIONS Br _ OiHER TS MEMBERS, WEL~ AL~-AROUND WITH 3/ifi" FlLIET rp SYMBOL (M~) INDICATES A AIOh1ENT CON ,~If14~,16..pf@U~l~O"~s 4„ OR EQUNALEtrT, EACH 9DE OF CONTIOUOUS PIECES. ~r ~X~~Q,~~Si,~E~I A:.rq~y~%~178ifD*+kI`k~6 M15 A COLU Q, R'
~ "'~„w,,.~ n ~~r„~,;~;,~,.,,,, ,~.M1 a,,, B,OS. ai^E6C~ CHANNEL IS TO EOUAL 80.5. OF W BEMIS ~q w..A +,Nf ~...*'w.d'ro.~^*~.~✓'*v,,."' to, ^ 1YPICAL,~~.~'+.~/~...,~'~.~,"~.,.e«,-..h.../+,..~"'+~._!~«/"^...1' ~ v.~~
R M
~ MEZZANINE FRAMING PLAN ~
~ a~ i/e° = i,-o^ t
oa~ ~
~'~"~E ~ea3 ; 8Y6
B L D E R S S ~ C I A T E S I N C. 0 U , 1
Arcbitectttre + Interior DeTign i
1 2 3 4 5 B 7 7,5 8 i4 IS I& 1J 2D I vno,tecrNUemsA 03038.00
i6 ~ SSA S4A a
DBAVPN BY
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. . . . - - I , _ . . ~ _ , . . ' . , . . . . . . . i ~ ; : January 12, 2004
. . . . - , . ~r w..--~+ ~ . . . . , , . ~.~-r . = i, i '
. . . ~ 1 F~~ ~ . ' i . . , . ~ , . . ~ . , . " . , w. . ~ . . • : ~ ~ ~ . , ~ . < ~ ,il , . . , . , , . . ~ :f ~ . . . , . . . ~ ~ , - , . , ~ . eyvtSIONs
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. . ~ . ~ : COORDINATION, VALUE ENGINEERING REVISIdNS
~ 11 FEBRUARY 2004 REVISiON t
. . . . . . . . .
13 na.
$SA 56,0 WEST El.EVATION
ELEvATIOrv NDTES: i/8" > 1'-9 . I. SEE ROOF fkAAIiNG FUJJ FOR ALl COLUMN AND BEAM 512ES.
2. AU, p1AGONPI BRACES SMAll~BE TSSxSrt/4, ttPICAL UNLESS s:a~`rgyPS+r~~c-,~. ~y b~'~q~,~ . NOiE6 OiHERwiSE ARaCES M ENTRnvar ia BE i5 6x6.3/~6. ~~~y ~ ~eF"
3, 5EE GENERAL NOTES, SHEET 50.1, FOR a00inONAI tNfORt~A00N S/8"Kt 1" PL. PUU SEE MCH. OW85. ANO REOIDAEMENTS. ~ LEt~CiH OF OPENiNG-~ ~ ~ TYP. N2CH. ~ Uxlx1/4 UMEL EA
~ ~ ExPOSED ~ S~DE OF OPENINC ~ , ~ SiRUCt. ~~~5 BEnR EACH END PER wELD LOOSE UNTEI SCnED.
2 Y.6 v U T S R 0 A R.4 ,4 7 B 8.2 B.4 U ~ . "„~Y ~ ~2~-O' ~ rs
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. . , ~ . . & k _ g : : ~ ~
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. Q~, , ~ , . . _ TvP, . _ ~ Q~ ~ ; ; ' ~ 4 . MEZ iNE - SEE _ . . , ~ 4 t ` ~~a, Pt1W N SHEfT 52.0 ' , y r--~ v 2,
RO . . ~ - " 5.0 5+.01 - . . - 55.0 54.9 ~ , ; a 16 I m5 ; ; ~ c
:::h _ : ~ , ' ~ ' ~ SS.o S o , _ _ - . ~ . ' ~ 1~. ~ , ` ` „ , - ~ - ; :
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tva. o.N. ~ 55.0 54.0 55.0 54.6
SaUTN ELEVATIdN NORTH ELEVATION ENTRY NORTH WALL ELfVATION ELEVAiION NOLE4 1/8" = 1'-0" ELEVAiION NOiES: I/8" _ ELEVATION NO1E5'. iJ8" = 1'-0" £
i. SEE ROOf tRAMINC PLAN FOR ALL COLUMN ANO BEaM1~ 512E5. i, SEE ROOF FRA~iNG PUN fOF ALL COLUMN AND BEMI S¢ES, t, SEE ROOf fRMAMG PIAN FOR ALL COLUAIN AN~ BEAM SIZES. 2. dLl DIACONA~ BRaCES SNALI BE TSSx5Kt/a, ivPiCa~ pt~~E55 2. dLl D~aGONaL BRnCES SHdLL BE T55x5M1/a, imtCAL UNlESS 2. all aACONAI BRACES SNaL~ 8E iS5M5xf/4, TrPoCO! I~NLE55 NOTED OTHERVIiSE. BRnCES IN EN7RYWAY TO BE T56xSx3/15. NOTED OTNERWi5E. NDTEp OTF~RVME.
3. SEE CENERAL NOTES, SHEET 50.1, fOFt MDITIDNAL iNFORA~At10N 3, SEE GENERAL NOTES, SHEET 50.1, fOR Ap~IiIONAI iNFORMATitlN ~ 3. SEE GENERAL NOTES, SHFEi SD.t, fOR ADpIiIONAL INfORAtATiON AND FEOUIREMENTS, AND AEQUiREAdENFS. AND PEWIftEAlENTS. L
. , ~a~w.~r~a~~s~ . ~
II 10 9 ~8.1 7.2 6 5 4.6 4 3 2 I
'
' ° . _ _ . _ . - - _ _ . . . _ . . . P. ~ : ~ ~ . . ~ . , . , ~ . , , - _ .f. . ~ . . . . _
- SSA 4A ~ ~ . 55 0 54.0
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, :t~: , , , - . , . a ~ , ' . ,
. . . . . ~ - - - - - - ~
13
EAST ELEVATiQN ss.os4.o
ELE4ATIDN NOTES~~ 1/8" = 1'-0" ~ 1. SEE ROOF FRAAIING PtAN FOR ALl COWUN ANp BEAM SRES, 4. ALL OIAGONAI BRACES SHALL BE i55k5ztI4. 7YVICAI UNLE55
NOfEO OTNERWISE. 3. SEE GENERAI NO7ES. SHEET SD,1. FOR WDITIONAL INFORMATiON AND REQUIREA1EN75.
6' 4•,} I
~ eaua~ Eour~ ;~4 B R
55.0 S4,0 ~
i5 HANGHR-~
T1P, ~ ~
55.0 54,0 ~ c, X . ~ ~
~
INTERIOR ELEVATION ALONG GRID "5" e~EVanow r+oTes: ~/e" = r-o"
SEE ROOF fRAMMG P1AN fOR pll COLUMN ANO BEAJd 52E5. 2. Al~ DIAGONAL BRACES SHpL6 BE tS6x8ai/2, TYPICAL UNLESS
NO7E0 OTHERWISE ~ 3, SEE G6NERAL NOTES, SHEET 50,1, FOR AODIfIpNAL iNFORGAT10N AND REOUIRENENTS.
4. BRpCE HAN~ER 70 8E TS 3x3~3/18, WElOED ALL AROUNO EACH END. ~ ~
B 0 L D E C. U R S S 0 C I A T E S I N
,
Architecture + Interior Desi n g ~ :
RFI
Project #9279D - Clear Creek Ambulatory Surgery Center Tumer Construction Company
Wheat Ridge, Colorado Tel: 303.753-9600
Fax: 303.753-9700
TO.,... FBOM . e "
Jon Tucker Bryon Casper
Boulder Associates, Architects
4747 Table Mesa Drive, Suite 202
Boulder, CO 80305
Phone:303.499.7795 Fax: 303.499.7767
Turner Construction Company
1873 S. Bellaire Street, Suite 1200
Dender, CO 80222
Phone:303-753-9600 Fax: 303-753-9700
SubjecY=` Discipline !Category, ;
Drawing References: Spec Section References:
Dwq No. Rev No Revision Date Title Sketch References:
A1.1, -
Question: Jon, on A1.1 at N.E. corner of building it references a sidewalk chase for roof drain, see
civil. On sheet P2.1 A shows exterior wall drain note #32 between column line 2 8 3 east elevation.
P2.1A also shows 6" storm drain between columns lines A& B North elevation terminate in sidewalk
chase coordinate with civil. Civil does not show this sidewalk chase.
Are the storm dreins in the right location, or does the sidewalk chases need to be moved? Is a
sidewalk chase needed at the East side of the 6uildina?
Suggestion:
Answer:
Main, overflow, and canopy roof drain discharge locations are shown correctly on the P sheets. The two
sidewalk chases shown on tha Civil dwgs. are generally in the appropriate locations but should be field located
to coordinate with the P sheets. The sidewalk chases shall be extended through landscaping to the building to
provide drainage for the roof drains. Sheets A1.1 and A2.1 indicating a main roof drain discharge in the
northeast corner are incorrect. They should be revised to match the drain location indicated on P2.1A on the
north side of the building. The overflow roof drain discharges located between Grids 2& 3 east elevation and
at Grid 4 east elevation are to discharge onto the sidewaik. Splashblocks are not required at these locations.
Cc:
Company Name
Contact
Name Copies Fax Number
Notes
TCCO
- RFI Individual Print ouLrpt (9125102)
Turner Construction Company
Printed on: 2/412004
Page 1 of 1
RFI
Project #9219D - Clear Creek Ambulatory Surgery Center Turner Construction Company.
Wheat Ridge, Colorado Tei: 303.753-9600
Fax: 303753-9700
TO _ . = FROM. - Jon Tucker Bryon Casper
Boulder Associates, Architects
4747 Table Mesa Drive, Suite 202
Boulder, CO 80305
Phone:303.499.7795 Fax: 303.499.7767
Turner Construction Company
1873 S. Bellaire Street, Suite 1200
Denver, CO 80222
Phone:303-753-9600 Fax: 303-753-9700
,
Subject r Discipline. Category
Drawing References:
Dwq No. Rev No Revision Date Title
M'1.2 - -
Spec Section References:
Sketch References:
, y.. .
stub the 4" gas main in through the exterior wall above the diagonal bracing. The 4" main could be
ated in wall cavity to above ceiling space and over to the mechanical room. This routing would allow
a gas main to no4 be placed on the roof which would eliminate any potential problems and minimize
: amount ot pipe running on the exterior of the north side of building.
Relocation of the gas meter to near Column B.4 with revision to the piping to route inside the building instead
of on the roof is acceptable if the following criteria is met:
-Final location of gas meter must be approved by X-cel Energy.
-Meter regulator vent must be 36" from common bldg. openings (doors, windows) with minimum 36" clearance
around meter set per X-cel requirements.
-All joints of gas piping installed in concealed spaces must be welded.
-Coordinate gas riser routing with HVAC retum air duct and roof drain leader in same chase in OR #1.
-Piping must be supported per UPC 1211.8.
-Pipe routing in ceiling space shall be coordinated with aIl trades.
Cc Company Name
Contad Name Copies Fax Number Notes
TCCO - RFI Individual Print ouGrpt (9/25/02) Tumer Construction Company Printed on'. 21412004 Page 1 of 1
RFI
Project #9219D - Clear Creek Ambulatory Surgery Center Turner Construction Company
Wheat Ridge, Colorado Tel: 303753-9600
Fax: 303.753-9700
TO: Jon Tucker
Boulder Associates, Architects
4747 Table Mesa Drive, Suite 202
Bouider, CO 80305
Phone:303.499.7795 Fax: 303.499.7767
FROM. `
Bryon Casper
Turner Construction Company
1873 S. Bellaire Street, Suite 1200
Denver, CO 80222
Phone:303-753-9600 Fax: 303-753-9700
Subject;, , Discipline Gategory
Drawing References:
Dwo No Rev No Revision Date Titie
A4.1
Spec Section References:
Sketch References:
5# Bldg. Paper over 5/8 Gyp. Sheathing over 6" metal studs @ 16 O.C."
Should this be "Exterior Grade" sheathing and in lieu of 518" can the sheathing be Ys"
Answer:
Note shall read as suggested: "15# BLDG. PAPER OVER'/z" EXTERIOR GRADE GYPSUM SHEATHING
OVER 6" METAL STUDS @ 16" O.C."
Cc: Company Name
Contact Name Copies Fax Number
Notes
TCCO-RFIlndividualPnntouLrpt(9/25/02)
TurnerConstmctionCompany
Printedon:?l4/2004
Pagetofl
RFI
Project #9219D - Clear Creek Ambulatory Surgery Center Turner Construction Company
Wheat Ridge, Colorado Tel: 303.753-9600
Fax: 303.753-9700
Jon Tucker
Boulder Associates, Architects
4747 Table Mesa Drive; Suite 202
Boulder, CO 80305
Phone:303.499.7795 Fax: 303.499.7767
FROM._
Bryon Casper`~
Turner Construction Company
1873 S. Bellaire Street,.Suite 1200
Denver, CO 80222
Phone:303-753-9600 Fax: 303-753-9700
SubjecYDiscipline Category
`
Drawing References:
Dwq No. Rev No Revision Date Title
52.0
Spec Section References:
Sketch References:
Question: Jon, Reference 52.0 Note #13, Per previous request by Dave Arneson Turner Construction is
requesting this note be waived and removed from the documents. The wall systems, member sizes,
connections and assemblies will be built in accordance with the plans and specifications.
If we have the steei stud supplier procure shop drawings stamped by a registered professional
engineer. This will only drive our costs up more and potentially put us over the GM°.
Have the structural engineer delete note #13, or waive this requirement.
Answer:
See the attached response from the structural engineer, J.C. Baur and Associates.
Cc: Company Name Contact Name Copies Fax Number Notes
TCCO-RFIlndivitlualPrintout.rp[(9/25/02) TurnerConstmctionCompany Printedon: 2/4I2004
Page 1 of 1
ME ,~.~.B AU ~
& ASSOCIA'I'ES, INC.
RESPONSE TQ RFI
Consulting Engineers
- 2551 3l" Street Boulder, Colorado 80301
(303) 444-9121 (voice)
(303) 415-1070 (Fax)
ro: BoulderAssociates
4747 Table Mesa Drive, Suite 202
Boulder, CO 80305
RFI No.: 004
aROJecr: Clear Creek Surgery Center
joe#: 03085
coNrancroa: Tumer
RESPONSE BV: J350I3 KIDTZOI, P.E.
J.C. Baur & Associates has no objection to waiving the requirement stated in the specifications and plan
note #13 to have the cold formed stud supplier provide a registered engineer's stamp on the shop
drawings. While the provided framing schedule and details are intended to address the vast majority of
conditions on the project, there is no warantee that every condition has been identified and addressed. If
the stud supplier does not have the system they install completely engineered on their own, it is their
responsibility to seek clarification of unusual conditions from the design team and provide systems
(potentially different than those described in the framing schedule) to accommodate the design
requirements for those conditions, as determined by the design team.
J.C. Baur & Associates has found through years of experience that there is significant value in the
preparation and review of shop drawings for the cold formed installation. By demonstrating through
shop drawings that the supplier has interpreted the requirements of the contract documents correctly, the
correct quantity of materials can be ordered, placed in the correct locations, and adequately connected to
supporting elements, resulting in a building system which has a much higher probability of functioning
as intended. Shop drawings need only consist of enough documentation to convey the installation intent
and its conformance with the requirements of the contract documents. We recommend that as a
minimum each of the architectural building elevations and wall sections be marked up by the stud
supplier's project manager, indicating where each type/size of cold formed framing element will be
installed and how elements will typically be connected. We also recommend that the stud supplier
provide sketches of intallation/connection conditions that vary from those which have already been
defined in the contract documets, indicating the location and size of elements/connectors.
P:19381CA\Requests !or Information\RFI 004 - JCB Response.tloc
RFI
Project #92190 - Clear Creek Ambulatory Surgery Center Turner Construction Company
Wheat Ridge, Colorado Tel: 303.753-9600
Fax: 303.753-9700
TO.: F,ROM
Jon Tucker Bryon Casper
Boulder Associates, Architects Turner Construction Company
4747 Table Mesa Drive, Suite 202 1873 S. Bellaire Street, Suite 1200
Boulder, CO 80305 Denver, CO 80222
Phone:303.499.7795 Fax: 303.499.7767 Phone:303-753-9600 Fax: 303-753-9700-
SubjecY', -0iscipline Category;
Drawing References:
Dwq No. Rev No Revision Date Title
A1.2 #3
Spec Section References:
Sketch References:
There is no dimensions or reinforcing bar sizes for the footer and stem wall.
II, #4 vertical @ 24" O.C. with hook alternate hook direction, horizontal #4 @ 24" O.C. one top bar #5
below surface.
Answer:
J.C. Baur & Associates has no objection to the suggested monument sign foundation.
Ca
Company Name
Contact
Name Copies Fax
Number
Notes
TCCO
- RFI Individual Print outrpt (9/25/02)
Turner Construction Company
Printed on: 2/4/2004
Page 1 of 1
RFI
Project #9219D - Clear Creek Ambuiatory Surgery Center Turner Construction Company
Wheat Ridge, Coiorado Tel: 303.753-9600
Fax: 303.753-9700
Jon Tucker
Boulder Associates, Architects
4747 Table Mesa Drive, Suite 202
Boulder, CO 80305
Phone:303.499.7795 Fax: 303.499.7767
FROM: '
Bryon Casper
Turner Construction Company
1873 S. Bellaire Street, Suite 1200
Denver, CO 80222
Phone:303-753-9600 Fax: 303-753-9700
Subject' Discipiine , Category
Drawing References:
Dwq No. Rev No Revision Date Titie
A22
Spec Section References:
Sketch References: -
uestion: Jon, reference sheet A2.2 medical records room # 106 rolling file system equipment # 134.
has been my experience in the past in areas that have these rolling file systems on a S.O.G. the slab
eeds to be thickened to 6" with a mat of #4 reinforcing bar. The weight of the files and roiling back and
rth across the floor slab eventually breaks the slab down and causes differential settling.
Within the area of the rolling files, thicken S.O.G. to 6" with a matt of #4 reinforcing steel
2" O.C. each way.
Answer:
J.C. Baur & Associates has no objection to thickening the slab under the rolling file storage units. Detail
11/S3.0 will be modified to conform to the suggested configuration of 6" slab with a mat of #4 at 12" on center
at the bottom of the slab. For the locations and extents of each area to have thickened slabs, please refer to
the architectural drawings.
Cc Company Name - Contact Name Copies Fax Number Notes
TCCO - RFI Individual Print outrpt (9/25/02) Turner Conslruction Company Printed on: 24I2004 Page 1 of 1
RFI
Project #9219D - Ciear Creek Ambulatory Surgery Center Turner Construction Company
Wheat Ridge, Colorado Tel: 303.753-9600
Fax: 303.753-9700
- . . _ _ . . , .
TO: ~ _ . PROM:,,
Jon Tucker Bryon Casper
Bouider Associates, Architects
4747 Table Mesa Drive, Suite 202
Boulder, CO 80305 Phone:303.499.7795 Fax: 303.499.7767
Turner Construction Company
1873 S. Bellaire Street, Suite 1200
Denver, CO .80222
Phone:303-753-9600 Fax: 303-753-9700
Subjectr Discipline Category;
Drawing References: Spec Section References:
Dwq No Rev No Revision Date Title Sketch References:
A22
S1.0
estion: Jon, Reference sheet A2.2 and S1.0 future tenant space. Since the floor slab in this area will
placed at future date. The entire perimeter of this space will become a construction joint and there is
for differential settling.
Suggestion: Place a key way and #4 dowel bars at 24" O.C. along the entire perimeter of this space in
the adjacent S.O.G. that will be placed at this time.
Answer:
J.C. Baur & Associates has no objection to the suggested slab edge condition adjoining the future tenant
space. A detail appropriate for this condition will be included in the upcoming addendum package.
Cc Company Name Contact Name Copies Fax Number Notes
TCCO - RFI Individual Print out.rpt (9/25l02) Turner Construction Company Printed on: 21412004 Page 1 of 1
RFI
Project #9219D - Clear Creek Ambulatory Surgery Center Turner Construction Company
Wheat Ridge, Colorado Tel: 303.753-9600
. Fax: 303753-9700
Su6ject Discipline Category,
Drawing References: Spec Section References:
Dwq No. Rev No Revision Date Title Sketch References:
E0.1
Question: Jon, Reference E0.1 662 fixture is called out as "Victorian Acorn style pedestrian light, to
match existing city of Wheatridge standard.
uggestion: Electrical subcontractor needs more information or cut sheet numbers to find this type of
ahtfixture.
Answer:
Provide a$1,200.00 allowance for this light fixture.
Cc: Company Name Contact Name Copies Fax Number Notes
TCCO-RFIlndividualPrintouLrpt(9/25/02) TumerConstmctionCompany °nntedon'?l4/2004 Pagelofl
RFI
Project.#9219D - Clear Creek Ambulatory Surgery Center Turner Construction Company
Wheat Ridge, Colorado Tel: 303.753-9600
Fax: 303.753-9700
, . - . . .
TO: FROM:
- -
Jon Tucker Bryon Casper
Boulder Associates, Architects
4747 Table Mese Drive, Suite 202
Boulder, CO 80305
Phone:303.499.7795 Fax: 303.499.7767
Turner Construction Company
1873 S. Bellaire Street, Suite 1200
Denver, CO 80222
Phone:303-753-9600 Fax: 303-753-9700
Subject,: ybiscipline. Category '
Drawing References: Spec Section References:
Dwq No. Rev No Revision Date Title Sketch References:
Soecsec
# 08343
Question: Jon, Reference spec section 08343 ICUICCU sliding entrance door.
Section 2 PRODUCTS 2.03 B.4 Finish framing, doors, sidelight and header with Class 1, clear anodic
finish.
Section 2.07 Aluminum FINISHES 1. Finish: Finish framing, doors, sidelights and header with high
performance organic finish (3-coat fluoropolymer).
Which finish is correct? Please clarify and advise.
Answer:
Delete Section 2.07. Provide clear anodic finish as specified in Section 2.03 6.4.
Cc: Company Name Contact Name Copies Fax Number Notes
TCCO - RFI Individual Pnnt outrpt (9/25102) Tumer Cons[mction Company Printed on' 214/2004 Page 1 of 1
RFI
Project #92190 - Clear Creek Ambulatory Surgery Center Turner Construction Company
Wheat Ridge, Colorado Tel: 303753-9600
Fax: 303.753-9700
TO:' . . FROM•
Jon Tucker Bryon Casper
Boulder Associates, Architects Turner Construction Company
4747 Table Mesa Drive, Suite 202 1873 S. Bellaire Street, Suite 1200
Boulder, CO 80305 Denver, CO 80222
Phone:303.499.7795 Fax: 303.499.7767 Phone:303-753-9600 Fax: 303-753-9700
Subject, Discipline. :i Category'i „
Drawing References: Spec Section References:
Dwq No. Rev No Revision Date TiNe Sketch References:
Question: Jon, Reference sheets A2.1, A2.2 & A8.1 Door # 161A, 1826 & 201
As shown on sheet A2.1 and A2.2 these doors are a pair of doors two of them exterior.
The door schedule on A8.1 Shows these doors to be single 4'-0" X 7'-6" door HM Frame Type #5, Door
201 is shown as 4'-0" X 7'-6" Alum Frame type "L"
Suggestion: Please clarify door sizes and types.
Answer:
Sizes and types for poors 161A, 182B, and 201 are correctly shown on the Door Schedule on A8.1. The
hardware group for these doors shall be provided in Addendum No. 1. Frame Type L will be revised in
Addendum No. 1 to accommodate the new door size. Door 202 on the Door Schedule should be listed as
Door 185 located in Comm. Closet 185.
Ca Company Name Contact Name Copies Fax Number Notes
TCCO - RFI Intlividual Pnnt outrpt (9125102) Tumer Consfmction Company Printed on: 2/4/2004 Page 1 of 1
~-.::.~,.a..~5.r*^ ..,:rw ,~.:.;a n..!...:.a~-t..-i~e-•~s;a:.::~wwa.s.k~~.usw-:,:::-..-..,i.. _ . . _ ,c ..,..w.~...-.-,.
" NFPA REtCORD OF COMyyP~LETION~{,,
-,Nameol ~rotected Pro rty: ~ ~ ~v ~ 1c+ + tJ
Address: 7S ~
Rep. of Protected Prop. (name/phone): Autherity Having Jurisdiction: G'
- - Address/Phone Number: ' - 7. Type(s) of System or Service -
.Q NFPA 72, Chapter 3'- Local If alarm is transmitted to location(s) off premises, list where received: ~ NFPA 72, Chapter 3- Emergency Voice/Alarm Service
Quantity of voice/alarm channels: Single: Multiple:
Quantity of speakers installed: Quantity of speaker zones .
Quantity of telephones or telephone jacks induded in system: . . Q NFPA 72, Chapter 4 - Auxiliary
. Indirate type of connection:
Local energy: Sfiunt: Parallel telephone: . Location and telephone number for receipt of signals: . . Q NFPA 72, Chapter 4- Remote Station . .
~ NFPA 72, Chapter 4 - Proprietary
. . . . . .
If alarms are retransmitted to public fire service communications center or others, indicate loration and telephone number
of the organization receiving alarm:
Indicate how alartn is retransmitted:
~NFPA 72, Chapter 4- Central Station The Prime Contractor. .
Central Station Location: • Means of transmission of signals from the protected premises to the central station:
McCulloh . Multiptex Digital Alarm Communicator Two-Way Radio
Means of transmission of alarms to the public fire service communications center.
~ . One-Way Radio
(e)
. . (b) . . . . . .
Others
-r-----------
Organization Name/Phone
. .
Representative Name Phone
Installer
.tl `f'~"G-
Supplier
L)J~
Service organization-
Loration of Record (As-Built) Drawings: .
Location of Owners Manuals: ~ S . .
Location of Test Reports: _5 . .
A contrac[, dated Fv r, ' t for test and.inspeciion in accordance with NFPA standard(s) No(§). dated , isin effect . 2. Record of System Installation . ' . . . .
(Fill out after installation is complete and wiring checketl for opens; shorts, ground faults, and improper branching,
but prior to conducting operational acceptance tests.) . . . This system has bee-n As-t.4Iled in accorda ce with the NFPA stan rds as s 6wn below, was inspected by t~ - on, indudes the devices shown below, . ,
and hasbeen in service since ~ NFPA 72, Chaptere/l 3. 4 5 6 (cirde all that apply)
NFPA 70, National Electncal Code, Article 760 . . Manufacturer's Instmctions
Other (specify): 1' Signed: ~1----Date~ ~ ~ ejC" . .
AHJ - White; Owner - Canary; District - Pink; SRe Copy - Goldenrod
~ MC24-2-014 Part 1 of 3~
3. hoc-ox"fgsystem Operation
-:5 11,4 14 e"l"
All operational features a unctions of this system were tested by -
on,
and found to be operating pr , bperl ' U' accordance with the requirements of:
0'
0
o
w)(circle all that apply)
5
nc
NFPA72,Chapter7l 3 4
NFPA 70, National Electrical Code, Article 760
Manufacturees Instructions
Otlher (specify):
-
4
Signed: Date:
Organization: /
4. Alarm-initiating Devices and Circuits (use blanks to indicate quantity of devices)
MANUAL
(a) - Manual Stations Non coded, Activating Transmifters
Coded
(b) - Combination Manual Fire Alarm and Guard's Tour Coded Stations
AUTOMATIC
Coverage: Complete: Partial:
(a)7-/- Smoke Detectors - Ion Photo
(b) Duct Detectors - Ion Photo
(6) Heat Detectors - FT HR - FT/RR RC
(d) SprinklerW~~l Switches: - Transmifters - Non coded, Activating
Coded
(e) Other (list): / %ZJA P_e"_,S
5. Supemisory Signal-init'iating Devices and Circuits (use blanks to indicate quantity of devices)
GUARD'STOUR
(a) - Coded Stations
(b) - Non coded Stations, Activating Transmitters
(c) - Compulsory Guard Tour System Comprised of - Transmifter Stations and Intermediate Stations
NOTE: Combination devices recorded under 4(b) and 5(a).
SPRINKLER SYSTEM
(a) - Coded Valve Supervisory Signaling Attachments
Valve Supervisory Switches, Activating - Transmitters
(b) - Building Temperature Points
(c) - Site Water Temperature Points
(d) - Site Water Supply Level Poinls
Electric Fire Pump:
(e) - Fire Pump Power
(f) - Fire Pump Running
g) - Phase Reversal
Engine-Driven Fire Pump:
(h) - Selector in Auto Position
(i) - Engine or Control Panel Trouble
- Fire Pump Running
Engine-Driven Generator.
(k) - Selector in Auto Position
(1) - Control Panel Trouble
(m) - Transfer Switches
(n) _ Engine Running
Other Supervisory Function(s) (specify):
6. Alarm Notification Appliances and Circuits
Quantity of indicating appliance circuits connected to the system:
Types and quantifies of alarm indicating appliances installed:
(a) Bells Inch
(b) Speakers
(c) Homs
(d) Chimes
(e) Other:
(o Visuat Signals Type: withaudible/_;2 w/oaudibleq
(g) - Local Annunciator
7. Signaling Line Clrcults
Quantity and Style (see NFPA 72, Table 3-6) of Signaling line Circuits connected to system:
Quantity: Style: Z~3
AHJ - White; Owner - Canary; District - Pink; Site Copy - Goldenrod
MC24-2-014 Part 2 of 3
} ti r/
t
~
. . . . - . . t~. 1 ~ i
8. SA/stertrPawer Supplies
(a) Primary (Main): Nomit?/ Ita e: Current Rating: Overcurrent Protection: Typ ~ Qe-°& Current Rating:
Location: -..t
. (b) Secondary (Standby):
Storage Battery: Amp-Hour Rating '
. Calculated capaciry to drive system, in hours: 24 1V 60 _ . i
I
• . Engine-driven generator dedicated to fire alarm system: . . i
i
. Location of fuel storage: ..(c) Emergency or Standby System used as backup toPrimary Power Supply, instead of using a Secondary Power Supply: i.
_ Emergency System described in NFPA 70, Artide 700 " . . Legally Required Standby System describetl in NFPA 70; Article 701 . '
Optional Standby System described in NFPA 70, Article 702, which also~meets the pertormance requirements of Article 700 or 701 i
" . . . . ,
9. System Software
(a) Operating System Software Revision Level(s):
(b) Application Software Revision Level(sjlJ
' (c) Revision Completed by:
/ (name) (firm) 1
I
. 10. Comments ,I . . i
~s ~ f . H A ;s ~ ~
i
. , . . . . .
. . . . . . . . ;c,~
. . ...-..i yP
. . . / 'i.`I
aI
G/LP1
~
. (signed)forCentralStationorAlarmServiceLompany(title). .(date) .
Frequency of routine tests and inspections, if other than m accordance with the referenced NFPA standards(s):f'°l
~ - /f . . . . . .
System deviations from the referenced NFPA standard(s) arei . . .
. ~
. (signed) for Central Station or Alarm Service Company- - (title) (date)_ . ~
Upon compleyion of the system(s) satisfactory test(s) wftnessed (if required by the authoriry having jurisdiction):
(signed) r p sentative of the authoriry having jurisdiction -(title)
~ ~ . . . (d8t2) ~ ~ . .
AHJ - White; Owner - Canary; District - Pink;Site Copy - Goldei
MC242A74Part 3of3 .