The URL can be used to link to this page

Home My WebLink About11297 W. 44th AvenueFrom: no-reolvCalci.wheatridae.co.us To: CommDev Permits Subject: Online Form Submittal: PERMIT APPLICATION Sewer or Water Line Repair Date: Thursday, May 26, 2022 10:03:07 AM CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Report any suspicious activities to the IT Division. PERMIT APPLICATION Sewer or Water Line Repair This application is exclusively for SEWER OR WATER LINE REPAIR -IN YARD Your Permit will be emailed to the email address provided below once it is processed. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. Right of Way permits must be applied for with the Public Works Department. Is this application for Yes sewer line or water line repair - in yard only? PROPERTY INFORMATION Is this Residential or Residential Commercial? Property Address Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email Address Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" 11297 W. 44th Ave Trey 303-547-7762 ramexsite@aol.com Electronic Oavment form 052622. Cd CONTRACTOR INFORMATION Contractor Business Ramstetter Excavating, Inc. Name Contractor's License 120256 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 303-901-9271 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email ramexsite@aol.com Address Retype Contractor ramexsite@aol.com Email Address 0]:K16]CiIi1W0N]&TWO]S21 Is this a sewer line or Sewer Line, Water Line water line repair? Length of repair 100 Location of repair frontyard (backyard, frontyard, etc) Provide additional Cleanouts to be installed along east side of house. Meter pit to details Including be installed in existing driveway installation of clean - outs. Project Value (contract 11270. value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have Yes been authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying for David Ramstetter Pe rm it Email not displaying correctly? View it in your browser. September 3, 2021 Trey Mallon 11297 West 44th Avenue Wheat Ridge, CO 80033 mallon.trey@gmail.com 303.547.7762 Dear Trey Mallon, =�)Arhe'ac�ge RENEWED FOR CODE COMRIANCE These drawings were reviewed under the applace In effect at the Ease INwbmian. Reasonable effort was exercised In cbxking for rode compared The damping of tbcse document mau not be commued to be a permit mr, or an approval of any oration or rote ani roar saes, ordinances or amentlmen[ZMelem. Plan Reviewer Monday Date 1Wm/2021 The successful completion of your project is important to us! Equally important is the health and safety of you, your team, building occupants and any other party affected. As such, we bring both experience and diligent adherence to federal and state regulations in order to provide your organization with complete and accurate asbestos surveys for all your project needs. We strive to provide you and your clients with a pleasant, yet professional, experience all the way through your project duration. That means you can count on us for timely response and arrival for the initial asbestos inspection, adaptive turn -around times for delivery of your results and reports, and continuous consulting support that's only a phone call away. From start to finish, you can count on us to bring you excellent service. This comprehensive report has been prepared for you with your goals in mind. Our aim is to encompass the thoroughness of our inspection in a concise, easy to read report that delivers inclusive results so your project can move forward with informed and accurate decisions. Please let us know how we can further assist the success of your goals. Thank you for choosing Advent Environmental Consulting! Sincerely, Drue Beasley, President Advent Environmental Consulting CDPHE Registration #: ACF - 22068 7830 West Alameda Avenue Suite 103 - 216 Lakewood, Colorado 80226 myteam@advent-enviro.com 720.675.7175 .ti o W heal R� 030821-D81 U J•• m VENT o� o� nvirolunental Consulting ming 01`i`s ASBESTOS INSPECTION REPORT 11297 West 44th Avenue Wheat Ridge, CO 80033 Prepared for: Trey Mallon 11297 West 44th Avenue Wheat Ridge, CO 80033 mallon.trey@gmail.com 303.547.7762 Year Bulk 1948 Type of ProuerN Residential - House, Detached Garage and Shed Type of Inspection DESTRUCTIVE INVESTIGATION Reason for Inspection Demolition Reaulations Satisfied 40 CFR 61 Subpart M Reg No. 8 Part B Prepared Bv: Advent Environmental Consulting LLC 7830 West Alameda Avenue Suite 103 - 216 Lakewood, CO 80226 1720.675.7175 CDPHE Asbestos Consulting Firm # 22068 myteam@advent-enviro.com NT A8M WW AbmWa Avenw CONSULTING / w mffi m@t]5 ]830 Wes1ke moc, dom Su8e 103-216 'Fla �� myleam@aMen[cnvimmm LakevwW, Cdoada 80236 wwx.alveMenWo.com TABLE OF CONTENTS Section 1 - Project Snapshot ok W heatR. 1.1 Project Site Summary ZiNm 1.2 Sampled Materials Summary = L 1.2.a Asbestos Hazard & Damage/Potential Damage Indicator BO". oo Section 2 -Inspection Photos 8 Sample Locations ung pMs Section 3 - Asbestos Content Summary & Recommendations 3.1 Regulatory Overview 3.2 Project Results & Recommendations Section 4 - Purpose Section 5 - Comments & Limitations Glossary Appendix A - Laboratory Report Material Result ACM Asbestos Containing Materials Material Condition G Good D Damaged SO Significantly Damaged Material Type LAI F -SM Friable -Surfacing Material F -TSI Friable -Thermal System Insulation F-MISC Friable -Miscellaneous NF -TSI Non -Friable Thermal System Insulation NF-MISC Non -Friable Miscellaneous NEI Non -Friable CategoryI Sample Locations N North S South E East W West Other Acronyms LAI Limited Asbestos Inspection PPE Personal Protective Equipment SFRD Single -Family Residential Dwelling Material Codes CMS CMU Sealant CT Ceiling Tile DT Duct Tape/Wrap DW Drywall FTM Floor Tile Mastic JC Joint Compound MA Miscellaneous Adhesive MS Miscellaneous Sealant OT Other Material PI Pipe Insulation PL Plaster RSG Roof Shingle RSH Roof Sheeting RSL Roofing Sealant SVF Sheet Vinyl Flooring SM Surfacing Material WG Window Glazing BBA Baseboard Adhesive CA Carpet Adhesive CB Cove Base 7206757175 myea lm�aMentcnvimm .m � al ntanvlro.mm ADVENT ENVIRONMENTAL CONSULTING 7830 West Alameda Avenue Suite 103 - 216 Lakewood, Colorado 80226 JO4UrlI I -rlUJI lJ11O JI NI Plaase use this Sal to gain a qu%Ck orermawofthe ora l anOdaR/ls about 1. 1 Project Site Summary saPecleomarer/als.0earxisiAnd//gswllok Rheinrotherepot Project Address: 11297 West 44th Avenue Wheat Ridae CO 80033 Type of Property: Residential- House, Detached Garage and Shed Reason for Intimation : Demolition Full demolition of detached garage and shed and verification of interior surfaces demoed prior to inspection. 1.2 Sampled Materials Summary ru Write stipple a xmreo Amster various mtenor, garage wens PL2 White Stucco Surrounding exterior of garage RSG1 Roof shiNies Roof of garage SMI Multicolored textured drywall Walls throughout interior of residence VENT Site Confect: Vacant Inspection Date: August 3, 2021 1 o<W hea/,pa. d w o Ba �n9 pN\`? Your Inspector: Brune Beasley CO Cert #: 18325 Haunt Appoo l ofel Condition Rating Ouardity` Samples Result rw F -SM Good Low 300 h2 3 None -Detected F -SM Good Low 600 ft2 3 None -Detected NFI Good Low 60 f2 2 None -Detected F -SM S. Damaged! Low 1500 112 5 None -Detected 1.2.a Asbestos Hazard & Damage/Potential Damage Indicator Damaged materials containing asbestos have been identified which presents a high hazard from potentially airborne asbestos. In addition to the recommendations below, pease see Section 3 for acidulated response actions and keep away from the contaminated area. The above materials have been identified as damaged or significantly damaged due to partial removal. Approximately 120 square feet (cumulative total) of the wall was removed In various locations Including the kitchen, bathroom and laundry room. Damaged or signgkantly damaged materiae, that have been verified to contain asbestos, are given a high hazard rating due to are potential of asbestos fibers dislodging from the material and becoming airborne as a result of the damage. To avoid further disturbance and radia lel Adverse health asks, please keep away from the damaged material and have it contained by central personnel. See Section 3.2 Project Results & Recommendations for further information. - aampre results re7lecr anry a arrear portion c scope o/ work into other areas of the property. "Approximate quantities are used by inspector to determine number of samples to collect per regulatory requirements and should not be usedpr purposes otherwise. See Glossary (identifying Homogenous..) for more details. ADVENT ENVIROa Avenue CONSULTING kt )20615)1)5 993ENT EAbmede Avenue CO IDLTINGear ad"nt a ro.cn n.mm LaFewom, cdnam armsrn. mvendventecemSection 2 - Inspection Photos & Sample Locations Please note: Any joint compound (Material Cotle JC) samples on this report, are typically pall of a shed, textured wall or ceiling system with texture samples (Material Code SM). The texture and joint compound, from the same wall or ceiling, are sampled separately, but may be represented by the same picture. The overall asbestos content, for a material with multiple samples, is the highest result in the set. Material Code: PLf None -Detected Description: White stipple hudured plaster Class: F -SM Condition: G Hazard: Low Material Code: PI -2 None -Detected Description: White Stucco Location: Surrounding exterior of garage Class: F -SM Condition: G Ham is Low PL2-1 PI-2-2 PI-2-3Eallam of nonhwnl cameral ease None DetWed Top Material Code: RSG1 None -Detected Description: Roof shingles Class: NFI Condition: G Hamrtl: Low o W heargo Y m of nonhwealminer of ganga None Detected None Detected PL2-1 PI-2-2 PI-2-3Eallam of nonhwnl cameral ease None DetWed Top Material Code: RSG1 None -Detected Description: Roof shingles Class: NFI Condition: G Hamrtl: Low o W heargo Y m ADVENT ENlameca venue CONSULTING 9ffiamsba5 9830 West Abmeda Avenue Sufte . VENT www sdeaM ro.c immm LakevwW, Cdoada 80236 wwx.&IVBn19nWro.Com Section 2 - Inspection Photos & Sample Locations (Continued) The overall asbestos content, for a material with multiple samples, is the highest result in the set. Materiel Code: SM1 None -Detected Description: Multi -colored textured drywall Location: Walls throughout interior of residence SM1-1 SM1-2 smiJ SM14 SM1-5 SoulimeNtedmandosdwall None-Ddeded BoWmn, west caner of north wall F norhwest room NoneDowded Middle M kikhemleundry WOWn gdchen edde) None-Ddeded TW 0 cooreay in hallway ldoorre wall vent None -Detected Laundry rows wall nearwaterspgo6 None-Dateated Class: F -SM Condltlon: SD Hazard: Low Causeof Damage: Demolition Material Code: JC1 None -Detected Description: Joint compound of SM1 Class: F-MISC Condition: D Hazard: Low Material Code: MM2 MxSpill Description: Multi -colored textured drywall Class: F -SM Condition: SD Hazard: Low Cause of Damage: o W heargo Y m �'dansoM� N D i m m C c r N D v r m m C C r ADVENT EHlameca venue CONSULTING 9ffiwnsba5 9830 Wes1kemeda Avenue Sufte . VENT vmwam@aMemcnvimmm LakewaW, Cdoadb80236 wxw.savenranvlro.com Section 2 - Inspection Photos & Sample Locations (Continued) The overall asbestos content, for a material with multiple samples, is the highest result in the set. Class: F-MISC Condition : D Hazard: Low Materiel Code: JC2 Major Spill Description: Joint compound of SM2 ADVENT ENVWONMENrw CONSULTING / vow )20.6)5.)95 )bio Wen Abmetla Avence Suite ONSU-216 mr�m to ron.lm.mm �sewom, edoam arms ,�NT w rn@a&erto.mm Section 3 - Summary & Recommendations 3.1 Regulatory Overview Any material with an asbestos content greater than 1% that is friable or will become friable during work activities is considered a regulated asbestos containing material (RACM) by both the Environmental Protection Agency (EPA) and the Colorado Department of Public Health and Environment (CDPHE) due to its potential to release hazardous asbestos fibers, polluting the air. g the amount of RACM that will be impacted during work exceeds trigger levels, it must be removed by a certified asbestos abatement contractor prior to beginning work. Initial results are generated from a visual estimate by the analyst and could differ with a more accurate analysis known as point counting. Any friable material sample identified as having a trace (equal to or less than 1 %) amount of asbestos, must be considered a RACM unless verified by point -counting to be equal to, or less than 1% and, in fad, a trace material. For materials with a set of multiple samples (i.e. SM with 3, 5, or 7 samples) the asbestos content is whatever the highest result is out of the set; therefore, if one result of a material with multiple samples is baro, but another result of the same material is 3%, then the 3% result supersedes the other results for regulatory and asbestos management purposes. 3.2 Project Results & Recommendations Major Spill Numeric quantities, representing either the length, square footage, or volume of building materials, have been established by the EPA and the CDPHE as guidance for asbestos building inspectors to determine the hazard level of PALMS that have been damaged. These quantities are known as trigger levels and when the damage of an asbestos -containing material falls below any of these levels, the result is a minor asbestos fiber release episode (minor spill). Regulatory protocol is not required; however Advent recommends adherence to EPA protocol, outlined in Section 3.2.a, to ensure safe asbestos work activities. Trigger levels are as follows: -With regard to single-family residential dwellings: -32 square feet on surfaces .50 linear feet on pipes -the volume equivalent to a 55 -gallon drum -With regard to all areas other than single-family residential dwellings: -160 Square feet on surfaces -260 linear feet on pipes -the volume equivalent to a 55 -gallon drum Damaged materials with an asbestos content greater than 1% have been identified within the work area. The extent of damage exceeds the trigger levels resulting in a major fiber release episode (major spill). CDPHE Regulation No. 8 Part 6 - Asbestos requires major spill decontaminationicleanup be performed by a Certified Asbestos Abatement Contractor. Avoid entering or otherwise disturbing the contaminated area. Disable any air -circulating equipment (HVAC systems, fans, windows, etc.) which could force contaminated air throughout the property. Please see Section 3.2a for regulatory requirements for major spills. ADVENT WW ENVIRONMENTAL Avenue Sufte CONSULTING / e� w ]206]5]1)5 ]Dao WestNVIRON ENTA CONSU5-416 m SdveamnAro.wonom �kem�m, cavern aozzs `�NT wrw. m@advnwo.�m 3.2.a CDPHE mandated actions in the event of a major spill: 1. Restrict access to the area, and post warning signs to prevent entry to the area by persons other than those necessary to respond to the incident. 2. Shut off or temporarily modify the air handling system to prevent the distribution of asbestos fibers to other areas (if applicable) 3. Immediately contact the CDPHE Air Quality Division by telephone (303.692.2000), submit notification of contamination and apply for a permit. 4. Be exempted from the requirements to have a certified Supervisor on site at all limes, until such time as immediate danger has passed. Any clean up or asbestos abatement that must occur after the immediate danger has passed shall be supervised by a person certified by the Division. 5. Using certified Supervisors and certified Workers in accordance with regulation, seal all openings between the contaminated and uncontaminated areas and establish negative air pressure within the Contaminated areas in accordance with regulation. This is to be accomplished using polyethylene sheeting to cover areas such as doorways, windows, elevator openings, corridor entrances, grills, drains, grates, diffusers, and skylights. 6. HEPA vacuum or steam clean all carpets, drapes, upholstery, and other non -clothing fabrics in the Contaminated area, or discard these materials. 7. Launder or discard Contaminated clothing in accordance with regulation. 8. HEPA vacuum or wet clean all surfaces in the contaminated area. 9. Discard all materials In accordance with regulation. 10. Following the completion of the work, a final air clearance (see - Final Air Clearance (FAC) Advisory) shall be performed by collecting air samples, aggressively, as per regulation by an AHERA state -certified Air Monitoring Specialist (AMS). 11. Comply with any other measures deemed necessary by the Division to protect human health. None -Detected Materials with a result of None -Detected have been verified by the laboratory to be free of asbestos fibers. Although those materials are free of asbestos (a known and regulated hazardous air pollutant) other airborne contaminants may still cause adverse health symptoms, both acute and chronic, if one inhales elevated amounts of particles. vigilance and caution should be used to minimize airborne particulates regardless of the material and if visible or perceived emissions are present one should take action to protect their respiratory health by use of personal protective equipment, or otherwise. Please work safely and if new materials are discovered, which are not Covered in this report, Contact Advent to have them sampled for asbestos. o W heaego Y n ADVENT ENCONSULTING ]206]5]1)5 7 8MWWAbmipJa Avenw Suite mymyleemvem "ntmentt!) ro.erim �wo. ,_mm sem, cdoam aozzs ,�NT w Section 4 - Purpose The purpose of the inspection was to verify the absence or presence of asbestos in the building materials included in the project scope of work which may be disturbed during work activities to determine if asbestos management and notification is required prior to beginning work. The property located at the site address identified in this report was inspected by a building inspector trained by an approved EPA, Asbestos Hazard Emergency Response Act (AH ERA) training organization and certified by the Colorado Department of Public Health and Environment. During inspection, the inspector inspected and assessed suspect building materials, pursuant to the EPA "Green Book," Managing Asbestos in Place, Appendix G (1990), described by the client to be affected during demolition or renovation which would need to be sampled and analyzed for the presence of asbestos prior to commencement of work activities that would break, crack or otherwise damage the materials) in a manner that could allow asbestos fibers to release from its compound. This inspection was conducted in accordance with applicable EPA National Emission Standards for Hazardous Air Pollutants (NESHAP) 40 CFR Part 61, Subpart M and/or CDHPE Colorado Regulation Number 8 Part B - Asbestos (Reg. 8). Samples were submitted to a laboratory accredited under the National Voluntary Laboratory Accreditation Program (NVLAP) to be analyzed for the presence of asbestos. The NESHAP standard for asbestos states that the owner or operator of a demolition or renovation activity involving asbestos must remove all such material from a facility being demolished or renovated before any activity begins that would break up, dislodge, or similarly disturb the material, or, preclude access to the material for subsequent removal. Section 5 - Comments 8 Limitations The inspection of the site address listed at the beginning of this report was limited to only specific materials of the project scope of work as directed by the client. The limitation of the inspection also includes only portions of a material sampled as identified in the location and quantity sections of this report and any material beyond the specified quantity should not be considered adequately sampled to represent the entirety of the material. Additional samples may be needed to represent materials outside of the work Scope even if they are included in this report. Quantities listed in this report (Section 1 - Project Snapshot) are approximate quantifies of the amount of material that will be included within the scope of work based on information gathered from the client. This approximate quantity is used by the inspector to determine the amount of samples to collect respective to the regulatory requirements outlined in the Identifying Homogenous Areas 8 Sampling section of the Glossary. Contractors using this report should gather more accurate measurements before drawing Conclusions of subsequent work activities. In order to collect samples, various marks, cuts, breaks or other slight damage to materials may be required. In order to prevent damage extending outside of the work scope, samples were collected in client designated areas of remodel/renovation which the client will remove during work activities. This is done so that damage created by the inspection will be removed with the bulk removal in the work scope. Alternatively, samples were collected in Inconspicuous, hidden places to avoid unsightly damage. The best possible measures were taken to collect the minimal amount of materials necessary, to get accurate results, in the most inconspicuous places possible; however, no guarantee is made that the conditions exist to prevent visible damage. o W heargo Y n ING ADVENT Wixt ENVIRONMENTAL verw Sure 103- 216 / w ]206]5]1)5 ]aao West Alameda ENTAL ONSU -416 myreem@amlm ke, cdoam arms !)Aro.�m�m�m`�NT AEC and its consultants, partners, agents and employees shall not be liable to the client for any materials damaged, during the rendering of services by the AEC. Additionally, AEC shall not be liable to the client for any materials damaged, during work activities subsequent to the services rendered by AEC, which were not property inspected by AEC. Finally, AEC shall not be liable to the client for any special or consequential damages, including but not limited to, lost profits, loss of use, or any other cause whatsoever. Any compensation to the client for damages shall not exceed the total compensation received by AEC from the client. Although diligence was used to inspect and sample all materials within the work scope, there may be additional materials not covered in this report discovered during gross removal which may need to be sampled. If additional, suspect materials are discovered which are not covered in this report, please contact AEC prior to disturbing them to have them property sampled. ANY MATERIAL NOT PROVEN TO BE FREE OF ASBESTOS SHOULD BE ASSUMED TO CONTAIN ASBESTOS UNTIL PROVEN OTHERWISE. This report, including any other documents attached hereto or referred to herein, which form a part hereof, embodies the entire agreement and understanding of the parties hereof including, but not limited to, any verbal or written agreements) made prior or subsequently to the preparation of this report. This report may not be amended except in writing signed by a duly authorized representative of the respective parties. The receiving party shall not alter, modify, decompile, disassemble, ravens engineer, translate or create derivative works from this report. The receiving parry shall use this report only for the limited purpose descrbed above and not for any other purpose. The asbestos inspection was conducted in a manner consistent with the degree of care and skill ordinarily exercised by and consistent with the standards of competent consultants of the asbestos inspection profession. The results, findings, conclusions and recommendations expressed in this report are based on conditions of the specific areas, defined by the client, observed during the time of the limited inspection. The information contained in this report is relevant to the date on which this survey was performed, and should not be relied upon to represent conditions at a later date. This report has been prepared on behalf of and exclusively for use by the client for specific application to the project as discussed. Contractors or consultants reviewing this report must draw their own conclusions regarding further investigation or remediation deemed necessary. Advent Environmental Consulting does not warrant the work of regulatory agencies, laboratories or other third -parties supplying information which may have been used in the preparation of this report. No warranty, express or implied is made. Respectfully Submitted, Drue Beasley, CO Asbestos Building Inspector#18325 Advent Environmental Consulting CDPHE Business Registration #: ACF - 22068 7830 West Alameda Avenue Suite 103-216 Lakewood, Colorado 80226 myteam@advent-enviro.com 720.675.7175 o W heaega Y n ADVENT aimNVmxla Awnw CONSULTING / vow ]206]5]1)5 ]9aoweslA6meN Avenue $Yik SULTING my "nmeAro. �,_mm "keYmm, cdomm arms ,�NT vmm.savemeexorvim GLOSSARY Material Friability These categories were used to determine methods for assessing suspect materials based on their friability and ability to release harmful asbestos fiber i.e. finable materials are more likely to release asbestos fibers. 1. Friable (F) - materials that can be crumbled or reduced to powder by hand pressure. 2. Category I Non -Friable (NFI) - materials that cannot be crumbled or reduced to powder by hand pressure including resilient floor coverings, gaskets, packing materials and asphalt impregnated roofing materials. 3. Category II Non -Friable (NF) -All other materials that cannot be crumbled or reduced to powder by hand pressure that do not include category I non -triable materials. Material Type AHERA and Reg 8 require building inspectors to categorize the type of suspect building materials into one of three categories: 1. Surfacing Material (SM) - a material that is sprayed on, troweled on, or otherwise applied to surfaces, such as acoustical plaster in ceilings and fireproofing materials on structural members, or other materials on surfaces for acoustical, fireproofing, or other purposes. 2. Thermal System Insulation (TSI)- a material applied to pipes, fittings, boilers, breaching, tanks, ducts, or other interior structural Components to prevent heat loss or gain, or water Condensation, or for other purposes. 3. Miscellaneous (MISC) - an interior building material on structural Components, structural members or fixtures, such as floor and ceiling tiles, and does not include surfacing material or thermal system insulation. Friability and material type categories for each material inspected are reported with their respective friability and type codes (e.g. F -SM, F -TSI, NFI, etc.). Non -friable category II materials are identified with non -friable code (NF) and the type code for the material (e.g. NF -SM, NF -TSI, NF-MISC). Identifying Homogenous Areas & Sampling Homogenous areas of each material are identified within the work area. Homogenous materials are grouped based on color, texture, and date of application. These materials are then given an approximate quantification of removal or disturbance during work activities to determine the amount of samples to take for each material as defined by AHERA and Reg. 8: 1. Surfacing materials • Minimum of 3 random samples for quantities under 1,000 fl° • Minimum of 5 random samples for quantities >1,000 W & <5,000 ft2 • Minimum of 7 random samples for quantities>5,000 fta 2. Thermal system Insulation • Minimum of 3 random samples for all TSI `except patches <6 linear ft. or 6 ft' 3. Miscellaneous materials • Minimum of 1 sample o W neaega Y n ADVENT WW AbmWa Avenw CONSULTING / w mffi m@a& ]830 Wes1ke moc, dom Su8e 103-216 'Fla myleam@aMen[cnvimmm LakevwW, Cdoada 80236 wwx.alveMenWo.com APPENDIX A - Laboratory Report o W neaega Y n �'�anOOM� SEEML Reference Number: 210005024-1`1,11 Date his ed: 09/06/21 Southeast Environmental Microbiology Laboratories 102 Edinburgh Court SEEML Labs Phone: SC 29607 Phonne.e:(011) 233659900 Pae: (864)233-6589 Asbestos Analytical Report By: Polarized Light Microscopy This report has been prepared for Advent Environmental Consulting the information and data has been checked for thoroughness and accuracy. The results reported apply only to the materials as received. The documents(s) contained herein are confidential and privileged information intended for the exclusive use of the individual or entity named above. This report shall not be reproduced except in full without SEEML's approval. Client Project Name: 11297 West 44th Avenue The Following report was prepared using this test method(s) contained within this document. ® PLM Bulk Asbestos Either Analysis: EPA 600/R-93/116 ❑ PLM 400 Point Count (<0.25%) EPA 600/R-93/116 ❑ PLM 1000 Proud Count (<0.1%) EPA 6008-93/116 ❑ PLM Carb 435 Level A Reporting Limit (<0.250/*) ❑ PLM Carb 435 Level B (Reporting limit <0.1%) ❑ PLM by EPAIWOVP-93/116 with Milling Prep 401) Point Count ❑ PLM Vermiculite Initial Screening EPA 600R-93/116 ❑ PLM Cincinnati Metbod 600/R-04/004 (Ampbibole Only) ❑ PLM Vermiculite Method SOF-V 198.8 (Step 1 Chrysofile&Prep) ❑ PLM Vermiculite Method SOF-V 198.8 (Step 2 (Amphibole) Thank you for choosing SEEML Labs. We strive to provide superior quality testing, mulytical dam and customer service. SEEML is accredited through the National instimm of Standards and Technology (NIST) National Voluntary Accreditation Program (NVLAP) for bulk asbestos aonlysis LAP ft 201031-0) and licensed by the Texas Department of State Health Services (License Numbs c: 300474). This report must not be used to claim product certification, approval, or endorsement by NVLAP, NIST, or any agency of the IIS government. o,shagr s, Ot Firm 16 Rev. 705/11/20 -Or <scsno aW Southeast Environmental Microbiology laboratories - Asbestos Division 102 Edinburgh Court Greenville, SC 29607 SEEML Labs Plwne: 854-233-3770, Fax: 864-233-6509, Nosm.seeml.caan Niel Lab ID:201031-0 Texas Lic: 300474 PLM Asbestos Bulk Sample Summary Client: Allyl EvinwnmeMal Consulting Dme Beasley 7830 W. Alameda Ave. Suite 103-216 Lakewood, CO 80226 720-675-7175 Date Sampled: Will Date Received: OS/05/21 Date Pnaltzed: Will Dale Reported: 08ill DMB Revlsed: Project Name: Project No: 030821 -DBI Analyzed by: Vi Sandoval Projec[Address: 11297 West 99M Averwe City, SMW. IIP: Wheat Ridge, CO 80033 Methodology EPA/600/R-93/116 Without Cravimery SEEML Ref#: 210805024-P1M Lab No.: %Psbcstvs Type %Fibrous None Asbestos Material Ti %Non-Nbrous MMariel Dasbiltipn/laotgn Client NI 106A None Detected None Detected 100%Binds/Aller Skim Gut PL -1 im None Detected None Detxted 100%OrbwuR/Qui Near PL 1-1 107A None annual None Dttttted 100%Mina/Aller win Coa PL -2 1078 None Detected None DeMCRd 10o%Qrbwute/Qumtx Mater PL 1-2 lOM None Detected None Detected 100%Ander/Aller Skim Coat Fell 13 1088 None Detected None Detected 100 iDarbwaR/Quare Master PL 1-3 109A None Detected None Detected 100%Blnda/Alla Som CoA PL 2-1 109B None Dissected None Detected 100%Carbonate/Quartz Nater PL 2-1 110A None Detected None DeMCRd 100%Binaa/Aler Slam Gut PL 2-2 Approved By: Jayson Dunn Darlyear the results in this ren art only apply M .oe omoise a.e inrenax..1...�p�prve.xw. n�x«urnmeredfur xerithey INN sona xshouxwi.Was than re Asbestos to IN nnae by TOM or Not MoNe. Mcoppossel son IM Wwwat on than 1% also point pis s�wmm. nmx tie mM1s�Ama,mrseen hisamoares i imemreamnams It Is mmmnm1 wWue atvMee poeaftO ON mrymamrvxl" Nan v to I the deal national In muwgngn apaulln mMrexed areniydl a ewm, istheIndear Rents apemen erearex. repixyymisnlara xl: uamntanineimpixp�axssxemn�uxa4xM1zinemxm¢uurysssmnm�iana4xM1e wn NennrysssAL�kanrtn�lux'ttnssevnudlrtt'IxvtlimNeufiMniaoewnmemdxnxM1senimluoxAM1arcpuM1bM1etlrva�finnbxaxxnxmemaM �mnomwex.a..dmeim.�m.e.eaanwma.rceuAw' oWheal ronsibee,. a doll Y n t'ayng OM'e Southeast Environmental Microbiology laboratories - Asbestos Division 102 Edinburgh Court Greenville, SC 29607 SEEML Labs Plwne: 854-233-3770, Fax: 864-233-6589, vraveseeml.cvm kill Lab ID:201031-0 Texas Lice 300474 "Asbestos Bulk Sample Summary Client: Advert Evirtwnmeaal Consulting Dme Beasley 7830 W. Alameda Ave. Suite 103-216 Lakewood, CO 80226 720-675-7175 Dare Sampled: 08/(15/21 Date Received: 08/05/21 Date Mallzed: Will Dale Reported: 08ill Dae Revised: Project Name: Project No: 030821 -DBI Analyzed by: Vi Sdndwal ProjectAddre5a: 11297 West 44th Averwe City, Store. IIP: Wheat Ridge, CO 80033 McNodology: EPA/600/R-93/tl6 Widlad Cfavimeby SEEML Ref#: 210805024-P1M Lab No.: ak Jamemos Type IFilamu6 Nene Asbestos Material Type INon-MismiS Material DaWlPtgn/IYOtgn Client No.: 1108 None pet¢cend None Detttletl 100%Urbwwte/Quarez Hauer PL 2-2 SISA None avoided None Derectad 10M Blntla/Fllla slum Coat PL 2-3 1118 None annual None Dctecled 100%CarbM1dte/Quartz Hasler PL 2-3 112A None Detected 40%D.dlulose SIM&sank Matra Roof Shingle RSG 1-1 10A None Detected I Cellulose 60% CollapseMatrk R[Of Shingle RSG 1 2 11M None De[etetl None Otec'4tl 100%Bintla/Ella TatWR SM 1-1 1148 None Detected 20%Cellulose 80%Gypsum Drywall SM 1-1 115A None Deo ted Nmrt Dctahtl 100%Binds/Ella TesWre SM 1-2 1158 None Detected 20%Witnime 80%Gypsum Drywall SM 1-2 Approved By: Jayson Dunn Darlyear the results in this spot only apply to noe nmmes a.e inree as a m<i�m�pry oNs,w.nav,«arameadfur xeritha<Psynnae.re.ux.vine..than 1% Amnwasm an nM1he by TOM e.ra,m A.arva. MhOrpossel spar IM WwwatNan NO Misil l" Nan her than 1% also Penn piss�wnim. mm �iemmas�Ama,muoamamgs amoun¢adimertarena mmams It Is mmmnm1 wWue atvMee po hnnnepdntmamamrysv muwgnmes apaulln mMresed aresni Pnal a ewme the Indndparofsonly pemm ereares. to Nor the deal national In renaixyymisnlera xl: uemntanineimnaixq�amnamniuxa4sM1e��em�m¢uurysssmnmlisM4the sun NennrysssAL�kanrtn�lus'ttnssevnudlrtt'IxvtlimNeufiMniaoewnmemdxnxM1senimluoxAM1arcpu%sM1etlrva�finnb�assnsmemaM �mnomwe�.a..nrneim.�m.e.Na�•nwma.rcenAw' oWOeargo ronnr.a neu.eoyas/u Y n tayino brie Southeast Environmental Microbiology laboratories - Asbestos Division 102 Edinburgh Court Greenville, SC 29607 SEEML Labs Plwne: 854-233-3770, Fax: 864-233-6589, vrJnv.seeml.curn kill Lab ID:201031-0 Texas Lic: 300474 pith Asbestos Bulk Sample Summary Client: Advert Evinwnmental Consulting Dme Beasley 7830 W. Alameda Ave. Suite 103-216 Lakewood, CO 80226 720-675-7175 Date Sampled: Will Date Recapped: Mill Date Pnaltzed: Will Dale Reported: Will Date Revised: Pal Name: ProleR No: 030821 -DBI Analyzed by: Vi Sandoval Project Address: 11297 West 44th Aven0e City, SMW. IIP: Wheat Ridge, CO 80033 Methodology: EPA/600/R-93/116 WiMod Cravimeey SEEML Ref#: 210805024 -PLM Lab No.: %Axbes[ps type IMmus None Asbearos MaMrial Type %Non-Rbrous MMaritl Dswiptgn/Inotgn Client No.: 116A None Demaced Nine petaled 10M linda/Hyla Tell SM 1-3 1168 None DeteRed 20%CellJnse 80%Gyysum Drywall SM 1-3 SDR None Dimeted None petaled 100%Mina/Bila Texture SM 14 1178 None Detacted 20% Will 80%Gyysum Drywall 31114 1taA None Detected Nme Delated 100%Nnax/Nllx Tel SM 1-5 1198 None DetaRed 20% Withal 80%Gyyam Drywall SM 1-5 119A None Deladed NI DHaRN 100%Blndx/Filler John[CnmpeuM SMl-%-1 1MA None Dem ted Nara petaled 100%Binds/Bila hint CanpouM Si 131A a%Chrysotile Plane pe[ecLLN 97%Birder/Rlkr Tedum SM 2-1 Approved By: Jayson Dunn Darlynar the results in this repat only apply M noe xamoiex ane inree as a ani�m�n�nrve.xw. navx«oarameadfur xerithey P s..naex Alin Na than r% All an NNp1M1rTOM nam A.arvn. her than 1% ul Penn piss�swnim. xm tile mM1s�Amarmrseen NW amoares i imemreamnams It Is mmmnm1 wWue atvMee po mn ON rymamrvxv to I the deal national In muwIN PM apaulln mMrexed areniydl a ewme the Indndearofsonly pemm erearex. renaixyymisnlara xl: uamntanineimnaixgwsa:IXemnyuxa4xM1zinemxmpaurysssmnm�iaM4the wn nxsssAle�n<renrt bx'ttnssevnudlrtt'IxvelimNeufiMniaoewnmemdxnxM1senimluoxsl M1arcpuM1bM1etlrv�finnbxaxxnxmemaM �mnomniex.a..drneim.�m.nrea�•nw n,n.rcsuAw' oWOsal ronsibine,. a aa/ss/u Y n t'ayng OM'e Southeast Environmental Microbiology laboratories - Asbestos Division 102 Edlnburgn Coun Greenville, SC 29607 SEEML Labs Phone: 864-233-3770, Fax: 864-233-6509, vlwvi.sceml.cvm kill Lab ID:201031-0 Texas Lic: 300474 "Asbestos Bulk Sample Summary Client Advert Evirtwnmental Consulting Dme Beasley 7830 W. Alameda Ave. Suite 103-216 Lakewood, CO 80226 n0-675-7175 Dare Sampled: 08/05/21 Date Received: OS/05/21 Date Analyl Will Date Reported: Will Dare Revised: Project Name: Project No: 030821 -DBI Analyzed by: VriShni Sandoval ProleRAddrell 11297 West 99M Aventre Cry, SMW. IIP: Wheat Ridge, CO 80033 Methodology EPAy600/R-93/116 Wil Cravimeby SEEML Ref#: 210605021 Lab No.: %Aabutva TYR %Mbmus Nan- AabMtds Na[erial Type %Non -Fibrous Material Das gi ntLo n Mount No.: 1218 None Contacted 20%Cellulose 80%Gypsum Drywall SM 2-1 12M 2%ChryaDLlle None Detected 98%Moder/Nlkr Teduie SM 2-2 12M None Detected 20%CNlNlose 80%Gypsum Novel SM 2-2 MA 49BEChryatile None DReRed %%Under/Miler Temure SM 2-3 fns None Detected 20%Cellulose 80%Gypsum Drywall SM 2-3 12M 3%Chryamile None DReRed 97%Under/Filler Joint CampouM SM2-%-1 125A 41'vChroaile None Detected 96%Bander/UMr John[Cnmpaund 54121 Approved By: Jayson Dunn Disclaimer The results in this report only apply W as .oa xamriex are tested axamei�m�.rr�=.xInyx.«�..bfur innocee.oe..ma.xracculi. Wtha. l..mntiam on nnne M1nn. Not. NSi• nscroppy Nan Nor Ml hen pre than 1% unessess piston piss�swnim. Floortilemaremuaamamx amourvadimeeerence Woo It Is ammme m1 �Wxm�a'mMeepo mnnx pdmmrymamryxv or PMUP�IM muwmnmex apaulln mMrexed arexmiydl a ewme the Indemmineemity Es im eremv. renaixyymisnlara xl: uamntanineimnaixq�a�emnruxa4xM1a�aemxm¢uurysssmnm(isM4the sun Naanxsssnle�kanrtn�lux'ttnsseonudlrtt'IxvelimNeufiMniaoewnmemdxnxM1senimluoxsl M1a.<puM1bM1etlrv�finnbxaxxnxmemaM .mnomwera.rnrneran.�mrn.4aonwmn.wrnnw. oW6eargo ronnr.aneas. a da/call Y n t"+vny bM� of has -';u ya;a1a ndle, APPROVED wnbled OUNetizetl, Or mtluced io requlBlBo by rola reguavon. told: As By Cody Archuleta of 9:59 am, Sep 08, 2021 ekknet were 11 DEMOLITION NOTIFICATION APPLICATION FORM Colorado Dep. d Pabka APPLICATION FEE MUST ACCOMPANY THIS FORM ErM APco4sal m.mem 1a7s• INCOMPLETE APPLICATIONS WILL BE RETURNED ags Chmyaeak Gnve Vorado Department (Notice will be mailed to me demelhlon Contractor unless specified otherwise) seem oemw, Co W246-1530 ofrnbllcHeattbMna: MM92-3100 and Environment Fee: $50+$5 per 1000ft orareato be demolished=$ SYS Fee M3a'782.027e Isee imalrue3an Mi on reverse aide] ®:manors -w CcmPeny tame, BUIN"g Nure: 11,r„,Detached Garage sm : Se,amNNaPeNNem,m mNtlllry w entire m bemry m be eemnlshad wH Sdaur --„ [u 3UYS1 11297 W44'^Ave M Telepnmetl Laxe N CItY CwnN Lp CYN: u Jo v—y4y nemarznaw a Iwaa M, Man, rt.pa-.Na2are oeweee —fuow AapsMw C ,n j97u -9E9-/tic lH iIi -nzWfm -c —zz} ivekM tat file carried Aabeabe eunaing importer has E Nemdauwne of ownaiuon: o mb,med me about any remaining aebmtaacomalnin0 E mmenaa in mdtadld robe damdiahaa. S eeen0 oaanno' ❑ answer, ❑Start ❑oma. seamy: oenalomto/ PdNNada. �Ua/ Senalwe: Yder /� SS Hamr BuminA renulrea MElBNal wNwCedm-Pleaw Cal M31 RM100 and laMftllPadN,ga Iliaurb'¢: ,l e ai ,e e.a.•k to me OWBumnP Parent mWN Gene2l AhalvnenlLmhadIX l3PC) o:meh Name: `O N/A Structure Free of RACM COPHEaAenu Pami,e Tow OwmrydAee.wa 3 slmC 0 yE Renewer! o 11231w.Mm Ave meflmmal Command� Tele{Mnea 9_ city µ1,y1Poch, WE 3, �Cemii m p O to CmIM'S Nrme: Trey Malibu I TelepM1matl 303.547.]]82 Typya]NA+bMaa0 f ring Nelviel aemzM: Wlih my signature bebw, cemy that possess Curren[ AHERA acrred'dation and state of Colorado certification `o as an Asbestos Building Inspector. I also canny mat I have thoroughly inspected the facility to be demolished, as black all suspect materials, had all samples analyzed for the listed in the Demolition Site above, sampled u presence of asbestos by a NVLAP-accredited laboratory, and have determined that no Regulated ACM exists anywhere in the facility.' I also certify that I have informed the owner/operator of the facility or me distribution o contractor that any asbestos -containing material allowed to stay in the facility must remain nonfiiable during N $0 demolition. Specify type(s)of AGM remaining, below: (chedt appropriate bax(ea)): 'O T 0 ye ❑ Vinyl asbestos now file (VAT) ❑ VAT mastic ❑ Taflaspha0 impregnated roofing ❑ Asphalhe pipe coatings ' u S re a lietl tar coatin s Caulkin Glazin s Sc NOsipnqun. (in awe N Pnmeeam[r Cne laamhY Y V I CON wee Ba"oaYa Ne i COCFlY E.praYm Dalr forearm'.R06T5T119 la3.er5.T115 %a3no +saes Tnozz I earn, that at tehieeanN man aur mnddlml..OWN e'aa eeellancee have been omeerN recweredmacwNancewlm AOCC RaAuladdn News (demands radoWNe maMiag have No. 15 for - information on LFG reOUamenls eall0aLJ+Oei.I N rna,"my mat a4 luminous sent 3AA3(M informetimmluminoue out men re?uhemw6®11303EBIJ330). bean deameend d inacwdance and, G CCR 1007-1su[part CGS Nii! ILHECNT11EAPPROPRMTEBOx: a ❑ aia're Dina _ [� cmBeov ❑ aria fir' — )— 2 / D p�ae: arm Nan.: ✓St itisor. </ TRIG Box s Fart CDPHE USE DNLY' 9%//21 LIMB: Xin4eV310 ❑Vanaler300 P wMaA or Hand DelhreN Owe t'AFNARN05Y m '�R.cNdx Forel at Payments A. 174526372/$55 Permit a: Iome la:vad: of has -';u ya;a1a ndle, APPROVED wnbled OUNetizetl, Or mtluced io requlBlBo by rola reguavon. told: As By Cody Archuleta of 9:59 am, Sep 08, 2021 APPROVED By Cody Archuleta at 9:59 am, Sep 08, 2021 � 1Rp1--ryryo DEMOLITION NOTIFICATION APPLICATION FORM •+'x.'.:+", Pump 0 "on" m cdwde dEnom br= •• APPLICATION FEE MUST ACCOMPANY THIS FORM PPm�iaa�`nmrmm�am ilei INCOMPLETE APPLICATIONS WILL BE RETURNED �'�^ Ctmr Menodse :olotale Depztttneat (Notice will be mailed to the demolition Contractor unless specified otherwise ) amA oemw. W2a of ylltlGcHtlI1)t Environment Fee: $SD ♦ $5 per 1000 Weasel be denrolishetl = $� 3mX2 3 100 03 303-7azaz le and I6ae Instmellan Rt on reverie aide) ,"tesla®stam.re. Cmwrt+'Nmme: 1WHAK Name e.. ,r. o. Detached Gars a sa.. sdwmmwee ar]oxl>"m misaur nlpmaol mraNnrla tea.noBnd `oa r RB7> ,fir c e 2a see.: atm.e ! ! n k Cu Fp rl'1 r 11297 W 44'^ Ave Tdepime% Fmf el'Y: Lwn1Y: w.m w000 emead 3b wade: soon N ___ PrdBGMeruger CM Plwmx rd9lxrow pmpuml Convened2-2-1oel. tees Y e a r- tL_ Holdin-£s_2- e ,Aon. z't/ - McNddRHeans a Drnaiton: -Icart._ ff hd6 I carttat Aebmms Holding dm Nee E IS me deals ale aeteatoemnWNna ameaboutenyre a / E moms be maleneb in the keili b be EemolieM1eG. [6gAvb+lg ] Wenlnp (I lmp=Ym ❑ all ] ahr, weWy: 0 Derl CNMtlu I PAM Name: Slq,me, l I ♦ au.Lq S m on 'a rpWss edaNmal aummla.nnn-Pt:sae P03169zJ1a0and Iznm, emNna wwN Det'x: zz�/A uk b seek to Me open Bummg P m9 Coondi t GenuelPtakmentCwrecW IA1C1 deal Name: N/A Structure Free of RACM t seebexaalowuelm 9 y CDPHE A.e®tre Pemil 4 Tax puemayJA,bmw emi aemn0 Ce 11391 W. NN Ave. Ce Cele aemonl LrmPM� moo:ptmaf Cur op CC e: � 'MIM sal co T34H*tp Aetex®'arvemtno wr.w a.,,o.m'. m c,Neas Nem,: Troy Mallon Tekatm 303.547.7762 With my signature below, I celi that I possess Cl AHERA accreditation and state of Cabrado certlficaaan an Asbestos Building Inspector. I also certify that I have thoroughly Inspected the facility to be demolished, as as listed in the Demolition Site block above, sampled all suspect materials, had all samples analyzed for the n presence of asbestus by a NVLAP-accredited laboratory, and have determined that no Regulated ACM exists SIC anywhere in the facility.' also cel that I have informed the owner/operator of the facility or the demolition Co that any asbestos-comalning material allowed to stay in the facility must remain non -friable during m S m contractor demolition. Specify type(s) of ACM remaining, below(check appropriate bozlell a` E ❑ Vinyl asbestos floor tile (VAT) ❑ VAT mastic ElTar/asphalt impregnated roofing El Asphaltic pipe Coatings U 5 re a lietl tar coatin Caulkin Glezi Other s Both?: ,a spnM: tF aAx In PMIeE Neme'. Y CrYeamxey V oW d Flrel lrcp - ICO Ce,Ip Repin�DnH TeleoAoneY GrFtmef Mala.T1]5 lxps]st]s 081031 leazs 72022 I E In axmEanmvmn AQl cep loa I very, that an etanol from at c"niminl;'refiigamna apdiances hae ateen eaperly reemmem wminoue and ons (connive nmoal midenap news No. 15 (for oriental on CFC reauitxmn6 WI sal Wj.l roma, verity that all lmmoon on miwus nlmmm inrolu ut agn repuee coil 303-4692-3320).of been deNU in embedded Mi 8CCR tWT-3 leaden 3.6A.3(b `e 9... Pre p CHECK THE APPROPRATE aD[: -- ------ -- 9 Ep@@@@@ _ m O C]Bmxaomer wla.m ❑ omr7-Z/__ somal : PAn'Kne vsJ rens erne / THS Boz Is Fol _ A•raovm 817/21 AppweO ay nv. —� Code: %I ripa13t0 ❑tmmaAx360 rei. PoaMark or Hem Delivery Dab: PermII N'. Records Dale ltluae. Form IXPaYINIM6V 1Td59R3� ]7 / A5� . . APPROVED By Cody Archuleta at 9:59 am, Sep 08, 2021 City of W heat �igge LOMMUNnV DFVELOnMENT Building 8lnspection Services 7500 W. 29^ Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 4 Fax: 303-237-8929 Inspection Line: 303-2345933 Email: oermitsfa d.wreatrdue.m.us FOR OFFICE USE ONLY pea. PiervFam## Plan Review Fee: Building Permit Application Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed...` Property Address: 1Ia297 W `/`/ri' 4ve byA+ 1 Ro7je Co 61 Property Owner(pleasepdnt)' aeor B a1 Anq /.. M // Phone: 303-5SY7. 776.2 Property Owner Email: Tenant Name lCommercial Projects Only) Property Owner Mailing Address: (d different than property address) Address: //„797 lL/ YYrr` 4V& O City Stat Zip: /d/ur� /Z/,yr PO0 Z ? Archilect/Engineer Eanall: Contracrtor Name: Ernp i1'P Us mQ Ii I [An cios;k Pr par14 Se"Iii Gl LLG City of Wheat Ridge Licenses: 2100-89 Phone: 303-S6 Y -111e Contractor E-mail Address: 6MafP eo l 4 ' dpoe mA / For Plan Review Questions & Comments (��pl//ease prim): CONTACT NAME (please print): 4S.5 Hame/ Phone: ?M-3glq-16/6 CONTACT EMAIL(please print): o --- I -:-:o �4 M Sub Contractors (Must provide Wheat Ridge License No S Signed Subcontractor Authorization form): Electrical: Run ire: Mechanical'. W.R. City License # W.R. City License # WR. City License # Mer City Licensed Sub: Other City Licensed Sub: City License # Citylicense # Complete all highlighted fields, if applicable. ❑ LI COMMERCIAL RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. Demo and regi a bodgoJ STru&4vr€j on ?roperJj Bq. FULF 9,F/ BTUs Gallons Amps_equana For Solar. _Rw x of Panels —Requires srmdural For Commercial Projects Only: Occupancy Type: _ Construction Type: Occupancy Load: _ Square Footage: pfolael Value:(Contract value or the coat of all meaterialsand labor included in the ord spooled) 9 t/n OWNFOUCONTRACIOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby aedity Na: the seduck distances prulmaed by the permit application art accurate and An not airline applimble ordinances. roles or renames of the City of Wheat Ridge or covenants, eesemems or romicdr:n ofrcwrlthat all measmeoohlb shown and allegaulloa made are awards; that I have aid and some to abide by all conditions primed on this application and d,a I assume NII responsibility for compliance with spiduable, City of Wheat Ridge codes and m inneces for work under my pool issued based on this applomon; Nae I am the legal owner or have hem aathonzed by the legal owner of the property on per ems the docnlxd work and am also audtnnzM by the legal owner of any entity included on this application to list Ihat enfity on this application. 1, the applicant for Ravi building Permit application, wenant doe mastodons of the information provided on the application. CIRCLE ONE: (OWNER) (ro/N//i/R�ACroR/ or (eDT//ORIZED REPRESENTATTFE.) of (OWNER)(CONTR.gC'TOIr) Smatu (flneendhcname: wA Di Printed Name Q Ss i)oo DEPARTMENT USE ONLY ZONING OOMMMFM6: ReNewar. BUILDING DEPARTIEW COMMENTS: ReNexer PUBLIC"WSCOMMENTS: OCCUPANCY Q0.561FIGTIIXr: GI NSTRUCTION TWE: I RMe es: I Building DlvlfilDn Valuation: dOk W heat q� U m This permit does not authorize any work to be performed on or in the existing Home _ V E 42 - (Mra USL -�o 3 VIa97 y/ yyt" I+ve _wl, k _R,a t *VOJ3 � ► � i City of Wheat Ridge E -Res. Window Replacement PERMIT - 202101128 PERMIT NO: 202101128 ISSUED: 05/27/2021 JOB ADDRESS: 11297 W 44th Ave EXPIRES: 05/27/2022 JOB DESCRIPTION: Replace 17 Windows with .29 U -factor or better. 3 living room, 5 bedroom, l dining room, 3 kitchen, 2 laundry room, 3 utility room *** CONTACTS *** OWNER EDWARDS PHILLIP G SUB (770)433-8211 GARY CUMMINGS 170102 HOME DEPOT U.S.A., INC. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2408 / FRUITDALE, LEES, STONERIDGE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 13,661.00 FEES Window Replacement 50.00 Total Valuation 0.00 Use Tax 286.88 ** TOTAL ** 336.88 *** COMMENTS *** *** CONDITIONS *** Both the front and back of this permit are required to be posted on the job site at all times. If the complete permit is not present, inspections WILL NOT be performed. Work shall comply with 2018 IRC & 2020 NEC. Smoke alarms shall comply with 2018 IRC Section 134. Interior alterations, repairs, fuel -fired appliance replacements, or additions, any of which require a building permit, occurs or where one or more rooms lawfully used for sleeping purposes shall have an operational carbon monoxide alarm installed within fifteen feet of the entrance to each room lawfully used for sleeping purposes. 1* � � i City of Wheat Ridge �� E -Res. Window Replacement PERMIT - 202101128 PERMIT NO: 202101128 ISSUED: 05/27/2021 JOB ADDRESS: 11297 W 44th Ave EXPIRES: 05/27/2022 JOB DESCRIPTION: Replace 17 Windows with .29 U -factor or better. 3 living room, 5 bedroom, 1 dining room, 3 kitchen, 2 laundry room, 3 utility room I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain thispermit and perform the work described and approved in conjunction with this,permrt. I further attest that I am leg ally authorized to include alI entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180, days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and��procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all requ�ired inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any �pplicabje code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. 05/27/2021 Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. From: no-reolv(alci.wheatridae.m. us To: CommDev Perm is Subject: Online Form Submittal: Residential Window/Door Replacement Permit Application Date: Thursday, May 27, 2021 12:34:56 PM Residential Window/Door Replacement Permit Application This application is exclusively for RESIDENTIAL REPLACEMENT WINDOWS and DOORS - LIKE FOR LIKE ONLY. YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM AND WINDOW/DOOR CUTSHEET (SPEC SHEET) IN ORDER FOR THE PERMIT TO BE PROCESSED. Your Permit will be emailed to the email address provided below once it is processed. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. Is this application for Yes replacement window(s) and/or door(s) like for like? PROPERTY INFORMATION Property Address 11297 W 44th Ave Property Owner Name Trey Mallon Property Owner Phone Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email Address Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" 303-547-7762 Field not completed. CONTRACTOR INFORMATION Contractor Business HOME DEPOT U.S.A., INC. Name Contractor's License 170102 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone Number (enter WITH dashes, eg 303-123- 4567) Contractor Email Address 1.181Ci[8bbi81/I jamie@reedysetgo.com Retype Contractor Jamie@reedysetgo.com Email Address DESCRIPTION OF WORK What is being replaced Windows Number of window 17 and/or doors being replaced Location of 3 living room, 5 bedroom, 1 dining room, 3 kitchen, 2 laundry window(s)/door(s) room, 3 utility room being replaced (for example, master bedroom, kitchen, bathroom, etc): What is the u -value of .30 the window(s)/door(s)? City of Wheat Ridge requires the u -value to be .30 or better on windows.. Attach copy of Mallon soecs.odf window/door cut sheets showing sizes and u - value Project Value (contract 13661 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have Yes been authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying for Jamie Reed Permit Email not displaying correctly? View it in your browser. INSPECTION RECORD OccuDanc4 /Type 'INSPECTION LINE: (303) 234 -5933 Inspections will not be made unless this card is posted on the building site Call by 3:00 PM to receive inspection the following business day. 1'() ZAM Mv/ ? INSPECTOR MUST SIGN ALL' PACES PERTAINING TO THIS JOB FOUNDATION INSPECTIONS DATE INSPECTOR NITIALS 'I COMMENTS: Footings /Caissons 1 Stemwall / (CEG) Concrete. Encased Ground - Reinforcing or Monolithic I 1C,P Weatherproof /French Drain' Sewer Service Lines Water Service Lines .INSPECTIONS FOR PLANNING &ZONING, FIRE AND PUBLIC WORKS SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. CONCRETE SLAB FLOOR Electrical (Underground) Plumbing (Underground) Heating (Underground) ROUGHS .Sheathing Lath/ Wall tie - 1 - Mid -Roof El ectrical Service I 1C,P Rough Electric Rough Plumbing. Gas. Piping .INSPECTIONS FOR PLANNING &ZONING, FIRE AND PUBLIC WORKS SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. Rough Mechanical. - ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING Framing. Insulation Drywall Screw - FINALS:( - Electrical Plumbing Mechanical Roof % ed 1C,P Building Final Fire Department R O.W &.Drainage .INSPECTIONS FOR PLANNING &ZONING, FIRE AND PUBLIC WORKS SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. Parking & Landscaping ""NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING. AND ZONING, BUILDING AND PUBLIC WORKS BEFORE CERTIFICATEOF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTEAUTHORIZATION. OFA CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED �I PROTECT THIS CARD FROM THE WEATHER ♦ i CITY OF WHEAT RIDGE r �� Building Inspection Division r (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type: J�Igzst_ RZOF Job Address: !/ 1/ 7 &&' t1Y76fZ Permit Number: /&0 7/,/ ❑ No one available for inspection: Time /. , z;5' AM/ 'M I r Re- Inspection required: Yes When corrections have been made, call for � re - Inspection at 303 Date: V ,a Inspector: DO NOT REMOVE THIS NOTICE ♦ ► < I CITY OF WHEAT RIDGE fj Building Inspection Division (303) 234-5933 Inspection line 40111111111111111 (303) 235-2855 office • (303) 237-8929 Fax INSPECTION NOTICE , Inspection Type: r"',// Job Address: //99 7 (L) /-~4/& o~~P Permit Number- 0 No one available for inspection: Time AM M Re-inspection required: Yes No "When corrections have been made, calf for re-inspection at 303-234-5933 11{ Date: 3 cc~ I Inspector: L h 1% I DO NOT REMOVE THIS NOTICE Ale City of 'Wheat. Ridop. I PERMIT NO: 6 16 ;ISSUED:. 03/19/ 7 W 44TH.: AVE EXPIRES: 09/15/.: of `19 sqs UH: EE :)n I ~~OF WHEgT~iO City of Wheat Ridge Building Division Date: m 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Plan cO~ORA00 Inspection Line: 303-234-5933 Permit Building Permit Application Property Addl `ess: 2 /7 C n z_ Property Owner (please print): S J56~ w,V" S Phone: 3d Lh7 7 yb v Mailing Address: (if different than property address) Address: 5~9,4z_ City, State, Zip: Contractor: 4~a0„~ Contractor License Phone: 3d3 ~32 25'3 Sub Contractors: Electrical City License Plumbing City License Mechanical City License Company: Company Company: Exp. Date: Exp. Date: Exp. Date: Approval: Approval: Approval: Use of space (description):Construction Value: $ Description of -work. (as calculated per the Building Valuation Data sheet) Plan Review (due at time of submittal): $ Sq. Ft./L.Ft added: Squares IL BTU's Gallons Amps OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and allegations made are accurate; that I. have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work under this permit. Plans subject to field inspection. - CIRLCE ONE:: (OWNER) t( O TRACT ) or PERSONAL REI PRINTNAME: C5(euz Y. 4ca_., SIGNATURE: (CONTRATOR) i Date: Bldg Valuation: =1 L w ta Wpz <it p~A~ ~ a ° c o° m 0 00 ~A,~G77 ` 3 . `1 i f ~ C 1 Lei ; t ~ i ;1 i q z - 4 X-0 i q Q vts= O N W fi a m m` P ~ K ~ t a C 'Y ~ to ~ ff 3 P o - ~ s r ' S p j} t~ F to m r m 07 mac, ~a t t X n A rn 0 0 d m S+3 n 0 O G O O N I a CJ 0 1 . Tt ~ tr7 C2 I 4 I 1 a c ~ z C CC) u C: m' m m r~j 0 w o a 6 'Q 5 a a v ~@ m N q 3 Ch m a o y m _ oyq o m y c ~ ~ atn - q . 0 m 4 0 ID Q ~F 42 *k W m. O Q 1 CT C A £1 ~ - C a `E t& 5 00 0 to OM ~ A y ~ A e ^GJJ a C+ }a ~ o 4 m as o X CL CL 3 0 t" X# a a a ~ Q ~m 3 ra' m: A x cry 3 nr0~ o co ~F 0 i") w +D -~*~y PR a 3 0.y r.J ^G. Q a c a II ~ W K W Q m ~ y0y Cj :a V O m O W m t' O a eri tD rn f.O (D 09 = N 357 Q rz i ~ s5,C 0. 0 r"n tx .0 cL m ~ m DEPARTPAENT OF COMMUNITY DEVELOPMENT 7500 WES7 29tn AvENUE BUILDING INSPECTION DIVISION PERMIT N0. M92//18055 237-6944 ExT. 255 P.O. eox sae CiTY OF WHEAT RIDGE, COLO. THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDINGINSPECTOR ANO RECEIPTED BEL'JW. APPLICATION FOR MISCELLANEOUS~ERMI ~ LL ~~s. JOB ADDRESS OWNER ~ CONTRACTOR y~ DG(~~YL~ ADDRESS~ ~ 7 9 ~ ~ ~ ~L ` ADDRESS ~ 2 / / PHONE y q / L p ZIPCODE.~Ld'1~ CITY ZIP CODE CONTRACT PRICE Od PHONE LICENSE NO. 1. TVPE GroundLJ WoIILJ ProieotinQlJ Oiher SorOFaes 2. MATERIAL Totol Square Fest _ SIGN$ 3. ILLUMINATION Yaa❑ No❑ Type Eleef. Permit No. 4 SET BACK FROM PROPERTY LINE N_ S_ E _ W Zons_ Apprwed, 2one Inspaetor (Speeify which is fronf ) ❑ ❑ ❑ ❑ DiaopDrp'ed 1. TYPE Solid❑ Mors TAOn 80% ODani5z Lsge Thon 80% Open FENCES ? ' MATERIAL ~~61N ~l~~~ Hai } ` 3. SET BACK FROM PROPERTY LINE N 30 0 S OU E C:' WVO Zon Approved,Zons Intpeeta (SOeeify whith is front) ❑ 10 ❑ ❑ Disapprovsd OTHER a. DRAW SKETCH OR SHOW BELOW,?HE FENCE, SIGN, OR OTHER STRUCTURE,GIViNG DISTANCES FROM PROPERTY LINES. (SETBACKS OR PROJECTIONS INCI.UDED) S/DC~ A, Z C ~ _ 300' O V r SPEqFY NORTH FIOU~jI ~UiLD T, . C~ J'f p~ STREET NAME SHOW DISTANCES FROM THE MAIN BUIIDING TUADJOINING HOUSES, STREETS, AND PROPERTY LINES; ON IRREGUTAR LOTS. SHOW LEAST DISTANCE TO PROPERTY LINES, NOT MA%IMUM OR AVERAGE DISTANCE. /l/ ' APPLICATION FOR PLUMBMG; ELECTRICAL; MECHANICAL PERMIT THIS APPLICATION WILL BECOME A PERMIT TO PERFORM THE INDICATED WORN ONLY UPON VALIDATION BY THE BUILDING INSPECTION DIVISION. PERMIT WILI EXPIRE 60 DAYS FROM DATE OF ISSUANCE !F WORK IS NOT STARTED WITHW THAT TIfAE ELECTRICAL PERMIT STATE LICENSE N0. ALUMINUM WIRE UNDER SIZE B ILLEGAL PIUMBING PERMIT STATE LICENSE N0. FLOOR BSM I ST 2ND 3RD 4TH MECHANICAL PERMIT N0. FUEU•C'rccleQ» Gap ol Propone Cool Elx Solar ryp, WATER CLASET FORCED AIR - BTU TEMPORARY METER WASH BOWI HOT WATER -BTU NEW SERVICE AMPS BATH TUB STEAM - BTU CHANGE SERVICE-AMPS SHOWER AIR CONDITIONINCa-BTU LIGHTIN6 SINK OTHER HEATING GARBAGE DISP. REFRIGERATION SYSTEM POWER SUB-CIFCUITS UTILITY (RANGE, DISPOSER, ETC.) FIXTURES WATER HEATER AUTO. WASHER DISH WASHER Refri erant Grou Poundf CAOr s AUTOMATIC SPRINKLER SYSTEM WIRING MOTOFtS B CONTROLS FLOOR DRAIN ELEVATOR SIGNS URINAL TRANSFORMERS 9 RECTFIERS SEWERS ADDITION TO OLD WORK OTHER MOTORS OVER 1 HP TOTAL FIXTURES I hereby acknowledqe ihot thia applico- fion is correct and undersfond that I tonnof afort this projecf until this appli- eation is approved. I sholl comply wifh fhe lawe of the Stofe of Colorodo and to ths Zoninq Repulations and Buildinp Code of the Cify of Wheat Ridqe. Any violation of the above tarme will eause imme i e revocotion of this permit. eenls 9ianalan PERMIT FEE > - '~_v USE TAX TOTAL FEE s CHIEF BUILDING~(~SPECTOR,City of Wheat Ridqe Z Date Issued - g C(?6 RECEIPTED CALL 237-8944 EXT. 255 24 HOURS IN ADVANCE FOR INSPECTIONS DEPARTMENT OF GOMMUNITY DEVELOPMENT 7500 WEST 29tn AveNUE BUILDING INSPECTION DIVISION PERMIT N0. M91#17721 237-6944 EXT. 255 P.O. BOX 638 CITY OF WNEAT RIDGE, COLO. THIS PERMIT VALID ONI.Y WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND RECEIPTED BELOW. JOB ADDRESS ~/-pn / 4 W 1 CONTRACTOR d w~~~~ ADDRESS 54 /7) GG CITY ONE ZIP CODE _ LICENSE NO. 1. TYPE Ground❑ Ofher S or D Faes 12. MATERIAL Total Squara Faaf SIGN$ 3. ILLUMINATION Yas❑ No❑ Type Elae}. Psrmif No.. 4. SET BACK FROM PROPERTY LINE N_ S_ E_ W Zone_ Apprwsd,ZOnelnspector (Specily whichiefront) ❑ ❑ ❑ ❑ DieaDDroved 1. TYPE Solido More Thon BO% OpenO Lese Than 80% Open FENCES MATERIAL Heipht 3. SET BACK FROM PROPERTY LINE N_ S_ E_ W Zona_ Apprwed,lons InsOeetor (Specify whiah is }ront) ❑ ❑ ❑ ❑ DieapDroved 1. "`7 OTHER Z ~ 3O L L~ -LL a. DRAW SKETCH OR SHOW BEIOW,THE FENCE,SIGN,OR OTHER STRUCTURE,GIWNu DISTANCES FROM PROPERTY LINES. (SETBACKS OR PROJECTIONS INCLUDED) ~ SPECIFY NORTH STREET NAME SHOW DISTANCES FROM THE MAIN BUILDIN6 T6ADJOINING HOUSES,STREETS, AND PROPERTYLINES{ON IRREGULAR lATS,SHOW LEAST DISTANCE TO PROPERTY LINES, NOT MAXIMUM OR AVERAGE DISTANCE. APPLICATION FOR PLUMBING; ELECTRICAL; MECHANICAL PERMIT THISAPPLICATION WILL BECOME A PERMITTO PERFORM THE INDICATED WOAK ONLY UPON VALIDATION BYTHE BUILDING INSPECTION DIVISION.. PERMIT WILL EXPIRE 180 DAYS FROM THE DATE OF ISSUANCE IF WOHK IS NOT STARTED WITHIN THAT TIME. ELECTRICAL PERMIT STATE LICENSE N0. PLUMBING PERMIT STATE LICENSE N0. MECHANICAL PERMIT ALUMINUM WIRE UNDER SIZE 8 ILLEGAL FLOOR BSM IST 2ND 3RD 4TH N0. FUEUCircbOne Gog dl Vropone Cod Elx Solar ryp, WATER CIASET FORCEO AIR - BTU TEMPORARY METER WASH BOWL HOT WATER - BTU NEW SERVICE AMPS BATH TUB STEAM - BTU CHANGE SERVICE-AMPS SHOWER AIR CONDITIONING-BN LIGHTING SINK OTMER HEATING GARBAGE DISF REFRIGERATION SYSTEM POWER SUB-CIFCUITS WATER HEATER Refri eront Grovp UTIUTY(RANGE,DISPOSER,ETC.) AUTO.WASHER Poundt Chor s FI%TURES DISH WASHER AUTOMATIC SPRINKIER SYSTEM WIRING MOTOF2S d CONTROLS FIDOR DRAIN ELEVATOR SIGNS URINAL TRANSFORMERS 9 RECTFIERS SEWERS ADDITION TO OLD WORK OTHER MOTORS OVER I HP TOTAL FI%TURES I hereby ocknowledQe that this applica- tion ia correct ond understand ihot I connot atart tAie project until this oDPli- eafion ie approved. I sholl comply with }hs laws of Ihe State o} Colorado and to }hs ZoninQ Requlalions ond 8uildin4 Code of the City of Wheat Ridqe. Any violation of the above terme will cause immldiate revoCation of this permit ~ 40 eanta 9i0nalun PERMIT FEE 3 _ 6-0 USE TAX TOTAL FEE $ 3 3. ae~ CHIEF BUILDI O INSPECTOR,City of Ulyheat Ridqe Date Issued OWNER 'L~14/ ~ v vvi i i :1 ~ ADDRESS ~ ~ti v LI T ~ V ~ vL PHONE L~ Z _ZIPCODE CONTRACT PRICE $ O~ olo C:> DATE Np7 VA~LI2 UNLESS RECEIPTED cSS~~ d CALL 237-8944 EXT. 255 24 HOURS IN ADVANCE FORINSPECTIONS