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ENT Em•ironmental Consulting 7830 West Alameda Avenue Suite 103 - 216 Lakewood, Colorado 80226 CDPHE Registration #: ACF 22068 myteam@advent-enviro.com 720.675.7175 Final Air Clearance Report 12535 West 31 st Avenue Wheat Ridae, CO 80215 Report Date: May 22, 2019 Prepared for: Geoff Miller New Customer 12535 West 31 st Avenue Wheat Ridge, CO 80215 303.656.9175 geoffdmiller@gmail.com Job ID: 200519-DB1 Advent Environmental Consulting 7830 West Alameda Avenue Suite 103 - 216 VENT Lakewood, Colorado 80226 720.675.7175 E„-1111121,,al c0115„1,1,,Q myteam@advent-enviro.com Purpose The purpose of the Final Air Clearance (FAC) was to determine if the asbestos abatement was successful and the air quality of the contained, asbestos abatement area, located at the site address described in this report, is at a level which is safe to re -occupy. The FAC was conducted in accordance to federal regulatory procedures, outlined in the 40 C.F.R. Part 763, Appendix A to Subpart E promulgated by the Environmental Protection Agency (EPA) and asbestos Regulation No. 8, Part B - Asbestos (Reg. 8) promulgated by the Colorado Department of Public Health and Environment (CDPHE), by CDPHE certified Air Monitor Specialist trained by an EPA accredited training organization. 40 C.F.R Part 763, Appendix A to Subpart E and Reg. 8 have defined the Maximum Allowable Asbestos Level (MARL) to be equal to, or less than, 0.01 fibers/cubic centimeter of air. The FAC was conducted in accordance to those regulations to determine if the MAAL was achieved through successful abatement activities and that the air quality is at a safe level to remove the containment and re -occupy the work area. Procedure A visual inspection of the contained area was conducted to verify the absence of asbestos containing materials (ACM) in accordance to Reg. 8. Upon completion of the visual inspection, fans and leaf blowers were utilized to agitate the air, dislodge and make airborne any settled fibers (creating worse case air conditions) to be collected in air samples. Air samples were collected using high volume pumps to draw air through a 25mm diameter, mixed cellulose ester, 0.08 micron pore size (25mm, 0.8 pm MCE) filter, housed in a three piece cassette with a 50mm, electrically conductive cowl. The pumps were ran for a specific amount of time and calibrated before and after air sampling to collect a minimum volume of 490 Liters of air/sample. Flow rates, sampling periods and air volume were recorded in this report. Samples were then transported, with a chain of custody, to an American Industrial Hygiene Association (AIHA) member laboratory accredited by the National Voluntary Laboratory Accreditation Program (NVLAP). Samples were analyzed using the National Institute for Occupational Safety and Health (NIOSH) 7400 analytical method using Phase Contrast Microscopy (PCM) to determine the concentration of fibers in the air of the sampled area. This method is not specific to asbestos, rather it is used to count ALL fibers present in the work area, including asbestos fibers. List of Acronyms FAC - Final Air Clearance ACM - Asbestos Containing Material MAAL - Maximum Allowable Asbestos Level N - North S - South LPM - liters per minute CLR - Clearance (sample type) AMB - Ambient [Air] (sample type) BLK - Blank (sample type) PEL - Permissible Exposure Level EL - Excursion Level NAM - Negative Air Machine CDPHE - Colorado Department of Public E - East SF - Square feet W - West LF - Linear feet Health & Environment EPA - Environmental Protection Agency E T N (f) � � 0 _0 _� .E Q CO 0 0 Z v N U") 0 0 o o v O N m �LL 00 5 C N � O E Q O cfl N Y o -0a fA a+ cm v E °o O N Z a U) U) a. 0 a .Q o N N a O rO � N J v Co Q O O M W N m Q 00 U N O r U -o E 0' v (n Cl) 0 O = Z LO U) aj LO oo > E CL a) a, o z ayi � 0 0 0 0 L.0 O o E Z d Cl) a) v E LO L N N r = J C c Q Q O r O_ U � O O T N LU Z z LU N 1.1 W T O a O a N t >, — ` 'D N C a+ d 0 Q O M Q O M O (..cc '2 O wo Z m U m V O J m m T D } ���illlf z z T a c? r c Q LL- L ci T N (f) � � o _0 _� .E Q CO 0 0 Z v N U") 0 0 0CO o v O N m �LL z C C N � O E Q O cfl v Y o -0a fA a+ cm v E °o O N Z a U) U) a. 0 a .Q N O a O QJ N @ � N J 0 T Co Q CU M Q Q M O m rl rl 7 ai Fn c O C N E c (0 C O U 0 a`) .n E z M O .c a) .E a) N Q- E E O L X W E O cu U O J c a� E m c O U U) W O Z LL co C O 0 Q N O 70- C: C O 70 70 m O Z m O O x N O 70 C m O C O U � U N c Co m U m _0 E co C � C: C O. _ E c L o o O .c L c � .E .� m E E .0 � 0) U ■ a e J N E Q D L U LL Q Z ¢ Z Q Z a z (f) co U _0 N L Q Co 0 0 _0 _� .E Q CO 0 0 L 0) E ca N U Q Co c O o C%j O > O C O mo m Q�o W Q Om > fII N 2i - O C O O @ Ln m �LL z Z 00 rn cfl co Y E ca U)U fA a+ cm O U m C O N Z a U) U) a. 0 a .Q N O m m E a? E (D O (n cl L a 0 T Co Q CU M Q 0 T ai Fn c O C N E c (0 C O U 0 a`) .n E z M O .c a) .E a) N Q- E E O L X W E O cu U O J c a� E m c O U U) W O Z LL co C O 0 Q N O 70- C: C O 70 70 m O Z m O O x N O 70 C m O C O U � U N c Co m U m _0 E co C � C: C O. _ E c L o o O .c L c � .E .� m E E .0 � 0) U ■ a e J N E Q D L U LL Q Z ¢ Z Q Z a z N 'F Q co o o _0 _N .c Q r- 0 0 _0 �_ .E Q 00 0 0 _0 N L Q Co 0 0 _0 _� .E Q CO 0 0 L 0) Q Q Ln u� Ln m �LL z Z 00 rn cfl co � Q Q O O O O O m z z o 0 T 0 T 0 0 T M N E Q Q 0 0 0 0 0 Z Z LO U) LO LO LD ayi Q 0 0 0 0 o O c Z Z d d _E F- C c Q Q O r O O T O O T N LU Z z 1.1 T r a E d Q Q O M O M O M O (..cc O M Z m Z m m T r m m T M EwQ4����� E' ���illlf z z T T T r c O Y 12 c Q Q I Q W z Z T r r r U d EE Q Q rt d !/3 Z Z r O E T J J J J J J J m~ m m U U U U U co C m N LD E 2 (LO O Y m C 0 m a c MCJ C� o J E J L LL -tf -E L 5 .2 N O Z z U O Q Ln LO E J cM UCL—Moj Cl) — !Li lli L() LL NTr E Q 7 C a) a c D (D m fl CO CD m U) m (�6 0 L VENT Hncironmencal Consulting Component Checklist & Notes Advent Environmental Consulting 7830 West Alameda Avenue Suite 103 - 216 Lakewood, Colorado 80226 (checked boxes indicate use of defined containment) component. Unchecked indicates absence of component [ZI Permitted Job ❑ Non -permitted Job ❑ Opt -out Containment Type 0 Full containment present ❑ Secondary containment present ❑ Glove bag containment(s) Decontamination Unit lZ Full decontamination unit present ❑ Partial decontamination unit present ❑ Single chamber used as entry/egress I] Clean room lI Shower Q Hot & cold water 0 Waste water filtered I] Equipment room Waste Load -Out I] Full waste load -out present 0 2 chambers ❑ Single entry/egress chamber used as waste load -out Misc. Containment Components I] Asbestos warning signs used lI Critical barriers in place 0 Containment sealed at seems and unbreached I] Negative air machine(s) in use Quantity: 1 0 Manometer in use 0 Adequate pressure differential ❑ No Manometer in use 2 View port present ❑ No view port present Additional Notes: 720.675.7175 myteam@advent-enviro.com Photos of Site Observations Containment clean and free of Dumpster components clean visible ACM debris and free of texture overspray � Y Critical barriers intact and unbreached Decontamination unit No picture provided No picture provided VENT Environmental Consulting Advent Environmental Consulting 7830 West Alameda Avenue Suite 103 - 216 Lakewood, Colorado 80226 Conclusion & Recommendations 720.675.7175 myteam@advent-enviro.com The above detailed project has met the asbestos abatement requirements defined in asbestos regulations 40 CFR Part 61 - Asbestos, established by the Environmental Protection Agency, and Regulation No. 8 Part B - Asbestos, established by the Colorado Department of Public Health and Environment, and it is the opinion of the undersigned, certified Air Monitor Specialist that the air quality inside the reported containment(s) is at a level which is safe for the removal of the containment and continued occupancy. Comments & Limitations The possibility of fibers being present on unused, unopened new sampling cassettes does exist. To accommodate for this possibility, unopened cassettes (identified as LAB sample) are included with the set of project samples, along with a sampling cassette which was opened for a short period to partially account for ambient field conditions (identified as FIELD sample). These two sampling cassettes are shipped with the project samples and are analyzed for fiber concentration ONLY when any of the project samples exceeds MARL. This process is used to account for the possibility of existing fibers on unopened cassettes, prior to being used at the project site, and ambient site conditions which may increase fiber concentration results from the project samples. The resulting fiber density of these two samples are averaged and deducted from fiber density from all other samples analyzed, when calculating fiber concentrations, to ensure accurate, project specific results. This report has been prepared on behalf of and exclusively for use by the client for specific application to the project as discussed. Advent Environmental Consulting is diligent about verifying the validity of information received through documents, permits issued, reports and other documentation related and relevant to the project; however, relies on information gathered and provided by the client and contractors involved and cannot be held liable for fallacious or inaccurate information used to conduct services. Contractors or consultants reviewing this report must draw their own conclusions regarding further, subsequent work 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, Certified Air Monitor Specialist #18325 Advent Environmental Consulting, LLC 7830 West Alameda Avenue Suite 103 - 216 Lakewood, Colorado 80226 drue@advent-enviro.com 720.675.7175 i CITY 01F WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: LA v ,r Job Address: LO T 8U Permit Number: k ❑ No one available for inspection: TMe � MAIM Re -Inspection required: Yes When corrections have been made,, caM,for re -in ert' 03 234-5933,, Dat —T InspectoI DO NOT REMOVE THIS NOTICE e A i CITY OF WHEAT RIDGE _:�9rBuilding Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office - (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: i-) C� a Job Address: _ u >� ��� \. A Permit Number: ( t e ; Ca t 0--\ (-� ❑ No one available for inspection: Time I I 10 AM/PM Re -Inspection required: Yes (I *When corrections have been made, call for re -inspection at 303-234-5933 Date:—(,) �;)- ,,cInspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: - f-¢- Job Address: (� S Permit Number: <0 I ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes When corrections have been made, call or/ mspec -2 4-5933 Date) Inspect6r: DO NOT REMOVE THIS NOTICE i .,CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type:9 1 Job Address: d Permit Number: ❑ No one available for inspection: Tim KW -PM Re -Inspection required 1_ 'Ies No When corrections have been madel for re -inspection at 303-234-5933 Date —2 — InspectorX. DO NOT RE-'MDt/E THIS NOTICE e i CITY OF WHEAT RIDGE _1�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office - (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: Cs \r -i t1 10`-s C, i J a, ❑ No one available for inspection: Time ` AM/PM Re -Inspection required: Yes Flo When corrections have been made, call for re -inspection at 303-234-5933 Date:, ) \ • 4 `-, Inspector: DO NOT REMOVE THIS NOTICE 41 CITY OF WHEAT RIDGE V, Building Inspection Division (303) 234-5933 Inspection fine '(303) 235-2855 Office # (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: J No one available for inspection: Time - AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303 -234 - Date: _6___h 19 Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: ` Job Address: Permit Number: '1 {' ' 4M one available for inspection: Time ,_,°{>> s �� AM/PM `XRe-inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: \. Inspector: DO NOT REMOVE THIS NOTICE 3 i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line r (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: L) C1 �r No one available for inspection: Time g> AM/PM £ARe-inspection required: Yes No When corrections have been made, call for re -inspection at 303 -234 - Date: ' � \ Inspector: �'. DO NOT REMOVE THIS NOTICE fiy i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: , -) i � Job Address: Permit Number: a ❑ No one available for inspection: Time l L) AM/PM Re -Inspection required: Yes Flo-, When corrections have been made, call for re -inspection at 303-234-5933 Date:—' ' Inspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge Homeowner Interior Remodel PERMIT - 201901049 PERMIT NO: 201901049 ISSUED: 06/03/2019 JOB ADDRESS: 12535 W 31st Ave EXPIRES: 06/02/2020 JOB DESCRIPTION: SWO Homeowner bathroom remodel removing all tile, bath tub, vanity and fixtures, and adding all new. Adding electrical circuits and tub heater with pump. Replacing hot water heater, 40k and 50 gallons. Square feet: 80 *** CONTACTS *** OWNER (303)656-9175 MILLER GEOFF *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 9,698.00 FEES Total Valuation 0.00 Plan Review Fee 132.80 Use Tax 203.66 Permit Fee 204.30 Investigative Fees 204.30 ** TOTAL ** 745.06 *** COMMENTS *** *** CONDITIONS *** I, the property owner, by my signature, attest that I currently reside at the project property, intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers. If professionals are hired, those contractors are licensed with the City of Wheat Ridge and are listed on the permit. Consultations and inspections will only be performed with the homeowner of record present. All roughs to be done at Framing Inspection. Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections. PERMIT NO: JOB ADDRESS: JOB DESCRIPTION: City of Wheat Ridge Homeowner Interior Remodel PERMIT - 201901049 201901049 12535 W 31st Ave SWO Homeowner bathroom remodel fixtures, and adding all new. with pump. Replacing hot water Square feet: 80 ISSUED: 06/03/2019 EXPIRES: 06/02/2020 removing all tile, bath tub, vanity and Adding electrical circuits and tub heater heater, 40k and 50 gallons. 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 authonzed by the legal owner of the property and am authorized to obtain this pennit and perfonn the work described and approved in conjunction with this ennit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be per ed and that all work to be p rformed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date I . This permit was issued based on the information provided in thepermit 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 originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or grant' of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any appl�le code or anjfrdinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chfef Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of W heat f e CONiMIINITY D[VI I0VMI N I Building & Inspection Services 7500 W. 291 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits .ci.wheatridge.co.us FOR OFFICE USE ONLY Date: 5723// ? Plan/Permit # bbl 9010V� 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: 12535 W 31 st Ave. Wheat Ridge, CO 80215 Property Owner (please print): Geoff Miller Phone: 303-656-9175 Property Owner Email: geoffdmiller(dgmail.com Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address Zi Arch itect/Engineer: Property Owner Arch itect/Eng1neer E-mail: Contractor Name: City of Wheat Ridge License #: Contractor E-mail Address: For Plan Review Questions & Comments (please print): Phone: Phone: CONTACT NAME (please print): Geoff Miller Phone: 303-656-9175 CONTACT EMAIL(please print): geoffdmiller@gmail.com Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # �►iA� City of -A Wheat id e COMMUNITY DEVELOPMENT g Official Certification of Property Owner Permit THIS IS TO CERTIFY that I, the property owner, by my signature, attest that I currently reside at the project property, or intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers, or, if hiring sub -contractors, list them on the permit. Consultations and inspections will only be performed with the homeowner of record present at the project property. Property Owner(s): Geoff Miller Project Property: 12535 W 31st Ave. Wheat Ridge, CO 80215 N61arized signature of Applicant State of Colorado } County of CNye)2 } ss The foregoing instrument was acknowledged by me this ;2 day of i"` �i , 20 1� by Geoff � ;�'A\ems XAVIER I RIVERA NOTARY PUBLIC - STATE OF COLORADO NOTARY ID 20134073212 MY COMMISSION EXPIRES DEC 18, 2022 My Commission Expires I w / l g /20,�z Not Pu is LL. O Ow LL z Z tJ OW Hil� Um J J a. J a� a� E" O U W -j CL IL IL �¢ LU Z J O� a° UL c Z Q OZ = W~ W Q i— < 0 —ao m a� U¢ H to 2 W W LL 1.0 4�0 � A OD LIJca o � u o kr. N 0 i Qc 4)n S u N _ U sl 00 Off" YJ U �1 G 1- •� Fn 0 IV %A Q N } v � I 1 i-' - 7 "" z > O N N� a o 0 ` '20 tm N o LU _ C4 2 - �D a) u o E z U ° Q - z Q 7 -, m a �O i>: 3 0 3= > m c a E E O U io U Fm- j U (U a LL a a s � d tt' O f a 00 6 O S 0 Cas k .9 > U : t l L Q o 0 m aL to c 3 7 L. _o C>L a4 1 Z 0) oV). o e3 �� >a 0 0 s m Of] w C to U [D to (o U W v uN N c� N w H v, vrCD c C O O .b •1 0 N( LLL a '� o " o L)6U o s a m <[ < E • '� E cc cl �" n. d) y 5 C a o z m z s ► a ECk m v ,2 m_ c w — > C m�: J 24k U 4t ii ai'f o ro o s QLOu c tCL m c v c c t a E 0 E , CL N m (L o a a C) a. vi t D-n cv in v � v.. � u � �ww11 0 i S u N _ sl 00 Off" YJ C) G 1- •� Fn %A 3 � I 1 i-' - 7 "" z � u p O i N _ C`m � Off" YJ Fn %A � I 1 NORTH MILLER - BATHROOM REMODEL 12535 W 31ST AVE. WHEAT RIDE, EO 80215 FLOOR PLAN ige R vie f Code Compliance Plan n Ia�miner IDate [ c Valid :[p;s++h�icq�proycti�lll�4�hl��VNC1� ondcomputahons shall not be o permit for, or on opproval of, orry vrolobon to any of the Provisions of the building code or of any City ardrrronces. permits presuaung to give authority to violate or cancel the prowslons of the WlJal9ip codes or odW ordinonces of the City shall not be valid AU, cA)04fe _r13 GOMR�y GA) fT� Zm I z r 2C_ /,?0[—) NIe—(— NORTH MILLER - BATHROOM REMODEL 12535 W 31ST AVE WHEAT RIDGE, CO 80215 DEMO: DEMO: VANITY LIGHT VANITY/CABINET FIXTURE DEMO: TILE WAINSCOTING BASEBOARD TRIM AS NEEDED AROUND PERIMETER DEMO PLAN ALL DIMENSIONS IN IVHNES°*,, R/a9e NORTH NEW: AMERIl=AN - TANDARC1 MOClEL# 1 c14,500.0) 0 OVERFLOW GRAIN PF15 TER SIN,-ILE C=ONTROL PRESSURE BALANI IN6 VALVE BODY NEW: TILE SURROUND /W NICHE NEW. AMERICAN STANDARD MODEL# 2425E -RHO WHIRLPOOL EZHEAT-100 HEAT / NEW: � I� (1) 120V 15A GFCI � (1) 120V 20A GFCI MILER - BATHROOM REMOOEE 12535 W 31ST AVE WHEAT RIOCE, CO 80215 NEW: TOILET LOC MOVED 2" PUMPHEATER \ NEW: PLUMBING AND DRAIN TO PROPOECl ACCOMODATE DUAL SINK NORTH VENT STACK i MILLER - BATHROOM REMODEL 12535 W 31ST AVE WHEAT RIDGE, CO 80215 ALL DIMENSIONS ORIGINAL 15A GFCI N�Cy4E r= V D May 13,2099 Geoff Miller 12535 W 31 st Ave Wheat Ridge, CO 80215 Geoffdmiller@gmail.com 303.656.9175 Dear Geoff Miller, VENT Environmental Consulting 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, c 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 ENT Environmental Consulting 090519-DT2 ASBESTOS INSPECTION REPORT 12535 W 31 st Ave Wheat Ridge, CO 80215 Yi Prepared for: Geoff Miller 12535 W 31 st Ave Wheat Ridge, CO 80215 Geoffdmiller@gmail.com 303.656.9175 Year Built 1961 Type of Property Residential - SFRD - House Type of Inspection NON-DESTRUCTIVE INVESTIGATION Reason for Inspection General survey Regulations Satisfied 40 CFR 61 Subpart M Reg No. 8 Part B Prepared By: Advent Environmental Consulting LLC 7830 West Alameda Avenue Suite 103 - 216 Lakewood, CO 80226 1 720.675.7175 CDPHE Asbestos Consulting Firm # 22068 myteam@advent-enviro.com 720.675.7175 myteam@advent-enviro.com www.advent-enviro.com TABLE OF CONTENTS Section 1 - Project Snapshot ADVENT ENVIRONMENTAL CONSULTING 7830 West Alameda Avenue Suite 103 - 216 Lakewood, Colorado 80226 1.1 Project Site Summary 1.2 Sampled Materials Summary 1.2.a Asbestos Hazard & Damage/Potential Damage Indicator Section 2 - Inspection Photos & Sample Locations 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 LIST OF ACRONYMS Material Result ACM Asbestos Containing Materials Material Condition G Good D Damaged SD Significantly Damaged Material Type Limited Asbestos Inspection 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 NFI Non -Friable Category I Sample Locations N North S South E East W West Other Acronvms LAI Limited Asbestos Inspection PPE Personal Protective Equipment SFRD Single -Family Residential Dwelling TAT Turnaround Time VENT ra m iiLJ C,,i 1tmg 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 g. J M C) t.0 Z�� N O 0 00 O O Z) - w > U Z O ori 0 jo z Q v W Y � J Z w > O 0 00 r - E 0 U o E U N O m 4-0 L o -o ir co U) U LL o o V , .� -(0o m co � m o Z to N _ O a M CV CV x� m a C Q O 00 N CV c) o 00 00 C3 T L T L Of 3 O vtm O C N CU _cm _ = J _ m O '.:. fo co co 0 0 0 U 2 (n- U a CL U) O O F— LL LL N 76 Z O L C ca Co N N C i O i O C m > LL ((n Eo Eo o o o,. Na LL a) L —CL O J co m co m co m fo C fo M N E d c.i C OU a o p CL { N Eco,, o E U) ��'+ Li -o = o * (D 0 o C o O O < O LL @ E o .co .- 0 a m -C m CL a > " E Co L (U U Y ayi 0 — N Co � L 3 p -0 o o oD m +r O (V � x > U H F- m a� U) U) -> O O o -o -(0o m � m a o E o U O p O E C 0 m OCV F- O fo E o O O m N 76 Y co O 2:1 m m3 �_ co a) m —CL o O m '� Eco - 0 0 M N E c.i C OU 'v o p m N E C CoCD O o co (n cm E (6 C > o (m @ E o .co .- 0 a m -C m CL a > " E Co L (U U Y C (o 0 — N Co L 3 U -0 o N oD m +r O � w c � x > oCL c_ " o m a� (' W Qi 0) C O to � N Col N E C a E m d Nco O CD O f0 N U X 06 o o tCu E E `n m Co U) m N c mO N Ci = C C M d L m L N N F cno Oo C Co o 3 ''o^^ VJ(Q (n V/ f0 N (� Co Q _O U N L cn E a o c0cc > C s O >= N�° 3 r E o co Co 0 ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 www.advent-enviro.com VENT ,, nomnencal C--hing Section 2 - Inspection Photos & Sample Locations `N Please note: Any joint compound (Material Code JC) samples on this report, are typically part of a set of a finished, 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: SM1 Major Spill Description: Texture Location: Bathroom Walls SM1-1 Err= SM1-2 SM1-3 Class: F -SM Condition: SD Hazard: Moderate Cause of Damage: Material Code: JC1 Major Spill Description: Joint Compound for SM - Location: Bathroom Walls Class: F-MISC Condition: JC1-1 JC1-2 Demolition Bathroom S wall W corner middle 2% Chrysotile Bathroom S wall W corner middle 2% Chrysotile SD Hazard: Moderate Cause of Damage: Material Code: OT1 Major Spill Description: Wall Tile Location: Shower Surround Class: NF-MISC Condition: SD Hazard: Low OT1-1 OT1-2 Demolition Dumpster in driveway 2% Chrysotile Dumpster in driveway 2% Chrysotile Demolition D r M X M U) C: r CKY of Wheat is t Ige ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 VENT www.advent-enviro.com 6niun,ncmal Cousulimg Section 2 - Inspection Photos & Sample Locations (Continued) The overall asbestos content, for a material with multiple samples, is the highest result in the set. Material Code: OT2 None -Detected Description: White Floor Tile Location: Bathroom Floor OT2-1 I Dumpster in driveway OT2-21 Dumpster in driveway Class: NF-MISCCondition: SD Hazard: Low Cause of Damage: Demolition None -Detected None -Detected [n D 17- M x M rn C: r ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 VENT www.advent-enviro.com Section 3 - Summary & Recommendations ���.­ '.1C`.1`.' 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. If 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 fact, 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 trace, 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 RACMs 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 B - Asbestos requires major spill decontamination/cleanup be performed by a Certified Asbestos Abatement Contractor. Avoid entering or otherwise disturbing the contaminated area. Disable any air -circulating equipmen VS&OV systems, fans, windows, etc.) which could force contaminated air throughout the property. Please a Sectior� 3.2a for regulatory requirements for major spills. wl,,at RRid9e ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 VENT www.advent-enviro.com 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 times, 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. NO DELINEATION WAS COMPLETED ON THE INSIDE. THEREFORE, THE WHOLE HOUSE MUST BE CONSIDERED CONTAMINATED, UNTIL DELINEATION IS COMPLETED. NO VISIBLE DEBRIS WAS DISCOVERED ON THE EXTERIOR WALKWAY FROM THE HOUSE,BACK DOOR TO DUMPSTER; HOWEVER, THE DUMPSTER AND EXTENDING 5' TO THE NORTH, 10' TO THE SOUTH AND 5' TO THE WEST MUST BE DECONTAMINATED. INTERIOR DECONTAMINATION IS RECOMMENDED, BUT NOT MANDATED, IF THE HOMEOWNER DOES NOT REQUIRE IT. HOMEOWNER MUST SUBMIT IN WRITING WAIVER OF DECONTAMINATION TO THE AIR POLLUTION CONTROL DIVISION. 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. ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 VENT www.advent-enviro.com 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 (AHERA) 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 material(s) 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 & 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 quantities 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 & 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 werecolleded in inconspicuous, hidden places to avoid unsightly damage. The best possible measures were taken 10 .collect the minimal amount of materials necessary, to get accurate results, in the most inconspicuous places Opssib e; however, no guarantee is made that the conditions exist to prevent visible damage.,, 720.675.7175 myteam@advent-enviro.com www.advent-enviro.com ADVENT ENVIRONMENTAL CONSULTING 7830 West Alameda Avenue Suite 103 - 216 Lakewood, Colorado 80226 VENT k\1:_1 tomnencal Coasulcin¢ 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 properly 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 properly 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 agreement(s) 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, reverse engineer, translate or create derivative works from this report. The receiving party shall use this report only for the limited purpose described 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, Derek Beasley, CO Asbestos Building Inspector #25353 Advent Environmental Consulting CDPHE Business Registration #: ACF - 22068 7830 West Alameda Avenue Suite 103 - 216 Lakewood, Colorado 80226 myteam@advent-enviro.com ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 VENT v7na6v�at1�v��o.com Encirorunemal CouuliuK GLOSSARY Material Friability These categories were used to determine methods for assessing suspect materials based on their friability and ability to release harmful asbestos fibers— i.e. friable 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 -friable 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, breeching, 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: Surfacing materials ■ Minimum of 3 random samples for quantities under 1,000 ft2 ■ Minimum of 5 random samples for quantities >1,000 ft2 & <5,000 ft2 r,jNq,V0je3 ■ Minimum of 7 random samples for quantities >5,000 ft2 Thermal system insulation Minimum of 3 random samples for all TSIexcept patches <6 linear ft. or 6 ft2 3. Miscellaneous materials ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 www.advent-envo vinlmum of 1 sample APPENDIX A - Laboratory Report VENT —'--1 c"..1—g Enci g EMSL Analytical, Inc. 1010 Yuma Street Denver, CO 80204 Tel/Fax: (303) 740-5700 / (303) 741-1400 http://www.EMSL.com / denverlab@emsl.com EMSL Order: 221903704 Customer ID: AVTE25 Customer PO: 0 Project ID: Attention: Lab Info Phone: (720) 432-3153 Advent Environmental Consulting Fax: 7830 W. Alameda Ave Received Date: 05/09/2019 6:30 PM Unit 103-216 Analysis Date: 05/10/2019 - 05/11/2019 Lakewood, CO 80226 Collected Date: Project: 12535 W 31 st Ave Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized Light Microscopy Non -Asbestos Asbestos Sample Description Appearance % Fibrous % Non -Fibrous % Type SMI -1 -Texture White 15% Ca Carbonate 2% Chrysotile Non -Fibrous 83% Non-fibrous (Other) 221903704-0001 Homogeneous Inseparable paint / coating layer included in analysis HA: 1 SM1-1-Drywall Brown/White 10% Cellulose 65% Gypsum None Detected Fibrous <1% Glass 25% Non-fibrous (Other) 221903704-0001A Homogeneous HA: 1 SM1-2-Texture White 15% Ca Carbonate 2% Chrysotile Non -Fibrous 83% Non-fibrous (Other) 221903704-0002 Homogeneous Inseparable paint coating layer included in analysis HA: 1 SMI -2 -Drywall Brown/White 10% Cellulose 65% Gypsum None Detected Fibrous <1 % Glass 25% Non-fibrous (Other) 221903704-0002A Homogeneous HA: 1 SMI -3 -Texture 1 White 20% Ca Carbonate None Detected Non -Fibrous 80% Non-fibrous (Other) 221903704-0003 Homogeneous HA: 1 SM1-3-Texture 2 White/Beige 20% Ca Carbonate 2% Chrysotile Non -Fibrous 78% Non-fibrous (Other) 221903704-0003A Homogeneous Inseparable paint /coating layer included in analysis HA 1 SM1-3-Drywall Brown/White 15% Cellulose 70% Gypsum None Detected Fibrous 15% Non-fibrous (Other) 221903704-0003B Homogeneous HA: 1 JC1-1-Texture White 15% Ca Carbonate 2% Chrysotile Non -Fibrous 83% Non-fibrous (Other) 221903704-0004 Homogeneous Inseparable paint coating layer included in analysis HA: 2 JCI -1 -Tape White 98% Cellulose 2% Non-fibrous (Other) None Detected Fibrous 221903704-0004A Homogeneous HA: 2 JC1-1-Joint Compound White 15% Ca Carbonate 2% Chrysotile Non -Fibrous 83% Non-fibrous (Other) 221903704-00048 Homogeneous HA: 2 JCI -1 -Drywall Brown/White 10% Cellulose 65% Gypsum Non�teded Fibrous <1% Glass 25% Non-fibrous (Other) 221903704-00040Homogeneous W�.1e�t Ridge HA: 2 g�lldtnQ Initial report from: 05/11/2019 10:55:43 ASB—PLM-0008-0001 - 1.78 Printed: 5/11/2019 8:55 AM Page 1 of 3 EMSL Analytical, Inc. EMSL Order: 221903704 Customer ID: AVTE25 1010 Yuma Street Denver, CO 80204 Customer PO: 0 TeUFax: (303) 740-5700 / (303) 741-1400 Project ID: http://www.EMSL.com / denverlab@emsl.com Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized Light Microscopy Non-Asbestos Asbestos Sample Description Appearance % Fibrous % Non-Fibrous % Type JC1-1-Composite BrownlTan/White 25% Cellulose 60% Gypsum <1% Chrysotile Fibrous 15% Non-fibrous (Other) 221903704-0004D Homogeneous This is a composite result of tape, joint compound, and drywall HA: 2 JC1-2-Texture 1 White 20% Ca Carbonate None Detected Non-Fibrous 80% Non-fibrous (Other) 221903704-0005 Homogeneous HA: 2 JC1-2-Texture 2 White/Beige 15% Ca Carbonate 2% Chrysotile Non-Fibrous 83% Non-fibrous (Other) 221903704-00054 Heterogeneous Inseparable paint/ coating layer included in analysis HA: 2 JC1-2-Tape Tan 95% Cellulose 5% Non-fibrous (Other) None Detected Fibrous 221903704-00058 Homogeneous HA: 2 JC1-2-Joint Compound Beige 15% Ga Carbonate 2% Chrysotile Fibrous 83% Non-fibrous (Other) 221903704-0005c Homogeneous HA:2 JC1-2-Drywall Brown/White 15% Cellulose 70% Gypsum None Detected Fibrous 15% Non-fibrous (Other) 221903704-0005D Homogeneous HA: 2 JC1-2-Composite BrownfTan/White 25% Cellulose 60% Gypsum <1% Chrysotile Fibrous 15% Non-fibrous (Other) 221903704-0005E Homogeneous This is a composite result of tape, joint compound, and drywall HA: 2 OT1-1-Ceramic Tile White 100% Non-fibrous (Other) None Detected Non-Fibrous 221903704-0006 Homogeneous HA: 3 OT1-1-Grout White 20% Ca Carbonate None Detected Non-Fibrous 80% Non-fibrous (Other) 221903704-0006A Homogeneous HA: 3 OT1-1-Mastic White 20% Ca Carbonate None Detected Non-Fibrous 80% Non-fibrous (Other) 221903704-0006B Homogeneous HA: 3 OT1-1-Mud Beige 15% Ca Carbonate 2% Chrysotile Non-Fibrous 83% Non-fibrous (Other) 221903704-00060 Homogeneous HA: 3 OT1-2-Ceramic Tile White/Black 100% Non-fibrous (Other) None Detected Non-Fibrous 221903704-"7 Homogeneous HA: 3 OT1-2-Grout White 20% Ca Carbonate None Detected Non-Fibrous 80% Non-fibrous (Other) 221903704-0007A Homogeneous HA: 3 OT1-2-Mastic White 20% Ca Carbonate None Detected Non-Fibrous 80% Non-fibrous (Other) 221903704-000713 Homogeneous Initial report from: 05111/2019 10:55:43 ASB PLM 0008 0001 - 1.78 Printed: 5/11/2019 8:55 AM Page 2 of 3 EMSL Analytical, Inc. 1010 Yuma Street Denver, CO 80204 TeUFax: (303) 740-5700 / (303) 741-1400 http://www.EMSL.Com / denvedab@emsl.com EMSL Order: 221903704 Customer ID: AVTE25 Customer PO: 0 Project ID: Test Report: Asbestos Analysis of Bulk Materials via EPA 6001R-93/116 Method using Polarized Light Microscopy Non -Asbestos Asbestos Sample Description Appearance % Fibrous % Non -Fibrous % Type HA: 3 OT1-2-Mud Beige 15% Ca Carbonate 2% Chrysotile Fibrous 83% Non-fibrous (Other) 221903704-0007C Homogeneous Analyst(s) Ashley Boyd (9) Stuart Printz (21) Melanie Rech, Laboratory Director or Other Approved Signatory EMSL maintains liability limited to cost of analysis. The above analyses were performed in general compliance with Appendix E to Subpart E of 40 CFR (previously EPA 600/M4-82-020 "Interim Method"), but augmented with procedures outlined in the 1993 ("final") version of the method. This report relates only to the samples reported above, and may not be reproduced, except in full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations . Interpretation and use of test results are the responsibility of the client. All samples received in acceptable condition unless otherwise noted. This report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST or any agency of the federal government. EMSL recommends gravimetric reduction for all non -friable organically bound materials prior to analysis. Estimation of uncertainty is available on request. Samples analyzed by EMSL Analytical, Inc. Denver, CO NVLAP Lab Code 200828-0 `\n, �,,adtn9 DMso'- Initial report from: 05/11/2019 10:55:43 ASB -PLM -0008-0001 - 1.78 Printed: 5/11/2019 8:55 AM Page 3 of 3 HA: 3 OT2-1-Ceramic Tile White/Red 100% Non-fibrous (Other) None Detected Non -Fibrous 221903704-0008 Homogeneous HA: 4 OT2-1-Mastic Gray 15% Ca Carbonate None Detected Non -Fibrous 85% Non-fibrous (Other) 221903704-0008A Homogeneous HA:4 OT2-2-Ceramic Tile White/Red 100% Non-fibrous (Other) None Detected Non -Fibrous 221903704-0009 Homogeneous HA: 4 OT2-2-Mastic Gray 15% Ca Carbonate None Detected Non -Fibrous 85% Non-fibrous (Other) 221903704-0009A Homogeneous HA: 4 Analyst(s) Ashley Boyd (9) Stuart Printz (21) Melanie Rech, Laboratory Director or Other Approved Signatory EMSL maintains liability limited to cost of analysis. The above analyses were performed in general compliance with Appendix E to Subpart E of 40 CFR (previously EPA 600/M4-82-020 "Interim Method"), but augmented with procedures outlined in the 1993 ("final") version of the method. This report relates only to the samples reported above, and may not be reproduced, except in full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations . Interpretation and use of test results are the responsibility of the client. All samples received in acceptable condition unless otherwise noted. This report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST or any agency of the federal government. EMSL recommends gravimetric reduction for all non -friable organically bound materials prior to analysis. Estimation of uncertainty is available on request. Samples analyzed by EMSL Analytical, Inc. Denver, CO NVLAP Lab Code 200828-0 `\n, �,,adtn9 DMso'- Initial report from: 05/11/2019 10:55:43 ASB -PLM -0008-0001 - 1.78 Printed: 5/11/2019 8:55 AM Page 3 of 3 City of Wheat Ridge Residential Asbestos Abatement PERMIT - 201901124 PERMIT NO: 201901124 ISSUED: 05/31/2019 JOB ADDRESS: 12535 W 31st Ave EXPIRES: 05/30/2020 JOB DESCRIPTION: Residential asbestos decontamination of dumpster from contaminated .materials from the home. State permit number: 19JE3094A *** CONTACTS *** OWNER (303)656-9175 MILLER GEOFF SUB (720)883-3750 OSWALDO TR;VINO 190151 CAE ABATEMENT LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 3,500.00 FEES Total Valuation 0.00 Demolition Fee 50.00 ** TOTAL ** 50.00 *** COMMENTS *** *** CONDITIONS *** Work shall comply with 2012 IRC & 2017 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. I, byy m signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicle building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the 1 gal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this pe �t. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be perform and thaf all wort to be pertorme�-is�sclosed in this document and/or its' accompanying approved plans and suecifications. Signature of OWNER or CONTRACTOR (Circle one) Date I. This permit was'issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This pen -nit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6, The : ante orgranf x of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any ap is le cgde ora rdinance or regulation of this jurisdiction. Approval of work is subject to fyeld inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of W h6at �,id�e COMMUNITY DEVELOPM[.NT Building & Inspection Services 7500 W. 29' Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(a)ci.wheatridge.co.us I FOR OFFICE USE ONLY I Date: Plan/Permit # Pla Review Fee: Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: _1_Z S 3�� W 3l � A v -e--- Property Owner (please print): C� ec,-�C /Z'1. (1 r - Phone: Property Owner Email:��G✓~C+ i c Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: y City, State, Zip: Architect/Engineer E-mail: Phone: Contractor Name: (_ fit- F Agctta,'t-� City of Wheat Ridge License #: 190(:S I Phone: 7?6 Z' 6 3• 7 56 Contractor E-mail Address: C C- e-- a 6t t -lt- �f ` i (. Cc4-1-7 For Plan Review Questions & Comments (please print): CONTACT NAME (please print): �; a vS LC / Phone: 7Z0 - G7 5 LP 7S CONTACT EMAIL(p/ease print): Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. ❑COMMERCIAL 0 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. rr r r r S cj F 7 S CGYt ru rn ��/1Gt t~Un �} I— c3 c� {- S cc�-e vc h Ct s a Ffnov'.ecl b/ G t P P kc'v C Sq. Ft./LF BTUs Gallons Amps Squares / t-`� For Solar: KW # of Panels Requires Structural For Commercial Projects Only: Occupancy Type: Construction Type: Occupancy Load: Square Footage: Project Value: (Contract value or the cost of all materials and labor included in the entire project) S MAY674 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record: that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. 1, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CONTRACTO�(AUTD REPRESENTA VE) of (OWNER) (CONTRACTOR) Signature (first and last name): ✓ DATE: Printed Name: Y )d�Q_ SIS EGc.S Qy DEPARTMENT USE ONLY ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: Building Division Valuation: Colorado Department of Public Health and Environment Air Pollution Control Division — Indoor Environment Program — Asbestos/IAQ Unit 4300 Cherry Creek Drive South, APCD-IE-B1 Denver, Colorado 80246-1530 Phone: 303-692-3100 —Fax: 303-782-0278 E-mail: asbestos@state.co.us ASBESTOS ABATEMENT PERMIT This permit is granted subject to Colorado Air Quality Control Commission Regulation No. 8, Part B, adopted December 21, 2007, and effective January 30, 2008, the Colorado Air Pollution Prevention and Control Act (25-7-101 or 25-7-501 et seq., C.R.S.) and the following provisions. it is only for the purpose of allowing asbestos abatement. ADDITIONAL PERMIT PROVISIONS: By performing work under this permit the abatement contractor agrees that the Division may revoke or suspend this permit should the Division find that the contractor: • has violated or has aided and abetted in the violation of 25-7-101 or 25-7-501 et seq., C.R.S. or Regulation No. 8, Part B, or an order of the Division or Commission, • has failed to meet any permit and notification requirement or failed to correct any violations cited by the Division during any inspection within a reasonable period of time, as may be determined by the Division, • has used misrepresentation or fraud in obtaining this permit, or, • has committed any act or omission which does not meet generally accepted standards of the practice of asbestos abatement. As a contractor, you may be subject to other licenses and permits, depending on the requirements of the county and municipality in which the work is being performed. The Colorado Department of Public Health and Environment, Air Pollution Control Division strongly suggests that you check with county and municipal authorities in order to determine any other local building/permitting requirements that must be met. THE ORIGINAL PERMIT MUST BE POSTED ON SITE AT ALL TIMES. Immediately notify the Asbestos/IAQ unit of project modifications by fax (number above) or e-mail (address above) and the appropriate county health department by fax. Project modifications include changes in the scope of work or the scheduled work dates, etc. This asbestos abatement permit is valid beginning 5/16/2019 through 11:59 PM on 6/14/2019. The actual scheduled work dates are from 5/16/2019 through 5/20/2019. Approval issued on: 5/22/2019 Record number: 148645 Notice Number: 19JE3094A Variance: None Comments: None For the location specified below: SFRD outside dumpster in driveway 12535 W. 31st Ave W heatridge Jefferson County This permit has been issued to: C.A.E. Abatement 19884 Elk Pl Denver, CO 80249 Fee paid: $180.00 Check number: CC 2297 Project Supervisor: Fernando Medina Cerification No.: 12719 Project AMS: Drue M. Beasley Cerification No.: 18325 Project Manager: Issued by: CA of colo C� h y� D 4 � t f /876 Colorado Deparunent of public Health and Environment ASBESTOS ABATEMENT NOTIFICATION and PERMIT APPLICATION FORM FEE MUST ACCOMPANY THIS FORM. INCOMPLETE APPLICATIONS WILL BE RETURNED. Single Family Residential Dwelling (SFRD) > 50 LF or 32 SF or a 55-gatdrum, buts 260 LF of 160 SF or a 55 -gallon drum Public and Commercial Building, School, and Single -Family Residential Dftoirg: > 26o LF or 160 SF or a 55—gallon drum submit form to Permit Coordinala Colorado Dept. of Public Fleattlr code 200 $0 Courter Notice code 100 s0 Courter Notice 205 S60 Non-Publ'x: Access Notice O Out code 105 S80 Non -Public Access Notice and Environment hPCD-IE-B7 e 210 _ISI Contact ea>f f M; (der Street Address code 110 $80 Notice 4300 cherry Creek Drive South ,4code e 230 $180 30 -Da Permft code 1301232 $400 30-DayP&C/SFRD Permit Denver, CO 80246-1530 Phone: 303.692-3100 a ermit code 1901292 $600 913-DayP&C/SFRD Permit code 265 $420 365 -Day Permit code 165/267 1 U $1200 365 -Da P&C/SFRD Permit Fax 303.782-0278 acbealosestale co.us I code 180/280 J $55 Notice or Permit Transfer [ code 177 J $80 Phase of Muhiple Phase Permit # Abatement Contractor Abatement Site Building Owner Company Name A– Building Name Owner Name rf CRE it �rg t t7 -Lei Street Address I Spetlry locatlen h sre htri frq there wart w01 take gate (e g, sour, roan, vhq, etc) k; n ive,.l _ISI Contact ea>f f M; (der Street Address City State Zip code Stre tAddress n� r U 86Z 12 w 31 Iz,535 W 1 0 ., Telephone # Fax # CityCou iP code Dh o t City Slate Zip code Telephone # Fax # Pr 'ect Supervisor CO. Cert # Building nta ne # vnol ; h Z� I i,ict' t 6- Ci I"�5 6- ► — Project Personnel Project Information Disposal Site CO Project Mgr. Name Sta End Dale Landfill Name 5 - ICA 5-Zo-(6f WA 0,J Cell Phone # CO Project Desgner # ( ) Start MW End Time Street Address C' AAA 6, 00 PM 1 law .IJ I CO ProjectDesigner Name Check the day(s) of operation: Su M Tu W❑ ThrF S City ate HSI Zip code r o .0-00119 Cell Phone # CO PrO-Designer # f Emergency? YY NO Type of ACM: TSI, Texture, VAT, etc. 0r CDPHE Use Only/ Consult Virm Name r Regis�,ralbnG# v'✓ on L20 Linear Feet /Type S eel !Type {Ochs F cy 55 gel. Drums •t ci• xt 1 Postmark or Deliveryto Approvec�by: !^ 'd? A.M.S. Name Di &as Form of Payment & # PM req /515iC J+�C CC Z1 7 Y 6DW Cell Phone #_ CO AVS. Cert # J p3 25 O Pe # e # Date Issued: t Please descnbe below the work practices and procedures to be employed in conducting the abatement of asbestos. BE SPECIFIC. Indicate lype(s) of ACBM to be abated (e.g. VAT, ceiling tile, TSI, etc.). Use another page if necessary. N`�tJ�r SPi 1� acCovx-\ctrrtivla ;o✓i a C G)Ct2viov C, ++ kl-tc 5c,rrounLt n t M4301' 5 t( ( �S or15C, U,;11 bl' ✓iZt�VCAI 1h �jll CDvti c rt�5tle✓ 111t remwct� In 1111. 7, rn� l_ � w�aIa5n�Ge� 400��S C7oUr4e:1 1h4ce(rrpmG1G +-F,SI /C +f_oma"1–'G–+°0`o.0a2– nd Nuf�Jrrtl`�elb� 5�6 t k•Is Wa1'1"�6, G rvj "�k1"�hdGLc�VL �Ct Yv�t J1G� � i U v1 1 lPP�✓✓Ot;ve-Y 5O -_1 Gl1C tpvCAyey WJk anl11lCnC�ec1 Fo ,k,,MPAm `,- acv ul/JMnc„ 13 May 2019 Geoff Miller (Homeowner) 12535 W 31" Ave. Wheat Ridge, CO 80215 To whom it may concern, Pursuant to the results in the "Asbestos Inspection Report" report prepared by Advent Environmental Consulting LLC (Asbestos Firm) on 5/13/19, Geoff Miller (Homeowner) requests a waiver of the standard waiting period for Colorado Department of Public Health and Environment (CDPHE). In early May, Homeowner began a "do it yourself' bathroom remodel that included the demolition of a master math. Areas demoed were existing drywall, the and grout. The homeowner was not aware of state and federal protocol for asbestos testing and potential abatement. Furthermore, the homeowner was not aware of the types of building materials, old and new, that contained asbestos. All demolition work was completed and waste moved to a dumpster located in the side yard drive way of the homeowner's property. Upon guidance from the City of Wheat Ridge, an inspection test was completed Asbestos Firm and revealed levels of asbestos in the demoed materials that warranted additional measures of mitigation. Due to the location of the asbestos contaminated demoed building material, this letter represents the homeowners request to permit the selected abatement contractor to proceed with necessary abatement to ensure reduced possibility of the introduction of asbestos in to the general public's habitat. Since the remodel project is a smaller bathroom and the care taken to reduce dust and debris from accumulating in the homeowner's house, the homeowner has elected to forgo additional remediation within the homeowner's residence. Future remodel work is planned and additional testing and possibly abatement is expected. Do to the now understood risk to the public, please consider this request to fast-track a permit for abatement. Crews are on standby to resolve this mistake. Thank you for your time and consideration, Regards, Geoff Miller (Homeowner) 303-656-9175 G�ew`ev\'f I I L MA Y 11 i Per May 13, 2019 Geoff Miller 12535 W 31 st Ave Wheat Ridge, CO 80215 Geoffdmiller@gmail.com 303.656.9175 Dear Geoff Miller, VENT Environmental Consulting 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 NT Enviroinnental Consultuig 090519-DT2 ASBESTOS INSPECTION REPORT 12535 W 31 st Ave Wheat Ridge, CO 80215 Prepared for: Geoff Miller 12535 W 31 st Ave Wheat Ridge, CO 80215 Geoffdmiller@gmail.com 303.656.9175 Year Built 1961 Type of Property Residential - SFRD - House Type of Inspection NON-DESTRUCTIVE INVESTIGATION Reason for Inspection General survey Regulations Satisfied 40 CFR 61 Subpart M Reg No. 8 Part B Prepared Dy. 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 720.675.7175 myteam@advent-enviro.com www.advent-enviro.com TABLE OF CONTENTS Section 1 - Project Snapshot ADVENT ENVIRONMENTAL CONSULTING 7830 West Alameda Avenue Suite 103 - 216 Lakewood, Colorado 80226 1.1 Project Site Summary 1.2 Sampled Materials Summary 1.2.a Asbestos Hazard & Damage/Potential Damage Indicator Section 2 - Inspection Photos & Sample Locations 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 LIST OF ACRONYMS Material Result ACM Asbestos Containing Materials Material Condition G Good D Damaged SD Significantly Damaged Material Type Limited Asbestos Inspection 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 NFI Non -Friable Category I Sample Locations N North S South E East W West Other Acronvms LAI Limited Asbestos Inspection PPE Personal Protective Equipment SFRD Single -Family Residential Dwelling TAT Turnaround Time VENT k\- t —,.,aI Coos J..g 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 720.675.7175 myteam@advent-enviro.com www.advent-enviro.com Section 1 - Project Snapshot 1.1 Project Site Summary ADVENT ENVIRONMENTAL CONSULTING 7830 West Alameda Avenue Suite 103 - 216 Lakewood, Colorado 80226 VENT Please use this section to gain a quick overview of the project and details about inspected materials. Detailed findings will follow further into the report. Project Address: 12535 W 31st Ave Wheat Ridge, CO 80215 Type of Property: Residential - SFRD - House Reason for Inspection: General survey General survey to determine if asbestos -containing materials were disturbed prior to inspection 1.2 Sampled Materials Summary Site Contact Johnathan Cassidy Inspection Date: May 9, 2019 Your Inspector: Derek Beasley CO Cert #: 25353 ID Description of Sampled Material(s) Area of Representation of Condition Hazard Rating Apprx. Quantity' #f Samples Material Result Main Level Master Bath Type SM1 Texture Bathroom Walls F -SM S. Damaged High 120 ft' 3 Major Spill JC1 Joint Compound for SM1 Bathroom Walls F-MISC S. Damaged High 120 ft' 2 Major Spill OT1 Wall Tile Shower Surround NF-MISC S. Damaged High 80 ft' 2 Major Spill OT2 White Floor Tile Bathroom Floor NF-MISC S. Damaged Low 80 ft' 2 None -Detected 00.151 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, please see Section 3 for additional response actions and keep away from the contaminated area. The above materials have been identified as damaged or significantly damaged due to demolition. In addition to the asbestos hazard, a moderate hazard exists due to the following: Drywall on the West wall of the bathroom has been demolished and replaced along with floor and wall tile. Quantities exceed trigger levels on all materials. . Sample results reflect only a limited portion of a material (Area of Representation, above) included in the scope of work even if the material appears to extend beyond the scope of 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 used for purposes otherwise. See Glossary (Identifying Homogenous-) for more details. ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 VENT www.advent-enviro.com (4F—imurnesual Consulting Section 2 - Inspection Photos & Sample Locations Please note: Any joint compound (Material Code JC) samples on this report, are typically part of a set of a finished, 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: SM1 Major Spill Description: Texture Location: Bathroom Walls SM1-1 i SM1-2 SM1-3 Class: F -SM Condition: SD Hazard Class: F-MISC Condition: :'N' A Moderate Cause of Damage: Demolition Material Code: JC1 Major Spill Description: Joint Compound for SM1 Location: Bathroom Walls JC1-1 Bathroom S wall W corner middle 2% Chrysotile JC1-2 Bathroom S wall W corner middle 2% Chrysotile SD Hazard: Moderate Cause of Damage: Material Code: OT1 Major Spill Description: Wall Tile Location: Shower Surround OT1-1 OT1-2 Class: NF-MISC Condition: SD Hazard: Low Demolition Dumpster in driveway 2% Chrysotile Dumpster in driveway 2% Chrysotile Demolition D r M X M U) C r D K 0 r M X M Cn C r —I ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 VENT www.advent-enviro.com Gncironmcnta1 Consulting Section 2 - Inspection Photos & Sample Locations (Continued) The overall asbestos content, for a material with multiple samples, is the highest result in the set. Material Code: OT2 Mone -Detected Description: White Floor Tile Location: Bathroom Floor —nor�Q OT2-1 Dumpster in driveway • t OT2-21 Dumpster in driveway Class: NF-MISCCondition: SD Hazard: Low Cause of Damage: Demolition None -Detected None -Detected ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 VENT www.advent-enviro.com Section 3 - Summary & Recommendations (k\E-­i-­1C­,d,ing 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. If 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 fact, 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 trace, 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 RACMs 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 B - Asbestos requires major spill decontamination/cleanup 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 ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 VENT www.advent-enviro.com En •���n� coy 3.2.a CDPHE mandated actions in the event of a major spill: driN 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 times, 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. NO DELINEATION WAS COMPLETED ON THE INSIDE. THEREFORE, THE WHOLE HOUSE MUST BE CONSIDERED CONTAMINATED, UNTIL DELINEATION IS COMPLETED. NO VISIBLE DEBRIS WAS DISCOVERED ON THE EXTERIOR WALKWAY FROM THE HOUSE,BACK DOOR TO DUMPSTER; HOWEVER, THE DUMPSTER AND EXTENDING 5' TO THE NORTH, 10' TO THE SOUTH AND 5' TO THE WEST MUST BE DECONTAMINATED. INTERIOR DECONTAMINATION IS RECOMMENDED, BUT NOT MANDATED, IF THE HOMEOWNER DOES NOT REQUIRE IT. HOMEOWNER MUST SUBMIT IN WRITING WAIVER OF DECONTAMINATION TO THE AIR POLLUTION CONTROL DIVISION. 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. ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 VENT www.advent-enviro.com Fmwrmmrnral Conwilnng 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 (AHERA) 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 material(s) 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 & 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 quantities 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 & 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. ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 VENT www.advent-enviro.com k\-11mnrncnr,JCowu1tin_g 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 properly 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 properly 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 agreement(s) 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, reverse engineer, translate or create derivative works from this report. The receiving party shall use this report only for the limited purpose described 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, Derek Beasley, CO Asbestos Building Inspector #25353 Advent Environmental Consulting CDPHE Business Registration #: ACF - 22068 7830 West Alameda Avenue Suite 103 - 216 Lakewood, Colorado 80226 myteam@advent-enviro.com ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 VENT w a�v . "T.com 4\11.11 mnmennl Co dung GLOSSARY Material Friability These categories were used to determine methods for assessing suspect materials based on their friability and ability to release harmful asbestos fibers— i.e. friable 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 -friable 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, breeching, 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 ft2 ■ Minimum of 5 random samples for quantities >1,000 ft2 & <5,000 ft2 ■ Minimum of 7 random samples for quantities >5,000 ft2 2. Thermal system insulation ■ Minimum of 3 random samples for all TSI *except patches <6 linear ft. or 6 ft2 3. Miscellaneous materials ADVENT ENVIRONMENTAL CONSULTING 720.675.7175 7830 West Alameda Avenue Suite 103 - 216 myteam@advent-enviro.com Lakewood, Colorado 80226 www.advent-env0rUnlmum of 1 sample APPENDIX A - Laboratory Report VENT En�irorvnennl Consulting EMSL Analytical, Inc. 1010 Yuma Street Denver, CO 80204 Tel/Fax: (303) 740-5700 / (303) 741-1400 http://www.EMSL.com / denveriab@emsl.com EMSL Order: 221903704 Customer ID: AVTE25 Customer PO: 0 Project ID: Attention: Lab Info Phone: (720) 432-3153 Advent Environmental Consulting Fax: 7830 W. Alameda Ave Received Date: 05/09/2019 6:30 PM Unit 103-216 Analysis Date: 05/10/2019 - 05/11/2019 Lakewood, CO 80226 Collected Date: Project: 12535 W 31st Ave Test Report. Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized Light Microscopy Non -Asbestos Asbestos Sample Description Appearance % Fibrous % Non -Fibrous % Type SM1-1-Texture White 15% Ca Carbonate 2% Chrysotile Non -Fibrous 83% Non-fibrous (Other) 221903704 -WOO Homogeneous Inseparable paint/coating layer included in analysis HA 1 SM1-1-Drywall Brown/White 10% Cellulose 65% Gypsum None Detected Fibrous <1% Glass 25% Non-fibrous (Other) 22IW3704-MIA Homogeneous HA: 1 SM1-2-Texture White 15% Ca Carbonate 2% Chrysotile Non -Fibrous 83% Non-fibrous (Other) 221903704-0002 Homogeneous Inseparable paint coating layer included in analysis HA:I SMI -2 -Drywall Brown/White 10% Cellulose 65% Gypsum None Detected Fibrous <1% Glass 25% Non-fibrous (Other) 22IW3704-0002A Homogeneous HA: 1 SM1-3-Texture 1 White 20% Ca Carbonate None Detected Non -Fibrous 80% Non-fibrous (Other) 221903704-0003 Homogeneous Ha � SM1-3-Texture 2 White/Beige 20% Ca Carbonate 2% Chrysotile Non -Fibrous 78% Non-fibrous (Other) 221903704-00o3A Homogeneous Inseparable paint coating layer included in analysis HA: I SM1-3-Drywall Brown/White 15% Cellulose 70% Gypsum None Detected Fibrous 15% Non-fibrous (Other) 221903704-00038 Homogeneous HA: 1 JC1-1-Texture White 15% Ca Carbonate 2% Chrysotile Non -Fibrous 83% Non-fibrous (Other) 221903704.0004 Homogeneous Inseparable paint/ coating layer included in analysis HA: 2 JCIA-Tape White 98% Cellulose 2% Non-fibrous (Other) None Detected Fibrous 221903704-0004A Homogeneous HA: 2 JCI -1 -Joint Compound White 15% Ca Carbonate 2% Chrysotile Non -Fibrous 83% Non-fibrous (Other) 221903704-00044 Homogeneous HA: 2 JC1-1-Drywall Brown/White 10% Cellulose 65% Gypsum None Detected Fibrous <1% Glass 25% Non-fibrous (Other) 221903704-00044 Homogeneous HA:2 Initial report from: 05/11/2019 10:55:43 `;B_PLM_0008_0007, - 1.745 Printed: 5/11/2019 8:55 AM Page 1 of 3 EMSL Analytical, Inc. EMSL Order: 221903704 Customer ID: AVTE25 1010 Yuma Street Denver, CO 80204 Customer PO: 0 TeVFax: (303) 740-5700 / (303) 741-1400 Project ID: http://www.EMSL oom / denveriab@emsl.com Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized Light Microscopy Non -Asbestos Asbestos Sample Description Appearance % Fibrous % Non -Fibrous % Type JCI -1 -Composite Brownlran/White 25% Cellulose 60% Gypsum <1% Chrysotile Fibrous 15% Non-fibrous (Other) 221903704-0004D Homogeneous This is a composite result of tape, joint compound, and drywall HA: 2 JC1-2-Texture 1 White 20% Ca Carbonate None Detected Non -Fibrous 80% Non-fibrous (Other) 221903704-0005 Homogeneous HA: 2 JC 1 -2-Texture 2 White/Beige 15% Ca Carbonate 2% Chrysotile Non -Fibrous 83% Non-fibrous (Other) 221903704-00054 Heterogeneous Inseparable paint /coating layer included in analysis HA: 2 JCI -2 -Tape Tan 95% Cellulose 5% Non-fibrous (Other) None Detected Fibrous 221903704-00058 Homogeneous HA:2 JC1-2-Joint Compound Beige 15% Ca Carbonate 2% Chrysotile Fibrous 83% Non-fibrous (Other) 221903704-0005C Homogeneous HA: 2 JC1-2-Drywall Brown/VVhite 15% Cellulose 70% Gypsum None Detected Fibrous 15% Non-fibrous (Other) 221903704-0005D Homogeneous HA: 2 JCI -2 -Composite BrownfTan/White 25% Cellulose 60% Gypsum <1% Chrysotile Fibrous 15% Non-fibrous (Other) 221903704-0005E Homogeneous This Is a composite result of tape, joint compound, and drywall HA 2 OT1 -1 -Ceramic Tile White 100% Non-fibrous (Other) None Detected Non -Fibrous 221903704-0005 Homogeneous HA: 3 OT1-1-Grout White 20% Ca Carbonate None Detected Non -Fibrous 80% Non-fibrous (Other) 221903704-00054 Homogeneous HA:3 OTI-1-Mastic White 20% Ca Carbonate None Detected Non -Fibrous 80% Non-fibrous (Other) 221903704-00058 Homogeneous HA: 3 OTI-I-Mud Beige 15% Ca Carbonate 2% Chrysotile Non -Fibrous 83% Non-fibrous (Other) 221903704-0006C Homogeneous HA: 3 OT1-2-Ceramic Tile White/Black 100% Non-fibrous (Other) None Detected Non -Fibrous 221903704-0007 Homogeneous HA 3 OT1-2-Grout White 20% Ca Carbonate None Detected Non -Fibrous 80% Non-fibrous (Other) 221903704-00074 Homogeneous HA: 3 OT1-2-Mastic White 20% Ca Carbonate None Detected Non -Fibrous 80% Non-fibrous (Other) 221903704-00078 Homogeneous Initial report from: 05/11/2019 10:55:43 J ASB -PLM -0008_0001 - 1.7F Printed: 5/11/2019 8:55 AM Page 2 of 3 EMSL Analytical, Inc. EMSL Order: 221903704 1010 Yuma Street Denver, CO 80204 Customer ID: AVTE25 Tel/Fax: (303) 740-5700 / (303) 741-1400 Customer PO: 0 http://www.EMSL.com / denvedab@emsl.com Project ID: Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-931116 Method using Polarized Light Microscopy Analyst(s) Ashley Boyd (9) Stuart Printz (21) PC Melanie Rech, Laboratory Director or Other Approved Signatory EMSL maintains liability limited to cost of analysis. The above analyses were performed In general compliance with Appendix E to Subpart E of 40 CFR (previously EPA 600/M4-62-020 "Interim Method"), but augmented with procedures outlined in the 1993 ('final") version of the method. This report relates only to the samples reported above, and may not be reproduced, except in full, without written approval by EMSL. EMSL Clears no responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client. All samples received in acceptable condition unless otherwise noted. This report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST or any agency of the federal government EMSL recommends gravimetric reduction for all non -friable organically bound materials prior to analysis. Estimation of uncertainty is available on request. Samples analyzed by EMSLAnalytical, Inc. Denver, CO NVLAP Lab Code 200828-0 Initial report from: 05/11/2019 10:55:43 ASB_PLM_0008_000I • 1.78 Printed: 5/11/2019 8:55 AM Page 3 of 3 Non -Asbestos Asbestos Sample Description Appearance % Fibrous % Non -Fibrous % Type HA: 3 OT1-2-Mud Beige 15% Ca Carbonate 2% Chrysofile Fibrous 83% Non-fibrous (Other) 221903704 M7C Homogeneous HA 3 OT2-1-Ceramic Tile White/Red 100% Non-fibrous (Other) None Detected Non -Fibrous 221903704-0008 Homogeneous HA:4 OT2-1-Mastic Gray 15% Ca Carbonate None Detected Non -Fibrous 85% Non-fibrous (Other) 221903704-000eA Homogeneous HA: 4 OT2-2-Ceramic Tile White/Red 100% Non-fibrous (Other) None Detected Non -Fibrous 221903704-0008 Homogeneous HA: 4 OT2-2-Mastic Gray 15% Ca Carbonate None Detected Non -Fibrous 85% Non-fibrous (Other) 221903704-0009A Homogeneous HA: 4 Analyst(s) Ashley Boyd (9) Stuart Printz (21) PC Melanie Rech, Laboratory Director or Other Approved Signatory EMSL maintains liability limited to cost of analysis. The above analyses were performed In general compliance with Appendix E to Subpart E of 40 CFR (previously EPA 600/M4-62-020 "Interim Method"), but augmented with procedures outlined in the 1993 ('final") version of the method. This report relates only to the samples reported above, and may not be reproduced, except in full, without written approval by EMSL. EMSL Clears no responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client. All samples received in acceptable condition unless otherwise noted. This report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST or any agency of the federal government EMSL recommends gravimetric reduction for all non -friable organically bound materials prior to analysis. Estimation of uncertainty is available on request. Samples analyzed by EMSLAnalytical, Inc. Denver, CO NVLAP Lab Code 200828-0 Initial report from: 05/11/2019 10:55:43 ASB_PLM_0008_000I • 1.78 Printed: 5/11/2019 8:55 AM Page 3 of 3 PERMIT NO: JOB ADDRESS: JOB DESCRIPTION: City of Wheat Ridge Residential Mechanic PERMIT - 201702057 201702057 ISSUED: 06/16/2017 12535 W 31st AVE EXPIRES: 06/16/2018 Install Evap cooler 6800 CFM *** CONTACTS *** OWNER (303)656-9175 MILLER JEFF SUB (303)733-2813 Todd Terry 022239 Todd Terry Ltd DBA Apple Aire *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,000.00 FEES Evaporative Cooler 40.00 Total Valuation 0.00 Use Tax 105.00 ** TOTAL ** 145.00 *** COMMENTS *�* *** CONDITIONS *** Work shall comply with 2012 IRC & 2014 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am leggally authorized to include alI entities named within this document as parties to the work to be performed and that all work to be perf rmed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date I, This permit was issued based on the information provided in the permit application and accompanyingplans 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 andprocedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any a rd n pce or regulation.of this ju isdiction. Approval of work is subject to teld inspection. Signature of Chief Building Official Date REQUESTS NUST BE MADE BY 11:59PH ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. 1 -, ; -z--t 1 n 1e')e ",-. V i ) -(),) T, s1 't:T , A --_n Z' D �"I ` yam- INSPECTION RECOR� V'�}-� INSPECTION REQUEST LINE: (303) 234-5933 Occupancy/Type Electrical Inspections will not be performed unless this card is posted on tlie-pro-ject site. Call the inspection request line before 11:59 p.m. to receive an inspection the folTowing business day. Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Comments lnitials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter Do Not Pour Conc to Prior To Ap he Above Inspections Underground/Slab Inspections DateIniti Commen Electrical Commen sewer =er`ric:; I Plumbing r Do Not Cover Underground or Below/In-Slab Wor,J:C%R'rior To Appro Tie Aoov'e_Ini�pktions Rough Inspections Date Inspector Initials Commen Wall Sheathing Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical (7 Mid -Roof Final Plumbing Final Mechanical V Iii Lath / Wall Tie Roof Final Window/Doors Rough Electric Final Building NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy. Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw / Nail Final Inspections Date Inspector Initials Comments Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaeinp and oarkinq inspections caii 303-235 2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. i ROW & DrainaoP / Public Works Dent. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical (7 r v Final Plumbing Final Mechanical V Iii Roof Final Window/Doors Final Building NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy. "For low voltage permits — Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. For notification of your assigned inspection time window please email insRtiinc_rc nest a ci_,heatnd,_,c.co.us by 8:00 A.M. the day of the inspection with the property address in the subject line of the email. Time windows are assigned based on inspection routing. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather i INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/forms.aspx?fid=79 INSPECTION REQUEST LINE: (303) 234-5933 Occupancc'y/jT pe Inspections will not be performed unless this card is posted on the project site. Call the inspection request line before 11:59 p.m. to receive an inspection the following business day.** Inspector Must Sign ALL Spaces pertinent to this project-, Foundation Inspections Date Inspector Com ents Initials Pier Concrete Encased Ground (CEG) Mid -Roof Foundation / P.E. Letter' Floodplain Inspection (if applicable) Do Not Pour ConcretP'r Te Al6proval G Inspections Underground/Slab Inspections Date Inspe or Comments Initial Electrical Sewer Service Plumbing Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. Mid -Roof Floodplain Inspection (if applicable) Lath / Wall Tie " Rough Electric' Final Electrical Rough Plumbing/Gas Line Final Plumbing Rough Mechanical Final Mechanical Rough Framing Roof + �• �% Rough Grading Final Window/Doors Insulation Final Building Drywall Screw / Nail NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy. Final Inspections Date Inspector Initials Comments Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical Roof + �• �% Final Window/Doors Final Building NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy. For low voltage permits — Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather N* i CITY OF WHEAT RIDGE _:�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax (/ INSPECTION NOTICE Inspection Type: 14,z:-10 Job Address: -3 S V/ Permit Number: 2©/`–/ D Z `r ❑ No one available for inspection: Time 1Z u AM/PM Re -Inspection required: YesNo. When corrections have been made, call for re -inspection at 303-234-5933 Date: '? ~` /—Inspector: DO NOT REMOVE THIS NOTICE 4 City of Wheat Ridge Residential Roofing PERMIT - 201702288 PAID PERMIT NO: 201702288 ISSUED: 06/21/2-0111 JOB ADDRESS: 12535 W 31st AVE EXPIRES: 06/21/2018 JOB DESCRIPTION: Residential re -roof to install asphalt shingles - Tamko Heritage - 27 sq. *** CONTACTS *** OWNER (303)656-9175 MILLER JEFF SUB (303)237-5179 Curt Marceau 022364 Roofing Plus *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 9,000.00 FEES Total Valuation 0.00 Use Tax 189.00 Permit Fee 188.45 ** TOTAL ** 377.45 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding AM -inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturera€TMs installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer&#39;s technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. City of Wheat Ridge Residential Roofing PERMIT - 201702288 PERMIT NO: 201702288 ISSUED: JOB ADDRESS: 12535 W 31st AVE EXPIRES: JOB DESCRIPTION: Residential re -roof to install asphalt shingles 06/21/2017 06/21/2018 - Tamko Heritage - 27 sq. 1 S (D 1, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perforin the work described and approved in conjunction with ,p thisernit. I further attest that I am legally authorized to include all entities named within this document as parties to the work 10 be pertormed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. c =----40'0"'- Signature 'Signature of OWNER or CONTRACTOR (Circle one) Date I . This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and 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, feesand rocedures for approval of any new permit. Re -issuance or extension of expired pen -nits is at the sole discretion of the Chief Building Offcial and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. Kimberly Cook From: no-reply@ci.wheatridge.co.us Sent: Monday, June 12, 2017 3:09 PM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. Permits are currently being processed within 3-5 business days, subject to change based on volume. 0 vvWU For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number Property Owner Email Address Do you have a signed contract to reroof this property? It will need to be provided at the time of permit pick-up. 12535 W 31 st Ave Jeff Miller 303-656-9175 Field not completed. Yes CONTRACTOR INFORMATION Contractor Name Roofing Plus Contractor's License 022364 Number (for the City of Wheat Ridge) Contractor Phone 303-263-7656 Number Contractor Email Address roofingplus1982@gmail.com (permit pick-up instructions will be sent to this email) Retype Contractor Email roofingplusl982@gmail.com Address DESCRIPTION OF WORK Is this application for a Yes new permit for a residential roof? Are you re -decking the No roof? Description of Roofing TAMKO Heritage Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 27 material selected above? Does any portion of the No property include a flat roof? If yes, how many squares Field not completed. on the flat roof? TOTAL SQUARES of all 27 roofing material for this project z Provide additional detail remove existing house roof, install new TAMKO Heritage, here on the description of pitch=4/12 work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract 9000.00 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that this Yes application is NOT a permit. I understand I will be contacted by the City to pay for and pick up the permit for this property. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have been Yes authorized by the legal owner of the property to submit this application and to perform the work described above. Name of Applicant Curt Marceau Email not displaying correctly? View it in your browser. 3 PERMIT NO: JOB ADDRESS: JOB DESCRIPTION City of Wheat Ridge Residential Mechanic PERMIT - 201702057 201702057 ISSUED: 06/16/2017 12535 W 31st AVE EXPIRES: 06/16/2018 Install Evap cooler 6800 CFM *** CONTACTS *** OWNER (303)656-9175 MILLER JEFF SUB (303)733-2813 Todd Terry 022239 Todd Terry Ltd DBA Apple Aire *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: UA / Unassigned 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,000.00 Evaporative Cooler FEES 40.00 Total Valuation 0.00 Use Tax 105.00 ** TOTAL ** 145.00 *** COMMENTS *** *** CONDITIONS *** Work shall comply with 2012 IRC & 2014 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. appliI by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, cable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this_�ppermit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all work t e 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 p pp a 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 andprocedures 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 an manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shal be xs ed to be a JV,permit for, or an approval of, any violation of any provision of any applicable code or any or ' ance or regu ' risdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptimerequestgci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. FOR OFFICE USE ONLY I City Of Date: W heat ll)k \ COMMUNrry DEVELOPMENT I j (( Plan/Permit # � � i`/'J Building & Inspection Services Di I wsron 7500 W. 29"' Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 - Fax; 303-237-8929 Plan Review Fee: Inspection Line: 303-234-5933 Email: perrnits(a)ci-wheatridge.co.us Building Permit Application "` Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. "' Property Address: Owner Property Owner Email: W v ' / S J Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Enaineer Arch itecVEngineer E-mail: 1()d 0.t L TeN� Contractor. i L*t br�P K Phone: I Contractors City License #: C) Phone: Contractor E-mail Address: Y .V-VLI an (-1"l n rA -, , '-v Sub Contractors: Electrical: OvAk" �!Iucfv�c plumbing: Mechanical: W.R. City License # (� D J W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all information on BOTH sides of this form ❑ COMMERCIAL Cq�RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESIDENTIAL ADDITION D WINDOW REPLACEMENT (� COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) El RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT OTHER (Describe) (For ALL projects. please provide a detailed description of work to be performed, including current use of areas. proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used. etc.) 1 V�s�� \J oVA, -kms c C 0 0 U -,k— (�o Sq. FtJLF Btu's Gallons Amps Squares Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) Voo_ _ __ ONN'NER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree; to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. CIRCLE ONE ^ (OWNER) (CONTRACTOR) o (AUTHORIZED REPRESENTATIV of (OWNER) 'TRACTOR) PRINT NAME: ZONING COMMME% TS Reviewer BUILDING DEPARTMENT COVMMENTS Reviewer PUBLIC WORKS COMMENTS Reviewer PROOF OF SUBMISSION FORMS SIGNATIRE: Fire Department ❑ Received ❑ Not Required (Nater District ❑ Received ❑ Not Required Sanitation District Received ❑ Not Required DEPARTMENT USE ONLY DATE: L ` /-7 OCCUPANCY CLASSIFICATION TYPE OF CONSTRUCTION SPRiNKLERED OCCUPANT ;.OAD Building Division Valuation: $ i CITY OF WHEAT RIDGE _��9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 5 Job Address: I Z 5_(�✓it Permit Number: ur % L) 3q3y ❑ No one available for inspection: Time j AM/60 Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: 7l b1 /1 Inspector: k� DO NOT REMOVE THIS NOTICE City of Wheat Ridge v M' Residential Plumbing PERMIT - 201703430 PERMIT NO: 201703430 ISSUED: 07/07/2017 JOB ADDRESS: 12535 W 31st AVE EXPIRES: 07/07/2018 JOB DESCRIPTION: 10 ft spot repair in the front yard and we will install double sweep cleanouts *** CONTACTS *** OWNER (303)656-9175 MILLER JEFF SUB (303)519-0240 R. Andrew Russell 120161 The Elite Pipe MD *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 2,500.00 FEES Total Valuation 0.00 Use Tax 52.50 Permit Fee 93.35 - ** TOTAL ** 145.85 *** COMMENTS *** *** CONDITIONS *** ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection by any Sanitation District representative. Inspection and approval of work by any Sanitation District representative DOES NOT grant authority to cover work without the approval of the Building Division. **For trenchless sewer replacements - The contractor will verify proper slope of new sewer piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed specifically by the applicable code. The plumbing contractor will provide verification of proper slope and drainage in writing as a condition of approval of the permitted work.** City of Wheat Ridge Residential Plumbing PERMIT - 201703430 PERMIT NO: 201703430 ISSUED: 07/07/2017 JOB ADDRESS: 12535 W 31st AVE EXPIRES: 07/07/2018 JOB DESCRIPTION: 10 ft spot repair in the front yard and we will install double sweep cleanouts I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that alI work to be performed is disclosed in this docurnent 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 required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. Thi!issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of anv ap ode or an finance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. City of " f W heat j�idge OMMMUNm DEVELOPMENT Building & Inspection Services Division 7500 W. 29"' Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 FOR OFFICE USE ONLY I Date: Man/Permit Cku Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. — Property Address: 12 5 3 5 W . 313k Ave • W hew\ R : � S �. , Co 6 C)Z j 5 Property Owner (please print): G eo f -c Phonw — 3 - 6 5 6 - `A k7 5 Property Owner Email: Mailing Address: (if different than property address) Address: City, State, Zip: Architep- Engineer: ArchitectlEngineer E-mail: r Contractor: 1 1n e t} e • p e, M Contractors City License #: Contractor E-mail Address: J e 35c - Go) e k Q e; pe ma, r-o.%� Sub Contractors: Electrical: W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Phone: Phone: 7 Z O- 66 Z- LA 3"%\ Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this forth Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ® PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ OTHER (Describe) (For ALL projects, please provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.) 16' S IP o k Z"c,', r , v% a -V4-, fro" -,r 13o1Jb\.e, 5 W c, -LV CIeC V, -0v k 5 Sq. FtAF Btu's Amps Squares CGv%,d We, W'.\. ', n5kc,\\ Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) Z Soon OWNERICONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) PRINT NAME: DrIv d Sc.. v ; 6' -C, -t- SIGNATURE �---- DATE: 7 6 / 1- — DEPARTMENT USE ONLY ZONING COMMMENTS: Reviewer. BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: PROOF OF SUBMISSION FORMS Fire Department ❑ Received ❑ Not Required Water District ❑ Received ❑ Not Required Sanitation District ❑ Received ❑ Not Required OCCUPANCY CLASSIFICATION: Building Division Valuation: City of Wheat . gc COMMUNITY DEVELOPMENT City of Wheat Ridge Municipal Building 7500 W. 29' Ave. Wheat Ridge, CO 80033-8001 P: 303.235.2855 F: 303.237.8929 Permit Extension Request Form Permits 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 may 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. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. Please complete this form in its entirety and submit to the Building Division at permitskci.wheatrid eg co.us or fax to 303-237-8929. Party requesting permit extension 6G" Permit # -Al_, 10080 Property Address: �o (A 7 Phone # Email Address: Reason for extension request: V��l1i MGLI�, �n Ec14 roams= l�lQ_ (Also Number of days requested: Printed Name:�Ac_o 113-01 oignature: o Date: --7-6--/7 For office use only CC This request has been: Approved Denied Extended until: J Approved by: Date: �� www.ci.wheatridge.co.us y i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: _ ) �� �� 3 1 V (- Permit Number: 0 I -7 b a 0 7 A/ Q A- N S Gv P K P, -f -� t t) 6 o tt o r G• rJ 1/ b N D U c T P /--" S a /ri r I3 N L w1 -p cP 0 S -/,, 6, Pr ,.-s ❑ No one available for inspection: Time /a - AM/PM Re -Inspection required:S No r -A )J - � S e' ("[)v When corrections have been made, call for re -inspection at 303-234-5933 Date:-'? I' Inspector: It . DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE _:�9�s Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: tzU1= Job Address: Z S 3S' W 31 ST A VE Permit Number: 201 i C) Z `92 ❑ No one available for inspection: Time /PM Re -Inspection required: Yes CN— o) corrections have been made, call for re -inspection at 303-234-5933 g c� Date: �J ' /7. • f 7 Inspector:�� DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE _1�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type:r� rvA P Job Address: ��-- � (10 31 .4 r Permit Number: 0 — -7 ❑ No one available for inspection: Time Q —Y -Y ASI/PM Re -Inspection required: Yes No,.,) When corrections have been made, call for re -inspection at 303-234-5933 Date:' Inspector: DO NOT REMOVE THIS NOTICE f c/r e3'i°''n OF Wy F i o3J��s 835933 e�tio n ob S,e�tioh T //(p ON NOT /cF Oct � a�ai/ab�� ctioh r for 'c�%as ha g��recy. y N�cti� e be E'S ep Daae A, tea/ for a i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: M Job Address: w !. d e Permit Number: . ca r `7 t ')., 6 i Q-) 14 ' r tit .s re C� �' o n) (" o V r)" is rJ o f In, V-, 19-e i; r e f m t P) . .C"an fee rA(ctt Si z ht P � F � � n \ 1 � Q i � ��' � i�D � c�^i P c �la K •. ❑ No one available for inspection: Time AM/PM Re -Inspection required( Yes- No�- When corrections have been made, call for re -inspection at 303-234-5933 Date: /7 Inspector:, � DO NOT REMOVE THIS NOTICE " 4' City of Wheat Ridge _ Residential Roofing PERMIT - 093361 PERMIT NO: 093361 ISSUED: 10/15/2009 JOB ADDRESS: 12535 W 31ST AVE EXPIRES: 12/31/2010 DESCRIPTION: Reroof 27 sqs * ** CONTACTS * ** owner 303/238 -7791 Scott Feavel sub 303/237 -5179 Curt Marceau 02 -2364 Roofing Plus ** PARCEL INFO ** ZONE CODE: UA SUBDIVISION: 0706 USE: UA BLOCK /LOT #: 0/ ** FEE SUMMARY ** ESTIMATED PROJECT VALUATION: 6,750.00 FEES Extend Expired Permi 90.55 Permit Fee 181.10 Total Valuation .00 Use Tax 121.50 ** TOTAL ** - 393.15 Conditions: 6 nail installation & mid -roof inspection required. Board sheathing spaced more than a 1/2 of an inch apart requires plywood overlay on entire roof. Ice and water shield required from eave edge to 2' inside exterior walls. ** *Contractor /Property owner shall provide ladder(s) secured in place for inpsections. Subject to field inspection. 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. Signature of contractor /owner date 1. This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the State of Colorado and to the Zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable ordinances of the City. 2. This permit shall expire 180 days from the issue date. Requests for an extension must be received prior to expiration date. An extension may be granted at the discretion of the Building Official. 3. If this permit expires, a new permit may be acquired for a fee of one -half the amount normally required, provided no changes have been or will be made in the original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes have been or if suspension or abandonment exceeds one (1) year, full fees shall be paid for a new permit. 4. No work of any manner shall be done that will change the natural flow of water causing a drainage problem. S. Contractor shall notify the Building Inspector twenty -four (24) hours in advance for all inspections and shall receive written approval on inspection card before proceeding with successive phases of the job. 6. The issuance of a permit or the approval of drawings and specifications shall not be construed to be a permit for, nor an approval of, any violation of the provisions of the building codes or any other ordinance, law, rule or regulation. All plan review is subject to field inspections. Signature of Chief INSPECTION REQUEST LINE: (303)234 -5933 REQUESTS MUy4STQ BEMADE BY JPM BUUSIINNESS ot date BUILDING OFFICE: ( 303)235 -2855 DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. 'E i ,.,,;CITY OF WHEAT RIDGE Building Inspection Division { I (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: -Z, Job Address: y/S Permit Number: c No one available for inspection: Time AM PM t' Re Inspection required: 'Yes No *When corrections have been made, call for re-inspection at 303-2345933 Date: / /0 Inspector: ~//J) , x DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: ~00--r Job Address: I r? , ?_s, (1. 2L Ale, Permit Number: f)t7-3 xp n i ❑ No one available for inspection: Time 2; 30 ANJ 6 -Re-Inspection required: 'Yes No ' When corrections have been made, caii for re-inspection at 303-234-5933 f~ Date: Inspector: cr, DO NOT REMOVE THIS NOTICE ~HFS'S Tn._x~..- ~ R ~"rvti 4c FFt emu, ~^<iv ♦ i 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: M Job Address: /fir) j ~1 I51 AU Permit Number: o 1 33(,l ❑ No one available for inspection: Time AM/PM Re-Inspection required: Yes No When corrections have been made, call for r -inspection at 303-2345933 Date:)-LS-- Dci Inspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Roofing PERMIT - 093361 PERMIT NO: 093361 `.ISSUED:`. 10/15/2009 JOB ADDRESS: 12535 W 31ST AVE EXPIRES: 04/13/2010 DESCRIPTION: Reroof 27 sqs CONTACTS owner 303/238-7791 Scott Feavel sub 303/237-5179 Curt Marceau 02-2364 Roofing Plus **PARCEL INFO ZONE.. CODE: UA -USE: UA SUBDIVISION:' 0706 BLOCK/LOT#: 0/ FEE SUMMARY ESTIMATED PROJECT VALUATION: ,6,750.00 FEES Permit Fee ' 181.10 Total Valuation , pp Use Tax 121 .50 f {;~}s' ~C`p7 [ x* TOTAL 302.60 r. Conditions: S nail installation & mid-roof inspection required. Board sheathing spaced more _han'a 1/2 of an inch apartrequires plywood overlay on entire roof. Ice and water shield` required from eave edge to 2' inside exterior walls. a**Contractor/Property owner shall provide ladder(s) secured in place fors. inpsections." Subject to field inspection.. 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. Signature of contractor/owner ..date This permit was issued in accordance with the <provisions set forth in your application and is subject to the :laws of the State of Colorado and to the Zoning; Regulations andBuilding Codes of Wheat Ridge. Colorado or anvl other anolirahla a+ x run 1INb' t,lIVN 111ri Tli1.LUWINU`:BU61NESS DAY..:: ~oF W"rqo 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 - - o Inspection Line: 303-234-5933 °cORpO Permit M, t) ~J Building Permit Application Property Address: / Z 5`2'-~-- G✓ `S A 'e4ve- Property Owner (please print): Phone:- ~r- )>g/ Mailing Address: (if different than property address) Address: City, State, Zip: tAtJ /;Z ro Jc~~ .z-S-- Sub Contractors: Electrical City License Company: Plumbing City License Company Mechanical City License Company: Exp. Date: Exp. Date: Exp. Date: Approval: Approval: Approval Use of space (description): /LCir Construction Value: $ Description of work: (as calculated per the Building Valuation Data sheet) U_ Plan Review (due at time of submittal): $ °~4✓u F' 3G y!L ~ti~~i~ cJ 12e Sq. Ft./L.Ftadded: Squares 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 (LB.C) and all other applicable Wheat Ridge Ordinances, for work under this permit. Plans subject to fi inspection. CIRLCE ONE, (OWNER) ONTRACTO or PERSONAL REPRESENTATIVE of (OWNER) (CONTRATOR) - PRINT NAME: o-[ SIGNATUR ? - Date;Z /S=CV 7 6m d s DEPARTMENT tbSE 4NLY ZONING c l ENTs ~onlag:' Reviewer.; pUBLIC`tNORKS C°tv1MENTS' - i Reviewer, r . z 1 ~ q BUILOING_ oEPAtjTt31EFIT COMMEN'F.S ~ c . - - OC~UPAYJCY `I 3 t fIFFE pEP.ARTICIENT, I7, a'Pro vedtt co>llfrtents ❑dlsdpprpved E7no{evlew req~3iYed-~ Bldg Valuation: Contractor License 6),Z - ~2 ? V Phone: 3 4? 3 > -15"/ > c DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : 95-384 BUILDING INSPECTION DIVISION - 235-2855 CITY OF WHEAT RIDGE Date :2/21/95 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 Property Owner : FEAVEL SCOTT D Property Address : 12535 31 ST AV Phone : 232-1630 Contractor License No. : Company: Phone: OWNER/CONTR,4CTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurete, 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 accurete; 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 (U.B.C.) and all other applicable Wheat Ridge ordinances(for work under this permit. (OWNER)(CONTRACTOR) SIGNED 'f,~ ~%(M. 1- c,GC.ix X~ DATE ~2 Description : BASEMENT FINISH Construction Value : $3,500.00 Permit Fee : $63.00 Plan Review Fee : $0.00 Use Tax : $43.75 Totai : $106.75 Electrical License No : Company: Expiration Date : Approval: Plumbing License No : Company : Expiration Date : Approval: Mechanical License No : Company : Expiration Date : Approval: (1) This permit was issuetl in accordance with the provisions set forth in yopur application antl is subject lo the laws of the State of Colorado and lo the Zoning Regulations antl 8uiltliny Code of Vvheat Ridge, Colorado or any other applicable ortlinances of the City, (2) ' This permit shall expire if (A) the work authorizetl is not commenced within sixty (60) tlays from issue tlate or (B) the builtling authonzed is suspended or abantloned for a period of 120 days. (3) If ihis permit expires, a new permit may be acquired for a fee of one-half the amount normally required, providetl no changes have been orwill be matle in the original plans and specifications and any suspension or abandonment has not exceetled one (i) year. If changes are matle or if suspension or abandonment exceetls one (1) year, (ull fees shall be paid tor a new permit. (4) No work of any manner shall be done that will change lhe naNral Bow o(water causing a drainage problem. (5) Contrector shall notify Ihe Building Inspector twenty-four (24) hours in advance ior all inspections and shall receive written approval on inspection card betore proceediing with successive phases of the 1~ob. (6) The issuance of a permit or the approval of drawings and specifications shall not be consVUetl to be a permit for, nor an approval of, any viola6on of ihe provisions oF ihe building codes or any other ortlinance, law, rule or regulation. ~ 7,, Chief Building Mspector THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR CALI: 234-5933 24 HOURS PRIOR TO INSPECTION DEPkRTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : BUILDING INSPECTION DIVISION - 235-2855 Date : CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 Property Owner : SCoTi Phone: _232- /Ca 3c, Property Address : i a S 3 S uJ 31 Sf A"e , Contractor License No. : Company : Phone : OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback tlistances proposed by this permit application are accurale, and do not violate appliwble ordinances, mles or regulations of the Ciry of Wheat Ridge or covenants, easements or restnctions of rewrd; that all measurements shown, and allegations made are accurete; that I have read and agree to abide by all conditions printed on this application, and that I assume full responsibility for wmpliance with the Wheat Ridge Building Code (U.B.CJ and all other appliwble Wheat Ridge ordinances, f work under this permit. ~ TE a Construction Value : 3Sb Permit Fee : Use Tax: Total : (OWNER)(CONTRACTOR) SIGNED DA ~C'ew.od~e.1 - l~E.o r«w.ccQ wu.115 ~ 0.~c~ ~'.~ec{'~~c~..f f3GX Description: -6Ci5Cin'Ne"4 Electrical License No : Plumbing License No : Mechanical License No : Company: Company: Company: Expiration Date : Expiration Date : Expiration Date : Approval : Approval : Approval : Cio tha lews af the State of COlorado antl to Ne Zonin9 (7) Thi5 permit was i5sued in eaorUance with Ue provisions set fofth In YOpur appliWUon anO is 5ubjett t ry Regulatlons antl Builtling Cotle of Wheat Ridge, Colorado or any other applicaCla ortlinances of ihe . (2) This permrt shall expire if (A) the woAC authotlzetl is not commencetl within sixly (60) days fiom issue date or (B) the builtling auNOnzeE is suspentled or abantlonetl for a penod of 120 days. (3) If this pertnit expires, a new petmit may be aCquiretl for a fee of one-half the amount normally required, provitled no changes have been or will Oe matle m e original plans antl specifica6ons anE any suspension or abandonment has not exceeded one (1) year. If changes are matle or if suspension or ahan0onment exceeds one (1) year, full fees shall be paid for a new pertnrt. (4) Nb work of any manner shall be tlone Nat will change iha naNral Ilow of water Causing a drainage problem. (5) ConVactor shall notify the Buiiding Inspector hvenry-four (24) hours in aOvance for all inspections antl shall receive wntten approval on inspectlon cartl befare proceetliing wiM successive phases of the lob. (8) The aissuance o cotles or i any l oNer portlna'nce lawln rule otlreg~ulafiionlions shall not be consWed to be a permit for, nor an approval o[ any violaUOn of Ne provisions of the bu Chief Building Inspector For Mayor THIS PERMIT VALID CONLY ALL W 34 5933 24 HOURS PRIOR TO~IN PIECTION ECTOR AND MAYOR tta•------+ . I i i I li< b, I t6I , I i i i ~tt I I ~ ~ ~ i i I I ~ ~ I I I AVE. - BASEMENT REMODEL SE 1 2-95 SCALE 1 PICA = 1 FOOT = tp VOLT OUTLET = 220 VOLT OIITl.ET = DEDICATFD OUfLET FOR CONPUTER = PEW FRANED WALL II II I I I ' ~ - _ - - _ - ---y ~ ~ sim~ ~ , ~O ~ . v ir U47 a T I I I I ~ ~ ~ ~12,r ir ~ ~ ~ ~ ~ Qo*PT8W425fLFPLM 2-95 7500 WEST 29th AVENUE 2345933 P.O.BOX638 PERMIT VALID ONLY WHEN DEPARTMENT OF COMMUNITY DEVELOPMENT BUII DING INSPECTION DIVISION CITY OF WHEAT RIDGE, COLO. THE CNIEF JOB ADDRESS CONTRACTOR //"v v'~- n ADDRESS ~,i.r~.s~ ~ CITY ZIP CODE O O PHONE LICENSENO. ❑ QNC RECEIPTED BELOW. PERMIT N0. Np„194#q33/~ OWNER y~- ADDRESS PHONE =ZIPCODE CONTRACT PRICE $ DATE Proitttin4Ea-_L TYPE Ground - - 2. MATERIAL SIGNS 3 ILLUMINATION YSs❑ NoU Typ° 4. SET BACK FROM PROPERTY LINE N-_ 5_ E_- W-r (SOecily which is frOnl) ❑ E] Cl L JOB I. YVPE Solido More Than 80% OpsnC] Loss Than ADDRESS MATERIAL FENCES 3. 5ET BACN FROM PROPERTY LINE (Snecitv which it front) 1. OTHER Z 3. N__ g_- E- W ❑ ❑ ❑ DRAW SKETCH OR SHOW BELOW,THE FENCE,SIGN,OR OTHER STRUCTURE,GIVIhi (SETBACNS OR 7ROJECTIONS INCLUDED) IMF DISH WASMER FI-DOR DRAIN STREET NAME SHDS A'NCENTO PROPERT~Y L~INESBNOTD'MA%MUMJOR'AVERGEEDISTANCES'ANC SEWERS / ppPLICATION FOR PLUMBING; ELECTRICAL, • • NLY VALI UPON LDING THIS APPLICATIO PERMIB WIOLME P RE r180 DAYS F RFORM OM THEEDAT~E OF WORKUANCE I~F WORK S NOT STARTEO WITHIN TIHAT TIME PECTION DIVISION. PLUMBING PERMIT MECHANICAL PERMIT ELECTRICAL PERMIT STATE LICENSE N0 STATE LICENSE N0. . q~ ENt FLOOR BSM IST 2N0 3RD 4T!1 N~. FUIEIL'C,° )MINUM NIIRE UNDER S12E 8 ILIEGAL FpqCED AIR - BTU -r-- WATER GIASET i ,,,~r w~tro _ fiTll /SlQ E?E WASH BOWL BATH 7U8 IHE ATING TRANSFORMERS 9 RECTFI ADDITION TO OLD WORK MOTORS OVER I HP REMARKS I Mroby ocknowledQe that this aDDGco- tion n correct and understond that I cannof start this prolbct until this oppli- cotion is oDVroved. 1 shall comply wifh 1M Iowa of the Stote ol Colorodo and to the Zoninp Repulotions and Bwldinq Code ofthe City of Wheat RidQe. QnY violotron of the obove terma will cause immediote revocotion 9,f fnls permii PERMIT FEE USE TAX TOTAL FEE ~ yl~ 111 4Y DATE: BLDG. PERMITB `433& PERMITM BLDG. CONTR. SUBCONTRACTOR --DATE INSP. REQ. '2 TYPE OF INSP. ) INSPECTION MADE REMARKS W.R. FORM &19 C,. " O!J Y-`'i~ $ dY - C/ AP~R~~~ . CHIEF BUILDIN INSPECTOR,City of Wheat Ridqe Issued _ INSPECTION TICKET OT VALID UNLESS REGEIf 9M (,0 L-7 0 L± I -'I l -7 CALL 234-5933 24 HOURS IN ADVANCE FORINSPECTIONS