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Home My WebLink About10616 W 48th Avenuei CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Vp �__-v Job Address: k 0\'` �.A \,j Permit Number:-' ❑ No one available for inspection: Time ;a AM/PM Re -Inspection required: Yes N�,�% When corrections have been made, call for re -inspection at 303-234-5933 l Date:_ i ' i • a�� Inspector: i DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: � ---1 'C1r C/ Job Address: �- Permit Number: Q114 -1,11, JF� t7 tt.-2r=;. c. L tom' C ❑ No one available for inspection: TimeJ� AM/PM Re -Inspection required: YNo _.. When corrections have been made, schedule for re -inspection online at: http://www.ci. wheatridgge.co.uslinspecti Dated pec DO NOT OVE THIS NOTICE A i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: mac - Job Address: �\_q w L-\'Zv\, njt-- Permit Number: r9l U 1 r -A Cl) \ y', 25 ,...,--- �_ - L") _ ct 1cr Y _f s F % `. , .q r e—k, r! Y / 1 fY. t 01 r `moi.-��'�- c�•� �—E' � �`� � �� ar��' ❑ No one available for inspection: Time AM/PM Re -Inspection required: QYes No When corrections have been made, schedule for re -inspection online at: http://www. ci. wheatridge. co. usdnspection Date: � �" � (� Inspector:_ ®O NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: V03 Enot to - Job Address: I o (o I & k A! t/4A tlC. Permit Number: 99259 ; 301401 (G I- 6 rcz 'A kildmen Jbes e p l" rese4 n ❑ No one available for inspection: Time AM/PM Re -Inspection required: es No When corrections have been made, schedule for re -inspection online at: http✓/www.ci. wheatridge. co. usfinspection Date: l J - dl' lf Inspector: 1 DO NOT REMOVE THIS NOTICE City of Wheat Ridge r Residential Remodel PERMIT - 201901668 PERMIT NO: 201901668 ISSUED: 08/29/2019 JOB ADDRESS: 10616 W 48th Ave EXPIRES: 08/28/2020 JOB DESCRIPTION: SWO Replace all ceiling drywall and insulation; replace 3 windows, all wiring and damaged outlets, switches, lights - 750 sq ft total *REVISION 12/26/2019: Install new 240/120v 125 amp panel bypass meter housing; Valuation included in original scope *** CONTACTS *** OWNER (303)517-5917 CAPRA ROBERT E GC (303)749-5830 MARK PIJANOWSKI 130245 ALL PHASE RESTORATION SUB (303)227-9112 MARK BURNS 120240 ARTISAN PLUMBING, HEATING&AIR SUB (303)227-9112 MARK BURNS 120240 ARTISAN PLUMBING, HEATING&AIR SUB (303)278-4044 LOUIS KARSTEN 022118 KARSTEN ELECTRICAL SERVICES, L *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: U / Utility structures SUBDIVISION CODE: 2408 / FRUITDALE, LEES, STONERIDGE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 40,000.00 FEES Total Valuation 0.00 Plan Review Fee 399.46 Use Tax 840.00 Permit Fee 614.55 Investigative Fees 614.55 ** TOTAL ** 2,468.56 *** COMMENTS *** *** CONDITIONS *** 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. V City of Wheat Ridge Residential Remodel PERMIT - 201901668 PERMIT NO: 201901668 ISSUED: 08/29/2019 JOB ADDRESS: 10616 W 48th Ave EXPIRES: 08/28/2020 JOB DESCRIPTION: SWO Replace all ceiling drywall and insulation; replace 3 windows, all wiring and damaged outlets, switches, lights - 750 sq ft total *REVISION 12/26/2019: Install new 240/120v 125 amp panel bypass meter housing; Valuation included in original scope 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 all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. 7- C Signature of OWNER or CONTRAC�(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 androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable code or any ordinance or regtliLtion 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. City of Wheat F-1- dge MUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 291h 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 FOR OFFICE USE ONLY Date: lalk Add to Permit # !1 � f,)l� �i Building Permit Revision/Amendment Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 16V�12; G✓ ylg"14 Property Owner (please print): Phone: Property Owner Email: Mailing Address: (if different than property address) Address: , State, Zi Submitting Comag_ny: /M/ Contact Person: :LL Phone: -7 z) - S"37 - 6 Contractor: Contractors City License #: Contractor E-mail Address: Phone: Please Note: Additional valuation must include all general and subcontracted work to be performed related to the revisions and/or amendments declared in the description of work and which were not included in the original permit valuation. If revisions or amendments increase the original valuation, additional fees will be due at the time of approval. Depending on the scope of work, additional plan review fees may be due upon approval ($60.00 an hour — 2 hour minimum). Description of revised/amended work: 7 vs7 i9/l /J r fir' / Z ",rt Sq. Ft./LF Amps Btu's Squares Gallons Other Additional Project Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above) Iq i ONVNER/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) (ONTRACZdR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) PRINTNAME: �l-/< ¢L v r` SIGNATURE: DATE: /?Z2 F' / 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 DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION' Building Division Valuation: $ 41 CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: - rn � � �lv "� hof-si- Job Address: LA�\A-' Permit Number: acn C\y \ \_j Irl J 'yv�. t. c.. ;.1 S ✓� r EA ✓1 J ❑ No one available for inspection: Time AM/PM s"~ Re -Inspection required: `Yes) No When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. usrnspection Date: \)• 2-L4 ICA Inspector: L� DO NOT REMOVE THIS NOTICE I* � 4 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: % C3 Permit Number: w 1.jNo one available for iVYes on: Time AM/PM Re -Inspection required:No When corrections have been made, call for re -inspection at 303-234-5933 Date: ff 6/1—Inspector: I DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: t. ry,*) Job Address: \0\,.p 't Permit Number: E) 0 \ C I rte,) l ❑ No one available for inspection: Time I ) '-( `' AM/PM Re -Inspection required: &es When corrections have been made, schedule for re -inspection online at: h ttp ✓/www. ci. wheatridge. co, uslinspection Date: ; ; Inspector: DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: -lin �L) 0 A Job Address: ou t Permit Number: u ❑ No one available for inspection: Time Cr"�, AM/PM Re -Inspection required: Yes , low, When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. uslinspection C Date:-. ' Q-, .' i Inspector: DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: ;�, `�� C� cf� Job Address: k,` VV -1 Permit Number: C4 V t, i � t w ❑ No one available for inspection: Time AM/PM Re -Inspection required: bs. No r ) When corrections have been made, schedule for re -inspection online at: http://www. ci. wheatridge.co. uslinspection Date: Inspector: ®O /NOT REMOVE THIS /NOTICE 1* � 4 i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE r Inspection Type:l- Job Address: tai .a k \-® V-) 47,k\,N �tti6C Permit Number: �� `I U U ,4 ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes,.-,-' 0 When corrections have been made, schedule for re -inspection online at; http✓/www.ci. wheatridge.co. usfinspection Date:_1 '�?' i�, Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: r>" h Job Address: L-�qy\, n„f Permit Number: U1 ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes L/_No When corrections have been made, schedule for re -inspection online at: http://www. ci. wheatridge.co. uslinspection Date: \; U -TI. V-,' Inspector:' -;'i DO NOT REMOVE THIS NOTICE i - -CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: -3 0� k h t, t 1 i c Job Address: Iv& 1 +N� ��`�✓ . Permit Number: • o ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes 0*0 When corrections have been made, schedule for re -inspection online at: http ✓/www. ci. wheatridge. co. usfnspection Date: Inspector: DO NOT REMOVE THIS NOTICE e , s_ CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: 30-2 poj&k ec,166� Job Address: i �-, W L12TY A vj�' Permit Number: ZO D 166 S? i J44 a celvve ❑ No one available for inspection: Time AM/PM Re -Inspection required: CqDe— No When corrections have been made, schedule for re -inspection online at: http://www. ci. wheatridge. co. uslinspection Date: ( y -/Y1*/ � Inspector: ®O NOT REMOVE THIS NOTICE A s_ CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Y c C Job Address: ,-( Permit Number: f ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When *When corrections have been made; schedule for re -inspection online at: http.I www. ci. wheatridge. co. uslinspection Date:.` 7 P 7 Inspector DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: _( Job Address: kouk Permit Number:=:)C-)\C, ❑ No one available for inspection: Time `£ AM/PM Re -Inspection required: Yes /-No When corrections have been made, schedule for re -inspection online at: http.lAvww.ci.wheatridge.co.uslinspection Date: —\ L, V\ k Inspector: DO NOT REMOVE THIS NOTICE e s_ CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: i i*� V Permit Number: �C P K r Tz-. H 1p- _z�� tAot No one available for inspection: Tim M Re -Inspection requir<.�es,)No When corrections have been made, schedule for re -inspection online at; http://www.ci.wheatridge.co.us,rinsp Date: Inspec t DO NOT REMOVE THIS NOTICE 1* � 4 i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Permit Number: ❑ No one available for inspection: Time j AM/PM Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: http://www.ci. wheatridge.co. usfinspection Date: r1 `_ �, , `-i Inspector DO NOT REMOVE THIS NOTICE City of Wheat Ridge *** Residential Remodel PERMIT - 201901668 PERMIT NO: 201901668 ISSUED: 08/29/2019 JOB ADDRESS: 10616 W 48th Ave EXPIRES: 08/28/2020 JOB DESCRIPTION: SWO Replace all ceiling drywall and insulation; replace 3 windows, all ALL PHASE RESTORATION wiring and damaged outlets, switches, lights - 750 sq ft total *** CONTACTS *** ZONE CODE: UA / Unassigned OWNER (303)517-5917 CAPRA ROBERT E / FRUITDALE, LEES, STONERIDGE BLOCK/LOT#: GC (303)749-5830 MARK PIJANOWSKI 130245 ALL PHASE RESTORATION SUB (303)227-9112 MARK BURNS 120240 ARTISAN PLUMBING, HEATING&AIR SUB (303)227-9112 MARK BURNS 120240 ARTISAN PLUMBING, HEATING&AIR SUB (303)278-4044 LOUIS KARSTEN 022118 KARSTEN ELECTRICAL SERVICES, L *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: U / Utility structures SUBDIVISION CODE: 2408 / FRUITDALE, LEES, STONERIDGE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 40,000.00 FEES Total Valuation 0.00 Plan Review Fee 399.46 Use Tax 840.00 Permit Fee 614.55 Investigative Fees 614.55 ** TOTAL ** 2,468.56 *** COMMENTS *** *** CONDITIONS *** 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. City of Wheat Ridge Residential Remodel PERMIT - 201901668 PERMIT NO: 201901668 ISSUED: 08/29/2019 JOB ADDRESS: 10616 W 48th Ave EXPIRES: 08/28/2020 JOB DESCRIPTION: SWO Replace all ceiling drywall and insulation; replace 3 windows, all wiring and damaged outlets, switches, lights - 750 sq ft total I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this�permrt. I further. attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. r ._ % 5 Signature of OWNER or��CO�NTRACTQR? (Circle one) Date 1. This permit was issued baseaon 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 originalermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building 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 app cable 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. City of Wheat ridge COMMUNITY DEVELOPMENT Building & Inspection Services 7500 W. 2911 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(a.ci.wheatridge.co.us FOR OFFICE USE ONLY Date: )3P 7 Plan/Permit # Plan Review Fee: i l , Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address Owner Property Owner Email: 4„oic. 41 e ti,, / c- o, -,7 Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer: Architect/Engineer E-mail: Phone: �- 0 ,55%/ Phone:362 S/7 Sy/ Contractor Name: City of Wheat Ridge License #: Phone: �J, Contractor E-mail Address: e Z v For Plan Review Questions & Comments (please print): CONTACT NAME (please print): .?l�uc ��.7 Phone: _170-_5_37-0016' 5ry)V-A(?,rS��'1 aP� t�l't�n. cD' yn CONTACT EMAIL(p/ease print): Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: !'Si E�c� r�"� `Y: `ic-'Plumbing: Mechanical: ,9� 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. [—]COMMERCIAL 7�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, app /(Illance size and efficiency, typeand amount of materials to be used, /etc. /'l�f!/G•.L'/7`l �ilG�'Z f✓G//�itc/ /?✓`J/c%�`U�f..""'CC•�'s*-r+'� Sq. Ft./LF' �C� BTUs Gallons Amps Squares 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) $ 7C, 000 . 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 pr e application. CIRCLE ONE: (OWNER (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) SilInature (first and last name): �� _ �G � DATE: - _ Printed Name: ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: J G lL b` Building Division Valuation: HC), V 0c, City of heat Rjd COMMUNITY DEVELOPMENT SUB -CONTRACTOR AUTHORIZATION FORM This form must be signed by each sub -contractor. 'Phis form will not be accepted with missing information. Subcontractor's Cit' of Wheat Ridge License number must be provided in the applicable space. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: General Contractor: Electrical Sub -Contractor Permit #: Company Name: Karsten Electrical Services LLC Phone #: 303-278-4044 State License #: EC.0006514 Master #: ME. 0025618 Whe;kt Ride UFC].l, : o22�1a (required field) 08/20/2019 Signat r of _uthorized Agent Date Company Name: Phone #: State License #: Master #: Wheat Ridge License #: (required field) Signature of Authorized Agent Date Mechanical Contractor Company Name: Phone: Wheat Ridge License #: (required field) Signature of Authorized Agent Date RECD IV ED City of ` Wheat P,jJdge MMUNay DEVELOPMENT SUB -CONTRACTOR AUTHORIZATION FORM This form must be signed by each sub -contractor. This form will tint be accepted with musing information. Subcontractor's City of Wheat Ridge License number must be provided in tite applicable space. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: Permit #:_ General Contractor: Electrical Sub -Contractor Company Name: Phone #: State License #: Master #: Wheat Ridge License #: (required field) Signature of Authorized Agent Date Plumbing Sub -Contractor Company Name. 4S 7 fd /,-xr*hone State License #: %L�� _ Master Wheat Ridge License #: (required fiend) Signature of Au -i rizcd Ag_ent Date Mechanical Contractor 1 Company'Name-.)""/�I� " Phone Wheat Ridge License #: (required field) Signature of Autho ' Agent Date . All Phase Restoration a All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 Tax ID#27-3667484 All Phase Restoration is a specialty general contractor specializing in assisting the owners and insurers of residential, commercial, industrial, medical, public, and multi -family buildings in recovery following fire, water, and most every possible type of emergency loss. All Phase also provides Capital Improvement services and Construction Defect consulting and reconstruction. Our services include; general contracting, technical recovery solutions, drying, mold remediation, consulting, engineering, and architectural services. We are licensed in many of the major municipalities and counties in Colorado and carry General Liability, Automobile, Worker's Compensation, and Pollution/Mold insurance policies. All Phase cares about our customers and formed our business with the sole purpose of becoming the best operated company in our industry. While All Phase maintains an excellent staff of construction professionals, we may need to subcontract all or some of the work. All Phase reserves the right to take any and all applicable trade discounts and substitute suppliers and vendors at our discretion, independent of estimates provided. Any supplier or vendor bids provided are for reference purposes only & that vendor may or may not be ultimately used for the project. We have an excellent array of committed suppliers and vendors and will select the best team of individuals for your project. You can be guaranteed that we will treat you with honesty and integrity with a personal dedication to your project. It is my goal to make your recovery time and headaches as minimal as possible. I am confident that our expertise is second to none in our industry and will become evident once our processes are implemented. If I can answer any questions please do not hesitate to contact me. ROBERT CAPRA_AP 6/17/2019 Page: 2 All Phase Restoration All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 Tax ID#27-3667484 Insured: Robert Capra & Stacy Capra -Fire Property: 10616 W 48TH AVE WHEAT RIDGE, CO 80033-2641 Home: 10616 W 48TH AVE WHEAT RIDGE, CO 80033-2641 Claim Rep.: SEWALD, BRIAN Business: 14123 DENVER W PKWY GOLDEN, CO 80401 Claimant: Capra, Robert Estimator: Scott Sarkisian Position: estimator Company: All Phase Restoration Business: 12362 Dumont way Littleton, CO 80125 Contractor: Scott Sarkisian Company: All Phase Restoration Business: 12362 Dumont Way Littleton, CO 80125 Claim Number: 040094738-01 Date Contacted: 6/4/2019 Date of Loss: 6/4/2019 Date Inspected: 6/6/2019 Policy Number: OY7295273 Price List: CODE8X_JUN19 Restoration/Service/Remodel Estimate: ROBERT CAPRA AP Date Received Date Entered t1ftlW1 gJ0111 Cell: (303) 517-5917 Cell: (303) 870-1841 E-mail: BRIAN. SEW ALD@LIBERTYMUTUAL. COM Cell: (303) 517-5917 Business: (303) 720-3390 E-mail: ssarkisian@aprestoration. com Business: (303) 749-5930 E-mail: ssarkisian@aprestoration. com Type of Loss: Fire 6/4/2019 6/5/2019 12:58 PM ROBERT_CAPRA_AP EMS DESCRIPTION QTY 1. General clean -up 1.00 HR 2. Haul debris - per pickup truck load - including dump fees 1.00 EA 3. R&R Board -up windows and doors 64.00 SF 4. Padlock and hasp -for front door 1.00 EA 5. Emergency service call - during business hours 1.00 EA NOTES: Exterior Front Elevation DESCRIPTION QTY 6. Clean with pressure/chemical spray 120.00 SF NOTES Right Elevation DESCRIPTION 7. Clean siding -wood 8. Clean soffit -wood QTY 68.75 SF 70.00 SF ROBERT CAPRA AP 6/17/2019 Page: 3 All Phase Restoration All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 TaxID#27-3667484 ROBERT_CAPRA_AP EMS DESCRIPTION QTY 1. General clean -up 1.00 HR 2. Haul debris - per pickup truck load - including dump fees 1.00 EA 3. R&R Board -up windows and doors 64.00 SF 4. Padlock and hasp -for front door 1.00 EA 5. Emergency service call - during business hours 1.00 EA NOTES: Exterior Front Elevation DESCRIPTION QTY 6. Clean with pressure/chemical spray 120.00 SF NOTES Right Elevation DESCRIPTION 7. Clean siding -wood 8. Clean soffit -wood QTY 68.75 SF 70.00 SF ROBERT CAPRA AP 6/17/2019 Page: 3 CONTINUED - Right Elevation DESCRIPTION 9. R&R Spot light fixture - double 10. Prime & paint exterior fascia - wood, 4"- 6" wide 11. Seal & paint wood siding 12. Prime & paint exterior soffit - wood 13. Seal & paint wood gable vent 14. R&R Attic vent - gable end - metal - 14" x 24" NOTES: Rear Elevation DESCRIPTION QTY 1.00 EA 26.50 LF 53.00 SF 70.00 SF 1.00 EA 1.00 EA QTY 15. Clean exterior masonry - acid wash 80.00 SF 16. Clean with pressure/chemical spray 150.00 SF 17. Clean soffit -wood 70.00 SF 18. Content Manipulation charge - per hour 1.00 HR 19. Prime & paint exterior soffit - wood 70.00 SF NOTES attic ROBERT CAPRA AP 6/17/2019 Page:4 All Phase Restoration Nit 1 All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 Tax ID#27-3667484 CONTINUED - Right Elevation DESCRIPTION 9. R&R Spot light fixture - double 10. Prime & paint exterior fascia - wood, 4"- 6" wide 11. Seal & paint wood siding 12. Prime & paint exterior soffit - wood 13. Seal & paint wood gable vent 14. R&R Attic vent - gable end - metal - 14" x 24" NOTES: Rear Elevation DESCRIPTION QTY 1.00 EA 26.50 LF 53.00 SF 70.00 SF 1.00 EA 1.00 EA QTY 15. Clean exterior masonry - acid wash 80.00 SF 16. Clean with pressure/chemical spray 150.00 SF 17. Clean soffit -wood 70.00 SF 18. Content Manipulation charge - per hour 1.00 HR 19. Prime & paint exterior soffit - wood 70.00 SF NOTES attic ROBERT CAPRA AP 6/17/2019 Page:4 All Phase Restoration All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 Tax ID#27-3667484 Attic 1�-66's" —1 66' ai 298.83 SF Walls 2004.68 SF Walls & Ceiling 174.78 SY Flooring 183.69 LF Ceil. Perimeter Height: Peaked 1705.85 SF Ceiling 1573.00 SF Floor 179.67 LF Floor Perimeter DESCRIPTION QTY 20. Deodorize building - Hot thermal fog 5505.50 CF 21. Deodorize building - Ozone & hydroxyl treatment 5505.50 CF 22. Clean truss system - 6 to 8/12 1573.00 SF 23. Blown -in cellulose insulation - 10" depth - R38 1705.85 SF 24. Baffle vent - foam 132.00 LF 25. Seal attic framing for odor control - 6 to 8/12 1573.00 SF NOTES: Missing Wall Door Missing Wall - Goes to Floor Living Room Main Level 401.69 SF Walls 633.31 SF Walls & Ceiling 25.74 SY Flooring 59.10 LF Ceil. Perimeter 2'8"X8' 2'6"X6'8" 3'9"X6'8" Height: 8' 231.63 SF Ceiling 231.63 SF Floor 48.43 LF Floor Perimeter Opens into HALLWAY Opens into Exterior Opens into KITCHEN ROBERT CAPRA_AP 6/17/2019 Page:5 All Phase Restoration All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 Tax ID#27-3667484 1-2'6" -t Door ;nets (B ) F -2r � T T 1rC1-t 2r N 1 i n Door Subroom: Coat Closet (1) 97.31 SF Walls 108.06 SF Walls & Ceiling 1.19 SY Flooring 14.25 LF Ceil. Perimeter 2'6"X6'8" Subroom: Linen Closet (2) 62.30 SF Walls 67.79 SF Walls & Ceiling 0.61 SY Flooring 9.38 LF Ceil. Perimeter 1'11"X6'8" DESCRIPTION 26. Clean baseboard heater - exterior - Heavy 27. Final cleaning - construction - Residential 28. R&R Interior door unit 29. R&R Storm door assembly 30. R&R Exterior door - metal - insulated - flush or panel style 31. Additional charge for a retrofit exterior door 32. 1/2" drywall - hung, taped, ready for texture 33. Texture drywall - light hand texture 34. R&R Outlet 35. R&R Switch 36. Rewire - average residence - copper wiring 37. Tile floor covering 38. 1/4" Cement board 39. Vinyl - metal transition strip 40. Laminate - simulated wood flooring 41. T- molding - for wood flooring 42. Baseboard - 2 1/4" stain grade 43. Corner trim 44. Window stool & apron Height: 8' 10.74 SF Ceiling 10.74 SF Floor 11.75 LF Floor Perimeter Opens into LIVING_ROOM Height: 8' 5.50 SF Ceiling 5.50 SF Floor 7.47 LF Floor Perimeter Opens into LIVING ROOM QTY 27.25 LF 247.87 SF 2.00 EA 1.00 EA 1.00 EA 1.00 EA 809.16 SF 809.16 SF 6.00 EA 3.00 EA 247.87 SF 14.06 SF 14.06 SF 10.50 LF 233.81 SF 3.00 LF 67.65 LF 29.00 LF 10.75 LF ROBERT_CAPRA_AP 6/17/2019 Page:6 AdAll Phase Restoration i All Phase Restoration 47. Door peephole 12362 Dumont way 48. Baseboard heat - steam/hot wtr cover only - Detach & reset Littleton, Co. 80125 49. Batt insulation - 4" - R13 - paper faced p 303.749.5830 exterior walls c 720.339.7290 50. Paneling Tax ID#27-3667484 CONTINUED - Living Room DESCRIPTION QTY 45. Door lockset & deadbolt - exterior - Detach & reset 1.00 EA 46. Detach & Reset Door knob - interior 2.00 EA 47. Door peephole 1.00 EA 48. Baseboard heat - steam/hot wtr cover only - Detach & reset 27.25 EA 49. Batt insulation - 4" - R13 - paper faced 246.00 SF exterior walls 50. Paneling 52.00 SF 51. Stain & finish baseboard 67.65 LF 52. Seal & paint closet shelving - single shelf 1.00 EA 53. Seal & paint closet shelving - linen closet 1.00 EA 54. Seal & paint corner trim - two coats 29.00 LF 55. Paint door slab only - 2 coats (per side) 6.00 EA 56. Seal ceiling joist system (shellac) 247.87 SF 57. Mask and prep for paint - plastic, paper, tape (per LF) 82.73 LF 58. Mask the floor per square foot - plastic and tape - 4 mil 247.87 SF 59. Paint door or window opening - 2 coats (per side) 8.00 EA 60. Seal & paint paneling 52.00 SF 61. Seal/prime then paint the walls and ceiling (2 coats) 809.16 SF 62. Seal & paint window stool and apron 10.75 LF 63. Seal stud wall for odor control (shellac) 561.30 SF 64. Seal underlayment for odor control 247.87 SF 65. Window blind - PVC - 3.5" - 14.1 to 20 SF 2.00 EA 66. Window drapery - hardware 1.00 EA 67. R&R Vinyl window, horizontal sliding, 12-23 sf 2.00 EA 68. Additional charge for a retrofit window, 12-23 sf 2.00 EA NOTES: ROBERT CAPRA_AP 6/17/2019 Page: 7 Hallway All Phase Restoration All Phase Restoration 12362 Dumont way Littleton, Co. 80125 1 u 1> t2"-,' 11" .z c'°s p 303.749.5830 39.46 SF Ceiling c 720.339.7290 i ry oom Hae' Tax ID#27-3667484 Hallway Height: 8' 1 u 1> t2"-,' 11" .z c'°s 188.09 SF Walls 39.46 SF Ceiling i ry oom Hae' 227.55 SF Walls & Ceiling 39.46 SF Floor 9'2"L2!2!242'6"02' - 8" 9 6 2'2" 4.38 SY Flooring 22.26 LF Floor Perimeter C wt 29.76 LF Ceil. Perimeter Missing Wall 2' 8" X 8' Opens into LAUNDRY -ROOM Door 2' 6" X 6' 8" Opens into BED -1 Missing Wall 21811 X 8' Opens into LIVING_ROOM Door 2' 6" X 6' 8" Opens into BATHROOM Door T 6" X 6' 8" Opens into BED -2 DESCRIPTION QTY 69. Final cleaning - construction - Residential 39.46 SF 70. 1/2" drywall - hung, taped, ready for texture 227.55 SF 71. Texture drywall - light hand texture 227.55 SF 72. Door bell/chime 1.00 EA 73. Combination CO/Smoke detector 1.00 EA 74. Carpet 62.17 SF 0 % waste added for Carpet. 75. Carpet pad 39.46 SF 76. Attic entrance cover and trim 1.00 EA 77. Thermostat 1.00 EA 78. Light fixture 2.00 EA 79. Seal floor ceiling joist system (shellac) 39.46 SF 80. Mask and cover light fixture 1.00 EA 81. Mask and prep for paint - plastic, paper, tape (per LF) 29.76 LF 82. Mask the floor per square foot - plastic and tape - 4 mil 39.46 SF 83. Seal/prime then paint the walls and ceiling (2 coats) 227.55 SF NOTES: ROBERT CAPRA_AP 6/17/2019 Page: 8 All Phase Restoration All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 TaxID#27-3667484 lose l (I Laundry Room T N mdry Ro RP 1 7 Missing Wall DESCRIPTION 51.85 SF Walls 56.93 SF Walls & Ceiling 0.57 SY Flooring 6.48 LF Ceil. Perimeter 2' 811 X 8' 84. Final cleaning - construction - Residential 85. Clean shelving - wood 86. Vinyl floor covering (sheet goods) 0 % waste added for Vinyl floor covering (sheet goods). 87. Underlayment - 1/4" lauan/mahogany plywood 88. Baseboard - 2 1/4" stain grade 89. Stain & finish baseboard 90. Seal & paint closet shelving 91. Seal ceiling joist system (shellac) 92. Mask and prep for paint - plastic, paper, tape (per LF) 93. Mask the floor per square foot - plastic and tape - 4 mil 94. Seal/prime then paint the walls and ceiling (2 coats) 95. Seal stud wall for odor control (shellac) 96. Seal underlayment for odor control NOTES: Height: 8' 5.09 SF Ceiling 5.09 SF Floor 6.48 LF Floor Perimeter Opens into HALLWAY QTY 5.09 SF 3.00 LF 47.00 SF 5.09 SF 6.48 LF 6.48 LF 3.00 LF 5.09 SF 6.48 LF 5.09 SF 56.93 SF 51.85 SF 5.09 SF ROBERT_CAPRA_AP 6/17/2019 Page:9 1--9' 7"-� Missing Wall - Goes to Floor Door DESCRIPTION Kitchen 241.67 SF Walls 333.26 SF Walls & Ceiling 10.18 SY Flooring 38.33 LF Ceil. Perimeter 3'9"X6'8" 6'X6'8" 97. Garbage disposer 98. Microwave oven - over range w/built-in hood 99. Refrigerator - top freezer - 14 to 18 cf 100. Range - slide in - electric 101. Countertop - wood - butcher block (hardrock maple) 102. Countertop - post formed plastic laminate 103. Filler/scribe board - 1" x 4" - hardwood 104. Cabinet knob or pull 105. Cabinetry - lower (base) units 106. Re -skin toe kick 107. Cabinetry - upper (wall) units 108. Clean baseboard heater - exterior - Heavy 109. Final cleaning - construction - Residential 110. 1/2" drywall - hung, taped, ready for texture 111. Texture drywall - light hand texture 112. R&R Ground fault interrupter (GFI) outlet 113. R&R 220 volt outlet 114. R&R Outlet 115. R&R Switch 116. Rewire - average residence - copper wiring 117. Tile floor covering 118. Tile base 119. 1/4" Cement board 120. Trim board - 1" x 4" - installed (cedar) 121. Casing - 2 1/4" at patio door 122. Shelving - 12" - in place Height: 8' 91.59 SF Ceiling 91.59 SF Floor 28.58 LF Floor Perimeter Opens into LIVING _ROOM Opens into PATIO 1.00 EA 1.00 EA 1.00 EA 1.00 EA 3.00 SF 15.00 LF 16.00 LF 5.00 EA 6.75 LF 6.75 LF 14.00 LF 6.00 LF 91.59 SF 348.66 SF 348.66 SF 1.00 EA 1.00 EA 4.00 EA 3.00 EA 91.59 SF 91.59 SF 28.58 LF 91.59 SF 6.00 LF 20.00 LF 4.25 LF ROBERT CAPRA AP 6/17/2019 Page: 10 All Phase Restoration All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 Tax ID#27-3667484 1--9' 7"-� Missing Wall - Goes to Floor Door DESCRIPTION Kitchen 241.67 SF Walls 333.26 SF Walls & Ceiling 10.18 SY Flooring 38.33 LF Ceil. Perimeter 3'9"X6'8" 6'X6'8" 97. Garbage disposer 98. Microwave oven - over range w/built-in hood 99. Refrigerator - top freezer - 14 to 18 cf 100. Range - slide in - electric 101. Countertop - wood - butcher block (hardrock maple) 102. Countertop - post formed plastic laminate 103. Filler/scribe board - 1" x 4" - hardwood 104. Cabinet knob or pull 105. Cabinetry - lower (base) units 106. Re -skin toe kick 107. Cabinetry - upper (wall) units 108. Clean baseboard heater - exterior - Heavy 109. Final cleaning - construction - Residential 110. 1/2" drywall - hung, taped, ready for texture 111. Texture drywall - light hand texture 112. R&R Ground fault interrupter (GFI) outlet 113. R&R 220 volt outlet 114. R&R Outlet 115. R&R Switch 116. Rewire - average residence - copper wiring 117. Tile floor covering 118. Tile base 119. 1/4" Cement board 120. Trim board - 1" x 4" - installed (cedar) 121. Casing - 2 1/4" at patio door 122. Shelving - 12" - in place Height: 8' 91.59 SF Ceiling 91.59 SF Floor 28.58 LF Floor Perimeter Opens into LIVING _ROOM Opens into PATIO 1.00 EA 1.00 EA 1.00 EA 1.00 EA 3.00 SF 15.00 LF 16.00 LF 5.00 EA 6.75 LF 6.75 LF 14.00 LF 6.00 LF 91.59 SF 348.66 SF 348.66 SF 1.00 EA 1.00 EA 4.00 EA 3.00 EA 91.59 SF 91.59 SF 28.58 LF 91.59 SF 6.00 LF 20.00 LF 4.25 LF ROBERT CAPRA AP 6/17/2019 Page: 10 All Phase Restoration All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 Tax ID#27-3667484 CONTINUED - Kitchen DESCRIPTION QTY 123. Window stool & apron 3.00 LF 124. Sliding patio door reinforcement/security lock hardware 1.00 EA 125. Add for interior/cabinet soffit framing 15.40 LF 126. Baseboard heat - steam/hot wtr cover only - Detach & reset 5.00 EA 127. Ductwork - hot or cold air- for microwave 4.00 LF 128. Batt insulation - 4" - R13 - paper faced 153.50 SF exterior walls 129. Light fixture 1.00 EA 130. R&R Fluorescent - one tube - 2'- fixture w/lens 1.00 EA 131. Sink faucet - Kitchen 1.00 EA, 132. Sink sprayer attachment - side pull 1.00 EA 133. P -trap assembly - ABS (plastic) 1.00 EA 134. Sink - double 1.00 EA 135. Plumbing fixture supply line 2.00 EA 136. Seal & paint casing - two coats 20.00 LF 137. Seal ceiling joist system (shellac) 91.59 SF 138. Seal & paint cabinetry - lower - inside and out 6.75 LF 139. Mask and cover light fixture 1.00 EA 140. Mask and prep for paint - plastic, paper, tape (per LF) 38.33 LF 141. Mask the floor per square foot - plastic and tape - 4 mil 91.59 SF 142. Paint door or window opening - 2 coats (per side) 2.00 EA 143. Seal & paint wood shelving, 12"- 24" width 4.25 LF 144. Seal/prime then paint the walls and ceiling (2 coats) 333.26 SF 145. Seal & paint window stool and apron 3.00 LF 146. Seal stud wall for odor control (shellac) 241.67 SF 147. Seal & paint trim - two coats 6.00 LF 148. Seal underlayment for odor control 91.59 SF 149. Seal & paint cabinetry - upper - inside and out 14.00 LF 150. R&R 6-0 6-8 vinyl sliding patio door 1.00 EA 151. R&R Additional charge for a retrofit sliding door 1.00 EA 152. Window blind - PVC - 3.5" - 32.1 to 42 SF 1.00 EA ROBERT_CAPRA_AP 6/17/2019 Page: 11 All Phase Restoration All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 Tax ID#27-3667484 CONTINUED - Kitchen DESCRIPTION 153. Window blind - PVC - 2" - 7.1 to 14 SF 154. Window drapery - hardware 155. R&R Vinyl window, horizontal sliding, 12-23 sf 156. Additional charge for a retrofit window, 12-23 sf NOTES � 6' V" =Ba[hmom� ils B -2'7 L T Clos (2) Door DESCRIPTION Bathroom 236.67 SF Walls 287.48 SF Walls & Ceiling 5.65 SY Flooring 31.67 LF Ceil. Perimeter 157. Medicine cabinet 158. Cabinetry - upper (wall) units 159. Vanity 160. Clean baseboard heater - exterior - Heavy 161. Final cleaning - construction - Residential 162. R&R Interior door unit 163. 1/2" drywall - hung, taped, ready for texture 164. Texture drywall - light hand texture 165. R&R Ground fault interrupter (GFI) outlet 166. R&R Switch 2'6"X6'8" QTY 1.00 EA 1.00 EA 1.00 EA 1.00 EA Height: 8' 50.81 SF Ceiling 50.81 SF Floor 29.17 LF Floor Perimeter Opens into HALLWAY QTY 1.00 EA 1.75 LF 2.00 LF 6.00 LF 50.81 SF 1.00 EA 223.48 SF 223.48 SF 1.00 EA 2.00 EA ROBERT_CAPRA_AP 6/17/2019 Page: 12 All Phase Restoration All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 Tax ID#27-3667484 CONTINUED - Bathroom DESCRIPTION 167. Rewire - average residence - copper wiring 168. Tile floor covering 169. Tile base 170. 1/4" Cement board 171. Add-on for diagonal tile installation 172. Detach & Reset Door knob - interior 173. Towel bar 174. Toilet paper holder 175. Baseboard heat - steam/hot wtr cover only - Detach & reset 176. R&R Bathroom ventilation fan 177. Batt insulation - 4" - R13 - paper faced exterior walls 178. Light bar - 3 lights 179. Vanity top - one sink - cultured marble 180. Mirror - framed 181. Sink faucet - Kitchen 182. Sink faucet - Bathroom 183. P -trap assembly - ABS (plastic) 184. Plumbing fixture supply line 185. Toilet 186. R&R Tub/shower faucet 187. Bathtub 188. Paint door slab only - 2 coats (per side) 189. Seal & paint full height cabinetry - inside and out 190. Seal ceiling joist system (shellac) 191. Mask and cover light fixture 192. Mask and prep for paint - plastic, paper, tape (per LF) 193. Mask the floor per square foot - plastic and tape - 4 mil 194. Paint door or window opening - 2 coats (per side) 195. Seal/prime then paint the walls and ceiling (2 coats) 196. Seal stud wall for odor control (shellac) QTY 50.81 SF 50.81 SF 29.17 LF 50.81 SF 50.81 SF 1.00 EA 2.00 EA 1.00 EA 6.00 EA 5.00 EA 153.50 SF 1.00 EA 2.00 LF 5.00 SF 1.00 EA 1.00 EA 1.00 EA 3.00 EA 1.00 EA 1.00 EA 1.00 EA 2.00 EA 1.00 LF 50.81 SF 1.00 EA 31.67 LF 50.81 SF 2.00 EA 287.48 SF 236.67 SF ROBERT CAPRA_AP 6/17/2019 Page: 13 CONTINUED - Bathroom DESCRIPTION All Phase Restoration QTY All Phase Restoration 12362 Dumont way 198. 1/2" Cement board Littleton, Co. 80125 64.00 SF p 303.749.5830 c 720.339.7290 200. Tile tub surround - 60 to 75 SF Tax ID#27-3667484 CONTINUED - Bathroom DESCRIPTION QTY 197. Seal underlayment for odor control 50.81 SF 198. 1/2" Cement board 64.00 SF 199. Add-on for tile feature strip - High grade 11.00 LF 200. Tile tub surround - 60 to 75 SF 1.00 EA includes tub area 201. Additional charge for a retrofit window, 3-11 sf 1.00 EA 202. Vinyl window, single hung, 4-8 sf 1.00 EA NOTES: J u ry oom Hallway Bed I 9'2" 2'6"g.. Height: 8' g 9 C �t 307.92 SF Walls 119.10 SF Ceiling 427.02 SF Walls & Ceiling 119.10 SF Floor Bed I = 13.23 SY Flooring 37.42 LF Floor Perimeter cr'a 00se 43.84 LF Ceil. Perimeter 2, �I2'6"� Door 2' 6" X 6' 8" Opens into HALLWAY Subroom: Closet (1) 83.25 SF Walls 93.36 SF Walls & Ceiling 1.12 SY Flooring 13.67 LF Ceil. Perimeter Height: 8' 10.12 SF Ceiling 10.12 SF Floor 9.75 LF Floor Perimeter Door 3' 11" X 6' 8" Opens into BED -1 ROBERT_CAPRA_AP 6/17/2019 Page: 14 DESCRIPTION All Phase Restoration 203. Clean baseboard heater - exterior - Heavy All Phase Restoration 204. Final cleaning - construction - Residential 12362 Dumont way 205. Clean light fixture Littleton, Co. 80125 206. Clean shutter p 303.749.5830 207. R&R Interior door unit c 720.339.7290 208. 1/2" drywall - hung, taped, ready for texture Tax ID#27-3667484 DESCRIPTION QTY 203. Clean baseboard heater - exterior - Heavy 7.00 LF 204. Final cleaning - construction - Residential 129.22 SF 205. Clean light fixture 1.00 EA 206. Clean shutter 2.00 EA 207. R&R Interior door unit 1.00 EA 208. 1/2" drywall - hung, taped, ready for texture 129.22 SF 209. Texture drywall - light hand texture 129.22 SF 210. Smoke detector 1.00 EA 211. Laminate - simulated wood flooring 129.22 SF 212. Detach & Reset Door knob - interior 1.00 EA 213. Baseboard heat - steam/hot wtr cover only - Detach & reset 7.00 EA 214. Detach & Reset Light fixture 1.00 EA 215. Seal & paint baseboard - two coats 47.17 LF 216. Seal/Paint bypass door set - slab only- 2 coats (per side) 2.00 EA 217. Seal & paint closet shelving - single shelf 1.00 EA 218. Paint door slab only - 2 coats (per side) 2.00 EA 219. Seal ceiling joist system (shellac) 129.22 SF 220. Mask and prep for paint - plastic, paper, tape (per LF) 57.51 LF 221. Mask the floor per square foot - plastic and tape - 4 mil 129.22 SF 222. Paint door or window opening - 2 coats (per side) 4.00 EA 223. Seal & paint window shutters - per side (set) 1.00 EA 224. Seal/prime then paint the walls and ceiling (2 coats) 520.38 SF 225. Seal & paint window stool and apron 4.50 LF 226. Seal underlayment for odor control 129.22 SF 227. Window blind - PVC - 3.511- 14.1 to 20 SF 2.00 EA NOTES: ROBERT CAPRA_AP 6/17/2019 Page: 15 Door Door DESCRIPTION Bed 2 292.78 SF Walls 401.17 SF Walls & Ceiling 12.04 SY Flooring 41.67 LF Ceil. Perimeter 2'6"X6'8" Subroom: Closetl (1) 75.43 SF Walls 83.75 SF Walls & Ceiling 0.92 SY Flooring 12.42 LF Ceil. Perimeter 3' 711 X 8 1 1 228. Clean baseboard heater - exterior - Heavy 229. Final cleaning - construction - Residential 230. Clean light fixture 231. Clean shutter 232. R&R Interior door unit 233. 1/2" drywall - hung, taped, ready for texture 234. Texture drywall - light hand texture 235. Smoke detector 236. Laminate - simulated wood flooring 237. Detach & Reset Door knob - interior 238. Baseboard heat - steam/hot wtr cover only - Detach & reset 239. Detach & Reset Light fixture 240. Seal & paint baseboard - two coats 241. Seal/Paint bypass door set - slab only- 2 coats (per side) 242. Seal & paint closet shelving - single shelf 243. Paint door slab only - 2 coats (per side) 244. Seal ceiling joist system (shellac) 245. Mask and prep for paint - plastic, paper, tape (per LF) 246. Mask the floor per square foot - plastic and tape - 4 mil Height: 8' 108.40 SF Ceiling 108.40 SF Floor 35.58 LF Floor Perimeter Opens into HALLWAY Height: 8' 8.32 SF Ceiling 8.32 SF Floor 8.83 LF Floor Perimeter Opens into BED -2 QTY 7.00 LF 116.71 SF 1.00 EA 2.00 EA 1.00 EA 116.71 SF 116.71 SF 1.00 EA 116.71 SF 1.00 EA 7.00 EA 1.00 EA 44.42 LF 2.00 EA 1.00 EA 2.00 EA 116.71 SF 54.08 LF 116.71 SF ROBERT_CAPRA_AP 6/17/2019 Page: 16 All Phase Restoration All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 Tax ID#27-3667484 Door Door DESCRIPTION Bed 2 292.78 SF Walls 401.17 SF Walls & Ceiling 12.04 SY Flooring 41.67 LF Ceil. Perimeter 2'6"X6'8" Subroom: Closetl (1) 75.43 SF Walls 83.75 SF Walls & Ceiling 0.92 SY Flooring 12.42 LF Ceil. Perimeter 3' 711 X 8 1 1 228. Clean baseboard heater - exterior - Heavy 229. Final cleaning - construction - Residential 230. Clean light fixture 231. Clean shutter 232. R&R Interior door unit 233. 1/2" drywall - hung, taped, ready for texture 234. Texture drywall - light hand texture 235. Smoke detector 236. Laminate - simulated wood flooring 237. Detach & Reset Door knob - interior 238. Baseboard heat - steam/hot wtr cover only - Detach & reset 239. Detach & Reset Light fixture 240. Seal & paint baseboard - two coats 241. Seal/Paint bypass door set - slab only- 2 coats (per side) 242. Seal & paint closet shelving - single shelf 243. Paint door slab only - 2 coats (per side) 244. Seal ceiling joist system (shellac) 245. Mask and prep for paint - plastic, paper, tape (per LF) 246. Mask the floor per square foot - plastic and tape - 4 mil Height: 8' 108.40 SF Ceiling 108.40 SF Floor 35.58 LF Floor Perimeter Opens into HALLWAY Height: 8' 8.32 SF Ceiling 8.32 SF Floor 8.83 LF Floor Perimeter Opens into BED -2 QTY 7.00 LF 116.71 SF 1.00 EA 2.00 EA 1.00 EA 116.71 SF 116.71 SF 1.00 EA 116.71 SF 1.00 EA 7.00 EA 1.00 EA 44.42 LF 2.00 EA 1.00 EA 2.00 EA 116.71 SF 54.08 LF 116.71 SF ROBERT_CAPRA_AP 6/17/2019 Page: 16 CONTINUED - Bed 2 DESCRIPTION QTY 247. Paint door or window opening - 2 coats (per side) All Phase Restoration 248. Seal & paint window shutters - per side (set) All Phase Restoration 249. Seal/prime then paint the walls and ceiling (2 coats) 12362 Dumont way 250. Seal & paint window stool and apron Littleton, Co. 80125 251. Seal underlayment for odor control p 303.749.5830 252. Window blind - PVC - 3.511- 14.1 to 20 SF c 720.339.7290 4 technicians at 5 days Tax ID#27-3667484 CONTINUED - Bed 2 DESCRIPTION QTY 247. Paint door or window opening - 2 coats (per side) 4.00 EA 248. Seal & paint window shutters - per side (set) 1.00 EA 249. Seal/prime then paint the walls and ceiling (2 coats) 484.92 SF 250. Seal & paint window stool and apron 4.50 LF 251. Seal underlayment for odor control 116.71 SF 252. Window blind - PVC - 3.511- 14.1 to 20 SF 2.00 EA NOTES General General DESCRIPTION QTY 253. Hydroxyl generator - odor counteractant - 3 optics 3.00 DA 254. Dumpster load - Approx. 30 yards, 5-7 tons of debris 2.00 EA 255. General Demolition - per hour 160.00 HR demolition of all areas affected down to studs. Living room, kitchen, bathroom, attic area. 4 technicians at 5 days 256. Megohmmeter check electrical circuits - average residence 1.00 EA 257. Asbestos test fee - full service survey - base fee 1.00 EA emergency turn around 258. Asbestos test fee - full service survey - per sample 51.00 EA 259. Taxes, insurance, permits & fees (Bid Item) 1.00 EA 260. Residential Supervision / Project Management - per hour 50.00 HR 5hrs a week for 10 weeks 261. Plumber - per hour 4.00 HR pressure test all water and gas lines 262. Temporary toilet (per month) 3.00 MO ROBERT_CAPRA_AP 6/17/2019 Page: 17 All Phase Restoration All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 Tax ID#27-3667484 CONTINUED - General DESCRIPTION NOTES: QTY CODE REQUIREMENTS DESCRIPTION QTY once incurred NOTES: Labor Minimums Applied DESCRIPTION QTY 263. Temporary repair services labor minimum 1.00 EA 264. Siding labor minimum 1.00 EA 265. Framing labor minimum 1.00 EA 266. Vinyl floor covering labor minimum 1.00 EA 267. Paneling labor minimum 1.00 EA 268. Carpet labor minimum 1.00 EA NOTES: ROBERT_CAPRA AP 6/17/2019 Page: 18 All Phase Restoration All Phase Restoration 12362 Dumont way Littleton, Co. 80125 p 303.749.5830 c 720.339.7290 Tax ID#27-3667484 Grand Total Areas: 2,476.51 SF Walls 2,313.62 SF Floor 0.00 SF Long Wall 2,313.62 Floor Area 1,251.09 Exterior Wall Area 0.00 Surface Area 0.00 Total Ridge Length 2,446.47 SF Ceiling 257.07 SY Flooring 0.00 SF Short Wall 2,448.16 Total Area 300.67 Exterior Perimeter of Walls 0.00 Number of Squares 0.00 Total Hip Length 4,922.99 SF Walls and Ceiling 440.90 LF Floor Perimeter 510.76 LF Ceil. Perimeter 2,476.51 Interior Wall Area 0.00 Total Perimeter Length ROBERT_CAPRA_AP 6/17/2019 Page: 19 _ o � N c N b 05 —� rn 0 N L.2; U cwt Cd o. M Main Level L .. City of _ �ro3.atiUNiTI' DEVEl01'MENT APPROVED Peviewed fa_ r C°de wr—pl__ iante - rorw�va��,(Idom sceajKollons ..,. .,, �Ppr evnl n1, ony violutbn do .ud. If ony p,y O'dinnnces- Permif3 NOn3 of the suitdm9 �,,,., I "•tc of cancel the Plov "J ll: t• nl t�, ca, shoes "Of be ✓Ohd. r 26' 11"- I`� ' r Z ' .� is �6'��.:�,',� C�'�a 'd,� .. •k:: �F,;ti. jA JE i d d 5' 10" ROBERT_CAPRA_AP t 6/17/2019 -- Cegew" F` -o 6 & 0.4c Main Level Page: 20 �,,- -��C",vv (-oM , o C4�u:v�'OC; �'1v+r1� Coca( 1— City of Wheat Ridge Building Division attic ROBERT_CAPRA_AP attic 6/17/2019 Page: 21 5366 Godding Hollow Pkwy EARTH ENERGY ENVIRONMENT (E3) Longmont, co 80504 Local: 303.902-5851 Industrial Hygiene and Environmental Engineering July 30, 2019 Mr. Case Hushen All Phase Restoration 12362 Dumont Way Littleton, CO 80125 Subject: Clearance Report — Load Out 10616 W 48" Ave Wheat Ridge, CO 80033 Dear Mr. Hushen: Following is the project completion report for the work area located at 10616 W 48th Ave in Wheat Ridge, CO 80033. The purpose of this report is to document this remediation project was successfully completed, and indoor asbestos amplification was not occurring in the work area. An Industrial Hygienist for Earth Energy Environment (E3) performed the remediation project completion inspection and testing procedures. The remediation work area (Load Out Area) was visually inspected in order to confirm the scope of work was properly followed and completed. The containments were also visually inspected to verify breaches and/or defects were not present. Phase Contrast Microscopy (PCM) samples were collected in accordance with the National Institute for Occupational Safety and Health (NIOSH) method 7400 using cassettes (standard 3 piece, 25 mm dia., 0.8 um MCE filter) purchased from Zefon International, Inc. Asbestos concentrations in the containment were calculated as airborne fibers per cubic centimeter of air (F/cc). Table 1 provides a summary of the sample numbers, sample volumes, and calculated concentrations. The National Emission Standards for Hazardous Air Pollutants (NESHAP) clearance standard is 0.01 F/cc. Visual inspection confirmed that no asbestos -containing debris was observed in the work areas. The PCM clearance air sample results were all below the NESHAP clearance standard of 0.01 F/cc. Based on the information presented above, E3 concludes the asbestos abatement in the work area has been successfully completed, and the work area may be reoccupied after build back. PCM Air Clearance Page 2 of 2 TABLE 1: PCM CLEARANCE AIR SAMPLING RESULTS Date Unit/ Area Sample # Descrmiple Vo uSamme "Fibers/cc Air Clearance at: CL -072919-1 765 0.001 10616 W 48th CL -072919-2 Inside 755 0.001. Ave in Wheat CL -072919-3 Containment 745 0.001 July Ridge, CO CL -072919-4 730 0.001 29, 2019 80033 CL -072919-5 715 0.001 (Load Out Area) BLK-1 Blanks - BRL BLK-2 - BRI, *BRL denotes "Below Reporting Limits". The PCM Colorado Department of Public Health and Environment (CDPHE) clearance standard is 0.01 F/cc. Thank you for allowing E3 the opportunity to provide environmental services to you. If you have questions or require additional information, do not hesitate to contact me directly at (303) 902-5851. Sincerely, Eli Willden Certified Air Monitoring Specialist No. 20139 *** CONTACTS *** OWNER (303)517-5917 CAPRA ROBERT E SUB (303)749-5830 MARK PIJANOWSKI 130245 ALL PHASE RESTORATION *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: U / Utility structures SUBDIVISION CODE: 2408 / FRUITDALE, LEES, STONERIDGE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 36,686.85 FEES Asbestos Abatement 50.00 Total Valuation 0.00 Investigative Fees 50.00 ** TOTAL ** 100.00 *** 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, 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 1 am the legal owner or have been authorized by, the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this_permrt. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all wor to be performed ed disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER ori TL2 12 TRACT Circle one) 'Date 1. This permit was issued based on the—i—nformnfion 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 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 androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4, No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any ap2llicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of chief ]wilding Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of Wheat Ridge Residential Asbestos Abatement PERMIT - 201901657 PERMIT NO: 201901657 ISSUED: 08/12/2019 JOB ADDRESS: 10616 W 48th Ave EXPIRES: 08/11/2020 JOB DESCRIPTION: Residential abatement for fire restoration. No removal of framing. Square feet of removal: 1,970 *** CONTACTS *** OWNER (303)517-5917 CAPRA ROBERT E SUB (303)749-5830 MARK PIJANOWSKI 130245 ALL PHASE RESTORATION *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: U / Utility structures SUBDIVISION CODE: 2408 / FRUITDALE, LEES, STONERIDGE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 36,686.85 FEES Asbestos Abatement 50.00 Total Valuation 0.00 Investigative Fees 50.00 ** TOTAL ** 100.00 *** 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, 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 1 am the legal owner or have been authorized by, the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this_permrt. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all wor to be performed ed disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER ori TL2 12 TRACT Circle one) 'Date 1. This permit was issued based on the—i—nformnfion 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 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 androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4, No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any ap2llicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of chief ]wilding Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Building & Inspection Services 7500 W. 2911 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 " Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(c)ci.wheatridcle.co.us FOR OFFICE USE ONLY DateVaP Planmermit # P/a7leiew l " Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 106 IC y) q6A I-tytKo-t_, LJVA&+" 94p, 003 3 Property Owner (please print): Apb Cgora Phone: 303-517 - 5917 Property Owner Email: COPM, tl (2, -16 1 . -CO kf Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: (132 (o lei 2..(0'x (A, � City, State, Zip: L2 ",o -e e c F LO 66z!5' Architect/Engineer: Architect/Engineer E-mail: Contractor Name: City of Wheat Ridge License #: I3OZ'15_ Phone: Phone: 303-7q9-6'630 Contractor E-mail Address: Ap dQ Av4-r Wes 4414 Pc on . c 0"i For Plan Review Questions & Comments (please print): CONTACT NAME (please print): CaSt_ 9VS1+1tk Phone:_ 7?.n -qqO -3y38 CONTACT EMAIL(p/ease print): 6\osVxer1 &_ QRes4eraNyn . 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 # ❑COMMERCIAL RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and 4 roposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. 5%ott4.65d- +o c&vnaAt. In3vl&k#A /dentd-yd dtytw(( , XiMMl aF all dcY"11 4Kd F;n;364 s^ Ic;kk't-, b ovAWDYA, AA uwtw�5 wem . Q0 N. WVJ ( & d -y t,vAb�__ rr Mwtvvt4 . Corps' fi Pad 9C,6eA6.S tO1�Mtnil1"Cd Wab�tr Sq. RAF BTUs .� all awas +-o b -L Gallons 1, 170 st r`ntat'td as Amps Squares 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) %, a8�. 85- OWNER/CONTRACTOR S OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that 1 assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER)CONTRACTO ar (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): 1 DATE: p Printed Name: ��a� I��►ar�G11� ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: Colorado Department of Public Health and Environment Air Pollution 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 7/15/2019 through 11:59 PM on 8/13/2019. The actual scheduled work dates are from 7/15/2019 through 8/2/2019. Approval issued on: 7/12/2019 Fee paid: $400.00 Record number: 150312 Notice Number: 19JE4436A Variance: None Comments: None For the location specified below: Kitchen, living rm, bthrm, hllwy, bdrms 10616 W. 48th Ave. Arvada Jefferson County This permit has been issued to: All Phase Restoration Denver, LLC 12362 Dumont Way Littleton, CO 80125 Check number: CC 5381 Project Supervisor: Javier E Saenz-Alonso Cerification No.: 24173 Project AMS: Eli Willden Cerification No.: 20139 Project Manager: Issued by: SK 11 ?�:9 >8-( fl, � o �m Vow m � � moo a -- o O Dd,9761, o.L,m° p � c m y_CN- 3 m�Nrn'N r pa � C_ O OK IA fl_a n m� m o � m m 0 5 r -L a ' M ID �Q ymN� X, ogg_ N �?- N ° a cad Z��+� 4 o W CLm mm m 1m�co w R n ry 5 �®mrnm a�3Q o ;, �� g: O �� U) n-. 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Colorado Dept. of Public Health and Environment AI'CD-IEP-B 1 COLORADO 4300 Cheng Creek Drive South Denver, CO 50246-1530 Department of Public Phone: 303-692-3100 Health & Environment GENERAL ABATEMENT CONTRACTOR CERTIFICATION APPLICATION Please type or print. WHO MUST APPLY: All persons who wish to perform asbestos abatement activities in the State of Colorado. Certification is required under Colorado law (§§25-7-505, C.R.S. 1982, as amended). Certification must be renewed annually. FEES: Please make checks or money orders payable to: Colorado Department of Public Health and Environment or CDPHE. Visa, MasterCard & Discover accepted in person only. (We do not accept cash.) PART I — Please check the appropriate box: [code 511] ❑ $2,00000 Initial Registration (in-state) [code 512],r$1,00o Renewal of Registration (in-state) [code 521] ❑ $3,000Q0 Initial Registration (out-of-state) [code 522] ❑ $2,000Q0 Renewal Registration (out-of-state) PART II - General Information Name of Company Physical Address City Mailing Address GAC# 141,41 Expiration Date: GAC# I Expiration Date: Website www. Y j V 1 I (- b ! I Email: �;j G' ! l i�L r� �} n -P Phone numberFax :> D) �' 1 "1 ` , 0 a / This company conducts asbestos abatemen services in the f (lowing: ]f Single Family Residential Dwellings APublic & Commercial Buildings Schools Demolition ❑ Other (please list) T is firm offers its services in the following Colorado locations: ❑ Entire State or only: IRf Denver Metro M Front Range Western Slope ❑ Northern Colorado Area [:1 Colorado Springs Area ❑ Other Locations (please list): Has this company or its principal(s) ever bccn licensed as an asbestos abatement contractor in another state? ❑ Y XN If yes, please list the business names and state(s) in which you operated (attach a separate sheet if necessary): Does the company - or any principal of the company - have any past, present, or pending asbestos activity violation(s) of EPA, state, U.S. territory, OSHA or Indian tribal land(s) regulations? ❑ Y N (If yes, please attach a copy of all enforcement documents pertaining to each enforcement action.) APCD USE ONLY Form: GAC 17 Revised May 2017 5366 Godding Hollow Pkwy EARTH ENERGY ENVIRONMENT (E3) Longmont, CO 80504 Local: 303.902-5851 Industrial Hygiene and Environmental Engineering July 30, 2019 Mr. Case Hushen All Phase Restoration 12362 Dumont Way Littleton, CO 80125 Subject: Clearance Report — Unit Interior RECEIVED 10616 W 48' Ave Wheat Ridge, CO 80033 Dear Mr. Hushen: Per Following is the project completion report for the work area located at 10616 W 48" Ave in Wheat Ridge, CO 80033. The purpose of this report is to document this remediation project was successfully completed, and indoor asbestos amplification was not occurring in the work area. An Industrial Hygienist for Earth Energy Environment (E3) performed the remediation project completion inspection and testing procedures. The remediation work area (Unit Interior) was visually inspected in order to confirm the scope of work was properly followed and completed. The containments were also visually inspected to verify breaches and/or defects were not present. Phase Contrast Microscopy (PCM) samples were collected in accordance with the National Institute for Occupational Safety and Health (NIOSH) method 7400 using cassettes (standard 3 piece, 25 mm dia., 0.8 um MCE filter) purchased from Zefon International, Inc. Asbestos concentrations in the containment were calculated as airborne fibers per cubic centimeter of air (F/cc). Table 1 provides a summary of the sample numbers, sample volumes, and calculated concentrations. The National Emission Standards for Hazardous Air Pollutants (NESHAP) clearance standard is 0.01 F/cc. Visual inspection confirmed that no asbestos -containing debris was observed in the work areas. The PCM clearance air sample results were all below the NESHAP clearance standard of 0.01 F/cc. Based on the information presented above, E3 concludes the asbestos abatement in the work area has been successfully completed, and the work area may be reoccupied after build back. PCM Air Clearance Page 2 of 2 TABLE 1: PCM CLEARANCE AIR SAMPLING RESULTS Date Unit/ Area Sample # Description Sa voluple me *Fibers/cc Air Clearance at: CL -073019-1 915 0.002 10616 W 481h CL -073019-2 Inside 905 0.001 Ave in Wheat CL -073019-3 Containment 885 0.002 July Ridge, CO CL -073019-4 870 0.003 30, 2019 80033 CL -073019-5 865 0.003 (Unit Interior) BLK-1 Blanks - BRL BLK-2 - BRL *BRL denotes "Below Reporting Limits". The PCM Colorado Department of Public Health and Environment (CDPHE) clearance standard is 0.01 F/cc. Thank you for allowing E3 the opportunity to provide environmental services to you. If you have questions or require additional information, do not hesitate to contact me directly at (303) 902-5851. Sincerely, Eli Willden J Certified Air Monitoring Specialist No. 20139 RECEIVED SilverKey Services Per Asbestos Inspection and Sampling Report Presented To: All Phase Restoration 12362 N Dumont Way Littleton, CO 80125 10616 W. 48th Ave. Wheat Ridge, Co 80033 Performed & Prepared By: Kevin Bruscas SilverKey Services P.O. Box 2641 Loveland, CO. 80539 Phone: 720-538-6629 kbruscas@silverkeyservice.com Project Details: Project Number:A19-11780 Conducted: June 6th 2019 1 1 Page h TABLE OF CONTENTS PROJECT OVERVIEW 1. Introduction 2. Scope of Work 3. Site Description 4. Certifications S. Inspection, Sampling & Analytical Procedures 5.1 Inspection Procedures 5.2 Sampling Procedures 5.3 Analytical Procedures 6.0 Homogeneous Areas 6.1 Material Friability 6.2 Material Classifications 6.3 Material Conditions 6.4 Sample Quantities 7.0 Overview of findings 8.0 Findings & Recommendations 8.1 Asbestos Spill Responses 9.0 Asbestos Abatement & Demolition Requirements 10.0 Disclaimer & Limitations _ 2 Page PROJECT OVERVIEW 1.0 Introduction On June 6th 2019, Kevin Bruscas with SilverKey Services conducted a limited asbestos inspection and collected asbestos bulk -samples of suspect asbestos -containing materials (ACM) within a portion of the bathroom. The southeast bedroom. The living room. The hallway. The north bedroom and the kitchen located at 10616 W. 48th Ave. Wheat Ridge, Co 80033. The purpose of the limited inspection was to identify and sample potentially hazardous friable and non -friable ACM that has either been affected by a recent fire loss and/or may be impacted by subsequent restoration activities. 2.0 Scope of Work The scope of the limited inspection and bulk -sampling was limited to specific areas of the residence defined by the contractor. These areas included the bathroom purple shower tile and grout. The bathroom white shower tile and grout. The bathroom tile flooring and grout. The bathroom vinyl flooring and mastic. The southeast bedroom tile flooring and mastic. The living room west wall surfacing material. The hallway north wall surfacing material. The north bedroom south wall surfacing material. The living room south wall surfacing material. The kitchen west wall surfacing material. The kitchen east wall surfacing material. The living room northeast wall joint compound. The living room southwest wall joint compound. The living room ceiling surfacing material. The hallway ceiling surfacing material. The hallway ceilingjoint compound. The living room ceiling joint compound. The bathroom wall surfacing material. The bathroom wall joint compound. The kitchen flooring tile and grout. The kitchen laminate countertop and mastic as well as the kitchen window caulking. The remaining areas within the residence, garage or any outbuilding on the property were not included in the scope of the inspection. The limited asbestos inspection did not constitute a full building inspection and does not fulfill the asbestos inspection requirements for structures that are to be demolished. 3.0 Site Description Single Family Residence 4.0 Certifications The limited asbestos inspection and bulk -sampling was conducted by Kevin Bruscas with SilverKey Services. Kevin Bruscas is a Colorado Department of Public Health and Environment (CDPHE) certified Building Inspector; having certification number 25338. 5.0 Inspection, Sampling & Analytical Procedures 3 1 Page I ,I 5.1 Inspection Procedures The limited asbestos inspection was conducted by an Environmental Protection Agency (EPA) and CDPHE certified Building Inspector. The inspection procedures included identifying and sampling suspect ACM within the pre -defined areas, submitting samples to an accredited laboratory for analysis, classifying the materials and assessing their condition, and compiling a final report detailing the inspection and the analytical results of the bulk -samples. 5.2 Sampling Procedures Statistically random bulk -samples representative of the suspect ACM of each homogeneous area were collected according to the guidelines published as EPA Final Rule: Title II of the Toxic Substances Control Act (TSCA), 15 USC, Sections 2641 through 2654 and in compliance with 40 CFR, Part 763 and CDPHE Regulation Number 8, Part B- Asbestos (Reg. 8). SilverKey Services has collected the appropriate number of bulk -samples to meet all regulatory requirements for the classification and quantity of each homogeneous area. Some minor destructive sampling was conducted; however, walls, columns and perimeter pipe chases were not broken into in order to locate and quantify suspect ACM. SilverKey Services is not responsible for repairing the damage from collecting bulk samples. It should be noted that additional ACM might be located in these and other inaccessible areas. Materials containing less than 1% asbestos are not regulated by CDPHE Regulation 8, Part B - Asbestos. However, all demolition/abatement activities should be performed following the applicable Occupational Safety and Health Administration (OSHA) regulations. This would include, but not limited to, the appropriate asbestos training for the type of material being removed/disturbed as well as having a properly trained supervisor onsite, using wet removal methods, wearing adequate personal protective equipment (HEPA-filtered particulate respirators), medical surveillance of workers, personal -exposure air monitoring, area air monitoring in occupied buildings, etc. There may also be landfill disposal requirements for these materials, depending on the facility. SilverKey Services recommends that all demolition/renovation areas involving any amount of asbestos be subjected to visual inspections and a final clearance air testing by a CDPHE-certified Air Monitoring Specialist (AMS) after the work has been completed, but before any containments are dismantled and the area is reoccupied. 5.3 Analytical Procedures All asbestos bulk -samples were analyzed by a National Voluntary Laboratory Accreditation Program (NVLAP) accredited laboratory via Polarized Light Microscopy (PLM) for asbestos content (see Appendix B for laboratory report). 6.0 Homogeneous Areas A Homogeneous Area (HA) includes materials that are uniform in appearance, color, texture and date of application. The asbestos content of the bulk -samples collected within a homogeneous area can be applied to the entire homogenous area if they conform to the above characteristics and the regulated minimum sample quantities of each type of material are collected and analyzed. 4 1 Page 6.1 Material Friability A material can either be friable or non friable. A friable material is one that, when dry, can be pulverized, or reduced to powder by hand pressure, a non -friable material cannot. A non -friable material may become friable if its condition had deteriorated or has been impacted by forces that have rendered it friable. 6.2 Material Classifications Sampled materials are divided into one of the following three categories: • Surfacing Material: sprayed or troweled onto structural building members • Thermal System Insulation (TSI): any type of pipe, boiler, tank, or duct insulation • Miscellaneous Material: all other materials not classified in the above two categories 6.3 Material Conditions Sampled materials are placed into one of the three following categories of conditions: • Good: none to very little visible damage or deterioration • Damaged: the surface is crumbling, blistered, water -stained, gouged, marred or otherwise abraded over less than one-tenth of the surface if the damage is evenly distributed, or one-quarter if the damage is localized • Significantly Damaged: the surface is crumbling, blistered, water -stained, gouged, marred or otherwise abraded over greater than one-tenth of the surface if the damage is evenly distributed, or one-quarter if the damage is localized 6.4 Sample Quantities SilverKey Services collected at least the minimum number of samples from each homogeneous area necessary to meet all regulatory requirements for the quantity of material to be disturbed. The quantities listed in this report are approximate and on-site verification of the exact quantity of each material is required. The following outlines the minimum sample quantities required per homogeneous area: • Surfacing Materials: up to 1,000 ft2 of material requires a minimum of three (3) samples; between 1,000 ft2 and 5,000 ft2 of material requires a minimum of five (5) samples; over 5,000 ft2 of material requires a minimum of seven (7) samples; one (1) sample of each patch • Thermal System Insulation (TSI): each homogeneous area requires a minimum of three (3) samples; at least one (1) sample must be collected from each patch; and collect enough samples sufficient to adequately assess the material and determine the asbestos content for TSI fittings such as pipe elbows or T's. • Miscellaneous Materials: collect enough samples sufficient to determine the asbestos Content 7. Overview of Finding Asbestos was reported within some of one or more of the samples collected. Therefore, abatement of these materials will be required. SilverKey Services collected a total of (51) asbestos bulk -samples of (21) homogeneous areas. 5 1 Page 9 � � Table 1 below describes the materials composing each homogeneous area as well as the locations of each bulk -sample collected. Also listed is the classification, condition, friability and estimated quantity of material to be removed and/or disturbed, as well as the asbestos content within each bulk -sample. Please see Appendix B: Analytical Data for the layer break -down of each bulk -sample. ASBESTOS SURVEY COLLECTION DATA HOMOGENEOUS SAMPLING AREA: HA1 MATERIAL DESCRIPTION: Tile COLOR: Purple PATTERN. Square CONDITION: G MATERIAL CATEGORY.• MM LOCATION: Bathroom shower # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HAI -001, HAl-002 RESULT. ND FRIABILITY: Non -friable HOMOGENEOUS SAMPLING AREA: HA2 MATERIAL DESCRIPTION: Grout COLOR: Tan PATTERN: NA CONDITION: G MATERIAL CATEGORY.• mm LOCATION: Bathroom purple showertile # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA2 -003, HA2 -004 RESULT.• ND FRIABILITY.• Non -friable HOMOGENEOUS SAMPLING AREA: HA3 MATERIAL DESCRIPTION: Tile COLOR: White PATTERN: Square CONDITION: G MATERIAL CATEGORY. MM LOCATION: Bathroom shower # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA3-005, HA3-006 RESULT: ND FRIABILITY.• Non -friable 6 1 Page HOMOGENEOUS SAMPLING AREA: HA4 MATERIAL DESCRIPTION: Grout COLOR: Tan PATTERN: NA CONDITION: G MATERIAL CATEGORY: MM LOCATION: Bathroom white shower tile # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA4-007, HA4-008 RESULT: ND FRIABILITY: Non -friable HOMOGENEOUS SAMPLING AREA: HAS MATERIAL DESCRIPTION: Tile COLOR: Red PATTERN: Square CONDITION: G MATERIAL CATEGORY. MM LOCATION: Bathroom flooring # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA5-009, HA5-010 RESULT: ND FRIABILITY: Non -friable HOMOGENEOUS SAMPLING AREA: HA6 MATERIAL DESCRIPTION: Grout COLOR: Brown PATTERN: NA CONDITION: G MATERIAL CATEGORY: MM LOCATION: Bathroom tile flooring # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA6-011, HA6-012 RESULT: ND FRIABILITY: Non -friable 7 1 Page HOMOGENEOUS SAMPLING AREA: HA7 MATERIAL DESCRIPTION: Vinyl COLOR: Off white PATTERN: Square CONDITION: G MATERIAL CATEGORY. MM LOCATION: Bathroom flooring # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA7-013, HA7-014 RESUL T: N D FRIABILITY- Non -friable HOMOGENEOUS SAMPLING AREA: HA8 MATERIAL DESCRIPTION: Mastic COLOR: Tan PATTERN: NA CONDITION: G MATERIAL CATEGORY.- MM LOCATION: Bathroom vinyl flooring # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA8-015, HA8-016 RESULT.• ND FRIABILITY.- Non -friable HOMOGENEOUS SAMPLING AREA: HA9 MATERIAL DESCRIPTION: Tile COLOR: Brown PATTERN: Square CONDITION: G MATERIAL CATEGORY. mm LOCATION: Southeast bedroom flooring # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA9-017, HA9-018 RESULT. • 5% Chrysotile FRIABILITY. • Non -friable 8 1 Page HOMOGENEOUS SAMPLING AREA: HA10 MATERIAL DESCRIPTION: Mastic COLOR: Black PATTERN: NA CONDITION: G MATERIAL CATEGORY: MM LOCATION: Southeast bedroom tile flooring # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA10-019, HA10-020 RESULT: ND FRIABILITY.• Non -friable HOMOGENEOUS SAMPLING AREA: HA11 MATERIAL DESCRIPTION: Surfacing material, drywall COLOR: Beige, white PATTERN: Light hand trowel, light orange peel CONDITION: SD MATERIAL CATEGORY: SM, MM LOCATION: Living room west wall, hallway north wall, north bedroom south wall, living room south wall, kitchen west wall, kitchen east wall # OF SAMPLES TAKEN: 7 SAMPLE ID NUMBER(S): HA11-021, HA11-022, HA11-023, HA11-024, HA11-025, HA11-026, HA11-027 RESULT: 2% Chrysotile in surfacing material FRIABILITY: Friable HOMOGENEOUS SAMPLING AREA: HAl2 MATERIAL DESCRIPTION: Joint compound, drywall COLOR: Beige, white, off white PATTERN: NA CONDITION: G MATERIAL CATEGORY.• MM LOCATION: Living room northeast wall, living room southwest wall # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HAl2-028, HAl2-029 RESULT: 2% Chrysotile in joint compound FRIABILITY, Friable 9 1 Page HOMOGENEOUS SAMPLING AREA: HA13 MATERIAL DESCRIPTION. Surfacing material, drywall COLOR: Off white, gray PATTERN: Light hand trowel CONDITION: G MATERIAL CATEGORY. SM, MM LOCATION: Living room ceiling, hallway ceiling # OF SAMPLES TAKEN: 5 SAMPLE ID NUMBER(S): HA13-030, HA13-031, HA13-032, HA13-033, HA13-034 RESULT: 2% Chrysotile in surfacing material FRIABILITY: Friable HOMOGENEOUS SAMPLING AREA: HA14 MATERIAL DESCRIPTION: Joint compound, drywall COLOR: Off white, gray PATTERN: NA CONDITION: G MATERIAL CATEGORY: mm LOCATION: Hallway ceiling, living room ceiling # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA14-035, HA14-036 RESULT: 2% Chrysotile in joint compound FRIABILITY.• Friable HOMOGENEOUS SAMPLING AREA: HA15 MATERIAL DESCRIPTION: Surfacing material, drywall COLOR: Off white, gray PATTERN: Light orange peel CONDITION: G MATERIAL CATEGORY.• SM, MM LOCATION: Bathroom wall # OF SAMPLES TAKEN: 3 SAMPLE ID NUMBER(S): HA15-037, HA15-038, HA15-039 RESULT: 2% Chrysotile in surfacing material FRIABILITY: Friable 10 1 Page HOMOGENEOUS SAMPLING AREA: HA16 MATERIAL DESCRIPTION: Joint compound, drywall COLOR: Off white, gray PATTERN: NA CONDITION: G MATERIAL CATEGORY: MM LOCATION: Bathroom wall # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA16-040, HA16-041 RESULT: 2% Chrysotile in joint compound FRIABILITY: Friable HOMOGENEOUS SAMPLING AREA: HA17 MATERIAL DESCRIPTION: Ceramic the COLOR: Green, tan PATTERN: Square CONDITION: G MATERIAL CATEGORY: MM LOCATION: Kitchen flooring # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA17-042, HA17-043 RESUL T.• N D FRIABILITY: Non -friable HOMOGENEOUS SAMPLING AREA: HA18 MATERIAL DESCRIPTION: Grout COLOR: Gray PATTERN: NA CONDITION: G MATERIAL CATEGORY: MM LOCATION: Kitchen tile flooring # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA18-044, HA18-045 RESULT: ND FRIABILITY: Non -friable 11 1 Page I { 0 HOMOGENEOUS SAMPLING AREA: HA19 MATERIAL DESCRIPTION: Laminate COLOR: Brown PATTERN: Square CONDITION: G MATERIAL CATEGORY. MM LOCATION: Kitchen countertop # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA19-046, HA19-047 RESUL T.• N D FRIABILITY. Non -friable HOMOGENEOUS SAMPLING AREA: HA20 MATERIAL DESCRIPTION: Mastic COLOR: Beige PATTERN: NA CONDITION: G MATERIAL CATEGORY.- MM LOCATION: Kitchen countertop # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA20-048, HA20-049 RESULT: ND FRIABILITY: Non -friable HOMOGENEOUS SAMPLING AREA: HA21 MATERIAL DESCRIPTION: Caulking COLOR: White PATTERN: NA CONDITION: G MATERIAL CATEGORY. MM LOCATION: Kitchen window # OF SAMPLES TAKEN: 2 SAMPLE ID NUMBER(S): HA21-050, HA21-051 RESULT. • ND FRIABILITY.- Non -friable ND -Non -detect D -Damaged MM -Miscellaneous Material HA- Homogenous Area G -Good SM -Surfacing Material TR -Trace, <1% SD -Significantly Damage TSI -Thermal System Insulation Itis the responsibility of the asbestos abatement company to give a scope of work for all abatement. 12 1 Page 8. Findings & Recommendations ACM was identified within the areas of the southeast bedroom tile flooring. The living room west wall surfacing material. The hallway north wall surfacing material. The north bedroom south wall surfacing material. The living room south wall surfacing material. The kitchen west wall surfacing material. The kitchen east wall surfacing material. The living room northeast wall joint compound. The living room southwest wall joint compound. The living room ceiling surfacing material. The hallway ceiling surfacing material. The hallway ceiling joint compound. The living room ceiling joint compound. The bathroom wall surfacing material as well as the bathroom wall joint compound that were within the scope of the limited inspection and bulk -sampling performed on June 6th 2019; therefore, professional abatement activities are required to remove or disturb the above -reference sampled materials. ACM was impacted or disturbed. We do consider this a major spill; SilverKey Services recommends that when ACM is removed/abated, that only a licensed asbestos abatement contractor using personnel trained in the handling of ACM be allowed to conduct such activities using appropriate methods (HEPA- filtered vacuuming, wet cleaning methods, respiratory protection, protective clothing, personnel decontamination, negative -air enclosures, air monitoring, etc.). For all spills, SilverKey Services recommends that all soft goods (carpet, pad, clothes, couches, etc.) and any ceiling and/or wall surfacing restoration activities be removed from the interior of the building as asbestos waste. SilverKey Services also advises that only hard surfaces (plastic, metal, wood, concrete, etc.) are allowed to be left in place before the final visual and final air clearance tests are completed. SilverKey Services urges that electronics and appliances (refrigerators, air conditioners, DVD players, microwaves, toasters, etc.) are removed due to the mechanical openings and working parts that make it difficult to clean thoroughly. 8.1. ASBESTOS SPILL RESPONSES Major Spill Response Protocols If ACM is significantly damaged and the total quantity exceeds the regulatory trigger levels, the area is deemed a "Major Asbestos Spill." The area is consequently subject to the requirements in Reg. 8, Section III.T.1. — Major Asbestos Spills, as outlined below. Additional asbestos air or dust sampling should also be conducted within the remaining areas not directly impacted by the Major Asbestos Spill to determine if asbestos -containing dust/debris has spread to adjacent areas. If asbestos fibers are found within any other areas or on building contents, they should be included in the scope of professional abatement and decontamination. The following response actions must be followed per Colorado Reg. 8 when a Major Asbestos Spill occurs: • 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. Shut off or temporarily modify the air handling system to prevent the distribution of asbestos fibers to other areas. 13 1 Page • Immediately contact the Division by telephone, submit a notification in compliance with subsection III.E. (Notifications) and, if in an area of public access, apply for a permit in accordance with subsection IILG. (Permits). • Be exempted from the requirements to have a certified Supervisor on-site at all times, until such time as the immediate danger has passed. Any cleanup or asbestos abatement that must occur after the immediate danger has passed shall be supervised by a person certified by the Division. • Using certified Supervisors and certified Workers in accordance with section IL (Certification Requirements) of this Regulation, seal all openings between the contaminated and uncontaminated areas and establish none- detect air pressure within the contaminated area in accordance with paragraph III.J. (Air Cleaning and None- detect Pressure Requirements). 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. • HEPA vacuum or steam clean all carpets, drapes, upholstery, and other non -clothing fabrics in the contaminated area, or discard these materials. • Launder or discard contaminated clothing in accordance with subsection III.R. (Waste Handling). • HEPA vacuum or wet clean all surfaces in the contaminated area. • Discard all materials in accordance with subsection III.R. (Waste Handling). • Following completion of subparagraph III.T. La. through III.T.l.i. above, comply with air monitoring requirements as described in subsection III.P. (Clearing Abatement Projects); air samples shall be collected aggressively as described in 40 C.F.R. Part 763, Appendix A to Subpart E (EPA 1995), except that the air stream of the leaf blower shall not be directed at any friable ACM that remains in the area and comply with any other measures deemed necessary by the Division to protect public health. Minor Spill Response If ACM is significantly damaged and the total quantity is less than the regulatory trigger levels, however, more than three square feet or three linear feet (3 ft2/3 In/ft.), the area is deemed a "Minor Asbestos Spill." The area is consequently subject to the requirements in Reg. 8, Section III.T.2. — Minor Asbestos Spills, as outlined below. Additional asbestos air or dust sampling should also be conducted within the remaining areas not directly impacted by the Minor Asbestos Spill to determine if asbestos -containing dust/debris has spread to adjacent areas. If asbestos fibers are found within any other areas or on building contents, they should be included in the scope of professional abatement and decontamination. The following response actions must be followed per Colorado Reg. 8 when a Minor Asbestos Spill occurs: • 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. 14 1 Page • Shutoffortemporarilymodifytheairhandlingsystemtopreventthedistributionofasbestosfiberstoother areas. • Using certified Supervisors and certified Workers in accordance with section Il. (Certification Requirements) of this Regulation, seal all openings between the contaminated and uncontaminated areas and establish none -detect air pressure within the contaminated area in accordance with paragraph III.J. (Air Cleaning and None -detect Pressure Requirements). 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. • HEPA vacuum or steam clean all carpets, drapes, upholstery, and other non -clothing fabrics in the contaminated area, or discard these materials. • Launder or discard contaminated clothing in accordance with subsection III.R. (Waste Handling). • HEPA vacuum or wet clean all surfaces in the contaminated area. • Discard all materials in accordance with subsection III.R. (Waste Handling). • Following completion of subparagraph III.T.I .a. through III.T. Li. above, comply with air monitoring requirements as described in subsection III.P. (Clearing Abatement Projects); air samples shall be collected aggressively as described in 40 C.F.R. Part 763, Appendix A to Subpart E (EPA 1995), except that the air stream of the leaf blower shall not be directed at any friable ACM that remains in the area and comply with any other measures deemed necessary by the Division to protect public health. 9.0 Asbestos Abatement & Demolition Requirements If ACM is to be removed or disturbed in a single-family residence, and the total quantity exceeds any of the regulatory trigger levels of 50 linear ft. on pipes, 32 ft2 on other surfaces, or the volume equivalent of a 55 -gallon drum, a CDPHE-certified General Abatement Contractor (GAC) is required to perform the work. The regulatory trigger levels within a commercial building are 260 linear ft. on pipes, 160 ft2 on other surfaces, or the volume equivalent of a 55 -gallon drum. In addition, formal notification to CDPHE prior to the abatement of ACM as well as air monitoring, visual inspections, and final air clearances by a CDPHE-certified Asbestos AMS is required. CDPHE regulations allow for the demolition of a building that contains non -friable asbestos containing materials, such as caulking, mastic or resilient floor tiles. However, demolition must be completed without causing the non -friable ACM to be rendered friable. Burning a building with any ACM is prohibited. Operations such as sanding, cutting, crushing, grinding, pneumatic jacking, etc. of ACM are not permitted. Recycling of building materials such as concrete, metal, or wood that are bonded or contaminated with ACM, e.g. glue, caulking, or mastic is also prohibited. If any of the non -friable asbestos containing materials are to be recycled and rendered friable after demolition (i.e. 7 crushing mastic -coated concrete), these materials must be abated of all ACM prior to shipping offsite for recycling. OSHA regulations regarding occupational exposure during demolition activities is still mandatory. OSHA 29 CFR 1926.1101 requires that workers performing construction -related activities be protected from asbestos fibers in excess of the permissible exposure limit of 0.1 f/cc of air. Contractors are must comply with applicable provisions of OSHA 29 CFR 1926.1101 during demolition and renovation activities. These OSHA provisions include, but are not limited to, PPE 15 1 Page and respirators, personnel training, personal -exposure air monitoring, employee medical surveillance, wet removal methods, signage for regulated areas, etc. 10.0 Disclaimer & Limitations The activities outlined in this report were conducted in a manner consistent with a level of care and expertise exercised by members of the environmental consulting and industrial hygiene profession. All activities were performed in accordance with all applicable federal, state, and local regulations as well as generally accepted standards and professional practice. No warranty is either expressed or implied. SilverKey Services assumes no responsibility or liability for error in public information utilized, statements from sources other than SilverKey Services, or developments resulting from situations outside the scope of this project. The details provided within this report outline the inspection activities on the date(s) indicated and should not be relied upon to represent conditions at a later date, the limited number of bulk samples collected, and the laboratory results of those bulk -samples. The laboratory results contained in this report apply specifically to the materials in which bulk -samples were collected. The results do not include or apply to any other materials within the structure that were not sampled, but may contain asbestos; including materials that may be hidden or inaccessible. Additional inspection and bulk -sampling activities would be required to determine if any other materials contain asbestos. This report has been prepared on behalf of and exclusively for use by the Client, with specific application to their project as discussed in the scope of work. The results of any surfacing material indicated in this report also includes any associated overspray of that material, e.g., under carpet, above suspended ceilings, etc. The information contained in this report is intended as supplementary material for abatement design and is not to be used as the scope of work for abatement activities, bidding or billing purposes. Contractors or consultants reviewing this report must draw their own conclusions regarding further investigation or remediation deemed necessary. Thank you for your business. Sincerely, Kevin Bruscas State of Colorado Building Inspector Accreditation No: 25338 Exp. 2/26/2020 16 1 Page _ . _ 17 1 Page 19 1 Page G .,,._ � c��. : �, :�� .�'' 22 1 Page 23 1 Page tib. eurofins A* June 7, 2019 SilverKey Services, LLC PO Box 2641 Loveland, CO 80539 CLIENT PROJECT: 10616 W 48th Ave, Wheat Ridge, CO 80033 CEI LAB CODE: Al 911780 Dear Customer: Enclosed are asbestos analysis results for PLM Bulk samples received at our laboratory on June 7, 2019. The samples were analyzed for asbestos using polarizing light microscopy (PLM) per the EPA 600 Method. Sample results containing >1% asbestos are considered asbestos -containing materials (ACMs) per EPA regulatory requirements. The detection limit for the EPA 600 Method is <1% asbestos by weight as determined by visual estimation. Thank you for your business and we look forward to continuing good relations. Kind Regards, Tianbao Bai, Ph.D., CIH Laboratory Director INV AV TESTING NVLAP LAB CODE 101768-0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 ® eur®fins ASBESTOS ANALYTICAL REPORT By: Polarized Light Microscopy Prepared for SilverKey Services, LLC CLIENT PROJECT: 10616 W 48th Ave, Wheat Ridge, CO 80033 LAB CODE: Al 911780 TEST METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020 REPORT DATE: 06/07/19 TOTAL SAMPLES ANALYZED: 51 # SAMPLES >1% ASBESTOS: 20 tiff eurofins Asbestos Report Summary By: POLARIZING LIGHT MICROSCOPY CEI PROJECT: 10616 W 48th Ave, Wheat Ridge, CO LAB CODE: Al 911780 80033 METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020 ASBESTOS Client ID Layer Lab ID Color Sample Description % HAI -01 A163472 Purple Shower Tile None Detected HA1-02 A163473 Purple Shower Tile None Detected HA2 -03 A163474 Tan Grout None Detected HA2 -04 A163475 Tan Grout None Detected HA3-05 A163476 White Shower Tile None Detected HA3-06 A163477 White Shower Tile None Detected HA4-07 A163478 Tan Grout None Detected HA4-08 A163479 Tan Grout None Detected HA5-09 A163480 Red Floor Tile None Detected HA5-10 A163481 Red Floor Tile None Detected HA6-11 A163482 Brown Grout None Detected HA6-12 --------------------------------------------------------------- Layer 1 Layer 2 A163483 A163483 Brown Brown Grout Backing Material None Detected None Detected HA7-13 A163484 Off-white Floor Vinyl None Detected HA7-14 A163485 Off-white Floor Vinyl None Detected HA8-15 A163486 Tan Mastic None Detected HA8-16 A163487 Tan Mastic None Detected HA9-17 A163488 Brown Floor Tile Lai i u=. HA9-18 A163489 Brown Floor Tile Lei M=- U am HA10-19 A163490 Black Mastic None Detected HAI 0-20 A163491 Black Mastic None Detected HAI 1-21 --------------------------------------------------------------- Layer 1 Layer 2 A163492 A163492 Beige White Surface Material Drywall None Detected HAI 1-22 --------------------------------------------------------------- Layer 1 Layer 2 A163493 A163493 Beige White Surface Material Drywall None Detected HAI 1-23 --------------------------------------------------------------- Layer 1 Layer 2 A163494 A163494 Beige White Surface Material Drywall None Detected HAI 1-24 --------------------------------------------------------------- Layer 1 Layer 2 A163495 A163495 Beige White Surface Material Drywall None Detected HAI 1-25 --------------------------------------------------------------- Layer 1 Layer 2 A163496 A163496 Beige White Surface Material Drywall None Detected Page 1 of 3 tiff eurofins CEI PROJECT: 10616 W 48th Ave, Wheat Ridge, CO 80033 Asbestos Report Summary By: POLARIZING LIGHT MICROSCOPY METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020 LAB CODE: Al 911780 ASBESTOS Client ID Layer Lab ID Color Sample Description % HA11-26 Layer 1 A163497 Beige Surface Material --------------------------------------------------------------- Layer 2 A163497 White Drywall None Detected HAI 1-27 Layer 1 A163498 Off-white Surface Material None Detected ---------- ------ Layer 2 -------- A163498 --------- White --------------- Drywall --------------- None Detected HAI 1-28 Layer 1 A163499 Beige Joint Compound ---------- ------ Layer 2 -------- A163499 --------- White --------------- Drywall --------------- None Detected HAI 2-29 Layer 1 A163500 Off-white Joint Compound --------------------------------------------------------------- Layer 2 A163500 Gray Drywall None Detected HA13-30 Layer 1 A163501 Off-white Surface Material ---------- ------ Layer 2 -------- A163501 --------- Gray --------------- Drywall --------------- None Detected HAI 3-31 Layer 1 A163502 Off-white Surface Material --------------------------------------------------------------- Layer 2 A163502 Gray Drywall None Detected HA13-32 A163503 Off-white Surface Material HAI 3-33 A163504 Off-white Surface Material HA13-34 Layer 1 A163505 Off-white Surface Material --------------------------------------------------------------- Layer 2 A163505 Gray Drywall None Detected HA14-35 Layer 1 A163506 Off-white Joint Compound ---------- ------ Layer 2 -------- A163506 --------- Gray --------------- Drywall --------------- None Detected HA14-36 Layer 1 A163507 Off-white Joint Compound --------------------------------------------------------------- Layer 2 A163507 Gray Drywall None Detected HA15-37 A163508 Gray Drywall None Detected HAI 5-38 Layer 1 A163509 Off-white Surface Material --------------------------------------------------------------- Layer 2 A163509 Gray Drywall None Detected HA15-39 A163510 Gray Drywall None Detected HA16-40 Layer 1 A163511 Off-white Joint Compound --------------------------------------------------------------- Layer 2 A163511 Gray Drywall None Detected HA16-41 Layer 1 A163512 Off-white Joint Compound --------------------------------------------------------------- Layer 2 A163512 Gray Drywall None Detected HAI 7-42 A163513 Green,Tan Floor Tile ( Ceramic) None Detected HAI 7-43 A163514 Green,Tan Floor Tile ( Ceramic) None Detected HAI 8-44 A163515 Gray Grout None Detected Page 2 of 3 ti�ti eurofins Asbestos Report Summary CEI By: POLARIZING LIGHT MICROSCOPY PROJECT: 10616 W 48th Ave, Wheat Ridge, CO LAB CODE: Al 911780 80033 METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020 ASBESTOS Client ID Layer Lab ID Color Sample Description HA18-45 A163516 Gray Grout None Detected HAI 9-46 A163517 Brown Laminate Countertop None Detected HAI 9-47 A163518 Brown Laminate Countertop None Detected HA20-48 A163519 Beige Mastic None Detected HA20-49 A163520 Beige Mastic None Detected HA21-50 A163521 White Caulking None Detected HA21-51 A163522 White Caulking None Detected Page 3 of 3 : eurofins m Client: SilverKey Services, LLC PO Box 2641 Loveland, CO 80539 ASBESTOS BULK ANALYSIS Project: 10616 W 48th Ave, Wheat Ridge, CO 80033 &SRFRTCIC RI II K PI M FPA RM MFTI r)n By: POLARIZING LIGHT MICROSCOPY Lab Code: A1911780 Date Received: 06-07-19 Date Analyzed: 06-07-19 Date Reported: 06-07-19 Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % HAI -01 Shower Tile Heterogeneous 90% Binder None Detected A163472 Purple 10% Silicates Non-fibrous Bound HAI -02 Shower Tile Heterogeneous 90% Binder None Detected A163473 Purple 10% Silicates Non-fibrous Bound HA2 -03 Grout Heterogeneous 75% Binder None Detected A163474 Tan 25% Silicates Non-fibrous Bound HA2 -04 Grout Heterogeneous 75% Binder None Detected A163475 Tan 25% Silicates Non-fibrous Bound HA3-05 Shower Tile Heterogeneous 98% Binder None Detected A163476 White 2% Silicates Non-fibrous Bound HA3-06 Shower Tile Heterogeneous 98% Binder None Detected A163477 White 2% Silicates Non-fibrous Bound HA4-07 Grout Heterogeneous 75% Binder None Detected A163478 Tan 25% Silicates Non-fibrous Bound Page 1 of 11 : eurofins W ASBESTOS BULK ANALYSIS By: POLARIZING LIGHT MICROSCOPY Client: SilverKey Services, LLC Lab Code: Al 911780 PO Box 2641 Date Received: 06-07-19 Loveland, CO 80539 Date Analyzed: 06-07-19 Date Reported: 06-07-19 Project: 10616 W 48th Ave, Wheat Ridge, CO 80033 ASRFSTnS RI II K PI M FPA RM MFTHnn HA4-08 Grout A163479 Heterogeneous Tan Non-fibrous Bound 75% 25% Binder None Detected Silicates HA5-09 Floor Tile Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % HA4-08 Grout A163479 Heterogeneous Tan Non-fibrous Bound 75% 25% Binder None Detected Silicates HA5-09 Floor Tile Heterogeneous 95% Binder None Detected A163480 Red 5% Silicates Non-fibrous Non-fibrous Bound HA5-10 Floor Tile Heterogeneous 95% Binder None Detected A163481 Red 5% Silicates Binder Non-fibrous Layer 1 Brown Bound Silicates HA6-11 Grout Heterogeneous 80% Binder None Detected A163482 Brown 20% Silicates Non-fibrous Bound HA6-12 Grout Heterogeneous 80% Binder None Detected Layer 1 Brown 20% Silicates A163483 Non-fibrous Bound ------------------------------------------------------------------ Layer 2 Backing Material Heterogeneous 80% Cellulose 20% Binder None Detected A163483 Brown Fibrous Bound HA7-13 Floor Vinyl Heterogeneous 30% Cellulose 50% Vinyl None Detected A163484 Off-white 20% Fiberglass Fibrous Bound Page 2 of 11 *aeurofins ASBESTOS BULK ANALYSIS V:: CEI By: POLARIZING LIGHT MICROSCOPY Client: SilverKey Services, LLC PO Box 2641 Loveland, CO 80539 Project: 10616 W 48th Ave, Wheat Ridge, CO 80033 &SRFSTO.q RI II K PI M ;=PA r%nn MFTWnn Lab Code: A1911780 Date Received: 06-07-19 Date Analyzed: 06-07-19 Date Reported: 06-07-19 Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % HA7-14 Floor Vinyl Heterogeneous 30% Cellulose 50% Vinyl None Detected A163485 Off-white 20% Fiberglass Fibrous Bound HA8-15 Mastic Heterogeneous 10% Cellulose 75% Mastic None Detected A163486 Tan 5% Fiberglass 10% Silicates Fibrous Bound HA8-16 Mastic Heterogeneous 10% Cellulose 75% Mastic None Detected A163487 Tan 5% Fiberglass 10% Silicates Fibrous Bound HA9-17 Floor Tile Homogeneous 95% Vinyl A163488 Brown Non-fibrous Bound HA9-18 Floor Tile Homogeneous 95% Vinyl A163489 Brown Non-fibrous Bound HA10-19 Mastic Homogeneous 85% Mastic None Detected A163490 Black 15% Binder Non-fibrous Bound HAI 0-20 Mastic Homogeneous 85% Mastic None Detected A163491 Black 15% Binder Non-fibrous Bound Page 3 of 11 tiff eurofins M Client: SilverKey Services, LLC PO Box 2641 Loveland, CO 80539 ASBESTOS BULK ANALYSIS Project: 10616 W 48th Ave, Wheat Ridge, CO 80033 By: POLARIZING LIGHT MICROSCOPY Lab Code: Al 911780 Date Received: 06-07-19 Date Analyzed: 06-07-19 Date Reported: 06-07-19 ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % HA11-21 Surface Material Heterogeneous 60% Paint Layer 1 Beige 38% Calc Carb A163492 Non-fibrous Bound ------- Layer 2 ------------ Drywall --------------------- Heterogeneous 15% Cellulose ---- 85% --------- Gypsum ------- - - - - -- None Detected A163492 White Fibrous Loosely Bound HAI 1-22 Surface Material Heterogeneous 60% Paint MAMIPPM Layer 1 Beige 38% Calc Carb A163493 Non-fibrous Bound ------- Layer 2 ------------ Drywall --------------------- Heterogeneous 15% Cellulose ---- 85% --------- Gypsum ------- - - - - -- None Detected A163493 White Fibrous Loosely Bound HA11-23 Surface Material Heterogeneous 60% Paint Layer 1 Beige 38% Calc Carb A163494 Non-fibrous Bound ------- Layer 2 ------------ Drywall --------------------- Heterogeneous 15% Cellulose ----- 85% -------- Gypsum ------- - - - - -- None Detected A163494 White Fibrous Loosely Bound HAI 1-24 Surface Material Heterogeneous 60% Paint Layer 1 Beige 38% Calc Carb A163495 Non-fibrous Bound Page 4 of 11 tioti eurofins M Client: SilverKey Services, LLC PO Box 2641 Loveland, CO 80539 ASBESTOS BULK ANALYSIS Project: 10616 W 48th Ave, Wheat Ridge, CO 80033 ASBESTOS BULK PLM, EPA 600 METHOD By: POLARIZING LIGHT MICROSCOPY Lab Code: Al 911780 Date Received: 06-07-19 Date Analyzed: 06-07-19 Date Reported: 06-07-19 Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % ----------------------------------------------------------------- Layer 2 Drywall Heterogeneous 15% Cellulose 85% Gypsum None Detected A163495 White Fibrous Loosely Bound HA11-25 Surface Material Heterogeneous 60% Paint Layer 1 Beige 38% Calc Carb A163496 Non-fibrous Bound ------------------------------------------------------------------ Layer 2 Drywall Heterogeneous 15% Cellulose 85% Gypsum None Detected A163496 White Fibrous Loosely Bound HAI 1-26 Surface Material Heterogeneous 60% Paint - Layer 1 Beige 38% Calc Carb A163497 Non-fibrous Bound ------- Layer 2 ------------ Drywall ---------- Heterogeneous ---- 15% ------- Cellulose ---- 85% --------- Gypsum ------- - - - - -- None Detected A163497 White Fibrous Loosely Bound HAI 1-27 Surface Material Heterogeneous 40% Paint None Detected Layer 1 Off-white 60% Calc Carb A163498 Non-fibrous Bound ------- Layer 2 ------------ Drywall ---------- Heterogeneous ---- 15% ------- Cellulose ----- 85% -------- Gypsum ------- - - - - -- None Detected A163498 White Fibrous Loosely Bound Page 5 of 11 tiff eurofins Client: SilverKey Services, LLC PO Box 2641 Loveland, CO 80539 ASBESTOS BULK ANALYSIS Project: 10616 W 48th Ave, Wheat Ridge, CO 80033 By: POLARIZING LIGHT MICROSCOPY Lab Code: A1911780 Date Received: 06-07-19 Date Analyzed: 06-07-19 Date Reported: 06-07-19 ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % HA11-28 Joint Compound Heterogeneous 20% Paint Layer 1 Beige 80% Calc Carb A163499 Non-fibrous Bound ------- Layer 2 ------------ Drywall --------------------- Heterogeneous 15% Cellulose ---- 85% ---------------- - - - - -- Gypsum None Detected A163499 White Fibrous Loosely Bound HAl2-29 Joint Compound Heterogeneous 73% Calc Carb Layer 1 Off-white 15% Binder A163500 Fibrous 10% Paint Bound ------- Layer 2 ------------ Drywall --------------------- Heterogeneous 25% Cellulose ----- 75% --------------- - - - - -- Gypsum None Detected A163500 Gray Fibrous Bound HAI 3-30 Surface Material Heterogeneous 73% Calc Carb Layer 1 Off-white 15% Binder A163501 Fibrous 10% Paint Bound ------- Layer 2 ------------ Drywall --------------------- Heterogeneous 25% Cellulose ----- 75% --------------------- Gypsum None Detected A163501 Gray Fibrous Bound HAI 3-31 Surface Material Heterogeneous 73% Calc Carb Layer 1 Off-white 15% Binder A163502 Fibrous 10% Paint Bound Page 6 of 11 ti eurofins C" Client: SilverKey Services, LLC PO Box 2641 Loveland, CO 80539 ASBESTOS BULK ANALYSIS Project: 10616 W 48th Ave, Wheat Ridge, CO 80033 By: POLARIZING LIGHT MICROSCOPY Lab Code: A1911780 Date Received: 06-07-19 Date Analyzed: 06-07-19 Date Reported: 06-07-19 ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % ----------------------------------------------------------------- Layer 2 Drywall Heterogeneous 25% Cellulose 75% Gypsum None Detected A163502 Gray Fibrous Bound HA13-32 Surface Material Heterogeneous 73% Calc Carb. - A163503 Off-white 15% Binder Fibrous 10% Paint Bound HA13-33 Surface Material Heterogeneous 73% Calc Carb A163504 Off-white 15% Binder Fibrous 10% Paint Bound HA13-34 Surface Material Heterogeneous 73% Calc Carb Layer 1 Off-white 15% Binder A163505 Fibrous 10% Paint Bound ------- Layer 2 ------------ Drywall --------------------- Heterogeneous 25% Cellulose ----- 75% -------- Gypsum ------- - - - - -- None Detected A163505 Gray Fibrous Bound HA14-35 Joint Compound Heterogeneous 73% Calc Carb Layer 1 Off-white 15% Binder A163506 Fibrous 10% Paint Bound ------- Layer 2 ------------ Drywall --------------------- Heterogeneous 25% Cellulose ----- 75% -------- Gypsum ------------ None Detected A163506 Gray Fibrous Bound Page 7 of 11 ti eurof ins ASBESTOS BULK ANALYSIS CEI By: POLARIZING LIGHT MICROSCOPY Client: SilverKey Services, LLC PO Box 2641 Loveland, CO 80539 Project: 10616 W 48th Ave, Wheat Ridge, CO 80033 Lab Code: A1911780 Date Received: 06-07-19 Date Analyzed: 06-07-19 Date Reported: 06-07-19 ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % HA14-36 Joint Compound Heterogeneous 73% Calc Carb Layer 1 Fibrous Off-white 15% Binder A163507 Fibrous 10% Paint HA16-40 Joint Compound Heterogeneous 73% Bound Layer 1 Off-white 15% ------- Layer 2 ------------ Drywall --------------------- Heterogeneous 25% Cellulose ---- 75% ---------------- - - - - -- Gypsum None Detected A163507 Gray Fibrous Bound HA15-37 Drywall Heterogeneous 25% Cellulose 65% Gypsum None Detected A163508 Gray 10% Paint Fibrous Bound Lab Notes: Surface Material is not present. HA15-38 Surface Material Heterogeneous 73% Calc Carb Layer 1 Off-white 15% Binder A163509 Fibrous 10% Paint Bound ------- Layer 2 ------------ Drywall --------------------- Heterogeneous 25% Cellulose ---- 75% ---------------- - - - - -- Gypsum None Detected A163509 Gray Fibrous Bound HA15-39 Drywall Heterogeneous 25% Cellulose 65% Gypsum None Detected A163510 Gray 10% Paint Fibrous Bound Lab Notes: Surface Material is not present. HA16-40 Joint Compound Heterogeneous 73% Calc Carb Layer 1 Off-white 15% Binder A163511 Fibrous 10% Paint Bound Page 8 of 11 ASBESTOS BULK ANALYSIS Qe.� e u rof i n s CEI By: POLARIZING LIGHT MICROSCOPY Client: SilverKey Services, LLC PO Box 2641 Loveland, CO 80539 Project: 10616 W 48th Ave, Wheat Ridge, CO 80033 ASBESTOS BULK PLM, EPA 600 METHOD Lab Code: A1911780 Date Received: 06-07-19 Date Analyzed: 06-07-19 Date Reported: 06-07-19 Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % ----------------------------------------------------------------- Layer 2 Drywall Heterogeneous 25% Cellulose 75% Gypsum None Detected A163511 Gray Fibrous Bound HA16-41 Joint Compound Heterogeneous 73% Calc Carb Layer 1 Off-white 15% Binder A163512 Fibrous 10% Paint Bound ------- Layer 2 ------------- Drywall -------------------- Heterogeneous 25% Cellulose ----- 75% -------- Gypsum ------- - - - - -- None Detected A163512 Gray Fibrous Bound HA17-42 Floor Tile ( Ceramic ) Heterogeneous 75% Silicates None Detected A163513 Green,Tan 25% Binder Non-fibrous Tightly Bound HA17-43 Floor Tile ( Ceramic) Heterogeneous 75% Silicates None Detected A163514 Green,Tan 25% Binder Non-fibrous Tightly Bound HA18-44 Grout Heterogeneous 75% Silicates None Detected A163515 Gray 25% Binder Non-fibrous Bound HA18-45 Grout Heterogeneous 75% Silicates None Detected A163516 Gray 25% Binder Non-fibrous Bound Page 9 of 11 tiff eurofins ASBESTOS BULK ANALYSIS CEI By: POLARIZING LIGHT MICROSCOPY Client: SilverKey Services, LLC PO Box 2641 Loveland, CO 80539 Project: 10616 W 48th Ave, Wheat Ridge, CO 80033 ASBESTOS BULK PLM, EPA 600 METHOD Lab Code: A1911780 Date Received: 06-07-19 Date Analyzed: 06-07-19 Date Reported: 06-07-19 Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % HA19-46 Laminate Countertop Heterogeneous 15% Cellulose 65% Vinyl None Detected A163517 Brown 20% Binder Beige Non-fibrous Bound Non-fibrous HA19-47 Laminate Countertop Heterogeneous 15% Cellulose 65% Vinyl None Detected A163518 Brown 20% Binder HA20-49 Non-fibrous Heterogeneous <1% Cellulose 100% Mastic Bound A163520 HA20-48 Mastic Heterogeneous <1% Cellulose 100% Mastic None Detected A163519 Beige Non-fibrous Bound HA20-49 Mastic Heterogeneous <1% Cellulose 100% Mastic None Detected A163520 Beige Non-fibrous Bound HA21-50 Caulking Heterogeneous 100% Caulk None Detected A163521 White <1% Binder Non-fibrous Bound HA21-51 Caulking Heterogeneous 100% Caulk None Detected A163522 White <1% Binder Non-fibrous Bound Page 10 of 11 ti eurofins LEGEND: Non-Anth = Non-Asbestiform Anthophyllite Non-Trem = Non-Asbestiform Tremolite Calc Carb = Calcium Carbonate METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020 REPORTING LIMIT: <1% by visual estimation REPORTING LIMIT FOR POINT COUNTS: 0.25% by 400 Points or 0.1% by 1,000 Points REGULATORY LIMIT: >1 % by weight Due to the limitations of the EPA 600 method, nonfriable organically bound materials (NOBs) such as vinyl floor tiles can be difficult to analyze via polarized light microscopy (PLM). EPA recommends that all NOBs analyzed by PLM, and found not to contain asbestos, be further analyzed by Transmission Electron Microscopy (TEM). Please note that PLM analysis of dust and soil samples for asbestos is not covered under NVLAP accreditation. Estimated measurement of uncertainty is available on request. This report relates only to the samples tested or analyzed and may not be reproduced, except in full, without written approval by Eurofins CEI. Eurofins CEI makes no warranty representation regarding the accuracy of client submitted information in preparing and presenting analytical results. Interpretation of the analytical results is the sole responsibility of the client. Samples were received in acceptable condition unless otherwise noted. This report may not be used by the client to claim product endorsement by NVLAP or any other agency of the U.S. Government. Information provided by customer includes customer sample ID, location, volume and area as well as date and time of sampling. ANALYST: 6'I APPROVED BY: Cass' y Ploch Tianbao Bai, Ph.D., CIH Laboratory Director Danielle Carrier NVkA. TES NVLAP LAB CODE 101768-0 Page 11 of 11 %�- �" CHAIN OF CUSTODY � LAB USE ONLY. CD 730 SE Maynard Road, Cary, NC 27511 CEI Lab Code: Tel: 866-481-1412; Fax: 919-481-1442 CEI Lab I.D. Range: �^ COMPANY INFORMATION M OD PROJECT INFORMATION CEI CLIENT #: TURN AROUND TIME Job Contact: boww C Company: 4 HR 8 HR 1 DAY 2 DAY 3 DAY Email 1 Tel: Address: '�• l x:Pro EPA 600 ' ect Name: Nbu, J 19 "WL A G � �� Project ID#: J�a,a,-4 J2,-'A4e C0 90033 Email 1:1 1, PO #: Tel: �;?�_' ', - ` r;"�`' Fax: STATE SAMPLES COLLECTED IN: IF TAT IS NOT MARKED STANDARD 3 DAY TAT APPLIES. OS M OD Relinquished By: TURN AROUND TIME DatelTime 4 HR 8 HR 1 DAY 2 DAY 3 DAY 5 DAY BUL EPA 600 ' ❑ ❑ ❑ ❑ 1:1 PLM POINT COUNT (400) EPA 600 ❑ ❑ ❑ ❑ ❑ ❑ PLM POINT COUNT (1000) EPA 600 ❑ ❑ ❑ ❑ ❑ ❑ PLM GRAY w POINT COUNT EPA 600 ❑ ❑ ❑ ❑ ❑ PLM BULK CARB 435 ❑ ❑ ❑ ❑ ❑ PCM AIR NIOSH 7400 ❑ ❑ ❑ ❑ ❑ ❑ TEM AIR EPA AH ERA ❑ ❑ ❑ ❑ ❑ ❑I TEM AIR NIOSH 7402 ❑ ❑ ❑ ❑ ❑ ❑ TEM AIR (PCME) ISO 10312 ❑ ❑ ❑ ❑ ❑ ❑ TEM AIR ASTM 6281-15 ❑ ❑ ❑ ❑ ❑ ❑ TEM BULK CHATFIELD ❑ ❑ ❑ ❑ ❑ TEM DUST WIPE ASTM D6480-05 (2010) ❑ ❑ ❑ ❑ ❑ ❑ TEM DUST MICROVAC ASTM D5755-09 (2014) ❑ ❑ ❑ ❑ ❑ ❑ TEM SOIL ASTM D7521-16 ❑ ❑ ❑ ❑ TEM VERMICULITE CINCINNATI METHOD ❑ ❑ ❑ ❑ TEM QUALITTATIVE IN-HOUSE METHOD ❑ ❑ ❑ ❑ ❑ OTHER: ❑ ❑ ❑ ❑ ❑ ❑ REMARKS / SPECIAL INSTRUCTIONS: Accept Samples Reject Samples Relinquished By: Received By: DatelTime jDate/Time Samples will be disposed of 30 days after analysis Page of Version: CCOC.01.18.1/21D n ti�� eurofins CEI A 1-� u v SAMPLING FORM AMPL lIP _ Company: Job Contact: Project Mame: Project 1D #: Tel: AMPL lIP _ _-),D_>!:S!f RIP rN�'('iL"�CA000N VQLU M� ' f U (e- PLM EF71 TEM 0 `ml_ �t! 02 7e PLM TEM 0 Az- 03 �u `l`k ��fiw i1`2 L PLM TEM 0 Ai Ott 0 PLM Er7l TEM 0 A.3 _ D S fe-L, PLM TEM 0 I I PLM TEM 0 - 0I bikk 5kbw--e,,(411-e- iroA PLM Lip TEM Z It PLM TEM �6q PLM TEM 0 o PLM TEM (kld' it ! o po ,Q ( PLM TEM t i .c PLM TEM 14 jq_ j&fhrov r, PLM TEM I r 1 IL PLM TEM �] _ srlum irlaw r 6h PLM EPTEM 0 PLM TEM Zile PLM TEM PLM E tD TEM PLM TEM 0 �� 7c PLM E= TEM PLM E= TEM PLM E= TEM Nom( PLM E TEM 0 Z O S(jEA PLM Ep TEM 0 Z Li f�Mom PLM TEM 0 PLM TEM PLM TEM 0 yY1 - 2,9 4i V PLM TEM (-1 Page of Version: CCOC.01.18.2/2.LD 4 tiff eurofins CE SAMPLING FORM COMPANYYCONTAC INFOfWATlOff' Com an : Job Contact: Project Name: Project ID #: Tel: SAMPLE I! , _ :. I i pESCRLPl ICON' /'LOCATION' `QLUE1 AREA -TEST ..... _ . - fA ►Al2—Z°j Ltvt CDC M dAoak PLM TEM 0 -NA 'J" rofl Ge. rt ✓ PLM TEM 0 �\ PLM TEM 0 'Z C PLM TEM 3361. PLM TEM Jj `\ PLM TEM JAN JH- PLM E TEM � PLM E TEM PLM E= TEM 0 PLM E= TEM x << PLM E= TEM 0 PLM E = TEM 0 PLM E= TEM PLM TEM 0 R \ ( PLM E= TEM Q f6 PLM El= TEM [� PLM TEM 0 qlq "',Q -- �w�C 46 u JC PLM TEM I I t ( PLM L TEM lt)m-yvkCI L PLM 4= TEM G I J 1\ PLM TEM 0 i VI 6� v /yr PLM TEM 0 PLM TEM PLM, TEM PLM 0 TEM PLM TEM II PLM TEM 0 PLM TEM 0 Page of Version: CCOCA1.18.2/2.LD PERMIT:- AVZV7A,_YADDRESS:_x�/4 60 af INSPECTION RECORD Inspection online form: http://www.ci.wheatridge.co.us/inspection Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Inspections will not be performed unless this card is posted on the project site Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business Foundation Inspections Date Inspector Initials Comments 102 Caissons / Piers 103 Footing / P.E. Letter 104 Foundation Setback Cert. 105 Stem Walls 106 Foundation wall Insulation uo Not Pour Concrete Prior To Approval Of The Above Inspections Underground / Slab Inspections Date Inspector Initials Comments 201 Electrical / Cable/ Conduit 202 Sewer Underground Int. 203 Sewer Underground Ext. 204 Plumbing Underground Int. 205 Plumbing Underground Ext. 206 Water Underground fDJ 3 I Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections Rough Inspection Date Inspector Initials Comments 301 Rough Framing 302 Wall Sheathing 303 Roof Sheathing 304 Sheer Inspection 305 Insulation 306 Mid -Roof fDJ 3 I 307 Metal / Lath / Stucco 308 Rough Electrical Residential 309 Rough Electrical Commercial 310 Electrical Meter Residential 311 Electrical Meter Commercial 312 Temp. Const. Meter 313 Rough Plumbing Residential 314 Rough Plumbing Commercial 315 Shower Pan SEE OVER FOR ADDITIONAL INSPECTIONS Pei 164� / ro AJ Vey /-* Rough Inspection (continued) Date Inspector CommentsInitials 316 Rough Mechanical Residential 317 Rough Mechanical Commercial 318 Boiler / Furnace 319 Hot water tank 320 Drywall screw and Nail 321 Moisture board / shower walls 322 Rough Grading 323 Miscellaneous Final Inspections Date Inspector CommentsInitials 402 Gas Meter Release 403 Final Electrical Residential 404 Final Electrical Commercial 405 Final Mechanical Residential 406 Final Mechanical Commercial 407 Final Plumbing Residential 408 Final Plumbing Commercial 409 Final Roof 410 Final Window/Door 411 Landscape/Park/Planning Inspections from these entities shall be requested one week in advance. For landscaping and parking inspections please call 303-235-2846 For ROW and drainage inspections please call 303-235-2861 For fire inspections please contact the Fire Protection District for your project. 412 Row/Drainage/Public Works 413 Flood plain Inspection 414 Fire Insp. / Fire Protection 415 Public Works Final 416 Storm Water Mgmt. 417 Zoning Final Inspection 418 Building Final Inspection 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 by the Fire District and Electrical low voltage by the Building Division. 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: C 16� �zw Job Address: IC)ly ( to \W ?�)TVA tA r Permit Number: '7,01"1 O-1 b��' ❑ No one available for inspection: Time ! bA,�) M/ M Re -Inspection required: Yes 9 When corrections have been made, call f re-inspection�at 303-234-5933 Date: V Inspector: `i1 �' 0�� DO NOT REMOVE THIS NOTICE i 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: _` D/ ra, yy' Ll No one available for inspection: Time `- I AM/PM Re -Inspection required: Yes- *When corrections have been made, call for re -inspection at 303-234-5933 Date: '!/ Inspector: i DO NOT REMOVE THIS NOTICE a J CITY OF WHEAT RIDGE �(303) Building Inspection Division (303) 234-5933 Inspection line 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: J Job Address: Permit Number:`'f,�(� ❑ No one available for inspection: Time ' AMOKA Re -Inspection required: Yes Io When corrections have been made, call for If r re -ins pectiion at 303-234- 0>Date: f!/ Jl f)Inspector: / `� I � � DO NOT REMOVE THIS NOTICE A City of Wheat Ridge � r Residential Roofing PERMIT - 201707853 PERMIT NO: 201707853 ISSUED: 09/29/2017 JOB ADDRESS: 10616 W 48th AVE EXPIRES: 09/29/2018 JOB DESCRIPTION: Residential Re -roof to install GAF asphalt shingles - 27 sq Pitch = 4/12 *** CONTACTS *** OWNER (303)517-5917 CAPRA ROBERT E SUB (720)301-2634 Ken Baldwin 170174 Apex Roof & Consulting Svc Inc *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: U / Utility structures SUBDIVISION CODE: 2408 / FRUITDALE, LEES, STONERIDGE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,000.00 FEES Total Valuation 0.00 Use Tax 168.00 Permit Fee 172.60 ** TOTAL ** 340.60 *** COMMENTS *** *** CONDITIONS *** Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be required for both the midroof and final inspections. The 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the Homeowner. REGARDING ROOF VENTILATION: Roof ventilation shall comply with IBC Sec. 1203.2 or IRC Sec. R806. The installation of ridge venting requires the installation or existence of soffit venting. For calculation purposes, one hat or turtle vent equal to one-half of one square foot of opening. 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) is required on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and mid -roofs may be called in at the same time, one hundred percent of the sheathing must be complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be required, the 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the Homeowner. City of Wheat Ridge Residential Roofing PERMIT - 201707853 PERMIT NO: 201707853 ISSUED: 09/29/2017 JOB ADDRESS: 10616 W 48th AVE EXPIRES: 09/29/2018 JOB DESCRIPTION: Residential Re—roof to install GAF asphalt shingles — 27 sq Pitch = 4/12 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 permit4l further attest that I am legally authorized to include all entities named within this document as parties to the work to be perfbnd that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. 77 7T t c o-_0:7- Signafilre4 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 originalermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4, No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or 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 Held inspection. Signature ofZ'Iiief Building Official 0 Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dane Lovett 0l 7 0 / �i _), From: no-reply@ci.wheatridge.co.us Sent: Wednesday, September 27, 2017 9:38 AM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Follow Up Flag: Follow up Flag Status: Completed 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 and due to the volume of requests, time to process varies and is subject to change. 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. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes residential roof? How many dwelling units Duplex are on the property? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123-4567) 10616 W. 48th Ave. Rob Capra 303-517-5917 13 Property Owner Email Address Do you have a signed contract to reroof this property? Applications cannot be submitted without an executed contract attached below. Attach Copy of Executed Contract Field not completed. Yes Capra contract - 10616 W. 48th Ave..pdf CONTRACTOR INFORMATION Contractor Business Name Contractor's License Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone Number (enter WITH dashes, eg 303-123-4567) Contractor Address (Primary address of your business) Apex Roof & Consulting, Inc. 170174 720-301-2634 PO Box 33965, Northglenn, Co. 80233 Contractor Email Address apexroof@comcast.net Retype Contractor Email apexroof@comcast.net Address DESCRIPTION OF WORK TOTAL SQUARES of 27 , the entire scope of work: f Project Value (contract 8000.00 value or cost of ALL materials and labor) Are you re -decking the roof? Is the permit for a flat roof, pitched roof, or No Pitched roof (2:12 pitch or greater) 14 both? (check all that apply) What is the specific pitch 4/12 of the PITCHED roof? How many squares are 27 part of the PITCHED roof? Describe the roofing GAF Armor Shield II materials for the PITCHED roof: Type of material for the Asphalt PITCHED roof: Provide any additional House re roof detail here on the description of work. (Is this for a house or garage? Etc) 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 15 submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Name of Applicant Ken Baldwin Email not displaying correctly? View it in your browser. 16 Apex Roof & Consulting, Inc. Work Authorization Roof Quote: Rob Capra 10616 W. 48th Ave. Lakewood, Co. 60215 Price House/Sheds Roof Scope: -Remove existing roof (1 layer) including all haul off included -Install 36" ice/water shield at all eaves and in valleys included -Install new GAF Armor Shield 11 shingle roof system including 30# felt — Included Color: Weathered Wood -install GAF "Z" Ridge cap included -Ail new plumbing jacks, step flashing, pre -painted drip edge and roof vents included -R/R new skylight on shed roof Included ROOF PRICE including all materials, tax, and labor 27 sq. $11,350.00 Payment Terms: 500% upon contract acceptance. 50% upon job completion. WARRANTY: Workmanship warranty good for "2" years. Roof to be free from any leaks related to original installation. Does not include any future storm related or mechanical damage. Customer Signature: ?` . Date: e Apex Rep Signature: � ' 8/17 Date: 81, Signature obove acknowledges that customer agrees to oimnd—t—_ conditions of Work Authorization. PO Box 33965 Northglenn, Co. 80233 Ph. 720-30]-2634 E. opexroof@comcost.net ♦ i CITY OF WHEAT RIDGE Building Inspection Division Ir (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 235 -2857 Fax INSPE,fTION NO ICE Inspection Type: y Job Address: Permit Number: ❑ 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: ' Inspector: �� 1-0 DO NOT REMOVE THIS NOTICE ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 235 -2857 Fax INSPECTION NOTICE Inspection Type: �"k lrtw Job Address: /1 %Y f y, ll tr rf r/ Permit Number: 0 el ig7t) ❑ No one available for inspection: Time A %P Re - Inspection required: Yes rN � o � When corrections have been made, cafl for re at 303 Date: -a_r, -t Inspector: 1 P LZ DO NOT REMOVE THIS NOTICE " 1 City of 'Wheat Ridge rte Residential Roofing PERMIT - 091470 PERMIT NO: 091470, - ISSUED: 08/19/2009 JOB ADDRESS: 10616.. W. 48TH AVE EXPIRES: 02/15/2010 DESCRIPTION: Reroof 24.5 sqs CONTACTS.'*** owner 303/423.-2831 `DebWorden sub 303/762-0089 Heyward C. Oliver 01.9720-Five Sons Roofing . PARCEL INFO ZONE CODE:... UA USE: U.. SUBDIVISION: 0140 'BLOCK/LOT#: '0/. FEE SUMMARY ESTIMATED PROJECT VALUATION: 6,370.00 FEES Permit Fee Total Valuation 161.00 ~36L ~t Use Tax 114.66 TOTAL .**.a ..`295.76 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.. Subject to field inspections. I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or'covenants, . easements or restrictions of record; that all measurements. shown, and allegations made are. accurate;: that I have read and agree to. abide by all conditions printed on this application. and that '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. LEO S nature of contractor/ ~ sr :.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. 3. No work of any manner shall be done that will change the natural flow of water causing a drainage problem.. Contractor shallnotify -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. o The issuance of a permit or the approval of drawingsand 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. >ignature. of Ch ding Official date LNSPECTIO 11 RE ST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855 2EQUESTS'14UST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. loiaadsul Suiplmg oo991n8m ao aim `mq •a>mMHOo mgto.(ue+o saPoa 8u!pimq ay1Jo suo!a%Wd ayt jo uoae[ou .Cue yo (enwdde ue+ou •+oj uuuad a aq of panusum aq mu pegs suoueastaads pug 58u!m¢spjo Ienotdde atp+o um ad a Jo a mnss! aqj (9) P-3 uogaadsm uo (enmdde me" annals Keys pm suouaadsm +o um ¢ m ssdo qof ag1 jo saszyd anlssa>ans gqm 8mp=o d a+olaq Ile 1 al p V(bU moj-puamum>adsul8mplme ayo.(jnou peys+m>euug3 (S) 'malgotd a8¢mup a 8u!meo stem jo .mo() Iemlev ayo a8uey> lp.m oeyt loop aq ipnls aauu¢w.(ue}o t(aom ON (b3 +o uouvadms p ao uaaq an 8 lmuad mau e+oj p!ed aq Ilegs -j 1)n1'+ea,C (I) auo spaaaxa wamuopuege e4 saueg> JI 'MA (1) auo papasoza on seq Im muopuege +o uo!suadsns .Cue pm suone>y!>ads pue sueld leu!8uo aqo at aPem ag o!.m +o uaaq aneq sa8ueq3 ou pop!Awd'pambw Sileuuou Iunoum aqt jleq-auo Jo aaj e+oJ pw!nb>e aq Rem Uuuad mzu a •sandxa o!uuad s!yt A (E3 +o papmdsns st pazuoytn¢ 8u!PI.~^9 agt (9)+o at anssl m s.( step oZl Jo Pouad e+oi pauopuege ep ng ep (09) qns myltm paauammo> toy n pazuoyonu Ipom atp (v)j, w dva pegs uuuad s!yJ, (Z) 'Aq app jo s>auemp+o a(gea!Idde+ayto Aue+o opmo(oO'a8p!y u*qM Jo sapoO 9mppn3 pue suouein8ad Sumaz atp m put opuo(o0 jo mnS ago jo smel aqi of o>o(gns s! pue uou"!Idde mot to quoj oas mmsumd aqt qum aauep+m oe u! panss! sz.m otuuad s!ql (1) :IenoJ V :IeAOJ V ?AOJ V :lieu uouendxg :aieu uopendxg :ale(l uoilendxg :fEmdmon :Xuedumn :AuedEuoZ) :ON asuaai-I leaial! Z)O \l :ON 3=31-1 8aiqum[d :ON asua3l leaiAaalg :Shun lepuapisQH :sauoiS :;oog :SIIeM :Xauedn33o :Ienolddy :S1N"WOD SMIOM *n9nd :lenolddV :S1N3W WO3 ONiumns IME10Z :IenolddV :'id'bS :S1N3WWOO ONINOZ ~nIS N INTO ffSI1 LNI3Y~[L2IVdgQ 9N[IQIIflff ltu" jbald Off' } LgMyco *I1c-o lquio,L $:X73,L aSfl $:aad MgIAag UWId $:aa3 I!tw3d ?42 $:anlzA UOTIOMISUOD oa~ P~ ~ Is.a3Fl~s~a :(HOJ3Va1NO3)(83NMO) a , - im=d sigl aapun liiom>OJ'saaueuop+p a8pg( IeagM a!geagdde+aglo Ile pug (3-g (t) apoJ %u!p(!ng OSPIJJ leayM ayl qlm+ aauegdwoo +oj Qgogosuodsa+ pnj atunsse I legs pue uoneagdde sign uo paluud suo!ypuoa 6 ,Cq apoge of aaj2e pue peso aneq 17eg1 'alenaae we apem suo1je8ai!epue'umoys slua eMSZOUJ lie legl'p+oaas;o suotmWsal+o siu osea'siueuanoa 10 98p.ru leagM jo kith agi jo suone)ngai+o sa(nt'=usu!pm aigeagdde M(q!n loo op pue 'alelnaae ale uopeagdde umad s!ql Aq posodold seouns!p t(asglas aql legl,(jiuaa,Cgwaq I 1N3W33N`JV O.NV ON[O.W1S1t30Nn d03N(11VN9IS 1[O.IJVlIiNOJRI3N,t\O / Cb"J°&?L , :aaogd (A! ~ u ?Nd :,(ueduJon ~~~7 ouogd ~c1gV ( L OL°LbtD of l asuaaiI joiaeauon W %h M 6)I090I :ssaJPPV KU;adOJd UBp30M q?( :JauA\O,CiJadOJd 4 lOUVW744~V (558Z-S£Z-£0£) - ££008 OJ 19CIM LVHIIM °°pao 1pd WINRAV H16Z SSgM OOSL 99~ d9QRI •LVaHAL AO A•LIJ o n I ( 1 'lieu ££65 6£Z £0£ - 2[NII'I NIOLLJddSNII 9NIIQ IInff d Y 7 ~ :Jaqumll iiuuad 3uiplmg ,LNIgL1IZ2IVd~Q ,LN[dL1id0'IdAgQ ,[•LINInLQL~IOJ 1 b3Hm i° COMMUNITY DEVELOPMENT DEPARTMENT `.B1111M:DING INSPECTION LINE - (305-2345935) CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80033 - (303-235-2855) PropertyOwner. DEBRA MUERHOFF Property Address : 10616 W 48TH AVE Contrector License No. : 18278 18429 3/9/2005 3 - ~b~s - be3~ Phone : 868-6829 Company : Tuff Shed Inc. Phone : 399-8833 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this pertnit appliption are accurate, and do not violate applipble ordinances, rules or regulations of the City of Wheat Ridge or . covenants, easements or restricGons of record; that all measurements shown, and allegations matle are accurete; that I have read and agree to abide by all conditions pdnted on this appliCation, and that I assume PoII responsibility for compliance with the Wheat Ridge Building Code (I.B.C.) and ali other applicable Wheat Ridge ordinances, for work under thls permi . (OWNER)(CONTRACTOR)SIGNED P . DATE ~ I~ Building Permit Number Date Valuation : $1,745.82 Permit Fee : $$2.16 Plan Review Fee : $0.00 Use Tax : $31.42 Total: $113.58 Use: Description : SHED - 10'X16'. 8' DOUBLE DOOR, NAVAJO W HITE. 9'11" HEIGHT AT PEAK. Occupancy: U Walls BUILDING DEPARTMENT US y~`/cpnhaetor is responsible `or nrenert} lines 2nd cS►Qttvcting im;?r~StinFVs 2.c:.:.......... ~ tu,`.: approved plan atid ri ,J:e6 2/25105 The City is not respors'oi,, in~ormat1on submitted tivithi;i ; u., i.- -',d :'.ny cimtiMucticn errorsresulth.g;rominsc:.l.~a!-, in:arma:iun. MUST BE PROPERLY ANCHORED ON ALL CORNERS Roof Electrical License No : Company : Plumbing License No : Company : Stories : Residential Units : Mechanical License No : Company : Expiration Date : Expiration Date : Expiration Date : Approval : Approval : Approval : (1) This permit was issued in eaordance wRh the provisions set forth in yopur application arM is subject to the laws of the Sfate of Cobiado and W ihe Zoning Repulations and Building Code of W heat Ridge, Colorado or any ofher appliwble ordinances of the City. (2) TNs pefmit shall er.pire if (A) the work authorized is not commenced within sixry (80) days from issue tlate or (B) the buiMinp authorized is suspeMed or . abantloned tor e period of.180 days. (3) If thls pertnit ezpires, a new permit may be acquired for a fee o( one-half the emount normally required, Drovided rro chanpec have been or will be made in the originel plans and specific8tions and any suspension or abandonment has not ezceeded one (1) year. If changes are made ar if suspension w abantlonment exceeds one (1) year, full fees shall be paitl for e new permil . (4) No vrork of any manner shell be done that will chanqe the natural flow of water causing a drainape problem. (5) Contractor shall notify the. Building Inspector twenMfour (24) hours in advance for all inspections and shall receive wriflen approval on inspectlon ceM 6efore proceediing wkh suaessive phases ot the job. (6) The issuanpey( a pemgif.~_af drawings and specifications shall not be constiued to be a pertnit for, nor an eppmval of, eny violation of Ne proYiewns f ihe ~I~ng codes or a Rer ordinance, law, rule or regulation. Chi Building~pect~ Please sign Terms and Conditions on reverse side of page. Building Permit Number: COMMUNITY OEVELOPMENT DEPARTMENT Date: BUILDING INSPECTION LINE - 303-234-5933 ~ CITY OF WHEAT RIDGE ' 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80033 - (303-235-2855) APPLICATION Property Owner.-b.: rr)q m l'1~E Property .4ddress: I ~~p I ~ ~/V ' 1 , Contractor License No.: Company~~~ ~ h-ed. Phone31)3--06'Wa'-I Phone3o3'399 -V3 OWNEWCONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT V alue:S I hereby certify Nat the setbadc Cislances proposed by this per+nit appiication are Permit Fee:S am,r-yte and Ap np( violate aOWicable ordinances, rules or regulations ot the Ciry of WheatRitlpeacovenants.easemenisarestriGimsofrecord:tnatallmeaswements plyn Review Fee:S shown, and allegalirns maAe are accurate; tt~at I have read and agree 1o abde by all ditrons printed on Nis application and ihat I assume 1Wi responsiDiliry fa `SC T3X'~ ~rr compliance +vith the Wheat Ritlge Building Code (U.B.C) and atl oMer ap0limbie Tota1:5 Wheat Ridge Ordnance5, ior work under iM5 pemit. ((ZffWNGOMTWNCiOrt):SIGMEn~.'. DATE 7 Description:5 `'12d - ~ ~ 'A )l0 JDUO)e G~UO✓~~- ~ /L/f} VfFJU Sq. Ft. adMd 1 (0 O q+ I I" hC.1 GIYU /.1.1 ~ri ~ ~J ONL COMMENTS: % p,pproval: ~ Zonin9: ~i IG C0IMIENTS: Approval: , WORKS COAMdENTS: p,pproval: / W alls: Roof: Stories: sic: Residendal Units: Electrical LYCense No: Company. , i Expiration ~ate: Plumbing License No: Company. Expiration Date: Mechanical License No: Company: 6cpiration Date: ~.,.a,. l waa issued in aocadanx with 1he W°v,.W^g set fOrth in your applic•alwn a^d is subjed 1u the Wws of the S1ate of (1) This perrti p~ arW BuiWirq Codes ol W heat Ridpe. CdoraAO a any other applicade ordi^a^ces o1 Cpqr-dpo ~p W Ux Zonirg Repuu Me Ci1Y. hom issue date w (8) the buildinp (2) TTiis permil shall enpire if (A) the woA~ aulhorized 1+ ^ut ca^^~e^°ed ~"'ia'in sixAy (60) deYs autlvorized is wsPanded a abandoned ior a Pe^od ol 120 days. 1f Ctis Pom^n e~res ~ a new D~ ~Y b° acGuired for a lee of one-fia11 the amount namalH re0uireC ~Orohdad d+a^qes (3) naw e~ a wai oe ~„aee in the «girw vw+: ana ~dep~ons ar,a a~+r ~Svensiw+ o. ana~,eo~e~+t ror a r,~ v~ (1) Ysar. If dwrpes have been or N suspens'on a~^^1°M exceeAs one (1) Year, futl fees sha! De DaiO (q) No work ot anY manner ahaM De done tliat will dnnpe the naWral 1bw o( waler causi^G a dninape MoGlemII rece+ve written (5) ConVaUOr ahall no1iH Itx Bui1d"uq InspeUOr tw°^N"four (21) houn in aOvance ta all inspecUOna a i1 tor, nM an apprpvy on Mspectio^ t0rd Detore Drocoodwwg Wilh Suaessive Phases of Uw 1ob. (6) Tne isau+ce ot a vamit w the avweral of arawinus aM *vedfio~nona ahaN rwt be construeE m be a De^^ aCWo"eI of, any viobtion of ihe Droi^sio^s of the buiWinp mdes a any otMr ordinance, law, ruk a re9Wauon. Chief Building Offcial _ 1 71 d lz~ 6 74, 1f . V+ Q i n O < d .~r Q T ~ W ~ ' ~ i Q ~ "Y ~r.. / ti ~ i ~ !(I~i 1 ~ I ~ A ~ , h- y ~ . . k~ iawoaH-~O lepaleaoj -uomeo,eip,g/ioyouy,gg SVM$ x . ap eig Isix 3 ~ uiof iooli -ZPF xZ . qelSalaJOuo3 wnwiuiW.L/T-£ ape1D.uix3 E E ~ vawoo waI,Zj q '0'o .0.9 M ioyoutl e!0 .L/I 'wW ~ 'lloq „Z/T/M ioyoue puna8 0l palloq pue slieu pgt/g y]!M sdeiu jejaw 'eg gt wnwiuiW m n Suipig ~ z o„ ~ ,T~ @ SPnu W xZ !7 C. m I^ \ ueds / r. i J 4011d ZI 8 alAis )ooil auO Pa4O.~ ~ 0'0 ~D ya4e8-)~xZ leualew ianoa looy _ ' tlal~looU 8uiyoap+008 uoiiewaojui anoqe ayl ypM~uoje ~3!wJadEuipjing, e aiinbailaa7 aienbs OZL ueqjjaleai8 spayg *6Iuo „3!wAad luawaoeld P94S,3390N e annbai azis ui laa} aienbs OZI japun spa4S uopeaijddeliuuadejnolli_j /a/dwexapayseAreaaSJ -saup,(}iadad ~uilsixa olaauelsip ayIpue dyadmd ayluo samjoruls io s8uipjmq Huilsixa oj diysuoilelaisli pue laafoidino,(lo suoisuawip 8uimoys (ueld a3is) ueldioog e apuad 'z 'sHuelqalqeailddeayl uiEuipy6qapin28uippqsiy3alaidwo3 'I •1!wjad ouiplinq e jo~ 6jdde ol papinoid aq lsnw sluawnaop palaidwoo oNqiseal iV Bpifl 514] S00]MOH aping 6uiplin8 62/18/2005 11:30 3035737714 TUFF SHED RIO r PAGE 01 SALES ORDER Inc. TUFF SHB ~ - , Sforoga Buildings • Garagas , Carports 3TORE20•DENVER DeM ?H712005 4500 GIPpe SL CustofllarNO 1215Y9 Oenvqr.CO 80216 9hlp Te 127519 phpne:309 399•8833 FB%' ~3 393~9833 . OMer Num~r 123851 fA 1-800•BUY•7UPF RdmIM W.O. 00105653 Shlp To: Sold Tc: Oeve Worden Mt Hom9 303 423-2831 Mr.Da~k+Wwdem hi0~+e 803 9Y~Z831 , 10618 W. 48M Ave, Fax Fm 106t9 W. 46Ih Ave. ' ~OB~° ~ Ofllea 903 6A8-6829 eelr~dge CO 80033 Ollice 803 988b828 Wh Cell Gell CuelomerP.O. Shl VIE P Shl InaWCUonelSB~1aINUmbar Da~ ONerDe1e R6quaeteE Jlm oowu Os 7/18«005 y24~~Od' iMm No. R9queetep Oate Line 51110Ded luoM Pfte EmnEeO Maufit Desenp[bn ~ 00 EA ^ 3WED 212412005 1.000 7. 3had Sxdee lar 4' OMdlO DOa (e1 3W 9ase PBIIiI Cdor. Nn'aJ0 Yhha • EXterlof 3atln T11T PeIM P 9 ' ' Color. 540n1ah 6EIge ~ . r m WI09 76 LOng PreMier T911 Rent11 10 ExtefWr Setln SMmgla poim' BrownwDOtl• Cleetk 3 Tad Bmwn Grip Edp 4112 ttaof PXCh 00 3 245 2J242oo6 11075 7.00 EA , . 3,2+5.~ 8qllding Base Pden ' 22414005 1.014 7.00 EA 324.5000 924.50 Shed Pelnt Charge 4281 ' 4/24I2005 1.003 2.00 EA 750.0000 300.00 x 7 gkyligllt 2 8" z 16 Nent Stman N71M0 2413 7124/2005 -1.006 2.00 EA 15.0000 30.00 21242005 1.073 1.00 EA 125.0000 125.00 3hed Gow Uvgrdde Gharge DISCOl1NT 21202005 2.000 1.00 EA 607.BBW- 603.68- pi6counl Hom9 $haw Giacount Order Sub Tofal 3,420,82 Sublotel 561es Tax - Dellvery 75.00 ' OrderTohl 3,495.82 Paymenta •^•µ••M• 0 IO VlsalMasta[Cerd 212462005 1,750.00- Beianca Dua 1,745•82 Signature Date afeaee read me mrtnx and wndnrona eenminad in me above ieleranced werrany. rnoso WHnne end conamone we part ot tlhle ordar. 9uyef dglBae to pumheB9 9nd PeY iM the pfOCYCm 50t kM1h In tl718 Rele9 eldN, IndUENp ihoBB relmeflcBd ln tha eb0V0 QTU.FF SHED.Inc. Sforaga Buildings • Garages • Carporfs STORE20-DENVER 4500 Grepe St. DenveqCO 80216 Phone:303 399-8833 Fax:303 393-8833 1-800-BUY-TUFF Mr. Dave Worden 10616 W. 48th Ave. Wheatridge CO 80033 r-- Ortler Oate Requested 2/i6/2005 2/24/2005 Sold To Home 303 423-2831 Fax ORice 303 868-6829 Cell Customer P.O Mr. Oave Wordan 10616 W. 48th Ave. WheatridgeCO 80033 Ship Via Shipping Inslmctions/Serial Number SALES ORDER Page 1 Date 2/1712005 CusromerNO 121529 Ship To 721529 OrderNumber 123951 SO Related W.O. 00105553 hip To: Home 303 423-2831 Fax Office 303 868-6829 Cell Salesperson I Jim Downs OS Uescnpuon Item No. Requested Dale Line Shippe0 UOM Price ExtenOed Amount J SheA Senes SHED 2/24/2005 1.000 1.00 EA Premier Tall Ranch 70' Wide 16' Long 1 Premier 4' STANDARD Door SW Base Paint Coloc Navajo White - Ezterior Satin Trim Paint Color. Stonish Beige - Exterior Satin Shingle Color: Brownwood- Classic 3 Tab Brown Drip Edge 4/12 Roof Pitch Building ease Price 2/24/2005 1.013 1.00 EA 3,245.0000 3,245.00 Shed Paint Charge 2/24/2005 1.012 1.00 EA 324.5000 324.50 8" x 16 "VenlScraen White 2413 2124/2005 1.004 2.00 EA 15.0000 30.00 Discount OISCOUNT Spring Discounl 2/24/2005 2.000 1.00 EA 1772500- 177,25_ Sub Total Subtotal 3,42225 Sales Tax Delivery 75.00 Order Total 3,497.25 Payments "°""0/ 0 Visa/Master Card 2/24/2005 7,750.00- Balance Due I,747.25 Signature Date Please rea0 ihe lerms antl conditions coNainetl in the above refarencetl warrenry. Those tarms and conditions are part of lhis order. Buyer agrees lo purehase antl pay for ihe producls set forth in lhis sales order, including those referenced in iha above stated warranry. Final payment is due upon delivery of builtling.