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HomeMy WebLinkAbout10925 W. 39th Avenuei CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Permit Number: C� 7 e i r —} ❑ No one available for inspection: Time i AM/PM Re -Inspection required:; Yes; No When corrections have been'Made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. usl'inspection Date: '� �� ��' 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: i �% `' -�; �' r" ^� Permit Number: `� ! t V w" 7 I, S ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes ;No lO,1 �_ When corrections have been made, schedule for re -inspection online at: http✓/www.ci. wheatridge.co. usVinspection Date: 3 - I U_ & ? U Inspector: f'3 DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTIONNOTICE Inspection Type: Job Address: Permit Number:; 0 i o 5 (- �- it ❑ No one available for inspection: Time ` AM/PM Re -Inspection required: YO �No When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. uslinspection Date: _�D -Cl' ) bl b Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type:��` Job Address: Permit Number: '"'" 75 ❑ No one available for inspection: Ti M M Re -Inspection required: Yes When corrections have been made, schedule for re -inspection online at: hffp:llwww. ci. wheatridge,co. uslinspe \7 Date . Inspe or: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: ' Job+'Address• U �. t �,� ' ' Permit Number: ` �., A v J ()-fed r(pv ( <el)- r'e F1C�r�5 ❑ No one available for inspection: Time / AM/PM ,-;pection required: Yep) No -s have been made, schedule for re -inspection online at: ',7,?.co.uslinspection `- `'nT/CE 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: 0 Vj ) (y' ' ;, S Job Address: O C-1 Dl- �d Permit Number: Do \ 01 0 a= ❑ No one available for inspection: Time Airs -f "� AM/PM Re -Inspection required: Yes No ) When corrections have been made, call for re -inspection at 303-234-5933 Date: V v Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Vr Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: _7L Q '�) u \ 0 � - L Job Address: 9 0, 1, -,)`- a%, -� c . `. C� �a Permit Number: - ` o 7_--'? 1 "1, t) e ❑ No one available for inspection: Time ; / i.: °' AM/PM Re -Inspection required: Yes No t When corrections have been made, call for re -inspection at 303 -234 - Date:— I _j z Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: n� Job Address: i �� 11 Permit Number: � 0 1 �l U 1_ TL_ ❑ No one available for inspection: Timed' AM/PM Re -Inspection required: Yes;' No When corrections have been made, call for re -inspection at 303 -234 - Date: �2'1 Inspector: b^ DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE; Inspection Type: 0, !`'y1,j"�) P r`c Job Address: 0 1 of W c`t"►� �J� Permit Number: :a 1 c" V V_- ry-, C Le F K\0� i r C ('v �{ r &,- rt </mac 1- ❑ No one available for inspection: Time L WO AM/PM Re -Inspection required: Yes &�, When corrections have been made, call for re -inspection at 303-234-5933 Date: U. �_� t `" Inspector:}` DO NOT REMOVE THIS NOTICE It, � 4 CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type:tr �� +___ -. - Job Address: !2_, Permit Number: ❑ No one available for inspection:,Ti Re -Inspection required: Yes When corrections have been made, c'iaill-id re-inspocCibn of 303-234-5933 Date �- ns ecto . 1 DO NOT REMO E THIS NOTICE Square footage: 700 **REVISION 12/27/2019: Replacing ductwork and furnace; Replace well tap; conditioned crawl space to prevent freeze on plumbing; insulate pipes, crawl space wall. Added valuation: $5,000.00 *** CONTACTS *** OWNER (720)220-2059 PSOTNY PETE GC (303)564-1787 PHIL LOVISONE SUB (303)775-0971 CESAR ARRIOLA SUB (303)523-3512 PATRICK LEE SUB (303)335-6866 RICARDO CORONADO 190251 ADVANCE CONSTRUCTION 170072 2 BROTHERS ELECTRIC 170670 MAIN LINE PLUMBING AND SEWER 190037 J & J HEATING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** City of Wheat Ridge FEES Total Valuation Residential Remodel PERMIT - 201902332 302.28 PERMIT NO: 201902332 ISSUED: 11/20/2019 JOB ADDRESS: 10925 W 39th Ave EXPIRES: 11/19/2020 JOB DESCRIPTION: Residential remodel of kitchen and bathroom. New windows, new electrical and plumbing. Square footage: 700 **REVISION 12/27/2019: Replacing ductwork and furnace; Replace well tap; conditioned crawl space to prevent freeze on plumbing; insulate pipes, crawl space wall. Added valuation: $5,000.00 *** CONTACTS *** OWNER (720)220-2059 PSOTNY PETE GC (303)564-1787 PHIL LOVISONE SUB (303)775-0971 CESAR ARRIOLA SUB (303)523-3512 PATRICK LEE SUB (303)335-6866 RICARDO CORONADO 190251 ADVANCE CONSTRUCTION 170072 2 BROTHERS ELECTRIC 170670 MAIN LINE PLUMBING AND SEWER 190037 J & J HEATING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 32,000.00 FEES Total Valuation 0.00 Plan Review Fee 302.28 Use Tax 672.00 Permit Fee 522.55 Misc. Fee 60.00 Reinspection Fee 60.00 Re-insp fee 2 60.00 ** TOTAL ** 1,676.83 *** 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. ► A City of Wheat Ridge Residential Remodel PERMIT - 201902332 PERMIT NO: 201902332 ISSUED: 11/20/2019 JOB ADDRESS: 10925 W 39th Ave EXPIRES: 11/19/2020 JOB DESCRIPTION: Residential remodel of kitchen and bathroom. New windows, new electrical and plumbing. Square footage: 700 **REVISION 12/27/2019: Replacing ductwork and furnace; Replace well tap; conditioned crawl space to prevent freeze on plumbing; insulate pipes, crawl space wall. Added valuation: $5,000.00 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 ow er of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this_�ppermit. her attest that I am legally authorized to include all entities named within this document as parties to the work to be pertorme thha,all�wJork to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. n/7!/.tel I-- i_--) _ Sig?faturb'of OWNER or CONTRACTOR (Circle one) Date 1. 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 maybe 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 ganting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any icable code o) 9ny ordinance or regulation of this jurisdiction. Approval of work is subject to any inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of` W heat j�ide COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 29"' Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(aci.wheatridge.co.us I FOR OFFICE USE ONLY Date. /a 060 Add tope. Building Permit Revision/Amendment Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address:----��---=---- (�_.- ------------------ Property Owner (please print): Rt L Yse fi :,� Phone: Property Owner Email::f ti;_ j:�-_'�f--------------------------------- Mailing Address: (if different than property address) Address: State �Ox Submitting Compony:�AN_P Contact Person: _ �1�_1..�a s, � Phone:_ _;� _.7J__11__IiZ _z Contractor: Contractors City License #: _ 'r%�_________________ Phone:_ =� �I Contractor E-mail Address: -�� Den Y\n a i I 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: D, 00 d Z�,To (GNJ To Vf,\ ak14 �, Sq. Ft,/LF Amps P? 19 -e --S CRA w/ _ Btu's Gallons Squares Other Additional Project Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above) OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this penTd application are accurate and do not violate applicable ordmances, rules or regulations of the City of Wheat Ridge or covermus, easements or restrictions of record; that all rneasurerre its shown and allegations matte are accrrate; that I have read and agree to abide by all conditions prnrted on this application and that I assume full responsibility for coup Nance with applicable City of Wheat Ridge codes and aadinarces for vwrk under any peunit issued based on this application, that I am the legal owner or have been authorized by the legal owner of the property to perfoun the described work and am also arbhorized by the legal ovmer of any entity included ort this application to list that entity on. this application. CitRCLEONE: (OWNER) NTRACTOR) (AUTHORIZED REPRESENTATIVE) of (OWNER) (C01VM'CT0 P,)�) PRINT NAME: �T.t S6Lr(Q_ SIGNATURE: DATE: 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: $______________________ i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Q I? Job Address: Permit Number: + e �f W d`tai- 3' Wes' s, \Il ✓ i \ r 1. ,sem a i �. 1 y 1n2 t1 � •19 i It �i ! Y� ® r/�" � l < f t" e ❑ No one available for inspection: Time(.`°q1L) AM/PM Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: h ttp://www. ci. wheatridge. co. uslinspection Date: -k ' � � u-' f- Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: w r- -- 4 Job Address: 1 z-�_ C� t Permit Number: ❑ No one available for inspection: Tim Re -Inspection required: Yes' No` When corrections have been made, schedule for re -inspection online at: http://www. ci. wheatridge. co. uslinspec Date: nspect DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Y�2_ Y -r' C_ c �- _ Job Address: Permit Number: � y Y'-P-saIra -PAU C' 6y�N. <n A.U)4,,1�\.0,b\.1 ❑ No one available for inspection: Time A% �� AM/PM Re -Inspection required:) No When corrections have been made, schedule for re -inspection online at: h ttp ✓/www. ci, wheatridge, co, uslinspection Date: f" Inspector - DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: 3d _ o Job Address: P 2- J Permit Number: 'i71 G 0 ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: httpJ/wwwci.wheatridge.co.unspec io Dote: Inspect - i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: ! t`l � o Job Address: C1 Permit Number:('] I i��� � V -- oc ❑ No one available for inspection: Time \ 00'V AM/PM Re -Inspection required: Y7" l No When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. uslinspection Datej' Inspector: DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: ry"\ c- L �-\ Job Address: _ " y � T -i L1% Permit Number: ,-CJ Cj U 2��2 m .�L 0 � ❑ No one available for inspection: Time kk ��� `" AM/PM Re -Inspection required: s No When corrections have been made, schedule for re -inspection online at: http://www.ci. wheatridgge.co. uslinspection Date: ' J Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: (j Permit Number: 22)`1 r -7L-2 ❑ No one available for inspection: Time � f AM/PM� Re -Inspection required: Yes YNo When corrections have been made, schedule for re -inspection online at: http.I www. ci. wheatridge.co. uslinspection Date: i � ' i , j`7 Inspector:_),_ --a DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: 4 0 'A ",3 c�, Job Address: f =_ ��` -_` Permit Number: ❑ No one available for inspection: Time% '> A�M Re -Inspection required: Yes ,`r, No When corrections have been made, schedule for re -inspection online at: http://www. ci. whea tridge. co. usrnspection Date:-/ Inspector:�--- DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Permit Number: 01 No one available for inspection: Tim Re -Inspection required es No When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. uslinspection Date i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: �z f" Job Address: OCA V� __ 1C, Permit Number: J No one available for inspection: Time AM/PM Re -Inspection required: ,/,Ye� No When corrections have been made, schedule for re -inspection online at: httpYlwww. ci. wheatridge. co. uslinspection Date: ` 2-0-)- (.� Inspector: DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: ��, �� i-`�.`•_ Permit Number: 01 r, �\ G M 9 LJ No one available for inspection: Time L' AM/PM Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. uslinspection Date: inspector: 3 1, 20 DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Roofing PERMIT - 201902541 PERMIT NO: 201902541 ISSUED: 12/09/2019 JOB ADDRESS: 10925 W 39th Ave EXPIRES: 12/08/2020 JOB DESCRIPTION: Re -roof and re -deck with OC. Squares: 11; Pitch: 5/12 *** CONTACTS *** OWNER (720)220-2059 PSOTNG PETE SUB (303)568-9896 FREDIS DIAZ 170058 DILIGENT ROOFING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,525.32 FEES Total Valuation 0.00 Use Tax 95.03 Permit Fee 125.05 ** TOTAL ** 220.08 *** COMMENTS *** *** CONDITIONS *** ALL PITCHED ROOFS REQUIRE A MIDROOF INSPECTION REGARDLESS OF PITCH. FOR ROOF PITCH 6/12 AND OVER: Midroof & Final Roof inspections for ROOFS with 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 Building Division Policy BD -18-001 for Balanced Ventilation Systems, or manufacturer installation instructions, whichever is more stringent. MIDROOF & SHEATHING: Effective December 1, 2014, asphalt shingle installations require an approved mid -roof inspection, conducted when 25-75% 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% 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. LADDER MUST BE SET FOR ALL ROOF INSPECTIONS: A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. COMMERCIAL ROOFS: 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. w®`t PERMIT N0; JOB ADDRESS: JOB DESCRIPTION: City of Wheat Ridge Residential Roofing PERMIT - 201902541 201902541 ISSUED: 12/09/2019 10925 W 39th Ave EXPIRES: 12/08/2020 Re -roof and re -deck with OC. Squares: 11; Pitch: 5/12 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 ermrt. I further attes{ that I am legally authorized to include al[ entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, po plans and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original ermit 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 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, anviolation of any provision of any applicable codq,.mVny ordinance�or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADS BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of W heat�idge COMMUN7Ty 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(cD-ci.wheatridge.co.us FOR OFFICE USE ONLY I Date: Plan/Permit # Plan Review Fee: Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: Gc Ve IyI en -1 yL/ 6 c"C 11Z�3? Property Owner (please print): Phone: Z -a Z26 Zc Property Owner Email: rciyl Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer E-mail: Contractor Name: Phone: City of Wheat Ridge License #: 1 c�'�' J Phone: 3 `7-3 �L,a ��5 46 Contractor E-mail Address: Yid Sid,/i 901Iroof - Ccs}% For Plan Review Questions & Comments (please print): CONTACT NAME (please print): 611 Phone:�C' CONTACT EMAIL(p/ease print): Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. ❑COMMERCIAL t� RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. 05 5 5L�i6 Sq. Ft./LF #001 BTUs Gallons Amps Squares /_ For Solar: KW # of Panels Requires Structural For Commercial Projects Only: Occupancy Type: Construction Type: 2f-fen47 Occupancy Load: Square Footage:)/ Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ /Y1p n6,, :'�'G 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. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name):/� DATE: ! �` Printed Name: ,C�c1-/ r� ZONING COMMMENTS: Reviewer:x2Q/'i tJPJ7 Gt / BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: �/��2,�; - .jL City of Wheat Ridge Residential Asbestos Abatement PERMIT - 201902389 PERMIT NO: 201902389 ISSUED: 11/13/2019 JOB ADDRESS: 10925 W 39th Ave EXPIRES: 11/12/2020 JOB DESCRIPTION: Residential abatement of 3,405 square feet. *** CONTACTS *** OWNER (303)796-0203 COLORADO HOME BUYERS SUB (720)583-0840 CHE RAMIREZ 170213 COLORADO HAZARDOUS ENVIRON. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 16,965.80 FEES Asbestos Abatement 50.00 Total Valuation 0.00 ** TOTAL ** 50.00 *** COMMENTS *** *** CONDITIONS *** Work shall comply with 2012 IRC & 2017 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. I, 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 thispenrut 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. Signature of OWNER or CONTRACTOR (Circle one) Date I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and maybe subject to a fee equal to one-half of the originalpermitfee. 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 an manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a pen -nit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of CKO C 1W Date REQUESTS MUST BE MADE, Y 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of W heat Ridge C(]MMUNI-FY DEVELOPMENT Building & Inspection Services 7500 W. 291 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(oki.wheatridge.co.us I FOR OFFICE USE ONLY I Date: 8//. _// Plan/Permit # J&/1O, .3 Plan Review Fee: Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 10925 W 39th Ave. Wheat Ridge, CO 80033 Property Owner (please print): Colorado Home Buyers, Inc. Phone:(303) 796-0203 Property Owner Email: PPsotny@gmail.com Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: 8101 E Belleview Ave. Ste. F City, State, Zip: Denver, CO, 80237 Architer�tfEngineer: Architect/Englneer E-mail: Phone: Contractor Name: Colorado Hazardous Environmental City of Wheat Ridge License #: Phone: (720) 583-0840 Contractor E-mail Address: Main a@cheabatement.com For Plan Review Questions & Comments (please print): CONTACT NAME (please print): xb(*.CAv1 t 0'fi. Phone:361 ­ 60 -6 G [, CONTACT EMAIL(please print):�� t c� �� (� (,� n� i� Vi '(0,0 Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. ❑COMMERCIAL M RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. A full containment will be erected. 3 Stage shower Decon & 2 Stage load out will be utilized. Negative air pressure will be established with manometer(Alarm set at 0.025 inches of water). Wet methods using airless sprayer with amended water + Hand tools will be used to remove 3,405 Sq. Ft. of Drywall(on wood studs).Tool that will be used during abatement(Demo bars, hammers,flat bars,putty knives, 4 in. scraper blades, Utility knives, 5in1, ETC). Earth energy environment will perform final air clearance. All reg 8 will be followed. Waste will be placed inside a primary Emil. "Asbestos" Labeled bag, then place into another Emil. bag. Detail cleaning will be conducted using leaf blowers, hepa vacumms, and wet wiping. Waste will be transported with a manifeste to a landfill. Sq. Ft./LF 3,405 Sq. Ft. BTUs Amps Squares For Solar: Gallons 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) OH'NER/CONTRACTOR SIGNAT1..7RE OF UNDERSTANDING AND AGREENIENT 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 tinder 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 perforin the described work and am also authorized by the legal owner of any entity included on this application to list that entit% on this application. 1. the applicant for this building permit application. warrant the truthfulness of the information provided on the application. CIRCLE ONE: 0— ) (CONTRACTOR (AUTHORIZED REPRESENT4TI1 E) of (011'NER) (CONTR4CTOR) Sianature (first and last name): DATE: Printed Name: L^ F FA Ad IIZE-Z ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE::- Building Division Valuation: a c�'3 oin 5, �m •cg2,m � A CD ¢�CD_C v0 3-�-n O I@' rU3--'�' (D 0 mm `BN=m rog d0;u sED0 °mm3'P d o�(n m To 3 Tm a Q� o -uT 0 XQm d may G) CL En CC:, mcnm r r- r�r m8m }07 m o $ 2 mWr rn 3 Q 2 ma u 0 �1 _ ;> n v 0 0 tfD.wm ^O 0 i z yo a �o 3 q�oo� i bro 3 m ro rn QQa �1 q° C z IU N � SA W ik m i m ppz�� " �• w m (y f 5 3 ro 9! 3N O 3 a a' m n o ° a �{ i r C7 r Oa i Q.a O -u c om F N 0' a a 0 w m a v _ O Co Oo m ri — AAl1 # Sfl lS) g a oC C. 3 7 vv 6i v Si c f1 q W m d m � c� g 3 d� ro D o 03 CD 3 w i o J m 0 z w 4 ` 333acm W J C 8 }n'' 3. e� T s � W dog A Ipi �+ n > aQ > Q (D ID1 j d17A m El �s9 3 �. ro Qa _� j 0 � a _ � -i ❑ V u S9 t�y - � p SO Tro m W o o q m W o SD T 11 IQ D a m 11 O CL w f to X ra C� O 7. Ln 0 0. T EL ' ' +� CD L o5 N (7 7 ', 0a; ° Om N c a d _ a z m� g� o 0 mcn w m c� cn0 co 0 � 0W z E �m 6 -4 n Z 0 0 o� K 0 v 1— z m mM 3 0-0 rm Z * -V TJ rr �0 M > ca Z Z -n mQ l 'd Ml "N 4;[�;H �o ;u;w;ja daa op�aC�OD WdZti:ti 6l0Z'�l'^oN Che Main <main@cheabatement.com> Permit Request for Colorado Home Buyers Address: 10925 W 39th ave. Wheat Ridge, CO 80033 Asbestos - CDPHE, cdphe <cdphe.asbestos@state.co.us> Wed, Nov 13, 2019 at 10:28 AM To: Che Main <main@cheabatement.com> Brian, Unfortunately, we cannot control the requirements of local municipalities. This permit request was sent in yesterday, and thus it hasn't even been entered into our system yet, and likely won't for several days. Until it is entered into the system, there is no way we can generate an official permit for you. We are sorry for your inconvenience, but this is our process. Jeff Wolfe Permit Coordinator Asbestos Unit Indoor Environment Program Colorado Department of Public Health and Environment P 303-692-3100 1 F 303-782-0278 4300 Cherry Creek Drive South, Denver, CO 80246-1530 cdphe.asbestos@state.co.us I www.colorado.gov/cdphe/asbestos COLORADO Air Pollution Control Division )c De rtment of Public HeaM & Environment 11 As of January 1, 2017, the Indoor Environment Program will not accept incomplete forms for certification, abatement or demolition. Any application with missing information may result in longer processing times or the application may be returned to you which will restart the required notification period. Please note that all submissions must be completed using forms supplied by the Division. If you need assistance, please refer to: https://www.colorado.gov/ pacific/cdphe/asbestos-forms or https://www.colorado.gov/pacific/cdphe/certification-and-lead- abatement-forms or contact the Indoor Environment Program at 303-692-3100. [Quoted text hidden] WEECYCLE ENVIRONMENTAL CONSULTING, INC. 1208 Commerce Court, Suite 5B Lafayette, Colorado 80026 (303) 413-0452 Fax(303)413-0710 October 22, 2019 Peter Psotny Metro Brokers 8101 E Belleview Ave Unit F Arvada, CO 80237 280 W Kagy Blvd., Suite D-259 Bozeman, MT 59715 (406)548-5450 Re: PLM analysis for 10925 W 39th Ave, Wheatridge, CO 80033 (the property) Dear Mr. Ptsony: On October 17, 2019, David Sawitsky #13463, a Building Inspector, certified and accredited by the Colorado Department of Public Health and Environment (CDPHE), collected and submitted for analysis thirteen (13) samples of suspected asbestos -containing material (ACM) from the property. The Asbestos Inspector visually inspected the area to identify all suspected ACM and asbestos containing building materials (ACBM). All building materials were touched to determine friability. The results of this Asbestos Containing Building Materials Survey determined that Asbestos Containing Building Materials are present in the area tested. The following building materials were determined to have asbestos levels that exceed regulatory limits. The Homogenous Areas with corresponding Analytical Results are located on Table 2. Table 1: SUMMARY OF ASBESTOS CONTAINING BUILDING MATERIALS HOMOGENEOUS AREA DESCRIPTION OF MATERIAL TOTAL SQUARE FOOTAGE Kitchen and NW Bedroom walls Drywall Texture 450 & ceilings NE Bedroom, S Bedroom walls, Drywall Texture 600 Bathroom walls & ceilings NE Bedroom, S Bedroom, Hallway, and Living room Drywall Texture 750 ceilings ANALYTICAL PROCEDURES The bulk samples collected of suspect asbestos containing materials were delivered to CEI Labs, a National Voluntary Laboratory Accreditation Program (NVLAP) asbestos laboratory, located in Cary, North Carolina for analysis. All bulk samples are archived for six months unless otherwise stipulated by the client. According to the laboratory, the bulk samples were analyzed in accordance with EPA Method 600/R-93/116. Small portions of the sample were placed in Series: E High Dispersion Refractive Index Liquid on a microscope slide. The prepared samples were observed at 100X (power) Metro Brokers 10925 W 391h Ave, Wheatridge, CO 80033 — Asbestos Report under polarized light using a McCrone Dispersion Staining Objective. The characteristics of the fibers were compared to the known properties of asbestos fibers for dispersion, color, polarity, extinction and general morphology. Sample content (percentage) was made by visual estimates comparing of asbestos fibers to total sample material. If the laboratory detects asbestos in a sample of a particular homogeneous material, the remaining samples in that batch are not analyzed, and are assumed to contain asbestos. Samples returning Trace Asbestos (TR) results were resubmitted for Point Count analysis. Samples with Point Count results of less than one percent (1 %) are not considered to be ACM. All thirteen (13) samples obtained from the Property were analyzed. RECOMMENDATIONS AND SUMMARY The materials listed, in Table 1, are regulated asbestos containing building materials. Prior to demolition or renovation activities these building materials must be removed by a licensed asbestos abatement contractor accredited under Section 206 (b) of the AHERA act and by the Colorado Department of Public Health and Environment Regulation No. 8. It is the responsibility of the owner to meet the requirements as stated in Federal Regulations 40 C.F.R. 763.84 and Colorado Regulation No. 8. Suspect materials are sometimes located behind walls and above ceilings and were considered inaccessible during the onsite survey. Therefore, all materials that contain asbestos may not have been observed or sampled. If additional suspect asbestos containing materials are identified during periods of disturbances, all activities must stop until these materials are sampled. Work shall not resume until the results are reported and removed by a licensed asbestos abatement contractor. Weecycle has assigned Job #19-16845 and CEI Labs Report #A1918300 to this study. Weecycle Environmental Consulting, Inc. appreciates the opportunity to assist you with your asbestos sampling needs. If you have questions regarding this report, please contact Lauren York at (303) 413-0452. This is not a complete AHERA Asbestos Survey for renovation or demolition. The laboratory report is enclosed. Submitted By: 4— Lauren York State of Colorado Asbestos Inspector #3748 Metro Brokers 10925 W 39th Ave, Wheatridge, CO 80033 — Asbestos Report LF+ CZ O c E- cr� p pLo N p LOp 0 Q> N N N O S 0 U) O Q �U cU c�U Q d L L L CD co `° o 0 w — m E 75 _ 3:O O0 a% m = = C `- Z�� -- 0 �� 3 mai_ _�• O 0 0 w E��z o c E 0 0 �_• °UJZ ZE00E0020 v ccamico-°oOo-0-0o 0-0mm L Y UY m��m��m aa) m W .� �wm �mwwm O � Z 22 Z Y m z w m w z z w �NM� �COfl00M---- p � N M N , , , , C NC H LO Cn aLi a Z Lo LO LO 2 20 L L. �`O V L O U cn Cl) CO U) 2 06 c z CD c �3 0 0 °EE ° 00 QmE V a) 0 a) 00 00 0) N 0 L N O_j O c�-a:c = N 00 w N '� w N O 2 v Zmm v .> Zm.J C d O M C E 'i =to m� Q- �E 3: 0- 3��E �� 3�- x ._ 0� x ._ x �F0- �U 0E- i a F o 0 0 C O CZ ti c E N cn T co (C5 C L N O U) O 0 0 cn Q m Cl) M CD 00 0 � U c U 0 ``^)VJ O o > Q O L Y UY co o W OL LON C6 O � � r tiff e u r o f i n s CEI October 22, 2019 Weecycle Environmental Consulting, Inc 1208 Commerce Court, 5B Lafayette, CO 80026 CLIENT PROJECT: W. 39th Ave 10925, 19-16845 CEI LAB CODE: Al 918300 Dear Customer: Enclosed are asbestos analysis results for PLM Bulk samples received at our laboratory on October 18, 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, Ile �- -, � k � --- Tianbao Bai, Ph.D., CIH Laboratory Director NVk&V TES NVLAP LAB CODE 101768-0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 tiff eurof ins CEI ASBESTOS ANALYTICAL REPORT By: Polarized Light Microscopy Prepared for Weecycle Environmental Consulting, Inc CLIENT PROJECT: W• 39th Ave 10925, 19-16845 LAB CODE: Al 918300 TEST METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020 REPORT DATE: 10/22/19 TOTAL SAMPLES ANALYZED: 13 # SAMPLES >1 % ASBESTOS: 9 % eurofins C PROJECT: W. 39th Ave 10925, 19-16845 Asbestos Report Summary By: POLARIZING LIGHT MICROSCOPY METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020 LAB CODE: Al 918300 ASBESTOS Client ID Layer Lab ID Color Sample Description % DT1-1 Layer 1 A254465 Beige Texture FaIRM. 11111127A --------------------------------------------------------------- Layer 2 A254465 White Drywall None Detected DT1-2 --------------------------------------------------------------- Layer 1 Layer 2 A254466 A254466 Beige White Texture Drywall None Detected DT1-3 --------- Layer 1 ------- Layer 2 A254467 -------- A254467 Beige ---------- White Texture ---------------- Drywall ------------- None Detected JCI -4 A254468 White,Beige Drywall/Joint Compound Chrysotile <1% JC1-5 A254469 White,Beige Drywall/Joint Compound Chrysotile <1% DT2-6 --------------------------------------------------------------- Layer 1 Layer 2 A254470 A254470 Beige White Texture Drywall None Detected DT2-7 --------------------------------------------------------------- Layer 1 Layer 2 A254471 A254471 Beige White Texture Drywall SO= lim None Detected DT2-8 --------------------------------------------------------------- Layer 1 Layer 2 A254472 A254472 Beige White Texture Drywall None Detected JC2-9 A254473 White,Beige Drywall/Joint Compound Chrysotile <1% JC2-10 A254474 White,Beige Drywall/Joint Compound Chrysotile <1% DT3-11 A254475 Beige Texture DT3-12 A254476 Beige Texture DT3-13 A254477 Beige Texture ZMEMEW Page 1 of 1 eurof ins ASBESTOS BULK ANALYSIS By: POLARIZING LIGHT MICROSCOPY Client: Weecycle Environmental Consulting, Inc Lab Code: Al 918300 1208 Commerce Court, 5B Date Received: 10-18-19 Lafayette, CO 80026 Date Analyzed: 10-22-19 Date Reported: 10-22-19 Project: W. 39th Ave 10925, 19-16845 ASBESTOS BULK PLM, EPA 600 METHOD (Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS` Lab ID Description Attributes Fibrous Non -Fibrous DT1-1 Texture Heterogeneous 70% Silicates Layer 1 Beige 22% Calc Carb A254465 Fibrous 5% Paint Bound ------------------------------------------------------------------ Layer 2 Drywall Heterogeneous 10% Cellulose 75% Gypsum None Detected A254465 White 15% Binder Fibrous Bound DT1-2 Texture Heterogeneous 70% Silicates Layer 1 Beige 22% Calc Carb A254466 Fibrous 5% Paint Bound ------- Layer 2 ----------- Drywall ----------- Heterogeneous --- 10% ------------ Cellulose 75% --------- Gypsum ------- - - - - -- None Detected A254466 White 15% Binder Fibrous Bound DT1-3 Texture Heterogeneous 70% Silicates Layer 1 Beige 22% Calc Carb A254467 Fibrous 5% Paint Bound ------------------------------------------------------------------ Layer 2 Drywall Heterogeneous 10% Cellulose 75% Gypsum None Detected A254467 White 15% Binder Fibrous Bound JC1-4 Drywall/Joint Heterogeneous 10% Cellulose 70% Gypsum < 1 % Chrysotile A254468 Compound White,Beige 15% Silicates Fibrous 5% Calc Carb Bound Lab Notes: 3% Chrysotile found in Joint Compound. Sample contains 10% Joint Compound, composite contains 0.3% Chrysotile overall. Page 1 of 4 ��: eurofins ASBESTOS BULK ANALYSIS ti By: POLARIZING LIGHT MICROSCOPY CEI Client: Weecycle Environmental Consulting, Inc Lab Code: Al 918300 1208 Commerce Court, 513 Date Received: 10-18-19 Lafayette, CO 80026 Date Analyzed: 10-22-19 Date Reported: 10-22-19 Project: W. 39th Ave 10925, 19-16845 ASBESTOS BULK PLM. EPA 600 METHOD IClient ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS I Lab ID Description Attributes Fibrous Non -Fibrous JCI -5 Drywall/Joint Heterogeneous 10% Cellulose 70% Gypsum <1 % Chrysotile A254469 Compound White,Beige 15% Silicates Fibrous 5% Calc Carb Bound Lab Notes: 3% Chrysotile found in Joint Compound. Sample contains 10% Joint Compound, composite contains 0.3% Chrysotile overall. DT2-6 Texture Heterogeneous 70% Silicates Layer 1 Beige 22% Calc Carb A254470 Fibrous 5% Paint Bound ------------------------------------------------------------------ Layer 2 Drywall Heterogeneous 10% Cellulose 75% Gypsum None Detected A254470 White 15% Binder Fibrous Bound DT2-7 Texture Heterogeneous 70% Silicates Layer 1 Beige 22% Calc Carb A254471 Fibrous 5% Paint Bound ------------------------------------------------------------------ Layer 2 Drywall Heterogeneous 10% Cellulose 75% Gypsum None Detected A254471 White 15% Binder Fibrous Bound DT2-8 Texture Heterogeneous 70% Silicates Layer 1 Beige 22% Calc Carb A254472 Fibrous 5% Paint Bound ------------------------------------------------------------------ Layer 2 Drywall Heterogeneous 10% Cellulose 75% Gypsum None Detected A254472 White 15% Binder Fibrous Bound Page 2 of 4 ti%."w eurofins C El ASBESTOS BULK ANALYSIS By: POLARIZING LIGHT MICROSCOPY Client: Weecycle Environmental Consulting, Inc Lab Code: Al 918300 1208 Commerce Court, 5B Date Received: 10-18-19 Lafayette, CO 80026 Date Analyzed: 10-22-19 Date Reported: 10-22-19 Project: W. 39th Ave 10925, 19-16845 &RRFSTO.R Rill K PI M FPA r%nn MFT14c)n Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % JC2-9 Drywall/Joint Heterogeneous 10% Cellulose 70% Gypsum <1 % Chrysotile A254473 Compound White,Beige 15% Silicates Fibrous 5% Calc Carb Bound Lab Notes: 3% Chrysotile found in Joint Compound. Sample contains 10% Joint Compound, composite contains 0.3% Chrysotile overall. JC2-10 Drywall/Joint Heterogeneous 10% Cellulose 70% Gypsum <1 % Chrysotile A254474 Compound White,Beige 15% Silicates Fibrous 5% Calc Carb Bound Lab Notes: 3% Chrysotile found in Joint Compound. Sample contains 10% Joint Compound, composite contains 0.3% Chrysotile overall. DT3-11 Texture Heterogeneous 65% Silicates A254475 Beige 22% Calc Carb Fibrous 10% Vermiculite Bound Lab Notes: No drywall present. DT3-12 Texture Heterogeneous 65% Silicates A254476 Beige 22% Calc Carb Fibrous 10% Vermiculite Bound Lab Notes: No drywall present. DT3-13 Texture Heterogeneous 65% Silicates_. A254477 Beige 22% Calc Carb Fibrous 10% Vermiculite Bound Lab Notes: No drywall present. Page 3 of 4 eurofins CEI 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 asbestus 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 and sample description. ANALYST: j APPROVED BY: Michael HexiTianbao Bai, Ph.D., CIH Laboratory Director INVkAo TES NVLAP LAB CODE 101768-0 Page 4 of 4 pay 1 § x C -u 730 SE Maynard Road, Cary, NC 27511 Tel: 866-481-1412; Fax: 919-481-1442 �:1 Ikq i • o LAB USE ONLY: CEI Lab Code: A19 � n o CE1 Lab 12. Range: f - ) COMPANY INFORMATION PROJECT INFORMATION CEI CLIENT #: Job Contact: vL A w i rs KI( Com an : W e G - t/ Email / Tel:3 0 3 ® L-3 If ` 919 9 d Address: 2 t9 v,4 e rye C T Project NameW. 3` . 0% Ave.. 1 oZS' e CO a s )-� [D#: —Project Email:�eaCr'CL�,�4��ecY��e— COQ PO #: 0 `f r-)- Fax: 343— 4 _' 0 7 10 STATE SAMPLES COLLECTED IN: � C) IF TAT IS NOT MARKED STANDARD 3 DAY TAT APPLIES. ASBESTOS METHOD Reli wl ed By: DatefTime TURN AROUND TIME Date/Time 4 HR 8 HR I DAY 2 DAY 3--RDAY 5 DAY PLM BULK EPA 600 ED El [D El LJ 1:1PLM POINT COUNT (400) EPA 600 E] E] 1:1 El F-1 1:1PLM POINT COUNT (1000) EPA 600 El ❑ 11 1:1❑ PLM GRAV w POINT COUNT EPA 600 ? ❑ EJ 1-]0 ❑ PLM BULK CARB 435 ❑ ❑ ❑ ❑ ❑ PCM AIR NIOSH 7400 ❑ ❑ ❑ E]❑ ❑ TEM AIR EPA AHERA ❑ ❑ ❑ 1:1 E]❑ TEM AIR NIOSH 7402 El E] E]❑ El 1:1TEM AIR (PCME) ISO 10312 ❑ E] 11 ❑ C1 I TEM AIR ASTM 6281-15 ❑ ❑ ❑ ❑ ❑ El TEM BULK CHATFIELD ❑ ❑ ❑ E] E]TEM DUST WIPE ASTM D6480-05 (2010) E] ID E] ED ❑ TEM DUST MICROVAC ASTM D5755-09 (2014) El El E:1 F-1❑ ❑ TEM SOIL ASTM D7521-16 r s ❑ ❑ El❑ TEM VERMICULITE CINCINNATI METHOD ❑ ❑ ❑ ❑ TEM OUALITTATIVE IN-HOUSE METHOD ED ❑ ❑ E]OTHER: ❑ ❑ El L]❑ E] REMARKS / SPECIAL INSTRUCTIONS: Accept Samples I i F7 Reject Samples Reli wl ed By: DatefTime Received By: Date/Time 1011-7/q Samples will be disposed of 30 days after analysis Page __�_ of Version: CCOC.01.18.1/2.LD ml) eurofins SAMPLING FORM CEI VA CompanyWee cycic F-,vt/ Job Contact: DAvtd SA&d'(T-On/ Project Name:W. 31rk 1�-(;C- l0q)—s- ,Project ID #: I q — 16 0 L� 5- Tel ct S P �L`E' Vo 'um � A p (,t --r PLM EgD TEM DT'i-X I . PLM El= TEM DT -k-3 CL/ PLM TEM Tc COMPOUAJ6 PLM TEM C t PLM TEM D T-2-6 Lv�PLM 4 TEM Q T I -,r 7 PLM TEM D PLM Q TEM C; PLM TEM 0. PLM Q TEM C)7- 3— H PLM E 7-1 TEM T f— I --A.- PLM E = TEM CJ 7- PLM TEM PLM TEM PLM TEM PLM Q TEM PLM Q TEM PLM Q TEM PLM TEM PLM Q TEM ----- - PLM Q TEM QJ PLM Q TEM I I PLM TEM PLM Q TEM PLM Q TEM PLM TEM PLM 0 TEM PLM TEM Page Z --of Version: CCOC.01.18.2/2.L[) Square footage: 700 **REVISION 12/27/2019: Replacing ductwork and furnace; Added valuation: $5,000.00 *** City of Wheat Ridge FEES IFAV Residential Remodel PERMIT - 201902332 302.28 PERMIT NO: 201902332 ISSUED: 11/20/2019 JOB ADDRESS: 10925 W 39th Ave EXPIRES: 11/19/2020 JOB DESCRIPTION: Residential remodel of kitchen and bathroom. New windows, new electrical (303)523-3512 and plumbing. 170670 MAIN LINE PLUMBING AND SEWER Square footage: 700 **REVISION 12/27/2019: Replacing ductwork and furnace; Added valuation: $5,000.00 *** CONTACTS *** FEES Total Valuation OWNER (720)220-2059 PSOTNY PETE 302.28 Use Tax GC (303)564-1787 PHIL LOVISONE 190251 ADVANCE CONSTRUCTION SUB (303)775-0971 CESAR ARRIOLA 170072 2 BROTHERS ELECTRIC SUB (303)523-3512 PATRICK LEE 170670 MAIN LINE PLUMBING AND SEWER SUB (303)335-6866 RICARDO CORONADO 190037 J & J HEATING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED FEES Total Valuation 0.00 Plan Review Fee 302.28 Use Tax 672.00 Permit Fee 522.55 ** TOTAL ** 1,496.83 *** COMMENTS *** PROJECT VALUATION: 32,000.00 *** 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. Square footage: 700 **REVISION 12/27/2019: Replacing ductwork and furnace; Added valuation: $5,000.00 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 code, popeies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorize to obtazn thw permit and perform the work described and approved in conjunction with this pennrt. I further attest that I am leggally autho zed to include all entities named within this document as parties to the work to be per and that all work to be performed is disclo din #hi/s�Uoe�ument and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date i 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, po plans 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 an manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 51 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 pen -nit for, or an approval of, any violation of any provision of any applicable car any ordinalkV 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 Residential Remodel PERMIT - 201902332 PERMIT NO: 201902332 ISSUED: 11/20/2019 JOB ADDRESS: 10925 W 39th Ave EXPIRES: 11/19/2020 JOB DESCRIPTION: Residential remodel of kitchen and bathroom. New windows, new electrical and plumbing. Square footage: 700 **REVISION 12/27/2019: Replacing ductwork and furnace; Added valuation: $5,000.00 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 code, popeies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorize to obtazn thw permit and perform the work described and approved in conjunction with this pennrt. I further attest that I am leggally autho zed to include all entities named within this document as parties to the work to be per and that all work to be performed is disclo din #hi/s�Uoe�ument and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date i 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, po plans 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 an manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 51 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 pen -nit for, or an approval of, any violation of any provision of any applicable car any ordinalkV 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 ,00"Wheat Idge COMMUNITY DEVELOPMENT Building & Inspection Services 7500 W. 290' Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 FOR OFFICE USE ONLY Date: � I an 1 U' Plan/Permit # J Plan Review Fee: Email: permits(a_ci.wheatridge.co.us � wi 5 2 Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: J b q Z5 L,-)C"(� ( a) � C-�- CT D_t- A clE C Property Owner (please print): G r Phone: q 20 Z7 0 Property Owner Email: Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer E-mail: Phone: Contractor Name: i Ccs C �C� f CZ�•2GC� City of Wheat Ridge License Phone: 3 (gig Contractor E-mail Address: q+CG C-� ri�'-L � C �G �IC�o - coS ,,I For Plan Review Questions & Comments (please print): CONTACT NAME (please print): T (C-O'c �_o Phone: 3U -5 CONTACT EMAIL(p/ease print): I� �- m ik1 Q2� y1Cct� sic ; �� • C Gr'�1 Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. COMMERCIAL ❑ RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. Sq. FULF (V) C) CVo"PiC� (J 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) S 0(] 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. I, the applicant for this building permit application, warrant the truthfulness of the inforniation provided on the application. CIRCLE ONE: (OWNER) (CONTRACTOR) oaIIr (AUTHORZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): (r\ ( /\/ `C�' l _ F°j�)G�� DATE: ( L ^ 2-7 — Iq Printed Name: ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: City of Wheat Ridge Residential Remodel PERMIT - 201902332 PERMIT NO: 201902332 ISSUED: 11/20/2019 JOB ADDRESS: 10925 W 39th Ave EXPIRES: 11/19/2020 JOB DESCRIPTION: Residential remodel of kitchen and bathroom. New windows, new electrical and plumbing. *** 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. Square footage: 700 *** CONTACTS *** OWNER (720)220-2059 PSOTNY PETE GC (303)564-1787 PHIL LOVISONE 190251 ADVANCE CONSTRUCTION SUB (303)775-0971 CESAR ARRIOLA 170072 2 BROTHERS ELECTRIC SUB (303)523-3512 PATRICK LEE 170670 MAIN LINE PLUMBING AND SEWER *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 27,000.00 FEES Total Valuation 0.00 Plan Review Fee 302.28 Use Tax 567.00 Permit Fee 465.05 ** TOTAL ** 1,334.33 *** 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 - 201902332 PERMIT NO: 201902332 ISSUED: 11/20/2019 JOB ADDRESS: 10925 W 39th Ave EXPIRES: 11/19/2020 JOB DESCRIPTION: Residential remodel of kitchen and bathroom. New windows, new electrical and plumbing. Square footage: 700 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 perfo and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and maybe 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 6. The : ance or gran of a permit shall not be construed to be a permit for or an approval of, an violation of any provision of any ap is le ode or 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 Idg COMMUNITY DEVELOI'MENT Building & Inspection Services 7500 W. 29' Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(a)ci.wheatridge.co.us FOR OFFICE USE ONLY Date: i/ PS -1 Plan/Permit # �JO%9t)33�- Plan Review Fee: #Jaq. 2ff Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: /� 4'��7 L✓_ , �j (/o Property Owner (please print): Pe_JC otA/ k/ Phone: '7�)1 22Q ,X 9 Property Owner Email: Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: AN 1. LSE _NLei 41zc City, State, Zip: Architect/Engineer E-mail: Phone: Contractor Name: JM LAAI (C_ %n`�f ✓; U C i � „/ City of Wheat Ridge License #: lqJ�>� Phone: Contractor E-mail Address: yam/ j 1 For Plan Review Questions & Comments (please print): CONTACT NAME (please print): Lhj� Z_Vl< I JV'V/ _ Phone: 30)-- 5(e J7 CONTACT EMAIL(p/ease print): Alli 11i", 5 Olvla �_ G l • � (/"7 LG✓t S •4iI-C Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: %p Plumbing: 10.41)V t_iNf )0jw J 1011/� Mechanical: W.R. City License # � S i R t C W.R. City License # W.R. City License # Other City Licensed Sub: ��,��5�i(Z04{�� Other City Licensed Sub: City License # City License # Complete all ❑COMMERCIAL highlighted field , ' applicable. RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. KylAce k0j "5:41-k 0-F �1- w��� , iZ� �� ►,(fC1AC_C �o1�^�b;nr c ��xtu 2eL--IJQ `W`IA-AOVV) £�cte` g� J� nae S/ f 1)�� .� � ��v�� � \art �\oc� CJ��I r�_"e1Aco_ C4)o5Z5 A 'yV�-(n Sq. FULF 70 C BTUs YO�000 Gallons 30 Amps 0 5 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) $ 1 -�, DOO,C' o 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. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) ( R) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name):: DATE: Printed Name: /1 2l � (�JVlstl�� ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: ulL- Reviewer: 2 PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: '4/10 or_ — Building Division Valuation: Tom►.= — i I IV& 1w. +ae► �' i � t � f I ty of' W he, at i clla'— Ohliki I fKJFTY Df _ i'1 f'DP;AA F _ T SUB -CONTRACTOR AUTHORIZATION FOR,' This form must be signed by each sub -contractor. This f6i iii will isvt ht a rcepted with missing information. SUbconti uciol % Ciin of Wheal ftirige License dumber must be provided in the appli Subcontractor's insuraut a and license ,oust be up, to dat:.• pAor to per it ;3su, oject Address:) Z�hPena;, n. Zi7/9 _3 32 eneral Contractor: COLORAPO' DL DRIVER LICENSE 1 IEEE tate License #• : ' 2 1ATP=O lYW e O"FOURAY," { 4! E 00000" n E. Y.Ow+�wes 4e=w. Mwv_ a � rt/MIIWorat f OO ft n 71" 0W."M NNat•tlwa ZL47M A R riser ,4Mp ignature of Authorized Agent tib $Iwo FE) Mlb oe_.WMLk�oan3i1 a.a stases n _ +_' .., iJ!!LZ'iiL'tDr '�ry I L ',It / /u�+414 Aad tYilrn? fir: c.�03S23 -,55 jG ;srs:f-,a , AraiF_. uu•n QI tate i.i¢Ll:4(=_ OVO J��P ��CL!//% A;J,4•ui KuiKe License Tf: I ! V� irefallfrtti S.rQ�3l "gnature or Awjjorize,? Agln--- anf �.•. w •t.:2T—aaa'i. r nntrtrielot "-.1u:;toss: '+-�esst• firhea. �F.itls"'e ;.it<ense il: iipa*.urc of .k t"-b'jrized Agent 'Pat,. Phone: I.-equiresi Heidi Byte Brandon Fresquez From: Brandon Fresquez Sent: Thursday, November 7, 2019 7:51 AM To: 'phillovisone@gmail.com' Subject: 10925 w 39th ave Good morning. We have noticed you have asbestos inside the property being remodel. We will require a clean air report prior to issuing your permit. You will need to come in and get an asbestos permit from the city. Thank you. Brandon Fresquez, Building Inpector Building Division 7500 W. 29th Avenue Wheat Ridge, Colorado 80033 Office Phone: 303-235-2892 www.ci.wheatrid eg co.us r Whea 1 t Rislage WEECYCLE ENVIRONMENTAL CONSULTING, INC. 1208 Commerce Court, Suite 5B Lafayette, Colorado 80026 (303) 413-0452 Fax(303)413-0710 October 22, 2019 Peter Psotny Metro Brokers 8101 E Belleview Ave Unit F Arvada, CO 80237 280 W Kagy Blvd., Suite D-259 Bozeman, MT 59715 (406)548-5450 RECEIVED NOV 0 5 2019 Per Re: PLM analysis for 10925 W 391h Ave, Wheatridge, CO 80033 (the property) Dear Mr. Ptsony: On October 17, 2019, David Sawitsky #13463, a Building Inspector, certified and accredited by the Colorado Department of Public Health and Environment (CDPHE), collected and submitted for analysis thirteen (13) samples of suspected asbestos -containing material (ACM) from the property. The Asbestos Inspector visually inspected the area to identify all suspected ACM and asbestos containing building materials (ACBM). All building materials were touched to determine friability. The results of this Asbestos Containing Building Materials Survey determined that Asbestos Containing Building Materials are present in the area tested. The following building materials were determined to have asbestos levels that exceed regulatory limits. The Homogenous Areas with corresponding Analytical Results are located on Table 2. Table 1: SUMMARY OF ASBESTOS CONTAINING BUILDING MATERIALS HOMOGENEOUS AREA DESCRIPTION OF MATERIAL TOTAL SQUARE FOOTAGE Kitchen and NW Bedroom walls Drywall Texture 450 & ceilings N E Bedroom, S Bedroom walls, Drywall Texture 600 Bathroom walls & ceilings NE Bedroom, S Bedroom, Hallway, and Living room Drywall Texture 750 ceilings ANALYTICAL PROCEDURES The bulk samples collected of suspect asbestos containing materials were delivered to CEI Labs, a National Voluntary Laboratory Accreditation Program (NVLAP) asbestos laboratory, located in Cary, North Carolina for analysis. All bulk samples are archived for six months unless otherwise stipulated by the client. According to the laboratory, the bulk samples were analyzed in accordance with EPA Method 600/R-93/116. Small portions of the sample were placed in Series: E High Dispersion Refractive Index Liquid on a microscope slide. The prepared samples were observed at 100X (power) Metro Brokers 10925 W 391h Ave, Wheatridge, CO 80033 — Asbestos Report under polarized light using a McCrone Dispersion Staining Objective. The characteristics of the fibers were compared to the known properties of asbestos fibers for dispersion, color, polarity, extinction and general morphology. Sample content (percentage) was made by visual estimates comparing of asbestos fibers to total sample material. If the laboratory detects asbestos in a sample of a particular homogeneous material, the remaining samples in that batch are not analyzed, and are assumed to contain asbestos. Samples returning Trace Asbestos (TR) results were resubmitted for Point Count analysis. Samples with Point Count results of less than one percent (1 %) are not considered to be ACM. All thirteen (13) samples obtained from the Property were analyzed. RECOMMENDATIONS AND SUMMARY The materials listed, in Table 1, are regulated asbestos containing building materials. Prior to demolition or renovation activities these building materials must be removed by a licensed asbestos abatement contractor accredited under Section 206 (b) of the AH ERA act and by the Colorado Department of Public Health and Environment Regulation No. 8. It is the responsibility of the owner to meet the requirements as stated in Federal Regulations 40 C.F. R. 763.84 and Colorado Regulation No. 8. Suspect materials are sometimes located behind walls and above ceilings and were considered inaccessible during the onsite survey. Therefore, all materials that contain asbestos may not have been observed or sampled. If additional suspect asbestos containing materials are identified during periods of disturbances, all activities must stop until these materials are sampled. Work shall not resume until the results are reported and removed by a licensed asbestos abatement contractor. Weecycle has assigned Job #19-16845 and CEI Labs Report #A1918300 to this study. Weecycle Environmental Consulting, Inc. appreciates the opportunity to assist you with your asbestos sampling needs. If you have questions regarding this report, please contact Lauren York at (303) 413-0452. This is not a complete AH ERA Asbestos Survey for renovation or demolition. The laboratory report is enclosed. Submitted By: Lauren York State of Colorado Asbestos Inspector #3748 Metro Brokers 10925 W 39th Ave, Wheatridge, CO 80033 — Asbestos Report ;a�Loa (� N Cl) O o Cr LL Co o I.- C0 Lo o U 0) t 7 U @ a) � — d r C Q y > O> T T T co m rn U YO M . MU MU chU @ - N CS g a) d � fl. C E y C F: CO O 3 aJ — a) i c0 = i O cn 0) C C co LU 3000 ==� p°:--zo3Cn30�vc0i� 02 o� 3 owl o�Nz o o U *. owZ oZ E 0 o E o 0 0 0 v 0 c c c O� 0 0 0�-0 0 J a� W (v mLLm�sm o (D -0 o a)� N a) 0 mm 0 U+3: �Wmc�DmWWm Z Y Y Z Y m z w m w z z w p �NM�tf��01�00�� p c- N ' y 0 C)d HI-E-0� Hf -F C14 C14 C14NN 1 I-hF- ) m O M t0 N w` .a E 0 Z U-) LO LO � Z L 20 _ p LL A (Q L •� pOH ap+ G? p V cn Cn U) •L c co cn CR G 025 oa cn N c cn3•� O Z cdc0 �3 c0 o33 c6 U o=E c mE 0E 0E0 Q cv t1 N o0 co N 00 00 ( c " 00 y O L C c-0 _ m - C -0 ++ — m- C LS .- J *= w 0 Ym C.) LU a) MZ Zmm C) W 0> ZmJ C d Ocp C _0 O _0 E •` co c co c p — O p ca — a) G >, X c E 3ca X� E 3 X au p 0 (v 0 Lam' O O a o 0 M 0 C: O m C: E a, T N O H 0) m cn f- O Z5 vi ai 0 O O C Q N 1 (� N Cl) O Co o U c U 0) t 7 U @ a) � L 3 T Q O > O> Q a) co m rn U YO M . m C LO @ - N CS g a) �o tiff eurofins October 22, 2019 Weecycle Environmental Consulting, Inc 1208 Commerce Court, 5B Lafayette, CO 80026 CLIENT PROJECT: W. 39th Ave 10925, 19-16845 CEI LAB CODE: Al 918300 Dear Customer: Enclosed are asbestos analysis results for PLM Bulk samples received at our laboratory on October 18, 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 HVkAo TES NVLAP LAB CODE 101768-0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 ,Q-eurofins ASBESTOS ANALYTICAL REPORT By: Polarized Light Microscopy Prepared for Weecycle Environmental Consulting, Inc CLIENT PROJECT: W. 39th Ave 10925, 19-16845 LAB CODE: Al 918300 TEST METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020 REPORT DATE: 10/22/19 TOTAL SAMPLES ANALYZED: 13 # SAMPLES >1% ASBESTOS: 9 eurofins PROJECT: W. 39th Ave 10925,19-16845 Asbestos Report Summary By: POLARIZING LIGHT MICROSCOPY METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020 LAB CODE: Al 918300 ASBESTOS Client ID Layer Lab ID Color Sample Description % DT1-1 Layer 1 A254465 Beige Texture --------------------------------------------------------------- Layer 2 A254465 White Drywall None Detected DT1-2 Layer 1 A254466 Beige Texture White,Beige --------------------------------------------------------------- Layer 2 A254466 White Drywall None Detected DT1-3 Layer 1 A254467 Beige Texture Layer 2 --------------------------------------------------------------- Layer 2 A254467 White Drywall None Detected JC1-4 A254474 A254468 White,Beige Drywall/Joint Compound Chrysotile <1% JCI -5 Texture A254469 White,Beige Drywall/Joint Compound Chrysotile <1% DT2-6 Layer 1 A254470 Beige Texture --------------------------------------------------------------- Layer 2 A254470 White Drywall None Detected DT2-7 Layer 1 A254471 Beige Texture --------------------------------------------------------------- Layer 2 A254471 White Drywall None Detected DT2-8 Layer 1 A254472 Beige Texture --------------------------------------------------------------- Layer 2 A254472 White Drywall None Detected JC2-9 A254473 White,Beige Drywall/Joint Compound Chrysotile <1% JC2-10 A254474 White,Beige Drywall/Joint Compound Chrysotile <1% DT3-11 A254475 Beige Texture DT3-12 A254476 Beige Texture DT3-13 A254477 Beige Texture OEM MEMF— Page 1 of 1 tiff eurofins ma Client: Weecycle Environmental Consulting, Inc 1208 Commerce Court, 56 Lafayette, CO 80026 Project: W. 39th Ave 10925, 19-16845 &-QRFCTr1C Ri ii K PI M FPA RM MFT41rN'1 ASBESTOS BULK ANALYSIS By: POLARIZING LIGHT MICROSCOPY Lab Code: Al 918300 Date Received: 10-18-19 Date Analyzed: 10-22-19 Date Reported: 10-22-19 Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % DT1-1 Texture Heterogeneous 70% Silicates Layer 1 Beige 22% Calc Carb A254465 Fibrous 5% Paint Bound ------------------------------------------------------------------ Layer 2 Drywall Heterogeneous 10% Cellulose 75% Gypsum None Detected A254465 White 15% Binder Fibrous Bound DT1-2 Texture Heterogeneous 70% Silicates Layer 1 Beige 22% Calc Carb A254466 Fibrous 5% Paint Bound ------------------------------------------------------------------ Layer 2 Drywall Heterogeneous 10% Cellulose 75% Gypsum None Detected A254466 White 15% Binder Fibrous Bound DTI -3 Texture Heterogeneous 70% Silicates Layer 1 Beige 22% Calc Carb A254467 Fibrous 5% Paint Bound ------------------------------------------------------------------ Layer 2 Drywall Heterogeneous 10% Cellulose 75% Gypsum None Detected A254467 White 15% Binder Fibrous Bound JC1-4 Drywall/Joint Heterogeneous 10% Cellulose 70% Gypsum <1 % Chrysotile A254468 Compound White,Beige 15% Silicates Fibrous 5% Calc Carb Bound Lab Notes: 3% Chrysotile found in Joint Compound. Sample contains 10% Joint Compound, composite contains 0.3% Chrysotile overall. Page 1 of 4 e u rof i n s ASBESTOS BULK ANALYSIS ti By: POLARIZING LIGHT MICROSCOPY Client: Weecycle Environmental Consulting, Inc Lab Code: Al 918300 1208 Commerce Court, 5B Date Received: 10-18-19 Lafayette, CO 80026 Date Analyzed: 10-22-19 Date Reported: 10-22-19 Project: W. 39th Ave 10925, 19-16845 ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % JCI -5 Drywall/Joint Heterogeneous 10% Cellulose 70% Gypsum <1%Chrysotile A254469 Compound White,Beige 15% Silicates Fibrous 5% Calc Carb Bound Lab Notes: 3% Chrysotile found in Joint Compound. Sample contains 10% Joint Compound, composite contains 0.3% Chrysotile overall. DT2-6 Texture Heterogeneous 70% Silicates Layer 1 Beige 22% Calc Carb A254470 Fibrous 5% Paint Bound ------------------------------------------------------------------ Layer 2 Drywall Heterogeneous 10% Cellulose 75% Gypsum None Detected A254470 White 15% Binder Fibrous Bound DT2-7 Texture Heterogeneous 70% Silicates Layer 1 Beige 22% Calc Carb A254471 Fibrous 5% Paint Bound ------------------------------------------------------------------ Layer 2 Drywall Heterogeneous 10% Cellulose 75% Gypsum None Detected A254471 White 15% Binder Fibrous Bound DT2-8 Texture Heterogeneous 70% Silicates Layer 1 Beige 22% Calc Carb A254472 Fibrous 5% Paint Bound ------------------------------------------------------------------ Layer 2 Drywall Heterogeneous 10% Cellulose 75% Gypsum None Detected A254472 White 15% Binder Fibrous Bound Page 2 of 4 ASBESTOS BULK ANALYSIS til e u rof i n s By: POLARIZING LIGHT MICROSCOPY Client: Weecycle Environmental Consulting, Inc Lab Code: Al 918300 1208 Commerce Court, 513 Date Received: 10-18-19 Lafayette, CO 80026 Date Analyzed: 10-22-19 Date Reported: 10-22-19 Project: W. 39th Ave 10925, 19-16845 ACRFST(1S Rill K DI M FPA ann MFTI-Inn Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % JC2-9 Drywall/Joint Heterogeneous 10% Cellulose 70% Gypsum <1 % Chrysotile A254473 Compound White,Beige 15% Silicates Fibrous 5% Calc Carb Bound Lab Notes: 3% Chrysotile found in Joint Compound. Sample contains 10% Joint Compound, composite contains 0.3% Chrysotile overall. JC210 Drywall/Joint Heterogeneous 10% Cellulose 70% Gypsum <1%Chrysotile A254474 Compound White,Beige 15% Silicates Fibrous 5% Calc Carb Bound Lab Notes: 3% Chrysotile found in Joint Compound. Sample contains 10% Joint Compound, composite contains 0.3% Chrysotile overall. DT3-11 Texture Heterogeneous 65% Silicates A254475 Beige 22% Calc Carb Fibrous 10% Vermiculite Bound Lab Notes: No drywall present. DT3-12 Texture Heterogeneous 65% Silicates A254476 Beige 22% Calc Carb Fibrous 10% Vermiculite Bound Lab Notes: No drywall present. DT3-13 Texture Heterogeneous 65% Silicates A254477 Beige 22% Calc Carb Fibrous 10% Vermiculite Bound Lab Notes: No drywall present. Page 3 of 4 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 and sample description. ANALYST: APPROVED BY: Michael (:xi Tianbao Bai, Ph.D., CIH Laboratory Director NVkAo TES NVLAP LAB CODE 101768-0 Page 4 of 4 eur®fins 730 SE Maynard Road, Cary, NC 27511 Tel: 866-481-1412; Fax: 919-481-1442 CHAIN OF CUSTODY LAB USE ONLY. a CEI Lab Code: CEI Lab I.D. Ra COMPANY INFORMATION PROJECT INFORMATION CEI CLIENT #: Job Contact: b V L S A w i AS k f Compan :we G Email / Tel:30 3 " I¢3 Lf 8 S 9 d Address: l 10 S C p mm a k -c e C 7- Project Name. 31-rk R u e- l Z i` A, th YetL.rCO00 )-6 Pro'ectlD#: Email:U/eaCrr-L,r—@ Iveecyc-lr— . COW PO#: Tela- D3 If i3 , 0 `f r-)- Fax: 301— 4 ( *` Ci ? 1 D STATE SAMPLES COLLECTED IN: IF TAT IS NOT MARKED STANDARD 3 DAY TAT APPLIES. ASBESTOS METHOD 4 HR 8 HR TURN AROUND TIME 1 DAY 2 DAY Y 5 DAY PLM BULK EPA 600 ❑ ❑ ❑ ❑ ,3-D{ t�!J ❑ PLM POINT COUNT (400) EPA 600 ❑ ❑ ❑ ❑ ❑ ❑ PLM POINT COUNT (1000) EPA 600 ❑ ❑ ❑ ❑ ❑ ❑ PLM GRAV w POINT COUNT EPA 600 ❑ ❑ ❑ ❑ ❑ PLM BULK CARB 435°``% ❑ ❑ ❑ ❑ ❑ PCM AIR NIOSH 7400 ❑ ❑ ❑ ❑ ❑ ❑ TEM AIR EPAAHERA © ❑ ❑ ❑ ❑ ❑ 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 TEM VERMICULITE ASTM D7521-16 CINCINNATI METHOD.., �' `ZN r��- {'����°"£� ❑ ❑ ❑ EJ ❑ ❑ ❑ ❑ TEM QUALITTATIVE IN-HOUSE METHOD ❑ ❑ ❑ ❑ ❑ OTHER: ❑ ❑ ❑ ❑ ❑ ❑ REMARKS / SPECIAL INSTRUCTIONS: ❑ Accept Samples Reject Samples Reli 4ished By: DatelTime Received By: Date/Time Samples will be disposed of 30 days after analysis Page I of D— Version: CCOC.01.18.1/2.LD SAMPLING FORM � `�, -,Q COMPANY, /ONT Com an : Vel ee C iC (G F iv v Job Contact: D A V� SA {il t Ts Project Name:w. 39TH► AUC, 10 q Z PLM TEM Q Project ID #: I Cf " ( 68 1� S Tel: QJ - td2 a q $`l l SAMP_.LElD# fir,,. � a ,st"' �,.__ `s s F �+Al ! s ,� . s �»� �,E DESCF2IPTION,/LOCQTIONms ,r� TESTx,x.. QT PLM TEM Q Dl- ►-)L- PLM TEM Q PLM TEM Q !- J o i Co Wt p� PLM TEM Q C t PLM Q TEM Q D T-2-6 L„,, { f- k v�- PLM Q TEM Q D T Z*r % PLM En TEM Q D 1 2.- PLM TEM Q CoAll,ov PLM QQ TEM Q C Z^ 1 PLM TEM Q l 3--tI Qry W)-'-,cu-T v2 PLM TEM Q lx- PLM TEM Q D 7- 13 PLM TEM Q PLM TEM Q PLM TEM QQ PLM Q TEM Q PLM Q TEM Q PLM Q TEM Q PLM Q TEM Q PLM Q] TEM U PLM Q TEM Q PLM Q TEM Q PLM Q TEM Q PLM Q TEM Q] PLM Q] TEM Q PLM Q TEM Q PLM Q TEM [^� PLM Q TEM Q Page )—of 2 - Version: CCOC.01.18.212.LD ��E�VED : i t Nov 1 5 2019 V V bi=''ori= must be signed by each sub -contractor. • £- ._. ;la . pted �Oth" T :,s_: g 1-fo a ui3 '0 ;U ox;a3 s. �� sicir;r-� z...i:a 3'':ii3i;:a. Subc-Ontrac or's t" f -f VVheat Ridge Lir;r_—a*c aa.-Inber must be provided in the applicable space. S;:Fs_ontractores insitranct n- ii_e se. �3 'a- ? y ybU date. P;s;G= AEG a - ssH f�a�an-a "s . Project Address: 1 Vq Z,51,,1 ,3 c/IA Cts_ Permit -: 201923 32 General Contractor. j 3J iLL484.'ytki r-.��:.:-�-�i<ii <Y._t3vfa .ltiEt�va�ty ii'err,:: �a -.:. �; '�• State License #: Master #: Signature of Authorised Agent �a-,z U--- i - 4g or 9t�e;zs l'e'as t.Es yea. se^ Date Z-ii;3.i.afa �" z' -;F, (,l 1l q`s/N•"rOrr� CkACY,.f rii,[ii't Stake Ueensiv V4riEa ;:f iiiil},' License- 1 ! a / V 4 required €iel� s Signature ____ 0ho.ized Ageni eta�y � j /L/_ z61e� i ;vvttf.'-st:.'.Ssd:zy't i:.atInMe fT. r z=z3a3a=' i� •ur o :^ r,.i nEj y�rt 3cysant r��tn Jai l� ON ago � O N J � V U N � C � o 4 cl � o o -0 U 3ci --- QII/ E G � J F -P I ► 1 t � QII/ E G � J F -P I ► I �bro �y G � \ U O O N N COD 0 3 -a ami CU 'sem %) 71 uj r - — L a r4 CL . Fzc5t- cn 75 ctt 1 U � C4 "It ` 4 4 f .: r 9Whj&atPsjdg�°Y 1 37(ii9 COMIMUNiTYDEVELOPMENT er SUB -CONTRACTOR AUTHORIZATION FORM This form must be signed by each sub -contractor. This form will not be accepted with missing information. Subcontractor's City 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: Permit #: General Contractor: PJw1,4 Electrical Sub -Contractor 2 ?� „ r` �if ' Phone #: -PA ; Company Name: `� •�'� State License #•:- "° Master #• g� Wheat Ri a Licens (required field) �lJ� (\,A A4 Y 14� ljll2l1Q Signature of Authorized Agent Date Plumbing Sub -Contractor Company Name: State License #: Wheat Ridge License #: Signature of Authorized Agent Mechanical Contractor Company Name: Wheat Ridge License #: Signature of Authorized Agent Phone #: Master #: _(required field) Date Phone: (required field) Date City of h6 �dg rnDEVELOPMENTPrrCcintrtPa2,,-,,.� Building & inspection .Services Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Plan Revrevr Office: 383-235-2855 * 'ax:: 3013-237-8929 Inspection Line: 303-234-5933 Building Permit Application Please mplete all highlighted areas on both sues of this form Intomplate,applications may not to processed. Property Address- Far apse nor (pies e ,cri t . t Phone: zere-z_f-11 S4? Property ner Email.* Mailing Address: (if different than property address Address. Cii , ete%"�i Arc h tectlEnglrrs r - l Phone Contractors City License #: leo z 2.2 ContractorE-mail Address: ' Sub Contractors: Electrical: Plumbing- Mechanical: W.k City License # W,k City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License Complete aU information on BOTH sides of this farm i+unt of materials to be Si, etc.} .. � . Sq. FULF Btu's Gallons Amps Square r ~ FoRm (K) aia oz nsa pUBLIC~SERVICECQNp_ OF COLORADO `67393 II AOOPE55 . . ~ ~ Oil' N OP COU~NaTY FLOOR 7 I~PT NO. . p EflNA~.AEIPFINTI rl'- ~I . ~ OWNER ~ ~ " TENANT~ AGENT ~ . SPECI Y . . . OTHER ~ ' . . . , HAZARD ~ - - E PUT BACK IN ~ GON01210N TO BE CORRECTEO AS SHUWN BELUW CAEATES AN IMMEOIATE HAZARO: TNIS EQUIPMENT MUST NOT B NTIL REPPIRS ANO A THOROUGH INSPECTION HAVE BEEN MAOE BY A QUALIFIEO CONTRACTOR. CONTACT YUUfl LOCpI r E SEHVIC U rBUILOING OEPARTMENT.FOR COOE ANO PEAMITREQUIflEMENTS PRIOA TO PERFOFMMGREPAIR.WORK. - i ~ NAME ANDTYPE OF APPLIAyyGE~'~/~,. . . ' . r.~ 9E flEC D O^ TO i COND .Ch~f v/o ' O ~ 1r! V- ~ ~ . . M . V Q ~ . ~ . ++fr`:.5./ W ~ ( . 7`••~,ti~ . FOR FURTHER INFORMATION, PHONE: T ' • J . OATE TFGGEO BY . TIME . S i •:--+-+-+.'`.k ) . , . . ;k . / "i J . PAf~T SIGNATUflE TIME ATE ~ NSTOMEP/G CN ( ! flELAT10N5H(P bF OCCUPHNi TO NSTOMEP . . COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number : 17292 BUILDING INSPECTION LINE -(303-234-5933) Date : 6/28/2004 CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80033 - (303-235-2855) Property Owner. Property Address Contractor License No. JAMES PAYNE 10925 W 39TH AVE 18061 Phone : 403-5904 Company: Wilson Brothers, Inc. Phone : 294 9535 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Construction Value : $1,700.00 I hereby certiy that the setback distances proposed by this permit application are accurate, and Permit Fee : $78.19 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 Plan Review Fee : $0.00 made are accurate; that I have read nd agree to abide by all conditions printed on this appliration, and that I assume full r s nsibi' o com liance with the Wheat Ridge Building USe TeX : $20.40 Code (U.B.C.) and all other applic bl at for worl nder thisrmit. (OWNER)(CONTRACTOR) SIG ED ' eg~ATE~~rG?'~ Total: $98.59 Use : Description : TEAR OFF EXISTING ROOFING, INSTALL NEW 15# FELT AND 11 2/3 SQ 3-TAB SHINGLES BUILDING DEPARTMENT USE ONLY Approval : Zoning : u"ng Commen~s~ Approval : SIC : Sq. Ft. : Approval : Occupancy : Walls : Roof : Stories : Residential Units : Electrical License No : Plumbing License No : Mechanical License No : Company: Company: Company: Expiration Date : Expiration Date : Expiration Date : Approval : Approval : Approval : (1) This pertnitwas issued in accordance with the provisions set forth in yopur application and is subjed to the laws of the St2teof Colorado and to the Zoning RegulaUons and Building Code of Wheat Ridge, Colo2do or any other applirable ordinances of ihe City. (2) This pertnit shall expire if (A) the work authorized is not commenced within sixry (80) days from issue date or (8) Fhe building aufhorized is suspentled or abandoned for a period of 120 days. (3) If ihis permit expires, a new permit may be acquired for a fee of one-half the amount normally required, provided no changes have been or will be made in the original plans and specifcations and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspension or abandonmentezceeds one (1) year, full fees shall be paid for a new permit. . (4) No work of any manner shall be done ihat will change the natural Flow of water causing a drainage problem. ; (5) Contractor shall notifyihe Buildinglnspector Iwenty-four (24) hours in advance for all inspections and shall receive wntten approval on inspection card before proceediing with successive phases of the job. (6) The issuance of a permit or ihe approval of drewings and specifcations 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 regulatiort . . ChieYBuil ' g Ins Please sign Terms and Conditions on reverse side of page. cf w~EST COMMUNITY DEVELOPMENT DEPARTMENT Building Pemvt NUmber: ~ BUILDING INSPECTION LINE - 303-234-5933 Date: CITY OF WHEAT RIDGE V m 7500 WEST 29TA AVENUE VVHEAT RIDGE, CO 80215 - (303-235-2855 ~`~C OR P0~ 4 I33"~~L3 ~Cp+~ yyi`lgTIi~/~ ~X Yy Property Owner I~~ j t~ S`i o' ~ ~ PropertyAddress:+(fj2 5 , Q-V-Q-- Phone:4403-s9d I Contractor License No.: (bp(pj t Company: Phone: ON\'SER/CONTRAC70R SICNATURE OF UNDERSTANDI.A G AND AGREEMEN7 I hercby cenify that the setback dismnces proposed by this permit application are acwrate, and do not violate applicabte ordinances, ruies or regulations of the Cily of Wheat Ridge or covenants, easemenU or restrictions of record; that all meuurements showm, and allegations made are accurate; that 1 have read and agree to abide by all conditions pnnled on ihis application and ihat 1 assume ful] responsibiliry for compliance Hith the Wheat Ridge DuilPing Code (U.B.C) and all oth^ applicable t Ridge Ordinanc~s, for work under this ermn. ConstructionValue:$ jrf~8~ ~ Permit Fee:$ Plan Review Fee:$ Use Tax:$ Tot3l:$ ~ 4 DESCRIPTION: ~ fp Afi6 3-7k°b "oL~J C . u BUILDI\G DEPARTMENT USE ONLY SIQ Sq.Ft.: ZONING COMMENTS: Approval: Zoning: BUILDING COMMENTS: Approval: PUBLIC WORNS COMMENTS: Approval: Occupancy: Walls: Roof: Stories: Residential Uniu: Electrical License No: Plumbing License No: Mechanical License No: Company: Company: Company: Expiration Date: Expiration Date: Expiration Date: Approval: Approval: Approval: (I) This permit wu issued in accordance with the pmv+sions W fonh io wur application and is subj<ct in the laus of the Sum ofColorzdo and to the Zoning RegulauonsandBuildingCodeso(UTwtRidge,ColoredooranyotherapplicableordinaneesoftheCiry. - This yermil shali exyirt if(A) the work authonzed is noi comm<nced within sixry (60) days from iuuc dam or (6) tlm building amhorized is snspendcd or abandoned for a yeriod of 120 days. - (3) If lhis permit <nyira, a ne. permit may be acquieed for a ttt of one-half the amaunt normally reqoired, pmvided no changes have bcen or wiii be made in the orignai Dlans and spaificaoons aod my saryeasion or abandonmrnt hu not uceeded on< (I) ytar. ]f changes have been or if suspensian or abandomment ezcads one (1) year. fuil far shall be paid for a new pertnil (7) No work of any mnnner sha0 be done tLat w~ll <hang< the nawrzl flow af water causing a dninage pro6km. - (5) ContracWr shn11 norify the BuiWing lrttpator twenry-fow (24) hours in advann for il1 inspecuons and sfiail rec<ir< wrinrn approval on inspecdon card before procxding widi sunessive phues of the job. (6) The issuance of a pemnit mth< appraval of drawings and specifiodons shill not be construed to be a permit for, nor an apyroval af, any v9olation of the provdsions of the bwWing codes or any othtt ordinunc<, lau•, rule or regulaoon. Chief Building Inspector COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number : 16871 BUILDING INSPECTION LINE -(303-234-5933) Date : 3/31/2004 CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80033 - (303-235-2855) Property Owner: BASICS ETC. Property Address : 13201 W 43RD DR Phone : 807-0189 Contractor License No. : 19988 Company : M D Building Corp. Phone : 761-2422 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 wvenants, 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 (U.B.C.) and all other applicable Wheat Ridge ordinances, for work under this permit. (OW NER)(CONTR4CTOR) SIGNED DATE Description : OFFICE / WAREHOUSE Construction Value : $700,000.00 Permit Fee : $5,439.95 Plan Review Fee : $3,535.97 Use Tax : $8,400.00 Total: $17,375.92 Use: BUILDING DEPARTMENT USE ONLY SIC : Sq. Ft. : Approval : TRC Zoning : pID B il Ning~Corrime ts~ Approval : MS Pub ie~Works}CO enfs':'a Approval : DFB Occupancy: Walls OK. NEED TO INCLUDE HANDICAP ACCES AISLES - 1- 8' WIDE VAN ACCESSIBLE & 1- 5' WIDE. WALL LIGHTS MAY NOT EXCEED 12' FROM GRADE 3/15/04 3122104. SEE ATTACHED COMMENTS Roof : Stories : Residential Units : Electrical License No : Zpgpg Company : Denver Electrical Contractors INC. Expiration Date : 2/28/2005 Approval: oklks Plumbing License No :19557 Company :Security Plumbing & Heating Expiration Date : 6/7/2005 Approval : OK/KS Mechanical License No : 17977 Company : K C A Companies Inc. Expiration Date : 3/31/2005 Approval : OKIKS (1) This permit was issued in accordance vrith the provisions set forth in yopur application and is subject to the laws of the Slate of Colorado and to the Zoning Regulations and Building Code of Wheat Ridge, Colorado or any other applicable ordinances of the City. (2) This permit shall expire if (A) the work authorized is not commenced within sixty (60) days from issue date or (B) the building authorized is suspended or abandoned for a period of 720 days (3) If this pertnit expires, anew permit may be acquired for a fee of one-half the amount nortnally required, pmvided no changes have been orwill6e made in the original plans and specifications and any suspension or abandonment has not ezceeded one (1) year. If changes are made or if suspension orabandonment exceeds one (1) year, full fees shall be paid for a new permit. (4) No work of any manner shall be done that will change the natural flow of water causing a dreinage problem. (5) Contrddor shall notify the Building Inspectorhventy-four (24) hours in advance for all inspections and shall receive written approval on inspection card before proceediing with successive phases of the job. (6) The issuance of a pertnit or the approval of drawings and specifications shall not be consirued to be a pertnit for, nor an approval of, any violation of the provisions of ihe building codes or anyother ordinance, law, rule or regulation. Chief Building Inspector Please sign Terms and Conditions on reverse side of page. Certificate of Completion AND/OR Compliance CITY OF WJIEAT RIDGE 7500 W. 29TH AVEN[JE WHEAT RIDGE, COLOR.ADO 80215 THIS CERTIFICATE VERIFIES THAT THE PROPERTY DESCRIBED BELOW, DOES COMPLY WITH THE WHEAT RIDGE BUILDING CODE, ZONING AND OTHER RELATED LAND USE AND DEVELOPMENT LAW S OF THE CITY OF WHEAT RIDGE FOR THE FOLLOWING PURPOSE. PERMIT # 11040 Garage conversion to living area OWNER: Christopher & Judy Bouck ADDRESS: 10925 W. 39'Place PROPERTY ADDRESS: 10925 W. 39`t' Pl., Wheat Ridge, CO 80033 DATE 2/6/02 CHIEF BUIi,DING OFFICII ZONING ADMINiSTRATOR DEPARTMENT OF PLANNING AND DEVELOPMENT BUILDING INSPECTION LINE - 303-234-5933 CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 - (303-235-2855) Building Permit Number : 11205 Date : 9120/2000 Property Owner : Property Address : 10925 W. 39TH PL Phone : Contractor License No. : 20793 Company : A-Phase Electric Phone : 287-8497 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certiy 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 1 have read and agree to abide by all conditions printed on this application, and that I assume full responsibility for compliance with the Wheat Ridge Building Code (U.B.C.) and all other applicable WFjqat Rijge ordinances, for work under this permit. (OWNER)(CONTRACTOR) SIGN DATE 7'211-ac Description : INSTALL 200 AMP SERVICE FOR ADDITION Construction Value : $500.00 Permit Fee : $23.50 Plan Review Fee : $0.00 Use Tax : $7.50 Total: $31.00 Use: Electrical License No : Company : Expiration Date : Approval: Plumbing License No : Company : Expiration Date : Approval : Mechanical License No : Company : Expiration Date : Approval: (1) This permitwas issued in accordance with the provisions set forth in yopur application and is subJ'ect to the laws of the State of Coloredo and to the Zoning Regulations antl euilding Code of Wheat Ridge, Colorado or any other applicable ortlinances of the City. (2) This permit shall expire if (A) ihe work authorized is not commenced within sixty (60) days from issue date or (B) Ue building au[horized is suspended or abandoned for a period of 120 days. (3) If this permit expires, a new permit may be acquired for a fee of one-half ihe amount normally required, provided no chanqes have been or will be made in the original plans antl specifcations and any suspension or abandonment has not exceetled one (1) year. If changes are made or if suspension or abandonment euceeds one (1) year, full fees shall be paitl for a new pertnit (4) No work of any manner shall be done that will change the natural flow of water causing a drainage problem. (5) Contractor shall no6ry the Builtling Inspeclortwenty-four (24) hours in advance for all inspeclions antl shall receive written approval on inspection card before proceediing with successive phases of the 1~ob. (6) The issua of a permit r the approval of drawin9s antl specifications shall not be construed to be a permit for, nor an approval of, any violation of the provisions . of the b' m co~s~p~y other ortlinance, law, rule or regulation. DEFARTMENT OF PLANNING AND DEVELOPMENT BUILDING INSPECTION LINE - 303-234-5933 • CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 - (303-235-2855) PropertyOwner: C N/{ 1"5 Property Address : F C25 Building Permit Number Date : J30li G~C /.4ce- / Phone: Contractor License No. Company : ✓4 Phone : jp 3 '2~~•-~~~ OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Construction Vaiue I hereby certify that the setback distances proposed by this permit applieation are acwrate, antl do not violate applicable ordinances, rules or regulations of the City of Whea[ Ridge or covenants, easements or restrictions of record; that all measurements shown, and allegations matle are accurate; that 1 have read and agree to abide by all conditians printed on this appliwtion, and that I assume full responsibdity for eompliance with the Wheat Ridge Building Code (U.B.C.) and ail other applicable Whea~Ridge ordinances, forwork under this pertnit. (OWNER)(CONTRACTOR) Permit Fee : Use Tax : Total : Use: Description S"hv4-( r aoo , ,4~y) I BUILDING DEPARTMENT USE ONLY Zo~in_g e-"C'ommen~ Approval: Zaning : Buifdmg=-'`Commen Approval: Publ c~ or - :r e^.s., Approval: Occupancy : Walls SIC : Sq. Ft. : Roof : Stories : Residential Units : Electrical License No : Company: Expiration Date : Approval: Plumbing License No : Company: Expiration Date : Approval: Mechanical License No : Company : Expiration Date : Approval: (1) This permit was issue0 in accor0ance wiN the provisions set forth in yopur applicalion anE is SuDject to the laws of the State of ColoraEO antl to the Zoning RegWations antl Builtling CoEe of VJheat RiEge, Coloratlo or any oNer applirable oMinanres of the Ciry. (2) This pertnit shall expire if (A) the work auNanxed is nat commenceE wiNin sixty (60) tlays From issue tlate or (B) the buil0ing authonze0 is suspentleC ot ahanCOnetl for a penoC of 120 days. (3) 1t Nis pertnit expires, a new pertnit may be acquired tor a fee ot one-half the amount nartnally repuiretl, proviEeE no changes have Deen or will be ma0e in Ne onginal plans antl specifica6ans and any sus0ension or abantlonment has not ezceeEeC one (1) yeac If changes are matle or i( suspension or ahan0onment excee05 one (1) year, full fees shall be paiE tor a new pertnR. No work of any manner shall he tlone tthat will change the naNrzl fiow of wa[er causing a tlrainage pmOlem. - (5) ConVac[ot shall nofiy the Building' Inspector iwentyfour (24) hours in atlvance for all inspections antl shall receive written approval on inspection [artl before Pracaednn9 wiN successive phases of Ne 1~ob. (6) The issuance of a permit or the approval of tl2wings antl specifiptlons shall not he consWeE to be a Oermit for, nor an approval of. any violation of the provisions of the builtling coCes or any otherordinante. law, rule or regulation. Chief Building Inspector DEPARTMENT OF PLANNING AND DEVELOPMENT BUILDING INSPECTION LINE - 303-234-5933 CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 - (303-235-2855) Building Permit Number : 11040 Property Owner: Property Address : Contractor License No. : 10925 W. 39TH PL. Phone: 467-3348 Company: Phone: 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 ordinan rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of cord; that all measurements shown, and allegations made areaccurate; that I have read and yree to abide by all condi ons printed on this application, and that I assume full respon ibility or c liance t"the heat Ridge uilding Code (U.B.CJ and all other applicable W at R~ige rdanc4s~o orknder this prmit.] (OWNER)(CONTRACTOR) Description : ATTACHED GARAGE REMODEL TO LIVING AREA Construction Value Permit Fee Plan Review Fee Use Tax Total Date : 8121/2000 $5,000.00 $111.25 $0.00 $125.00 $236.25 Use: Electrical License No : Plumbing License No : Mechanical License No : Company: Company: Company: Expiration Date : Expiration Date : Expiration Date : Approval : Approval : Approval : (7) This permit was issued in accordance with the provisions set forth in yopur application and is suhjec[ to the laws of the Siate of Coloredo and to the Zoning Regulations and Building Code of Wheat Ritlge, Colorado or any other applicable ortlinances of the Ciry. -(2) 7his pertnit shall ezpire if (A) the work authorized is not commenced wiihin sixty (60) days from issue date or (B) the building authorized is suspended or abandoned for a period of 120 tlays. (3) If this permi[ expires, a new permit may be acquired for a fee of one-half the amount nortnally required, provided no changes have been orwill be made in the . original plans and speafcations and any suspension or abandonment has not ezceeded one (7) year. If changes are made or rf suspension or abandonment exceeds one (1) year, full fees shall be paitl for a new permit. (4) No work of any manner shall be done that will change the natural flow of water causing a drainage problem. (5) Contrector shall notiry the.Building Inspector lwenry-four (24) hours in advance for all inspeclions and shall receive written approval on inspec[ion card before - proceediing with successive phases of the job. .(6) The. issuance of a pertnit or the approval of drewings and specifications shall not 6e construed to be a permit for, nor an approval of, any violation of the provisions . of thet"ding codesyf' any o[her ordinance, law, mle or regulation. DEPARTMENT OF PLANNING AND DEVELOPMENT BUILDING IN'SPECTION LINE - 303-234-5933 CITY OF WHEA7' RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 - (303-235-2855) Property Owner: ~ Property Address Contractor License No. r i S lOPNmiJ Building Permit Number : Date : ~l i~3 Phone : ~3 ~6 1) C~,~mpany : Phone : OWNERlCONTRACTOR 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 ihis application, and that I assume full responsibility for compliance with the Wheat Ridge Building Code (U.B.C.) and all other applicable Wheat Ridge ordinances, for work under this permit. Permit Fee : Use Tax: Total : (OWNER)(CONTRACTOR) SIGNED DATE ' U52 : Description : CLl~ 0.C;~ ~ o BUILDING DEPARTMENT USE ONLY `,~~Sf'►i~~bri~ ~qf-'s'~' Approval ~ Zoning : ~G BaiCdiC~"q~~omarenf~ / / Approval: oJ~~1~o0sni9,~~ p7el~ecTa~g /'C~~,rp,a~ ~P'ii~tiErc e~~~ Approval: Occupancy : Walls Electrical License No : Company : Roof Plumbing License No : Company : Expiration Date : Approval: Expiration Date : Approval : Mechanical License No : Company : Expiration Date : Approval: (1) This permit was issued in accortlance with the provisions set forth in yopur applicalion and is subject to the laws of the State of Coloredo antl to the,ZOnin9 Regulations and Building Code of Wheat Ridge, Colorado or any other appiicable ortlinances of the City. - (2) This permit shall expire if (A) the work authonzed is not commenced within siaTy (60) days trom issue tlate or (B) the builtling authorized is suspended or abandonetl for a period of 720 days. (3) If ths pertnit expires, a new pertnii may be acquired for a fee of one-haltthe amount normally required, provided no changes have been or will be made in the orig inal plans antl specifications and any suspension or aCandonment has not exceeded one (1) year. It changes are matle or if suspension or abandonment exceeds one (7) year, tull fees shall be paid tor a new permit. (4) No work of any manner shall be done Nat will change the natural Flow of water wusing a drainage problem. (5) Contractor shall no6fy the Building Inspectoriwenty-four (24) hours in advance for all inspecdons and shafl receive wntten approval on inspection card betore proceediing with successive phases of the job. (6) The issuance of a pertnit or the approval of drawings and specifica[ions shall not be construetl to be a permit for, nor an approval of, any violation ot the provisions of the building w,4es yr anypfher ortlinance, law, rule or regula[ion. zx)Loek, SIC : le. . Ft. '1 2R?(I , . Stories : Residential Units : Construction Value : B - ~ C,/ n ~ i f ✓ ~ ~ .l~ C . \ n I 9 ~ i 7 ~ . 4 1 ~o ~ O r' Loan# 0014420434 Retum To: Ff MORTGAGE COMPANIES 70747 KING WILLIAM DRIVE DALLAS,TEXAS 75220 ATTN: POST CLOSING MAIL CENTER 7206 Above This Line For Recording DEED OF TRUST THIS DEED OF TRUST ("Security Instrument") is made on APrtiL 23, 7999 the grantor, CHRISTOPHER W. BOUCK AND JUDITH M. BOUCK , among ("Borrower"), [hC Pub1iC TNStCC Of JEPFERSON County ("Trustee"), and the beneficiary, FT MORTGAGE COMPANIES D/B/A SUNBELT NATIONAL MORTGAGE, A KANSAS CORPORATION which is organized and existing under the laws of THE Sin7E OF ic.4NSn5 , and whose addieSS iS 2974 LBJ FREEWAY, SUITE 200, DALLAS, TEXAS 75234 ("Lender"). Borrower owes Lender the principal sum of Sevenry Eight Thousand and 00/700 Dollazs (U.S. $ 7e,000.00 This debt is evidenced by Borrower's note dated the same date as this Security Instrument ("Note"), which provides for monthly payments, with the full debt, if no[ paid eazlier, due and payable on MaV i, 202e . 1'his Sewrity Ins[rument secures to Lender. (a) the repayment of the debt evidenced by the Note, with interest, and all renewals, extensions and modifications of [he No[e; (b) the payment of all other sums, with interest, advanced under pazagraph 7 to protect the security of this Security Instrument; and (c) the performance of Borrower's covenants and agreements under this Security Ins[rument COLORADO-Single Family-FNMA/FHLMC UNIFORM INSTRUMENT Form 3006 1I91 ~~6R(CO) Is7m1 pmended 5191 Pa9e 1 ot 8 Ini[ials: VMP MOftTGAGE FOflMS - (800)521-]291 Loan# 0074420434 and the Note. For this purpose, Borrower, in consideration of the debt and the trust herein created, irrevocably grants and conveys to Trustee, in trust, with power of sale, the following described property located in JEFFERSON LOT WIGHTEEN (18), WHEATRIDGE MANOR, COUNIV OF JEFFERSON, STATE OP COLORA00. County, Colorado: which has the address of 10925 WEST 39TH PLACE, WHEAT FIDGE (Street, Ci[y), COIOC3d080033- (ZipCode] ("Property Address"); TOGETHER WITH all the improvements now or hereafter erected on the property, and all easements, appurtenances, and fixtures now or hereaher a part of the property. All replacements and additions shall also be covered by this Security Instrument. All of the foregoing is referred to in this Security Instrument as the "Proper[y." BORROWER COVENANTS that Borrower is lawfully seised of the esta[e hereby wnveyed and has the right [o grant and convey the Property and that the Property is unencumbered, except for encumbrances of record. Borrower warran[s and will defend generally the title to the Property against all claims and demands, subject to any enwmbrances of record. 11 THIS SECURITY INSTRUMENT combines uniform covenants for national use and non-uniform covenants with limited vuiations by jurisdiction [o constitute a uniform security instrument covering real property. UNIFORM COVENANTS. Borrower and Lender covenan[ and agree as follows: 1. Payment of Principal and Interest; Prepayment and Late Charges. Borrower shall promptly pay when due the principal of and interest on the debt evidenced by the Note and any prepayment and late chazges due under the Note. 2. Funds For Taxes and Insurance. Subject to applicable law or to a written waiver by Lender, Borrower shall pay to Lender on the day monthly payments aze due under the Note, until the Note is paid in full, a sum ("Funds") for: (a) yeazly taxes and assessments which may attain priority over this Security Instrument as a tien on the Property; (b) yeazly leasehold payments or ground rents on the Property, if any; (c) yearly hazard or property insurance premiums; (d) yeazly flood insurance premiums, if any; (e) yeazly mortgage insurance premiums, if any; and (f) an sums payable by Borrower to Lender, in accordance with the provisions of pazagraph 8, in lieu of the payment of mortgage insurance premiums. These items are called "Escrow Items." Lender may, at any time, collect and hold Funds in an amount not [o exceed the maximum amount a lender for a federally related mortgage loan may require for Borrower's escrow account under the federal Real Estate Settlement Procedures Act of 1974 as amended from time to time, 12 U.S.C. Section 2601 et seq. ("RESPA"), unless another law that applies [o the Funds sets a lesser amount. If so, Lender may, at any time, collect and hold Funds in an amount not to exceed the lesser aznount. Lender may estimate the amount of Funds due on the basis of current data and reasonable esfimates of expendi[ures of future Escrow Items or otherwise in accordance with applicable law. The Funds shall be held in an institution whose deposits aze insured by a federal agency, instrumentality, or entity (including Lender, if Lender is such an institution) or in any Federal Home Loan Bank. Lender shall apply the Funds to pay the Escrow I[ems. L.ender may not chazge Borrower for holding and applying the Funds, annually analyzing the escrow account, or verifying the Escrow Items, unless Lender pays Borrower in[erest on the Funds and applicable law pemu[s Lender to make such a chazge. However, L,ender may require Borrower [o pay a one-time charge for an independent real esta[e taac reporting service used by L.ender in connection with this loan, unless applicable law provides otherwise. Unless an agreement is made or applicahle law requires in[erest to be paid, Lender shall not be required ro pay Borrower any interest or eamings on the Funds. Borrower and Lender may agree in writing, however, that interest shall be paid on the Funds. Lender shall give to Borrower, withoat chazge, an annual 6RIC01 ie7on I°~~~aIs: ' Paee 2 of e Farm 3006 1/91 DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : 3571 BUILDING INSPECTION DIVISION - 235-2855 CITY OF WHEAT RIDGE Date : 8/5/96 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 Property Owner : DURANT JAMES G Property Address: 10925 39TH AV Phone: 467-0626 Contractor License No. : 18729 Company : AMPTEK ELECTRICAL SERVICES, INC. phone : 421-9465 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certiTy that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the 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 (U.B.C.) and all other applicable Wheat Ridge ordinances, for work under this permit. (OWNER)(CONTRACTOR) Description : 150A SERVICE Construction Value : $600.00 Permit Fee : $25.00 Plan Review Fee : $0.00 Use Tax : $720 Totai : $32.20 Electrical License No : Plumbing License No : Mechanical License No : Company: Company: Company: Expiration Date : Expiration Date : Expiration Date : Approval: Approval: Approval: , mm ~ (1) This permit was issued in accordance with the provisions set forth in yopur application and is sub1'ec[ to Ne laws oFihe State of Colorado and to the Zoning Regulalions and Buiidin9 Code of Wheat Ritlge, Coloratlo or any other applicable ordinances of the Ciry. (2) This permit shall expire if (A) the work authonzed is not commenced within sixiy (60) days from issue tlate or (B) the building authorized is suspended or abandonetl for a period of 720 days. (3) If this pertnit expires, a new pertnit may be acquired for a fee of one-half the amount normally required, provided no changes have been or will be matle in the original plans and specifications and any suspension or abantlonment has not eacceeded one (7) year. If changes are made or if suspension or abandonmen[ exceeds one (7) year, full fees shall be paitl for a new permit. (4) No work of any manner shall be done thatwill change the natural Flow of watercausing a drainage problem. (5) Con[rec[or shall notity ihe Builtling Inspectorhventy-four (24) hours in advance for all inspections and shall receive wntten approval on inspection card before proceed~~ ithsuccessivephasesofUejo6. (6) Th e is a ce of a ermit or the approval f tlrawings antl specifcations shall not be construed to be a permit for, nor an approval of, any violation of the provisions of thu' ding cos or any othe~Vordce, law, rule or re9ulation. Building Inspector THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR CALL: 234-5933 24 HOURS PRIOR TO INSPECTION UEPARTMENT OF PLANNING AND DEVELOPMENT Buiiding Permit Number : BUILDING INSPECTION DIVISION - 235-2855 ' CITY OF WHEAT RIDGE Date :?):E-Ol~ 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 PropertyOwner: Property Address : \ O°~ a ~ ~~~k~ Phone ~07 - 8 (ca ~o Contractor License No. Company : Flt,N,o e Phone : \,}-J\ OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this pemit 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 accurete; that I have read and agree to a6ide by all conditions printed on this application, and that 1 assume full responsibility for compliance with the Wheat Ridge Building Code (U.B.C.) and all otM1er applicable Wheat Ridge ordingnces, for work under this permit. (OWNER)(CONTRACTOR) SIGNE ' ~_~~~~k_N_DATE 'g -5 f:~t b Description:5>C6` I-N, Zo nin'g'.C""ommen~ts ~ _ APProval : _ Zoning : Approval : Pu61ic`:1N-orks ~mments"~ Approval : Occupancy : Walls Q Construction Value : (a o.fl , U z) Permit Fee : Plan Review Fee : Use Tax: Total : _%S~ \ S0 T') BUILDING DEPARTMENT USE ONLY SIC : Sq. Ft. : Roof: Stories; Residential Units : ElectricalLicense No :`1Vb'~v Plumbing License No : Mechanical License No : Company : Company : Company : Expiretion Date Expiration Date : Expiration Date : Approval: Approval: Approval: J ~Pians_Required~ ~ ~Plans Required~ !.g _p(ans~RequffiI (1) This permit was issuetl in accordance with the provisions set forth in yopur application and is subject to Ihe lawsof the State of Colorado antl to ihe Zoning Regulations antl Building Code of Nfieat Ritl9e. Colorado or any other appliwble ortlinances of the Ciry. (2) This pertnit shall expire it (A) the work authonzeG is nol commenceC within siary (60) tlays from issue tlate or (B) the builtling auNanzed is suspendetl or ' abandoned for a periodbf 120 daya (3) If Uis pemit ezpires, a new pertnit may be au;uired for a(ee of one-half Ihe amounl normaliy requireC, proHdeE no changes have 6een or will 6e maae in the original plans antl specifirations antl any suspension or ahanAonment has nol exceeded one (i) year. If changes are made or if suspension or a0andonment exceeds one (1) year. tull fees shatl be paid far a new permit. ' (4) No work of any manner shall be tlone Nat wi11 change the natu2l 9ow of water causing a drainage problem. (5) Controctor shall notity the Builtling Inspector twenry-tour (24) hours in atlvance for all inspections and shall receive wntten approval an inspe[tion card before proceetliing with succe55ive Dhases ot Ue job. (6) The issuance of a pemit or the approval of tl2wings and speciGCations shall not he construed to be a pemit for, nor an approval ot, any violation o( the provisions ofthe builCing codes or any other ortlinance, law, rule or regulation. Building Inspector For Mayor THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR CALL: 234-5933 24 HOURS PRIOR TO INSPECTION