HomeMy WebLinkAbout3324 Zephyr Courti CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: of ¬,
Job Address: M12—
Permit
. Permit Number:
❑ No one available for inspection: Ti
Re -Inspection required: Yep No
When corrections have been made,
httpYlwww.ci. wheatridge.co. usrinspo
P
AM/PM
for re -inspection online at.
I* � 4 i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:
Job Address: C I
Permit Number:
IJNo one available for inspection: Ti AM/PM
Re -Inspection required• a No
When corrections have been mad , s G emorre- a tien-onl" a at:
http://www.ci.wheatridge.co.us ins ec o .*
i
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: ?'�-5�• �' `y'�
Job Address:
Permit Number:
i -
❑ No one available for inspection::Time 9' A M
Re -Inspection required: Yes `No;
When corrections have been made, schedule for re -inspection online at:
http✓/www, ci. wheatridge.co. usVinspection
Date: , ' Inspector:
DO NOT REMOVE THIS NOTICE
41
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: 32y) �41 kp/Z_lz
Job Address: 33'Z"j/ C-7,
Permit Number: -?Oeo 0C."
Ll No one available for inspection: Time AWPIVI
Re -inspection required: Yes No
When corrections have been made, schedule for re -inspection online at:
httpYlwww.ci.wheatridge.co. uslinspection
Date:—'3 3 1 - ZC' Inspector:
DO NOT REMOVE THIS NOTICE
■ ■
ajick
ENGINEERING
Client:
Emily Guldy
c/o:
Terry Weis
From:
Majick Engineering, LLC
Date:
March 24", 2020
Address:
3324 Zephyr Court
Wheat Ridge, Colorado 80033
Subject:
As Built Framing Observation
.3, zs --?() k^,
/02 ei� r
Z�v av 3��J
630 E. AM H ERS'�C AVE.
ENG)_rW00D, co 80113
(720) 612-2444
On March 17�", 2020 Majick Engineering was contacted by Terry Weis of Weis Construction to provide a site observation
of the structural framing for the tenant improvements at the residence at 3324 Zephyr Court, Wheat Ridge, Colorado
80033. The site observation was to determine if the as built condition met the structural design intent of the
construction documents.
Design changes were made during construction due to field conditions. The field changes are provided below.
• A roof kicker was discovered during demolitions at the location of were a wall was to be remove. To support
the roof kicker a 1 % inch by 7% inch Versa -lam was place on either side of the 2x4 kicker and attached with (4)
inch diameter lag screws. The new Versa -lam was supported at the exterior wall and interior beam. Majick
Engineering provided direction for the new support requirements and based on the site observation was
determined to be installed to the design intent of the construction documents.
• A new exhaust vent was required in the kitchen remodel which required retrofitting of the existing ceiling
framing. To support the modified bottom ceiling rafter the two adjacent bottom rafters were sister with a new
2x6. The modified rafter was supported a new header consisting of (2) 2x6 supported on the sister ceiling
rafters with LUS26-2 hanger. Majick Engineering provided direction for the new support requirements and
based on the site observation was determined to be installed to the design intent of the construction
documents.
• The center beam was change to a (2) 1% inch by 7% inch Versa -lam beam in lieu of the (2) 2x8 due to the
additional load from the field conditions. The change in beam size was provided by Majick Engineering and was
installed to the design intent of the construction documents.
All of the field changes were verified to be adequate and do not negatively impact the structural integrity of the house.
Based on the site observation performed on March 17In, 2020 and pictures provided on March 24'", 2020 the as built
framing were installed to the structural design intent of the construction documents.
The above is based upon:
• Visual observations and does not included areas unable to be observed due to access or coverings.
• No destructive or non-destructive testing was performed. Majick Engineering is not liable for any hidden
deficiencies that lead to failure or any incurred damage.
• Conclusions and recommendations are based on accepted industry standards and no warranty is either
expressed or implied as to continued structural integrity of the property.
• Opinions stated in this letter are subject to change if conditions, accessibility, or visibility from time of
inspection change or if additional information becomes available for consideration.
+ Therefore, the value (liability) of this design shall be limited to the amount of the fee charged for the service.
For any questions or concerns please contact Majick Engineering, LLC at 720-612-2444.
Thank you,
Ian McQuade, P.E., S.E.
Majick Engineering, LLC
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:_...(
Job Address:
Permit Number:
❑ No one available for
Re -Inspection required:
When corrections have been made,
http://www.ci. wheatridge.co. usrnspi
4' CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:
Job Address:
Permit Number: TO\10 00'-3w
a
1-1 No one available for inspection: T4rne /OM
Re -Inspection required: Yes
When corrections have been made, schedule for re -inspection online at:
httpYlwww. ci. wheatridge.co.uslinspection
Date:— - <–jInspector: _
DO NOT REMOVE THIS NOTICE
a CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:
Sc Z
6,511 FT
/ ID ITU 6,
Job Address:
33 7�y
Z��r<.
g: ,
Permit Number:
'ra-eca
3 4r
❑ No one available for inspection: Time (AMM
Re -Inspection required: Yes No
When corrections have been made, schedule for re -inspection online at:
http✓/www. ci. wheatridge. co. usrinspection
Date:—.-?' �?S• nspector: ;;�. .-,?--
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
3/6
Inspection Type:'—�
Job Address: 3.3 <y ZO_- ! R e -T:
Permit Number:?el?CJ C,0 '_3 �y
❑ No one available for inspection: Time5 : < 7 60M
Re -Inspection required: Yes No
When corrections have been made, schedule for re -inspection online at:
http✓/www.ci. wheatridge.co. uslinspection
Date: J - -74/i - �� Inspector: a ,
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: 31.E G.'a /04' .
Job Address: 7'3 �''��i ZZ�� C %
Permit Number: ZOZ& GGA;
❑ No one available for inspection: Time':M/pM
Re -Inspection required: Yes
When corrections have been made, schedule for re -inspection online at:
h ttp://www. ci. whea tridge. co. usfinspection
Date: -rt Inspector:
DO NOT REMOVE THIS NOTICE
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION:
City of Wheat Ridge
Residential Asbestos Abatement PERMIT - 202000426
202000426 ISSUED: 02/26/2020
3324 Zephyr Ct EXPIRES: 02/25/2021
Remove section of trace ACM walls in living room, dining room and kitchen -
450 sq ft total
*** CONTACTS ***
OWNER (303)917-3664 GULDY EDWARD A & EMILY
SUB (720)371-7972 JESUS RIVAS 202050 ENVIRONMENTAL CONNECTION
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 3,800.00
FEES
Asbestos Abatement 50.00
Total Valuation 0.00
** TOTAL ** 50.00
*** COMMENTS ***
*** CONDITIONS ***
Work shall comply with 2012 IRC & 2017 NEC. Smoke alarms shall comply with 2012 IRC Section
134. INTERIOR ALTERATIONS, REPAIRS, FUEL -FIRED APPLIANCE REPLACEMENTS, OR ADDITIONS, ANY OF
WHICH REQUIRE A BUILDING PERMIT, OCCURS OR WHERE ONE OR MORE ROOMS LAWFULLY USED FOR
SLEEPING PURPOSES ARE ADDED SHALL HAVE AN OPERATIONAL CARBON MONOXIDE ALARM INSTALLED
WITHIN FIFTEEN FEET OF THE ENTRANCE TO EACH ROOM LAWFULLY USED FOR SLEEPING PURPOSES
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 f attest that I am legally authorized to include all entities named within this document as parties to the work to be
pe€�Ptft th�ork to be performed is disclosed in this document apd/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Datd t
I _ This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the original permit fee.
3. If this permit expires, a new permit may be required to be obtamed. Issuance of a new permit shall be subject to the standard
requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4, No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6, The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
s -"-f i v-4-- t
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
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City of Wheat Ridge
Homeowner Interior Remodel PERMIT - 202000380
PERMIT NO: 202000380 ISSUED: 02/25/2020
JOB ADDRESS: 3324 Zephyr Ct EXPIRES: 02/24/2021
JOB DESCRIPTION: Demo and remodel of kitchen and laundry room. Adding new lighting and
breakfast bar. Widening entry points and raising load bearing header.
Square footage: 182
*** CONTACTS ***
OWNER
(303)917-3664
GULDY EDWARD A
SUB
(303)347-1958
JACK STEELE
080125 STEELE BROS.HEATING, INC.
SUB
(303)988-7997
KENT D. LANGFIELD
021958 SPECIALIZED ELECTRIC COMPANY
SUB
(303)932-9311
ARLIS BADER
202045 APB PLUMBING
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 I
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 50,000.00
FEES
Total Valuation 0.00
Plan Review Fee 474.21
Use Tax 1,050.00
Permit Fee 729.55
** TOTAL ** 2,253.76
*** COMMENTS ***
*** CONDITIONS ***
I, the property owner, by my signature, attest that I currently reside at the project
property, intend to reside at the property for a period of one year after completion of the
project, and am personally performing all work, without the assistance of hired or
professional workers. If professionals are hired, those contractors are licensed with the
City of Wheat Ridge and are listed on the permit.
NOTE: Consultations and inspections will only be performed with the homeowner of record
present.
All roughs to be done at Framing Inspection.
Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all
applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections.
City of Wheat Ridge
Homeowner Interior Remodel PERMIT - 202000380
PERMIT NO: 202000380 ISSUED: 02/25/2020
JOB ADDRESS: 3324 Zephyr Ct EXPIRES: 02/24/2021
JOB DESCRIPTION! Demo and remodel of kitchen and laundry room. Adding new Lighting and
breakfast bar. Widening entry points and raising Load bearing header.
Square footage: 182
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 roperty and am authorized to obtain this pen -nit and perform the work described and approved in conjunction with
this permit. I further attesthat I a le ally authorized to include all entities named within this document as partes to the work to be
per a d that all wo to b e formed is disclosed in this document and/or its° accom aAnnying approved plans and specifications.
nature of WN or`'CONTRACTOR (Mrcle one) Date
This perms 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.
This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalermit fee.
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.
No work of anmanner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
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.
The issuance or grants of a permit h ll not be construed to be a permit for, or an approval of, anviolation of any provision of any
applicable code or aro dinance or g6julation 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
I-
W heat d
�OMMVNriY DEVELOPMENT
Building & Inspection Services
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(a_ci.wheatridge.co.us
I FOR OFFICE USE ONLY I
Date:
�141��; I _d
Plan/Permit #
,,� 0 -2-0 � b
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: 33-R4
1 '/
Property Owner (please print):�NJ / L,� _ �,� LL,L� y Phone -303 '7/'7J44,/_
Property Owner Email: emaecId0 (b 1�1-d�tau-a,��. Ce,-
Tenant
y
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address
City, State, Zip:
Architect/Engineer: L1- r; 5-6ne. 9;md ,&-x
. L
Architect/Engineer E-mail: C-hrt'1;le5irxeo I �ft5nPho e 7d_ V a)_UD I7q le
Contractor Name:D1'y�p�-uJ/')Q�i'�
City of Wheat Ridge License #:
Contractor E-mail Address
u=rn. a uid
Phone: q1 7 3 & &
Ott t k�l,
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): ti►' I 10 G, U_ I ct Phone: 3 0.3 q 17:3
CONTACT EMAIL(p/ease print):
Sub Contractors (Must provide Wheat Ridge License N,j� & S' ned Subcontractor Authorization
Electrical: Plumbing: A Pp 1'1wwL6 , P,3 Mechanical:S�&�� �J'�(/
W.R. City License # 0 a r58 W.R. City License # _�J W.R. City License # 0?01-75
Other City Licensed Sub: Othe it License c ub:
City License # City License # aD e'2d '13
Complete all highlighted fields,
[-]COMMERCIAL P<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 materiaJs to be used, etc.
f'pl'�,�'o Y ki.en ru'►t.od el : r�.�b.� �ci�nq e n su.n ter -
1; a, K a e 5 . Act a al iA I i�' s wa 1"C° a,�i r1,✓t5 4 Z ' Ai; XI-
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Sq. Ft./LF /,?.Z Sf BTUs 11 b UA na Gallons D `�' ` --I
Amps Squares IV 4 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)
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
1 hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that 1 assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I. the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE.
WVE (C,ONTRACTOR) or (gTji�HOR/ZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last name):
Printed Name:
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:\ ,
PUBLIC WORKS COMMENTS:
Reviewer:
k. iL
DEPARTMENT USE ONLY
DATE: d C.)- 1) 0-
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:i Y `
Building Division Valuation: 17�1i ,<���
1#"zotooa3go
Ciiy Of
`1Vheat id e
COMMUN[TY DEVELOPMENT
J
Official Certification of Property Owner Permit
THIS IS TO CERTIFY that I, the property owner, by my signature, attest that I currently
reside at the project property, or intend to reside at the property for a period of one year after
completion of the project, and am personally performing all work, without the assistance of
hired or professional workers, or, if hiring sub -contractors, list them on the permit.
Consultations and inspections will only be performed with the homeowner of record present at
the project property.
Property Owner(s):
Um f LY 4 Z�b tVA-Ar? C x L)>
Project Property: 3.3�
Project Type:
Notarized signature of Applicant
State of Colorado }
County o 9 ss
The foregoln instrument was acknowledged by me thisALI�day of ✓ 11V 20_,&by
JODI L BAROS
STATEO COLORADO
NOTARY ID 2014401AM
W COIF MI MKS WAY Ok 2022
My Commission Expires L�f.6J20Z7—
Notary P iic
Wheat j�iclge
COMMUNITY DEVELOPMENT
SUBCONTRACTOR AUTHORIZATION FORM
Mechanical Subcontractor
This form must be completed & signed by the MECHANICAL SUBCONTRACTOR
performing mechanical work on site.
Subcontractor's insurance and license must be up to date prior to permit issuance.
Project Address: 3 3 Z 41 Z
e, 7—
General Contractor:
Company Name %RR & 9400 s k451f1',/v g Contact Phone #: 30 3 v 7- & 329
Wheat Ridge Contractor License #:0601257(required field)
kw 9'e�
Printed Name of Authorized Agent
Signatu n
�MEIVE�
r�c�
A — Z0-2oZ0
Date
City of
W heat ps
dge
�MUNITY DEVELOPMENT
W' f
Electrical Subcontractor
This form must be completed & signed by the ELECTRICAL SUBCONTRACTOR
performing electrical work on site.
Subcontractor's insurance and license must be up to date prior to permit issuance.
Project Address: 3324 Zephyr Court Wheat Ridge CO 80033
General Contractor:
FORM WILL NOT BE ACCEPTED WITTI MISSING INFORMATION
Company Name: Specialized ElectricCompany Contact Phone #:
Wheat Ridge Contractor License #:.
State License #: 5924
Master License #: 0025596
Michael Herrera
Printed Name of Authorized Agent
Signature of Authorized Agent
021958 (required field)
MeI
ECEIV
I'J,10, M-IXVWM-
303-988-7997
Date
2-18-2020
_v City of
Wh6atfkiLld �e
COMMUNITY DEVELOPMENT
SUBCONTRACTOR AUTHORIZATION FORM
Plumbing Subcontractor
This form must be completed & signed by the PLUMBING SUBCONTRACTOR
performing plumbing work on site.
Subcontractor's insurance and license must be up to date prior to permit issuance.
Project Address:
General Contractor: f =- M;
IM !'104 v V11e
Company Name: Av s P)4-mhi.rc4 Contact Phone #: )av "_V
Wheat Ridge Contractor License #: Q .`2 (; tj' . �— (required field)
State License #:C C7 dQ t�
Master License #: M P 6 C 1 ef !j .?.3Z
Printed Name of Authorized Agent
". P /j3 JA,- �, — A o - --N, C, -,A
Signature of Authorized Agent Date
E! I Tli f4 -Z a 7,62 1 Di
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City of
AV
Wh6atfZid. e
COMMUN iTY DEVELOPMENT
SUBCONTRACTOR AUTHORIZATION FORM
I Mechanical Subcontractor I
This form must be completed & signad by the MECHANICAL SUBCONTRACTOR
performing mechanical work on site.
Subcontractor's insurance and license must be up to date prior to permit issuance.
ProjectAddress:.,;�3Lq 2,ant+y R t_'c.? � ZcY5-,GZ
General Contractor: sM i 1-y &U'-'E�y
Company Name: 'bot- la-SUPLt A-ue-E f ontact Phone #:
Wheat Ridge Contractor License #: S 0 4 -C? -V75 (regnired field)
Printed NMe of Authorized Agent
Siguatnr nthorized Agent
Z. — t e� 7 0 -Z-0
Date
Environmental Development and Training ACM LLC.
2100 W. Littleton Blvd Suite 225
Littleton, Colorado 80120
Phone 303-638-3778, Fax 303-374-2755
Email: edtacm/lc(aicloud.com
January 29, 2020
Emily Guldy
3324 Zephyr Court
Wheat Ridge, Colorado
I[ III • ECEI
�11.P1_.i
if-ZZZ060396
RE: Asbestos Sampling — Scope of Services: 3324 Zephyr Court in Wheat Ridge,
Colorado. At client request, Interior Kitchen and Laundry closet plaster, and laundry
closet sheet flooring were sampled within the residence current planned construction
pathway. No other materials and or areas were assessed for asbestos. Any other
material/areas encountered during demolition must be assumed to contain asbestos unless
sampled and proven otherwise. The Site was field reviewed, and samples were collected
from all accessible areas.
Executive Summary:
1. Plaster walls, and ceilings in basement areas contained less than 1% asbestos
(trace). Plaster would require management as an OSHA regulated material and
would not currently be regulated by EPA/CDPHE.
2. Laundry closet Sheet Vinyl was confirmed non -ACM by PLM analysis.
Task 1 - Field Work:
The asbestos survey will be completed by an Environmental Protection Agency (EPA)
accredited AHERA and Colorado State certified Asbestos Building Inspector. The
inspector will perform the physical assessment of suspect materials, plan and organize the
building inspection; identify and map homogeneous areas and functional spaces; assess
the condition and potential for future damage to friable materials; and collect samples.
A minimum of three samples will be collected from each readily visible and accessible
homogeneous area, in accordance with EPA National Emissions Standards for Hazardous
Air Pollutants (NESHAPS) and the Occupational Safety and Health Administration's
(OSHA) regulation 29 CFR 1926.1101.
Sampling will follow the 3-5-7 rule under AHERA, specifying the collection of:
3 samples of surfacing materials less than 3,000 square feet in size.
5 samples of surfacing materials between 1,000 and 5,000 square feet in size; and
7 samples of surfacing materials greater than 5,000 square feet in size.
Fewer samples may be collected at inspector's discretion of miscellaneous materials, and
material in small patch areas.
Additional samples may still need to be collected during demolition if hidden areas are
revealed and materials are encountered that were not sampled earlier. A cost estimate for
collection of samples from materials discovered during demolition.
The samples will be submitted to Reservoirs, under proper chain -of -custody procedures,
for analysis of asbestos content on a Rusli Same D`ay turn -around time. Reservoirs, is an
American Industrial Hygiene Association (AIHA) accredited laboratory and participates
in the National Voluntary Laboratory Accreditation Program (NVLAP).
A minimum of three samples of a material is needed to categorize that material as non -
asbestos -containing. As a cost saving procedure, and as specified by the asbestos
inspector, the samples will be analyzed progressively. (If the first sample of a
material is analyzed and contains asbestos, then the subsequent samples are not analyzed,
since the material must be categorized as asbestos -containing.) Samples with layers will
not be analyzed progressively.
If less than or equal to ten percent of asbestos is detected in a friable sample, then the
sample must be pointed -counted, including samples with results less than one percent.
Point -counting is a systematic laboratory technique which can more accurately quantify
the percent of asbestos. Friable material and non -friable material that could be rendered
friable during renovation activities are required to be point -counted by Colorado
Regulation No. 8.
Task 1: Inspection.
1. Inspection Activities. Completion and field review of Statement of Work (SOW) related
to destructive and non-destructive sampling of homogeneous building materials is limited
to client specified specific small area locations planned for limited renovation. Building
samples will be analyzed per building based on EPA requirements, with a maximum of 3
to 7 samples per and at client request limited to specific homogeneous small scale
planned renovation areas. Additional sample of specific units may be required to fully
characterize all suspect materials within units, and unit wall and ceiling cavities
6 - INSPECTION COVER SHEET
Type of Inspection: [X] Initial [ ] Re -inspection [ ] Periodic Inspection
Building Assessed By: Kris T. Wilson I Telephone # 303-638-3778
317 Jasmine in 3324 Zephyr Court in Wheat Ridge, Colorado
Date, description, and location of additions/renovations for this building e.g., new structural additions or
application of surfacing material or fireproofing insulation.
Estimated 1960s, no major renovations reported.
Type of heating system: Basement system, not included in assessment SOW
Has any part of the heating system, including boiler(s), hot water pipes, water heater, etc., been renovated or
replaced? [ ] Yes [ X] No
Provide date, description and location of heating system renovations/replacements for this building: N/A.
The following inspector(s) conducted the inspection and is/are accredited under the state accreditation program
or E -approved course
Name:
State Accredit #
Signature
K4" T. W
Date
Kris Wilson
4663
SM.
01/08/2020
1
Firm:
Address
EDT ACM LLC
2100 Littleton Blvd. Suite 225, Littleton, CO
Phone # 303-638-3778
Course Name: CO AHERA
Expires
Training Agency
Inspector
07/31/2021
Colorado Hazard Control
7 - ROOM/FUNCTIONAL SPACE ASSESSMENT*
Type of Inspection [ X ] Initial [ ] Re -inspection [ ] Periodic
Date of Inspection: 01/08/2020
317 Jasmine in 3324 Zephyr Court in Wheat Ridge, Colorado
Room/ Functional Space: Kitchen/Laundry
Closet
Date of Original Construction: Estimated 1960s,
no other records.
Date & description of additions/ renovations for this room /functional space: Kitchen and laundry
closet Interior walls
Type of Material: I XI Surfacing I I Thermal I IMiscellaneous
Plaster
Material: IX I Friable I ]Non -Friable
All sampled materials determined less than 1% and OSHA Regulated material by Laboratory Analysis
Description:
Drywall wall board determined to be Non -ACM
Amount of Material: Plaster
Walls Percent of Area:
X
approximately 60% of wall area
Homogeneous Area:
Air Erosion
Interior plaster walls
Approx. 1840 SF
Vibration
X
Damage Assessment FOR ALL Materials Sampled
Type of Damage
YES NO
Amount of Material
Comments
(Severity, Cause)
Deterioration
X
Physical Damage
X
Water Damage
X
Air Erosion
X
Vibration
X
Other
Powder dust or debris present? NO Location: Interior Walls
Is this material in a supply or return air plenum? No, NA no plenum
Note the extent or spread of damage over large areas or large percentages of the homogeneous area: N/A
Room;' Functional Space Assessment continued on next page
7 — (CONTINUED) - ROOM/FUNCTIONAL SPACE ASSESSMENT
Potential for Contact with Material
1. Damaged/Significantly damaged TSI _
Comments: omments: N/A
[X ] High - Workers in vicinity more than once/week
6. ACBM with potential for significant damage _
or material is in a public area accessible to building
7. Any remaining friable ACBM or friable suspected ACBM
occupants (e.g., hallway or auditorium)
_
[ ) Moderate - Workers in vicinity once/month -
Firm
once/week or material is in a room/office
Materials verified less than 1% asbestos and OSHA
accessible to building occupants
Regulated
[ I Low - Workers in vicinity less than once/month or
Course Name: AHERA
material is visible but not within reach of building
Training Agency: CHC
occupants
07/31/2021
Note the potential for disturbance of the material:
Potential for disturbance is High
Assessment Category
1. Damaged/Significantly damaged TSI _
5. ACBM with potential for damage -
2. Damaged friable SURFACING ACBM _
6. ACBM with potential for significant damage _
3. Significantly damaged friable SURFACING ACBM _X
7. Any remaining friable ACBM or friable suspected ACBM
4. Damaged or significantly damaged friable miscellaneous
_
ACBM _
Firm
Address
Materials verified less than 1% asbestos and OSHA
EDT ACM LLC
Regulated
Reason for classification: Extent of damage. Material determined by Analysis to be OSHA Regulated
Preventative measures which might eliminate the reasonable likelihood of undamaged ACBM from becoming
Damaged. If removed, must be by using OSHA work Practices and Engineering Controls
The following inspector conducted the assessment and is accredited under the State of Colorado accreditation
program and EPA -approved course
Name
State Accreditation #
Signature
Date
Kris Wilson
4663
K. jkT'. wail,
01/08/2020
Firm
Address
Telephone Number
EDT ACM LLC
2100 W. Littleton Blvd. Suite 225, Littleton CO
303-638-3778
Course Name: AHERA
Expires
Training Agency: CHC
Inspector/
07/31/2021
7 - ROOM/FUNCTIONAL SPACE ASSESSMENT*
Type of Inspection [ X ] Initial [ ] Re -inspection [ ] Periodic
Date of Inspection: 01/08/2020
317 Jasmine in Denver, Colorado
Room/ Functional Space: Laundry Closet Sheet
Flooring
Date of Original Construction: Estimated 1960s,
no other records.
Date & description of additions/ renovations for this room /functional space: Main Floor laundry
closet
Type of Material: I I Surfacing I ]Thermal I XIMiscellaneous
Main Floor Laundry Closet
Material: IXI Friable IINon-Friable
All sampled materials determined NON -ACM material by Laboratory Analysis
Description:
White sheet vinyl
Amount of Material in planned
Floor Percent of Area:
renovation area
approximately 50% of closet floor
Vibration X
area
Homogeneous Area:
Laundry closet sheet flooring
Approx. 4 SF
Damage Assessment FOR ALL Materials Sampled
Amount of Material
Type of Damage YES NO
Comments
(Severity, Cause)
Deterioration X
Physical Damage X
Water Damage X
Air Erosion X
Vibration X
Other
Powder dust or debris present? NO Location: Interior laundry closet
Is this material in a supply or return air plenum? No, NA no plenum
Note the extent or spread of damage over large areas or large percentages of the homogeneous area: N/A
Room' Functional Space Assessment continued on next page
7 — (CONTINUED) - ROOM/FUNCTIONAL SPACE ASSESSMENT
Potential for Contact with Material
1. Damaged/Significantly damaged TSI _
Comments: omments: N/A
IX I High - Workers in vicinity more than once/week
6. ACBM with potential for significant damage
or material is in a public area accessible to building
7. Any remaining friable ACBM or friable suspected ACBM
occupants (e.g., hallway or auditorium)
Xy, *T Wi26&rV
I I Moderate - Workers in vicinity once/month -
Firm
once/week or material is in a room/office
Materials verified Non -ACM
accessible to building occupants
2100 W. Littleton Bldv. Suite 225, Littleton CO
I I Low - Workers in vicinity less than once/month or
Course Name: AHERA
material is visible but not within reach of building
Training Agency: CHC
occupants
7/31/2021
Note the potential for disturbance of the material:
Potential for disturbance is High
Assessment Category
1. Damaged/Significantly damaged TSI _
5. ACBM with potential for damage -
2. Damaged friable SURFACING ACBM _
6. ACBM with potential for significant damage
3. Significantly damaged friable SURFACING ACBM _
7. Any remaining friable ACBM or friable suspected ACBM
4. Damaged or significantly damaged friable miscellaneous
Xy, *T Wi26&rV
ACBM
Firm
Address
Materials verified Non -ACM
Reason for classification: Extent of damage. Material determined by Analysis to be NON -ACM
Preventative measures which might eliminate the reasonable likelihood of undamaged ACBM from becoming
Damaged. Determined to be NON -ACM
The following inspector conducted the assessment and is accredited under the State of Colorado accreditation
program and EPA -approved course
Name
State Accreditation #
Signature
Date
Kris Wilson
4663
Xy, *T Wi26&rV
01/08/2020
Firm
Address
Telephone Number
EDT ACM LLC
2100 W. Littleton Bldv. Suite 225, Littleton CO
303-638-3778
Course Name: AHERA
Expires
Training Agency: CHC
Inspector/
7/31/2021
ASBESTOS INSPECTION REPORT
EXECUTIVE SUMMARY:
This inspection for asbestos containing building materials (ABCMs) was conducted in
accordance with the Asbestos Hazard Emergency Response Act AHERA 40 CFR Part 763 and
the Occupational Safety and Health Administration (OSHA) 29 CFR 1926.1101. The suspect
ACBM defined within this study includes surfacing and finishing components of the floors, walls
and ceilings, thermal systems insulation on piping, and heating ventilation and air condition
systems (HVAC) and any miscellaneous suspect material encountered. A visual and tactile
inspection of suspect ACBM was performed throughout the client limited building area.
Samples were collected randomly of each suspect ACBM. The Environmental Protection
Agency (EPA) and the Colorado department of Public Health and Environment (CDPHE)
recognize building materials that contains greater than one -percent asbestos to be an ACBM.
The accessible areas of Interior areas of basement areas, with no subdivided areas,
This Scope of Work was performed by, Mr. Kris Wilson of EDT ACM LLC, EPA and
State of Colorado Certified Asbestos Building Inspector.
ACBM SAMPLE FINDINGS
Asbestos Sampling — 3324 Zephyr Court in Wheat Ridge, Colorado. At client request,
Interior Kitchen laundry closet plaster, and laundry closet sheet flooring were sampled
within the residence current planned construction pathway. No other materials and or
areas were assessed for asbestos. Any other material/areas encountered during demolition
must be assumed to contain asbestos unless sampled and proven otherwise. The Site was
field reviewed, and samples were collected from all accessible areas.
Executive Summary:
1. Plaster walls, and ceilings in kitchen and laundry areas contained less than 1%
asbestos (trace). Plaster would require management as an OSHA regulated material
and would not currently be regulated by EPA/CDPHE.
2. Laundry Closet Sheet Flooring was confirmed non -ACM by PLM analysis.
ASBESTOS CONCLUSIONS AND RECOMMENDATIONS
1. Kitchen Plaster wall and ceiling material must be managed as an OSHA Regulated
material.
***However: It should be noted building materials and areas not previously analyzed during this
inspection must be assumed asbestos, until tested and proven otherwise. Any material not
identified that will be impacted by renovation /remodel activities must be removed in
accordance with 40 CFR 763 AHERA and the State of Colorado Regulation 8 Part B and
OSHA.
Please contact me if you have any question related to this project.
Kris Thomas Wilson
President
Inspector 94663
FIRM #14900
Environmental Development and Training ACM LLC.
2100 W. Littleton Blvd Suite 225
Littleton, Colorado
LIMITATIONS
Limitations
Environmental Development and Training ACM LLC, (EDT ACM LLC) prepared this report,
for the exclusive and present use of Emily Guldy. This report addresses certain physical
characteristics of the site with regards to the release or presence of mold and asbestos in limited,
client determined, areas only. These services were performed in a manner consistent with
practices common in the environmental health profession. The information and conclusions
provided herein are valid only with respect to the specific locations and analytes investigated at
the time this report was prepared. The findings, conclusions, and recommendations presented
here are based on information available at the time the site was evaluated.
In the event of any reuse or publication of any portion of this report, Environmental
Development and Training ACM LLC shall not be liable for damages arising out or such reuse
of publication. Any reuse a third party makes of this report, or any reliance on or decisions made
are the responsibility of such third party. Environmental Development and Training ACM LLC
accepts no responsibility for damages, if any, suffered by any third party as the result of
decisions made or actions taken based on this report.
Reservoirs Environmental, Inc
Effective April 02, 2018
Reservoirs Environmental QA Manual
Q \QAQC1Lab\Reservmrs Environmental QA Manual.00c
REI LABReservoirs
wppp—
Environmental,
Inc.
January 31, 2020
Kris Wilson
Environmental Dev. & Training, LLC
2100 W. Littleton Blvd., Suite 225
Littleton CO 80120
Dear Kris,
Subcontractor Number:
Laboratory Report:
Project #/P.O. #:
Project Description
RES 455209-2
3324
3324
Reservoirs Environmental, Inc. is an analytical laboratory accredited for the analysis of Industrial Hygiene and
Environmental matrices by the National Voluntary Laboratory Accreditation Program (NVLAP), Lab Code
101896-0 for Transmission Electron Microscopy (TEM) and Polarized Light Microscopy (PLM) analysis and the
American Industrial Hygiene Association (AIHA), Lab ID 101533 - Accreditation Certificate #480 for Phase
Contrast Microscopy (PCM) analysis. This laboratory is currently proficient in both Proficiency Testing and PAT
programs respectively.
Reservoirs Environmental, Inc. has analyzed the following samples for asbestos content as per your request.
The analysis has been completed in general accordance with the appropriate methodology as stated in the
attached analysis table. The results have been submitted to your office.
RES 455209-2 is the job number assigned to this study. This report is considered highly confidential and the
sole property of the customer. Reservoirs Environmental, Inc. will not discuss any part of this study with
personnel other than those of the client. The results described in this report only apply to the samples analyzed.
This report must not be used to claim endorsement of products or analytical results by NVLAP or any agency of
the U.S. Government. This report shall not be reproduced except in full, without written approval from
Reservoirs Environmental, Inc. Samples will be disposed of after sixty days unless longer storage is requested.
If you have any questions about this report, please feel free to call 303-964-1986.
Sincerely,
by Liu Wenlong
Jeanne Spencer
President
P:(303)964-1986 5801 Logan St, Suite 100, Denver, CO 80216 1-866-RESI-EN V
E:(303) 477-4275—reilab.-ru
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Date:
Proposal Number:
Project Submitted To:
Project Location:
Proposal Submitted By
Acceptance:
ACCEPTANCE OF PROPOSAL
February 11, 2020
2021
Emily Guldy
Wheat Ridge, CO 80033
3324 Zephyr Ct
Wheat Ridge, CO 80033
Environmental Connection L.L.C.
746 Northridge Rd
Highlands Ranch, CO 80126
PH 720-371-7972
The above ENVIRONMENTAL CONNECTION L.L.C. proposal price, specifications, and
conditions are satisfactory and are hereby accepted. You are authorized to do the work as
specified at the contract value of $4,400.00. Payment shall be made as described above.
DATE:/ �� SIGNATURE:
TITLE: ��_ _ PRINT NAME:
•ECEIV ===
ACCREDITED
BUSINESS
ANN W, bbb..+
REMOVAL PROCEDURES TO BE UTILIZED
Environmental Connection LLC utilizes Federal, State, and Local rules and regulations
as minimal guidelines while conducting remediation procedures. Trained and certified
technicians in accordance with all applicable will execute all abatement phases,
including guidelines as established by Colorado Department of Public Health &
Environment Air Quality Control Commission Regulation 8.
OTHER SPECIFIC PROJECT REQUIREMENTS
Owner will provide adequate electrical power and potable water throughout the duration
of this project. Environmental Connection L.L.C. will not be held responsible for tape,
staple damage for required critical barriers.
SCHEDULE
Environmental Connection L.L.C. can start this project once permits have been
processed by CDPHE. We will begin the permit process immediately upon returning the
proposal with your authorized signature. Work hours will be scheduled as needed per
day to complete the project within the said time frame. This project is estimated to be
completed in up to 3 day(s).
ACCREDITED
BUSINESS
bbb..M
Q0 V)0) 31 .S 7RD
INSPECTION RECD x.5933
INSPECTION REQUEST LINE: (303) 23�,
project site.
Inspections will not be performed unless this card is posted on thy, - business day.**
Call the inspection request line before 11:59 p.m. to receive an inspection the following
OccUparc /v Twe
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections Date Inspector Comments
Initials
Pier --
Concrete Encased Ground (CEG)
Foundation / P.E. Letter —J
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground/Slab Inspections
Date Inspector Comments
Initials
Electrical
Comments
Sewer Service
Plumbing
Do Not Cover Underaround or Below/In-Slab Work Prior To Approval Of The Above Inspections
Rough Inspections
Date
Inspector
Initials
Comments
Wall Sheathing
Mid -Roof
Lath / Wall Tie
Rough Electric "
Rough Plumbing/Gas Line
Rough Mechanical
Rough Framing
Rough Grading
Insulation
Drywall Screw / Nail
Final Inspections
Date
Inspector
Initials
Comments
Landscaping & Parking / Planning Dept.
Inspections from these entities should be requested
one week in advance. For landscaping and parking
inspections call 303-235-2846. For ROW and drainage
inspections call 303-235-2861. For fire inspections
contact the Fire Protection District for your project.
ROW & Drainage / Public Works Dept.
Floodplain Inspection (if applicable)
Fire Inspection / Fire Protection Dist.
Final Electrical
Final Plumbing
Final Mechanical
Roof
Final Window/Doors
Final Building
NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate
of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy.
*For low voltage permits – Please be sure that rough inspections are compietea rrom the rire uistnct ano eiectricai iow voltage
by the Building Division.
**For Inspection Time Window – Please email insptimerequeSt@CI.wheatridge.CO.US by 8:00 A.M. the morning of the
inspection with the property address in the subject line of the email. Time window is based on th^ "-spector's route.
Occupancy V. Is Issued
itect T'
F
i CITY OF WHEAT RIDGE
_1�9�Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE,-,:
Inspection Type:
Job Address: g- C. 7r -
Permit Number: '� b / i 0 / :1 i
P r9 17 o
S'l A,TV S l61rk/,t �4
�w
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: _1 ' .� Inspector:
DO NOT REMOVE THIS NOTICE
a
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: V� i P
Job Address: � 2 -C P h b, rt e
Permit Number: i b / 7
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date:'`%_, 2 6 %" ? Inspector:
DO NOT REMOVE THIS N TILE
City of Wheat Ridge
s
Residential Roofing PERMIT - 201701375
PERMIT NO: 201701375 ISSUED: 06/01/2017
JOB ADDRESS: 3324 Zephyr CT EXPIRES: 06/01/2018
JOB DESCRIPTION: Reroof 31 squares and install OC DUration
*** CONTACTS ***
OWNER (303)232-2867 RUNDEN DIANE L
SUB (303)777-0333 Ron Tutton 021585 Homestreet Roofing Inc.
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 12,100.00
FEES
Total Valuation 0.00
Use Tax 254.10
Permit Fee 251.85
** TOTAL ** 505.95
*** COMMENTS ***
*** CONDITIONS ***
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) requires an approved inspection
prior to installation of ANY roof coverings and is require on the entire roof when spaced
or board sheathing with ANY gap exceeding k/2 -inch exists. Asphalt shingles are required to
be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is
required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturera€Tms installation
instructions, whichever is more stringent. In order to pass a final inspection of
elastomeric or similar type roof coverings, a letter of inspection and approval from the
manufacturer's technical representative stating that "the application of the roof at
(project address) has been applied in accordance with the installation instruction for
(roof material brand name) roof covering" is required to be on site at the time of final
inspection.
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION
City of Wheat Ridge
Residential Roofing PERMIT - 201701375
201701375 ISSUED: 06/01/2017
3324 Zephyr CT EXPIRES: 06/01/2018
Reroof 31 squares and install OC Duration
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 t e legal owner or have been authorized
by the legal owner of the pr m authorized to obtain this permit and perform the work described and approved in conjunction with
this permit. I further at at I am le ally authorized to include all entities named within this document as parties to the work to be
performed and that work to be e o is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER r (Circle one) Date
1. This permit was issue information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This. permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made -be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and_procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4, No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us
between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line.
City of
Wheat 1OiqMUNiTyg1e DEVELOPMENT
Building & Inspection Services Division
7500 W. 29th 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
1 FOR OFFICE USE ONLY
Date:
Add to Permit #
ac l �oBIE
Building Permit Revision/Amendment Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address: 2
Owner
Property Owner Email:
X2;2 `'ta.1 fjPhone:
Mailing Address: (if different than property address)
Address:�"�'�'
City, State, Zip:
Submitting Company:
Contact Person: Phone:
Contractor: ti `= '�A_ b—f . -C-
Contractors
GContractors City License #: I Y�-' �- Phone: `� 7— 5 3 3
Contractor E-mail Address: O N C 'K G -rt s w,
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:
3 `J
T
Sq. Ft./LF
Amps
Btu's
Squares
Gallons
Other
Additional Project Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above)
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 1 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 1 am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application.
CIRCLE ONE. (OWNER) or (AUT RESENTATIVE) of (OWNER) (CONTRACTOR)
/at/J,7
PRINT NAME: SIGNATURE: DATE: �
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS -
Reviewer:
PUBLIC WORKS COMMENTS-
Reviewer-
PROOF
OMMENTS-Reviewer
PROOF OF SUBMISSION FORMS
Fire Department ❑ Received
Water District ❑ Received
Sanitation District ❑ Received
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
❑ Not Required
❑ Not Required
❑ Not Required Building Division Valuation: $
IM I
Property Address
Property Owner (please print): >' ex �, Phone:
Mailing Address: (if different than property address)
Address:
ME=
EMU=
NMB=
(9 no
f" C
Gallons _ Amps _ Sq ft
6044A OWNER (AUTHORIZED REPRESENTATIVE) of (OWNER) (COATRACTOR)
Building Permit Application
(C omplete • a
s • *,'s
1_0 'x J. ;l. "J! • t: • 1 a*7lIA'la`l�7Ali�!'!)i7 11 1' 15
Fvellvffin
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : 14092
BUILDING INSPECTION LINE - 303-234-5933
Date 6/26/02
CITY OF WHEAT RIDGE :
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215 - (303-235-2855)
Property Owner: JERRY S. RUNDEN
Property Address : 3324 ZEPHYR CT Phone : 232-2867
Contractor License No. :
Company: Phone:
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Construction Value : $400.00
I hereby certiry that the setback distances proposed by this permit application are accurate, and P@ffilit FBe : $23.50
do not violate applicable ordinances, rules or regulations of the Ciry of Wheat Ridge or p~an Review Fee : $0.00
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 U58 TeX : $8.00
application, and that I assume full responsibility for compliance with the Wheat Ridge Building
Code (U.B.C.) and all other applicable eat Ridge ordinanc , or work under this permit. TOt81 : $31.50
(OWNER)(CONTRACTOR) SIGNED ~ DATE~
~ Use:
r2t/i= DKN' 1 ~
Description : ENLARGING EXISTING WINDOW TO CODE EGRESS WINDOW 9 SQ. FT. 24' X 32' BE
INSTALLED ~ r► rPr21
BUILDING DEPARTMENT USE ONLY
Approval :
Zoning :
Approval: BG
Approval :
Occupancy:
Electrical License No :
Company :
Expiration Date :
Approval :
6/26/02
Walls : Roof
Plumbing License No :
Company :
Expiration Date :
Approval:
Mechanical License No :
Company :
Expiration Date :
Approval :
(i) This permit was issuetl in accordance with the provisions set forth in yopur application antl is subject to the laws of the State of Coloratlo and to ihe Zoning
Regulations and Building Code of Wheat Ridge, Coloredo or any other applicable ordinances of the City.
(2) This permit shall expire if (A) [he work authorized is not commenced within sixty (60) days trom issue date or (B) the building authorized is suspended or
abandoned for a period of 720 days.
(3) If this permit expires, a new permit may be acquired tor a fee ot one-half the amount normally required, provided no changes have been or will be made in the
original plans and specifcations ana any suspension or abandonment has not exceeded one (1) yeac If changes are matle or if suspension or abantlonment
exceetls one (1) year, full Fees shall be paid (or a new permit.
(4) No work ot any manner shall be done that will change the natural flow of water causing a drainage problem.
(5) Contractor shall notify the Builtling Inspedor hventy-four (24) hours in advance for all inspections and shall receive written approval on inspection card bePore
proceediing with successive phases of the job.
(6) The issuance of a permit or the approval ot drawings and speciFlCations shall not be construetl to be a pertnit for, nor an approval of, any violation of the
provisi f the buildin codes or any other ortlinance, law, rule or regulation.
C6(Bui d;pec or
SIC : Sq. Ft. :
Stories : Residential Units :
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number
oF WHEqTy BUILDING INSPECTION LINE - 303-234-5933 Date:
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
~o~oRAO° WHEAT RIDGE, CO 80215 -(303-235-2855)
~~~UCATION
Property Owner: 'T(=- R-RI/ S. Rl3 ft& 363-
Properry Addtess: 3 3~.y Z E P}a Y R C O %J(C7- Phone
Contractor License No.: WµF~A`T- Z~OC\t C o. Ba633
Company: Q WA/~~ P
,/1/L Z) 6~~ Phone:
OWNER/CON'CRACTOR SIGNATURE OF UNDERSTANDING AND ACREEM ENT
I heroby certify that [he setback distances proposed by this pertnit application aze acwrate,
md do not violate applicable ordinances, mles or regulafions of the City of Wlieat Ridge or
covenants, easemen4 or rosRictions ofrocord; that all measuremen4 shown, md allegations
made are accurate; that I have read and agree to abide by all conditions prin[ed on this
application md that I azsume full msponsibiliry for compliance with the Whea[ Ridse
Bvilding Code (U.B.C) md aIl other applicable Wheat Ridge OCdinances, for work under
this pertnit
(OWNEA)(CONTRACTORJ:SIGNID AIEi
Construction Value:$ N15
Permit Fee:$
Plan Review Fee:$
Use 'l ax:$
1'Ot31:$
Description: ;Z-- MLJ~~,r<!p t►.J ~Xl' S r/ J/J w//t//~ dw `7z e o
W~N~
BUILDING DEPARTMENT USE ONLY
SIC:
ZONINO COMMENTS: ~
Approval: r r~\,
Zoning:
BUILDING COMMENTS: L c%fJ~
APProval:
PUBLIC WORKS COMMENTS: ~
Approval:
Occupancy: Walls: Roof: Stories: Reside ' x
Electrical License No: Plmnbing License No: Mechanicaf License No:
Company: Company: Company:
Expiration Date: Expirarion Date: Expiration Date:
Approval: Approval: Approval:
(1) Thic pecmit was issued iu accordence with tlie provisions set focth iu yoiv application and is mbject to Ne laws of the Staro of Colorado md to the Zoning
Regdafions md Hnild'wg Codes of Wlmat Ridgy COlorado or aay oiher appGcable Ordinavices ofNe City. (2) 'l7iis pelmit shall ezpire if (A) the work authonzed is ¢ot commenced wiNin sixry (60) days from issue date or (B) Ne building xuNorized is suspended or
abando¢ed for a puiod of 120 days.
(3) If tlils pe*mit ezpires, a uew permit may be acquired far a fee of one-half the amouvt no'mally required, proviAeA no changes have been or will 6e maAe in
the miginaf plavs md specificafions md any suspension or abandonmentbu not exceedeA one (1) year. ifchan¢es have be<n or if snspmsinn or ahanAnnmeni
exceeds one (1) yeaz, full fees shell be paid for a new pvmit.
(4) No work of any mama s6a11 be done tLat will change the nanval flow of water causing a drainage pmblem.
(5) ContractorshallnoefytheBuildingSnspectornveuty-fow(24)hoivsinadvanceforaliinspectionsandshallreceivewrittenapprovaloninsp<ctioncarAbefore
pcoceediug with successiw phases of the job. (6) 't7ie issuance of a pamit or the appmval of drawivgs md specificafions shall vot be covstrued ro be a permit for, nor en approvel of, nny violanon of the
provisions of the buildivg codes or any other ord'wance, Iaw, nile or regulatlon.
Cluef BuIlding sp tor
G
Directions
1. Draw a floor plan with dimensions, showing the layout of the entire basement. Label the use for all of the rooms.
2. Show electrical outlets, smoke detectors, lighting, fans, plumbing modifications, cleanouts, furnace, and water heater.
3. List window sizes and types, identify emergency escape and rescue windows, and egress window wells.
4. Identify modifications to the existing structure such as posts, beams and floor joists.
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This handout was developed by the Coloredo Chapter of the Intemational
Conference of Building Officials as a basic plan submittal under the
1997 Uniform Codes. It is not intended to cover all circumstances.
Check with your Building Department for additional requirements.
2
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Floa
Building Guide