HomeMy WebLinkAbout4750 Saulsbury Street1* � � i City of Wheat Ridge
�� E -Res. Sewer/Waterline Repair PERMIT - 202002058
PERMIT NO: 202002058 ISSUED: 10/12/2020
JOB ADDRESS: 4750 Saulsbury St EXPIRES:
JOB DESCRIPTION: Repairing 40 foot sewer line in basement of home.
*** CONTACTS ***
OWNER (6 l 7) 543-1743 GRIFFIN JULIE
SUB (503)593-5853 PATRICK PATEL 202243 ELITE ROOTER
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 61000.00
FEES
Total Valuation 0.00
Use Tax 126.00
Permit Fee 140.90
** TOTAL ** 266.90
*** COMMENTS ***
*** CONDITIONS ***
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the property and am authorized to obtain thispermit and perform the work described and approved in conjunction with
thispermrt. I further attest that I am leg ally authorized to include alI entities named within this document as parties to the work to be
performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180, days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and��procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all requ�ired
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any
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.
From: CommDev Permits
TO: Dina Kemp
Subject: Fw: Online Forth Submittal: Sewer or Water Line Repair Permit Application
Date: Sunday, December 13, 2020 5:54:09 PM
From: no-reply@ci.wheatridge.co.us <no -reply@ ci.wheatridge.co.us>
Sent: Monday, October 12, 2020 12:54 PM
To: CommDev Permits
Subject: Online Form Submittal: Sewer or Water Line Repair Permit Application
Sewer or Water Line Repair Permit Application
This application is exclusively for SEWER OR WATERLINE REPAIR -IN YARD
Your Permit will be emailed to the email address provided below once it is
processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
Right of Way permits must be applied for with the Public Works Department.
Is this application for Yes
sewer line or water line
repair - in yard only?
PROPERTY INFORMATION
Is this Residential or
Commercial?
Property Address
Residential
4750 Saulsbury Street
Property Owner Name Samuel Griffin
Property Owner Phone 617-543-1743
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email Field not completed.
Address
Attach City of Wheat Payment Form.odf
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business Elite Rooter
Name
Contractor's License
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
Number (enter WITH
dashes, eg 303-123-
4567)
202243
Contractor Email connor@eliterootermgt.com
Address
Retype Contractor
Email Address
DESCRIPTION OF WORK
connor@eliterootermgt.com
Is this a sewer line or sewer Line
water line repair?
Length of repair 40ft
Location of repair Basement of home
(backyard, frontyard,
etc)
Provide additional N/A
details including
installation of clean -
outs.
Project Value (contract 2200
value or cost of ALL
materials and labor)
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full Yes
responsibility for
compliance with
applicable City of
Wheat Ridge codes
and ordinances for
work under any permit
issued based on this
application.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal owner of the
property to submit this
application and to
perform the work
described above.
I attest that everything Yes
stated in this
application is true and
correct and that
falsifying information in
this application is an
act of fraud and may
be punishable by fine,
imprisonment, or both.
Person Applying for Connor Jimenez
Permit
Email not displaying correctly? View it in your browser.
41 CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:
A
Job Address: < I 0 0%.) 1
Permit Number:
IJ No one available for inspection: Time AM/PM
Re -Inspection required: Yes No
When corrections have been made, schedule for re -inspection online at:
http:lAvww.ci.wheatridge.co. uslinspection
Date:-,' -Inspector: la
DO NOT REMOVE THIS NOTICE
A i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: S CJ G
Job Address: /-/75-0 .Ser .S laut f
Permit Number: 2.O ZO C 'e- to S $'
y
❑ No one available for inspection: Time r- A M
Re -Inspection required: Yes 6
When corrections have been made, schedule for re -inspection online at:
http✓/www.ci. wheatridge.co.usdnspection
Date: /.O fl` G Inspector:
DO NOT REMOVE THIS NOTICE
s CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: `� ,L C,
Job Address: U
Permit Number:
❑ No one available for inspection: Time -'' AM/PM
Re -Inspection required: Yes Nod
T
*When corrections have been made, call for re -inspection at 303-234-5933
Dater �t Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
_1�9rBuilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address:
Permit Number: a �, C`U �,
v
❑ No one available for inspection: Time L; � -- AM/PM
Re -Inspection required: Yes NO;
When corrections have been made, call for re -inspection at 303 -234 -
Date: Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
_1�9rBuilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:`'' FI �-y
Job Address:
Permit Number: ( f
❑ No one available for inspection: Time- i `-- . IVI/PM
Re -Inspection required: Yeses
When corrections have been made, ca i f r re -i pec n- 303-234-5933
Date:-'`
Inspector/
DO NOT REIVOIVE THIS NOTICE
e_ 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: L--k�
Permit Number: \( : 0 0
,
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303 -234 -
Date: ` � ' I Inspector:
DO NOT REMOVE THIS NOTICE
M
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address:1-
Permit Number: r�C� l� 1 d o t C,
❑ No one available for inspection: Time AM/PM
Re -Inspection requiredLYes No
When corrections have been made, call for re -inspection at 303-234-5933
Date:____j 1 ` ; 1 `� Inspector:
DO NOT REMOVE THIS NOTICE
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:' lam,
Permit Number: ��-
f
❑ No one available for inspection: Tir AM/PM
,,//�4
Re -Inspection required: r'Yes k No
When corrections have been mae, for r ion at 303-234-5933
Date:"` I r�spec
DO NOT VE THIS NOTICE
i CITY OF WHEAT RIDGE
_1�9rBuilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: _(2 V
Job Address: r-) C� �c�
Permit Number:
e 1+ r5
❑ No one available for inspection: Time ���=. O AM/PM
f
Re -Inspection required: Yes �Vo
When corrections have been made, call for re -inspection at 303-234-5933
Date: 'V Inspector:
DO NOT REMOVE THIS NOTICE
CITY OF WHEAT RIDGE.. .
_:�9�Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
r --
Job Address: U jCs_Q r
Permit Number:
t 9`-'
❑ No one available for inspection: Time �v AM/PM
Re -Inspection required: Yes No
When corrections have been ma e, c I f�ceairaspection at 303-234-5933 '°�•, . .
Date: Insp` c N
DO NOT R OVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office o (303) 237-8929 Fax
INS.PECTION NOTICE
1 i 7 i
Inspection Type: c
Job Address:
Permit Number:
FA No one available for inspection: Time 2 AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-593
Date: ; Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 O{fice • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address: S u S
Permit Number: `aOl(?00 r-/!2
❑ No one availablefor inspeeVon: Time �� AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: /�/ Inspector: M7 W
DO NOT REMOVE THIS NOTICE
C
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address: O ��
Permit Number: a O V:- \Ci
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Yes �Vo
When corrections have been made, call for re -inspection at 303-234-5933
Date:-" \ - 1 0 - \ "I Inspector: �=
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Remodel PERMIT - 201900519
PERMIT NO: 201900519 ISSUED: 04/09/2019
JOB ADDRESS: 4750 Saulsbury St EXPIRES: 04/08/2020
JOB DESCRIPTION: SWO Narrowing bathroom by 15 square feet; relocating plumbing; Bedroom #2
will be divided into a master bedroom walk-in close and master bathroom;
234.55 sq ft total
*** CONTACTS ***
OWNER (617)543-1743 GRIFFIN SAMUEL
SUB (303)426-5576 WILL BOWEN 018974 WILL BOWEN INC.
GC (801)810-9372 TREVOR MADDUX 190066 CRANSTEN, INC.
SUB (303)931-2405 BRIAN POUNDERS 190084 POUNDERS ELECTRIC INC
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 45,000.00
FEES
Total Valuation 0.00
Plan Review Fee 436.83
Use Tax 945.00
Permit Fee 672.05
Investigative Fees 672.05
** TOTAL ** 2,725.93
*** 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 - 201900519
PERMIT NO: 201900519 ISSUED: 04/09/2019
JOB ADDRESS: 4750 Saulsbury St EXPIRES: 04/08/2020
JOB DESCRIPTION: SWO Narrowing bathroom by 15 square feet; relocating plumbing; Bedroom 42
will be divided into a master bedroom walk-in close and master bathroom;
234.55 sq ft total
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications2
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 rmrt. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be
pe rmed and that all work to be performed is disclosed in this documen d/or its' accompanying approved plans and specifications.
ignore oK O"ER c r CONTRACTOR (Circle one) % Date
This permit was•-issu4based on the information provided in tl7e permit application and accompanying pplans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
-7(,i
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 tee.
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 grantiof a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
appli^e code or anyrdinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of ChiSf Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
[� W heat �ge
COMMUNITY DEVELOPMENT
Building & Inspection Services R E C I V Fa
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits aa)ci.wheatridge.co.us
n/
FOR OFFICE USE ONLY
Date: 1-4
/" „/ / I
Plan/Permit #
r
Plan Review F
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address: 4-750 SAI,4,L.Si3t0_1/ 5T
Property Owner (please print): 5AM(AEL CztztFFtN Phone: (aL-7^ 5y3- I7y3
Property Owner Email: SAM7C,RtFFn489 (0 GiMAtt.. C-atJ
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address:
City, State, Zip:
Architect/Engineer: �At-LIE VE(TA (32-5 OESIGOJ G,R.ok-p)
Arch itect/Eng1neer E-mail: 1rJP0(-Z 526pESl'"Glt,eue - co" Phone: 3o 3 — 3 so - 9 155
Contractor Name: 0-&A-JSTEIJ (-(A-Nb'/kk',J 44 TLF)"ObFt IM 617
City of Wheat Ridge License #:
1900(.
Phone: (900� 716 -- (o o I S
Contractor E-mail Address: HELLO (�_2 Cita-►STEM. (00.1
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): MEPhone: (600 857' 155
CONTACT EMAIL(p/ease print): TMELSb�J OP CX*-r-JST�A! . C0-1
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: ?buNDe'Rs EEC_-fR-tcA(_ Plumbing: wtu- So -em x1�4c.. 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.
OintC41r.1kL 3A'1149 -aa WIL.- BE ►.lRR-2awED Zy AfPR0xaarcA-rCLy IS sa.FT."
tLEl.ochTtrb To SAIFTIM(n of tVPrLLS. SED, Z BE DIVIOC'b WTO
A "ArS'f t-),- 13t-DXov- t k/A LK -10•[ CLOSET NtJ q FA ft%S'f t'% 13A-Tt-ht0 V M .
Sq. Ft/LF 234'5 sQ f—r 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)
q5t vo o . 00
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) ONTRACTOR) or rUTHO/JRIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last name): C" Lr.. �t �1— / DATE: 3 Z 5' 19
Printed Name: —F"Y �Et,.Sati(
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION: Z '
CONSTRUCTION TYPE:
Building Division Valuation: `l `' r t ( C
city of
Wh6atpjdg e
COMMUNITY DEVELOPMENT
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: 4-I50 SMALS19k¢4 ST.
Permit
General Contractor: CK -A NsS-rEw) j4Ft►a6y Kp,W � 940' QEk L
Electrical Sub -Contractor
Company Name: ?O"tyOC' GLE'(.-rptc
Phone #:
State License #: EC' 000 (AG -7 Master #: "6'06C)1131
Whew idge License #: (required field)
S' nature of Authorized Agent Date
Plumbing Sub -Contractor
Company Name: WILL, Bou-;eN lw- . Phone #: 3 a,3 " q q q - q qq3
State License #: PG. Opo 116o ( Master #: MP . 00172514
Wheat Ridge License #: (required field)
�as
Signature of Authorized Agent Date
Mechanical Contractor
Company Name:
Phone:
Wheat Ridge License #: (required field)
Signature of Authorized Agent
Date
Enw = ec
j _ f� . ,
C`1VED
780 Simms Street, Suite 101
Golden, Colorado 80401
www.enviro-spec.com
Per
Limited Asbestos Bulk Sampling Report
Sam and Julie Griffin
4750 Saulsbury Street
Wheat Ridge, Colorado 80033
Prepared for:
Sam and Julie Griffin
4750 Saulsbury Street
Wheat Ridge, Colorado 80033
Page 1 of 9
En�/i� ecNJ
Table of Contents
Appendices
Appendix A Summary of Samples and Results
Appendix B Laboratory Results and Chain of Custody
Appendix C Certifications
Appendix D Photos
Page 2 of 9
En er
Executive Summary
EnviroSpec, LLC (EVS) Mr. Michael Ciccotti, and Mr. Luke Bochmann,
conducted a limited, area and material specific, asbestos inspection within the
structure located at 4750 Saulsbury Street in Wheat Ridge, Colorado.
y This inspection was conducted due to renovations in progress causing damage
to suspect asbestos containing materials (ACM).
➢ Eleven bulk samples were collected and submitted for analyses on a 24-hour
turnaround.
Samples were collected of gypsum lath and plasters.
Through laboratory analysis of bulk samples, EVS confirmed there was no
asbestos detected and no further action is necessary.
Page 3 of 9
-,
EnSL'�-jL/ir = ec
Introduction
EVS's Mr. Michael Ciccotti, and Mr. Luke Bochmann, conducted a limited, area and
material specific, asbestos inspection within the structure located at 4750 Saulsbury
Street in Wheat Ridge, Colorado.
The inspection was conducted due to renovations in progress causing damage to
suspect ACM. Materials impacted were limited to specific areas specified by the client
and did not include suspect materials in which the client stated would not be disturbed
during renovation activities. The Environmental Protection Agency (EPA) and Colorado
Department of Public Health and Environment (CDPHE) Colorado Regulation No. 8
(Reg. 8) requires that suspect ACM be properly sampled and analyzed prior to any
renovation activities that may disturb these materials. The purpose of this inspection
was to identify and sample specific suspect ACM that could be impacted by renovation
activities in these specific areas as requested by the client.
This asbestos inspection was conducted on March 20, 2019 by Colorado State Certified
Asbestos Building Inspectors Mr. Michael Ciccotti, Certificate #15072, and Mr. Luke
Bochmann, Certificate #25131.
Page 4 of 9
En ec
Asbestos Inspection
This limited asbestos inspection was conducted in general accordance with the United
States EPA procedures published in 40 Code of Federal Regulations (CFR) Part 763,
Subpart E — Asbestos -containing Materials in Schools and Colorado Reg. 8. These
inspection protocols specify requirements for the inspector (Section 763.85), laboratory
(Section 763.87), and number of samples collected during an inspection (Section
763.86).
This limited area and material specific asbestos inspection involved identification and
sampling of specific homogenous areas of suspect ACM in the specific areas that could
be impacted by renovation activities as requested by the client. Suspect ACM includes
nearly all building materials except concrete, glass, metal, wood, plastic and ceramic.
A physical assessment of each homogeneous area of suspect ACM was conducted to
assess the general condition of the material and determine the friability of the material.
Under the National Emissions Standards for Hazardous Air Pollutants (NESHAP),
asbestos -containing building materials are classified as either friable, Category I non -
friable or Category II non -friable ACM as described below:
r Non -friable ACM when dry, cannot be crumbled, pulverized or reduced to
powder by hand pressure.
Friable ACM when dry, can be crumbled, pulverized or reduced to powder by
hand pressure.
Category I non -friable ACM includes packings, gaskets, resilient floor
coverings, and asphalt roofing products containing more than 1 % asbestos.
Category II non -friable ACM are materials excluding Category I non -friable
ACM materials that contain more than 1 % asbestos.
Bulk samples of suspect ACM were collected in general accordance with the Asbestos
Hazard Emergency Response Act (AHERA) protocols as outlined in Colorado Reg. 8
and Asbestos in Buildings: Simplified Sampling for Friable Surfacing Materials as
referenced in the Pink Book. Random samples of suspect building materials were
collected for the specific areas and materials identified in this report.
Page 5 of 9
i
En i�pec
rM
Surfacing materials sampled in this report include, but are not limited to overspray, and
droppings, which may be under flooring materials, adjacent walls, structural beams, and
other concealed areas.
Title 40 CFR Part 61 regulates asbestos fiber emissions and asbestos waste disposal
practices and requires the identification and classification of existing building materials
prior to demolition or renovation activity.
Page 6 of 9
En ec
Suspect Asbestos Containing Materials
Building materials are historically known to contain asbestos and therefore suspected to
contain asbestos. OSHA maintains comprehensive lists of suspect ACMs frequently
encountered during inspections.
The following suspect ACMs were observed during the inspection and determined
based on review of renovation activities within the structure, to be potentially impacted
and subject to inspection and bulk sampling:
• (DW01)'/z" Gypsum lath associate with PL01, PL02, PL03 on walls and
ceilings in bedroom, bathroom, and hallway
• (PL01) Plaster with smooth finish, grey granular base coat, and white top
coat, on gypsum lath associated with DW01 on ceiling in hallway, and old
ceiling in bathroom
• (PL02) Plaster with grey granular base coat, and brushed applied top coat
on gypsum lath associated with DW01 on walls in bedroom, and
bathrooms
• (PL03) Plaster with grey granular base coat, and white swirl pattern top
coat, associated with DW01 on ceilings in bedrooms and master bathroom
Eleven samples were submitted under chain of custody procedures to Aerobiology
Laboratory Associates, Inc., of Golden, Colorado, for analysis by Polarized Light
Microscopy (PLM) with dispersion staining techniques per EPA methodology (40 CFR
763, Subpart F). Microscopic visual estimation was used in obtaining the percentage of
asbestos in bulk samples. Aerobiology is an accredited laboratory under the National
Voluntary Laboratory Accreditation Program (NVLAP 200860-0).
Page 7 of 9
EnM
I I fir9spec
Asbestos Containing Materials
No ACM was identified in the samples collected.
Recommendations
EVS's Mr. Michael Ciccotti, and Mr. Luke Bochmann, conducted a limited, area and
material specific, asbestos inspection within the structure located at 4750 Saulsbury
Street in Wheat Ridge, Colorado.
Through laboratory analysis of bulk samples, EVS confirmed there was no asbestos
detected and no further action is necessary.
Page 8 of 9
En pec
General Comments
EVS assumes no liability for any loss, injury, claim, or damages arising directly or
indirectly from any use or reliance on this inspection report or the opinions expressed
herein. EVS makes no risk assessment, warranty, guarantee or insurance policies of
any kind, express or implied. This report is limited only to the area(s) inspected. There
are no risk assessments, warranties, guarantees, or insurance available or provided by
EVS. Additional sampling may be needed to further identify other materials affected by
renovation in the future.
This report was prepared pursuant to the contract EVS has with the client, including an
exchange of information about the subject property that was unique and between EVS
and its client. No guarantees are made arising from any service rendered and liabilities
hereunder shall not exceed the total fee paid by the client to EVS. This report does not
serve as a scope of work or bidding document.
EVS greatly appreciates the opportunity to be your environmental consulting company.
Please feel free to call with any questions, comments, or concerns regarding this report.
Regards,
kms -
Luke Bochmann, Environmental Technician Luke(a�enviro-spec.com
Cell: 720.261.6228
Michael Ciccotti, Senior Environmental Scientist; Michael@enviro-spec.com
Cell: 303.880.5716
Serina Schenker, Managing Partneri Seri na(a-)enviro-spec.com
Cell: 303.242.0711
EnviroSpec, LLC
780 Simms Street, Suite 101
Golden, Colorado 80401
Page 9 of 9
�'W
En�/irec
Appendix A
Summary of Samples and Results
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—St1k AssOCWES, INCORPOROM
Expertise Since 1997
Lab use:
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AZ CA CO. GA, VA. NJ AZ. CA. W. VA
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Aerobiology
Client
I Envi roS pec, LLC
Field Contact
Luke Bochmann
ollocted BylDete: flirt wished BylDate:
o,bwa_ gwiann
Reporting
Relinquished By/Date. Received BOU to + /
{ !
Billing
Address
780 Simms Street, Suite 101
Sampler
T
Andersen Sap, l re
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Phone/Fax
720-261-6228
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roject Name:
' 750
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SAMPUNG LOCATION ZJP CODE
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Test Code
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SWAB - E. coli/total coliforms
SWAB - Sewage Screen JE, coli/Entem/fecal coliforms
WATER - Heterois Plate Count
- Pointcount
- PLM Analysis
ZMMS - Particle characterization
ASBESTOS - PCM Analysis
VI Q- -- -rte 03b (1Wi Phoenix, AZ Cherry Hill, NJ Los Angeles, CA
( i + (602) 441-3700 (856) 486-1177 (714) 895-8401
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Appendix C
Certifications
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COMIS 15P
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4730 Saulsbury %'I---
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heat Ridge
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AT THE NEAREST CI
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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: < VV 0
Job Address: '4—t c,_(.) S�v <J
Permit Number:
,.i
❑ No one available for inspection: Time I`f ` ` AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: �Inspector:
DO NOT REMOVE THIS NOTICE
q 7 .� ( IS i --k 11'/ S4-,
INSPECTION
RECORD
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection
INSPECTION REQUEST LINE: (303) 234-5933
Cancellations must be submitted via the online form before 8 a.m. the day of the inspection
Occupancy/Type
Inspections will not be performed unless this card is posted on the project site.
**Request an inspection before 11:59 p.m. (midnight) to receive an inspection the following business day.**
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections Date Inspector Comments
Initials
Pier
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Do Not Pour Concrete Prior To Approval Of The Above Insnections
Underground/Slab Inspections Date Inspector Comments
Initials
Electrical
Sewer Service
Plumbing
Do Not Cover Underground or Below/In-Slab Work Prior To ADDroval Of The Above Insner_tinns
Rough Inspections
Date Inspector
Initials
Comments
WkO Sheathing
Mid -Root
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 completed from the Fire District and electrical low voltage
by the Building Division.
Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued
Protect This Card From The Weather
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: 8i L/ r-
Job Address:
Permit Number:
❑ No one available for inspection: Time- AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: a /pq
Inspector: `ii / /7
DO NOT REMOVE THIS NOTICE
I i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NO
Inspection Type: ( I
Job Address: _
Permit Number: < Cf 7U T 7 el
❑ No one available for inspection: Time AM/P„ C9I
Re -inspection required: Yes
When corrections have been made, call for re -inspection at 303-234-5933
Date:
Inspector:
DO NOT REMOVE THIS NOTICE t
City of Wheat Ridge
® Residential Roofing PERMIT - 201705781
PERMIT NO: 201705781 ISSUED: 08/09/2017
JOB ADDRESS: 4750 Saulsbury ST EXPIRES: 08/09/2018
JOB DESCRIPTION: Residential Re -roof to install Owens Corning asphalt shingles with ROOF
DECKING - 27.65 sq (24.54 sq pitched / 3.11 sq flat)
*** CONTACTS ***
OWNER (617)543-1743 GRIFFIN SAM AND JULIE
SUB (303)524-5926 Keith Jacob 120259 Integrous Roofing & Restor.
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 11,652.23
FEES
Total Valuation 0.00
Use Tax 244.70
Permit Fee 236.00 r`
** TOTAL ** 480.70 --_
*** 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) is required on the entire roof
when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and
mid -roofs may be called in at the same time, one hundred percent of the sheathing must be
complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required
to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield
is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturer installation instructions,
whichever is more stringent. In order to pass a final inspection of elastomeric or similar
type roof coverings, a letter of inspection and approval from the manufacturer technical
representative stating that "the application of the roof at (project address) has been
applied in accordance with the installation instruction for (roof material brand name)
roof covering" is required to be on site at the time of final inspection.
Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd
party inspection report will be collected at final roof inspection performed by City of
Wheat Ridge. If report is not available the final inspection will not be completed.
A s City of Wheat Ridge
Residential Roofing PERMIT - 201705781
PERMIT N0: 201705781 ISSUED:
JOB ADDRESS: 4750 Saulsbury ST EXPIRES:
JOB DESCRIPTION: Residential Re -roof to install Owens Corning asphalt
DECKING - 27.65 sq (24.54 sq pitched / 3.11 sq flat)
08/09/2017
08/09/2018
shingles with ROOF
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 attest that I am le ahorized to include alI entities named within this document as parties to the work to be
perfpid-and thaall work to be p 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 accomranying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regula ions, po icies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applica lie code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official v Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Dan Schultz `070 7N
From: no-reply@ci.wheatridge.co.us
Sent: Sunday, August 6, 2017 3:06 PM
To: CommDev Permits
Subject: Online Form Submittal: Residential Roofing Permit Application
Categories: Dane
Residential Roofing Permit Application
This application is exclusively for new permits for residential roofs and for licensed
contractors only. This type of permit is ONLY being processed online --do not come
to City Hall to submit an application in person. Permits are processed and issued in
the order they are received and due to the volume of requests, time to process
varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR
PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE
AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if
your contractor's license or insurance has expired, and you may update those
documents at the time you are issued your permit.
For all other requests:
Homeowners wishing to obtain a roofing permit must apply for the permit in person
at City Hall. Revisions to existing permits (for example, to add redecking) must be
completed in person at City Hall. All other non -roofing permits must be completed in
person at City Hall. The Building Division will be open from 7:30-10:30 a.m.,
Monday through Friday to process these types of requests.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
REROOFING UNTIL PERMIT HAS BEEN ISSUED.
Is this application for a Yes
residential roof?
How many dwelling units Single Family Home
are on the property?
PROPERTY INFORMATION
Property Address 4750 Saulsbury st Wheat Ridge, CO 80033
Property Owner Name Sam and Julie Griffin
Property Owner Phone (617) 543-1743
Number
Property Owner Email josh.white@integrousinc.com
Address
Do you have a signed
Yes
contract to reroof this
property?
24.54
It will need to be
provided at the time of
Yes
permit pick-up.
Attached Copy of
Client -Griffin Sam and Julie - Signed Contract.pdf
Contract
3.11
CONTRACTOR INFORMATION
Contractor Business
Integrous Roofing
Name
(pitched + flat) of all
Contractor's License
120259
Number (for the City of
� `—
Wheat Ridge)
Contractor Phone
7202788087
Number
Contractor Email Address
josh.white@integrousinc.com
Retype Contractor Email
josh.white@integrousinc.com
Address
DESCRIPTION OF WORK
Are you re -decking the
Yes
roof?
Description of Roofing Owens Corning - TruDefintion Duration STORM
Material
Select Type of Material: Asphalt
If "Other" is selected
Field not completed.
above, describe here:
How many squares of the
24.54
material selected above?
Does any portion of the
Yes
property include a flat
roof?
If yes, how many squares
3.11
on the flat roof?
TOTAL SQUARES
27.65
(pitched + flat) of all
0
roofing material for this
project
Provide additional detail
here on the description of
work. (Is this for a house
or garage? What is the
roof pitch? Etc) -
11,652.23
tear off and reroof W/Owens Corning - TruDefintion Duration
STORM 4/12 pitch
Project Value (contract
value or cost of ALL
materials and labor)
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full Yes
responsibility for
compliance with
applicable City of Wheat
Ridge codes and
ordinances for work
under any permit
issued based on this
application.
I understand that this Yes
application is NOT a
permit. I understand I will
be contacted by the City
to pay for and pick up the
permit for this property.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have been Yes
authorized by the legal
owner of the property to
submit this application
and to perform the work
described above.
Name of Applicant Joshua White
Email not displaying correctly? View it in your browser.
3
9249 S. Broadway #200-386
Highlands Ranch, CO 80129 BBB
www.integrousinc.com
Sam and Julie Griffin David White
4750 Saulsbury st (617) 543-1743
Wheat Ridge, CO 80033
• See Insurance Terms & Conditions (Pg. 2)
First check is collected upon completion of roof*
• Remaining check(s) collected upon receipt
Licensed & Insured
.� Permit Furnished by Integrous Inc.
Multi -Point Quality Inspection
Transferrable Craftsmanship Warranty
Remove All Layers of Existing Roofing Material
Prep Surface & Ensure Decking is Sound & Smooth
Replace All Step Flashing
.. Replace Other Flashing As Needed (Eg. Chimneys,
Skylights)
.. Install Ice & Water Shield in Vulnerable Areas
.- 6 Nails Per Shingle to Meet Highest Wind Rating
Replace Pipe Flashings
Replace Roof/Attic Vents
Paint Flashing & Vents to Match Shingle Color
r Remove & Haul Roof/Gutter Debris
.. Roll Yard With Magnetic Roller to Ensure Safety
We Provide Certificate of Liability On Request
We Provide Conditional Waiver of Lien On All Our
Invoices
PREFERRED
CONTRACTOR
(720) 519-9643 david.white@integrousinc.com
$28,085.32
Owens Corning - TruDefintion Duration STORM
- UL 2218 Class 4 Impact Resistant - Estate
Grey
Laminated - High Grd - Dimensional Impact Resist
Shingle
RhinoRoof -Synthetic Felt -
UDL
install per code
Instal/
install per code
Instal/ per code
Gaivalume - Match Current
Galvalume - Match Current
None
Airvent - Shingle Vent II - 12"
None
15 Year
i
r
7/18/17
r
All work to be completed Per Ins Scope and Code. Scope of Work includes Roofing, Gutters, Painting, glass block repa
Window Screens and AC repair. Customer responsible for deductible and any upgrades. Accepted Upgrades - Upgrad
to Class 4 Impact Resistant Shingles - Free. Upgrade to ridge vent - Free. Upgrade to Synthetic felt - Free.
7/18/17
on
FOR OFFICE USE ONLY
�Wh
City offji d
Date* l&at][I�
at L?i trenre` rte,gg
...
Building & inspection Services Division
7500 W. 2e ,Ave., Wheat Ridge, CO 80033 'tan Review
Office: 303-235-2355 * Fax: 303-237-8929
Inspection Line: 303-234.5933
Building er it Application
Please complete ,all highlighted areae on both sides of Ws form Incomplete Applications may not bO PrOCIMsed.
Property Address:
Prooettv Owner ( glee a Drint): � ��� � �� Phc�
Property Owner mail
sllin dress: (if different than property address)
Address-
ddress.Cit
, tet , i
City,
Archit tt innerE-mail:
Phone:
Contractor.
Contractors City License,M..
Phone. �.
Contractor E-mail Acldr;�ss�
� t
Sub Contractors.*
Electrical:
plumbing:
Mechanical:
W.R. City License #
WWR. City License #
W.R. City License #
Other City Licensed Sub:
Other City Licensed Sub:
City License #
City License #
Complete all information ort BOTH sides of this for
NEW COMMERCIAL
twA STRUCTURE
RMM i y SERVICE UPGRADE
NEW RESIDENTIAL STRUCTURE COMMERCIAL ROOFING
COMMERCIAL ADDITION RESIDENTIAL ROOFING
RESDENTIAL ADDITION f-1WINDOW REPLACEMENT
CO
A lIY
.::..y..A ACCESSORY STRUCTURE
MUs (Garage, shed, deck,
. •..
RESIDENTIAL
RY STRUCTURE (Garage, shed, deck, etc.)
MECHANICAL
A :RSYSTEM/APPLIANCE
, ••:A REPAIR
M Y A.M REPLACEMENT
k r A
M/ SYSTEM/APPLIANCE
srAA r4 P• A o REPLACMENT
ELECTRICAL
A A M•.A REPAIR
A il1 A• REPLACEMENT ■ A
"WF,g ». M ".
rpt of materials to be usid, etc.}
. FULF Btu's Gallon
Amps Squares Other