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6610 W. 31st Avenue
i CITY OF WHEAT RIDGE � Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Otfice • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Ll /S Lf;Z:2< `P1 cJ . Job Address: L (© ✓ �= Permit Number: -9,y ! ❑ No one available for inspection: TimeOc35Z��PM Re -Inspection required: Yes` o When corrections have been made, call for re -inspection at 303-234-5933 Date:>' Inspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge Commercial Demolition PERMIT - 201900915 PERMIT NO: 201900915 ISSUED: 05/07/2019 JOB ADDRESS: 6610 W 31st Ave EXPIRES: 05/06/2020 JOB DESCRIPTION: Complete demolition of concrete slab of foundation of former church - 1,144 sq ft total *** CONTACTS *** OWNER (720)234-9375 6610 31ST AVE LLC SUB (303)427-1201 RALPH MENDOZA 022230 MENDOZA DEMOLITION SERVICES *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,800.00 FEES Total Valuation 0.00 Demolition Fee 50.00 ** TOTAL ** 50.00 *** COMMENTS *** *** CONDITIONS *** All work shall comply 2012 International Codes, 2017 NEC (if applicable), and ordinances adopted by the City of Wheat Ridge. Work is subject to field inspections. 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 er attest that I am legally authorized to include all entities named within this document as parties to the work to be per d t tall work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signa(ure"o-f OWNER or CONTRACTOR (Circle one) Date [ t 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 originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PH ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of W heat Midge COMMUNITY 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 FOR OFFICE USE ONLY Date: S1211 q Plan/Permit # �rlqvicj 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: r- Co IC) vim. �;1-� AU' Property Owner (please print): (,2(01 ( 20 f '5� k e__ Lt C_ Phone:_42C) 2 --'SH (3q Property Owner Email: be i CLro ch an -- Con &4-f uf.4 ►ori . c()M Tenant Name (Commercial Projects Only) t'J / r4 Property Owner Mailing Address: (if different than property address) Address: ; ? C) -6(Dy- C;(-�- l City, State, Zip: I A � ' .. i Arch itectlEng ineer E-mail: Phone: Contractor Name: �_AfY 6DZ City of Wheat Ridge License #: 02-2:2- S C'-) Phone:_ Wit 4,D --J 1 <�-C L Contractor E-mail Address:52 )�- -SCA'V IC� � a .Yy--� 4,tt l • Cbirr � For Plan Review Questions & Comments (please print): CONTACT NAME (please print):l Phone:��j CONTACT EMAIL(p/ease print): m Z igSev-yi cfs ,€1yy),sn i✓<t)vy) Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. /COMMERCIAL ❑ RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. �:v -ems - k 14L� S 0� . It-- -� . Sq. FULF I 1 LJ L4 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) 00 C) CD 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 I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. 1, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CONTRAC ) or (AUTHORIZED REPRESENTATIVE) (OWNER) (CONTRACTOR) Signature (first and last name): DATE: Printed Name: GV) C" f -A L3 ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: May, 1,2019 11:06AM Coloradel,arfrlen'i of 'rea1f' R� 04.0 DEMOLITION NOTIFICATION APPLICATION FORM U**1876*t 'l. 3 VIA APPLICATION FEE MUST ACCOMPANY THIS FORM INCOMPLETE APPLICATIONS WILL BE RETURNED Colorado De arrmgnV (Notice will be mailed to the demolition contractor unless specified otherwise) ofPublic)�ealth';', and )Environment Fee: $50 + $5 per 1000 ft2 of area to be demolished (See Instruction H1 on revere aduel G225 F, 1 Submit form to: Permit Coordinator Colorado Dept. of Public Health and Environment APCD-IE-B 1 4300 Cherry Creek Drive South Denver, CO 80246-163D f Phone: 303.692-3100 1i rax 303-782-0278 AEbeefa e@ state. oo. us Regulated asbeatos-containing materials means (e) friable asbestos-conla:n1nsf1213t_gria1, (b) CleS�Y I n nl`ria�l t '.:;as become frlab , (c) (, leoory I nonfrlable ACM that will boor hes been sublactee. to ennd8ng,e 'fir �, W r k ^yrs „r :I � ",Ct�1 thol `.; s a r d.;7 probability of becoming or has become crumbled, pulverized, or reduced to powd€r by the forces expected to act on the material In the course of demolition or renovation operations regulated by this regulation. Note: Asbestos -root n 1 and linoleum must be property 4 `i'P,►''4',Y P P tY abaled/removed prior to demolition, ' � r�,-moi ��,� i': � � )) �, It , �+,. �, Company me: Name: WenoBuifding I e. Square foolege of footprint of facility. or.ppr4r rl t' facillly to be damcl shed Street: J' _ ilas- Z G : � S to: Code: ` u z. siroeC a 116610 W. 311 Ave. C o Min F M. Clfy: Co"j—, - 714 Cor_"r' + � �- '"tat O Prof ger, P ne 4 I Propose -St II. a!r . 'rop_osed {((����t�(�(ompI on Date 1- -_9 1- lC(A 0 -. . -' - :� I cerlNy Oat the Certified Asbestos Building Inspector has fnfomted me E ! Meths !Meat ? of Demolition: alning asbestos-conialning malenais In trt.31`2Aity fa ba i W7 demolish Ptt Name: :/rocking 0 Running' 0 imploa!on ❑ Moving ❑ Other, apeclfy: SIDnat� Receiving guild Debris / ' ' Burnlaq reoulm s deditlonai alltnOdZador, Ploasa call (3D3) 6;32-3100 and ask to speak to the D� . Bu_ming Permit Cc d'nslc; . s � PJ3 batement ConVactor GAC (GAC) /�c�f h/��c2;,4frr kechclf Dw,:sYsNeme: p Rockies Environmental & Demo Services !_ 6610 31 gr LLC _ ebealoa Permit 0 Total Quan a[Agbeat'oa Removed Street: v 58(0 7 •fJ PO Bo�, 2171 t oval Comoteted Telephone ri oris IY October ID 2017 720 515-08_91 _ %'7e* Ridge � co � 80214 I Ty e(s or bas s Conlatnl Material Remove,,. t-' 361)Lac:'s Narr;e: Telephone 0 Brendan Gustafson f?23) 234-9375 With my signature below, Lkertify that a (itSSass cwiE it accreditation and state of Colorado certification as �- an Asbestos Building Inspector. I also certify that I h�, ve f"'?croughly inspeP'ed the facility ',� 1--c-'demolished, as Ilsted r.a In the Demolition Site block above, sampled all suspe ;t rterials, had aii samples analyzed for trie presert(.t of CIL asbestos by a NVLAP-accredited ist ._.;cry, and hay do:.._ , ; a�. t� I . - W anywhe — C facility.* I also certify that I have informed the owner/, jpe A)r of die teciiiry or the demolition contractor that any ,.o asbestos -containing material allowed tri, €tay in the as Jlib rrUnt renla-r, of ACM remaining, below, (check ap',propriate bOXL 1A LlVinyl asbestos floor tile (VAT ❑ V�,i mastic C 86--13;,haft im IG , roofing J-.giial is pipe coal;ngs [1 Spray -applied tar coatin Ciaz r._; ,t r t, �4,, Slgnatum (In Blue Ink) Dale) f Final nspecdon C n Exc�9 anon ` Ie Tei phone p Cei; pt;ane # _ vell 6 �� C� 2LI verify that all refrigerants from air condhlohingh,eMoeration app"I� cas a a keen prop ; :e-�veree in ac or •:: actio; AQCC tae elation ?fo. 15 (for Information on CFC requirements "�`i 032—"100), "100) ' furtherr'y is c^! i,mfious ilgrs (con ta(nlny r ;, ncl3rlal; hwaa b c disposed o1 In accordance with 6 CCR 1007 1 su ipart 3.6.4.3 (for )fon ;at'!on on lumino;is exit sin requlrerne^; II 303-692-3320). c L- m M CHECK THE APPROPRIATE 60X: — r- J3 M 3 0 Building Owner ❑ Contraetcr y j L❑ Other Dafe: �I y ly Slgnalura Brendan Gnsrafson THis BOX Is FOR CDPHE 9EUFJL : Postmark or Hand Delivery Date: 0 �(( Approved By: ���� Code: ❑ tlni6al-310 ❑ tranafer-380 Form of Payment & N:1$"G`( �(pp Permit #: Recon+ � Date 18cue a: ' Regulated asbeatos-containing materials means (e) friable asbestos-conla:n1nsf1213t_gria1, (b) CleS�Y I n nl`ria�l t '.:;as become frlab , (c) (, leoory I nonfrlable ACM that will boor hes been sublactee. to ennd8ng,e 'fir �, W r k ^yrs „r :I � ",Ct�1 thol `.; s a r d.;7 probability of becoming or has become crumbled, pulverized, or reduced to powd€r by the forces expected to act on the material In the course of demolition or renovation operations regulated by this regulation. Note: Asbestos -root n 1 and linoleum must be property 4 `i'P,►''4',Y P P tY abaled/removed prior to demolition, ' � r�,-moi ��,� i': � � )) �, It , �+,. �, City of Wheat Ridge Commercial Demolition PERMIT - 201900915 PERMIT NO: 201900915 ISSUED: 05/07/2019 JOB ADDRESS: 6610 W 31st Ave EXPIRES: 05/06/2020 JOB DESCRIPTION: Complete demolition of concrete slab of foundation of former church - 1,144 sq ft total *** CONTACTS *** OWNER (720)234-9375 6610 31ST AVE LLC SUB (303)427-1201 RALPH MENDOZA 022230 MENDOZA DEMOLITION SERVICES *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,800.00 FEES Total Valuation 0.00 Demolition Fee 50.00 ** TOTAL ** 50.00 *** COMMENTS *** *** CONDITIONS *** All work shall comply 2012 International Codes, 2017 NEC (if applicable), and ordinances adopted by the City of Wheat Ridge. Work is subject to field inspections. 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 er attest that I am legally authorized to include all entities named within this document as parties to the work to be per d t tall work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signa(ure"o-f OWNER or CONTRACTOR (Circle one) Date [ t 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 originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PH ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of W heat Midge COMMUNITY 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 FOR OFFICE USE ONLY Date: S1211 q Plan/Permit # �rlqvicj 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: r- Co IC) vim. �;1-� AU' Property Owner (please print): (,2(01 ( 20 f '5� k e__ Lt C_ Phone:_42C) 2 --'SH (3q Property Owner Email: be i CLro ch an -- Con &4-f uf.4 ►ori . c()M Tenant Name (Commercial Projects Only) t'J / r4 Property Owner Mailing Address: (if different than property address) Address: ; ? C) -6(Dy- C;(-�- l City, State, Zip: I A � ' .. i Arch itectlEng ineer E-mail: Phone: Contractor Name: �_AfY 6DZ City of Wheat Ridge License #: 02-2:2- S C'-) Phone:_ Wit 4,D --J 1 <�-C L Contractor E-mail Address:52 )�- -SCA'V IC� � a .Yy--� 4,tt l • Cbirr � For Plan Review Questions & Comments (please print): CONTACT NAME (please print):l Phone:��j CONTACT EMAIL(p/ease print): m Z igSev-yi cfs ,€1yy),sn i✓<t)vy) Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. /COMMERCIAL ❑ RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. �:v -ems - k 14L� S 0� . It-- -� . Sq. FULF I 1 LJ L4 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) 00 C) CD 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 I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. 1, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CONTRAC ) or (AUTHORIZED REPRESENTATIVE) (OWNER) (CONTRACTOR) Signature (first and last name): DATE: Printed Name: GV) C" f -A L3 ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: May, 1,2019 11:06AM Coloradel,arfrlen'i of 'rea1f' R� 04.0 DEMOLITION NOTIFICATION APPLICATION FORM U**1876*t 'l. 3 VIA APPLICATION FEE MUST ACCOMPANY THIS FORM INCOMPLETE APPLICATIONS WILL BE RETURNED Colorado De arrmgnV (Notice will be mailed to the demolition contractor unless specified otherwise) ofPublic)�ealth';', and )Environment Fee: $50 + $5 per 1000 ft2 of area to be demolished (See Instruction H1 on revere aduel G225 F, 1 Submit form to: Permit Coordinator Colorado Dept. of Public Health and Environment APCD-IE-B 1 4300 Cherry Creek Drive South Denver, CO 80246-163D f Phone: 303.692-3100 1i rax 303-782-0278 AEbeefa e@ state. oo. us Regulated asbeatos-containing materials means (e) friable asbestos-conla:n1nsf1213t_gria1, (b) CleS�Y I n nl`ria�l t '.:;as become frlab , (c) (, leoory I nonfrlable ACM that will boor hes been sublactee. to ennd8ng,e 'fir �, W r k ^yrs „r :I � ",Ct�1 thol `.; s a r d.;7 probability of becoming or has become crumbled, pulverized, or reduced to powd€r by the forces expected to act on the material In the course of demolition or renovation operations regulated by this regulation. Note: Asbestos -root n 1 and linoleum must be property 4 `i'P,►''4',Y P P tY abaled/removed prior to demolition, ' � r�,-moi ��,� i': � � )) �, It , �+,. �, Company me: Name: WenoBuifding I e. Square foolege of footprint of facility. or.ppr4r rl t' facillly to be damcl shed Street: J' _ ilas- Z G : � S to: Code: ` u z. siroeC a 116610 W. 311 Ave. C o Min F M. Clfy: Co"j—, - 714 Cor_"r' + � �- '"tat O Prof ger, P ne 4 I Propose -St II. a!r . 'rop_osed {((����t�(�(ompI on Date 1- -_9 1- lC(A 0 -. . -' - :� I cerlNy Oat the Certified Asbestos Building Inspector has fnfomted me E ! Meths !Meat ? of Demolition: alning asbestos-conialning malenais In trt.31`2Aity fa ba i W7 demolish Ptt Name: :/rocking 0 Running' 0 imploa!on ❑ Moving ❑ Other, apeclfy: SIDnat� Receiving guild Debris / ' ' Burnlaq reoulm s deditlonai alltnOdZador, Ploasa call (3D3) 6;32-3100 and ask to speak to the D� . Bu_ming Permit Cc d'nslc; . s � PJ3 batement ConVactor GAC (GAC) /�c�f h/��c2;,4frr kechclf Dw,:sYsNeme: p Rockies Environmental & Demo Services !_ 6610 31 gr LLC _ ebealoa Permit 0 Total Quan a[Agbeat'oa Removed Street: v 58(0 7 •fJ PO Bo�, 2171 t oval Comoteted Telephone ri oris IY October ID 2017 720 515-08_91 _ %'7e* Ridge � co � 80214 I Ty e(s or bas s Conlatnl Material Remove,,. t-' 361)Lac:'s Narr;e: Telephone 0 Brendan Gustafson f?23) 234-9375 With my signature below, Lkertify that a (itSSass cwiE it accreditation and state of Colorado certification as �- an Asbestos Building Inspector. I also certify that I h�, ve f"'?croughly inspeP'ed the facility ',� 1--c-'demolished, as Ilsted r.a In the Demolition Site block above, sampled all suspe ;t rterials, had aii samples analyzed for trie presert(.t of CIL asbestos by a NVLAP-accredited ist ._.;cry, and hay do:.._ , ; a�. t� I . - W anywhe — C facility.* I also certify that I have informed the owner/, jpe A)r of die teciiiry or the demolition contractor that any ,.o asbestos -containing material allowed tri, €tay in the as Jlib rrUnt renla-r, of ACM remaining, below, (check ap',propriate bOXL 1A LlVinyl asbestos floor tile (VAT ❑ V�,i mastic C 86--13;,haft im IG , roofing J-.giial is pipe coal;ngs [1 Spray -applied tar coatin Ciaz r._; ,t r t, �4,, Slgnatum (In Blue Ink) Dale) f Final nspecdon C n Exc�9 anon ` Ie Tei phone p Cei; pt;ane # _ vell 6 �� C� 2LI verify that all refrigerants from air condhlohingh,eMoeration app"I� cas a a keen prop ; :e-�veree in ac or •:: actio; AQCC tae elation ?fo. 15 (for Information on CFC requirements "�`i 032—"100), "100) ' furtherr'y is c^! i,mfious ilgrs (con ta(nlny r ;, ncl3rlal; hwaa b c disposed o1 In accordance with 6 CCR 1007 1 su ipart 3.6.4.3 (for )fon ;at'!on on lumino;is exit sin requlrerne^; II 303-692-3320). c L- m M CHECK THE APPROPRIATE 60X: — r- J3 M 3 0 Building Owner ❑ Contraetcr y j L❑ Other Dafe: �I y ly Slgnalura Brendan Gnsrafson THis BOX Is FOR CDPHE 9EUFJL : Postmark or Hand Delivery Date: 0 �(( Approved By: ���� Code: ❑ tlni6al-310 ❑ tranafer-380 Form of Payment & N:1$"G`( �(pp Permit #: Recon+ � Date 18cue a: ' Regulated asbeatos-containing materials means (e) friable asbestos-conla:n1nsf1213t_gria1, (b) CleS�Y I n nl`ria�l t '.:;as become frlab , (c) (, leoory I nonfrlable ACM that will boor hes been sublactee. to ennd8ng,e 'fir �, W r k ^yrs „r :I � ",Ct�1 thol `.; s a r d.;7 probability of becoming or has become crumbled, pulverized, or reduced to powd€r by the forces expected to act on the material In the course of demolition or renovation operations regulated by this regulation. Note: Asbestos -root n 1 and linoleum must be property 4 `i'P,►''4',Y P P tY abaled/removed prior to demolition, ' � r�,-moi ��,� i': � � )) �, It , �+,. �, .4 LIMITED - ASSESSMENT OF SUSPECT ASBESTOS -CONTAINING MATERIALS MID -DEMOLITION STRUCTURE BASEMENT 6610 WEST 31ST AVENUE, WHEAT RIDGE, COLORADO October 9, 2017 Prepared For: Rockies Environmental and Demolition Services, LLC 1100 731 Avenue, Unit C Denver, Colorado 80229 Prepared By: Tim Ponder Ponder Consulting, LLC PO Box 142 Kittredge, Colorado 80457 PC Project No.: PC17010.13 Rockies Environmental and Demolition Services, LLC (REDS), retained Ponder Consulting, LLC (PC), to conduct an assessment of suspect asbestos containing materials (ACM) at the previous Church structure located at 6610 West 319 Avenue, Wheat Ridge, Colorado (Site). Mr. Tim Ponder of PC is an AHERA- accredited building inspector and is also licensed as a building inspector by the Colorado Department of Public Health and Environment (CDPHE) (License No.: #13853 expires April 27t'', 2018) conducted the assessment on October V1, 2017. Copies of the inspector's certificates of accreditation and licensure are included in Appendix C. At the time of this limited inspection, only the skim coat texture (SCT1) on the concrete masonry units (CMU) material in the basement bathroom locations was sampled for suspect ACM prior to demolition. The following appendices supplement the results of this assessment: • Appendix A: Data Tables • Figure 1: Sample Locations & Pictures • Appendix B: Laboratory Reports • Appendix C: PC & Laboratory Credentials PC understands that the objective of this assessment was to identify ACM and/or presumed ACM (PACM) that must be removed prior to planned renovation/demolition of the Site. The samples collected by PC during this assessment were submitted to EMSL Analytical, Inc. in Denver, Colorado for analysis using polarized light microscopy (PLM) in accordance with United States Environmental Protection Agency's (USEPA) method EPA/600R-93/116 (July 1993) for determining asbestos in bulk building materials. This laboratory is accredited for asbestos analysis using PLM by the National Institute of Standards and Technology National Voluntary Laboratory Accreditation Program (NVLAP). Certificates of laboratory accreditation and licensure are included in AppendixC. The EPA National Emissions Standard for Hazardous Air Pollutants (NESHAP) (40 CFR 61, Subparts A and M) has a requirement related to assessment of suspect ACM in buildings. Per CDPHE, Section III.A.1.c., if the asbestos content of a sample of friable asbestos is estimated to be 1% asbestos or less, but greater than 0%, by a method other than point counting (such as visual estimation), the determination shall be repeated using the point counting technique with polarized light microscopy (PLM). If a result obtained by point count is different from a result obtained by visual estimation, the point count result must be used. When no asbestos is detected by PLM, point counting is not required. Prior to beginning thisassessment, Ponder Consulting, PO Box142, Kittredge Colorado PC confirmed with the client that PC would point count samples reported as trace (<1 %) asbestos, and consider results of 1 to 10% as positive for asbestos. The results of the assessment and recommendations are summarized in the table below. A table providing detailed results of the assessment is provided in Appendix A. A copy of the laboratory report is provided in Appendix B. Based on the laboratory analysis report, dQ samples collected contain asbestos. No samples collected during the inspection contained friable asbestos at concentrations greater than 1 % asbestos under PLM analysis. No samples collected during the inspection contained non -friable asbestos at concentrations greater than 1% asbestos under PLM analysis. II,Ffi=r1Mgi1 wM—,M No samples collected during the inspection contained concentrations of less than or equal to 1 % asbestos under PLM analysis. During renovation/demolition operations, materials may be uncovered which are different from those accessible for sampling during this assessment. Personnel in charge of demolition should be alerted to note materials uncovered during these operations which differ substantially from those included in this assessment. If suspect ACM are found, additional sampling by a CDPHE-licensed building inspector and analysis by a NVLAP-accredited laboratory should be performed to determine if the materials contain asbestos. The results, findings, conclusions, and recommendations expressed in the report are based only on conditions that were noted at the time of PC's assessment. PC's selection of sample locations and frequency of sampling was based on our observations and the assumption that like materials in the same area are homogeneous in content. The report is designed to aid the building owner, architect, construction manager, general contractors, and potential asbestos abatement contractors in locating ACM. Under no Ponder Consulting, PO Box142, Kittredge Colorado circumstances is the report to be utilized as a bidding document or as a project specification document since it does not have all the components required to serve as an Asbestos Project Design document or an Abatement Work plan. Our professional services have been performed, our findings obtained, and our conclusions and recommendations prepared in accordance with customary principles and practices in the fields of environmental science and engineering. This statement is in lieu of other statements either expressed or implied. This report does not warrant against future operations or conditions, nor does it warrant against operations or conditions present of a type or at a location not investigated. This report is certified to REDS. The scope of services performed in execution of this evaluation may not be appropriate to satisfy the needs of other users, and use or re -use of this document or the findings, conclusions, or recommendations is at the risk of said user. PC's inspector completed a walkthrough assessment of the building and recorded the areas of the building inspected, as well as areas where materials suspected of containing asbestos were located. PC's inspector also evaluated the condition, accessibility, and friability of suspect ACM according to the following ratings: • Condition, as good (G), fair (F), or poor (P) • Friability, as friable (F), Category I non -friable (CAT 1), or Category II non -friable (CAT II), according to the USEPA National Emissions Standard for Hazardous Air Pollutants (NESHAP) definitions in Section 4.0. When materials suspected of containing asbestos were identified, BTG's inspector collected representative bulk samples from each homogeneous area using the protocol presented in the following table: SUSPECT ACM SAMPLING PROTOCOL Homogeneous Area (HA) Category Surfacing Materials Thermal System Insulation (TSI) HA Size 1,000 SF or Less 1,001-5,000 SF >5,000 SF No Stipulation Ponder Consulting, PO Box142, Kittredge Colorado Minimum Number of Samples 3 5 7 or more 3 of each type of TSI. (Must also sample all repair SUSPECT ACM SAMPLING PROTOCOL Homogeneous Area (HA) Category HA Size Minimum Number of Samples Miscellaneous Materials I No Stipulation I One to 3 samples of each miscellaneous material. Note: A Homogeneous Area is defined to include surfacing material, thermal systems insulation, and miscellaneous material areas which are uniform in color, texture, construction and application date, and general appearance. Destructive access and sampling techniques were not used during this assessment. However, it is possible that additional materials -are present that were not visible or accessible during PC's assessment. If suspect materials are encountered during future renovation or demolition activities, they should be assumed to contain asbestos until evaluated by a qualified asbestos inspector. "Suspect" material includes, but is not limited to, any material serving as a sprayed on or troweled on acoustic or fireproofing surface; floor and ceiling tiles; drywall, joint compound, and related materials; transite panels, siding and shingles; thermal insulation and any material associated with mechanical systems; and binding agents such as tar sealant, mastic, adhesive, roofing tar, caulking, etc. EPA National Emissions Standard for Hazardous Air Pollutants (NESHAP) The U.S. Environmental Protection Agency (EPA) National Emissions Standards for Hazardous Air Pollutants (NESHAP) regulations for asbestos (40 CFR 61, Subparts A and M) apply to certain demolition and renovation projects in facilities containing ACM and/or presumed ACM (PACM). The NESHAP rule usually requires that all friable ACM and some categories of non -friable ACM be removed before a building is demolished, and may require localized removal before or as part of a renovation. For renovation projects where friable ACM will be disturbed, the NESHAP rule may require appropriate work practices or procedures for the control of emissions. The following EPA NESHAP definitions of ACM are very important in interpreting which NESHAP requirements may apply to your building: • Friable asbestos -containing material: any material containing more than 1 percent asbestos, determined using PLM analysis, that when dry, can be crumbled, pulverized, or reduced to powder by hand pressure. • Cate_gory / non -friable asbestos -containing material: asbestos -containing packings, gaskets, resilient floor covering, and asphalt roofing products containing more than 1 percent asbestos as determined using PLM. • Category 11 non -friable asbestos -containing material any material excluding Category I non -friable ACM, containing more than 1 percent asbestos as determined using PLM that, when dry, cannot be crumbled, pulverized, or reduced to powder by hand pressure. • Regulated asbestos -containing material iRACM]; (1) friable ACM, (2) Category I non -friable ACM that has become friable (3) Category I non -friable ACM that will be or has been subjected to Ponder Consulting, PO Box142, Kittredge Colorado sanding, grinding, cutting, or abrading, or (4) Category II non -friable ACM that has a high probability of becoming or has become crumbled, pulverized, or reduced to powder by the forces expected to act on the materials in the course of demolition or renovation operations regulated by NESHAP. According to NESHAPs, RACM need not be removed before demolition if: • It is Category I non -friable ACM that is not in poor condition and is notfriable. • It is on a facility component that is enclosed in concrete or other similarly hard material and is adequately wet whenever exposed during demolition • It was discovered after demolition began, and as a result, cannot be safely removed. If not removed, the material must be kept wet until disposal. • It is Category II non -friable ACM and the probability is low that the material will become crumbled, pulverized, or reduced to powder during demolition. NESHAP also requires that the EPA or the state (if the state has been delegated authority under NESHAP) be notified before a building containing RACM is demolished, or before certain renovations impacting RACM begin. OSHA Asbestos Standards The U.S. Occupational Safety and Health Administration (OSHA) regulates employee exposure to asbestos in general industry (29 CFR 1910.1001) and construction (29 CFR 1926.1101). The OSHA asbestos standards provide a permissible exposure limit (PEL) of 0.1 fibers (equal to or longer than 5 micrometers) per cubic centimeter of air (fibers/cc) determined as an 8 -hour, time -weighted average (TWA) and an excursion limit of 1 fiber/cc as a 30 -minute TWA. The asbestos construction standard applies to exposure of employees to asbestos during abatement and renovation/demolition activities. The construction asbestos standard also applies to employees who may contact or disturb ACM during their work activities (e.g. maintenance and custodial workers). It is important to note that the OSHA regulations apply to materials that contain any detectable concentration of asbestos, whereas the NESHAP regulations only apply when the concentration is greater than 1 %. The following are selected OSHA definitions regarding asbestos work: • Class I asbestos work.- means activities involving the removal of TSI and surfacing ACM and PACM. • Class // asbestos work. means activities involving the removal of ACM which is not thermal system insulation or surfacing material. This includes, but is not limited to, the removal of asbestos -containing wallboard, floor tile and sheeting, roofing and siding shingles, and construction mastics. • Class Ill asbestos work. means repair and maintenance operations, where "ACM", including TSI and surfacing ACM and PACM, is likely to be disturbed. • Class IV asbestos work. means maintenance and custodial activities during which employees contact but do not disturb ACM or PACM and activities to clean up dust, waste and debris resulting from Class I, II, and III activities. Ponder Consulting, PO Box142, Kittredge Colorado Intact. means that the ACM has not crumbled, been pulverized, or otherwise deteriorated so that asbestos is no longer likely to be bound with its matrix. OSHA requires that specific work practices and procedures be followed to control asbestos exposure of employees involved in abatement or renovation activities as well as the building occupants. In addition, the OSHA standard provides requirements for exposure monitoring, employee training, medical surveillance, respiratory protection, signage, and other protective measures. LOCAL AND STATE REGULATIONS The Colorado Department of Public Health and Environment (CDPHE) has promulgated regulations pertaining to asbestos activities in Colorado Regulation 8, Part B. Regulation 8B is based on the EPA NESHAP requirements, with additional state -specific provisions for asbestos inspections, abatement, and other activities. Regulation 8B also identifies training and certification requirementsfor professionals performing asbestos work in the State of Colorado. A summary of the requirements related to renovation and demolition of structures containing ACM is provided below: 1. Regulation 8B requires that any public or private building must have an asbestos survey performed to confirm the presence of ACM prior to renovation or demolition activities. 2. If friable ACM will be removed or disturbed as part of the renovation/demolition activities, the ACM must be removed under abatement conditions before demolition begins. CDPHE Regulation 8B requires that a State of Colorado Licensed General Abatement Contractor (GAC) perform the removal in accordance with Section III.H (Abatement Sequence). 3. CDPHE must be notified for all renovations and demolitions of all residential and commercial structures and all asbestos abatement projects that exceed the trigger levels (50 linear feet, 32 square feet, or the volume equivalent to a 55 -gallon drum, "residential'I and (260 linear feet, 160 square feet, or the volume equivalent to a 55 -gallon drum, "commercial'J. The notification requirements apply to both friable and non -friable asbestos materials. Notifications must be postmarked or delivered at least 10 working days before initiating abatement activities, and must be made using CDPHE forms. 4. During demolition, all non -friable asbestos -containing materials are exempt from abatement activities provided that they remain in a non -friable state and are kept wet at all times during demolition activities. 5. During renovation, non -friable materials may remain in place if they are not disturbed during the renovation activities. If these materials will be disturbed, they must be removed prior renovation. 6. Waste materials containing friable ACM must be properly disposed of at a landfill licensed to receive friable ACM materials. This requirement applies even if the quantities are below the CDPHE trigger levels requiring an abatement permit. Non -friable ACM waste must be disposed of at an approved landfill that accepts non -friable materials. If waste contains a mixture of friable and non -friable materials, it must be disposed of at a landfill licensed to receive friable ACMmaterials. 7. A CDPHE licensed Air Monitoring Specialist (AMS) shall follow Regulation 8B Section III.P (Clearing Abatement Projects) prior to signing any demo permits at the site. 8. The building owner should be aware that removing ACM does not discharge ownership of the ACM. During transport or after burial in an approved landfill, any contamination throughout the lifetime of the material remains the responsibility of the building owner. Ponder Consulting, PO Box142, Kittredge Colorado PC appreciates this opportunityto provide asbestos consulting services to REDS. We have enjoyed working with you on this project and look forward to meeting your needs in the future. Should any questions arise concerning this report, please contact us at (248) 767-3995. This report was prepared by: Tim Ponder Ponder Consulting, LLC Ponder Consulting, PO Box142, Kittredge Colorado Appendix A: Data Tables Ponder Consulting, PO Box142, Kittredge Colorado -0 0 CL m 0 0 � ■ � 2 � 0 ou 0 -A � � � � � � ■ 0 0 0 n � 0 00 2 Ul 4 ;@w22I nm O> f 0 0 Q m 2' 2 a CD � Q to a) m £ m 7 D / R k G f A E 0 @ E ƒ � m / m ° > n ƒ � E r 0 Q -D0 m ƒ n 2 H \ § 0 ƒ a \ / CD w 0 0 ■ 0 O E dU) > c m�E < -:n- E D � ■ n — R / 2 @ a @ i Cl) 0 3 /mow R � a 0 o 7 ■ Kcnco OSE \R o 3 o E cn g ] � / :3 \ \ 6 6 2 ? e 3 k k H C CD CDC E 0) E E0) k k k K2 � \ CD \ ¢E 2 2 2 0 � % M; � g g 0 � 2 2 =2 > �= D �0 >OZr SE■���ƒm \ 0=eIM■� 0@ ;U= �' 040 0- ■ g Q o D � ■ > C CD X c � 2 � _ r ■ z z z p m n 0 �Ju � -n -n -n -n ■ t $ $ ■ E £ E E } � — 0 ■ � % ■ � g g 0 � 2 2 =2 > �= D �0 >OZr SE■���ƒm 0=eIM■� 0@ ;U= �' 040 0- ■ g � ■ ■ > C CD c � 2 M r ■ Figure #1: Sample Locations & Pictures SE Corner Exterior Of - Bathrooms Interior Walls West Wall Bathrooms Basement Exterior Walls West Wall Bathrooms Basement Exterior Walls South Wall Ponder Consulting, PO Box 142, Kittredge Colorado 80457 SCT1-01/03: Skim Coat Texture w/Plaster On Concrete Masonry Units (CMU) SCT1-01 * ".f. PIT • 01 I Bathroom SCT1-02 * SCT1-03 * BASEMENT Appendix B: Laboratory Data EMSL Analytical, Inc. EMSL Order: 221707078 1010 Yuma Street Denver, CO 80204 Customer ID: PNDR42 TeVFax: (303) 740-5700 / (303) 741-1400 Customer PO: http:/twww-EMSL.com / denverlab@emsl.com L Project ID: Attention: Tim Ponder Phone: (248) 767-3995 Ponder Consulting Fax: PO Box 142 Received Data: 10/06/2017 9:50 AM Kittredge, CO 80457 Analysis Date: 10/06/2017 - 10/07/2017 Collected Date: 10/06/2017 Project: PC17010.13 Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-931116 Method using Polarized Light Microscopy Non-Asbesto Asbestos Sample Description Appearance % Fibrous % Non -Fibrous % Type 1 010 5/2 01 7 SCT1-01 Exterior Bathroom White 100% Non-fibrous (Other) None Detected Wall Basement West Non -Fibrous 221707078 -OWI - Skim Coat Texture Homogeneous hki 10/05/2017 SCT1-02 Exterior Bathroom White 100% Non-fibrous (Other) None Detected Wall Basement West Non -Fibrous 221707078-0002 - Skim Coat Texture Homogeneous HA 1 10/05/2017 SCT1-03 Exterior Bathroom Tan 100% Non-fibrous (Other) None Detected Wall Basement South Non -Fibrous 22177078-0003 - Skim Coat Texture Homogeneous Inseparable paint/ mating layer included in analysis HA. h Analysts, Gentry Catlett (2) Stuart Printz (1) Amanda Lang, Asbestos Laboratory Manager or Other Approved Signatory EMSL maintains liability limited to cost of analysis. This report relates only to the samples reported and may not be reproduced, except in full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. Interpretation and use attest results are the responsibility of the diem. This report most not be used by the clientto claim product certification, approval, or endorsement by NVLAP. NIST or any agency of the federal government. Nondriable organically bound materials present a problem matrix and therefore EMSL recommends gravimetric reduction prior to analysis. Samples received in good cendtion unless otherwise noted. Estimated accuracy, precision and uncertainty data available upon request Unless requested by the client building materials manufactured with multiple layers (.e. findeum, wallboard, etc.) are reported as a single sample. Reporting limit is 1% Samples analyzed by EMSLAnalytical, Inc. Denver, CO NVLAP Lab Code 200828-0 Initial report from: 10/07/2017 10:43:57 ASB—PLM-0008-0001 - 1.78 Primed: 10/7/2017 8:44 AM Page 1 of 1 Appendix C: Ponder Consulting, LLC & Laboratory Credentials Colorado Department of Public Health and Environment ASBESTI 0 CERTIFICATION* This certifiesthat Tim J. Ponder Certification No.: 13853 has met the requirements of25-7-507, C.R.S. and Air Quality Control Commission Regulation No. 8, Part B, and is hereby certified by the state of Colorado in the following discipline: Building Inspector* April 27, 2017 April 27, 2018 't�iiutd is��t c• Ssessir�, i ' � ; ,���:.� . II i 1 thon=ed APIC! L approved trailling course certijlcatioll in the disdplille specified above. SEAL 4% x tk G C) J GMM: s.a F !Ms' J m n. co _? n y N tv 4 O N N O `� Z 4 �• a) � o n C) CD CD O 4 COAD CD Q CDCD " O O n n N v Q 00 o CD zE Zr Co Cb Zr O(D CD rz °o n0 tl _.OD , N 0 CQ 0 4 � CD CD CD � n C).. CL v S: C/) CD CL �S o N O0 0 o� m O V O O Cr O O O rA P* rA fl1 n N 4 C^D 4 a CD ztN O sv W Q O_ O O �v Cb C/)� C) o a' a o CD v 0 0 �C.) QC) CCD 4 O• 00 v 0 CD n� CD SO CD CD a� 0 h 0 0 MN (V rMF a _a �, on cn 0 m 0 y Q a Ul 0 C m CL rF r. rqlL m N °, v 0)(D C CL 'OL n CL --13 3 (DD so o `° City of- Wheat fWheat I. COMMUNITY DEVEIOIWEN"I Building & Inspection Services Division 7500 W. 29" Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(a-)_ci.wheatridge.co.us FOR OFFICE USE ONLY Date: Plan/Permit # Plan Review Fee: � r, 01 Building Permit Application OLS ,� , *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 6610 0. 91 S"' At Property Owner (please print): X6/0 3/" 14ye, A I Phone: 720 Z3�-y37S Property Owner Email: 69rNbAA- 9K6(2 C,r Al kvbM Mailing Address: (if different t n operty ad ss) Address: PL) &X Z I -I! \ Ij Zip: (A-Jhe,,t IC1jeC c�► �.el.S�ie��� Architect/Engineer E-m)q: R1.65e,AE- Contractor: Phone: ZZ0-3ZO.M5 /ZZO-ZZO-3695 Contractors City License #: �60Z� Phone: 303 -0416 -16612 Contractor E-mail Address: sTE�E. ST��Le EMAIL . cD� �J Sub Contractors: Electrical: W.R. City License # Other City Licensed Sub: City License # . A Plumbing: W.R. City License # Other City Licensed Sub: City License # Complete all in ormation on BOTH ,�,C �rU Mechanical: W.R. City License # of this form J - 1 ❑ COMMERCIAL (Check all that apply) WRESIDENTIAL ❑ NEW COM W RCIAL STRUCTURE [ELECTRICAL SERVICE UPGRADE ❑ NEW RESID TIAL STRUCTURE ❑COMMERCIAL ROOFING ❑ COMMERCIAL DDITION ErRESIDENTIA ROOFING ErRESDENTIAL A ITION [WINDOW R LACEMENT ❑ COMMERCIAL AC ESSORY STRUCTURE (Garage, shed, deck, e.) ❑ RESIDENTIAL ACC SORY STRUCTURE (Garage, shed, deck, c.) EYMECHANICAL SYST /APPLIANCE REPAIR or REPLACEMENT PLUMBING SYSTEM/A LIANCE REPAIR or REPLACMENT VELECTRICAL SYSTEM/A PLIANCE REPAIR or REPLACEMEN ❑ OTHER (Describe) (For ALL projects, please provide atailed description of work to be proposed uses, square footage, existin condition and proposed new amount of materials to be used, etc.) /-- on VA 1�e,Ko �114� /Aew sJ 4J . Sq. Ft./LF `y 72 e,,+. Btu's Amps Squares ormed, including current use of areas, ition, appliance size and efficiency, type and Gallons Other Value: (Contract value or the cost of all materials ar/d laNr included in the entire project) v . OWNER/CONTRACTOR SIGNATURE OF U 'DE RST DING AND N GREEMENT I hereby certify that the setback distances proposed by this pe it application accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easeme is or restrictions o ecord; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditio printed on this apph tion and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances or work under any pe tissued based on this application; that I am the legal owner or have been authorized by the legal owner of the property o perform the described ork and am also authorized by the legal owner of any entity included on this application to list that entity on thi application. I, the applican or this building permit application, warrant the truthfulness of the information provided on the applicati CIRCLE ONE: (OWNER) (CONTRACTOR) or Electronic Signature (first and last name): ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: 7ZW4 DEPARTMENT USE ONLY of (OWNER) (CONTRACTOR) DATE: /0 l Z 0- —/)/o CLASSIFICATION:, -J Building Division Valuation: $ a—� 0 1 3 C 3 • - t City of Wheat .dg COMMUNI ri, DEVELOPMENT City of Wheat Ridge Municipal Building 7500 W. 29th Ave. Wheat Ridge, CO 80033-8001 P: 303.235.2846 F: 303.235.2857 August 9, 2017 OFFICIAL ADDRESS NOTIFICATION NOTIFICATION is hereby given that the following address has been assigned to the property/properties as indicated below: CURRENT ADDRESS: 6610 West 31' Avenue NEW ADDRESS: 6610 West 315' Avenue(l,ot ) and 6622 West 3161 Avenue ( Lot 1) SUBDIVISION: Gustafson Minor Subdivision LOT(s): 1&2 SECTION: 25 NOTES: This is a courtesy notification. 1-17 AUTHORIZED BY:Ue' Z'' DATE: t b DISTRIBUTION: 1. Property Owner 2. Jefferson County Assessor, ATTN: Data Control, Lacey Baker email to lbaker(a?ieffco.us 3. Jefferson County Elections, ATTN: H. Roth, 3500 Illinois St., Laramie Building, Suite 1100, Golden, CO 80401 4. Email to Jeffco IT (Mapping) Services at smitcheba )effco..us and edel}mko@jeffco.us 5. Jeffco Public Schools, ATTN: Communication Services, 1829 Denver West Dr., Bldg. 27, Golden, CO 80401 6. U.S. Post Office, 1990 Depew St., Lakewood CO 80214 7. Email to erlinda j.martinez.a uspsxov and kriss)_.1.sunixnerfiel u us s.gov and arlene.a.vickrey@,usps.g-ov 8. Xcel Energy, sandra.cardenas,s xceleneri� \.com 9. Century Link, Capacity Provisioning Specialist, 5325 Zuni St., Room 728, Denver, CO 80221 10. Comcast, Attn: Scott Moore, 6850 S. Tucson Way, Englewood, CO 80112 11. Consolidated Mutual Water 12. Wheat Ridge Sanitation District 13. West Metro Fire District 14. Wheat Ridge Planning Division 15. Wheat Ridge Building Division 16. Wheat Ridge Police Department 17. GIS Specialist 18. Log File NOTE: Please notify all other parties concerned. ADDRESS MAP UPDATED BY: www.d.whea tridge.com s DATE: Site "iF--' A., Vicinity Map 6622 W. 31%t Avenue ,Wheat Ridge, CO 80211 tot I Gustafson Minor Sub. �.AW40*2�,!* ,V.SY(AVE 6610 ,W. 31st Avenue Wheat Ridge, CO 80214 (existing address) Lot 2 Gustafson Minot Sub. 0 Z Z A N City of Wheat Ridge Community Development Department Memorandum TO: Accounting Department FROM: Kim Cook, Building Division SUBJECT: Refund for Permit DATE: August 2, 2017 Reason: Project could not be performed due to structural condition. Contractor requested to have permit #201602026, for 6610 W. 31St Avenue closed out. New project will be submitted. Please refund: Contractors License$ (acct 01-510-00-513) 80% permit fee: $ 1530.00 (acct 01-510-00-516) 0% plan review $ (acct 01-550-05-551) 100% use tax: $ 3,966.54 (acct 01-500-02-505) Total: $ 5,496.54 TO: 6610 W. 31 st Avenue LLC PO BOX 2171 Wheat Ridge CO 80034 Thank You! " C4104 Permit Technician City of // Wheatdge COMMUNITY DEVELOPMENT 0o 14 4y 1 /a, u!�-3�Rleb,sY ,. ft i,9ia.5� l City of Wheat Ridge Municipal Building 7500 W. 29th Ave. Wheat Ridge, CO 80033-8001 P: 3t3.235.2855 F: 303.237.8929 Refund Application Complete this application in its entirety, attach all copies of permits, permit cards (if issued) and receipts that were received at the time of permit issuance. Requests for more than 80 percent of the amount paid will not be approved without prior approval from the Building Official. The refund application must be received by the Wheat Ridge Building Division no later than 180 days after permit issuance. Applications received after 180 days of permit issuance will not be approved. You can mail or hand -deliver all required documents to: City of Wheat Ridge, Attn: Building Division, 7500 W. 291h Ave., Wheat Ridge, CO 80033. Company Name/Name (to whom check should be made out to): 6416 3 t S4Az GLC, Address: Pr.) f3,,x 01-71 City: (�z'+ gj5e State: C -U Zip: 666sy Phone: .1ZV - & ,,q-173'7 ,; Fax: Permit #: 2!0110'2-02-6 Permit Address: Reason for request: -44- AI/ ke s,; Email: 41enc(c.A, bkgL gn,C-I1. 601 . 66107 (Aj, 3"" Ae. ilew `71;r q�o✓A-i- 6 Printed Name: grendcl, Gy`` :6#,I Signature: 7AYZ Date: T 27 I7 For office use only This request has been: rove Denied ReAmount: $�% Approved by: UM A Date: VPJ) www.ci.w heatridge.co. u s City of Wheat Ridge Residential Addition PERMIT - 201602026 PERMIT NO: 201602026 ISSUED: 01/27/2017 J6B ADDRESS: 6610 W 31st AVE EXPIRES: 01/27/2018 JOB DESCRIPTION: Pop -top .addition/converting former church into a two-story house; 1072 sq ft.;*demo of siding; installing new siding; Updating electrical, plumbing and HVAC, new kitchen, bathrooms, etc.; new windows * * * CONTACTS OWNER (720)234-9375 6610 W. 31ST AVENUE GC (303)246=6612 Steve Steele 160251 Steve Steele SUB (303)579-5691 Jay Grundberg 170015 Wired Up Electrical Design LLC SUB (720)840-5429 Jared Bigham 170021.Front Range Heating & AC SUB (303)472-0833 William/Shelly Clark 170023 Just Plumbing Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 500 / Government/Church/Library BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 220,363.52 FEES Total Valuation 0.00 Plan Review Fee 1,243.13 Use Tax 3,966.54 Permit Fee 1,912.50 Investigative Fees 100.00 ** TOTAL ** 7,223.17 *** COMMENTS *** *** CONDITIONS *** Smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. Per City of Wheat Ridge policy, carbon monoxide detectors are required to be installed in the same manner and locations as smoke alarms. All work shall comply with applicable codes and ordinances and is subject to field inspections.All roughs to be done at Framing Inspection. For one- or two-family dwellings, the first twenty-five feet (25') of driveway area from the existing edge of pavement into the site shall be surfaced with concrete, asphalt, brick pavers or similar materials. A right-of-way permit may be required; contact Public Works Department at 303-235-2861. Driveway access shall be between 10 -feet and 24 -feet wide. The remaining gravel access areas shall be removed and replaced with landscaping. PERMIT NO: 201602026 JOB ADDRESS: 6610 W 31st AVE EXPIRES: U_L/Ztu— JOB DESCRIPTION: Pop -top addition/converting former church into a two-story house; i„ ft.; demo of siding; installing new siding; Updating electrical, plumbing and HVAC, new kitchen, bathrooms, etc.; new windows 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 ea owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 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 Budding Official and may be subject to a fee equal to one-half of the originalermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a 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 t t REQUESTS NUST 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. INSPECTION RECORD INSPECTION REQUEST LINE: (303) 234-5933 Occupancy/Type Inspections will not be performed unless this card is posted on the project site. Call the inspection request line before 11:59 p.m. to receive an inspection the following business day.** Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Comments Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter no Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Initials Comments Electrical Wall Sheathing Sewer Service Mid -Roof Plumbing Do Not Cover Under round 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 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. 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. **For Inspection Time Window Requests — Please email insptimerequest(aD-ci.wheatridge.co.us by 8:00 A.M. the day of the inspection with the property address in the subject line of the email. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather City of Wheat C�0kV\ UN1 il" DEVELOPMENT City of Wheat Ridge Municipal Building 7500 W. 29th Ave. Wheat Ridge, CO 80033-8001 P: 303.235.2846 F: 303.235.2857 August 9, 2017 OFFICIAL ADDRESS NOTIFICATION NOTIFICATION is hereby given that the following address has been assigned to the property/properties as indicated below: CURRENT ADDRESS: 6610 West 31" Avenue NEW ADDRESS: 6610 West 311 Avenue (1.ot 2) and 6622 West 31" Avenue (Lot 1) SUBDIVISION: Gustafson Minor Subdivision LOT(s): 1&2 SECTION: 25 NOTES: This is a courtesv notification. AUTHORIZED BY: f✓= Ze- DATE• g l o DISTRIBUTION: 1. Property Owner 2. Jefferson County Assessor, ATTN: Data Control, Lacey Baker email to lbakerta jeffco.us 3. Jefferson County Elections, ATTN: H. Roth, 3500 Illinois St., Laramie Building, Suite 1100, Golden, CO 80401 4. Email to Jeffco IT (Mapping) Services at smitchet,jeffco,us and ede1nko@jeffco.us 5. Jeffco Public Schools, ATTN: Communication Services, 1829 Denver West Dr., Bldg. 27, Golden, CO 80401 6. U.S. Post Office, 1990 Depew St., Lakewood CO 80214 7. Email to erhada.j.martinez a usps._ov and kriss} 1.summerfield(&sps_gov and arlene�a,-ici ey(c�uussps.gov 8. Xcel Energy, sandra.cardenas,�i xcelenergN .com 9. Century Link, Capacity Provisioning Specialist, 5325 Zuni St., Room 728, Denver, CO 80221 10. Comcast, Attn: Scott Moore, 6850 S. Tucson Way, Englewood, CO 80112 11. Consolidated Mutual Water 12. Wheat Ridge Sanitation District 13. West Metro Fire District 14. Wheat Ridge Planning Division 15. Wheat Ridge Building Division 16. Wheat Ridge Police Department 17, GIS Specialist 18. Log File NOTE: Please notify all other parties concerned. ADDRESS MAP UPDATED BY: www.d.wheat ridge.com s DATE: Site Vicinity Map 6522 W. 31st Avenue Wheat Ridge, CO 8021 Lot 1 Gustafson Minor Sub. ' STONVE 6610,W. 31st Avenue Wheat Ridge CO 80214 (existing address) Lot 2 Gustafson Minor Sub, 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: TG Job Address: G W • .3 / sr f Permit Number: ❑ No one available for inspection: Time -9 - AM/PM Re -Inspection required: Yes fNo) *When corrections have been made, call for re -inspection at 303-234-5933 Date: 2 - 7 /-17 Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 7`6 Job Address: Permit Number: Zo/(o 020Z ❑ No one available for inspection: Time A Re -Inspection required:Yes No' ICY * When corrections have been made, call for re -inspection at 303-234-5933 Date: 2 r 6-17Inspector:"'` DO NOT REMOVE THIS NOTICE ®l CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type C Job Address: 151 Permit Number: NOT 1WP904,EL> e ej i )- t g i 4 ❑ No one available for inspection: Time toAMRM Re -Inspection required:Yes` No When corrections have been made, call for re -inspection at 303-234-5933 Date: -t inspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Addition PERMIT - 201602026 PERMIT NO: 201602026 ISSUED: 01/27/2017 JOB ADDRESS: 6610 W 31st AVE EXPIRES: 01/27/2018 JOB DESCRIPTION: Pop -top addition/converting former church into a two-story house; 1072 sq ft.; demo of siding; installing new siding; Updating electrical, plumbing and HVAC, new kitchen, bathrooms, etc.; new windows *** CONTACTS *** OWNER (720)234-9375 6610 W. 31ST AVENUE GC (303)246-6612 Steve Steele 160251 Steve Steele SUB (303)579-5691 Jay Grundberg 170015 Wired Up Electrical Design LLC SUB (720)840-5429 Jared Bigham 170021 Front Range Heating & AC SUB (303)472-0833 William/Shelly Clark 170023 Just Plumbing Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 500 / Government/Church/Library BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 220,363.52 FEES Total Valuation 0.00 Plan Review Fee 1,243.13 Use Tax 3,966.54 Permit Fee 1,912.50 Investigative Fees 100.00 ** TOTAL ** 7,222.17 *** COMMENTS *** *** CONDITIONS *** Smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. Per City of Wheat Ridge policy, carbon monoxide detectors are required to be installed in the same manner and locations as smoke alarms. All work shall comply with applicable codes and ordinances and is subject to field inspections.All roughs to be done at Framing Inspection. For one- or two-family dwellings, the first twenty-five feet (25') of driveway area from the existing edge of pavement into the site shall be surfaced with concrete, asphalt, brick pavers or similar materials. A right-of-way permit may be required; contact Public Works Department at 303-235-2861. Driveway access shall be between 10 -feet and 24 -feet wide. The remaining gravel access areas shall be removed and replaced with landscaping. A City of Wheat Ridge a Residential Addition PERMIT - 201602026 P� PERMIT NO: 201602026 ISSUED: 01/27/2017 JOB ADDRESS: 6610 W 31st AVE EXPIRES: 01/27/2018 JOB DESCRIPTION: Pop -top addition/converting former church into a two-story house; 1072 sq ft.; demo of siding; installing new siding; Updating electrical, plumbing and HVAC, new kitchen, bathrooms, etc.; new windows 1, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this ermrt. I further st that I am legally authorized to include all entities named within this document as parties to the work to be performed an, 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 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 ord'na ce 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. FOR OFFICE USE ONLY Date: City 14 dJ1 0 of frWheatf dge com MUNI Y DEVLL0f'MEN'L Plan/Permit# . Building & Inspection Services Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Plan Review Fee: Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits ci.wheatridne.co.us Building Permit Application GOD *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 6610 0 91 Sf Ac. Property Owner (please print): 166/0 ,3/3' .49- «C Phone: 720 -Z3q-y375 Property Owner Email: 69e9,bAA. 9K6G GrMA1 L . a1A Mailing Address: (if different than property address) Address: 190 60X ZI.11 City State Zip: W6*� I GQ 80634 Architect/Engineer• g Ma.rf,'�e-c / !"l i cA&zI SAe.,;Ja ,. PE Architect/Engineer E-mail: 0 i5Z1.6Se ME -COM Phone: ZZ0-300-ZZSS %7Z0-ZZo-3699 Contractor: Sfeve Siez le, ContractorsCity License #: Phone: 303 -0416 -6612 Contractor E-mail Address: STEVE . S?'��[,E�. GMAII. • �0� Sub Contractors: J �l Electrical: Plumbing: Mechanical: W.R. City License # Other City Licensed Sub: City License # W.R. City License # Other City Licensed Sub: City License # W.R. City License # Complete all information on BOTH sides of this form ❑ COMMERCIAL @'RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION [►]RESIDENTIAL ROOFING PIRESDENTIAL ADDITION 24JVINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ❑ (ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ OTHER (Describe) (For ALL projects, please provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.) ��--ftO 6A.Jdfh`o, /6 0,7 inch �p/A, e/ 6A.,rck i/rN c.. -7tv0-s-h, Wuuse. J)eA&D 04� �t IA. blew sJ.4j. ele *1141; �1v�.SF.� " HV -4 /lea,, 16irle,,, 6a oo,wi arc . /vee,, ,A 4Ad*'A.s. Sq. FULF Amps 107j ,f. Btu's Squares Gallons Other Value: (Contract value or the cost of all materials and labor included in the entire project) $r72_fp000 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED WRESENgTIVE) of (OWNER) (CONTRACTOR) ^ Electronic Signature (first and last name): /z z2�� w X 0 7;'3 0 "�6 A/ C V/ I ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: dao) 3 (3 . s a -- [ON: Building Division Valuation: $ a—� 0 / 3 � 3 • 9 RESIDENTIAL Buil ling Permit — Plan Review Worksheet Address: � � W � �j� Zoning: (� Lot Size: �� 11� 2 - sq. ft. Lot Width: l( ft. Property in the flood plain?_ If yes, add surveying condition FLD. Type of project (applicable survey conditions in parenthesis): RKINK 0 Accessory ISP, ILC or site plan none Addition ILC and site plan if w/in 2' of setback or in floodplain (FND) U New ILC and site plan yes (FND) Maximum Lot Coverage: —C V % Existing Improvements: House: sq. ft. Shed: sq. ft. Detached garage: sq ft. Other: sq. ft. Total Existing sq. ft Lot Coverage —�_2� % Required Setbacks: FR Provided Setbacks: FR F O sq. ft. Proposed Improvements: House/addition: Shed: Detache�Gar.: Other: Prop6sed+Existing Lot Coverage - SS---- ---- S R Rev. 06/2014 if in floodplain (FLD) if in floodplain (FLD) if Win 2' of setback (NRS) if in flooclnlni„ IPT m sq. ft. sq. ft sq. ft. sq. ft. sq. ft or new construction, is the structure within 2 feet of minimum setbacks? If yes, add surveying condition FNTn Maximum Height: ft. Proposed Height: � ft. Maximum Size: sq. ft. Proposed Size:L sq, ft. Parkland: If the permit is for new construction, have parkland dedication fees been paid? If no, add condition PFEE, notify owner, and notifybuilding division. Streetscape: Does the permit result in any of the following conditions? Q Construction of new roads Q Platting of new lots Q New development Q Additions that increase floor area by 60% or more (see formula) (proposed floor area — existing floor area ) / existing floor area — o — �o inc. If any box is checked... SF/DUPLEX—Is there existing Q Curb Q Gutter 05 -foot sidewalk adjacent to the property? If curb, gutter or sidewalk is missing, streetscape construction or fees -in -lieu will be required. MULTIFAMILY—Does the frontage meet current city standards? If not, streetscape construction or fees -in -lieu will be required. Fees -in -lieu of dedication or construction are due at the time the permit is issued. Rev. 06/2014 Other notes/considerations: �Zess `For one and two-family dwellings, the first 25' of driveway area from the existing edge o i all be surfaced with concrete, asphalt, brick pavers or similar materials. pavement nto the site she entrancesmaybe ❑ For all uses other than one and two family dwellings, goint access sl for two or more lots. may be closer than 25' to any property line, except when used L)In residential zone districts, curb cuts shall be at leasttri 0 feet Snd ° that the street accest more than 24 feet in ses Lloneand two-family dwellings may have horseshoe Y provided are at least 30 feet apart, measured from the interior edges. ❑ For all uses, one access point per property is permitted. Landscaping ❑ For one -and two-family dwellings, one tree for every 70 feet of street frontage is required. required: �_ Street trees provided: Street trees lprior to issuance of C.O. ❑ 100% of the front yard and 25% of the entire due toinclement sweather prior to the issuance of ❑ In the event that landscaping cannot be install ed to ensure future a C.O., an escrow agreement with fin ociaol guarantees improvement once will be required with he agreement. installation. 125% of the cost of the proposed P These funds will be reimbursed back to the property owner or contractor once the improvements are in place. CL I CD C) N y n CD O C3 m tQ '< - CD i o ! 3 m o 3 CD ' D �, 'D v. O (CD i CD �. CD 0 i 3 dN ? 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Ory n (n = o CD c / 5366 Godding Hollow Pkwy EARTH ENERGY ENVIRONMENT (E3) Longmont, co 80504 Local: 303.902-5651 Industrial Hygiene and Environmental Engineering December 15, 2016 Mr. Cody Williams Precision Homes of Colorado 1900 Federal Blvd Denver, Colorado 80204 Subject: Clearance Report Commercial Building 6610 W. 31st Ave. Wheat Ridge, CO Dear Mr. Williams: Following is the project completion report for the work area at 6610 W. 31 st Ave., Wheat Ridge, CO. The purpose of this report is to document this remediation project was successfully completed, and indoor asbestos amplification was not occurring in the work area. An Industrial Hygienist for Earth Energy Environment (E3) performed the remediation project completion inspection and testing procedures. The remediation work area (Basement Area) was visually inspected in order to confirm the scope of work was properly followed and completed. It was noted that the scope of work did not include complete removal of the floor mastic. The containments were also visually inspected to verify no breaches or defects were present. Phase Contrast Microscopy (PCM) samples were collected in accordance with the National Institute for Occupational Safety and Health (NIOSH) method 7400 using cassettes (standard 3 piece, 25 rmu dia., 0.8 um MCE filter) purchased from Zefon International, Inc. The asbestos concentrations in the containment were calculated as airborne fibers per cubic centimeter of air (F/cc). Table 1 provides a summary of the sample numbers, sample volumes, and calculated concentrations. The National Emission Standards for Hazardous Air Pollutants (NESHAP) clearance standard is 0.01 F/cc. Visual inspection confirmed that no asbestos -containing debris was observed in the work areas. The PCM clearance air sample results were all below the NESHAP clearance standard of 0.01 F/cc. Based on the information presented above, E3 concludes the asbestos abatement in the work areas has been successfully completed. The work areas was also encapsulated following the clearance testing to prevent tracking of the remaining mastic during the build back process. PCM Air Clearance Page 2 of 2 TABLE 1: PCM CLEARANCE AIR SAMPLING RESULTS Date Unit/ Area Sample # De tiamiple Samplle *Fibers/cc Air Clearance at: CL -120916-1 1250 0.001 CL -120916-2 Inside 1210 0.002 6610 W. 31st CL -120916-3 Containment 1235 0.002 December Ave., Wheat CL -120916-4 1245 0.001 9, 2016 Ridge, CO CL -120916-5 1225 0.001 (Basement Area) BLK-I Blanks - BRL BLK-2 - BRI, -rsrcL, aenotcs --tseiow tcepornng Limits". The FUM Colorado Department of Public Health and Environment (CDPHE) clearance standard is 0.01 F/cc. Thank you for allowing E3 the opportunity to provide environmental services to you. If you have questions or require additional information, do not hesitate to contact me directly at (303) 478-0922. Sincerely, Art Willden / n"G =-- Certified Air Monitoring Specialist No. 20138 PCM Air Clearance Page 2 of 2 Attachment A Site Photographs PCM Air Clearance Page 2 of 2 Clearance Photographs PCM Air Clearance Page 2 of 2 PCM Air Clearance Page 2 of 2 PCM Air Clearance Page 2 of 2 PCM Air Clearance Page 2 of 2 Post Encapsulation Photographs PCM Air Clearance Page 2 of 2 PCM Air Clearance Page 2 of 2 5366 Godding Hollow Parkway 504 EARTH ENERGY ENVIRONMENT (E3) Longmont, 303.780922 Local: 303.478-0922 Industrial Hygiene and Environmental Consulting December 5, 2016 Mr. Cody Williams Precision Homes of Colorado 1900 Federal Blvd Denver, Colorado 80204 Subject: Clearance Report Residential Building 6610 W. 31" Avenue Wheatridge, CO Dear Mr. Williams: Earth Energy Environment (E3) is pleased to submit the results from the visual clearance conducted at the subject property. An Industrial Hygienist for E3 performed the remediation project completion inspection on December 5, 2016. The purpose of this report is to document this remediation project was successfully completed, and the work areas (select areas on the house exterior) were free of asbestos (Transite) and no associated debris was left on the ground surround the building. Note, the remediation did not include complete removal of all transite. Transite in select areas will remain in place. These areas include; behind select electrical conduit and the junction box and behind the basement entrance covering on the south side of the building. Transite in these areas will remain in place and will be incorporated into the building renovation without being disturbed. As a precautionary measure, any edges of the transite remaining in place that were broken or otherwise disturbed during partial removal will be encapsulated. In the removal areas, visual inspection confirmed that suspect debris were not present in the work areas or on the ground surrounding the work areas. The photographs below document the post remediation conditions. t 8£IOZ 'oN isgetoodS 2uuoituoW .tty paUpjaD uaPIUM JIV `Xlaaaouls 'ZZ60-8Lb (£0£) lu AIIO011p aw loeluoo of alullsoq iou op `uo[luuuojul luuoglppe a.nnba.t so suotlsanb anew noAjl •noA of saotnlas Jeluauzuonnua apinoid of fqlunaloddo aql Eg gulmoiie aoj nofi XttegZ •uotienoual of .toltd panowat oq saii[nlioe UopUA0u01 Sutlnp poq.tnislp aq Iltm 1'041 (ailsuu.q 8ululeula.t oql su gons) leualew 5uluteluoo -solsagse Xuu saatnbai luawuo.ttnug oqi pue glleaH o►lgnd jo luautiiedaQ opeioloj aqi `alou aseald -llinga.t aq new sum 110MN) puu pololdwoo Alinjssaoons uaaq sq Isom alis oqi sapnlauoa £g `anoqu paluasaid uotluwaojut aql uo pasug •(seat¢ leeowaa) suo.4lpuoj uol4ulpawag ;sod •9 puu `s `v `£ `Z `I gdea2ologd d n U a f z moday ajuv.ivolD 5366 Godding Hollow Pkwy EARTH ENERGY EKIVRO T (D) Longmont, CO 80504 Local: 303.902-5851 Industrial Hygiene and Environmental Engineering December 15, 2016 Mr. Cody Williams Precision Homes of Colorado 1900 Federal Blvd Denver, Colorado 80204 Subject: Clearance Report Commercial Building 6610 W. 31 st Ave. Wheat Ridge, CO Dear Mr. Williams: Following is the project completion report for the work area at 6610 W. 31st Ave., Wheat Ridge, CO. The purpose of this report is to document this remediation project was successfully completed, and indoor asbestos amplification was not occurring in the work area. An Industrial Hygienist for Earth Energy Environment (E3) performed the remediation project completion inspection and testing procedures. The remediation work area (Basement Area) was visually inspected in order to confirm the scope of work was properly followed and completed. It was noted that the scope of work did not include complete removal of the floor mastic. The containments were also visually inspected to verify no breaches or defects were present. Phase Contrast Microscopy (PCM) samples were collected in accordance with the National Institute for Occupational Safety and Health (NIOSH) method 7400 using cassettes (standard 3 piece, 25 mm dia., 0.8 um MCE filter) purchased from Zefon International, Inc. The asbestos concentrations in the containment were calculated as airborne fibers per cubic centimeter of air (F/cc). Table 1 provides a summary of the sample numbers, sample volumes, and calculated concentrations. The National Emission Standards for Hazardous Air Pollutants (NESHAP) clearance standard is 0.01 F/cc. Visual inspection confirmed that no asbestos -containing debris was observed in the work areas. The PCM clearance air sample results were all below the NESHAP clearance standard of 0.01 F/cc. Based on the information presented above, E3 concludes the asbestos abatement in the work areas has been successfully completed. The work areas was also encapsulated following the clearance testing to prevent tracking of the remaining mastic during the build back process. PCM Air Clearance Page 2 of 2 TABLE 1: PCM CLEARANCE AIR SAMPLING RESULTS Date Unit/ Area Sample # Desc iple Vo Sapile `Fibers/cc Air Clearance at: CL -120916-1 1250 0.001 CL -120916-2 Inside 1210 0.002 6610 W. 31st CL -120916-3 Containment 1235 0.002 December Ave., Wheat CL -120916-4 1245 0.001 9, 2016 Ridge, CO CL -120916-5 1225 0.001 (Basement Area) BLK-1 Blanks - BRL BLK-2 - BRL *BRL denotes "Below Reporting Limits". The PCM Colorado Department of Public Health and Environment (CDPHE) clearance standard is 0.01 F/cc. Thank you for allowing E3 the opportunity to provide environmental services to you. If you have questions or require additional information, do not hesitate to contact me directly at (303) 478-0922. Sincerely, Art Willden Certified Air Air Monitoring Specialist No. 20138 PCM Air Clearance Page 2 of 2 Attachment A Site Photographs PCM Air Clearance Page 2 of 2 Clearance Photographs PCM Air Clearance Page 2 of 2 PCM Air Clearance Page 2 of 2 Im PCM Air Clearance Page 2 of 2 PCM Air Clearance Page 2 of 2 PCM Air Clearance Page 2 of 2 Post Encapsulation Photographs PCM Air Clearance Page 2 of 2 PCM Air Clearance Page 2 of 2 5366 Godding Hollow Parkway Longont, CO 80504 EARTH ENERGY ENVIRONMENT (U) Lo aL 303.478-0922 Industrial Hygiene and Environmental Consulting December 5, 2016 Mr. Cody Williams Precision Homes of Colorado 1900 Federal Blvd Denver, Colorado 80204 Subject: Clearance Report Residential Building 6610 W. 31" Avenue Wheatridge, CO Dear Mr. Williams: Earth Energy Environment (E3) is pleased to submit the results from the visual clearance conducted at the subject property. An Industrial Hygienist for E3 performed the remediation project completion inspection on December 5, 2016. The purpose of this report is to document this remediation project was successfully completed, and the work areas (select areas on the house exterior) were free of asbestos (Transite) and no associated debris was left on the ground surround the building. Note, the remediation did not include complete removal of all transite. Transite in select areas will remain in place. These areas include; behind select electrical conduit and the junction box and behind the basement entrance covering on the south side of the building. Transite in these areas will remain in place and will be incorporated into the building renovation without being disturbed. As a precautionary measure, any edges of the transite remaining_ in place that were broken or otherwise disturbed during nartial removal will be encapsulated. In the removal areas, visual inspection confirmed that suspect debris were not present in the work areas or on the ground surrounding the work areas. The photographs below document the post remediation conditions. Clearance Report 21 Page ki Photograph 1, 2, 3, 4, 5, and 6. Post Remediation Conditions (removal areas). Based on the information presented above, E3 concludes the site work has been successfully completed and the work areas may be rebuilt. Pleasc flog., Clic Culp -l -(h, �c ; i:,.viji cr; ' ' ' • ' ' iru 1 tiui;.. I -C•d E ui;� t!._ l i.; 11 u. .. .; containing material (such as the remaining transite) that will be disturbed during renovation activities be removed prior to renovation. Thank you for allowing E3 the opportunity to provide environmental services to you. If you have questions or require additional information, do not hesitate to contact me directly at (303) 478-0922. trice• c �Y, Art Willden Certified Air Monitoring Specialist No. 20138 vv `' y �-'t�; s � '�"'�, _-•,.I -may _ - _ { T� Cp,� a s Colorado Department a ti } of Public Heal y and ENironment ASBESTOS ICATIONY ..:� CERTIF This certifies that m. Prokop , - Douglas �= r"19951 Certification No.: 4 . r = •� t:;C.R.S. and Air Quality Control r F require of 25-7-507, has met the req h is and hereby certified by the Regulation No. 8, Part B, -.f Commission Reg ^Y _ state of Colorado in the following discipline'- state iscipline: sl _ -� •fir Building Inspector* Issued: September 28, 2016 2017 �s 2 a Expires: September 28, , / _ m 41 ,f x This certificate is valid only with the possession of a� v roved training course certification k ' current Division-apP ithorized APeD Represe alive in the discipline specified above. SEAL r ti S1 l ��I Y �41a L 9� J Q W Q Oj) Q Q � � U Q Q ��� H ~ M + N Q ;��y•5 � O o � � w U •1 � Z N vI •� W cd � ° O •tu C3 C N O C A U cit J Q W 'a =WWAAMOW Doug Prokop Prokop Environmental, LLC 9457 S. University Blvd., Suite 100 Highlands Ranch CO 80126 Collected: 10/12/2016 Collected By: Doug Prokop collection Address: 6610 W. 31 st Avenue Lab ID Sample Location 1 Sample # Sample Description - 0022317 -012 Basement -East Wall 10-16.1657-12 Window Glazing, Gray, 23°C BATCH NO. 0022317 NVLAP Lab Code 102031 AIHA Lab Code 101536 Customer Project No.: 10-16.1657 Description: 6610 W. 31 st Avenue Date Received: 10/12/2016 Date Analyzed: 10/13/2016 Date Reported: 10/13/2016 Comments: Asbestos Non -Asbestos Constituents Constituents N (%) Chrysotile 5% OBSERVATION SET#1: Wavy Fibers Sign of Elongation (+) Parallel Extinction Non -Pleochroic @ 40x Birefringence (Low) Color: Clear Oil 1.68 Becke Line Used Initial Characterization: Chrysotile OS#1: Para.=1.554, Perp.=1.547 Cellulose Fiber (Incom) 3% Carbonates 40% Binder/Filler 52% Chrysotile 3% Cellulose Fiber (Incom) 10% 0022317-013 Basement -Ceiling OBSERVATION SET#1: LACarbonates 20% LAYER 1 10-16.1657-13 WavyFibers Non -Fibrous Material 67% Textured Paint, Off White, 23°C sign of Elongation (+) Parallel Extinction Non -Pleochroic @ 40x Birefringence (Low) Color: Clear Oil 1.68 Becke Line Used Initial Characterization: Chrysotile OS#1: Para.=1.556, Perp.=1.550 Cellulose Fiber (Incom) 85% None Detected Organic Matrix 15% LAYER 2 Ceiling Tile, White/ Brown Reviewed by: Analyzed by: M Page 5 of 5 PROKOP Environmental, LLC October 15, 2016 Brendan Gustafson 720-234-9375 brendangustafson@msn.com Re: Prokop Environmental, LLC Project Number: 10-16.1657 Subject Property Owner and Address: Brendan Gustafson 6610 West 31 st Avenue Arvada, CO 80214 To Whom It May Concern: Prokop Environmental, LLC was pleased to be contacted and authorized by the above referenced parties to perform a limited asbestos survey at the subject property. This limited asbestos survey was conducted for the purpose of identifying the presence of asbestos containing materials (ACM) in the areas of the building that was part of the scope of work communicated to Prokop Environmental, LLC as required by state and/or federal regulatory agencies. The survey was performed by a Colorado Department of Public Health and Environment (CDPH&E) certified asbestos inspector and in compliance with applicable federal, state, and local regulatory rules. Please see the attached copy of the limited asbestos survey report for detailed information on the survey performed. If you have any question regarding this report or need additional assistance please feel free to contact Prokop Environmental at anytime. Sincerely, Doug Prokop Prokop Environmental, LLC 720-232-7152 Enclosed: Limited Asbestos Survey Report Prokop Environmental, LLC 9457 S. University Blvd., Suite 612 Highlands Ranch, CO 80126 720-232-7152 10-16.1657 Brendan Gustafson 6610 West 31st Avenue Arvada, CO 80214 LIMITED ASBESTOS SURVEY REPORT PROJECT BACKGROUND INFORMATION Firm Performing Survey: Survey Site Name and Property Type: Survey Site Address: Survey Performed For: Prokop Project Number: Date of Survey: Prokop Environmental, LLC 9457 S. University Blvd., Suite 612 Highlands Ranch, CO 80126 Phone: 720-232-7152 Brendan Gustafson Church 6610 West 31 st Avenue Arvada, CO 80214 Brendan Gustafson 720-234-9375 brendangustafson@msn.com 10-16.1657 October 12, 2016 Licensed Inspector: Doug Prokop CDPH&E Asbestos Building Inspector: 22466 AHERA Certification Number: I15342 Inspector Signature: Date of Report: October 15, 2016 # of Samples Collected: 13 (Thirteen) # of Material(s) Containing >1% Asbestos: 7 (Seven) Report Attachments: List of Homogeneous Areas Identified & Sampled Summary Chart of Sample Collected for Analysis Photographs of the Property and Homogeneous Materials Chain of Custody and Laboratory Report Inspector, Consulting Firm and Laboratory Certifications Prokop Environmental, LLC 9457 S. University Blvd., Suite 612 Highlands Ranch, CO 80126 720-232-7152 10-16.1657 Brendan Gustafson 6610 West 31 st Avenue Arvada, CO 80214 PROJECT SUMMARY INFORMATION Sample Collection Protocol: As part of this limited asbestos survey a CDPH&E certified asbestos building inspector performed an onsite inspection of the property to visually and physically identify suspect ACM and it's condition within the area of the building that was damaged and part of the scope of work that was communicated to Prokop Environmental, LLC. The identified suspect ACMs were each assigned a homogenous area (HA) number and randomly sampled in accordance with regulatory guidelines. Homogenous areas are defined as an area of material that is uniform in color and texture. The HA list for this project including the description, location, categorization, and condition of each material on the HA list is attached to this report. Also attached is a digital photo of each HA. Materials that were not observable, accessible, or not part of the scope of work communicated to Prokop Environmental, LLC are not included in this limited survey. If additional materials that are not included in this survey are found, samples of these materials should be tested for asbestos content. Methods: The samples collected were delivered under chain of custody to Cardno ATC, a National Voluntary Laboratory Accreditation Program (NVLAP) and CDPH&E certified laboratory. Laboratory accreditations and certifications are attached to this report. Laboratory analytical method used: EPA Method 600/M4-82-020; 600/R-93/11. Findings: The following material(s) were found to contain greater than 1% asbestos: • The Siding located on the Exterior Walls. This material is categorized as Miscellaneous, Nonfriable, and in Good Condition. • The Vinyl Floor Tile and Mastic located on the North Church Entry and Basement Floor. This material is categorized as Miscellaneous, Nonfriable, and in Good Condition. • The Window Glazing located on the Basement Windows. This material is categorized as Miscellaneous, Nonfriable, and in Good Condition. • The Texture located on the Basement Ceiling. This material is categorized as Surfacing, Friable, and in Good Condition. Limitations: This limited asbestos survey was conducted following federal and CDPH&E protocols for identifying ACM. Areas of suspect ACM may be present in areas not visible or accessible during this limited asbestos survey. Prior repairs or remodeling of the subject property and materials may have altered building materials so that suspect ACM could not be identified during this inspection. If any additional suspect ACM is discovered these materials should be properly sampled and tested for asbestos content. Reasonable attempts have been made to ensure that this report is complete and accurate with respect to Prokop Environmental, LLC's authorized scope of investigation. Prokop Environmental, LLC 9457 S. University Blvd., Suite 612 Highlands Ranch, CO 80126 720-232-7152 10-16.1657 Brendan Gustafson 6610 West 31 st Avenue Arvada, CO 80214 HOMOGENEOUS AREA LIST "A 4 01 Material Description Texture/Skim Coat, Plaster Material Location Main Level - Church Walls & Ceiling Material Categories: Condition Surfacing - Friable - Good Quantity 3.000 Sq. Ft. 02 Siding Exterior Church - Walls Misc - Nonfriable - Good N/A 03 Foundation Material Exterior Foundation Misc - Nonfriable - Good N/A 04 Roofing Material Church - Roof Misc - Nonfriable - Good N/A 05 Vinyl Tile and Mastic Church North Entry - Floor Misc - Nonfriable - Good 150 Sq. Ft. 06 Vinyl Tile and Mastic Church - Basement - Floor Misc - Nonfriable - Good 800 Sq, Ft. 07 Cove Base and Mastic Basement - Walls Misc - Nonfriable - Good N/A 08 Window Glazing Basement - East Window Misc - Nonfriable - Good <32 Sq. Ft. 09 Ceiling Paneling/Tile, Texture Basement - Ceiling Surfacing - Friable - Good 800 Sq. Ft. SAMPLE SUMMARY CHART Sample # 10-16.1657 -01 Layer 1 HA # 01 Material Description Paint/Skim Coat Sample Location Church Entrance - South Wall % Asbestos None Detected 10-16.1657 -01 2 01 Plaster Church Entrance - South Wall None Detected 10-16.1657 -02 1 01 Paint/Skim Coat Church Entrance - West Wall None Detected 10-16.1657 -02 2 01 Plaster Church Entrance - West Wall None Detected 10-16.1657 -03 1 01 Paint/Skim Coat Church - North Wall None Detected 10-16.1657 -03 2 01 Plaster Church - North Wall None Detected 10-16.1657 -04 1 01 Paint/Skim Coat Church - West Wall None Detected 10-16.1657 -04 2 01 Plaster Church - West Wall None Detected 10-16.1657 -05 1 01 Paint/Skim Coat Church - Ceiling None Detected 10-16.1657 -05 2 01 Plaster Church - Ceiling None Detected 10-16.1657 -06 1 02 Siding Exterior - East Siding None Detected 10-16.1657 -07 1 03 Paint Exterior - Foundation None Detected 10-16.1657 -07 2 03 Foundation Material Exterior - Foundation None Detected 10-16.1657 -08 1 04 Roofing Material Church Roof None Detected 10-16.1657 -09 1 05 Vinyl Floor Tile Church North Entry - Floor , Chrysotile 10-16.1657 -09 2 05 Mastic Church North Entry - Floor 15% Chi 10-16.1657 -10 1 06 Vinyl Floor Tile Church Basement - Floor 8% Chi\ Ie 10-16.1657 -10 2 06 Mastic Church Basement - Floor 15% Chi de 10-16.1657 -11 1 07 Cove Base Basement - Wall None Detected 10-16.1657 -11 2 07 Mastic Basement - Wall None Detected 10-16.1657 -12 1 08 Window Glazing Fast Basement - Window 5% Chrysotile 10-16.1657 -13 1 09 Textured Paint 13asement - Ceiling 3% Chrysotile 10-16.1657 -13 2 09 Ceiling Tile Basement - Ceiling None Detected Prokop Environmental, LLC 9457 South University Blvd., Suite 612 Highlands Ranch, CO 80126 720-232-7152 10-16.1657 Brendan Gustafson 6610 West 31 st Avenue Arvada, CO 80214 PHOTO REPORT Brendan Gustafson 6610 West 31st Avenue Arvada, CO 80214 Prokop Environmental, LLC 9457 South University Blvd., Suite 612 Highlands Ranch, CO 80126 720-232-7152 RA -06 10-16.1657 Brendan Gustafson 6610 West 31 st Avenue Arvada, CO 80214 PHOTO REPORT Brendan Gustafson 6610 West 31 st Avenue Arvada, CO 80214 HA -07 Prokop Environmental, LLC 9457 South University Blvd., Suite 612 Highlands Ranch, CO 80126 720-232-7152 IIA -08 ;STC ANALYTICAL REPORT Prepared for: Prokop Environmental, LLC 9457 S. University Blvd., Suite 100 Highlands Ranch, CO 80126 Project: 6610 W. 31 st Avenue Order No.: 0022317 Report Date: 10/13/2016 ATC Group Services LLC 8985 E. Nichols Avenue, Suite 350, Centennial, CO 80112 Ph: 303-799-6100 IMF A rr AA 8985 E. Nichols Avenue, Suite 350 Centennial, CO 80112 Phone +1303 799 6100 Fax +1303 799 3441 www. atcgroups ervices. com PLM REPORT SUMMARY NVLAL Lab Code 102031 Customer: AIHA Lab Code 1015361536 Doug Prokop ATC Job No.: Z036000140 Prokop Environmental, LLC Batch No.: 0022317 9457 S. University Blvd., Suite 100 Report Date: 10/13/2016 Highlands Ranch CO 80126 Sample Date: 10/12/2016 Project: 6610 W. 31 st Avenue Date Analyzed: 10/13/2016 Customer Project No.: 10-16.1657 Identification: N/A Test Method: EPA Method 600/M4-82-020; 600/R-93/116 Page 1 of 3 Client No. Lab No. Sample Description / Location Asbestos Content 10-16.1657-01 0022317-001 LAYER 1 None Detected Paint/Skim Coat, Beige, 23°C Entrance -South Wall 10-16.1657-01 0022317-001 LAYER 2 None Detected Plaster, Lt. Gray Entrance -South Wall 10-16.1657-02 0022317-002 LAYER 1 None Detected Paint/Skim Coat, Beige, 23°C Entrance -West Wall 10-16.1657-02 0022317-002 LAYER 2 None Detected Plaster, Lt. Gray Entrance -West Wall 10-16.1657-03 0022317-003 LAYER 1 None Detected Paint/Skim Coat, Beige, 23°C Church -North Wall 10-16.1657-03 0022317-003 LAYER 2 None Detected Plaster, Lt. Gray Church -North Wall 10-16.1657-04 0022317-004 LAYER 1 None Detected Paint/Skim Coat, Beige, 23°C Church -West Wall 10-16.1657-04 0022317-004 LAYER 2 None Detected Plaster, Lt. Gray Church -West Wall These samples were analyzed by layers. Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only if it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) -- materials which are friable or may become friable -- be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full, and should not be used as a scope of work for abatement without consulting with ATC. ;STC 8985 E. Nichols Avenue, Suite 350 Centennial, CO 80112 Phone +1303 799 6100 Fax +1303 799 3441 www.atcgpoupsepvices.com PLM REPORT SUMMARY NVLAP Lab Code 102031 Customer: AIHA Lab Code 101536 Doug Prokop ATC Job No.: Z036000140 Prokop Environmental, LLC Batch No.: 0022317 9457 S. University Blvd., Suite 100 Report Date: 10/13/2016 Highlands Ranch CO 80126 Sample Date: 10/12/2016 Project: 6610 W. 31 st Avenue Date Analyzed: 10/13/2016 Customer Project No.: 10-16.1657 Identification: N/A Test Method: EPA Method 600/M4-82-020; 600/R-93/116 Page 2 of 3 Client No. Lab No. Sample Description / Location Asbestos Content 10-16.1657-05 0022317-005 LAYER 1 None Detected Paint/Skim Coat, Beige, 23°C Church -West Ceiling 10-16.1657-05 0022317-005 LAYER 2 None Detected Plaster, Lt. Gray Church -West Ceiling 10-16.1657-06 0022317-006 Siding, Gray, 23°C Chrysotile 25% Church -Siding 10-16.1657-07 0022317-007 LAYER 1 None Detected Paint, White, 23°C Foundation -Exterior 10-16.1657-07 0022317-007 LAYER 2 None Detected Foundation, Exterior, Gray Foundation -Exterior 10-16.1657-08 0022317-008 Roof Material, Black, 23°C None Detected Church -Roofing 10-16.1657-09 0022317-009 LAYER 1 Chrysotile 3% Floor Tile, Off White, 23°C Church -Entry, North Floor 10-16.1657-09 0022317-009 LAYER 2 Chrysotile 15% Floor Tile Mastic, Black Church -Entry, North Floor These samples were analyzed by layers. Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only if it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) -- materials which are friable or may become friable -- be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full, and should not be used as a scope of work for abatement without consulting with ATC. A A r# W AJ IL I MW Customer: Doug Prokop Prokop Environmental, LLC 9457 S. University Blvd., Suite 100 Highlands Ranch CO 80126 PLM REPORT SUMMARY Project: 6610 W. 31 st Avenue Customer Project No.: 10-16.1657 Identification: N/A Test Method: EPA Method 600/M4-82-020; 600/R-93/116 ATC Job No.: Z035000140 Batch No.: 0022317 Report Date: 10/13/2016 Sample Date: 10/12/2016 Date Analyzed: 10/13/2016 8985 E. Nichols Avenue, Suite 350 Centennial, CO 80112 Phone +1303 799 6100 Fax +1303 799 3441 www. atcgroups ervices. com NVLAP Lab Code 102031 AIHA Lab Code 101536 Page 3 of 3 Client No. Lab No. Sample Description / Location Asbestos Content 10-16.1657-10 0022317-010 LAYER 1 Chrysotile 8% Floor Tile, Brown, 23°C Basement -Floor 10-16.1657-10 0022317-010 LAYER 2 Chrysotile 15% Floor Tile Mastic, Black Basement -Floor 10-16.1657-11 0022317-011 LAYER 1 None Detected Cove Base, Brown, 23°C Basement-Covebase 10-16.1657-11 0022317-011 LAYER 2 None Detected Cove Base Mastic, Brown, 23°C Base ment-Covebase 10-16.1657-12 0022317-012 Window Glazing, Gray, 23°C Chrysotile 5% Basement -East Wall 10-16.1657-13 0022317-013 LAYER 1 Chrysotile 3% Textured Paint, Off White, 23°C Basement -Ceiling 10-16.1657-13 0022317-013 LAYER 2 None Detected Ceiling Tile, White/ Brown Basement -Ceiling These samples were analyzed by layers. Specific layer or component asbestos content is indicated when relevant. The EPA considers a material to be asbestos containing only if it contains more than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) -- materials which are friable or may become friable -- be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE. Our laboratory utilizes CVAE on a routine basis and does not include point counting unless specifically requested. The results may not be reproduced except in full, and should not be used as a scope of work for abatement without consulting with ATC. Customer: Doug Prokop Prokop Environmental, LLC 9457 S. University Blvd., Suite 100 PLM REPORT SUMMARY Highlands Ranch CO 80126 Project: 6610 W. 31st Avenue Customer Project No.: 10-16.1657 Identification: N/A Test Method: EPA Method 600/M4-82-020; 600/R-93/116 ATC Job No.: Batch No. Report Date: Sample Date: Date Analyzed: Z035000140 0022317 10/13/2016 10/12/2016 10/13/2016 8985 E. Nichols Avenue, Suite 350 Centennial, CO 80112 Phone +1303 799 6100 Fax +1303 799 3441 www.atcgpoupsepvices.com NVLAP Lab Code 102031 AIHA Lab Code 101536 Page 1 of 1 PLM Analysis Methodology PLM samples were analyzed utilizing the Environmental Protection Agency's Test Method: Method for the Determination of Asbestos in Building Materials (EPA 600/R-93/116. July, 1993). Reporting Limit <1% Asbestos. Additional treatment and tests may be required to accurately define composition (i -e. ashing, extractions, acetone treatment, andTEM). Unused portions of samples are archived for one year unless client requests special handling. Asbestos content of mastic/adhesive is separated from total percent asbestos and other materials. Laboratory Equipment Laboratory analysis was accomplished utilizing an Olympus BH -2 polarized light microscope. The microscope is equipped with dispersion staining lenses. Quality Control ATC Group Services is accredited by NVLAP Bulk Asbestos Sample Quality Assurance Program (Lab Code 102031). ATC participates in the NVLAP Bulk Asbestos Sample Quality Assurance Program and maintains an in-house QC/QA program for bulk samples whereby 10% of all submitted samples are reanalyzed and documented in a Quality Control Manual. ATC also participates in a quarterly round robin QC/QA program for bulk samples with several accredited laboratories throughout the United States. Current and past QC/QA program results are available in the laboratory for inspection. Laboratory Personnel Samples were analyzed by Jeff Lomme, Laboratory Director. Mr. Lomme is a professional geologist who has successfully completed the McCrone Institutes's "Advanced Asbestos Identification" Course. Approved Signatory ;,Jeff Lomme NVLAP LAB CODE 102031-0 The non -detection of asbestos fibers in floor tile by PLM is of itself inconclusive. Confirmation by Transmission Electron Microscope (TEM) is recommended for negative floor tile samples. This report must not be used by the client to claim product endorsements by NVLAP or an agency of the U.S- government. This test reports only to the items stated. Awl Aft r ENVIRONMENTAL• GEOTECHNICAL BUILDING SCIENCES • MATERIALS TESTING PROJECT INFORMATION Turnaround: 2 hour 24 hour 3-5 day 8985 East Nichols Avenue, Suite 350 Centennial, Colorado 80112 TEL: 303.799.6100 FAX: 303.799.3441 Company/Customer: Prokop Environmental, LLC Project Name: . , -- r � _ 7 Address: 9457 S. University Blvd. Collection Date: Address: Suite 612 Customer Number/P.O.: Phone/Fax: 720-232-7152 Collection Address: G /0 Customer Contact: Doug Prokop Positive Stop: YES / NO — If not indicated assume no positive stop Email: dprokop@prokopenv.com Note: Sample collector is responsible for ensuring that all samples have been preserved and prepared to the appropriate and applicable methodology. If package has sustained damage during transit, notify collector and shipper. Turnaround time begins upon receipt of sample (s) by laboratory. ATC will not be responsible for errors or omissions in calculations from inaccuracy of original data. CHAIN OF CUSTODY Sample Number Sample Material Sample Location 1 2 3 4 5 L �` 7 t rA ( ; Fi ' t d lX �� t v L' i K 8 9 u 10 u� 12 13 — 14 15 16 17 18 19 20 21 22 23 24 25 Note: Sample collector is responsible for ensuring that all samples have been preserved and prepared to the appropriate and applicable methodology. If package has sustained damage during transit, notify collector and shipper. Turnaround time begins upon receipt of sample (s) by laboratory. ATC will not be responsible for errors or omissions in calculations from inaccuracy of original data. CHAIN OF CUSTODY XTBATCH NO. ArAk 0022317 NVLAP Lab Code 102031 AV AIHA Lab Code 101536 Doug Prokop Customer Project No.: 10-16.1657 Prokop Environmental, LLC Description: 6610 W. 31 st Avenue 9457 S. University Blvd., Suite 100 Date Received: 10/12/2016 Highlands Ranch CO 80126 Date Analyzed: 10/13/2016 Collected: 10/12/2016 Date Reported: 10/13/2016 Collected By: Doug Prokop Comments: Collection Address: 6610 W. 31 St Avenue 0022317-004 Church -West Wall None Detected Cellulose Fiber (Incom) <1% 10-16.1657-04 LAYER 1 Aggregate 30% Paint/Skim Coat, Beige, 23°C Binder/Filler 70% None Detected Cellulose Fiber (Incom) 3% LAYER 2 Aggregate 60% Plaster, Lt. Gray Binder/Filler 37% Analyzed by: Reviewed by: Page 1 of 5 Asbestos Non -Asbestos Lab ID Sample Location / Constituents Constituents Sample # Sample Description ("/o) M 0022317-001 Entrance -South Wall None Detected Cellulose Fiber (Incom) <1% 10-16.1657-01 LAYER 1 Aggregate 30% Paint/Skim Coat, Beige, 23°C Binder/Filler 70% None Detected Cellulose Fiber (Incom) 2% Fibrous Glass (ISO) <1 Hair (Morph) <1 LAYER 2 Aggregate 60% Plaster, Lt. Gray Binder/Filler 38% 0022317-002 Entrance -West Wall None Detected Cellulose Fiber (Incom) <1% 10-16.1657-02 LAYER 1 Aggregate 30% Paint/Skim Coat, Beige, 23°C Binder/Filler 70% None Detected Cellulose Fiber (Incom) <1% LAYER 2 Aggregate 60% Plaster, Lt. Gray Binder/Filler 40% 0022317-003 Church -North Wall None Detected Cellulose Fiber (Incom) <1% 10-16.1657-03 LAYER 1 Aggregate 30% Paint/Skim Coat, Beige, 23°C Binder/Filler 70% None Detected Cellulose Fiber (Incom) <1% LAYER 2 Aggregate 60% Plaster, Lt. Gray Binder/Filler 40% 0022317-004 Church -West Wall None Detected Cellulose Fiber (Incom) <1% 10-16.1657-04 LAYER 1 Aggregate 30% Paint/Skim Coat, Beige, 23°C Binder/Filler 70% None Detected Cellulose Fiber (Incom) 3% LAYER 2 Aggregate 60% Plaster, Lt. Gray Binder/Filler 37% Analyzed by: Reviewed by: Page 1 of 5 rBATCH NO. Ar AJ 0022317 its W NVLALab Code 102031 L AIHA Lab Code 10153636 Doug Prokop Customer Project No.: 10-16.1657 Prokop Environmental, LLC Description: 6610 W. 31 st Avenue 9457 S. University Blvd., Suite 100 Date Received: 10/12/2016 Highlands Ranch CO 80126 Date Analyzed: 10/13/2016 Collected: 10/12/2016 Date Reported: 10/13/2016 Collected By: Doug Prokop Comments: Collection Address: 6610 W. 31 st Avenue Asbestos Non -Asbestos Lab ID Sample Location / Constituents Constituents Sample # Sample Description M M 0022317-005 Church -West Ceiling None Detected Cellulose Fiber (Incom) <1% 10-16.1657-05 LAYER 1 Aggregate 30% Paint/Skim Coat, Beige, 23°C Binder/Filler 70% None Detected Cellulose Fiber (Incom) <1% LAYER 2 Aggregate 60% Plaster, Lt. Gray Binder/Filler 40% 0022317-006 Church -Siding Chrysotile 25% Cellulose Fiber (Incom) <1% 10-16.1657-06 Siding, Gray, 23°C OBSERVATION SET#1: Binder/Filler 75% Wavy Fibers Sign of Elongation (+) Parallel Extinction Non -Pleochroic @ 40x Birefringence (Low) Color: Clear Oil 1.68 Becke Line Used Initial Characterization: Chrysotile OS#1: Para.=1.554, Perp.=1.546 0022317-007 Foundation -Exterior None Detected Cellulose Fiber (Incom) <1% Wollastonite (Morph) 2% 10-16.1657-07 LAYER 1 Aggregate 25% Paint, White, 23°C Non -Fibrous Material 73% None Detected Cellulose Fiber (Incom) <1% LAYER 2 Aggregate 70% Foundation, Exterior, Gray Binder/Filler 30% 0022317-008 Church -Roofing None Detected Cellulose Fiber (Incom) 35% Fibrous Glass (ISO) 10% Wool (Morph) 10% 10-16.1657-08 Roof Material, Black, 23°C Organic Matrix 10% Tar Binder 35% Analyzed by: f,,,, ` Reviewed by: Page 2 of 5 r BATCH NO. XC 0022317 NVLAP Lab Code 102031 Aff AIHA Lab Code 101536 Doug Prokop Customer Project No.: 10-16.1657 Prokop Environmental, LLC Description: 6610 W. 31 st Avenue 9457 S. University Blvd., Suite 100 Date Received: 10/12/2016 Highlands Ranch CO 80126 Date Analyzed: 10/13/2016 Collected: 10/12/2016 Date Reported: 10/13/2016 Collected By: Doug Prokop Comments: Collection Address: 6610 W. 31 St Avenue Lab ID Sample # Sample Location / Sample Description Asbestos Constituents M Non -Asbestos Constituents M 0022317-009 Church -Entry, North Floor Chrysotile 3% 10-16.1657-09 LAYER 1 OBSERVATION SET#1: Carbonates 60% Floor Tile, Off White, 23°C Wavy Fibers Binder/Filler 37% Sign of Elongation (+) Parallel Extinction Non -Pleochroic @ 40x Birefringence (Low) Color: Clear Oil 1.68 Becke Line Used Initial Characterization: Chrysotile OS#1: Para.=1.558, Perp.=1.550 Chrysotile 15% Cellulose Fiber (Incom) 15% LAYER 2 OBSERVATION SET#1: Aggregate 15% Floor Tile Mastic, Black Wavy Fibers Tar Binder 55% Sign of Elongation (+) Parallel Extinction Non -Pleochroic @ 40x Birefringence (Low) Color: Clear Oil 1.68 Becke Line Used Initial Characterization: Chrysotile OS#1: Para.=1.558, Perp.=1.550 Analyzed by: Reviewed by: Page 3 of 5 N Arr Ar AJ Doug Prokop Prokop Environmental, LLC 9457 S. University Blvd., Suite 100 Highlands Ranch CO 80126 Collected: 10/12/2016 Collected By: Doug Prokop Collection Address: 6610 W. 31 St Avenue BATCH NO. 0022317 NVLAP Lab Code 102031 AIHA Lab Code 101536 Customer Project No.: 10-16.1657 Description: 6610 W. 31 st Avenue Date Received: 10/12/2016 Date Analyzed: 10/13/2016 Date Reported: 10/13/2016 Comments: 60% Asbestos Non -Asbestos Lab ID Sample Location / Constituents Constituents Sample # Sample Description M M 0022317-010 Basement -Floor Chrysotile 8% 10-16.1657-10 LAYER 1 OBSERVATION SET#1: Carbonates 60% Floor Tile, Brown, 23°C Wavy Fibers Binder/Filler 32% Sign of Elongation (+) Parallel Extinction Non -Pleochroic @ 40x Birefringence (Low) Color: Clear Oil 1.68 Becke Line Used Initial Characterization: Chrysotile OS#1: Para.=1.558, Perp.=1.550 Chrysotile 15% Cellulose Fiber (Incom) 15% LAYER 2 OBSERVATION SET#1: Aggregate 15% Floor Tile Mastic, Black Wavy Fibers Tar Binder 55% Sign of Elongation (+) Parallel Extinction Non -Pleochroic @ 40x Birefringence (Low) Color: Clear Oil 1.68 Becke Line Used Initial Characterization: Chrysotile OS#1: Para.=1.558, Perp.=1.550 0022317-011 Basement-Covebase None Detected 10-16.1657-11 LAYER 1 Carbonates 30% Cove Base, Brown, 23°C Non -Fibrous Material 70% None Detected Cellulose Fiber (Incom) 5% Talc (Morph) 3% LAYER 2 Aggregate 10% Cove Base Mastic, Brown, 23°C Binder/Filler 82% Analyzed by: Reviewed by: Page 4 of 5 Doug Prokop Prokop Environmental, LLC 9457 S. University Blvd., Suite 100 Highlands Ranch CO 80126 Collected: 10/12/2016 Collected By: Doug Prokop Collection Address: 6610 W. 31 St Avenue Customer Project No. Description: Date Received: Date Analyzed: Date Reported: Comments: BATCH NO. 0022317 NVLAP Lab Code 102031 AIHA Lab Code 101536 10-16.1657 6610 W. 31 st Avenue 10/12/2016 10/13/2016 10/13/2016 Asbestos Non -Asbestos Lab ID Sample Location / Constituents Constituents Sample # Sample Description M M 0022317-012 Basement -East Wall Chrysotile 5% Cellulose Fiber (Incom) 3% 10-16.1657-12 Window Glazing, Gray, 23°C OBSERVATION SET#1: Carbonates 40% Wavy Fibers Binder/Filler 52% Sign of Elongation (+) Parallel Extinction Non -Pleochroic @ 40x Birefringence (Low) Color: Clear Oil 1.68 Becke Line Used Initial Characterization: Chrysotile OS#1: Para.=1.554, Perp.=1.547 0022317-013 Basement -Ceiling Chrysotile 3% Cellulose Fiber (Incom) 10% 10-16.1657-13 LAYER 1 OBSERVATION SET#1: Carbonates 20% Textured Paint, Off White, 23°C Wavy Fibers Non -Fibrous Material 67% Sign of Elongation (+) Parallel Extinction Non -Pleochroic @ 40x Birefringence (Low) Color: Clear Oil 1.68 Becke Line Used Initial Characterization: Chrysotile OS#1: Para -=1.556, Perp.=1.550 None Detected Cellulose Fiber (Incom) 85% LAYER 2 Organic Matrix 15% Ceiling Tile, White/ Brown Analyzed by: Reviewed by: l Page 5 of 5 O 01)Er O S U o 0 "U � � o �w a o °O O O -O Cd � O :P4 o � En N Q � ct O U I U OM J Q W U) 2: K- i e w U cd � U O i. A rA � c � W a <C O 01)Er O S U o 0 "U � � o �w a o °O O O -O Cd � O :P4 o � En N Q � ct O U I U OM J Q W U) 2: K- i e p O� CO� O . 1876 t` Colorado Department of Public Health .- and Environment ASBESTOS CERTIFICATION* This certifies that - Douglas M. Prokop Certification No.: 19951 has met the requirements of 25-7-507, C.R.S. and Air Quality Control _ Commission Regulation No. 8, Part B, and is hereby certified by the state of Colorado in the following discipline: _ Building Inspector* Issued: September 28, 2016 -- Expires: September 28, 2017 e This certificate is valid only with the possession of current Division-approved training course certification .. / in the discipline specified above. thorizedgAPCD Represe ative SEAL P � S � E LO o rx 4 c O o ro NN° .. o o Ucu N w8 , D o o koro tU O R 2 o a o EV ® �. ro oro. O � O 2 0 •� ° o a oC� `+— ca N rn 12 e; 4 co) O (UO 4 0 8 w NaL .� w •rte ov AW cdU� Q _ 0 CL co -cl, 05 Q U 5 �6Oo10 x UN�� •ti U) .0 V `�.' m %- 4) o o - a APO� � � cj co v i/3 N v d ca « .l/3 O .— CO03 z �-� M Cc) o +� O .Q N N V ro b c C) ro N M Clearance Report 21Page Photograph 1, 2, 3, 4, 5, and 6. Post Remediation Conditions (removal areas). Based on the information presented above, E3 concludes the site work has been successfully completed and the work areas may be rebuilt. Pleasc noii, the Col, aL-W- o 1}lt v, llt ve li: alit iii_ Ll.\:l U. :: 1:L 14.;quii" ally aJUC.JLus- containing material (such as the remaining transite) that will be disturbed during renovation activities be removed prior to renovation. Thank you for allowing E3 the opportunity to provide environmental services to you. If you have questions or require additional information, do not hesitate to contact me directly at (303) 478-0922. Art Willden Certified Air Monitoring Specialist No. 20138 q 5366 Godding Hollow Parkway Longont, CO 80504 EARTH ENERGY ENVIRONMENT (U) Local: B 303.4778-0922 Industrial Hygiene and Environmental Consulting December 5, 2016 Mr. Cody Williams Precision Homes of Colorado 1900 Federal Blvd Denver, Colorado 80204 Subject: Clearance Report Residential Building 6610 W. 31s` Avenue Wheatridge, CO Dear Mr. Williams: Earth Energy Environment (E3) is pleased to submit the results from the visual clearance conducted at the subject property. An Industrial Hygienist for E3 performed the remediation project completion inspection on December 5, 2016. The purpose of this report is to document this remediation project was successfully completed, and the work areas (select areas on the house exterior) were free of asbestos (Transite) and no associated debris was left on the ground surround the building. Note, the remediation did not include complete removal of all transite. Transite in select areas will remain in place. These areas include; behind select electrical conduit and the junction box and behind the basement entrance covering on the south side of the building. Transite in these areas will remain in place and will be incorporated into the building renovation without being disturbed. As a precautionary measure, any edges of the transite remaining in place that were broken or otherwise disturbed during nartial removal will be encapsulated. In the removal areas, visual inspection confirmed that suspect debris were not present in the work areas or on the ground surrounding the work areas. The photographs below document the post remediation conditions. PCM Air Clearance Page 2 of 2 PCM Air Clearance Page 2 of 2 PCI i Air Clearance Page 2 of 2 Post Encapsulation Photographs PCM Air Clearance Page 2 of 2 PCM Air Clearance Page 2 of 2 PCM Air Clearance Page 2 of 2 ft PCM Air Clearance Page 2 of 2 �._ _ PCM Air Clearance Page 2 of 2 Clearance Photographs 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: S . �'3 'o , Job Address: I a W 3 <z-3+ ✓ . 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: Inspect DO NOT REMOVE THIS NOTICE