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3910 Carr Street
i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: "`� �-- �•� Job Address: Ar2k_ Permit Number: ❑ No one available for inspection: Time(C) AM/PM Re -Inspection required: Yes When corrections have been i h ttp✓/www. ci. wheatridge. co. us Date.q. { In for re -inspection online at: i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: 1� rn e-. c Job Address: '-3cf 1 � ( C)l r Permit Number: a<-) � Ck U l -P �p ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes to When corrections have been made, schedule for re -inspection online at: http.lAvww.ci.wheatridge.co.uslinspection Date: L C Inspector:1 ` 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:�?r Job Address: Permit Number: 4 r. ❑ No one available for inspection; Time ;` z= ` AM/PM Re -Inspection required: Yes fiNo) When corrections have been made, call for re -inspection at 303-234-5933 Date: ? '' S 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: Job Address: -�� ! / /� S k Permit Number: G 1,4 c�d ,rO ❑ No one available for inspection: Time - AM/PM Re -Inspection required: Yes Na When corrections have been made, call for re -inspection at 303-234-5933 C: Date:_ / `� 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: Job Address: �-t L c A r a - Permit Number: (j } Gy i l-_-" ❑ No one available for inspection: Time tj AM/PM Re -Inspection required: Yes 149,J When corrections have been made, call for re -inspection at 303-234-5933 Date:3 * \ `I " \ (,\ Inspector: �) (-"- DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: K- V Qy*v% JobAddress: ty Sr Permit Number: �O \�� U i t C)n ',No" one available for inspection: TimeAM/PM Re -Inspection required: Yes) No When corrections have been made, call for re -inspection at 303 -234 - Date:— 0 1 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: Job Address: 7910 (a ✓r- S Permit Number: ❑ No one available for inspection: Time 01(W/PM Re -Inspection required: Yes When corrections have been made, call for re -inspection aat`303-234-5933 Date: D"-� Inspector: DO NOT REMOVE THIS NOTICE tC i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 0 C Job Address: r'�`'� 1 C� -r Permit Number: �—L n 1 e ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes 'M When corrections have been made, call for re -inspection at 303-234-5933 Date: '.i Inspector: �= DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Remodel PERMIT - 201901466 PERMIT NO: 201901466 ISSUED: 07/31/2019 JOB ADDRESS: 3910 Carr St EXPIRES: JOB DESCRIPTION: SWO Kitchen remodel, replace soffitts, no layout change - 200 sq ft total *** CONTACTS *** OWNER (303)378-9338 RAHNE RICHARD A GC (303)588-7844 DENNIS RICHARDSON 190198 RICHARDSON CONSTRUCTION SUB (303)843-6108 ROD HANSEN 018356 ROD HANSEN ELECTRIC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 25,000.00 FEES Total Valuation 0.00 Plan Review Fee 287.33 Use Tax 525.00 Permit Fee 442.05 Investigative Fees 442.05 ** TOTAL ** 1,696.43 *** COMMENTS *** *** CONDITIONS *** All roughs to be done at Framing Inspection. Approved per plans and red -line notes on plans. Must comply with 2012 IRC, 2017 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections. 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 ppermit. I further attest that I am leggally authorized to include all entities named within this document as parties to the work to be perform a that al r � rtormed is disclosed in this document and/or its' accompanying approved plans and specifications. iN *� _3 i Signature of OWNER or CONTRACTOR (Circle one) Date I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpenmt 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 gram of a permit shill not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or afiy dinance or lation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of Wheat j�dge COMMUNITY DEVELOPMENT Building & Inspection Services skq�� 7500 W. 291' Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: Permits(c)ci.wheatridge.co.us FOR OFFICE USE ONLY Date: I/ � -) /7 Plan/Permit # awq011% Plan Review Fee: j'�� 3 3 � Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 3910 Cc-,, r c-_)-( Property Owner (please print): c Phone: 3d-� - 9 3 Property Owner Email: 2 c i-) e rv� A) r Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer: 14 Architect/Engineer E-mail: lhi Phone: . Contractor Name: cHA ir 01 Ste, City of Wheat Ridge License #: Phone: -S $ a,-) $4/ '�C Contractor E-mail Address: For Plan Review Questions & Comments (please print): CONTACT NAME (please print): IDC�ru / S 1C i Phone: 3c>.3 6 az -) CONTACT EMAIL(p/ease print):' i E tiv nJu vF, " 'S 4KD l9yL, k - 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. Arc --A Sq. FULF 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) '5-_ vim% OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): Z✓�✓'T� V DATE: Printed Name: iv n.l S/ 1 I C l a v ►a S OJ DEPARTMENT USE ONLY �3 ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Reviewer: BUILDING DEPARTMENT COMME TS: Reviewer: Cj1 L�� PUBLIC WORKS COMMENTS: Reviewer: Building Division Valuation: Z5t Y City of W h6, at�idge COMMUNITY DEVELOPMENT SUB -CONTRACTOR AUTHORIZATION FORM This form must be signed by each sub -contractor. This form will not be accepted with missing information. Subcontractor's City of Wheat Ridge License number must be provided in the applicable space. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: / U Ca r Permit #: General Contractor: % c f 4/ 0 Electrical Sub -Contractor Company Name: ) ,J //,* ,, t -_Z /-'�hone #: S__ State License #: / % &� 5— Master #: 2 Y d Wheat Ridge License #: (required field) Signature of Authorized Agent Da e Plumbing Sub -Contractor Company Name: Phone #: State License #: Master #: Wheat Ridge License #: (required field) Signature of Authorized Agent Date Company Name: Phone: Wheat Ridge License #: (required field) Signature of Authorized Agent Date Richardson Construction Dennis Richardson 3910 Carr St Wheat Ridge, CO 80033 Property Type Residential PH 3035887844 Prepared By EnvioCore LLC Asbestos Consulting Firm No. 21660 1685 S. Colorado Blvd Denver, CO 80124 303-GoEnvio (463) 6846 John Peralta Asbestos Building Inspector Cert. No. 24339 Inspection Information Inspection Date 07/15/2019 Arrival Time 10:30 AM Report Date 07/16/2019 Inspection # 0719-17 Richardson, Dennis Protocols Followed Asbestos AHERA Lab Information ATC Group Services LLC 8985 E Nichols Ave Suite 350, Centennial, CO 80112 303-799-6100 Asbestos NVLAP Cert # 102031 a'-0 �qd '(0 � Limited Residential Asbestos Renovation Inspection Report 3910 Carr St .................................. Definitions....................................................................................................... ........... 3 KeyTerms..................................................................................................................... ...... 3 Limitedinspection Summary..................................................................................................................... 4 General....................................................................................................... .... 4 Asbestos......................................................................................................................................... .......... 4 Purpose and Scope of inspection............................................................................................................. 4 General..................................................................................................................................................... .....4 Asbestos...................................................................................................................................................................... 4 Background................................................................................................................................................5 Sampling.....................................................................................................................................................5 Asbestos Results Reporting........................................................................................................................6 Asbestos Inspection Conclusion...............................................................................................................6 Closing................................................................................................................... ...............7 Inspection Photos.............................................................................................................. ....8 ..................... LabResults................................................................................................................................................. 12 Inspection Certifications.................................................................... I . The term "Certified Inspector" shall mean individual who is identified on the first page of this Limited Inspection Report as conducting the Inspection. 2. The term "Client" shall mean the entity that has ordered the Limited Inspection on the Property on behalf of the Client. 3. The term "Limited Inspection Report" shall mean this report, which summarizes the Inspection, as applicable to the Property. 4. The term "Owner" shall mean the owner of the Property. 5. The term "Property" shall mean the building(s) or structure(s) at the address listed under Property Information on the first page of this Limited Inspection Report. 6. The terms "Work Activity" shall mean any construction, renovation, remediation, decontamination, cleanup, or other work. 1. Asbestos is a naturally occuring mineral. Asbestiform varieties include chrysotile, amosite, crocidolite, anthophyllite, tremolite and actinolite. 2. Asbestos abatement is the wrecking or removal of builiding materails that contain friable and non -friable asbestos fibers. 3. Asbestos abatement contractor is any person hired to conduct asbestos abatement. 4. Friable material can be crumbled, pulverized, or rendered to powder by hand pressure when dry. 5. A homogenous area is an area of surfacing material, thermal system insulation material, or miscellaneous material this is uniform in color, texture, construction, application date, and general appearance. 6. Miscellaneous material is interior building material on structural components, structural members, or fixtures, such as floor and ceiling tiles, and does not include surfacing material or thermal system insulation. 7. Non -friable material cannot be crumbled, pulverized, or reduced to powder by hand pressure when dry. 8. Point counting is a secondary analytical technique to verify the presences of asbestos in samples with 10% or lower asbestos. 9. Surfacing material is sprayed, troweled, or otherwise applied on surfaces, such as acoustical plaster on celilings and fireproofing materials on structural members, or other materials on surfaces for acoustical, fireproofing, or other purposes. 10. Thermal system insulation (TSI) is material tha tis applied to pipes, fittings, boilers, breeching, tanks, ducts, or other interior structural components to prevent heat loss, heat gain, or water condesation, or for other purposes. 11. The terms "Asbestos Containing Material" or "ACM" shall mean surfacing, thermal system insulation, or miscellaneous materials that contain I% or more of asbestos. 12. The terms "Asbestos Containing Buildina Material" or "ACBM" shall mean Asbestos Contai been used for construction or improvement of a building or other structure. 13. The term "Certified Asbestos Consulting . Firm" shall mean any person licensed with the State of Colorado and the EPA, hired for a fee to conduct any of the folowing activities, as required by Regulation No. 8, Part B, in the State of Colorado: asbetos builidng inspection and bulk sampling; development of asbestos management plans; air monitoring for asbestos fibers; development of asbestos project designs; and, project management, as specified in Section II.J. 14. The term "Certified Asbestos Laboratory" shall mean a laboratory with accreditation from the National Voluntary Laboratory Accreditaion Program (NVLAP) to analyze bulk samples for asbestos using polarized light microscopy (PLM). 15. The terms "Damaged ACM" and "Significantly Damaged ACM" shall mean friable or non -triable ACM that has deteriorated or delaminated to the point that it has lost its bond to the substratre or has otherwise suffered crumbling, blistering, nonadhesiveness, gouging, water staining, or marring. The term "Damaged ACM" applies when 1 /10 of the entire surface has suffer damage (1 /4 if the damage is localized). The terms "Significantly Damaged ACM" shall apply when more than I/ 10 of the surface has suffered damage. 16. The term "Limited Asbestos Inspection" shall mean an abbreviated inspection by the Inspector of the components of the Property that may be subject to Work Activity. The Inspection shall investigate the presence of ACBM and shall comply with all state and federal laws, rules, and regulations. General The Client agrees to read the Limited Inspection Report upon receipt and promptly call the Inspector with questions or concerns. This Limited Inspection Report is not intended to be exhaustive in the manner of inspecting the Property and all of its building materials and components. The Inspector only inspected specific areas that may be subject to Work Activity and that are visually and physically accessible. The Limited inspection was not a risk assessn?ent or physical inspection of systems, structure, or components of the Property. The use of this Limited Report and its contents, in whole or in part by persons or entities other than the Client is not authorized without the written mutual consent of the Client and envioCore LLC. Asbestos The Limited Inspection Report documents the findings of a Limited Asbestos inspection at the Property. The Limited Asbestos inspection intended to locate ACBM in areas that might be the subject of Work Activity. The Certified inspector performed the Limited Asbestos Inspection in accordance with the current state and federal laws at the time of inspection. General The scope of this report included a visual inspection of all affected rooms and/or areas throughout the subject property for visible suspect ACBM and/or Lead Based Paint. This does not include any materials that were covered or hidden by walls, structures, carpeting, wood flooring, multiple layers, wallpaper, texturing, etc. However, the Certified Inspector made every reasonable effort to access and identify all suspect ACM and/or Lead Based Paint. If the scope of work changes, the Client must inform the Certified Inspector to allow the Certified Inspector to supplement the Limited Inspection Report. This Limited inspection Report is solely a record of activities, observations, analytical results, and recommendations performed to date. Asbestos C:,tY °f Bulk asbestos samples were randomly collected from homogenous areas of suspect ACM by tf Certif'iE Inspector. If the color, texture, construction, application date, or general appearance differs b t��t materials or if for any reason the Certified inspector suspects that the materials might differ in a respe tp;vkso the Certified Inspector will take separate samples from each homogenous area. The Certified Ins L#IlcAoo-V representative bulk samples were similar materials, but this does not guarantee that materials of similar appearance are of the some composition. Even similar materials are subject to uneven mixing and distribution, and random sampling can miss ACM. EnvioCore used reasonable diligence and its professional judgment consistent with industry standards in order to identify all suspect A,CBM. Bulk samples were analyzed by Certified Asbestos Laboratory. The inspector was called to the subject property by Dennis Richardson of Richardson Construction. Mr. Richardson was concerned about asbestos containing building materials in the affected areas of the building. Per Mr. Richardson, suspect asbestos containing building materials to be disturbed in the scope of work include: The affected materials sampled: - Texture - Joint Compound The affected areas include: - Dumpster The Certified Inspector and the Client understand and agree that the Limited Asbestos Inspection shall include only the above -referenced potentially affected areas. If the Work Activity later includes other areas or materials that may contain ACBM, the Client understands that the Certified Inspector will only perform a Limited Asbestos Inspection of these areas upon a subsequent engagement. Using methods that are generally accepted in the industry, the Certified Inspector determined that it was necessary to collect _.5_._ bulk samples from the various homogenous areas (see the Asbestos Sampling below for exact areas). All samples were submitted to Certified Asbestos Laboratory. The laboratoryresults are incorporated into this report. Neither envioCore, LLC nor the Certified Inspector warrants the accuracy of any laboratory results. The Client and any other parties hereby agree that envioCore, LLC and the Certified Inspector shall not be liable in any manner for erroneous laboratory results or other errors with the laboratory testing process. See Data Table (table 1) Below for Tabulated Results along with Attached Photos (Figure 1, etc.) City 01 Vleat RW(3e Table l:Table ofasbestos samples taken during inspection wKhlabneyults. ND = Non Detected, Wall ^A"ineach room is the wall where the front entrance door opening blocated (or aligned with the street). Going clockwise and facing wall "A" (the street), wall "B" will always be to your right,wall ^C"directly tothe rear and wall ^Cr to the left. Doors, windows and closets are designated as left, center or right depending on their location on the wall. Asbestos containing building materials found inthe samples analyzed bythe laboratory. The affected building materials need to be removed according to Regulation 8 of CDPHE Regulation if any renovation or disturbing of the materials occur. Caution should still be taken and OSHA Regulation could still be in effect for the renovation or disturbing of the tested materials. Personal protective equipment and all state and federal regulations should beused during any removal ofsampled building materials byall parties. voeat Ridge EnvioCore assumes no liability for any loss, injury, claim or damages arising directly or indirectly from any use or reliance on this report or the opinions expressed herein. EnvioCore makes no risk assessment, warranty, guarantee or insurance policies of any kind, express or implied. This report is limited only to the samples taken and locations sampled. There are no risk assessments, warranties, guarantees, or insurance available or provided by EnvioCore. Additional sampling may be needed to further identify other pollutants, or other mold/fungus affected areas inside the subject property. This report was prepared pursuant to the contract EnvioCore has with the client. That contractual relationship included an exchange of information about the subject property that was unique and between EnvioCore and its client and serves as the basis upon which this report was prepared. Because of the importance of the communication between EnvioCore and its client, reliance or any use of this report by anyone other than the client, for whom it was prepared, is prohibited and therefore not foreseeable to EnvioCore. No warranty is made. EnvioCore's liability and that of contractors and subcontractors arising from any service rendered here under shall not exceed the total fee paid by the client to EnvioCore. Thank you for the opportunity to work with you on this project. Please call at (303) GoEnvio (463) 6846 with any questions or concerns. Thank you. Sincerely, John Peralta Certified Inspector EnvioCore LLC, Environmental Consulting Asbestos Building Inspector Cert. No. 24339 City of Wheat Ridge ing Divisor, City of Wheat Ridge uilding Diviso City of Wheat Ridge Figure 5- Sample location #2 Figure 6- Sample location #3 City Of Wheat Ridge ore PAGE 10 OF 21 Figure 7- Sample location #I Figure 8- Sample location #2 City of Wheat Ridge uilding D enbPAGE 11 OF 21 y,gore C: 7SON5 Lab Results ; '►TC ANALYTICAL REPORT Prepared for: EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver, CO 80222 Project: 0719-17/ 3910 Carr Street Order No.: 0028809 Report Date: 07/16/2019 ATC Group Services ILC 8985 E. Nichols Avenue. Suite 350, Centennial, CO 80112 Ph: 303-799-6100 Cor- APA'W TC Fk Customer• John Peralta EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver CO 80222 PLM REPORT SUMMARY ATC Job No.: Batch No.: 0028809 Report hate: 0711612019 Sample Date: 07/15f2019 8985 E. Nichols Avenue, Suite 350 Centennial, CO 80112 Phone -1303 799 6100 Fax -1303 799 3441 www.atcgroupservices.com NVLAP Lab Code 102031 AIHA Lab Code 101536 Project: 0719-17/ 3910 Carr Street Date Analyzed: 0711612019 Customer Project No.: 0719.17 Identification: N/A Test Method: 600/R-93/116 Page I of 2 Client No. Lab No. Sample Description/ Location Asbestos Content 3910-SM1-01 0028809-001 LAYER 1 None Detected Paint/Skim Coat, White/Off White, 25'C Dumpster 3910 -SMI -01 0028809-001 LAYER 2 Chrysotile 0% Plaster, Beige Dumpster 3910-SM1-02 0028809-002 LAYER 1 None Detected Paint/Skim Coat, White/Off White, 25'C Dumpster 3910 -SMI -02 0028809-002 LAYER 2 Chrysotile 2% Plaster, Beige Dumpster 3910 -SMI -03 0028809-003 LAYER I None Detected Paint/Skim Coat, White/Off White, 25'C Dumpster 3910 -SMI -03 0028809-003 LAYER 2 Chrysotile 2% Plaster, Beige Dumpster 3910 -JCI -01 0028809-004 LAYER I None Detected Paint(Joint Compound, White/Off White, 25'C Dumpster 3910 -JCI -01 0028809-004 LAYER 2 Chrysotile 2°% Plaster, Beige Dumpster These samples were analyzed by layers. Speck 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 liable — 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. City 0f teat Pidct�' Building Qi, lsc r A Core PAGE 13 OF 21 ENVIRONMENTAL INSPEr{{DN= :STC 8985 E. Nichols Avenue, Sub 350 Centennial, CO 80112 Phone -1303 799 6100 Fax +1 303 799 3441 cawnt.atcgroupser Aces.com 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 Theresults may not be reproduced except in full, and should not be used as a scope of work for abatement vAthout consulting with ATC. R Core PAGE 14 OF 21 PLM REPORT SUMMARY AHA Lab c��;o15 631 Customer: John Peralta ATC Job No.: EnvioCore Environmental, LLC Batch No.: 0028809 1685 S. Colorado Blvd. Report Date: 07/16!2019 Denver CO 80222 Sample Date: 07/15/2019 Project: 0719-17/ 3910 Carr Street Date Analyzed: 07/16/2019 Customer Project No.: 0719-17 Identification: N/A Test Method: 600/R-93/116 Page 2 of 2 Client No. Lab No. Sample Description / Location Asbestos Content 3910•JC1-02 0028809-005 LAYER 1 None Detected Paint(Joint Compound, White/Off White, 25°C Dumpster 3910 -JCI -02 0028809-005 LAYER 2 Chrysotile <1% Plaster, Beige Dumpster 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 Theresults may not be reproduced except in full, and should not be used as a scope of work for abatement vAthout consulting with ATC. R Core PAGE 14 OF 21 :STC 8985 E. Nichols Avenue. Suite 350 Centermial, CO 80112 Phone -1303 799 6100 Fax -1303 799 3441 wAmatcgroupservices.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) 40 CFR. Part 763. Appendix E to Subpart E. Reporting Limit <1% Asbestos. Additional treatment and tests may be required to accurately define composition (i.e ashing, extractions, acetone treatment. and TEM). 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 analysiswas 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 NV LAP 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 : �L.Ime Jeff NVLAP LAB CODE 102031-0 f 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 the 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. ' cAy of �+tieat R1d9e re PAGE 15 OF 21 enviENVIRONMENTALINSPECTIONS PLM REPORT SUMMARY Customer: John Peralta ATG Job No.: EnvioCore Environmental, LLC Batch No.: 0028809 1685 S. Colorado Blvd. Report Date: 07/16/2019 Denver CO 80222 Sample Date: 0711 5/2 01 9 Project: 0719-17/ 3910 Carr Street Dade Analyzed: 07/16/2019 Customer Project No.: 0719-17 Identification: N/A Test Method: 600/R-93/116 8985 E. Nichols Avenue. Suite 350 Centermial, CO 80112 Phone -1303 799 6100 Fax -1303 799 3441 wAmatcgroupservices.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) 40 CFR. Part 763. Appendix E to Subpart E. Reporting Limit <1% Asbestos. Additional treatment and tests may be required to accurately define composition (i.e ashing, extractions, acetone treatment. and TEM). 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 analysiswas 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 NV LAP 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 : �L.Ime Jeff NVLAP LAB CODE 102031-0 f 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 the 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. ' cAy of �+tieat R1d9e re PAGE 15 OF 21 enviENVIRONMENTALINSPECTIONS AIFA AN � ENVIRONNENrAL GCOVECHNICAL 8111LOING SCIENCES NAIENIALS TESTINN PROJECT INFORMATION 1/r C 8985 East Nichols Avenue, Suite 350 Centenn al, Colorado 80112 wv vw.cardnoatc.c= TEL: 303.799.6100 FAX- 303799.3441 Company/Customer: EnvioCore LLC Project Name: 0719-17 3910 Carr St Address: 1685 S. Colorado Blvd. Collection Date: 07/15/2010 City, ST, Zip Denver CO, 80222 Customer Number/P.O.: Phone/Fax: 303-475-5646 Collection Address: 3910 Carr St Customer Contact: John Peralta John@goenviocore.com Relinquished By: Datelrime: Recelv d By: Date: Time: John Peralta O 115.2010, 10:30 A10 b Special Instructions: ? ' Sample Type -TAT Sam le Number Sample Material Sample Location 1 PLM -2 HR 3910-SM1-01 SM - Piaster & Smooth Texture Dumpster 2 HR 2 3 HR 3 4 PLM -2 HR 3910-JC1-01 Misc. - Joint Compound Dum ster 5 HR 2 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 '..L ,Core PAGE 16 OF 21 J iRf NA N cPKf TSltN4 :STC John Peralta EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver CO 80222 Collected: 07/15/2019 Collected By: John Peralta Collection Address: 3910 Carr Street BATCH NO. 0028809 NVLAP Lab Code 102031 AWA Lab Code 101536 Customer Project No.: 0719-17 Description: 0719-17/ 3910 Carr Street Date Received: 07/16/2019 Date Analyzed: 07/16/2019 Date Reported: 07/16/2019 Comments: Sample # Analyzed by: O:. PAGE 17 OF 21 Core ENVIRONMENTAL INSPECTION= 3 Reviewed by: Page 1 of 3 F 01" dt WYe'at Ftid9e Chrysotile <1% Asbestos Non -Asbestos LAYER 2 Lab ID Sample Location / Constituents Constituents Wavy Fibers Sample # Sample Description M M 0028809-001 Dumpster None Detected Cellulose Fiber (Incom) 2% 3910 -SMI -01 LAYER 1 Aggregate 35% Birefringence (Low) Paint/Skim Coat, WhitelOft Whole, 25°C Carbonates 15% Binder/Fitier 48% Analyzed by: O:. PAGE 17 OF 21 Core ENVIRONMENTAL INSPECTION= 3 Reviewed by: Page 1 of 3 F 01" dt WYe'at Ftid9e Chrysotile <1% Cellulose Fiber (Incom) 2% LAYER 2 OBSERVATION SET#1: Aggregate 65% Plaster, Beige Wavy Fibers Binder/Filler 33% Sign of Elongation (+) Parallel Extinction Non -Pleochroic Q 40x Birefringence (Low) Color: Clear Liquids: 1.660 Becke Line Used Initial Characterization: Chrysotile OS#I: Para.=1.556, Perp.=1.549 0026809-002 Dumpster None Detected Cellulose Fiber (Incom) 2% 3910 -SMI -02 LAYER 1 Aggregate 35% Paint/Skim Coat, VtihitelOft Mile, 25"C Carbonates 151% Binder/Filler 481% Chrysotile 2% Cellulose Fiber (Incom) 3% Hair (Morph) 41 LAYER 2 OBSERVATION SET#1: Aggregate 60% Plaster, Beige Wavy Fibers Binder/Filler 3596 Sign of Elongation (+) Parallel Extinction Non -Pleochroic Q 40x Birefringence (Low) Color. Clear Liquids: 1.680 Becke Line Used Initial Characterization: Chrysotile OS#1: Para.=1.556, Perp -=1.549 Analyzed by: O:. PAGE 17 OF 21 Core ENVIRONMENTAL INSPECTION= 3 Reviewed by: Page 1 of 3 F 01" dt WYe'at Ftid9e John Peralta EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver CO 80222 Collected: 07/15/2019 Collected By: John Peralta Collection Address: 3910 Carr Street BATCH NO. 0028809 NVLAP Lab Code 102031 AIHA Lab Code 101536 Customer Project No.: 0719-17 Description: 0719-17/ 3910 Carr Street Date Received: 07/16/2019 Date Analyzed: 07/16/2019 Date Reported: 07/16/2019 Comments: 3% Asbestos Non -Asbestos Lab ID Sample Location / Constituents Constituents Sample # Sample Description M) (°/,) 0028809-003 Dumpster 3910 -SMI -03 LAYER 1 Paint/Skin Coat. Whde/Off VVhife. 25°C LAYER 2 Plaster, Beige 0028809-004 Dumpster 3910-JC1-01 LAYER 1 Paint/Joint Compound, White/Off White, 25°C LAYER 2 Plaster. Beige Analyzed by: f f n',v Core PAGE 18 OF 21 None Detected Chrysotile 2% OBSERVATION SET#1: Wavy Fibers Sign of Elongation {+) Parallel Extinction Non -Pleochroic a 40x Birefringence (Low) Color: Clear Liquids: 1.680 Becke Line Used Initial Characterization: Chrysotile OS#t: Para.=1.556, Perp.=1.549 None Detected Chrysotile 20% OBSERVATION SET#1: Wavy Fibers Sign of Elongation (+) Parallel Extinction Non -Pleochroic a 40x Birefringence (Low) Color: Clear Uquids: 1.680 Becke Line Used Initial Characterization: Chrysoble OS#1: Para =1.556, Perp.=1.549 Reviewed by:stt' Cellulose Fiber (lncom) 2% Aggregate 35% Carbonates 151% Binder/Filler 48% Cellulose Fiber (Incom) 3% Hae (Morph) <1 Aggregate 60% Binder/Filler 351% Cellulose Fiber (Incom) <t% Aggregate 15% Carbonates 25% Binder/Filler 601/6 Cellulose Fiber (Incom) 3% Hair (Morph) <1 Aggregate 6096 Binder/Filler 3596 Page 2 of 3 Fn - John Peralta EnvioCore Environmental, LLC 1685 S. Colorado Blvd. Denver CO 80222 Collected: 07/15/2019 Collected By: John Peralta Collection Address: 3910 Carr Street BATCH NO. 0028809 NVLAP Lab Code 102031 ABTA Lab Code 101536 Customer Project No.: 0719-17 Description: 0719-17/ 3910 Carr Street Date Received: 07/16/2019 Date Analyzed: 07/16/2019 Date Reported: 07/16!2019 Comments: 25% Asbestos Non -Asbestos Lab ID Sample Location / Constituents Constituents Sample # Sample Description M M 0028809-005 Dumpster None Detected Cellulose Fiber (Incom) <1% 3910-JC1-02 LAYER 1 Aggregate 15% Paint/Joint Compound, White/Off White, Carbonates 25% 25`C Binder/Filler 60% Chrysotile <1% Cellulose Fiber (Incom) 5% Har (Morph) <1 LAYER 2 OBSERVATION SET#1: Aggregate 60% Plaster, Beige Wavy Fibers Binder/Filler 35% Sign of Elongation (+) Parallel Extinction Non -Pleochroic @ 40x Birefrngence (Low) Color: Clear Liquids: 1.650 Becke Line Used Initial Characterization: Chrysotile OS#1: Para =1.556, Perp.=1.549 Analyzed by: enA ®re PAGE 19 OF 21 ENVIRONMENTAL ;NSPECTION5 t Reviewed by: Page 3 of 3 CAI p1 V� Aea�R�d9e �60� ep10 m 0 Colorado Department - of PublicHeil and Ealriroameat ASBESTOS -CONSULTING FIRM :This certifies that ��envioCore, LLC:,- _ % tegistration No.: ACF - 21660 ' ' _ has met the registratiorpquirements of 2-5.7-507, U.S. and,the Air Quality Conttol Commission RegulationM,h t $; and is hereby authorized to perform asbestos -consulting activities as required under.Regulation No 8, -Part B, in the state of Colorado. lssued. Feb-tuary 14; 2019 - 114 W 14, 2020 - -y� MRIQ MAI ®re PAGE 20 OF 21 R BYS m^Y•kaAV4L1•'1m6'p r��+9ii�......�..rJ "�� �i�� �S�Q Yf AU— 4 f 1 L� INSPECTION RECORD Inspection online form: http://www.ci.wheatridge.co.us/inspection Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Inspections will not be performed unless this card is posted on the project site Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business day PERMIT:`)��j�-/� ` ADDRESS:/ t) Err JOB CODE: Foundation Inspections Date Inspector Initials Comments 102 Caissons / Piers 103 Footing / P.E. Letter 104 Foundation Setback Cert. 105 Stem Walls 106 Foundation wall Insulation Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground / Slab Inspections Date Inspector Initials Comments 201 Electrical / Cable/ Conduit 202 Sewer Underground Int. 203 Sewer Underground Ext. 204 Plumbing Underground Int. 205 Plumbing Underground Ext. 206 Water Underground Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections Rough Inspection Date Inspector Initials Comments 301 Rough Framing 302 Wall Sheathing 303 Roof Sheathing 304 Sheer Inspection 305 Insulation 306 Mid -Roof 307 Metal / Lath / Stucco 308 Rough Electrical Residential 309 Rough Electrical Commercial 310 Electrical Meter Residential 311 Electrical Meter Commercial 312 Temp. Const. Meter 313 Rough Plumbing Residential 314 Rough Plumbing Commercial 315 Shower Pan SEE OVER FOR ADDITIONAL INSPECTIONS PERMIT,` �C���f` ADDRESS JOB CODE: L Rough Inspection (continued) Date Inspector Initials Comments 316 Rough Mechanical Residential 317 Rough Mechanical Commercial 318 Boiler / Furnace 319 Hot water tank 3 - 320 Drywall screw and Nail 321 Moisture board / shower walls 322 Rough Grading 323 Miscellaneous Final Inspections Date Inspector Initials Comments 402 Gas Meter Release 403 Final Electrical Residential 404 Final Electrical Commercial 405 Final Mechanical Residential 3 - 406 Final Mechanical Commercial 407 Final Plumbing Residential 408 Final Plumbing Commercial 409 Final Roof 410 Final Window/Door 411 Landscape/Park/Planning' Inspections from these entities shall be requested one week in advance. *For landscaping and parking inspections please call 303-235-2846 **For ROW and drainage inspections please call 303-235-2861 ***For fire inspections please contact the Fire Protection District for your project. 412 Row/Drainage/Public Works** 413 Flood plain Inspection** 414 Fire Insp. / Fire Protection*** 415 Public Works Final** 416 Storm Water Mgmt.** 417 Zoning Final Inspection* 418 Building Final Inspection Note: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building Inspection does not constitute authorization of occupancy. For Low Voltage permits please be sure that rough inspections are completed by the Fire District and Electrical low voltage by the Building Division. i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: y G' �' �, �< < %j i e c A Job Address: 3 `7 i o 4 - Permit Number: c o 9 cl 3 f �, a ) H C - rn►1e C! ❑ No one available for inspection: Time 9:- $T_AM PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234- Date:----'- 03-234-Date:3 Inspector: Tp DO NOT REMOVE THIS NOTICE 1 '<1 City of Wheat Ridge Residential Mechanic PERMIT - 201800493 PERMIT NO: 201800493 ISSUED: 02/22/2018 JOB ADDRESS: 3910 Carr ST EXPIRES: 02/22/2019 JOB DESCRIPTION: Furnace 80%, 110,000 BTUs A/C 2 ton 13 seer replacement. *** CONTACTS *** OWNER (303)378-9338 RAHNE RICHARD A SUB (720)420-0781 David Boehm 140099 Boehm Heating & Cooling LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 J *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,500.00 FEES A/C Replacement 60.00 Furnace Replacement 40.00 Total Valuation 0.00 Use Tax 136.50 ** TOTAL ** 236.50 *** COMMENTS *** *** CONDITIONS *** Work shall comply with 2012 IRC & 2014 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that l am the legal owner or have been authorized by the egal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this rmrt. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be er rmed aid that allywor be performed is disclosed in this docu nt 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 originalermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new pen -nit 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 roti the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not need or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuanco r gr ting o. permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable ccc o� ori Pegulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of W heat midge COMM UNiTy DEVELOPMENT Building & Inspection Services Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: perm its(a-)-ci.wheatridae.co.us I FOR OFFICE USE ONLY I Date: ,f} /�-1-1/ r b Plan/Permit # ,-�0/�'fjp���'3 Plan Review Fee: Building Permit Application Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address:. =/ U ( ci r co (70 0 3 3 Property Owner (please print): /Ick Phone: ,�� 3 -3%`�Jj 33g Property Owner Email: r i (' k/ Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer E-mail: Phone: Contractor: ROC kM� . _J" i 2cC v, :;�J c ���` J Contractors City License #: / q ('X' , Cl � Phone: 7_�O - 3 / ,3 - 09 �Lf Contractor E-mail Address: IOC n4)✓'�1c- <& ISN, Cof_S I , Ac T For Plan Review Questions & Comments (please print): CONTACT NAME (please print): Phone: CONTACT EMAIL(p/ease print): Sub Contractors: Electrical: W.R. City License # Other City Licensed Sub: City License # City License # Plumbing: W.R. City License # Other City Licensed Sub: Mechanical: W.R. City License # j yC; C jCj Complete all information on BOTH sides of this form ❑ COMMERCIAL N RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION ❑ WINDOW 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.) lc ► lA, c 3 5<--G?(' Sq. FULF Btu's �% ��, ©670 Gallons Amps Squares Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE. (OWNER) (CONTRACTOR or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) ZX Signature (first and last name): DATE: (-Q ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Building Division Valuation: $ -54i(o Goat& St, INSPECT RECORD INSPECTION ONLINE FORM: ,1;nspection INSPECTION REQI.jL_.'T LINE' Occupancy/Type Q�s Inspections will not be performed unless this card is posted on the project site. **Request an inspection before 11:59 p.m. (midnight) to receive an inspection the following business day.** Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Comments Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Sewer Service Plumbing Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing Mid -Roof (5 , 04\ Lath / Wall Tie Rough Electric " Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw/ Nail Final Inspections Date Inspector Initials Comments Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical Roof 1 �j . 1 yy�� LSC J C1 '• I �'1 Final Window/Doors Final Building NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy. "For low voltage permits — Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather Residential Roofing PERMIT - 201704489 PERMIT NO: 201704489 ISSUED: 07/20/2017 JOB ADDRESS: 3910 Carr ST EXPIRES: 07/20/2018 JOB DESCRIPTION: Residential Re-roof to install Owens Corning Duration Tru Def asphalt shingles with ROOF DECKING - 28 sq. *** CONTACTS *** OWNER (303)378-9338 RAHNE RICHARD A SUB (720)284-8831 Brent Roper 160146 BLLR dba Ropa Roofing *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 22,500.00 FEES Total Valuation 0.00 Use Tax 472.50 Permit Fee 410.35 ** TOTAL ** 882.85 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. INSPECTION RECORD Inspection online form: http://www.ci.wheatridge.co.us/inspection Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Inspections will not be performed unless this card is posted on the project site Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business day PERMIT: �7b ADDRESS: ��10 �,-9 JOB CODE: /, C Foundation Inspections Date Inspector Initials Comments 102 Caissons / Piers 103 Footing / P.E. Letter 104 Foundation Setback Cert. 105 Stem Walls 106 Foundation wall Insulation Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground / Slab Inspections Date Inspector Initials Comments 201 Electrical / Cable/ Conduit 202 Sewer Underground Int. 203 Sewer Underground Ext. 204 Plumbing Underground Int. 205 Plumbing Underground Ext. 206 Water Underground Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections Rough Inspection Date Inspector Initials Comments 301 Rough Framing 302 Wall Sheathing 303 Roof Sheathing 304 Sheer Inspection 305 Insulation 306 Mid -Roof 307 Metal / Lath / Stucco 308 Rough Electrical Residential 309 Rough Electrical Commercial 310 Electrical Meter Residential ° 7 - IS J& 311 Electrical Meter Commercial 312 Temp. Const. Meter 313 Rough Plumbing Residential 314 Rough Plumbing Commercial 315 Shower Pan SEE OVER FOR ADDITIONAL INSPECTIONS PERMIT: L— 1O) ? ADDRESS:c �/ �,� JOB CODE: Rough Inspection (continued) Date Inspector Initials Comments 316 Rough Mechanical Residential 317 Rough Mechanical Commercial 318 Boiler / Furnace 319 Hot water tank 320 Drywall screw and Nail 321 Moisture board / shower walls 322 Rough Grading 323 Miscellaneous Final Inspections Date Inspector Initials Comments 402 Gas Meter Release 403 Final Electrical Residential 404 Final Electrical Commercial 405 Final Mechanical Residential 406 Final Mechanical Commercial 407 Final Plumbing Residential 408 Final Plumbing Commercial 409 Final Roof 410 Final Window/Door 411 Landscape/Park/Planning* Inspections from these entities shall be requested one week in advance. '`For landscaping and parking inspections please call 303-235-2846 **For ROW and drainage inspections please call 303-235-2861 'For fire inspections please contact the Fire Protection District for your project. 412 Row/Drainage/Public Works** 413 Flood plain Inspection** 414 Fire Insp. / Fire Protection' 415 Public Works Final** 416 Storm Water Mgmt.** 417 Zoning Final Inspection* 418 Building Final Inspection Note: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building Inspection does not constitute authorization of occupancy. For Low Voltage permits please be sure that rough inspections are completed by the Fire District and Electrical low voltage by the Building Division. 6 � T i CITY F ' _" Z �] � O WHEAT RIDGT® Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 3Z �e lS0 Job Address:S Permit Number: 61 00 -3 %' ❑ No one available for inspection: Time e AM/,PM Re -Inspection required: Yes No�� When corrections have been made, call for re -inspection jat, 303-234-5933 Date: �' 7 /U Inspector: �(.VV— DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Electric PERMIT - 201800374 PERMIT NO: 201800374 ISSUED: 02/06/2018 JOB ADDRESS: 3910 Carr ST EXPIRES: 02/06/2019 JOB DESCRIPTION: Residential 200 AMP service upgrade and 30 AMP A/C feed with disconnect only. *** CONTACTS *** OWNER (303)378-9338 RAHNE RICHARD A SUB (720)458-8411 Scott Berkman 080190 Current Installations *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 2,400.00 FEES Total Valuation 0.00 Use Tax 50.40 Permit Fee 93.35 ** TOTAL ** 143.75 *** COMMENTS *** *** CONDITIONS *** Must comply w/ 2012 IRC & 2014 NEC. Subject to field inspection. 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 om this it. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be pei•fgrmed and that all work to be;performed is disclosed in this document and/or its accompanying approved plans and specifications. - I ' Signature of OWNP-R or -CONTRACTOR (Circle one) Date I. This permit wasasstied 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 regired to be obtained. Issuance of a new permit shall be subjeto the standard requict rements, 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 inspegions 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 i ermit shall not be construed to be a permit for or an approval of, an violation of any provision of any applicable cod r ary}cprd ma 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. City of W h6 t R,,dgC 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: Building Permit Application ** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. Property Address: '3 "5 Property Owner (please print): i C' K. (I i1� Phone: Property Owner Email: Mailing Address: (if different than property address) Address: State. Zi Arch itect/Enaineer: Architect/Engineer E-mail: Phone: Contractor: In � f o t1_5 Contractors City License #: �� ` / Phone:�� - �I �% Contractor E-mail Address: ,rwm - For Plan Review Questions & Comments (please print): f Q CONTACT NAME (please print): CP(� Cy -DA Phone: CONTACT EMAIL(please print) Sub Contractors: Electrical: W.R. City License # Other City Licensed Sub: City License # City License # Plumbing: W.R. City License # Other City Licensed Sub: Mechanical: 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 ❑ RESDENTIAL ADDITION ❑ WINDOW 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 SYSTE/APPLIANCE REPAIR or REPLACEMENT ETHER (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.) Sq. FtJLF Amps Btu's Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ 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 T 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) (CONT TOR or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): DATE: DEPARTMENT USE ONLY ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: Building Division Valuation: $ r City of Wheat Ridge Residential Roofing PERMIT - 201704489 PERMIT NO: 201704489 ISSUED: 07/20/2017 JOB ADDRESS: 3910 Carr ST EXPIRES: 07/20/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration Tru Def asphalt shingles with ROOF DECKING - 28 sq. *** CONTACTS *** OWNER (303)378-9338 RAHNE RICHARD A SUB (720)284-8831 Brent Roper 160146 BLLR dba Ropa Roofing *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 22,500.00 FEES Total Valuation 0.00 Use Tax 472.50 Permit Fee 410.35 ** TOTAL ** 882.85. *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. City of Wheat Ridge Residential Roofing PERMIT - 201704489 PERMIT NO: 201704489 ISSUED: 07/20/2017 JOB ADDRESS: 3910 Carr ST EXPIRES: 07/20/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration Tru Def asphalt shingles with ROOF DECKING - 28 sq. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable buildin codes, and all applicable municipal codes, policies and procedures, and that I am t -he legal owner or have been authorized by the legal o er f the roperty and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. r att I am le ally authorized to include all entities named within this document as parties to the work to be pertorme all t be performed is disclosed in this document and/or its' accompanyin approved plans and specifications. spa T 7 Signatur oVcoiance C NTRACTOR (Circle one) Date I. This permitased on the information provided in the permit application and accompanying plans and specifications and is subject to twith 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 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, oq'r-.- oyal of, an violation of an provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval ofeubrject�tot�eiirlspect' r►.mow` Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dan Schultz ao�o��9 From: no-reply@ci.wheatridge.co.us Sent: Wednesday, July 12, 2017 3:00 PM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Danny Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received and due to the volume of requests, time to process varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. Is this application fora Yes residential roof? How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address 3910 carr st wheat ridge co, 80033 Property Owner Name Rick Rahne Property Owner Phone 3033789338 Number Property Owner Email rickrahne@yahoo.com Address I i1 Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. CONTRACTOR INFORMATION Contractor Name BLLR LLC DBA Ropa Roofing Contractor's License 160146 Number (for the City of Wheat Ridge) Contractor Phone 4808614735 Number Contractor Email Address brady.roparoofing@gmail.com Retype Contractor Email brady.roparoofing@gmail.com Address DESCRIPTION OF WORK Are you re-decking the / No ✓ roof? Description of Roofing owens corning woodmoore Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 40 material selected above? Does any portion of the Yes ✓ property include a flat roof? If yes, how many squares 7 on the flat roof? TOTAL SQUARES of all 4uV roofing material for this project Provide additional detail remove and replace 40 sq on house, pitch is 5/12 here on the description of i work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract 22,500 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that this Yes application is NOT a permit. I understand I will be contacted by the City to pay for and pick up the permit for this property. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have been Yes authorized by the legal owner of the property to submit this application and to perform the work described above. Name of Applicant Brady Reay Email not displaying correctly? View it in your browser. 3 4995 Vallejo St, Denver, CO 80221 Office: 0-475-1065 RopaRoofing .. www RopaRaRoofinC.com General Liability Insurer: Colony Specialty, NAIC:39993 Colorado Insurancq Professionals, Inc. j303) 755-8600 AGREEMENT DATE: —7/11/1-7 OW-NER(S): ADDRESS: 39 JO e--AV-(Z ST —/HES RMC,E $CL033 PHONE: —�>?j �7_ ;� 1S EMAIL: QI(1N111=_Zyk.NC>D• CSM INSURANCE CO: CLAIM a: CV, i4342C! & SCOPE: Shingles removed: sq. Replaced: sq. Type: I R&� VA - E Pipe boots: i Ice/Water shield: _ft. Hip/Ridge Cap _ft. Starter Shingles: _ ft. Drip Edge: ____ ft. Color: Vent type: No.: _ Chimney Flashing: _ Step Flashing: Start Date: Price: General: Both Parties agree to cooperate in good faith efforts as follows. (1) to file a property damage claim with the owner's insurance company upon executing this agreement, if damage is found. (2) to share all information related to the insurance adjusters meeting and make every attempt to attend the adjusters meeting together. (3) To provide each other with all claims reports and other intormation related to this claim. RopaRoofing will prepare the file for production and acquire all permits and otner documents necessary to comply with local requirements. As consideration for the work provided by RopaRoofing, the owner hereby agrees to appoint RopaRoofing as their exclusive contractor If the claim is approved: RopaRoofing agrees to comnic+.! a'•: t%crk ou'i,rt- ie• the nuner's insurance claims report, including all supplements and additional item; agreed to by t' e w n, is insurance company. If the claim is denied: If the inspection is denied, then this ajzi eer.>er ; ry +•ai and Void. The owner is not responsible for any payments to RopaRoofing. Payments: The parties agree that RopaRoofire ' be e.a;ti=t : Lc •.•.:,=:ce proc:._'_s related to all claims subject to this agreement, and all other monie%c: .agradc� 4.1;trona- �k erk that i- approved in writing by the owner on the addendum to this agreement. "1 ne oumer understands that they are fully responsible for their insurance deductibles, as stated by the Colorado Law 6-22-105. Waiver of insurance deductible prohibited. Payments: Owner hereby releases their insurance company to provide RopaRoofing with information related to this claim and furthermore grants permission for their insurance company to negotiate and settle all claims on behalf of the owners with third party adjusters, if necessary. Owner's Rights: Should the owner decide to cancel this agreement, it must be done within 72 hours of the date signed. This may be done via mail, email, or hand delivered letter — stating that they wish to terminate this agreement. Scope: To be defined by the Owner's insurance summary plus any additional upgrades, which they choose; and shall be attached along with the addendum to this agreement. THE ROOFING CONTRACTOR SHALL HOLD IN TRUST ANY PAYMENT FROM THE PROPERTY OWNER UNTIL THE ROOFING CONTRACTOR HAS DELIVERED MATERIALS TO THE SITE TO WHICH THE WORK IS TO BE PERFORMED OR HAS PERFORMED A MAJORITY OF THE ROOFING WORK ON THE RESIDENTIAL PROPERTY. Accepted by Property Owner on: Date _7 /I_/ I i By: Sales Person: Date % /_ jam_/ 1-7 By, *THIS AGREEMENT IS NULL AND VOID IF INSPECTION 15 DENIED 4995 Vallejo St, Denver, CO 80221 �e+� Office: 720-475-1065 Ropla Roofs 1 ,^ g www RopaRoofinit.com General Liability Insurer: Colony Specialty, NAiC:39993 Colorado Insurance Professionals, Inc. (303) 755.86W ADDENDUM Ctwner(s):N" Agreement Date: Ili „f 7 Address: ?dl IC\ CAM 5-V. Addendum Date: \14H E&VC QI . )✓ 6= j Z; _ Addendum Number: Both parties hereby agree that this addendum is part of the Agreement between the parries. The original Agreement date is indicated above for reference. dwfm �♦ •►% Jit? No 4 A- - L MATERIAL SELECTION! Shingle Brand: (\a!5 L'f��(�C� -_ Drip'r.dtre COO-: Shingle Type: j,�[�C�(� �-h�k i r) Ls-: Gurar .Si2.Q: �- ShingleColor Owner(s) Initials:' -=k �r /— `JkLvvq V UPGRADES P aG��rice Unit Total s Total Upgrades $ initials: F- CONTRACT AMOUNT 9� Total Amount of Claim: $ Total Amount of Upgrades/Additional Work $ Sub Total $ C Less Credits for Work Not Performed $ Contract Amount Total $ •zZ, 5l� 7 �� *PLUS SUPPLEMENTS AND ADDITIONAL MONIES APPROVED BY INSURANCE COMPANY Property Owner's Signatures Print Name PAYMENT TERMS Deposit $ '54 Due I ,Gt�1QLEClvr Payment 5 Due Payment $Q�t1dAr1G Due CH K An, 'BALANCE TO BE ALL SUPPLEMENTS AND ADDITIONAL MONIES APPROVED BY INSURANCE COMPANY Rop g eprese tallve Signature Print Name 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: M 10 Job Address: 211 10 C14 -r— 2 t>i" Permit Number: Sc) 1 ().A4 LQ ❑ No one available for inspection: Timel 14 ACM Re-Inspection required: Yes (lo� When corrections have been made, call for re -inspection at 303 -234 - Date:— 115 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: Job Address: Permit Number: _ Io "[ ❑ No one available for inspection: Time Iii- AM M Re -Inspection required: Yes No When corrections have been made, calf for re -inspection at 303-234-5933 Date: Inspector: �� DO NOT REMOVE THIS NOTICE