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Home My WebLink About2816 Benton StreetCity of W P.,-_ge COMMUNITY DEVELOPMENT Building & Inspection Services 7500 W. 2911 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: PermitsCcDci.wheatridge.co.us FOR OFFICE USE ONLY I Date: ^/ F/ / 7 Plan/Permit # ov II()c4 Plan Review Fee4 I 8"t' 3 I Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: Owner P Phone: ?03 5 LS Property Owner Email: .5 u e 8 ee_ c. 60 ,' J , cc ✓n Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: i a (is c,), ST 3 ®�� i f � _ City, State, Zip: Architect/Engineer: / V Ct'%�2 Architect/Engineer E-mail: Phone: Contractor Name: &0(,,LLc- City of Wheat Ridge License #: _ 00 �_3 Phone: Contractor E-mail Address: 3Ct'k% d- 6, 4 �1 l For Plan Review Questions & Comments (please print): c� �! CONTACT NAME (please print):_ LCA. L ��'� Phone: 30-3 5 ? d d -/ 3-3 ( F CONTACT EMAIL(p/ease print): l�� By �� /7�'tin�G�,, cc � 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 ";IRCI RESIDENTIAL Provide description of work: For ALL projects, 6rovile a detailed description of work to be performed, including current use of areas, propol uses, squarg footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. ;v` de'- C'C-�ed 'ge y f; �JA fes: Sq. FULF BTUs LJ 1 -L 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) $ I i00o'L ' �doc OVVNER/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 vr2Yidad-@&4: r-avvlication. CIRCLE ONE: (OWNER (CON OR) for (AUTHORIZED REPRESENTATIVE) of (OWNER (CONTRACTOR) Signature (first and last name): 6,1, �r I "L1 DATE: 7 Printed Name: J JC -.IA _ `'1 DEPARTMENT USE ONLY ZONING COMMMENTS: U(nmen+i %')} I'l I G 11, 1) I IS I 101 A gprcue.d to C0r,,C3 ,hctiA r G Reviewer: v 1 BUILDING DEPA ENT�OMM NTS: Reviewer: - . l� -)Ica PUBLIC WORKS COMMENTS: Reviewer: OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: 19 Building Division Valuation: City of W heat idge COMMUNITY DEVELOPMENT City of Wheat Ridge Municipal Building 7500 W. 29th Ave. Wheat Ridge, CO 80033-8001 P: 303.235.2846 F: 303.235.2857 December 19, 2019 OFFICIAL ADDRESS UPDATE NOTIFICATION is hereby given that the following address has been assigned to the property/properties as indicated below: NEW ADDRESS: 2810 and 2816 28161/ Benton Street CURRENT ADDRESS: 2816 and 2816 % Benton Street • Subdivision: Lakeside Resub, Lots: 22, 23,24, 25, Section: 25, Parcel #: 39-254-16-012 NOTES: This is a courtesy notification. Existing address: 2816 and 28161/ Benton Street will remain and 2810 Benton will be added. --o AUTHORIZED BY: DATE: 17—of / of DISTRIBUTION: 1. Property Owner 2. Addressina(i ,ieffco.us Jefferson County Assessor: Data Control, Lacey Baker; Jefferson County Elections: Holly Roth; Jeffco IT Services (Mapping): Steve Mitchel 3. Jeffco Public Schools, ATTN: Communication Services, 1829 Denver West Dr., Bldg. 27, Golden, CO 80401 4. U.S. Post Office, 1990 Depew St., Lakewood, CO 80214 5. Email to arlene.a.vickrey_Ausps.gov; mariann.szasz(a,usps.gov; carmen.s.suarezna usps.g_ov; theresa.a.kraftAusps.gov 6. Xcel Energy, jacob.van.laere(&xcelenergv com 7. Century Link, robert.davisAcentMIink.com; rachel.weaverAcenturylink.com 8. Comcast, scott mooreAcable.comcast.com 9. WR Water District: bagy(a)wrwdistrict.com 10. WR Sanitation District: bwillisAmartinmartin.com; info ,wheatridgesanitation.com; mbakarich(&morainco.com 11. Fire Dept: planreview(&westmetrofire.org 12. Wheat Ridge Planning Division 13. Wheat Ridge Building Division 14. GIS Specialist 15. Log File NOTE: Please notify all other parties concerned. ADDRESS MAP UPDATED BY: www.ci.wheatridge.co.us DATE: Vicinity Map A IV . - City of W heatfdge COMMUNITY DEVELOPMENT City of Wheat Ridge Municipal Building 7500 W. 29th Ave. Wheat Ridge, CO 80033-8001 P: 303.235.2846 F: 303.235.2857 November 26, 2019 OFFICIAL ADDRESS CHANGE NOTIFICATION is hereby given that the following address has been assigned to the property/properties as indicated below: NEW ADDRESS: 2810 and 2816 Benton Street CURRENT ADDRESS: 2816 Benton Street • Subdivision: Lakeside Resub, Lots: 22, 23,24, 25, Section: 25, Parcel #: 39-254-16-012 NOTES: This is a courtesy notification. Existing address: 2816 Benton Street will remain and and 2810 Benton will be added. AUTHORIZED BY:-_,v�a�D DATE: DISTRIBUTION: 1. Property Owner 2. Addressing_(&jeffco.us Jefferson County Assessor: Data Control, Lacey Baker; Jefferson County Elections: Holly Roth; Jeffco IT Services (Mapping): Steve Mitchel 3. Jeffco Public Schools, ATTN: Communication Services, 1829 Denver West Dr., Bldg. 27, Golden, CO 80401 4. U.S. Post Office, 1990 Depew St., Lakewood, CO 80214 5. Email to arlene.a.vickrey(&usps.gov; mariann.szasz(&usps.gov; carmen.s.suarez(&usps.gov; theresa. a.kraft(&usps. goy 6. Xcel Energy, jacob.van.laere(aa)xcelener .com 7. Century Link, robert.davisAcentT ylink.com; rachel.weaver(a centurylink.com 8. Comcast, Scott mooreAcable.comcast.com 9. WR Water District: barry@wrwdistrict.com 10. WR Sanitation District: bwillis(&martinmartin.com; info(a,wheatridgesanitation.com; mbakarichAmorainco.com 11. Fire Dept: planreviewAwestmetrofire.org 12. Wheat Ridge Planning Division 13. Wheat Ridge Building Division 14. GIS Specialist 15. Log File NOTE: Please notify all other parties concerned. ADDRESS MAP UPDATED BY: www.ci.wheatridge.coms DATE: Vicinity Map AWWWr ,J, r , iii 3 .c:, ,. .�. o. • 10Tl — 1 Z( s , 4 e= a^ .. W. 28th AVENUE i �• ,,•c. .u.� 1O'Md�Vvhric ri66Wl.rav - •. - . N -F ---INS-- i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax 3 m.4- 46 tr� �PECT�O�NOTICE Inspection Type: 491 6� W"� Job Address: Permit Number: _ ❑ No one available for inspection: Time LAM/ -PM Re -Inspection required: Yes'-_-, When corrections have been made, call for re -inspection at 303 -234 - Dates �i 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 'N ECTION N""E, I tl tc2 Inspection Type: vv Job Address: Permit Number: ❑ No one available for inspection: Time kAM/ M Re -Inspection required: Yes �No When corrections have been made, call for re -inspection at 303-234-5933 Date:'l - (`) r if t 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: ,-;?&1 Permit Number: J� U No one available for inspection: Tim.,� , e�' -AM/FM Re -Inspection required�"'Yes o When corrections have been made, call for re -inspection at 303-234- Dater Inspector: 03-234- DaterInspector:"fy 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:_ l - Job Address: Permit Number: -2-7 / l/' no -? ❑ No one available for inspection: S ZAM&M Re -Inspection required: Yes '-No When corrections have been made, call for re -inspection at 303-234-5933 Date: 6 ' ? la' ( , 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 LtO3 J 1)`�j ed� of INSPECTION NOTICE Inspection Type: Job Address: Alto 13-e-v14ok, Permit Number: '?0/1°ioQ7 ❑ No one available for inspection: Time 0'y?-'>_ AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: —inspector: DO NOT REMOVE THIS NOTICE .. ... CITY OF WHEAT RIDGE., Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office - (303) 237-8929 Fax INSPECTION NOTIC Inspection Type: Job Address: Permit Number: Ll No one available for inspection: /PM Re -inspection requirelei No When corrections have been made, c01Mkr re -inspection at 303-234-5933 Date: 2--j 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: � J ❑ No one available for inspection} Re -Inspection required: Ye*_ Nom When corrections have been made, call for re -inspection at 303 -234- Date: - 03 -234 - Date: +�_ f `i Inspector: f -~-- DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Electric PERMIT - 201901007 PERMIT NO: 201901007 ISSUED: 05/16/2019 JOB ADDRESS: 2816 Benton St EXPIRES: 05/15/2020 JOB DESCRIPTION: Residential electric service change, 200 AMPS. *** CONTACTS *** OWNER (303)598-0433 HORTON TERRANCE L SUB (720)201-2067 BRYAN HAUBENSAK 180090 A ENERGY CO *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 2,250.00 FEES Total Valuation 0.00 Use Tax 47.25 Permit Fee 93.35 ** TOTAL ** 140.60 *** COMMENTS *** *** CONDITIONS *** Must comply w/ 2012 IRC & 2017 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 prop�;ty and am authorized to obtain this permit and perform the work described and approved in conjunction with this er ua filrther attest th ti�II a leg�ally authorized to include all entities named within this document as parties to the work to be performed andhat all work be perlorml is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OER-_fo_r MNTRACTOR (Circle one) Date I . This permit vM s 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. Thispermit 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 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 grnting of a permit shall not be construed to be a permit for or an approval of, an violation of any provision of any apykcable code orppy ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of thief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of :� Wheat COMMUNITY DEVELOPMENT �dge Building & Inspection Services 7500 W. 29' Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(aD_ci.wheatridge.co.us FOR OFFICE USE ONLY Date: Plan/Permit # bbl cI 6/,5 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: C�) 49 I K -,C"� 0 "(-) Owner Phone: Property Owner Email: Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer: 'Zll A Architect/Engineer E-mail: Contractor Name: /Y City of Wheat Ridge License #: Contractor E-mail Address: Phone: Phone:'? -__2o/ -J662 For Plan Review Questions & nts (pleas pri t): CONTACT NAME (please print): /i Phone CONTACT EMAIL(p/ease print): Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. ❑COMMERCIALE*\-"IDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. Sq. FULF BTUs Gallons Amps &-CLa 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) $ 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 informatioyPreujded on the application. f CIRCLE ONE: (OWNER)' -(4 'ON CTOR) or ,(AU O ZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (yrs and st name): n / DATE: Printed Name:V L_ DEPARTMENT USE ONLY ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: Building Division Valuation: 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:(C) Job Address: / _ ( L r Permit Number: _ 1gs (0kz) - ❑ No one available for inspection: Time �# ' 12 _/PM Re -Inspection required: � 'Yes-) No When corrections have been made, cag4or re -inspection at 303-234-5933 1` Date:5 (q Inspect i r DO NOT REMO E THIS NOTICE 1L City of Wheat Ridge Residential Siding PERMIT - 201900916 PERMIT NO: 201900916 ISSUED: 05/07/2019 JOB ADDRESS: 2816 Benton St EXPIRES: 05/06/2020 JOB DESCRIPTION: Residential siding, 2 squares and residential re -roof with 30 year dimensional, 8 squares with a pitch of 5/12. *** CONTACTS *** OWNER (303)515-0808 HORTON TERRANCE L SUB (303)598-0433 DALE HORTON 190093 GUNS N HOSES LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, CLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,000.00 FEES Total Valuation 0.00 Use Tax 84.00 Permit Fee 109.20 ** TOTAL ** 193.20 *** COMMENTS *** *** CONDITIONS *** **A MID -INSPECTION IS REQUIRED FOR HOUSE WRAP PRIOR TO SIDING INSTALLATION. A final inspection is required at completion. Work shall comply with 2012 IRC and ordinances adopted by the City of Wheat Ridge. Work is subject to field inspections. A mid -inspection is required for house wrap prior to siding installation. A final inspection is required at completion. City of Wheat Ridge Residential Siding PERMIT - 201900916 PERMIT N0: 201900916 ISSUED: 05/07/2019 JOB ADDRESS: 2816 Benton St EXPIRES: 05/06/2020 JOB DESCRIPTION: Residential siding, 2 squares and residential re -roof with 30 year dimensional, 8 squares with a pitch of 5/12. I, by m signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specificationst 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_perm�t. I further attest that I am legally authorized to include ali entities named within this document as parties to the work to be per of n and that al w, Ik to be performed is disclosed in this document; andf or its' accompanying approved plans and specifications. Signature of OWNEk 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 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 ' ance or gran ` of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any ap is le de ora ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of W heatdge COMMUNITy DEVELOPMENT Building & Inspection Services 7500 W. 2911 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: perm its(cDci.wheatridge.co.us I FOR OFFICE USE ONLY I Date: 5) /? // r7 Plan/Permit # �_fleol 70b'-71 (z� 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: Property Owner �) Y/ � r C" 'tr' (C' C_ 11 eC Property Owner Email: fit) 2 6P_ -e_ C �51 e �' "�"'`c�` I . Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: I d -y-5 'f'J\/ S-- City, State, Zip: � > kc_ W CA. ) J cc) �?C) a I 5 Architect/EngIneer E-mail: Phone: Phone: 303 5 iS 0,�?U? Contractor Name: Cues /I/ �e .S L L C_ City of Wheat Ridge License #: / 9Q0 _-/�_S Phone: 303 59P O`C. Contractor E-mail Address: Sor'v� �' S v, 11 (R�/7[TV11C' I- I .. C-C)L'L► For Plan Review Questions & Comments (please print): CONTACT NAME (please print): Phone: � O3 59,S> 0412 CONTACT EMAIL(p/ease print): o v` c% �cJ �''" " 1 , C -C) L --Ll 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 ESIDENTIAL 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. �vve 6- � o Lis e &J C�q M F/ ajd4f'OtA. ujo�5 4otr-o dOLL),�i- ('.") its) 60 I Vt- , AA S i Ovt L' Sq. FULF BTUs F Gallons Amps Squares For Solar: KIN # 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) yW 1 ^ 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. 1, the applicant for this building permit application, warrant the truthfulness of the information provide a application. CIRCLE ONE: (OWNER) (CONTRACTOR) orD (AU ORIZED REPRESENTATIVE) of (OWNER) (C NTRACTOR) Signature (first and last name): *;ZF— DATE: 7 Printed Name: Dc—LQ- -4b✓N ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: City of Wheat Ridge Residential Siding PERMIT - 201900916 PERMIT NO: 201900916 ISSUED: 05/07/2019 JOB ADDRESS: 2816 Benton St EXPIRES: 05/06/2020 JOB DESCRIPTION: Residential siding, 2 squares and residential re -roof with 30 year dimensional, 8 squares with a pitch of 5/12. *** CONTACTS *** OWNER (303)515-0808 HORTON TERRANCE L SUB (303)598-0433 DALE HORTON 190093 GUNS N HOSES LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, CLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,000.00 FEES Total Valuation 0.00 Use Tax 84.00 Permit Fee 109.20 ** TOTAL ** 193.20 *** COMMENTS *** *** CONDITIONS *** **A MID -INSPECTION IS REQUIRED FOR HOUSE WRAP PRIOR TO SIDING INSTALLATION. A final inspection is required at completion. Work shall comply with 2012 IRC and ordinances adopted by the City of Wheat Ridge. Work is subject to field inspections. A mid -inspection is required for house wrap prior to siding installation. A final inspection is required at completion. City of Wheat Ridge Residential Siding PERMIT - 201900916 PERMIT N0: 201900916 ISSUED: 05/07/2019 JOB ADDRESS: 2816 Benton St EXPIRES: 05/06/2020 JOB DESCRIPTION: Residential siding, 2 squares and residential re -roof with 30 year dimensional, 8 squares with a pitch of 5/12. I, by m signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specificationst 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_perm�t. I further attest that I am legally authorized to include ali entities named within this document as parties to the work to be per of n and that al w, Ik to be performed is disclosed in this document; andf or its' accompanying approved plans and specifications. Signature of OWNEk 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 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 ' ance or gran ` of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any ap is le de ora ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of W heatdge COMMUNITy DEVELOPMENT Building & Inspection Services 7500 W. 2911 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: perm its(cDci.wheatridge.co.us I FOR OFFICE USE ONLY I Date: 5) /? // r7 Plan/Permit # �_fleol 70b'-71 (z� 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: Property Owner �) Y/ � r C" 'tr' (C' C_ 11 eC Property Owner Email: fit) 2 6P_ -e_ C �51 e �' "�"'`c�` I . Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: I d -y-5 'f'J\/ S-- City, State, Zip: � > kc_ W CA. ) J cc) �?C) a I 5 Architect/EngIneer E-mail: Phone: Phone: 303 5 iS 0,�?U? Contractor Name: Cues /I/ �e .S L L C_ City of Wheat Ridge License #: / 9Q0 _-/�_S Phone: 303 59P O`C. Contractor E-mail Address: Sor'v� �' S v, 11 (R�/7[TV11C' I- I .. C-C)L'L► For Plan Review Questions & Comments (please print): CONTACT NAME (please print): Phone: � O3 59,S> 0412 CONTACT EMAIL(p/ease print): o v` c% �cJ �''" " 1 , C -C) L --Ll 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 ESIDENTIAL 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. �vve 6- � o Lis e &J C�q M F/ ajd4f'OtA. ujo�5 4otr-o dOLL),�i- ('.") its) 60 I Vt- , AA S i Ovt L' Sq. FULF BTUs F Gallons Amps Squares For Solar: KIN # 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) yW 1 ^ 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. 1, the applicant for this building permit application, warrant the truthfulness of the information provide a application. CIRCLE ONE: (OWNER) (CONTRACTOR) orD (AU ORIZED REPRESENTATIVE) of (OWNER) (C NTRACTOR) Signature (first and last name): *;ZF— DATE: 7 Printed Name: Dc—LQ- -4b✓N ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: City of Wheat Ridge .e, Residential Plumbing PERMIT - 201900796 PERMIT NO: 201900796 ISSUED: 04/26/2019 JOB ADDRESS: 2816 Benton St EXPIRES: 04/25/2020 JOB DESCRIPTION: Installation of gas line. *** CONTACTS *** OWNER (303)515-0808 HORTON TERRANCE L SUB (303)421-2161 STEPHEN LANYON 017835 BLUE SKY PLUMBING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA j Unassigned SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 552.65 FEES Total Valuation 0.00 Use Tax 11.61 Permit Fee 29.90 ** TOTAL ** 41.51 *** COMMENTS *** *** CONDITIONS *** Work shall comply with 2012 IRC & 2017 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. 1, by in 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 tithe legal owne of th,property and am authorized to obtain this permit and perform j�e work described and approved in conjunction with thi ermrt. I f era es th dam legally authorized to include all entities pained w'fihin this document as partes to the work to be per rmed an that�l�vorkbe performed is disclosed in this document and/or i accompanying approved plans and specifications. �5u Signat re of " OWNER or g NiI�C TOR (Circle one) D I , is permit was issued based on the information provided in the perm t 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 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 issua or granting permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicab�c e of any or nce 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 Wheatl d - CowN, lJNriy DEVELOPMENT Building & Inspection Services 7500 W. 29' Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(a-)_ci.wheatridge.co.us FOR OFFICE USE ONLY Date: V/ --FG, / / q Plan/Permit # Plan Review Fee: Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 0_9UO &-' c)4q Property Owner (please print): Phone: , n. S\S . Q � Property Owner Email: 5l � aSin L-lOC( FkU.QQM Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer: Architect/Engineer E-mail: Contractor Name: Phone: City of Wheat Ridge License #:i7�`Zc�� Phone:�e�EO`l.`�`��4'� Contractor E-mail Address: }),�m t� � CSI�S�C�'�Vl') y'an.COM For Plan Review Questions & Comments (please print): CONTACT NAME (please print): �"t k7 )1,� Phone: CONTACT EMAIL(p/ease print): KVV�S-CARL 1� �lll�rlLLitr��C�. C©('rl 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 highlig ❑COMMERCIAL fields. RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. Sq. FULF BTUs Amps Squares For Solar: Gallons KW # of Panels Requires Structural For Commercial Projects Only: Occupancy Type: Construction Type: Occupancy Load: Square Footage: Project Value: (Contract value or the cost of all materials and labor included in the entire project) $�>Sa('-,- 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 (A THORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): /�/ DATE: t Printed Name: &%rm ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: City of Wheat Ridge p .. Residential Demolition PERMIT - 201900708 PERMIT NO: 201900708 ISSUED: 04/17/2019 JOB ADDRESS: 2816 Benton St EXPIRES: 04/16/2020 JOB DESCRIPTION: Demolition of small addition on side of house - 600 sq ft total; Approved CDPHE demo application provided *** CONTACTS *** OWNER (303)515-0808 HORTON TERRANCE L GC (303)598-0433 DALE HORTON 190093 GUNS N HOSES LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,000.00 FEES Total Valuation 0.00 Demolition Fee 50.00 ** TOTAL ** 50.00 *** COMMENTS *** *** CONDITIONS *** Work shall comply with 2012 IRC & 2017 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest th t I am legally authorized to include alI entities named within this document as parties to the work to be performed and that all or a performed is disclosed in this document�nd/ r its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1 I . This permit was issued based on the information provided in the permit application and accompanying plaps 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 tee. 3, If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a 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 of proceed or conceal work without written approval of such work from the Building and Inspection Services Divi ' 6. Th , is ance or gra of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any ap able ' de or ce or regulation of this jurisdiction. Approval of work is subject to field inspection. T S 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 R.,,,d e 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(cDci.wheatridge.co.us FOR OFFICE USE ONLY I Date: Plan/Permit # Plan Review Fee: Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: ProDertv Owner Property Owner Email: Tenant Name (Commercial Projects Only) F 5 i G /t D - -tety 1, 1. C.b" Property Owner Mailing Address: (if different than property address) Address: 19,CT S- '/ S City, State, Zip: L a f� L )C"J C C Fr) o--3 d" Architect/Engineer E-mail: Contractor Name: - D o__ b- 4�_ Phone: Phone: 3o'' 5i_ C)''v'? �u�, s �✓ l�vzes G- L � City of Wheat Ridge License M Phone: 3303 Contractor E-mail Address: L3 '— 44`� a " / , c 0!t-11 For Plan Review Questions & Comments (please print): CONTACT NAME (please print): Phone: CONTACT EMAIL(p/ease print): Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. ❑COMMERCIAL 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. -0C, V" 0 4 -Lo- k o o �— Sq. Ft./LF Eco j� BTUs u%[ i i l ll f 4-, 6 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) 5f�cx3 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) br (AUTHORIZED REPRESENTATIVE) of (OWNER) CONTRACTOR) Signature (first and last name): , r DATE: / Printed Name: 1Jo-� lei' 6y\ ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: Colorado Department of Public Health and Environment DEMOLITION NOTIFICATION APPLICATION FORM APPLICATION FEE MUST ACCOMPANY THIS FORM INCOMPLETE APPLICATIONS WILL BE RETURNED (Notice will be mailed to the demolition contractor unless specified otherwise) Fee: $50 + $5 per 1000 ff2 of area to be demolished = $ " (See instruction #1 on reverse side) Submit form to: Permit Coordinator Colorado Dept. of Public Health and Environment APCD-IE-B1 4300 Cherry Creek Drive South Denver, CO 80246-1530 Phone: 303-692-3100 Fax: 303-782-0278 Asbestos@state.co.us * Regulated asbestos -containing materials means (a) friable asbestos -containing material, (b) Category I nonfriable ACM that has become friable, (c) Category I nonfriable ACM that will be or has been subjected to sanding,rig nding, cutting, or abrading or (d) Category II nonfriable 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 material in the course of demolition or renovation operations regulated by this regulation. Note: Asbestos -containing sheet vinyl and linoleum must be properly abated/removed prior to demolition. ` Form: DNA08/I -� �'�D�j- Rev. 01/30/08 Comp Name: > Building Name: � L)1 Al -- Residence Street: r� `-s= Square footage of footprint of facility or portion of facility to be demolished o 602 square feet ++ City: - State: Zip Code: Street: 2816 Benton St w C Telephone # Fax # City: County. Zip Code: L) (3 3) °1133 ( ) o Wheat Ride ,, l Project Manager: Cell Phone # Proposed-StartDate -� Proposed Completion Date C = Meth /Mi:ans-of Demolition: I certify that the Certified Asbestos Building Inspector has informed me y 0 about any remaining asbestos -containing materials in the facility to be p d demolished. t X Wrecking ❑Burning El Implosion El Moving [I Other, specify: Si nature: 1-- �— g � �' t Name: t Landfill Receiving Building Debris: f i Burning requires additional authorization — Please call (303) 692-3100 and ask to speak to the Open Burning Permit Coordinator General Abatement Contractor (GAC) Owner's Namy L ®.a �- L _ / 1 e t ✓' .%l `ve C. a Z_ / 1 ® V. O A p; W CDPHE Asbestos Permit # Total Quantity of Asbestos Removed 250�Sq #t TSS < ,t -; 3 Street: / ` n 2 /6 p U) U) E Date Removal Completed Telephone # n.A City: y State: Zip Code: U (,tid et r t co Type(s) of Asbestos -Containing Material Removed: TSIt}vct-wrap. s Contact's Names Telephone # / m With my signature below, I certify that I possess current AHERA accreditation 6nd state of Colorado certification as c an Asbestos Building Inspector. I also certify that I have thoroughly inspected the facility to be demolished, as listed in the Demolition Site block above, sampled all suspect materials, had all samples analyzed for the presence of CL asbestos by a NVLAP-accredited laboratory, and have determined that no Regulated ACM exists anywhere in the facility.* I also certify that I have informed the owner/operator of the facility or the demolition contractor that any N ,o asbestos -containing material allowed to stay in the facility must remain non -friable during demolition. Specify type(s) yof ACM remaining, below: (check appropriate box(es)): X Vinyl asbestos floor tile (VAT) ❑ VAT mastic ❑ Tar/asphalt impregnated roofing ❑ Asphaltic pipe coatings v ❑ Spray -applied tar coatings ❑ Caulking ❑ Glazing ❑ Other, specify: y Signature: (In Blue Ink) Printed Name: s- V Date of Final Inspection CO Cert # Expiration Date Telephone # Cell Phone # 3/16/2019 3143 December 22, 2019 i% I verify that all refrigerants from air conditioning/refrigeration appliances have been properly recovered in accordance with AQCC Regulation No. 15 (for information on CFC requirements call 692-3100). 1 further verify that all luminous exit signs (containing radioactive material) have been O p disposed of in accordance with 6 CCR 1007-1 subpart 3.6.4.3 (for information on luminous exit sign requirements call 303-692-3320). �—a a i CHECK THE APPROPRIATE BOX: m 03 Building Owner ❑ Contractor ❑ Other Date: 7 X17 V Signature: Print tg_t IPTHIS Box Is FOR CDPHE USE ONLY: Postmark or Hand Delivery Date: Approved By:Code initial-310 ❑ transfer -380 Form of Payment & #: ,��- , y M �A� 2 ) F" Permit #: Record # Date Issued: * Regulated asbestos -containing materials means (a) friable asbestos -containing material, (b) Category I nonfriable ACM that has become friable, (c) Category I nonfriable ACM that will be or has been subjected to sanding,rig nding, cutting, or abrading or (d) Category II nonfriable 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 material in the course of demolition or renovation operations regulated by this regulation. Note: Asbestos -containing sheet vinyl and linoleum must be properly abated/removed prior to demolition. ` Form: DNA08/I -� �'�D�j- Rev. 01/30/08 yr M • t 1876 Colorado Department of Public Health and Environment ASBESTOS CERTIFICATION* This certifies that Robert L. Ragan Certification No.: 3143 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: December 19, 2018 Expires: December 21, 2019 • This certiflcate Is valid only with the possession of a r��//�` - current Division -approved training course cerdficadon k_ ✓, In the discipline specified above. `t-1 AGlhorized APC Representative SEAL ATTACHMENT #3 STATE OF COLORADO INSPECTOR ACCREDITATION I 00 jW !({ _� i o 17 CD j � k l a J w � ► I � p 0 �( I ( IIifI # # I G X V I . 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OSI LOVL It WADI V83HV 111131 2C < 8a!tel1jen0 code, Euol wn00 lurod 40", IJ043 WId w C = in d M TC C 7 C hGc m m < O a m 4 G E c o M co 2C < 0 m D j L I'Iw G o m E m' i� o m r 2 Y - 17 c n m w o pm m a S G 3 la' R> to ( I y a E A r o N CC 11 n m Y ?s p o ra m Y n O L = LN O CL N+ D i y r a I S O m= s m a: m m x v i O v o N N rS fY L C C6 to �' 0:4 I I I I I C 1I E c 0 m Q 0 0 c 0 co a >= c Ix D o C 0 H' g V r in o c m U m m m a i 8 W a N Q m c O o � m n W m E U z °u D u rn o d Q 4 a U* m u. O W a U Reservoirs Environmental, Inc. Reservoirs Environmental QA Manual RESERVOIRS ENVIRONMENTAL INC. NVLAP Lab Code 101896.0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 430522-1 Client: R2 Analytical Client Project Number / P.O.: R219-40 Client Project Description: 2616 Benton St. Westminster, CO Date Samples Received: March 16, 2019 Effective April 2, 2018 Q:\QAQC\LAB\Reservoirs Environmental QA Manual.doc Method: EPA 600/R-93/116 - Short Report, Bulk ND=None Turnaround: Rush TR=Trace, Date Samples Analyzed: March 16, 2019 Trem/Act=Tremolite/Actinolite Detected <1% Visual Estimate Client Lab L Asbestos Content Non Non - Sample ID Number A Sub Asbestos Fibrous Number y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R (%) (%) 28168 -CTA -C2 EM 2271465 A Gray fibrous material TR ND 90 10 B White granular material 100 ND 5 95 2816B-FT1-D1 EM 2271466 A Black mastic TR ND 0 100 B Gray tile 100 ND 0 100 28168-FT1-D2 EM 2271467 A Gray granular material 100 ND 0 100 28168-FT2-E1 EM 2271468 A Black mastic TR ND 0 100 B Gray resinous material 2 ND 0 100 C Gray/multi-colored tile 98 Chrysotile 15 0 85 2816B-FT2-E2 EM 2271469 A Black mastic TR ND 0 100 B Gray/multi-colored tile 100 Chrysotile 15 0 85 2816B -RS -F1 EM 2271470 A Gray/black shingle 100 ND 15 85 2816B -RS -F2 EM 2271471 A Gray/black shingle 100 ND 15 85 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1%. Tyler Hultl9nson Analyst \ \ Brett S. Colbert Data QA P. 303-964-1986 5801 Logan Street, Suite 100, Denver, CO 80216 1-866-RESI-ENV F: 303-4774275 �y Page 2 0! 2 .reilab.com Reservoirs Environmental, Inc. Reservoirs Environmental QA Manual RESERVOIRS ENVIRONMENTAL INC. NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 430522-1 Client: R2 Analytical Client Project Number/ P.O.: R219-40 Client Project Description: 2616 Benton St. Westminster, CO D2te S2!r les Recei„oH. morv- , 16 9019 Effective April 2, 2018 0 \QAQC1AB\Reaervoirs Environmental QA Manual.doc Method: EPA 600/R-93/116 - Short Report, Bulk ND=None Detected Turnaround: Rush TR=Trace, <1% Visual Estimate Trem/Act=Tremolite/Actinolite Date Samples Analyzed: March 16, 2019 Client Lab L Asbestos Content Non Non - Sample ID Number A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R 28168-RDWT-A1 EM 2271459 A Tan/white paint w/ white texture 10 ND 0 100 B Pink/tan drywall 90 ND 15 85 2816B-RDWT-A2 EM 2271460 A White texture w/ tan/white paint 5 ND 0 100 B Pink/tan drywall 95 ND 13 87 2816B-RDWT-A3 EM 2271461 A White texture w/ tan/white paint 5 ND 0 100 B Pink/tan drywall 95 ND 15 85 28168 -CTG -B1 EM 2271462 A White granular material 40 ND 0 100 B Gray granular material 60 ND 0 100 2816B -CTG -B2 EM 2271463 A White granular material 10 ND 0 100 B Gray granular material 90 ND 0 100 28168 -CTA -C1 EM 2271464 A Tan/multi-colored paint TR ND 0 100 B Tan fibrous material 10 ND 85 15 C White granular material 90 ND 4 1 96 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1%. P: 303.964-1886 5801 Logan Street. Suite 100, Denver, CO 80216 1.866-RESI-ENV F: 303-477-4275 wvnv. reilab.com Pa9E 1 of 2 Reservoirs Environmental, Inc. Effective April 2, 2018 Reservoirs Environmental QA Manual Q:\QAQC\Lab\Reservoirs Environmental QA Manual.doc REe Rservoirs Environmental, Inc. March 17, 2019 Bob Ragan R2 Analytical 5177 S. Ventura Way Centennial CO 80015 Dear Customer, Subcontract Number: Laboratory Report: Project # / P.O. # Project Description: NA RES 430522-1 R219-40 2616 Benton St. Westminster, CO Reservoirs Environmental, Inc. is an analytical laboratory accredited for the analysis of Industrial Hygiene and Environmental matrices by the National Voluntary Laboratory Accreditation Program (NVLAP), Lab Code 101896-0 for Transmission Electron Microscopy (TEM) and Polarized Light Microscopy (PLM) analysis and the American Industrial Hygiene Association (AIHA), Lab ID 101533 - Accreditation Certificate #480 for Phase Contrast Microscopy (PCM) analysis. This laboratory is currently proficient in both Proficiency Testing and PAT programs respectively. Reservoirs Environmental, Inc. has analyzed the following samples for asbestos content as per your request. The analysis has been completed in general accordance with the appropriate methodology as stated in the attached analysis table. The results have been submitted to your office. RES 430522-1 is the job number assigned to this study. This report is considered highly confidential and the sole property of the customer. Reservoirs Environmental, Inc. will not discuss any part of this study with personnel other than those of the client. The results described in this report only apply to the samples analyzed. This report must not be used to claim endorsement of products or analytical results by NVLAP or any agency of the U.S. Government. This report shall not be reproduced except in full, without written approval from Reservoirs Environmental, Inc. Samples will be disposed of after sixty days unless longer storage is requested. If you have any questions about this report, please feel free to call 303-964-1986. Sincerely, Jeanne Spencer President P:303-964-1986 F:303-477-4275 5801 Logan Street, Suite 100 Denver, CO 80216 Page 1 of 1 1-866-RESI-ENV www.reilab.com ATTACHMENT #2 LABORATORY ANALYSIS REPORTS Structure, 2816 Benton Street, Westminster CO ASBESTOS INSPECTION SUMMARY DATE SAMPLED: 3/16/2019 AHERA CODE: Material Damaged/Significantly Damaged Thermal (6) PSD ACM = Potential for Significant damage Asbestos Containing Material System Insulation Condition ACM (2) D FSM = Damaged Friable Surfacing Material Type &Description Quantity of AHERA Greater Sample Number Sample Location of Sampled Material Material Code 1-8 Than 1% 216B -RS -FI South roof line west side Asphalt Roof Shingle Approx NR No AA As Above NR Not Required TBD To Be Determined Containing Material 667 sq ft < 21613 -RS -F2 South roof line west side AA AA NR No AHERA CODE: (1) D/SD TSI = Damaged/Significantly Damaged Thermal (6) PSD ACM = Potential for Significant damage Asbestos Containing Material System Insulation (7) F ACM G = Friable Asbestos Containing Material in Good Condition (2) D FSM = Damaged Friable Surfacing Material (8) NF ACM G = Non -Friable Asbestos Containing Material in Good Condition (3) SD FSM = Significantly Damaged Friable Surface Material (4) D/SD FMM = Damaged/Significantly Damaged Friable Miscellaneous Material MATERIAL TYPE: MM = Miscellaneous Materials TSI = Thermal System Insulation SM = Surfacing Material (5) PD ACM = Potential for Damage Asbestos NA Not Available AA As Above NR Not Required TBD To Be Determined Containing Material Structure, 2816 Benton Street, Westminster CO ASBESTOS INSPECTION SUMMARY DATE. CAMPi.F.D- 3/16/2019 AHEHA 00016: Material Damaged/Significantly Damaged Thermal (6) PSD ACM = Potential for Significant damage Asbestos Containing Material System Insulation Condition ACM (2) D FSM = Damaged Friable Surfacing Material Type &Description Quantity of AHERA Greater Sample Number Sample Location of Sampled Material Material Code 1-8 Than 1% 216B-RDWT-A1 North Room Ceiling West Rough Textured Drywall (SM) 900 sq ft NR No 216B-RDWT-A2 North Room Ceiling Center AA AA NR No 216B-RDWT-A3 North Room Ceiling East AA AA NR No 216B -CTG- B] South room floor East Side top Ceramic Floor tile grout Approx NR No layer of flooring 100 sq ft < 216B -CTG -B2 AA AA AA NR No 216B -CTA- Cl South room floor East Side top Ceramic Floor tile Adhesive Approx NR No layer of flooring 160 sq ft < 216B -CTA- C2 AA AA AA NR No 216B -FTI- Dl South room floor West Side middle 12"x12' gray Floor tile Approx NR No layer of flooring Southwest comer 260 sq ft 21613 -FTI- D2 AA AA AA NR No 216B-FT2- El South room bottom layer of 9110" gray multi colored Floor the Approx —8_rYes flooringEast side 260 s ft % chr s 216B-FT2- E2 AA AA AA 8 Yes 15% chrys AHEHA 00016: (1) D/SD TSI = Damaged/Significantly Damaged Thermal (6) PSD ACM = Potential for Significant damage Asbestos Containing Material System Insulation (7) F ACM G = Friable Asbestos Containing Material in Good Condition (2) D FSM = Damaged Friable Surfacing Material (8) NF ACM G = Non -Friable Asbestos Containing Material in Good Condition (3) SD FSM = Significantly Damaged Friable Surface Material (4) D/SD FMM = Damaged/Significantly Damaged Friable Miscellaneous Material MATERIAL TYPE: MM = Miscellaneous Materials TSI = Thermal System Insulation SM = Surfacing Material (5) PD ACM = Potential for Damage Asbestos NA Not Available AA As Above NR Not Required TBD To Be Determined Containing Material ATTACHMENT #1 BULK SAMPLE ANALYSIS TABLE SAMPLE LOCATIONS & DESCRIPTIONS SECTION 6 R2 ANALYTICAL REPRESENTATIVES: U.S. Environmental Protection Agency (EPA) and State of Colorado accredited inspector # 3143: Mr. Robert L Ragan Signature Reference Attachment #3 for EPA and Sate Inspector Accreditation. SECTION 7 CLIENT REPRESENTATIVES CONTACTED: Mr. Terry Horton 303-515-0808 suebee1951@hotmail.com SECTION 8 EXCLUSION STATEMENTS: R2 Analytical warrants that the findings contained herein have been with the level of care and skill exercised by experienced and knowledgeable environmental consultant who is licensed or otherwise trained to perform asbestos inspections pursuant to the scope of work required on this project. The quantities of materials identified in this study as ACM are approximate. Contractor providing asbestos remediation services must verify all field conditions and estimated quantities. SECTION 9 SAMPLING RATIONAL/INVESTIGATION METHODOLOGY: Sample locations were selected in a random manner. The number of samples were collected of each homogeneous material identified as suspect ACM in accordance with the referenced Colorado Regulation 8 protocol. 4 SECTION 3 SAMPLE RESULTS /CONCLUSIONS Areas designated by the client to be impacted by remodel activities were inspected and the following building materials were identified as suspect ACM; • Homogeneous area A — Textured Drywall North room walls & ceiling • Homogeneous area B — Ceramic tile grout • Homogeneous area C — Ceramic tile adhesive • Homogeneous area D — Floor tile Gray 12"x12" gray • Homogeneous area E — Floor tile Gray multi colored 9"x9" • Homogeneous area F — Asphalt Roof shingles Laboratory analysis detected asbestos in the following building material sampled; Homogeneous area B — Gray multi colored 9"x9" - The Gray multi colored 9"x9" floor tile contains 15% chrysotile asbestos and covers approximately 260 square feet of the concrete pad on the South Room floor. This material is not friable and may remain in place during demolition if it is not rendered friable. The person performing demolition or the Demolition Contractor may be required by the CDPHE to provide a written demolition procedure to assure the 9"x 9" floor tile is not rendered friable. Demolition debris from the floor tile and concrete pad must be disposed of in a landfill that accepts non friable asbestos waste. No asbestos was detected in samples of Homogeneous areas A, B, C,D and F. These materials may be demolished or altered without special engineering controls. Reference Attachment #1 for the Bulk Sample Table and Sample Descriptions. Reference Attachment #2 for supporting Laboratory Analysis data. SECTION 4 DATE OF INSPECTION: March 16, 2019 SECTION 5 LOCATION OF INSPECTION: 2816 Benton Street, Westminster CO Homogeneous Area divisions Suspect ACM were grouped into homogeneous areas based on physical characteristics and functional application. Homogeneous areas were divided into one of three categories based on as designated by Colorado Regulation 8 and the EPA. 1. Thermal systems insulation — (TSI) Insulations to control thermal conductivity pipe/ duct wrap, boiler & chiller insulations and tanks etc. 2. Surfacing material (SM)— Sprayed —on or troweled onto structural members or walls (i.e. fire -proofing on structural steel or drywall finishes) 3. Miscellaneous (MM) — Remaining suspect materials (i.e. flooring, gaskets, shingles, ceiling tiles fixtures etc.) Sampling was conducted per Colorado Regulation 8 protocol, specifying the minimum collection of • 3 samples of surfacing materials less than 3,000 square feet in size. • 5 samples of surfacing materials between 3,000 and 5,000 square feet in size; and • 7 samples of surfacing materials greater than 5,000 square feet in size. • 2 samples (minimum) are collected from miscellaneous materials A material is considered by the Environmental Protection Agency (EPA) and the Colorado Department of Public Health and Environment (CDPHE) to be ACM if at least one sample collected from the homogenous material has asbestos present in a concentration greater than one percent (>I %). All samples were submitted to Reservoirs Environmental, Inc., under proper chain -of -custody procedures. Analysis of the suspect asbestos Bulk sample building materials was performed by polarized light microscopy (PLM) according to EPA 600/R/116, July 1993 methodology. Reservoirs Environmental, Inc. participates in the National Voluntary Laboratory Accreditation Program (NVLAP) for asbestos 2 CONSTRUCTION SPECIFIC ASBESTOS INSPECTION REPORT 2816 Benton Street Westminster CO R Analytical Project Number R219-40 SECTION 1 SITE SUMMARY: Rz Analytical performed an asbestos survey at 2816 Benton Street, Westminster CO, in conjunction with the planned demolition of this Structure. The house was constructed in the 1950's -60's has a foot print of 602 square feet and has been remodeled. The dividing walls and ceilings are drywall the foundation is concrete slab -on -grade. The exterior and perimeter walls are wood and the roof is covered by asphalt shingles, SCOPE FOF WORK • Perform visual, tactile inspection of suspect ACM. • Identify, locate and areas to be sampled or presumed ACM • Collect samples of friable and non -friable ACM and presumed ACM that will be impacted by remodel activities as directed by client • Provide sample analysis by polarized light microscopy • Provide project report with laboratory results and conclusions SECTION 2 INSPECTION METHODOLOGY: The asbestos inspection was conducted in general accordance with the guidelines of the National Emissions Standards Hazardous Air Pollutants (NESHAPS) 40 CFR Part 61 and the Occupational Safety and Health Administration (OSHA) 29 CFR 1926.1101. A visual and tactile inspection of suspect friable and non -friable asbestos containing material (ACM) was performed. This inspection established and located homogeneous areas. Building material samples were collected of suspect asbestos ACM that will be impacted during structural demolition. 1 TABLE OF CONTENTS SECTION 1 SITE SUMMARY/ SCOPE OF WORK SECTION 2 INSPECTION METHODOLOGY SECTION 3 RESULTS /CONCLUSIONS SECTION 4 DATE OF INSPECTION SECTION 5 LOCATION OF INSPECTION SECTION 6 R2 ANALYTICAL REPRESENTATIVE SECTION 6 CLIENT REPRESENTATIVE CONTACTED SECTION 8 EXCLUSION STATEMENTS SECTION 9 SAMPLING RATIONAL/INVESTIGATION METHODOLOGY ATTACHMENTS ATTACHMENT #1 BULK SAMPLE ANALYSIS TABLE & SAMPLE LOCATION DRAWINGS ATTACHMENT #2 LABORATORY ANALYSIS REPORT ATTACHMENT #3 STATE OF COLORADO INSPECTOR ACCREDITATION R 77 South Ventura Way R2 Analytical Centennial, CO 80015 303-210-1349 Fax 303-632-8226 rragan2 (& c omc a st. net CONSTRUCTION SPECIFIC ASBESTOS INSPECTION REPORT STRUCTURE 2816 BENTON STREET DENVER COLORADO For Mr. Terry Horton R2 Analytical Project Number R219-40 March 16, 2019 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: za,2 I L z2a-17ny- Permit Number: ❑ No one available for inspection: Time AM PM Re -Inspection required: Yes No When corrections have been made, call for re -in ection at 303-234- 933 Date: l i b(� r� Inspector:Azo�k DO NOT REMOVE THIS NOTICE _CITY OF WHEAT RIDGE _:�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address:'— Permit Number: 2 019 (24- 1(p ❑ No one available for inspection: Time 1 U ,(AM/P Re -Inspection requir : Yes No When corrections have been made, call for tion at 03-234-5933 Date: ( Inspector: DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE _:�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: 1 Permit Number: ((� ❑ No one available for inspection: Time Jd AM PM Re -Inspection required: Yes No When corrections have been made, call for re -in at 3-234-5933 Date: (I 11D /-�"_ Inspector: DO NOT REMOVE THIS NOTICE ♦SII City Of c�7�IheatR�dge COMMUNITY DEVELOPMENT Memorandum TO: Terrance Horton FROM: Planning Division DATE: April 4, 2018 SUBJECT: Possible Subdivision at 2810/2816 Benton Street Please let this memorandum serve as a follow-up regarding property located at 2810-2816 Benton Street. The property in question is zoned Residential -Three (R-3) and is approximately 13,300 square feet, according to the Jefferson County Assessor. It currently contains two freestanding single-family residences and an accessory building along the rear alley which was converted into a residential unit. The City has records that the accessory building (2816 Yz Benton Street) received some permits for the kitchen/bathroom, and a gas line permit for the stove and heating, and was recognized as a dwelling unit. However, it would need to be brought up to current codes to be considered a legal dwelling unit. The property is currently nonconforming relative to several provisions of the Wheat Ridge Code of Laws. The zoning code allows only one primary structure on a single lot, and in this instance there are two houses on the property which likely predate this requirement. Staff has determined three possible solutions which would bring the property into compliance with current standards and in some cases allow the dwelling units to be sold separately. 1. Subdivision with lot width/size variances: If the "chicken coop" portion of the rear building (28 10 Yz Benton Street) were demolished, the property could be split into two pieces by numing a lot line between the two houses with ajog around the rear accessory structure (2816 Yz Benton Street). This would require variances to the minimum lot width of 60' because the lots created would be 50' wide at the front setback. The lot not containing the accessory structure would also require a lot size variance, as it would likely not meet the minimum lot size for single-family homes in the R-3 zone district (7,500 square feet). Staff is not supportive of a 3 -lot subdivision due to the lack of land area and because the rear lot would not directly access a public street. The subdivision would allow one of the homes to be sold separately. 2. Planned Building Group (PBG): This solution is an administrative process that will legalize the current conditions on the property, with the exception of the chicken coop, which would need to be demolished. This would allow the dwelling units on the property to be rented, but they could not be sold separately. 3. New construction: All structures on the site could be demolished and rebuilt as three multifamily units in a single structure, with a lot consolidation (removing the internal lot lines). The current square footage of the property and the R-3 zoning would allow for up to three units on the property. These could potentially take the form of townhomes or a small three -unit apartment building. This would require a re -subdivision and a site plan. Staff is not supportive of the possibility of acquiring a portion of the 2800 Benton Street property to the south in order to provide street access to the rear building or to increase the overall lot size. That property is already nonconforming from a lot width and square footage perspective, and carving off a portion of that lot would make it increasingly nonconforming. If you would like to move forward with making changes to the property, including a subdivision or a Planned Building Group, staff recommends scheduling a formal pre -application meeting. The Planning Division and Department of Public Works will be present to discuss the potential processes and provide advice regarding a formal application submittal. Please be aware that staff will provide the best advice available given existing regulations, current policy, and information submitted, but any time a property owner enters into a land use entitlement process, there are no guarantees. Feel free to contact Scott Cutler at 303-235-2849 or scutlerAci.wheatridge.co.us to schedule a pre -application meeting. - INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci-wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 111specrions 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 follnwir,n a___ — Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections11 Pier Date Inspector Initials �CoIncreteEncased Ground (CEG) n / P.E. Letter Do Not Pour Concrete Prior To A Underground/Slab Inspections Date Inspector Electrical Initials Sewer Service Plumbing Do Not Cover Unde Rough Inspections Wall Sheathing Mid -Roof Lath / Wall Tie Rough Electric Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw / Nail Final Inspections Comments Of The Above Inspections Comments and or Below/In-Slab Work Prior To Date Inspector Initials Landscaping Parking /Planm g Det ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical Roof Final Window/Doors Final Building If— Date Inspector Initials royal Of The Above I Comments Comments 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. NOTE: All items must be completed and approved by P[anninn, Public Wardr5 of Occupancy is issued. Approval of the Final Eui/ding inspeci,�,,,r'� Euiiding before a Certificate For low voltage permits —Please be sure that rough inspections are completed(from then Fire District and,e a Orio I lowv olta by the Building Division. ge Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather City of Residential Roofing PERMIT - 201704168 -- ISSUED: 07/17/2017 ZMIT NO: 201704168 EXPIRES: 07/17/2018 3 ADDRESS: 2816 Benton ST ear as halt shingles with 14 3 DESCRIPTION: Residential Re -roof to install Laminate 30 y P sq. * CONTACTS *** NER (303)515-0808 HORTON TERRANCE L 170275 Home Sky Contracting Inc B (720)670-9957 Ivan A. Valverde * PARCEL INFO *** GARDENS, OLI BLOCK/LOT#: USE: UA / Unassigned )NE CODE: UA / Unassigned 0 / JBDIVISION CODE: 2412 / LAKESIDE, STEWART ESTIMATED PROJECT VALUATION: 5,000.00 ** FEE SUMMARY *** FEES 0.00 otal Valuation 105.00 se Tax 125.05 ermit Fee 230.05 * TOTAL ** ** COMMENTS *** *** CONDITIONS *** roved midroof 2014, asphalt shingle installations require an app- prior to final Effective December 1, percent of the roof covering is installed, prroved inspection inspection, conducted when 25-75 p new or overlay) requires an app approval. Installation of roof sheathing one half inch exists. Asphalt shingles are the entire roof when space prior to installation of ANY roof coverings and is require on or board sheathing with ANY gap exceeding with 3 feet above required to be fastened toEthe e roof rakekmetal ism required. A ladder inimum of 6 nails pextending er el ce an water shield is required. be provided for all roof inspections. the roof eave and secured in place is required to with applicable codes and/or manufacturer ass a final inspection Roof ventilation is required to complyIn rival from the installation instructions, whichever is more stailetter of inspection and app the of elastomeric or similar type roof coverings, application of the roof at (project manufacturer technical representative stating that "the app 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. the 3rd art inspection will be required, ection performed by City of Roof inspections for ROOFS OVER 6/12 PITCH: 3r party party inspection report will be collected at final roof insp Wheat Ridge. If report is not available the final inspection will not be completed. City of Wheat Ridge Residential Roofing PERMIT - 201704168 PERMIT NO: 201704168 ISSUED: 07/17/2017 JOB ADDRESS: 2816 Benton ST EXPIRES: 07/17/2018 JOB DESCRIPTION: Residential Re -roof to install Laminate 30 year asphalt shingles with 14 sq. *** CONTACTS *** OWNER (303)515-0808 HORTON TERRANCE L SUB (720)670-9957 Ivan A. Valverde 170275 Home Sky Contracting Inc *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,000.00 FEES Total Valuation 0.00 Use Tax 105.00 Permit Fee 125.05 ** TOTAL ** 230.05 *** 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 - 201704168 PERMIT NO: 201704168 ISSUED: 07/17/2017 JOB ADDRESS: 2816 Benton ST EXPIRES: 07/17/2018 JOB DESCRIPTION: Residential Re -roof to install Laminate 30 year asphalt shingles with 14 sq. I, by my signature, do hereby attest that the work to be 1 applicable building codes, and all applicable municipal by the legal owner of the property and am authorized to thisermit. I further attest that I am legally authorized t, performed and that all work be p rt- is osei nply with all accompanying approved plans and specifications, procedures, and that I , the legal owner or have been authorizec and perform the work described and approved in conjunction with :s named within this document as parties to the work to be and/or its' accccompanying approved plans and specifications. ,.G �'? Signature of OWNER or CONTRACTOR (Circle one) Date I. This permit was issued based on the information provided in the permit application and accompanying pians 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 p%ro r, or an approval of, an violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. 1 ofp +_.workis sub'ect to fyeld inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dane Lovett 6 170 4_l From: no-reply@ci.wheatridge.co.us Sent: Sunday, July 9, 2017 2:48 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 for a Yes residential roof? How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number Property Owner Email Address 2816 Benton Terry Horton 303 515 0808 Field not completed. t;3O- as-- 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 Contractor's License Number (for the City of Wheat Ridge) Contractor Phone Number Home Sky Contracting Inc 170275 720 670 9957 Contractor Email Address ivan@omeskyinc.com Retype Contractor Email ivan@homeskyinc.com Address DESCRIPTION OF WORK Are you re -decking the No roof? Description of Roofing 30 year laminated shingles Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 14 material selected above? / Does any portion of the No V property include a flat roof? If yes, how many squares Field not completed. on the flat roof? TOTAL SQUARES of all 14 roofing material for this project Provide additional detail house here on the description of z work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract $5000.00 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 Ivan Valverde Email not displaying correctly? View it in your browser. 3 HH cii� kky.,..v No labor fees till job completion ;e%%% • Custom Basement Finish • Full kitchen and bathroom remodels Custom patio and deck builds -. Roofing & Exteriors Insurance Claims Specialist Local, Licensed Insured and BBB A+ Certified Authorization I hereby authorize Home Sky Contracting Inc., their agents or representatives to perform repairs, restoration and /or upgrades services for the below approved estimate on my behalf. I authorize my insurance company to Include Home Sky Contracting Inc. on any payment for work performed or rendered on my behalf. I understand that I am responsible for my deductible and I will pay said deductible prior to the completion of such repairs, restores, or upgrades. I acknowledge that I am responsible for payment(s) to Home Sky Contracting Inc. for all amounts not covered by my insurance and any additions or changes. Name: TERRY HORTON Phone: 303-515-0808 Address: 2816 BENTON City/Zip Wheatridge CO 80033 Property Address: same as above Cell: Email: S uE"E' 125 1 Cf ly.klhail re, — Insurance Co: / fr►'I IV -1 CA!, A Adjuster: V > Claim #: 353 AA Date of Loss: eA Approved Estimate Date: Estimate Total: $5,000.00 Deductible Amount: $ / 000 REPAIRS WILL BE COMMENCED UPON RECEIPT OF THE ABOVE SIGNED AUTHORIZATION AND VERIFICATION OF INSURANCE COVERAGE. Terry Horton Date Insured or representative (sign here) 7/5/17 Representative of Home Sky Inc. Please sign /date and send to ivan@homeskyinc.com. You will not be billed for estimated items that were not performed or were determined to be unnecessary. In the event of collections, the insured is responsible for all costs of attorney's court fees and interest on any outstanding balances as determined by the court and collections cost. s CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOf ICE Inspection Type: "- 'U'� ` Job Address:�G Permit Number: `10— r f iv i. r i + A (r;"f ❑ No one available for inspection: Time/ ''.> _ AM/PM ,_, 1 c Re -Inspection required: No When corrections have been made, call for re-' sp0cat 303-234-5933 Date: Inspector: DO NOT REMOVE THIS NOTICE L 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: 1111 d Job Address: 'a gl & VIA n n S Permit Number: 01-7 D 1 & IF ❑ No one available for inspection: Time I I ' OS AQ/PM Re -Inspection required: Yes (0 When corrections have been made, call for re -inspection at 303 -234 - Date: 9 /!;- Inspector: -7-fl DO NOT REMOVE THIS NOTICE 1Q 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: ' Job Address: Permit Number: 0 , -7 i1 3 ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303 -234 - Date: SS 1/3c: Inspector: Th DO NOT REMOVE THIS NOTICE