HomeMy WebLinkAbout3850 Chase StreetPERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION:
City of Wheat Ridge
Residential Solar PERMIT - 202101696
202101696
3850 Chase
Roof mount,
required.
ISSUED:
St EXPIRES:
flush mount, grid -tied 3.4 kW solar
08/06/2021
08/06/2022
PV 10 panels.
No structural
*** CONTACTS ***
OWNER (3 0 3) 9 6 0- 8 2 0 9 BECKER HAFNOR ADAM
SUB (303)577-9628 THOMAS BROOK 070159 SUNRUN INSTALLATION SRVS. 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: 61460.00
FEES
Total Valuation 0.00
Residential Solar 500.00
** TOTAL ** 500.00
*** COMMENTS ***
*** CONDITIONS ***
A printed copy of the permit and city stamped on-site plans must be available on-site for
the first inspection.
Approved per plans and red -line notes on plans. Must comply with 2018 IRC, 2020 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,
applicae building codes, and all applicable municpal 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�permrt. I further attest that I am leg ally authorized to include alI entities named within this document as parties to the work to be
performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180, days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and��procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all requ�ired
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any
�pplicabje code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
08/06/2021
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
� ► � i City of Wheat Ridge
Residential Remodel PERMIT - 202002361
PERMIT NO: 202002361 ISSUED: 12/10/2020
JOB ADDRESS: 3850 Chase St EXPIRES: 12/10/2021
JOB DESCRIPTION: Demo kitchen, bathroom, flooring. Plumbing locations stay the same.New
Water Heater and Furnace. Add can lights, move elec. locations slightly
Remove a small section of non bearing wall. Install new water heater - 300
sq ft
**REVISION: Install new gas fireplace insert and venting, Run new gas line
from meter into crawl space over to fireplace.
Added valuation: $4500
*** CONTACTS ***
OWNER (719) 659-2509
BECKER TERRI
GC (719)310-1079
SCOTT HOBBS
202261 HOBBS CONSTRUCTION LLC
SUB (719)651-3536
RODD WINTERROWD
202298 WINTERROWD ENTERPRISES
SUB (719)323-0323
CHADRICK NASH
202291 NASH ELECTRICAL SERVICES INC
SUB (720)984-4117
LEVI TORRES
120216 HIGH 5 PLUMBING INC.
SUB (303)523-6559
BRIAN GRAY
210062 GAS FIREPLACE SERVICES
*** PARCEL INFO ***
ZONE CODE:
UA / Unassigned
USE: UA / Unassigned
SUBDIVISION CODE:
2412 / LAKESIDE,
STEWART GARDENS,
OLI BLOCK/LOT#: 0 /
*** FEE SUMMARY ***
ESTIMATED PROJECT VALUATION: 34,500.00
FEES
Total Valuation
0.00
Plan Review Fee
324.71
Use Tax
724.50
Permit Fee
557.05
Reinspection Fee
60.00
** TOTAL **
11666.26
*** COMMENTS ***
*** CONDITIONS ***
1* ► � i City of Wheat Ridge
'/� Residential Remodel PERMIT - 202002361
PERMIT NO: 202002361 ISSUED: 12/10/2020
JOB ADDRESS: 3850 Chase St EXPIRES: 12/10/2021
JOB DESCRIPTION: Demo kitchen, bathroom, flooring. Plumbing locations stay the same.New
Water Heater and Furnace. Add can lights, move elec. locations slightly
Remove a small section of non bearing wall. Install new water heater - 300
sq ft
**REVISION: Install new gas fireplace insert and venting, Run new gas line
from meter into crawl space over to fireplace.
Added valuation: $4500
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�permrt. I further attest that I am leg ally authorized to include all entities named within this document as parties to the work to be
performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180, days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and��procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all requ�ired
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any
�pplicabje code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
12/10/2020
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
From: no-reolv(alci.wheatridae.m. us
To: CommDev Pets
Subject: Online Form Submittal: General Permit Application
Date: Thursday, March 18, 20211:26:22 PM
General Permit Application
This application is exclusively for Scopes of Work that do not already have a
specific form.
YOU MUST ATTACH AN ELECTRONIC PAYMENT FORM IN ORDER FOR THE
PERMIT TO BE PROCESSED.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
PROPERTY INFORMATION
Is the property Residential
Residential or
Commercial?
Property Address 3850 Cgase St
Property Owner Name Terri Becker
Property Owner Phone 719-659-2509
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email Field not completed.
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTACT INFORMATION
Submitting General Gas Fireplace Services
Contractor or Architect
Contractor's License 509855
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contract Phone 303-523-6559
Number (enter WITH
dashes, eg 303-123-
4567)
Contact Email Address fireplaceandrenovation@gmail.com
Retype Contact Email fireplaceandrenovation@gmail.com
Address
01:K161CiI91 ffl0N]ayOLib]N:/
Detailed Scope of
Install new gas fireplace insert and venting, Run new gasline
Work - Provide a
from meter into crawl space over to fireplace
detailed description of
work including
mechanical, electrical,
plumbing work
occurring,
adding/removing walls,
etc.
Square footage of
100
scope of work
Location of work
Living room
(backyard, on roof, etc)
Project Value (contract
4500
value or cost of ALL
materials and labor)
Upload Engineer letter,
Field not completed.
other documents on 8
1/2" x 11 "
Upload Asbestos
Field not completed.
Report if triggler level is
met per CDPHE
regulation.
Upload Drawings 11,, x
Field not completed.
17" or larger
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full Yes
responsibility for
compliance with
applicable City of
Wheat Ridge codes
and ordinances for
work under any permit
issued based on this
application.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal owner of the
property to submit this
application and to
perform the work
described above.
I attest that everything Yes
stated in this
application is true and
correct and that
falsifying information in
this application is an
act of fraud and may
be punishable by fine,
imprisonment, or both.
Person Applying for BRIAN GRAY
Permit
Email not displaying correctly? View it in your browser.
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: 185D c hit 5c 5
Permit Number: Z0 Z-002 6 /
1
❑ No one available for inspection: Time 3-5- 1M/PM
Re -Inspection required: Yes W)
When corrections have been made, call for re -inspection at 303-234-5933
f
Date: i` 4'16 l Inspector: .i
DO NOT REMOVE THIS NOTICE
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: �)R / A42; S t4--- Aj/E7/_
Job Address: 7 e- legr, J�
Permit Number: � CO Z
Z Qe
J No one available for inspection: Time AM/PM
Re -Inspection required: .,-Yes. No
When corrections are complete, schedule re -inspection online.
Date: Inspector:
DO NOT REMOVE THIS NOTICE
1* � i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
_1�9r
INSPECTION NOTICE
Inspection Type: �w ,
Job Address:
Permit Number: -mit L>
❑ No one available for inspection: Time( :: AM/PM
Re -Inspection required: Yes No
When corrections are complete, schedule re -inspection online.
Date: �� Inspector:?
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: ,'y ` L
Job Address:'
Permit Number: U
cu. !r , u
f
❑ No one available for inspection: Time AM/PM
Re -Inspection required: lies) No
When corrections are complete, schedule re -inspection online.
! r
Date: 1' r i Inspector:_
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: f` r_1 P S
Job Address:'
Permit Number: 3 (.-p
�d
t
u
❑ No one available for inspection: Time =` AM/PM
Re -Inspection required: Yes No
When corrections are complete, schedule re -inspection online.
Date: 1 r / . ' LA Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type -
Job
Job Address:c-
Permit Number: 0C) 4 ) C) D
❑ No one available for inspection: Time���� AM/PM
Re -Inspection required: Yes No
When corrections are complete, schedule re -inspection online.
Dater Inspector:
DO NOT REMOVE THIS NOTICE
. A.
Inspection Type:
Job Address:
Permit Number:
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
J No one available for inspection: Time AM/PM
Re -Inspection required: Yes No
When corrections are complete, schedule re -inspection online.
Date: Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE'
Building Inspection Division
(303) 235-2855 Office
INSPECTION NONCE
Inspection Type:..
Job Address: "-
Permit Number: Zczf ` ; ,� ;2 ,
❑ No one available for inspection: Time SAM/PM
Re -Inspection required: Yes 6
When corrections are complete, schequJe-xe-inspection online.
Date: 1. 2 - , k Inspeto
� ► � i City of Wheat Ridge
Residential Remodel PERMIT - 202002361
PERMIT NO: 202002361 ISSUED: 12/10/2020
JOB ADDRESS: 3850 Chase St EXPIRES: 12/10/2021
JOB DESCRIPTION: Demo kitchen, bathroom, flooring. Plumbing locations stay the same.New
Water Heater and Furnace. Add can lights, move elec. locations slightly
Remove a small section of non bearing wall. Install new water heater - 300
sq ft
*** CONTACTS ***
OWNER (719) 659-2509
BECKER TERRI
GC (719)310-1079
SCOTT HOBBS
202261 HOBBS CONSTRUCTION LLC
SUB (719)651-3536
RODD WINTERROWD
202298 WINTERROWD ENTERPRISES
SUB (719)323-0323
CHADRICK NASH
202291 NASH ELECTRICAL SERVICES INC
SUB ( 72 0 ) 984-4117
LEVI TORRES
120216 HIGH 5 PLUMBING 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: 30,000.00
FEES
Total Valuation
0.00
Plan Review Fee
324.71
Use Tax
630.00
Permit Fee
499.55
** TOTAL **
11454.26
*** COMMENTS ***
*** CONDITIONS ***
1* � � i City of Wheat Ridge
�� Residential Remodel PERMIT - 202002361
PERMIT NO: 202002361 ISSUED: 12/10/2020
JOB ADDRESS: 3850 Chase St EXPIRES: 12/10/2021
JOB DESCRIPTION: Demo kitchen, bathroom, flooring. Plumbing locations stay the same.New
Water Heater and Furnace. Add can lights, move elec. locations slightly
Remove a small section of non bearing wall. Install new water heater - 300
sq ft
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�permrt. I further attest that I am leg ally authorized to include all entities named within this document as parties to the work to be
performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180, days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and��procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all requ�ired
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
From: no-reolv(alci.wheatridae.m. us
To: CommDev Perm is
Subject: Online Form Submittal: Residential Interior Remodel
Date: Saturday, November 14, 2020 5:27:03 AM
Residential Interior Remodel
This application is exclusively for Residential Interior Remodels and other scopes
of work which do not have a specific form already available.
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN
ORDER FOR THE PERMIT TO BE PROCESSED.
Your Permit will be emailed to the email address provided below once it is
processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
PROPERTY INFORMATION
Property Address 3850 Chase St. Wheatridge, CO 80212
Property Owner Name Terri Becker
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
719-659-2509
terribecker3@gmail.com
Electronic payment form Wheatridae 001. Do
APPLICANT INFORMATION
Applicant Name Hobbs Construction LLC
What is your role in the
project?
Wheat Ridge
Contractor's License
Number (This is a 5 or
6 digit number for the
General Contractor
202261
City of Wheat Ridge)
Contact Phone Number
(enter WITH dashes,
eg 303-123-4567)
Contact Email Address
for Plan Review
Comments
Retype Contractor
Email Address
DESCRIPTION OF WORK
Detailed Scope of
Work - In the space
below (not as an
attachment), Provide a
detailed description of
work including
mechanical, electrical,
plumbing work
occurring,
adding/removing walls,
etc
I, the applicant,
understand my
application will be
rejected if I do not
include a Detailed
Scope of Work.
Location of Work
Square Footage Area
of Work Being
Performed
Asbestos Report
Upload letter size
documents here
Construction Plans
scanned on 11'x17" or
larger
719-310-1079
hobbsconstructionIlc4d8@gmail.com
hobbsconstructionIlc4d8@gmail.com
Demo kitchen, bathroom, flooring. Plumbing locations stay the
same.New Water Heater and Furnace. Add can lights, move
elec. locations slightly Remove a small section of non bearing
wall. Install new water heater.
I have entered a detailed scope of work.
Kitchen, bathroom living room,laundry room
300 sq. ft.
Asbestos Insoection Reoort - 3860 Chase Street.odf
Field not completed.
Project Value (contract 30,000 $30,000 Valuation
value or cost of ALL is OK
materials and labor)
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full Yes
responsibility for
compliance with
applicable City of
Wheat Ridge codes
and ordinances for
work under any permit
issued based on this
application.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal owner of the
property to submit this
application and to
perform the work
described above.
Person Applying for Scott Hobbs
Permit
I attest that everything Yes
stated in this
application is true and
correct and that
falsifying information in
this application is an
act of fraud and may
be punishable by fine,
imprisonment, or both.
Email not displaying correctly? View it in your browser.
CityW he
a
9
Coni zalv�r t v o�rllE"
SUBCONTRACTOR AUTHORIZATION FORM
Mechanical Subcontractor
This farm must be completed & signed by the MECHANICAL SUBCONTRACTOR
Performing mechanical work on site.
Subcontractor's insurance and license must be up to date prior to permit issuance
Project Address: 3 $ 5 Q (' I� r-�2.i" tn)ls-P�j' �; �qe.i ("a '602-1 Z
General Contractor:
Company Name: nh Q Sc o rS r k y 'gtS Contact Phone #: 7l $ % ' ` 6
Z� T
Wheat Ridge Contractor License #: 2-0 2_2 t t (required field)
r
a 2c-
__
Printed Name of Authorized Agent
2
t,n1-8- Lo2u
Si4ateoiAwth"nn'axd
llate
NO
•or
City of
_]A
V
Wh6
CMNITY
jA,e
OMUDEVELOPMEatl�,
NT
SUBCONTRACTOR AUTHORIZATION FORM
Electrical Subcontractor
This form must be completed & signed by the ELECTRICAL SUBCONTRACTOR
performing electrical work on site.
Subcontractor's insurance and license must be up to date prior to permit issuance.
Proj"-tAddress: '39r!;-0C,0a r v
General Contractor- jAu ti c t S�Giti2lY�
Company Name:i ia-%tts ^Qa l9504 Contact Phone #: 1lc1--,3Z3-03Z.3
Wheat Ridge Contractor License #: 2 0Z2- {required ficin)
State License #:
Master License #: Zl (oZl
Printed Name of Authorized Agent
Signature of Authorized Agent
Date
pity csf
Ti t
SUBCONTRACTOR AUTHORIZATION FORM
Plumbing Subcontractor
This form must be completed & signed by the PLUMBING %UBCONTRACTOR
Performing plumbing work on site.
Subcontractor's insurance and license must be up to date prior to permit issuance. }
Project Address: a - C�YIiFF�b� 1 i
General Contractor:,
wss s vas ss pct �rrr�s wsrs3 MiSSrNC i VFIiRiVIATiflV
Company Name: t �_)
.�.1�,�('otetactPhtmc#; -12 CJS" `t5 i�-i r
Wheat Ridge Contractor License #:-1102(requircdfield)
.`.state License
Master License #: C20 C2 } VN �H q
Printed Name of Authorized Agent'
i _ atore ofAu ized Agent Date
SRP Environmental, LLC
3001 8'h Avenue
Evans, Colorado 80620
Telephone: (970) 352-9106
I n t e r n e t: sroenvironmental.com
September 17, 2019
Trish Becker
3860 Chase Street
Wheatridge, Colorado 80212
Re: Asbestos Survey
SRP Environmental, LLC (SRP) was retained by Mrs. Beckert to conduct an asbestos building survey
at the residence located at 3860 Chase Street, Wheatridge, Colorado. The asbestos building survey
was completed by SRP Environmental as requested and authorized by Mrs. Becker. This survey was
conducted to identify any asbestos containing material (ACM) that may pose a hazard to human
health and/or the environment during any renovation and demolition activities. This survey is in
accordance with the Environmental Protection Agency's Title 40 CFR Part 61 National Emission
Standards for Hazardous Pollutants (NESHAP) and the Colorado Department of Public Health and
Environment (CDPHE) Regulation #8.
Identification of ACM is imperative to prevent the release of asbestos fibers during construction
activities and to avoid exposure of workers and the public. For the protection of human health and
the environment, recommendations are also given regarding the proper removal, handling and
disposal of ACM which may have been identified during this survey.
Facility Information
This survey was designed to encompass the walls, flooring, ceiling and attic insulation. General
construction of the sampled area includes plaster, drywall, wallpaper, vinyl flooring and vermiculite
insulation.
Survey Procedures
On August 30, 2019 an initial visual survey was conducted for the interior of the proposed sampling
areas. Efforts for this survey were focused on materials that may be disturbed during demolition
and renovation activities. The survey consisted of walking through the building and identifying
materials to be sampled for the presence of asbestos. Emphasis was placed on identifying friable
materials, those materials that can be pulverized or reduced to a powder by hand pressure, as well
as non -friable suspect materials. In order to determine if the suspect materials idenified during the
visual survey contained asbestos, the suspect materials were sampled and the samples were
submitted to EMSL Analytical Incorporated (EMSL) of Denver, Colorado for Polarized Light
Microscopy (PLM) analysis and Transmission Electron Microscopy.
Bulk Sample Collection and Analysis
Based on field observations during the visual survey, SRP collected samples of suspect ACM on
August 30, 2019. SRP personnel submitted fifteen (15) suspected asbestos -containing samples from
a total of five (5) homogeneous areas/materials for bulk analysis by PLM/TEM according to EPA
SRP ENVIRONMENTAL, LLC
S r p e n v i ro n m e nt a I. c o m
City of
Wheat Ridge
Building Division
Asbestos Survey
3860 Chase Street
Wheatridge, Colorado
September 17, 2019
Method 600/R-93/116. The National Voluntary Accreditation Program (NVLAP) for the analysis of
asbestos bulk samples accredits EMSL.
Based on the laboratory results, asbestos was found in the samples taken.
Recommendations and Limitations
This report summarizes our evaluation of the conditions observed at the subject site. Our findings
are based on our observations at the site and the analysis of the samples collected at the time of
this survey. Suspect asbestos -containing materials may have been undetected in inaccessible areas,
under floors, behind walls, above ceilings, or buried in the ground.
SRP ENVIRONMENTAL, LLC
S r p e n v i ro n m e nt a I. c o m
of
Wheat Ridge
Building Division
Percent (%)
Friable
Sample #
Material Description
Homogeneous Area
Asbestos
(Y/N)
< 1%
20190830-4
Vermiculite Insulation
3860—Attic
N
Tremolite
< 1%
20190830-5
Vermiculite Insulation
3860—Attic
N
Tremolite
< 1%
20190830-6
Vermiculite Insulation
3860—Attic
N
Tremolite
3860-1"Floor Bedroom—
None
20190830-7
Plaster
N
East Wall
Detected
3860-1"Floor Bedroom—
None
20190830-8
Plaster
N
West Wall
Detected
3860-1"Floor Bedroom—
None
20190830-9
Plaster
N
South Wall
Detected
20190830-10
Wallpaper/Plaster
3860—Kitchen—East Wall
None
N
Detected
20190830-11
Wallpaper/Plaster
3860—Kitchen—West Wall
None
N
Detected
3860—Kitchen—North
None
20190830-12
Wallpaper/Plaster
N
Wall
Detected
None
20190830-13
Vinyl Flooring
3860—Entry—North
N
Detected
None
20190830-14
Vinyl Flooring
3860—Entry—West
N
Detected
None
20190830-15
Vinyl Flooring
3860—Entry—Center
N
Detected
3850—North Bedroom
None
20190830-19
Ceiling Tile
N
Ceiling — North
Detected
3850—North Bedroom
None
20190830-20
Ceiling Tile
N
Ceiling — East
Detected
3850—North Bedroom
None
20190830-21
Ceiling Tile
N
Ceiling — Center
Detected
Recommendations and Limitations
This report summarizes our evaluation of the conditions observed at the subject site. Our findings
are based on our observations at the site and the analysis of the samples collected at the time of
this survey. Suspect asbestos -containing materials may have been undetected in inaccessible areas,
under floors, behind walls, above ceilings, or buried in the ground.
SRP ENVIRONMENTAL, LLC
S r p e n v i ro n m e nt a I. c o m
of
Wheat Ridge
Building Division
Asbestos Survey
3860 Chase Street
Wheatridge, Colorado
September 17, 2019
This report is for the sole use of Mrs. Becker and should not be used forbidding purposes by any
abatement contractor. Asbestos was found in the three (3) of the fifteen (15) samples that were
submitted for this survey. A "State" certified asbestos remediation contractor should be contacted
to remove the vermiculite insulation from the attic.
SRP appreciates your business and looks forward to assisting you with your consulting needs in the
future. If you have any questions or comments please feel free to contact us.
Sincerely,
SRP Environmental, LLC
Raymond Gibson
Asbestos Building Inspector (State Cetification # 23453)
SRP ENVIRONMENTAL, LLC
S r p e n v i ro n m e nt a I. c o m
City of
Wheat Ridge
Building Division
Asbestos Survey
3860 Chase Street
Wheatridge, Colorado
LABORATORY ANALYTICAL REPORT & C.O.0 FORM
SRP ENVIRONMENTAL, LLC
S r p e n v i ro n m e nt a I. c o rn
September 17, 2019
City of
Wheat Ridge
Building Division
EMSL Analytical, Inc.
1010 Yuma Street Denver, CO 80204
Tel/Fax: (303) 740-5700 / (303) 741-1400
4 M http://www.EMSL.com / denverlab@emsl.com
EMSL Order: 221907123
Customer ID: SRPE63
Customer PO:
Project ID:
Attention: Raymond Gibson Phone: (318) 222-2364
SRP Environmental Fax: (318) 222-2326
348 Aero Drive Received Date: 08/30/2019 5:40 PM
Shreveport, LA 71107 Analysis Date: 09/13/2019 - 09/16/2019
Collected Date: 08/30/2019
Project: 3860 CHASE
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-931116 Method using Polarized
Light Microscopy
Non -Asbestos
Asbestos
Sample
Description
Appearance
% Fibrous
% Non -Fibrous
% Type
20190830-4
ATTIC
Brown
100% Non-fibrous (Other)
<1% Tremolite
VERMICULITE -
Non -Fibrous
221907123-0001
EAST
Homogeneous
Vermiculite is a problem matrix.
Other analytical options are recommended such as EPA 600 PLM/TEM with milling prep or
TEM Qualitative
HA: B
20190830-5
ATTIC
Brown
100% Non-fibrous (Other)
<1% Tremolite
VERMICULITE -
Non -Fibrous
221907123-0002
NORTH
Homogeneous
Vermiculite is a problem matrix.
Other analytical options are recommended such as EPA 600 PLM/TEM with milling prep or
TEM Qualitative
HA: B
20190830-6
ATTIC
Tan
100% Non-fibrous (Other)
<1% Tremolite
VERMICULITE -
Fibrous
221907123-0003
WEST
Homogeneous
Vermiculite is a problem matrix.
Other analytical options are recommended such as EPA 600 PLM/TEM with milling prep or
TEM Qualitative
HA: B
20190830 -7 -Skim Coat
1 ST FLOOR NORTH
White
10% Ca Carbonate
None Detected
BEDROOM - EAST
Non -Fibrous
90% Non-fibrous (Other)
221907123-0004
WALL
Heterogeneous
Inseparable paint/coating layer included in analysis
HA: A
20190830 -7 -Plaster
1 ST FLOOR NORTH
Beige
5% Ca Carbonate
None Detected
BEDROOM - EAST
Non -Fibrous
95% Non-fibrous (Other)
221907123-0004A
WALL
Homogeneous
HA: A
20190830 -8 -Skim Coat
1 ST FLOOR NORTH
White
10% Ca Carbonate
None Detected
BEDROOM E -
Non -Fibrous
90% Non-fibrous (Other)
221907123-0005
WEST WALL
Heterogeneous
Inseparable paint/coating layer included in analysis
HA: A
20190830 -8 -Plaster
1 ST FLOOR NORTH
Beige
5% Ca Carbonate
None Detected
BEDROOM E -
Non -Fibrous
95% Non-fibrous (Other)
221907123-0005A
WEST WALL
Homogeneous
HA: A
20190830 -9 -Skim Coat
1ST JFLOOR NORHT
White
10% Ca Carbonate
None Detected
BEDROOM SOUTH
Non -Fibrous
90% Non-fibrous (Other)
221907123-0006
WALL
Heterogeneous
Inseparable paint/coating layer included in analysis
HA: A
20190830 -9 -Plaster
1ST JFLOOR NORHT
White
5% Ca Carbonate
None Detected
BEDROOM SOUTH
Non -Fibrous
95% Non-fibrous (Other)
221907123-0006A
WALL
Homogeneous
HA: A
20190830 -10 -Wallpaper
KITCHEN EAST
Tan
90% Cellulose
10% Non-fibrous (Other)
None Detected
WALL
Fibrous
221907123-0007
Homogeneous
HA: A
20190830 -10 -Skim Coat KITCHEN EAST White 10% Ca Carbonate None Detected
WALL Non -Fibrous 90% Non-fibrous (Other)
221907123-0007A Homogeneous City Of
HA: A
Initial report from: 09/16/2019 14:05:06 Wheat Ridge]
ASB_PLM_0008_0001- 1.78 Printed: 9/16/2019 12:05 PM BUildin of i'6h
EMSL Analytical, Inc. EMSL Order: 221907123
Customer ID: SRPE63
1010 Yuma Street Denver, CO 80204
Customer PO:
Tel/Fax: (303) 740-5700 / (303) 741-1400
M http://www.EMSL.com / denverlab@emsl.com Project ID:
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-931116 Method using Polarized
Light Microscopy
Non-Asbestos Asbestos
Sample Description Appearance % Fibrous % Non-Fibrous % Type
20190830-10-Plaster KITCHEN EAST Beige 5% Ca Carbonate None Detected
WALL Non-Fibrous 95% Non-fibrous (Other)
221907123-00078 Homogeneous
HA: A
20190830-11-Wallpaper KITCHEN WEST Tan 90% Cellulose 10% Non-fibrous (Other) None Detected
WALL Fibrous
221907123-0008 Homogeneous
HA: A
20190830-11-Texture KITCHEN WEST White 15% Ca Carbonate None Detected
WALL Non-Fibrous 85% Non-fibrous (Other)
221907123-0008A Homogeneous
Inseparable paint/coating layer included in analysis
HA: A
20190830-11-Skim Coat KITCHEN WEST White 10% Ca Carbonate None Detected
WALL Non-Fibrous 90% Non-fibrous (Other)
221907123-00088 Homogeneous
HA: A
20190830-12-Wallpaper KITCHEN NORTH Beige 95% Cellulose 5% Non-fibrous (Other) None Detected
WALL Fibrous
221907123-0009 Homogeneous
HA: A
20190830-12-Skim Coat KITCHEN NORTH White 10% Ca Carbonate None Detected
WALL Non-Fibrous 90% Non-fibrous (Other)
221907123-0009A Homogeneous
Inseparable paint/coating layer included in analysis
HA: A
20190830-12-Plaster KITCHEN NORTH White 5% Ca Carbonate None Detected
WALL Non-Fibrous 95% Non-fibrous (Other)
221907123-00098 Homogeneous
HA: A
20190830-13-Flooring ENTRY VINYL Brown 100% Non-fibrous (Other) None Detected
FLOORING NORTH Non-Fibrous
221907123-0010 Homogeneous
HA: F
20190830-13-Mastic ENTRY VINYL Tan 100% Non-fibrous (Other) None Detected
FLOORING NORTH Non-Fibrous
221907123-0010A Homogeneous
HA: F
20190830-14-Flooring ENTRY VINYL Brown 100% Non-fibrous (Other) None Detected
FLOORING WEST Non-Fibrous
221907123-0011 Homogeneous
HA: F
20190830-14-Mastic ENTRY VINYL Tan 100% Non-fibrous (Other) None Detected
FLOORING WEST Non-Fibrous
221907123-0011A Homogeneous
HA: F
20190830-15-Flooring ENTRY VINYL Brown/Black 100% Non-fibrous (Other) None Detected
FLOORING CENTER Non-Fibrous
221907123-0012 Homogeneous
HA: F
20190830-15-Leveler ENTRY VINYL White 100% Non-fibrous (Other) None Detected
FLOORING CENTER Non-Fibrous
221907123-0012A Homogeneous
HA: F
20190830-19 3850 NORTH Brown/White 95% Cellulose 5% Non-fibrous (Other) None Detected
BEDROOM CEILING Fibrous
221907123-0013 - NORTH Homogeneous
HA: C
city O
Initial report from: 09/16/2019 14:05:06 Wheat Qidg�
ASB—PLM-0008_0001- 1.78 Printed: 9/16/2019 12:05 PM Page 2 of 3
Building Division
EMSL Analytical, Inc. EMSL Order: 221907123
Customer ID: SRPE63
1010 Yuma Street Denver, CO 80204
Customer PO:
Tel/Fax: (303) 740-5700 / (303) 741-1400
M http://www.EMSL.com / denverlab@emsl.com Project ID:
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-931116 Method using Polarized
Light Microscopy
Non -Asbestos Asbestos
Sample Description Appearance % Fibrous % Non -Fibrous % Type
20190830-20
3850 NORTH
Brown/White 95% Cellulose 5% Non-fibrous (Other) None Detected
BEDROOM CEILING
Fibrous
221907123-0014
- EAST
Homogeneous
HA: C
20190830-21
3850 NORTH
Tan 98% Cellulose 2% Non-fibrous (Other) None Detected
BEDROOM CEILING
Fibrous
221907123-0015
-CENTER
Homogeneous
HA: C
Analyst(s)
Amanda Hammer (18)
Mollie Shreck (9)
1 i
Melanie Rech, Laboratory Director
or Other Approved Signatory
:-MSL maintains liability limited to cost of analysis. The above analyses were performed in general compliance with Appendix E to Subpart E of 40 CFR (previously EPA 600/M4-82-020 "Interim
Method"), but augmented with procedures outlined in the 1993 ("final') version of the method. This report relates only to the samples reported above, and may not be reproduced, except in full, without
vritten approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client. All
samples received in acceptable condition unless otherwise noted. This report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST or any agency of
he federal government. EMSL recommends gravimetric reduction for all non -friable organically bound materials prior to analysis. Estimation of uncertainty is available on request.
Samples analyzed by EMSL Analytical, Inc. Denver, CO NVLAP Lab Code 200828-0 City Of
Initial report from: 09/16/2019 14:05:06 WhmjrRW�e
ASB_PLM_0008_0001- 1.78 Printed: 9/16/2019 12:05 PM BuildilhgMAWOn
OrderID: 221907123
Asbestos Chain of Custody
EMSL Order Number (Lab Use Only):
PHONE:
axncmcd u e FAX:
Company Name: SP-? Fnv;confyxe,n EMSL Customer ID:
Street: r:
CIty: skm _ r
State/Province. L
Zi /Postal Code: l
Coun US Tale hone #: o •a z - 5to I
Fax #:
Report To (Name): I
r1 Please Provide Results: n Fax ® Email
Email Address: r r
n I. Purchase Order:
Project Nama!Number. _
a EMSL P❑ /naf Use Only;:
DCmcialRaxab.l
U.S. State Samples Taken: �
CTSam e Residential/Tax Exem t
EMSL-8111
to: ® Same Different - It aiii to is Dffferent note Instructions in Comments••
Third Party Billing requires written authorization from third party
Turnaround Time TAT 0,ons'-Please Check
❑ 3 Hour ❑ 6 Hour ❑ 24 Hour ❑ 48 Hour ❑ 72 Hour ❑ 96 Hour ❑ 1 Week 2 Week
*For TEM Air 3 hr through 6 hr, please call ahead to schedule. *Them is a premfum charge for 3 Hour TEM AHERA or EPA Level ll TAT. You will be asked to sign an
authorization form forthis service. Analysis completed in accordance with EMSL's Tenns and Conditions located In the Analyfical Price Guide.
PCM - Air LjCheck If samples are
from NY
❑ NIOSH 7400
❑ w/ OSHA 8hr. TWA
TEM — Air ❑4 4.5hr TAT (AHean cntt)
❑ AHERA 40 CFR, Part 763
❑ NIOSH 7402
❑ EPA Level 11
❑ ISO 10312
TEM -Dust
❑Microvac - ASTM D 5755
❑Wipe - ASTM D6480
❑Carpet Sonication (EPA 600/J-931167)
PLM - Bu{k reporting limit
PLM EPA 600/R-93/116 (<1%)
❑PLM EPA NOB (<1 %)
Point Count
400 (<0.26%) 01000 (<0.1%)
F1400i
Point Count w/Gravimetric
❑400 (<0.25%) ❑1000 (<0.1%)
❑ NYS 198.1 (liable in NY)
}NYS 198.6 NOB (non -liable -NY)
❑ NYS 198.8 SOF-V
❑ NIOSH 9002 (<1 %)
Soil/RockfVerrniculite
❑ PLM EPA 600/R-931116 with milling prep (<1 %)
❑PLM EPA 600[R-931116 with milling prep (<0.25%)
❑TEM EPA 600/R-93/116 with milling prep (<O.1%)
❑TEM Qualitative via Filtration Prep
❑TEM Qualitative via Drop Mount Prep
❑Cincinnati Method EPA BOOIR-04/004 - PLMITEM
BC only)
TEM - Bulk
❑i�t�T�EM EPA NOB
_pvYS NOB 198.4 (non -friable -NY)
[hhatfield SOP
EM Mass Analysis -EPA 600 sec. 2.5
TEM -Water'. EPA 100.2
Fibers >10pm ❑Waste ❑Drinking
All Fiber Sizes ❑Waste []Drinking
rOther:
u
❑Check For Positive Stop - Clearly
Identifys G
Homo enourou
Filter Pore Size Alr Samples): E30.8pm _00.45pm
Samplers Name: y 1 t� 0„1 Samplers Signature:
Sample #
Sample Description
VolumelArea (Air)
HA # Bulk
Datefrime
Sampled
%J190a 3o- 41
A4 ,
38
2U)Jq os O-5
c
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8 3C r?3
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vec 'L ,
$ 3 %5-37
2o1Q0 30- 7
wok1
& 30 /sYo
20I9Ca3o-8
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Client Sample # (a): 2�c3 68 -3 v •- 2-a/ 170 3 - 2li
Total # of Samples: / S—
Relinquished (Client):8-
3o / Time: 1 LIS—
Received (Lab):
Date: Time: S:
Comments/Special Instructions:
�-t!
CY.I2YA Dzunmt—ACEusbe COC —810—RS08R�10
Page i of?- pages
City of
Wheat Ridge
Building Division
Paste 1 Of 2
OrderID: 221907123
Asbestos Chain of Custody EMSL ANALYTICAL, INC.
® EMSL Order Number (Lab use Only): 1010 PUMA
DENVER CO, 8020404
V27;t-) PHONE: (303) 740-5700
FAx: (303) 741-1400
Additional Pages of the Chain of Custody are only necessary if needed for additional sample information
Sample #
Sample Description
VolumelArea (Air)
HA # Bulk
Date/Time
Sampled
08 30-
n �
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/
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20/ w> 30 -Io
4
k- We
/
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•Comments/Special Instructions:
Page 2 of 2, pages
City of
CgtlnCN DoomvN-LOL-0s ASpostm-R11-OTr112t10
Wheat Ridge
Building Division
Paqe 2 Of 2
o`k : _ s'l
ON SITE PLANS
MUST BE ON SITE FOR INSPECTION
ALL Projects are
Subject to Field Inspections
Shower head location. Shower heads shall be so located on the si, ewall f the shower
'- compartments or be arranged so the shower head does not discharge di ctly at the
entrance to the compartment and the bather can adjust the valve pTior to stepping into
I the shower spray. (Colorado Plumbing Code Amendment (P2709.5)
0
2018 IRC R402.4.1.1 14, d Insulat n Requirements j
M
m The air barrier installed at exterior walls adjacent to showers and tiks sh3'e eparate the wall from the shower or tub.
( Exteriorwalls adjacent to showers and tubs shall be insulated. —
r j
t
w
I
A
i
ALL WORK SHALL COMPLY WITH:
• 2018 INTERNATIONAL RESIDENTIAL
CODE
• 2020 NATIONAL ELECTRICAL CODE
• COLORADO PLUMBING CODE
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------------
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City of
Wheat-dW
0"0-:COMMUNM DEVELOPMENT
APPROVED
Reviewed for Code Compliance
Randy Slusser 11/24/2020
Plans Examiner Date
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disturbed per contractor, as it
J—J contains asbestos
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3 Ch5qs-E7 INSPECTION RECORD
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection
INSPECTION REQUEST LINE: (303) 234-5933
Cancellations must be submitted via the online form before 8 a.m. the day of the inspection
Occupancy/Type
U-�-
F— 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 Annroval Of The Above Insner-tinnc
Underground/Slab Inspections
Date Inspector Comments
Initials
Electrical
Comments
Sewer Service
Plumbing
--
Do Not cover Under round or Below/In-Slab Work Prior To ADoroval Of The Above Inspections
Rough Inspections
Date
Inspector
Initials
Comments
btY�Sheathing
Mid -Roof
- r,1,, LZ
Lath / Wall Tie
—
Rough Electric
�Roough Plumbing/Gas Line
—�
i RRough Met, :�)nical
I Rough Framing
Rough Grading
Insulation
Drywall Screw/ Nail
Final Inspections
Date Inspector
Initials
Comments
Landscaping & Parking / Planning Dept.
Inspections from these entities should be requested
one week in advance. For landscaping and parking
inspections call 303-235-2846. For ROW and drainage
inspections call 303-235-2861. For fire inspections
contact the Fire Protection District for your project.
ROW & Drainage / Public Works Dept.
Floodplain Inspection (if applicable)
Fire Inspection / Fire Protection Dist.
Final Electrical
Final Plumbing
Final Mechanical
Roof
Final Window/Doors
Final Building
NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate
of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy.
rur iow voltage permits - riease 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
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: 1-109- F" r, a I
Job Address: 3 Ss SZ) C a S4
Permit Number: -D 0 1-7 0 (o a 1
on� o
❑ No one available for inspection: Time : 08 M PM
Re -Inspection required: Yes '&
When corrections have been made, call for re -inspection at 303-234-5933
Date: /o,//g /1-7 Inspector: 'rte
DO NOT REMOVE THIS NOTICE
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City of Wheat Ridge
Residential Roofing PERMIT - 201706261
PERMIT NO: 201706261 ISSUED: 08/17/2017
JOB ADDRESS: 3850 Chase ST EXPIRES: 08/17/2018
JOB DESCRIPTION: Residential Re -roof to install Owens Corning asphalt shingles with ROOF
DECKING - 17 sq
*** COMMENTS ***
*** CONDITIONS ***
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) is required on the entire roof
when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and
mid -roofs may be called in at the same time, one hundred percent of the sheathing must be
complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required
to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield
is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturer installation instructions,
whichever is more stringent. In order to pass a final inspection of elastomeric or similar
type roof coverings, a letter of inspection and approval from the manufacturer technical
representative stating that "the application of the roof at (project address) has been
applied in accordance with the installation instruction for (roof material brand name)
roof covering" is required to be on site at the time of final inspection.
Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd
party inspection report will be collected at final roof inspection performed by City of
Wheat Ridge. If report is not available the final inspection will not be completed.
***revision add
redecking 17sq*****
*** CONTACTS ***
OWNER
ROBITAILLE SHIRLEY
SUB (303)804-0303
Tom Brown
070055 Northwest Roofing
*** PARCEL INFO ***
ZONE CODE:
UA / Unassigned
USE: UA / Unassigned
SUBDIVISION CODE:
2412 / LAKESIDE,
STEWART GARDENS,
OLI BLOCK/LOT#: 0 /
*** FEE SUMMARY ***
ESTIMATED PROJECT VALUATION: 7,567.13
Total Valuation
FEES
0.00
Use Tax
158.91
Permit Fee
172.60
_
** TOTAL **
331.51
*** COMMENTS ***
*** CONDITIONS ***
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) is required on the entire roof
when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and
mid -roofs may be called in at the same time, one hundred percent of the sheathing must be
complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required
to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield
is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturer installation instructions,
whichever is more stringent. In order to pass a final inspection of elastomeric or similar
type roof coverings, a letter of inspection and approval from the manufacturer technical
representative stating that "the application of the roof at (project address) has been
applied in accordance with the installation instruction for (roof material brand name)
roof covering" is required to be on site at the time of final inspection.
Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd
party inspection report will be collected at final roof inspection performed by City of
Wheat Ridge. If report is not available the final inspection will not be completed.
City of Wheat Ridge
Residential Roofing PERMIT - 201706261
PERMIT NO: 201706261 ISSUED: 08/17/2017
JOB ADDRESS: 3850 Chase ST EXPIRES: 08/17/2018
JOB DESCRIPTION: Residential Re—roof to install Owens Corning asphalt shingles with ROOF
DECKING — 17 sq
***revision add redecking 17sq*****
I, by m si ature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications
applicable ilding codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the le 1 wn of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this perm . fu r attest that I am legally authorized to include all entities named within this document as parties to the work to be
performe a t all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
,$ - - ��9
Signature ofl OWNLR 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 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, or an approval of, any violation of any provision of any
applicable code or anl. dinance 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.
FOR OFFICE USE ONLY
City of Date:
Wheat Ige ( /
COMMUN iTY DEVELOPMENT Add to PeImit #
Building & Inspection Services Division
7500 W. 291h Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 " Fax: 303-237-8929 �1
Inspection Line: 303-234-5933 U
Email:ep rmits(a ci.wheatridge.co.us q7
Building Permit Revision/Amendment Application
Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed.`
Property Address:
Propertv Owner
Property Owner Email:
Mailing Address: (if different than property address)
Address
City, State, Zip:
5
Phone: 20') --
Contact Person: �,� Phone: 3o-3-90 �
P � 3
Contractor:
Contractors City License #: ®6 lY Phone:
Contractor E-mail Address:
Please Note: Additional valuation must include all general and subcontracted work to be performed
related to the revisions and/or amendments declared in the description of work and which were not
included in the original permit valuation.
If revisions or amendments increase the original valuation, additional fees will be due at the time of
approval. Depending on the scope of work, additional plan review fees may be due upon approval
($60.00 an hour — 2 hour minimum).
Description of revised/amended work:
i4jM �6 - G Vtl5l
�42� ao�7
Sq. Ft./LF
Amps
Btu's
Squares ! J (T
Gallons
Other
Additional ProojS70,
jeectt Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above)
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that 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.
CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED
PRI_VT NAME: & a y SIGNATURE:
DEPART
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
PROOF OF SUBMISSION FORMS
Fire Department ❑ Received ❑ Not Required
Water District ❑ Received ❑ Not Required
Sanitation District ❑ Received ❑ Not Required
ATIV)jE) of (OWNER) (CONTRACTOR)
USE ONLY
DATE: - IS— 1�D'
OCCUPANCY CLASSIFICATION:
Building Division Valuation: $
City of Wheat Ridge
Residential Roofing PERMIT - 201706261
PERMIT NO: 201706261 ISSUED: 08/17/2017
JOB ADDRESS: 3850 Chase ST EXPIRES: 08/17/2018
JOB DESCRIPTION: Residential Re -roof to install Owens Corning asphalt shingles with ROOF
DECKING - 17 sq
*** CONTACTS ***
OWNER
ROBITAILLE SHIRLEY
SUB (303)804-0303
Tom Brown
070055 Northwest Roofing
*** PARCEL INFO ***
ZONE CODE:
UA / Unassigned
USE:
UA / Unassigned
SUBDIVISION CODE:
2412 / LAKESIDE,
STEWART GARDENS,
CLI BLOCK/LOT#:
0 /
*** FEE SUMMARY ***
ESTIMATED PROJECT VALUATION:
5,697.13
FEES
Total Valuation
0.00':
Use Tax
119.64
Permit Fee
140.90
** TOTAL **
260.54
*** COMMENTS ***
*** CONDITIONS ***
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) is required on the entire roof
when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and
mid -roofs may be called in at the same time, one hundred percent of the sheathing must be
complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required
to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield
is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturer installation instructions,
whichever is more stringent. In order to pass a final inspection of elastomeric or similar
type roof coverings, a letter of inspection and approval from the manufacturer technical
representative stating that "the application of the roof at (project address) has been
applied in accordance with the installation instruction for (roof material brand name)
roof covering" is required to be on site at the time of final inspection.
Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd
party inspection report will be collected at final roof inspection performed by City of
Wheat Ridge. If report is not available the final inspection will not be completed.
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION
City of Wheat Ridge
Residential Roofing PERMIT - 201706261
201706261 ISSUED: 08/17/2017
3850 Chase ST EXPIRES: 08/17/2018
Residential Re -roof to install Owens Corning asphalt shingles with ROOF
DECKING - 17 sq
I, byy my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
applic bl building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the eg 1 owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this pe i further attest that I am legally authorized to include all entities named within this document as parties to the work to be
perf"o that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signaturk�f 6*NER 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 issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official `bate
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Dane Lovett -�v I 70� ` /
From: no-reply@ci.wheatridge.co.us
Sent: Tuesday, August 15, 2017 12:27 PM
To: CommDev Permits
Subject: Online Form Submittal: Residential Roofing Permit Application
Follow Up Flag: Follow up
Flag Status: Completed
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 (enter WITH
dashes, eg 303-123-4567)
3850 Chase Street
Shirley Robitaille
303-421-7909
Ell
Property Owner Email
Address
Do you have a signed
contract to reroof this
property?
Applications cannot be
submitted without an
executed contract
attached below.
Attach Copy of Executed
Contract
Field not completed.
Yes
170403 - Contracts (2 contracts).pdf
CONTRACTOR INFORMATION
Contractor Business Northwest Roofing
Name
Contractor's License 070055
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone 303-804-0303
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address 2425 S Colorado Blvd
(Primary address of your
business)
US
Contractor Email Address aberg@northwest-roofing.com
Retype Contractor Email
Address
DESCRIPTION OF WORK
TOTAL SQUARES of
the entire scope of work:
Project Value (contract
value or cost of ALL
materials and labor)
Are you re -decking the
roof?
aberg@northwest-roofing.com
5,67,<�
Yes
2
Does the scope of the
project include a flat roof
(less than 2:12 pitch)?
Does the scope of the
project include a pitched
roof (2:12 or greater
pitch)?
How many squares are
part of the pitched roof?
Describe the roofing
materials for the pitched
roof.
Type of material for the
pitched roof:
Provide any additional
detail here on the
description of work. (Is
this for a house or
garage? What is the roof
pitch? Etc)
No
Yes
16
Owens Corning Duration Storm
Asphalt
House
SIGNATURE OF UNDERSTANDING AND AGREEMENT
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.
I understand that this
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
may not begin on this
property until a permit
has been issued and
posted on the property.
Yes
Yes
Yes
3
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.
I attest that everything Yes
stated in this application
is true and correct and
that falsifying
information in this
application is an act of
fraud and may be
punishable by fine,
imprisonment, or both.
Name of Applicant Amanda Berg
Email not displaying correctly? View it in your browser.
RECaGN1ZE0 AS A
O �L nL.T .CCCIkG
.• .• .-•. RO1r�f4Wft�6N{
North West
*vRoofing
Since 2963
2425 S. Colorado Boulevard, Suite 280 ) Denver, CO 80222 1 (303) 804-0303 1 Fax (888) 846-5545
3630 Sinton Road, Suite 100 ) Colorado Springs, CO 80907 ) (719) 632-6185 ) fax (888) 846-5545
Prgpos4l "nI
ACCREDITED
North West Roofing Esti at
BUSINESS
St t I
'395 D N �£ ,
Prgpos4l "nI
d i t
North West Roofing Esti at
Date � /}
6—
St t I
'395 D N �£ ,
City, State, Zip
w i�� t Cy 06 j, t 9--
Job Ltocati Pn/tom un'
1Jt/V ; iL�E�dt t
P�p— 0
ss i
Insurance Co p n { � AJ�
Policy #
E Email
t
Adjuster
Claim #
Scope of Work and Materials to be Provided: The scope of work and materials identified
ZZTea,
e completed by North West Roofing.
fLayers
Ing (7/16 in. OSB) CHECK DECK
Instatl 90 ce &Water Shield i� � i� V0
nsta x 4 in. Metal Drip Edge Color. --1-=V Initials :
:In�111,elt/so9f with 1 V �G t
tt
v Q Year Manufacturer's Warranty ,
(g"al'—signing this agreement the homeowner authorizes North West
Roofing to represent the homeowner's best interest in pursuit of
roof replacement or repair due to storm damage. This contract does
not obligate the homeowner or North West Roofing until the claim is
approved by the Insurance Company and accepted by North West
Roofing, Upon Approval of the claim, North West Roofing will
complete specific work at the price agreeable to the insurance
company and to North West Roofing. There is no additional cost to
the homeowner except for their deductible. The agreed upon price
will become the final contract price and North West Roofing will
receive al insurance proceeds and supplements for the work
completeffy Noqbmest Roofing.
The Approximate Costs of the Services $ / i r/
ngle Manufacturer e . -Color 121K lnitials Shall a The Agreed Upon Cost Between North West Roofing and
YY r Insurance Carrier. Their RCV Cast Plus Supplements.
r<Op�all'eV
lleys - With Ice and Water Shield Underlayment NOTICE If the Property Owner Plans to use The Proceeds Of a
Property and Causality Insurance Policy, Part 1 of Article 4 of Title
-With Painted Metal 10, C.R.S., In accordance to Title 10 C.R.S., section 6-22-105, the
O�Rid�. color Coordinated shingles roofing contractor cannot pay waive rebate, promise to pay or
waive rebate or any part of insurance deductible applicable to the
Repla Rubber Pipe lacks y, `tom (.'nsura cp a claim-f�orpaymentforthe work�q the[ v ryd pr erty
/^,TL'w"'� Ir -'CGS � t' jr
Paint Stacks To Match Shingle Color ALL Deposit Amount $j Date:
::Rep! Low Profile Vents Turbine Vents
North West Roofing 3 Year Labor Warranty
Metal p Flashing �tping Chimney
North st Roofing will Provide General Liability Insurance of at least $1,000,000.00
Cie Up an44ul Off all Trash
Pro t and Clean Up Landscaping
North West Roofing shall hold in trust any payment from the
property owner until materials are delivered or have performed a
majority of the roofing work on the property. *May not include any
additional taxes, base service fees and or supplements that pertain
to the claim.
NO CASH ACCEPTED ;Z-3 w j� p I 1 e
Approximate Dates of Service: 10 DAYS AFTER AGREEMENT
These dates of service are subject to change due to unusual delays in
transportation of materials, ordinary weather delays, or by any other
causes beyond the reasonable control of Contractor.
Clean around bushes and shrubs
CI Out Gutters qi 66(,x,
Roll rd with magnetic roller SPECIAL INSTRUCTIONS
Y�
Permit Furnished by North West Roofing L N
I agree,
both front & back of this agreement.
re0f�.���� 303400
Signature
(800) 333-1704
PUEBLO DENVER
(719) 633-7773 (303) 804-0303 ( fax (888) 846-5545
Date of Acceptance (0— t,i( - �:li-v 1 7
FORT COLLINS
(970) 484-9430
1i( -iC-�