The URL can be used to link to this page

Home My WebLink About2980 Newland Streeto� W hedf dim All 6> c 1o Clear lngo y` ]Environmental CONSULTING 128o Buffalo Grass Pl. Elizabeth, CO 801-07 1720-982-1513 Asbestos Inspection and Sampling Report elf?. Al I VU .� 298o ew an t,V# ood. 0 °o . • s • eatge,Co 021 e•°' ... • .0 '. o • i • o e �l • • • • • • . q .o•� 0 �A• ate',. P q�• QQ p[,� �.p. • •• �l�i+ ,Q • D� ti`s '• �,.~ O �' .4. loo r 0 1b 00 car• of • • b • , Q d •• , o d;' C e •00 o a •d' o ••, 6 p 1 •... Prepared for,*, �_�t a .. 0 •' ° Q 0�0•� A o ,.. o © o 0 go e& . • • • . p C . 1 of •. 00 • • • • • • • •� �. • O Y•'' •O �C • ••jd 1 Travis Justilian . • •� °� �Q d.•^��, oAs , ` � • /� 298o Newland St. • 0 r o �iDO •0 , p� •• p•0;o lQ Q, �So ••r••O9�� ' � c � Qom• a , , � . • ,� �� ' Wheat Ridge, Co 8021 IS do, 0, oI P �,� • c a E' m l� • 1 V4 0, b , ,, o , .� �, . o � ,, , �; . • �•� , a � . b n, oQ� , • � • to A g• , 1 .d ' Performed & Pre ared bye 1. • • • ` . • •. �� • V Ids OA kit -at *• of °j••el �• • ! ° . d 0 p •.. .. Josh Berard ��°� • �' ' ' `o ,•• p • • •• 0 C� �, 0 e ` •o• o All Clear Environmental Consulting0 o• a q a �o 12 8 o Buffalo Grass Pl. Elizabeth, Co 8o107 O (720) 982-1513 ro,�o Project Number: B.I - 1301 Inspection Date: March 1St, 2021 o+,\,Nheat , , CD 0 Table of Contents aG2'aing Inspection Overview Introduction.................................................................. I Site Description.............................................................. II Scopeof Work.................................................................. III Sampling and Analytical Procedures .............................. IV 'IV (a) ......................... Sampling Procedure IV (b) ......................... Analytical Procedure ,,,Inspection ection Protocol........................................................ V Homogenous Areas.......................................................... VI e .. ��..�Oj... •� VI (a) .......................... Classifications of Materials o. VI (b) Friable Material 'oil ................................ r_ b VI (c) ......................... Material Conditions e VI (d) Sample Quantities Result Overview................................................................ VII Photos................... .)....................................................... VIII Laboratory Results............................................................ IX Conclusion/ Recommendations ......................................... X Limitations......................................................................... XI Certifications...................................................................... XII I. INTRODUCTION On March 1st, 2021 Mr. Josh Berard with All Clear Environmental Consulting conducted an asbestos inspection and collected asbestos bulk -samples of suspect asbestos -containing materials (ACM) within the kitchen inside the residence located at 298o Newland St. The purpose of the inspection was to identify and sample potentia, "zardous friable ACM within the residence that would be impacted. Mr. Berard is Accredited by the Envi nmental Protection Agency (EPA) and certified by the Colorado Department of Public Health d Environment (CIHE) as an Asbestos Building Inspector. A copy of his accreditations and certifications can be found in section XI of this report. II. SITE DESCRIP �I N".. [Ad ��r.,n, • � ;�� .." .'' a•' � r'�RA . , r� Vit. ° � �°�,• The one structure is a single family, 1 story home with bTaasement •�p��w,'.ls'4i..%'�a1�q 9 �:d ;a tl {'Q�� 'e� • ;''iq 9 /�� °o.'"' E •da °� � � 4 101" ... ye 'e '• �s 4 v Ce`: •4:. '`$�9, oho/°' III. SCOPE OF WORK �o. • `� ° V Aj . ` CYik�D '•pYt Travis retained All Clear Environmental to conduct an asbestos inspection regarding suspect building materials that will be impacted during remodel. `°'° 0 .r`Yp 5. i � •foo Xg e ✓R ° m The asbestos inspection conducted on March 1st, 2021 constituted a limited inspection and fulfills the asbestos inspection requirements for structures that are to be renovated. IV. SAMPLIN CED (a) Sampling Procedures: 0 Random bulk -samples representati of the suspect ACM of each homogeneous area were collected according to the guidelines published as EPA Final Rule: Title II of the Toxic Substances Control Act (TSCA), 15 USC, Sections 2641 through 2654 and in compliance with 40 CFR, Part 763 and CDPHE Regulation Number 8, Part B - Asbestos (Reg. 8). All Clear Environmental has collected the appropriate number of bulk -samples to meet all regulatory requirements for the classification and quantity of each homogeneous area. Note some minor destructive sampling was conducted. 3 (b) Analytical Procedures: Bulk samples collected were analyzed utilizing the EPA's Method for the Determination of Asbestos in Bulk Building Materials (EPA boo/R/116, July, 1993) and the McCrone Research Institute's The Asbestos Particle Atlas as methods references. All bulk -samples were analyzed by a National Voluntary Laboratory Accreditation Program (NVLAP) accredited laboratory using the Polarized Light Microscopy (PLM) method for asbestos content (see X for laboratory report). „ . V. INSPECTION PROTOCOL V$ar,a: a, The asbestos inspection was conducted by an Environmental Protection Agency (EPA) and CDPHE certified Building Inspector. The inspection procedures included identifying and sampling suspect ACM within pre -defined areas. Suspect materials alike in appearance and application were sampled as HAs. After identifying the appropriate suspect ACM, with the use of a random number generator, random samples of plaster/texture & sheet vinyl flooring were taken in kitchen and sent to an NVLAP accredited laboratory for analysis. See lab results in section IX�°Q° ' J VI. HOMOGENOUS AREAS <� . ". v, n��; (a) Suspect materials are divided into three classifications: " ``, N 1. Thermal systems insulation (TSI): any type of duct, boiler, tank, or pipe insulation. 2. Surfacing material (SM): sprayed or troweled onto structural building member. 3. Miscellaneous (Mist.): other ect materials ie. flooring, ceiling tiles, insulation, and finishing materials. (b) Friable material is one that, when dry, can be pulverized, or reduced to powder by hand pressure, a non -friable material cannot. A non -friable material may become friable if its condition had deteriorated or has been impacted by forces that have rendered it friable. (c) The three categories in which sampled materials are placed are as follows: 51 Wheat Good: None to very little visible damage or deterioration = �/ Damaged: The surface is crumbling, blistered, water -stained, gouged, marred err oc otherwise abraded over less than one-tenth of the surface if the damage is evenlyG;'/a'ng 0\1j, distributed, or one-quarter if the damage is localized Significantly Damaged: The surface is crumbling, blistered, water -stained, gouged, marred or otherwise abraded over greater than 10% of the surface if the damage is evenly distributed, or %25 if the damage is localized (d) All Clear Environmental collected at least the minimum number of samples from each homogeneous area necessary to meet all regulatory requirements for the quantity of material to be disturbed. The quantities listed in this report are approximate and on-site verification of the exact quantity of each material is required. The following tlines the minimum sample quantities required per homogeneous area: Thermal Sgstem Insulation (TSI): Each homogeneous area requires a minimum of three (3) samples; at least one (1) sample must be collected from each patch; and collect enough samples sufficient to adequately assess the material and determine the asbestos content for TSI fittings such as pipe elbows or "T's". Surfacing Materials (SM): up to 1,000 ft2 of material requires a minimum of three (3) samples; between 1,000 ft2 and 5,000 ft2 of material requires a minimum of five (5) samples; over 5,000 ft2 of material requires a minimum of seven (7) samples; one (1) sample of each patch Miscellaneous Materials (Misc.): collect enough samples sufficient to determine the asbestos content A Homogenous Area (HA) is defined by material that is uniform in appearance, texture, color and date of application. Once the homogeneous area is determined, the inspector will choose the appropriate number of samples to take in accordance with EPA and CDHPE. (HA) 1. Plaster/Texture LI 0 Kitchen Walls & Ceilings 2. Sheet Vinyl Flooring 0 Kitchen Floor 5 VII. RESULTS Asbestos was NOT reported within AL nw-samples collected and analyzed. All Clear Environmental collected a total of four (4) asbestos bulk -samples of two (2) homogeneous areas. The following are the suspect asbestos -containing materials that were collected and their respective asbestos content: �. ��,�''� Material Asbestos Content All Materials Determined to be Non -Detect ND S6, R9 � a '• COQ O �.,oey.la.^,o�,.i• The following table describes the materials composing each homogeneous area as well as the locations of each bulk -sample collected. Also listed is the classification, condition, friability and estimated quantity of material to be removed and/or disturbed, as well as the asbestos content within each bulk -sample. Please see section IX for a breakdown of each bulk sample. u o , S6, R9 � a '• COQ O �.,oey.la.^,o�,.i• The following table describes the materials composing each homogeneous area as well as the locations of each bulk -sample collected. Also listed is the classification, condition, friability and estimated quantity of material to be removed and/or disturbed, as well as the asbestos content within each bulk -sample. Please see section IX for a breakdown of each bulk sample. u Wheat Asbestos Bulk Sampling Loi%nq 0Jec H.A Sample Material Sample Location Condition Friable ACM Type Quantity LD Type (YIN) N -1 - o1 Kitchen - E. Wall Middle ND 1 SM Good Y Approx. 235 Sq. Ft. 02 Kitchen - N. Wall Middle ND 03 Kitchen - N. Wall Left of Jamb as � � N ND a 2 N-3-01 Kitchen -Floor Middle Good N ND Approx. 40 Sq. Ft. I oq'�' b` Af•oj y1el. wJ „, ' �y~ Q Qj 4S,' 4 g ' • ' eQQe �G✓ u a .�.'•ooi�0 SM - Surfacing Material MM - Miscellaneous Material ND - Non Detect VIII. Laboratory Results Reservoirs Environmental, Inc Effective October 09, 2020 Reservoirs Environmental QA Manual Q:\QAQC\Lab\Reservoirs Environmental QA Manual.pdf REI LAB Reservoirs EnWronmental, lnc_ March 01, 2021 Subcontractor Number: Laboratory Report: RES 487248-1 Project #/P.O. #: 1301 Project Description: Newland St Josh Berard All Clear Environmental 11092 Mallard Ct r° sab Parker CO 80134 " "' ° 'a� l e'n�•` ° b � +V�4 0l '��°• At d Dear Josh, o,. 0� ZA' '(1 a��/', 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.o o Uo , z V� g, o ��9,� o J " 0: ,.. a. • ><Yu •, L3��.. �,'-' o �� t'� r'I '"jef (J--' 1 q—'^�" y . ,a, g • . _ 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 487248-1 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, I D Wf90 ° by Andrew Roberts 0 •0 Jeanne Spencer U President` (303) 9641986 5801 Logan St, Suite 100, Denver, C080216 www.reilab.com (866) RESI-ENV https://clients.reilab.com J r z CW 9 G 0) Z O N 'O O > U z m W N a. J O z M> I.L W N W ItFn `a E E c w ww 9 'N s �C O E E U N .T C Q 2 w H T u 2 0000000r- E z�� o O �Q LU E O oQU a) O O O N \ 0 0 0 0 0 0 0 0 aa)i o E Z N p N �'' M V Q Q 0 U U N LL D- Q E c O Q O Q ( U z�� m °!" *• m� C o o �' o 0 0 z z z z z z N E N >.W_.. U O N R � a� �O 7Cuc U) d O 0 0 In Co N N 00 N 00 00 M n N s • e 3 O N cu cu N O O O N ,�•g, 0 O O � 01 N E E y N N Y t N d - Cu Cu Cu> m m m Cu m m o E er d y d y d y o m m m m an Q m Q m Q m Q m M N O N � O O O U co W C 01� -o >. Q N N -6 Q oE o N W N M O O O O O N 0 0_0 C W E E M -C_ E 2 Cu � H D U fA Z z z z z 9 'N s �C O E E U N .T C Q 2 w H T u V Ih ftft M Ou 0 W loft O M W ct Q J W m cz m 2 U Q 0 E E 0 0 W W InIn CO J Q 00 m W t N N 2 W a W N N d Z Q O : co: 0 H a Ln : W CO d m ? a) R O O of d N: LL 0 N: > R 0 d U ca CO ~@ Z cE o: ir— is t O o: s: a5: a) o U Ua E : LL; U li R d E E ': v C; ++• M O U r a CO W =O cacm ca i U: O: i O a r a W U c: ui O : cz : a): a' N > EE aE Z 0:Qc N aS 0 p ; N T Z +0. cE d: E: Ev M O U �: �? CO O. o WE EO aECZ 0' 0 CM d 6: � n5 � o p Qp �p '• a 45i 2- LU EE $ a? ) cz: u): m E • N ; N oE_0 oE'o (q UE QE aEa U) W Z m J N O >C H Q D N .N C O L R N 0 C R J ............................................. WW:UU a paloapoO E)W!l c 2................................................................... m LL0 u' u E u E �� a e_0 �(�(/pp/lulu Pal°a11°O alsoo: o : ............................ ....................... ..LL Daa� saau!elu0310# .....I......I......�.....�.....{ cu c e ............................................ t ...................... e �: ia. o o): 0- apoOx!AIUN a Y (n (z o...............a................................................. QpEa'•cn.C:``z rn in'• �'• °� E E w (lonb!IVaa aaVao)glp!Mx(slonb!IVao)glbual Q: cu:wac CLe c c o~ e e e....................................................................... cn : e CO c Q eaaV / (l) awnloA aldwuS ..... ..... ..... ..... .................. E .....E .....E ..... E E E .................... CO m m m E E E .................... uo!leo!l!luapl alelno!ued `p!oW Mina `dealaaodS-aylOW E E E ....................................................................................................................... U' ............... ..... lVl`uapango!9-IVOIa3W O J ....................................................................................................................... O ............... ..... (O `dN `d) vIlauo!6al `(uo!leo!l!luen0 ao -/+) sn00000aalu3 m Alum ao aI/om) lunoO Ie!goao!W elge!A `p!oV o!loel `(uo!leo!l!luen0 O N °-/+ `aaleM bu!Mu!a(I-uoN `aaleM bu!Mu!aa `aalpM aluIS) -!loo'3/swjol!Io3`lunoO U aluld o!goaaV `IoW V lseaA `snaane-S `palvld - swAOI!100/!100'3 `LH:L5r0!100'3 U J `puals!l `(Z -r ao algeanllnO) ulleuowiPS `snll!oea `aaloegolAdwuo-STIOVIA E E E Q........................................................................................................................ Z SSl `au!wplagdwpglaW - SOINVOHO .................... i Q....................................................................................................................... ueoS s1plaW Ilnd `ueoS awnd bu!p1aM `ueoS 8 VHOH `d101 } .....¢.....¢.....¢..... `(p!nb!l-uoN ao p!nb!l) Hd `(O5Z [-GI VHSO `aaempood `aalPM alsuM `8'OOZ N N `VOZ09`SOSL) s1plaW W !IIn`(aaempood `aalpM elsuM `OZbL `Z80L) AluO peal W (s)alAIPuV-S-jV13W W E E : . (J .....................................................................................................................: algea!dsaH `Iplol-lsna W....................................................................................................................... VHSO `900bL `VOObL - WOd .....¢.....¢.....¢..... ....................................................................................................................... eaagV pa!1!p0W aHVO `-/+Mlna `aaleM alseM `aaleM bu!muua N O ....¢....¢....¢.... `pla4lvg3 `b6L8 1061 `Z I80 1061 '111-01 E)Iuwul. `ZObL HSOI N `(pa!l!luen0 ao -/+) ad!M `(pa!l!luen0 ao -/+) oenoao!W `(pa!l!luen0 ao -/+) VH3HV - W31 W M ........................................................................................................................ W .....¢.....¢.....¢..... (9 4 4/£6-a/009/Vd3) liodea laoLIS W -Id - W -Id Q X X X X x 0 � 0 Q O C W a m N R O LL LL i Co (y W oC 0 o W A d R O a 3 W co O O ct o > W U Z >, i E O Q Z W +' R i N CL 7 ct CL Z 0 Co Y d ago 13 G zCD t �/ .' i E N caZ o cn �! !Z LO 0 N O N g E 0 D D D a 0 'i cn E O CL m - r` CO CO rnCO CO CO a a �a 0N ��_ = CO �Z Qp C = C� Y H a D O N 4_ 4) O O cii y a o ,� a a o= a ctj N 0 N CO U)2>- O co co R J O > �O 0}C Q d O � N d E 2 d Q Q CO O m m J CO a CO 0 Z J Q J G N d V N �ED V N O N >% N C i i CL O a y 0 c p0 R H c E o 0 0 0 N UmA LU 0 O 0 ^, CO ysZ y ZT ZT ZM ZT N = 0 e_ U 1 0 O v o O 5; T N M vQ 10 heal Ok Vo IL C) cv U U f 5 cz 3 �U U fn CL LO t` O N O N O O N E N cz 0 0> O O N T No N N r 0 O 0 MCD O > 0 p C 0 O o o m N a cz cf) D CO cz m 0 0 J O LO N N p � L 21 E 0N 0 E i � d Lo i i y IZ m O � N 'i 2 0cz t U d Iz 3 LL m M W E ,Wheat o .Q,. IX. CONCLUSION & RECOMMENDATIONS Asbestos was NOT identified within the materials inside the building that were within fi'09g e of the asbestos inspection and bulk -sampling performed on March 1St, 2021; therefore, professional abatement activities are NOT required to remove or disturb the above -sampled building materials. All Clear Environmental (ACE) recommends that when ACM is removed/abated, that only a licensed asbestos abatement contractor using pers , nnel trained in the handling of ACM be allowed to conduct such activities using appropriate methods tEEPA-filtered vacuuming, wet cleaning methods, respiratory protection, protective clothing, personnel decontamination, negative -air enclosures, air monitoring, etc.) X. LIMITATIONS All reports and recommendations are based on conditions, practices observed and information made available to All Clear Environmental (ACE) by the client and the designated site on the days sampling was conducted. All activities were performed in accordance with all applicable federal, state, and local regulations as well as generally accepted standards and professional practice. No responsibility is adssumed by All Clear Environmental for the control or correction of conditions or practices existi at the facility/residence, for and on behalf of the client. Any materials encountered during demolition that were sampled during this inspection should be assumed positive until confirmed otherwise by a Certified Asbestos Building Inspector. Any ACM that will be disturbed should be handled according to CDPHE, EPA (Environmental Protection v Agency) and OSHA protocol: . , � �"•a`°�el�•`' e ��; a+� All Clear Envi of ental greatly reciate the opportunity in providing o services to you. Feel free to call us at any mom' t you ha e a y further questions! 0 oD Kindest Regards,�00�° Josh Berard All Clear Environmental Consulting 72o.982.1513 Josh@Al1ClearEC.com 11 7 N V lf1 =N N O 6! N ¢' m E N L u a o u o z a c m ° �oN v r- u c m 0 v 0 0 L) E O Z M u1 SC O Ln M � U v l� U f� 13 O /•V V) z cD z Q Wheat v o w Q I Q1 > ,:j C)2 .-1 'o C 68 Z �J O O fO 11u0 • `° o w E o � � O O 4 a U d H to .> N N c c J c c c O U N N 1— Q CQ CQ O I U i Ln < < U O c O N d' Q O ,:j C)2 'o a) O O 2 `° vN ~W Op V W E W r. J cn D c 00 U u0 v O U Luu Wheat , , , �s - 2018 IRC 2020 NEC - Interconnected Smoke/CO detectors required-ta__ code in new and existing areas o�\lheat CD c GI'laina Dv1410 46'2 3/4" CFpr cp C). 46031os I � LL(- C) " ri� -•,�tls_ay INs�n��,��y �g�sZ Q� Be") CqP Wr (z) 259.8 ft2 6'2 3/4" 2980 Newland St. Wheat Ridge, CO 26'3 1/16" 0 1' 2' 3' 4' 5' 10' z Scale: 1:50 <S�fv cv�udo, 1� a6ne s CQ -ca . -2- �z SI �.c�2 y LI3 I s yL1 sic / 0� Sok, C_A^_O ZrtLllk�) l,rAC e_ upj �-nr�`� rs ? 'p, rN< 26'3 1/16" 0 1' 2' 3' 4' 5' 10' z Scale: 1:50 <S�fv cv�udo, 1� a6ne s CQ -ca . -2- �z SI �.c�2 y LI3 \N heat c_> CD �o c 46'2 3/4" 0 k F. t) tic 0 259.8 ft2 6'2 3/4" '6 1/2" 26'3 1/16" 2980 Newland St.0 1' 2' 3' 4' 5' 10' Z Wheat Ridge'. CO Scale: 1:50 3 I 3 From: no-reolv(alci.wheatridae.m. us To: CommDev Farm is Subject: Online Form Submittal: Residential Interior Remodel Date: Friday, February 12, 2021 11:47:21 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 2980 Newland St., Wheat Ridge, CO 80214 Property Owner Name Travis M Justilian Property Owner Phone 512-457-9131 Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email travis.justilian@gmail.com Address Attach City of Wheat Justilian kitchen Electronic -Payment -Form. Af Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" APPLICANT INFORMATION Applicant Name Travis M Justilian What is your role in the Property Owner project? Are you performing the Yes work yourself, live in the home and will be living in the home 1 year after completion? Attach Notarized Wheat Ridae.odf Homeowner Authorization Form Contact Phone Number 512-457-9131 (enter WITH dashes, eg 303-123-4567) Contact Email Address for Plan Review Comments travis.justilian@gmail.com Retype Contractor travis.justilian@gmail.com 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. complete remodel of kitchen. This includes removal of 3 walls, one of which is load bearing. The load bearing wall will be replaced with steel I-beam and 44 steel posts supported from lower level slab. Existing electrical wiring will be removed, and new electrical circuits will be run to support new kitchen layout. Plumbing layout will not be altered. Plumbing fittings will be updated to support new fixtures and appliances. Will run new gas line to location of cooktop in new kitchen island. I have entered a detailed scope of work. Location of Work Kitchen Square Footage Area 200 of Work Being Performed Asbestos Report Field not completed. Upload letter size Field not completed. documents here Construction Plans scanned on 11'x17" or larger Kitchen Remodel Sketches. pdf Project Value (contract 15,444 value or cost of ALL materials and labor) Increase Valuation to $37,100 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 Travis M Justilian 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. � ► � i City of Wheat Ridge Homeowner Interior Remodel PERMIT - 202100277 PERMIT NO: 202100277 ISSUED: 03/19/2021 JOB ADDRESS: 2980 Newland St EXPIRES: 03/19/2022 JOB DESCRIPTION: Residential kitchen remodel removing 3 walls, one being load bearing being replaced with steel beams. Electrical, plumbing and HVAC will be included, running new gas line to location of cook top in new kitchen island. Sq ft: 200 *** CONTACTS *** OWNER (512) 457-9131 JUSTILLIAN TRAVIS *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 37,100.00 FEES Total Valuation 0.00 Plan Review Fee 384.51 Use Tax 779.10 Permit Fee 591.55 ** TOTAL ** 11755.16 *** COMMENTS *** *** CONDITIONS *** A printed copy of the permit and city stamped on-site plans must be available on-site for the first inspection. I, the property owner, by my signature, attest that I currently reside at the project property, intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers. If professionals are hired, those contractors are licensed with the City of Wheat Ridge and are listed on the permit. NOTE: Consultations and inspections will only be performed with the homeowner of record present. All roughs to be done at Framing Inspection. 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. 1* � � i City of Wheat Ridge �� Homeowner Interior Remodel PERMIT - 202100277 PERMIT NO: 202100277 ISSUED: 03/19/2021 JOB ADDRESS: 2980 Newland St EXPIRES: 03/19/2022 JOB DESCRIPTION: Residential kitchen remodel removing 3 walls, one being load bearing being replaced with steel beams. Electrical, plumbing and HVAC will be included, running new gas line to location of cook top in new kitchen island. Sq ft: 200 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. 03/19/2021 Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. 1* ► � i City of Wheat Ridge '/� E -Res. Electrical Service PERMIT - 202100624 PERMIT NO: 202100624 ISSUED: 04/06/2021 JOB ADDRESS: 2980 Newland St EXPIRES: 04/06/2022 JOB DESCRIPTION: upgrade main panel to 200 amps located on the house *** CONTACTS *** OWNER (512) 457-9131 JUSTILLIAN TRAVIS SUB (720)474-6701 MATTHEW L. ANDREAS 190228 ANDREAS ELECTRIC CO LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 21400.00 FEES Total Valuation 0.00 Use Tax 50.40 ** TOTAL ** 50.40 *** COMMENTS *** *** CONDITIONS *** Both the front and back of this permit are required to be posted on the job site at all times. If the complete permit is not present, inspections WILL NOT be performed. Work shall comply with 2018 IRC & 2020 NEC. Smoke alarms shall comply with 2018 IRC Section 134. Interior alterations, repairs, fuel -fired appliance replacements, or additions, any of which require a building permit, occurs or where one or more rooms lawfully used for sleeping purposes shall have an operational carbon monoxide alarm installed within fifteen feet of the entrance to each room lawfully used for sleeping purposes. I by m si nature do hereby attest that the work to be performed shall comply with all accompanyin approved plans and specifications applica le uilding codes, and all applicable municipal codes, policies and procedures, and that I am t e legal owner or have been authorized by the legal owner of theproperty and am authorize to obtain this ermit and perform the work described and approved in conjunction with this,permit. I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be per ormed and that all work to be per ormed 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. 04/06/2021 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: Electrical Service Change/Upgrade/Electrical Work Permit Application Date: Tuesday, April 6, 20218:03:23 AM Electrical Service Change/Upgrade/Electrical Work Permit Application This application is exclusively for RESIDENTIAL ELECTRICAL SERVICE CHANGE OR UPGRADE (200 amps or less). 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. Is this application for Yes electrical service change or upgrade - 200 amps or less? PROPERTY INFORMATION Is this Residential or Residential Commercial? Property Address 2980 Newland St Property Owner Name Travis Justilian Property Owner Phone Number (enter WITH dashes, eg 303-123- 4567) Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" 512-457-9131 CONTRACTOR INFORMATION Contractor Business Andreas Electric CO LLC Name Contractor's License 190228 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 720-474-6701 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email mlandreas@gmail.com Address Retype Contractor mlandreas@gmail.com Email Address DESCRIPTION OF WORK Is this an electrical Upgrade service upgrade or change? Number of Amps 200 Location of work house (garage, house, etc) Provide additional n/a details, if needed. Project Value (contract 2400 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have Yes been authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying for Matthew Andreas Permit Email not displaying correctly? View it in your browser. From: no-reolv(alci.wheatridae.m. us To: CommDev Farm is Subject: Online Form Submittal: Residential Interior Remodel Date: Friday, February 12, 2021 11:47:21 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 2980 Newland St., Wheat Ridge, CO 80214 Property Owner Name Travis M Justilian Property Owner Phone 512-457-9131 Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email travis.justilian@gmail.com Address Attach City of Wheat Justilian kitchen Electronic -Payment -Form. Af Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" APPLICANT INFORMATION Applicant Name Travis M Justilian What is your role in the Property Owner project? Are you performing the Yes work yourself, live in the home and will be living in the home 1 year after completion? Attach Notarized Wheat Ridae.odf Homeowner Authorization Form Contact Phone Number 512-457-9131 (enter WITH dashes, eg 303-123-4567) Contact Email Address for Plan Review Comments travis.justilian@gmail.com Retype Contractor travis.justilian@gmail.com 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. complete remodel of kitchen. This includes removal of 3 walls, one of which is load bearing. The load bearing wall will be replaced with steel I-beam and 44 steel posts supported from lower level slab. Existing electrical wiring will be removed, and new electrical circuits will be run to support new kitchen layout. Plumbing layout will not be altered. Plumbing fittings will be updated to support new fixtures and appliances. Will run new gas line to location of cooktop in new kitchen island. I have entered a detailed scope of work. Location of Work Kitchen Square Footage Area 200 of Work Being Performed Asbestos Report Field not completed. Upload letter size Field not completed. documents here Construction Plans scanned on 11'x17" or larger Kitchen Remodel Sketches. pdf Project Value (contract 15,444 value or cost of ALL materials and labor) Increase Valuation to $37,100 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 Travis M Justilian 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. All Clear Environmental CONSULTING 128o Buffalo Grass Pl. Elizabeth, CO 801-07 1720-982-1513 Asbestos Inspection and Sampling Report elf?. Al I VU 298o ew an t,V# o4d. • s • ea 1 e O 02141�. • • 4-'- i • o s� �l • • • • • . • b • ° •w 0 • . • P q�• QQ p[,� .p. • ' � •• �l�i+ ,Q • ° D � �� Ot �ti`s '• g,. 001�q Ah • • • b• , Q ddo 1 4 • e Ob I% ca g • • , o a ; • c • • p .• D .d• ell) 0 •e '' V Pre ared for:a •' ° go 0 lip a of • • • • • • • •�. • O Y•'' •O C • ••jd 1 Travis Justilian . • •� °� �Q 4%Op CP ^ o• s , ` b o o • •�. °r4 • ' 298o Newland St. ,jom• •r . ••• ,� O / 'e Mer. ' Wheat Ridge, Co 8021 ..0 � .. • 0.0 , O� i� ' ' •• . �e , p to I V4 ,• c a E' m l� • 1 Is b , o , �,. o ,, ,�; .••� ,a b n, oQ� , • Ag• Performed & Pre ared blow to y. • • • ` . • �• V Ids 0 lot O AkK .• 1 • / • • • • . / ' ��. of °j•, • • ! ° g 4 0el p •. .. Josh Berard ��°-Q � • p d `o ,•• • • •• 0 • 0 lb All Clear Environmental Consulting o• a q a o 12 8 o Buffalo Grass Pl. Elizabeth, Co 8o107 O (720) 982-1513 loi Project Number: B.I - 1301 Inspection Date: March 1St, 2021 nt \N,heat CD Wheat o .Q,. 0 Table of Contents 6GI'a'ng Inspection Overview Introduction.................................................................. I Site Description.............................................................. II Scope of Work a :......................................................... III Sampling and Analytical Procedures .............................. IV IV (a) ......................... Sampling Procedure IV (b) ......................... Analytical Procedure Inspection Protocol........................................................ V Homogenous Areas.......................................................... VI �� Classifications � x m .. O..........................f Materials VI (a) d, VI (b) Friable Materia ? j VI (c) ......................... Material Conditions 0 VI (d) ............................ Sample Quantities Result Overview................................................................ VII Photos..................... ).......!.............................................. VIII Laboratory Results.:.......................................................... IX Conclusion/ Recommendations ......................................... X Limitations......................................................................... XI Certifications...................................................................... XII 4 I. INTRODUCTION On March 1st, 2021 Mr. Josh Berard with All Clear Environmental Consulting conducted an asbestos inspection and collected asbestos bulk -samples of suspect asbestos -containing materials (ACM) within the kitchen inside the residence located at 298o Newland St. The purpose of the inspection was to identify and sample potentiajl�,,hazardous friable ACM within the residence that would be impacted. A ` Mr. Berard is Accredited by the Environmental Protection Agency (EPA) and certified by the Colorado Department of Public Health and Environment (CD�PHE) as an Asbestos Building Inspector. A copy of his accreditations and ce • tions can be found in section XI of this report. s eq II. SITE DESCRIPTION q� �a•° �q a aa� .0�6° B .q'` a d . The one structure is a single family, 1 story home A with basement ��w, •."V•-�'a!"�q 0 �:d �eeb \"N •eOD,,� nq ° `� e d ee a'• +• III. SCOPE OF WORK:,'' •QS(�. qGo d\• �. CN'�! df.°�°°�,'l nc'^.•tb°�•�2uh � Travis retained All Clear Environmental to conduct an asbestos inspection regarding suspect building materials that will be impacted during remodel. e�I. N➢i•f9• v� ,_t 0. hT: °4�. .r. m.e('�T'��' °'1. 1 • � ➢.°o � "^'Q ��b�,• . v M The asbestos inspection conducted on March 1st, 2021 constituted a limited inspection and fulfills the asbestos inspection requirements for structures that are to be renovated. V a {;��og�_' ¢q•B. °4 �...@��e 4YY''�(l� o•aii�: o`O a �ygd'�iK>• o o•� IV. SAMPLIN CED Eo (a) Sampling Procedures: 1 O Random bulk -samples representativ-eof the suspect ACM of each homogeneous area were collected according to the guidelines published as EPA Final Rule: Title II of the Toxic Substances Control Act (TSCA), 15 USC, Sections 2641 through 2654 and in compliance with 40 CFR, Part 763 and CDPHE Regulation Number 8, Part B - Asbestos (Reg. 8). All Clear Environmental has collected the appropriate number of bulk -samples to meet all regulatory requirements for the classification and quantity of each homogeneous area. Note some minor destructive sampling was conducted. 3 (b) Analytical Procedures: Bulk samples collected were analyzed utilizing the EPA's Method for the Determination of Asbestos in Bulk Building Materials (EPA boo/R/116, July, 1993) and the McCrone Research Institute's The Asbestos Particle Atlas as methods references. All bulk -samples were analyzed by a Nati (NVLAP) accredited laboratory using the Polgilz; oluntary Laboratory Accreditation Program 'ht,,Microscopy (PLM) method for asbestos content (see X for laboratory report). V. The asbestos inspection was conducted by an Environmental Protection Agency (EPA) and CDPHE certified Building Inspector. The inspection procedures included identifying and sampling suspect ACM within pre -defined areas. Suspect materials alike in appearance and application were sampled as HAs. •a.. = �r0 �a :,a o 4 .o�; ; a After identifying the appropriate suspect ACM, with the use of a random number generator, random samples of plaster/texture & sheet vinyl flooring were taken in kitchen and s, t to an NVLAP accredited laboratory for analysis. See lab results in section IX°Q �¢ :.0i R' age r ,�Ao� M p d,' •e� O phd, ea:�a ,. o. A 1 � tl, C°�p, • a. VI. HOMOGENOUS AREASq�.'gyp. 3 :•. . , ,off. ,e ' (a) Suspect materials are divided into three classifications: _. 8. 1. Thermal systems insulation (TSI): any t e of duct, boiler, tank, or pipe insulation. 2. Surfacing material (SM): sprayed or troweled onto structural building member. 3. Miscellaneous (Misc.): other �ect ate s ie. flooring, ceiling tiles, insulation, opav and finishing materials. ��;Q (b) Friable material is one that, when dry, can be pulverized, or reduced to powder by hand pressure, a non -friable material cannot. A non -friable material may become friable if its condition had deteriorated or has been impacted by forces that have rendered it friable. (c) The three categories in which sampled materials are placed are as follows: 51 Wheat Good: None to very little visible damage or deterioration = �/ Damaged: The surface is crumbling, blistered, water -stained, gouged, marred err oc otherwise abraded over less than one-tenth of the surface if the damage is evenlyG;'/a'ng 0\1j, distributed, or one-quarter if the damage is localized Significantly Damaged: The surface is crumbling, blistered, water -stained, gouged, marred or otherwise abraded over greater than 10% of the surface if the damage is evenly distributed, or %25 if the damage is localized (d) All Clear Environmental collected at least the minimum number of samples from each homogeneous area necessary to meet all regulatory requirements for the quantity of material to be disturbed. The quantities listed in this report are approximate and on-site verification of the exact quantity of each material is required. The following tlines the minimum sample quantities required per homogeneous area: Thermal Sgstem Insulation (TSI): Each homogeneous area requires a minimum of three (3) samples; at least one (1) sample must be collected from each patch; and collect enough samples sufficient to adequately assess the material and determine the asbestos content for TSI fittings such as pipe elbows or "T's". Surfacing Materials (SM): up to 1,000 ft2 of material requires a minimum of three (3) samples; between 1,000 ft2 and 5,000 ft2 of material requires a minimum of five (5) samples; over 5,000 ft2 of material requires a minimum of seven (7) samples; one (1) sample of each patch Miscellaneous Materials (Misc.): collect enough samples sufficient to determine the asbestos content A Homogenous Area (HA) is defined by material that is uniform in appearance, texture, color and date of application. Once the homogeneous area is determined, the inspector will choose the appropriate number of samples to take in accordance with EPA and CDHPE. (HA) 1. Plaster/Texture LI 0 Kitchen Walls & Ceilings 2. Sheet Vinyl Flooring 0 Kitchen Floor 5 VII. RESULTS Asbestos was NOT reported within AL nw-samples collected and analyzed. All Clear Environmental collected a total of four (4) asbestos bulk -samples of two (2) homogeneous areas. The following are the suspect asbestos -containing materials that were collected and their respective asbestos content: �. ��,�''� Material Asbestos Content All Materials Determined to be Non -Detect ND S6, R9 � a '• COQ O �.,oey.la.^,o�,.i• The following table describes the materials composing each homogeneous area as well as the locations of each bulk -sample collected. Also listed is the classification, condition, friability and estimated quantity of material to be removed and/or disturbed, as well as the asbestos content within each bulk -sample. Please see section IX for a breakdown of each bulk sample. u o , S6, R9 � a '• COQ O �.,oey.la.^,o�,.i• The following table describes the materials composing each homogeneous area as well as the locations of each bulk -sample collected. Also listed is the classification, condition, friability and estimated quantity of material to be removed and/or disturbed, as well as the asbestos content within each bulk -sample. Please see section IX for a breakdown of each bulk sample. u Wheat Asbestos Bulk Sampling Loi%nq 0Jec H.A Sample Material Sample Location Condition Friable ACM Type Quantity LD Type (YIN) N -1 - o1 Kitchen - E. Wall Middle ND 1 SM Good Y Approx. 235 Sq. Ft. 02 Kitchen - N. Wall Middle ND 03 Kitchen - N. Wall Left of Jamb as � � N ND a 2 N-3-01 Kitchen -Floor Middle Good N ND Approx. 40 Sq. Ft. I oq'�' b` Af•oj y1el. wJ „, ' �y~ Q Qj 4S,' 4 g ' • ' eQQe �G✓ u a .�.'•ooi�0 SM - Surfacing Material MM - Miscellaneous Material ND - Non Detect VIII. Laboratory Results Reservoirs Environmental, Inc Effective October 09, 2020 Reservoirs Environmental QA Manual Q:\QAQC\Lab\Reservoirs Environmental QA Manual.pdf REI LAB Reservoirs EnWronmental, lnc_ March 01, 2021 Subcontractor Number: Laboratory Report: RES 487248-1 Project #/P.O. #: 1301 Project Description: Newland St Josh Berard All Clear Environmental 11092 Mallard Ct r° sab Parker CO 80134 " "' ° 'a� l e'n�•` ° b � +V�4 0l '��°• At d Dear Josh, o,. 0� ZA' '(1 a��/', 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.o o Uo , z V� g, o ��9,� o J " 0: ,.. a. • ><Yu •, L3��.. �,'-' o �� t'� r'I '"jef (J--' 1 q—'^�" y . ,a, g • . _ 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 487248-1 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, I D Wf90 ° by Andrew Roberts 0 •0 Jeanne Spencer U President` (303) 9641986 5801 Logan St, Suite 100, Denver, C080216 www.reilab.com (866) RESI-ENV https://clients.reilab.com J r z CW 9 G 0) Z O N 'O O > U z m W N a. J O z M> I.L W N W ItFn `a E E c w ww 9 'N s �C O E E U N .T C Q 2 w H T u 2 0000000r- E z�� o O �Q LU E O oQU a) O O O N \ 0 0 0 0 0 0 0 0 aa)i o E Z N p N �'' M V Q Q 0 U U N LL D- Q E c O Q O Q ( U z�� m °!" *• m� C o o �' o 0 0 z z z z z z N E N >.W_.. U O N R � a� �O 7Cuc U) d O 0 0 In Co N N 00 N 00 00 M n N s • e 3 O N cu cu N O O O N ,�•g, 0 O O � 01 N E E y N N Y t N d - Cu Cu Cu> m m m Cu m m o E er d y d y d y o m m m m an Q m Q m Q m Q m M N O N � O O O U co W C 01� -o >. Q N N -6 Q oE o N W N M O O O O O N 0 0_0 C W E E M -C_ E 2 Cu � H D U fA Z z z z z 9 'N s �C O E E U N .T C Q 2 w H T u V Ih ftft M Ou 0 W loft O M W ct Q J W m cz m 2 U Q 0 E E 0 0 W W InIn CO J Q 00 m W t N N 2 W a W N N d Z Q O : co: 0 H a Ln : W CO d m ? a) R O O of d N: LL 0 N: > R 0 d U ca CO ~@ Z cE o: ir— is t O o: s: a5: a) o U Ua E : LL; U li R d E E ': v C; ++• M O U r a CO W =O cacm ca i U: O: i O a r a W U c: ui O : cz : a): a' N > EE aE Z 0:Qc N aS 0 p ; N T Z +0. cE d: E: Ev M O U �: �? CO O. o WE EO aECZ 0' 0 CM d 6: � n5 � o p Qp �p '• a 45i 2- LU EE $ a? ) cz: u): m E • N ; N oE_0 oE'o (q UE QE aEa U) W Z m J N O >C H Q D N .N C O L R N 0 C R J ............................................. WW:UU a paloapoO E)W!l c 2................................................................... m LL0 u' u E u E �� a e_0 �(�(/pp/lulu Pal°a11°O alsoo: o : ............................ ....................... ..LL Daa� saau!elu0310# .....I......I......�.....�.....{ cu c e ............................................ t ...................... e �: ia. o o): 0- apoOx!AIUN a Y (n (z o...............a................................................. QpEa'•cn.C:``z rn in'• �'• °� E E w (lonb!IVaa aaVao)glp!Mx(slonb!IVao)glbual Q: cu:wac CLe c c o~ e e e....................................................................... cn : e CO c Q eaaV / (l) awnloA aldwuS ..... ..... ..... ..... .................. E .....E .....E ..... E E E .................... CO m m m E E E .................... uo!leo!l!luapl alelno!ued `p!oW Mina `dealaaodS-aylOW E E E ....................................................................................................................... U' ............... ..... lVl`uapango!9-IVOIa3W O J ....................................................................................................................... O ............... ..... (O `dN `d) vIlauo!6al `(uo!leo!l!luen0 ao -/+) sn00000aalu3 m Alum ao aI/om) lunoO Ie!goao!W elge!A `p!oV o!loel `(uo!leo!l!luen0 O N °-/+ `aaleM bu!Mu!a(I-uoN `aaleM bu!Mu!aa `aalpM aluIS) -!loo'3/swjol!Io3`lunoO U aluld o!goaaV `IoW V lseaA `snaane-S `palvld - swAOI!100/!100'3 `LH:L5r0!100'3 U J `puals!l `(Z -r ao algeanllnO) ulleuowiPS `snll!oea `aaloegolAdwuo-STIOVIA E E E Q........................................................................................................................ Z SSl `au!wplagdwpglaW - SOINVOHO .................... i Q....................................................................................................................... ueoS s1plaW Ilnd `ueoS awnd bu!p1aM `ueoS 8 VHOH `d101 } .....¢.....¢.....¢..... `(p!nb!l-uoN ao p!nb!l) Hd `(O5Z [-GI VHSO `aaempood `aalPM alsuM `8'OOZ N N `VOZ09`SOSL) s1plaW W !IIn`(aaempood `aalpM elsuM `OZbL `Z80L) AluO peal W (s)alAIPuV-S-jV13W W E E : . (J .....................................................................................................................: algea!dsaH `Iplol-lsna W....................................................................................................................... VHSO `900bL `VOObL - WOd .....¢.....¢.....¢..... ....................................................................................................................... eaagV pa!1!p0W aHVO `-/+Mlna `aaleM alseM `aaleM bu!muua N O ....¢....¢....¢.... `pla4lvg3 `b6L8 1061 `Z I80 1061 '111-01 E)Iuwul. `ZObL HSOI N `(pa!l!luen0 ao -/+) ad!M `(pa!l!luen0 ao -/+) oenoao!W `(pa!l!luen0 ao -/+) VH3HV - W31 W M ........................................................................................................................ W .....¢.....¢.....¢..... (9 4 4/£6-a/009/Vd3) liodea laoLIS W -Id - W -Id Q X X X X x 0 � 0 Q O C W a m N R O LL LL i Co (y W oC 0 o W A d R O a 3 W co O O ct o > W U Z >, i E O Q Z W +' R i N CL 7 ct CL Z 0 Co Y d ago 13 G zCD t �/ .' i E N caZ o cn �! !Z LO 0 N O N g E 0 D D D a 0 'i cn E O CL m - r` CO CO rnCO CO CO a a �a 0N ��_ = CO �Z Qp C = C� Y H a D O N 4_ 4) O O cii y a o ,� a a o= a ctj N 0 N CO U)2>- O co co R J O > �O 0}C Q d O � N d E 2 d Q Q CO O m m J CO a CO 0 Z J Q J G N d V N �ED V N O N >% N C i i CL O a y 0 c p0 R H c E o 0 0 0 N UmA LU 0 O 0 ^, CO ysZ y ZT ZT ZM ZT N = 0 e_ U 1 0 O v o O 5; T N M vQ 10 heal Ok Vo IL C) cv U U f 5 cz 3 �U U fn CL LO t` O N O N O O N E N cz 0 0> O O N T No N N r 0 O 0 MCD O > 0 p C 0 O o o m N a cz cf) D CO cz m 0 0 J O LO N N p � L 21 E 0N 0 E i � d Lo i i y IZ m O � N 'i 2 0cz t U d Iz 3 LL m M W E ,Wheat o .Q,. IX. CONCLUSION & RECOMMENDATIONS Asbestos was NOT identified within the materials inside the building that were within fi'09g e of the asbestos inspection and bulk -sampling performed on March 1St, 2021; therefore, professional abatement activities are NOT required to remove or disturb the above -sampled building materials. All Clear Environmental (ACE) recommends that when ACM is removed/abated, that only a licensed asbestos abatement contractor using pers , nnel trained in the handling of ACM be allowed to conduct such activities using appropriate methods tEEPA-filtered vacuuming, wet cleaning methods, respiratory protection, protective clothing, personnel decontamination, negative -air enclosures, air monitoring, etc.) X. LIMITATIONS All reports and recommendations are based on conditions, practices observed and information made available to All Clear Environmental (ACE) by the client and the designated site on the days sampling was conducted. All activities were performed in accordance with all applicable federal, state, and local regulations as well as generally accepted standards and professional practice. No responsibility is adssumed by All Clear Environmental for the control or correction of conditions or practices existi at the facility/residence, for and on behalf of the client. Any materials encountered during demolition that were sampled during this inspection should be assumed positive until confirmed otherwise by a Certified Asbestos Building Inspector. Any ACM that will be disturbed should be handled according to CDPHE, EPA (Environmental Protection v Agency) and OSHA protocol: . , � �"•a`°�el�•`' e ��; a+� All Clear Envi of ental greatly reciate the opportunity in providing o services to you. Feel free to call us at any mom' t you ha e a y further questions! 0 oD Kindest Regards,�00�° Josh Berard All Clear Environmental Consulting 72o.982.1513 Josh@Al1ClearEC.com 11 7 N V lf1 =N N O 6! N ¢' m E N L u a o u o z a c m ° �oN v r- u c m 0 v 0 0 L) E O Z M u1 SC O Ln M � U v l� U f� 13 O /•V V) z cD z Q Wheat v o w Q I Q1 > ,:j C)2 .-1 'o C 68 Z �J O O fO 11u0 • `° o w E o � � O O 4 a U d H to .> N N c c J c c c O U N N 1— Q CQ CQ O I U i Ln < < U O c O N d' Q O ,:j C)2 'o a) O O 2 `° vN ~W Op V W E W r. J cn D c 00 U u0 v O U Luu Wheat , , , �s - 2018 IRC 2020 NEC - Interconnected Smoke/CO detectors required-ta__ code in new and existing areas o�\lheat CD c GI'laina Dv1410 46'2 3/4" CFpr cp C). 46031os I � LL(- C) " ri� -•,�tls_ay INs�n��,��y �g�sZ Q� Be") CqP Wr (z) 259.8 ft2 6'2 3/4" 2980 Newland St. Wheat Ridge, CO 26'3 1/16" 0 1' 2' 3' 4' 5' 10' z Scale: 1:50 <S�fv cv�udo, 1� a6ne s CQ -ca . -2- �z SI �.c�2 y LI3 I s yL1 sic / 0� Sok, C_A^_O ZrtLllk�) l,rAC e_ upj �-nr�`� rs ? 'p, rN< 26'3 1/16" 0 1' 2' 3' 4' 5' 10' z Scale: 1:50 <S�fv cv�udo, 1� a6ne s CQ -ca . -2- �z SI �.c�2 y LI3 \N heat c_> CD �o c 46'2 3/4" 0 k F. t) tic 0 259.8 ft2 6'2 3/4" '6 1/2" 26'3 1/16" 2980 Newland St.0 1' 2' 3' 4' 5' 10' Z Wheat Ridge'. CO Scale: 1:50 3 I 3 From: no-reolv(alci.wheatridae.m. us To: CommDev Farm is Subject: Online Form Submittal: Residential Interior Remodel Date: Friday, February 12, 2021 11:47:21 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 2980 Newland St., Wheat Ridge, CO 80214 Property Owner Name Travis M Justilian Property Owner Phone 512-457-9131 Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email travis.justilian@gmail.com Address Attach City of Wheat Justilian kitchen Electronic -Payment -Form. Af Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" APPLICANT INFORMATION Applicant Name Travis M Justilian What is your role in the Property Owner project? Are you performing the Yes work yourself, live in the home and will be living in the home 1 year after completion? Attach Notarized Wheat Ridae.odf Homeowner Authorization Form Contact Phone Number 512-457-9131 (enter WITH dashes, eg 303-123-4567) Contact Email Address for Plan Review Comments travis.justilian@gmail.com Retype Contractor travis.justilian@gmail.com 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. complete remodel of kitchen. This includes removal of 3 walls, one of which is load bearing. The load bearing wall will be replaced with steel I-beam and 44 steel posts supported from lower level slab. Existing electrical wiring will be removed, and new electrical circuits will be run to support new kitchen layout. Plumbing layout will not be altered. Plumbing fittings will be updated to support new fixtures and appliances. Will run new gas line to location of cooktop in new kitchen island. I have entered a detailed scope of work. Location of Work Kitchen Square Footage Area 200 of Work Being Performed Asbestos Report Field not completed. Upload letter size Field not completed. documents here Construction Plans scanned on 11'x17" or larger Kitchen Remodel Sketches. pdf Project Value (contract 15,444 value or cost of ALL materials and labor) Increase Valuation to $37,100 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 Travis M Justilian 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. City of Wheat�idge COMMIT UNY DEVELOPMENT Official Certification of Property Owner Permit THIS 15 TO CERTIFY that I, the property owner, by my signature, attest that I currently reside at the project property, or intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers, or, if hiring sub -contractors, list them on the permit. Consultations and inspections will only be performed with the homeowner of record present at the project property. Property Owner(s): Travis M Juslilian Pf"tPropefty: 2980 Newland St., Wheat Ridge, CO 80214 f2titrizejIl signature of Applicant State of Colorado k County of .11fLun Iss The foregoing instrument was acknowledged by methisis dayof Ltar 20-Qby IrAvis M Justiliart . xNNOTARYEVY WOES BiETE Of COLORADO NOTAnY ID 20191WB996 COM N� My Commission Expires c9J 3 Notary Public City of Wheat Ridge E -Res. Window Replacement PERMIT - 202100249 PERMIT NO: 202100249 ISSUED: 02/09/2021 JOB ADDRESS: 2980 Newland St EXPIRES: 02/09/2022 JOB DESCRIPTION: Replacing windows throughout home. U -value is .28 *** CONTACTS *** OWNER (512) 457-9131 JUSTILLIAN TRAVIS SUB (303) 934-4508 JASON LEWIS 090396 LIFETIME WINDOWS & SIDING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 91500.00 FEES Window Replacement 50.00 Total Valuation 0.00 Use Tax 199.50 ** TOTAL ** 249.50 *** COMMENTS *** *** CONDITIONS *** Both the front and back of this permit are required to be posted on the job site at all times. If the complete permit is not present, inspections WILL NOT be performed. Work shall comply with 2018 IRC & 2020 NEC. Smoke alarms shall comply with 2018 IRC Section 134. Interior alterations, repairs, fuel -fired appliance replacements, or additions, any of which require a building permit, occurs or where one or more rooms lawfully used for sleeping purposes shall have an operational carbon monoxide alarm installed within fifteen feet of the entrance to each room lawfully used for sleeping purposes. 1* � 4 41' PERMIT NO: JOB ADDRESS: JOB DESCRIPTION: City of Wheat Ridge E -Res. Window Replacement PERMIT - 202100249 202100249 2980 Newland St ISSUED: 02/09/2021 EXPIRES: 02/09/2022 Replacing windows throughout home. U -value is .28 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 pplicab e code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. 02/09/2021 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 Window/Door Replacement Permit Application Date: Tuesday, February 9, 202112:35:06 PM Residential Window/Door Replacement Permit Application This application is exclusively for RESIDENTIAL REPLACEMENT WINDOWS and DOORS - LIKE FOR LIKE ONLY. YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM AND WINDOW/DOOR CUTSHEET (SPEC SHEET) 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. Is this application for Yes replacement window(s) and/or door(s) like for like? PROPERTY INFORMATION Property Address 2980 Newland St Wheatridge CO Property Owner Name Travis & Jill Justilian 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" 512-457-9131 travis.justilian@gmail.com CONTRACTOR INFORMATION Contractor Business Lifetime Windows and Siding Name Contractor's License 90396 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone Number (enter WITH dashes, eg 303-123- 4567) Contractor Email Address Retype Contractor Email Address DESCRIPTION OF WORK What is being replaced Number of window and/or doors being replaced Location of window(s)/door(s) being replaced (for example, master bedroom, kitchen, bathroom, etc): What is the u -value of the window(s)/door(s)? City of Wheat Ridge requires the u -value to be .30 or better on windows.. Attach copy of window/door cut sheets showing sizes and u - value Project Value (contract value or cost of ALL materials and labor) 1918191NOIE,6ilI: rebecca@Iifetimewindowscolorado.com rebecca@Iifetimewindowscolorado.com NVA Morel, 19 FM, Master, Dining, Kitchen, Laundry, stairs bath bedroom 1 bedroom 2, bath W W16902JUST - order.Ddf 9500 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 Rebecca MAcMillan Permit Email not displaying correctly? View it in your browser. � ► � i City of Wheat Ridge E -Res. Furnace Replacement PERMIT - 202100114 PERMIT NO: 202100114 ISSUED: 01/20/2021 JOB ADDRESS: 2980 Newland St EXPIRES: 01/20/2022 JOB DESCRIPTION: Installing 80k BTU, 97% efficiency gas furnace in basement and 3 ton, 20.5 seer A/C on back or side yard. *** CONTACTS *** OWNER (512) 457-9131 JUSTILLIAN TRAVIS SUB (720)372-2211 R ANDERSON/ R TOWNSEND 210007 HEART HEATING & COOLING LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 61996.00 FEES A/C Replacement 60.00 Furnace Replacement 40.00 Total Valuation 0.00 Use Tax 146.92 ** TOTAL ** 246.92 *** COMMENTS *** *** CONDITIONS *** Both the front and back of this permit are required to be posted on the job site at all times. If the complete permit is not present, inspections WILL NOT be performed. Work shall comply with 2018 IRC & 2020 NEC. Smoke alarms shall comply with 2018 IRC Section 134. Interior alterations, repairs, fuel -fired appliance replacements, or additions, any of which require a building permit, occurs or where one or more rooms lawfully used for sleeping purposes shall have an operational carbon monoxide alarm installed within fifteen feet of the entrance to each room lawfully used for sleeping purposes. 1* � � i City of Wheat Ridge E -Res. Furnace Replacement PERMIT - 202100114 PERMIT NO: 202100114 ISSUED: 01/20/2021 JOB ADDRESS: 2980 Newland St EXPIRES: 01/20/2022 JOB DESCRIPTION: Installing 80k BTU, 97% efficiency gas furnace in basement and 3 ton, 20.5 seer A/C on back or side yard. 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. 01/20/2021 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: Furnace/Boiler Replacement Permit Application Date: Tuesday, January 19, 20214:56:29 PM Furnace/Boiler Replacement Permit Application This application is exclusively for RESIDENTIAL REPLACEMENT FURNACE or BOILER - LIKE FOR LIKE ONLY. 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. Is this application for a Yes replacement residential furnace or boiler like for like? PROPERTY INFORMATION Is this Residential or Residential Commercial? Property Address 2980 NEWLAND STREET Property Owner Name 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" Travis Justilian 512-457-9131 travis.justilian@gmail.com CONTRACTOR INFORMATION Contractor Business Heart Heating & Cooling, LLC. Name Contractor's License 210007 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 720-386-1046 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email angel.dorn@heart-hvac.com Address Retype Contractor angel.dorn@heart-hvac.com Email Address DESCRIPTION OF WORK What type of unit is Furnace being installed? Number of BTUs 80K What is the efficiency 97% (%) of the unit? Is the unit GAS or GAS ELECTRIC? Where is the furnace or BASEMENT boiler located (for example, basement, crawlspace, etc)? Project Value (contract 3498.00 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 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 Angel Dorn Permit Email not displaying correctly? View it in your browser. From: no-reolv(alci.wheatridae.m. us To: CommDev Pets Subject: Online Form Submittal: Air Conditioner/Evaporative Cooler Permit Application Date: Tuesday, January 19, 20214:47:50 PM Air Conditioner/Evaporative Cooler Permit Application This application is exclusively for AIR CONDITIONER OR EVAPORATIVE COOLER. YOU MUST ATTACH THE ELECTRONIC PAYMENT 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 Is this a new install or Replacement of Existing Unit replacement for an existing AC unit? Is this Residential or Residential Commercial? Property Address 2980 Newland Street Wheat Ridge, CO. 80214 Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123- 4567) Travis Justilian Property Owner Email travis.justilian@gmail.com Address Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" Electronic oavment form.odf CONTRACTOR INFORMATION Contractor Business Heart Heating & Cooling, LLC. Name Contractor's License 210007 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 720-386-1046 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email angel.dorn@heart-hvac.com Address Retype Contractor angel.dorn@heart-hvac.com Email Address DESCRIPTION OF WORK What type of Air Conditioner replacement unit are you installing? How many tons is the 3 unit? For AC - what is the 20.5 SEER? For Evaporative Coolers, what is the CFMs? Where is the unit back or side yard outside located (for example, rooftop, backyard on ground etc)? Is electrical needed for No re -hook? Project Value (contract 3498 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have Yes been authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying for Angel Dorn Permit Email not displaying correctly? View it in your browser. Inspection Type: _5 616 le_ --- Job Address: /V,'o 7 Permit Number: 2C2 C C_- a, ❑ No one available for inspection: Time AMIP" Re -inspection required: Yes No When corrections are complete, schedule re -inspection online, Date: Inspector: DO NOT REMOVE THIS NOTICE 41 CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: _5 616 le_ --- Job Address: /V,'o 7 Permit Number: 2C2 C C_- a, ❑ No one available for inspection: Time AMIP" 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 �� E -Res. Sewer/Waterline Repair PERMIT - 202002691 PERMIT NO: 202002691 ISSUED: 12/29/2020 JOB ADDRESS: 2980 Newland St EXPIRES: 12/29/2021 JOB DESCRIPTION: Sewer line repair, 50 feet in front yard. *** CONTACTS *** OWNER (512) 457-9131 JUSTILLIAN TRAVIS SUB (303)215-1348 BRIAN WILKIE 060162 APEX PLUMBING INC. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 81700.00 FEES Total Valuation 0.00 Use Tax 182.70 Permit Fee 188.45 ** TOTAL ** 371.15 *** COMMENTS *** *** CONDITIONS *** ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection by any Sanitation District representative. Inspection and approval of work by any Sanitation District representative DOES NOT grant authority to cover work without the approval of the Building Division. **For trenchless sewer replacements - The contractor will verify proper slope of new sewer piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed specifically by the applicable code. The plumbing contractor will provide verification of proper slope and drainage in writing as a condition of approval of the permitted work.** Both the front and back of this permit are required to be posted on the job site at all times. If the complete permit is not present, inspections WILL NOT be performed. 1* � 4 41' PERMIT NO: JOB ADDRESS: JOB DESCRIPTION: City of Wheat Ridge E -Res. Sewer/Waterline Repair PERMIT - 202002691 202002691 ISSUED: 2980 Newland St EXPIRES: Sewer line repair, 50 feet in front yard. 12/29/2020 12/29/2021 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 al entities 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 Pets Subject: Online Form Submittal: Sewer or Water Line Repair Permit Application Date: Tuesday, December 29, 2020 11:33:54 AM Sewer or Water Line Repair Permit Application This application is exclusively for SEWER OR WATER LINE REPAIR - IN YARD Your Permit will be emailed to the email address provided below once it is processed. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. Right of Way permits must be applied for with the Public Works Department. Is this application for Yes sewer line or water line repair - in yard only? PROPERTY INFORMATION Is this Residential or Residential Commercial? Property Address 2980 Newland st Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123- 4567) Travis Justillian 1�VA151t.MGSK>i Property Owner Email trais.justillian@gmail.com Address Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" CONTRACTOR INFORMATION Contractor Business Apex Plumbing Name Contractor's License 060162 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 3039906981 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email permitting@apexplumbing.com Address Retype Contractor permitting@apexplumbing.com Email Address DESCRIPTION OF WORK Is this a sewer line or Sewer Line, Water Line water line repair? Length of repair 50 Location of repair front yard (backyard, frontyard, etc) Provide additional n/a details including installation of clean- o uts. Project Value (contract 8770 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have Yes been authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying for Anthony stieb Permit Email not displaying correctly? View it in your browser. PERMIT: ADDRESS: JOB CODE: INSPECTION RECORD ' Inspection online form: http://www.cl.wheatridge.co.us/inspection Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Inspections will not be performed unless this card is posted on the project site Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business Foundation Inspections Date Inspector Initials Comments 102 Caissons / Piers 103 Footing / P.E. Letter 104 Foundation Setback Cert. 105 Stem Walls 106 Foundation wall Insulation Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground / Slab Inspections Date Inspector Initials Comments 201 Electrical / Cable/ Conduit 202 Sewer Underground Int. 203 Sewer Underground Ext. 204 Plumbing Underground Int. 205 Plumbing Underground Ext. 206 Water Underground V11 r, Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections Rough Inspection Date Inspector Initials Comments 301 Rough Framing 302 Wall Sheathing 303 Roof Sheathing 304 Sheer Inspection 305 Insulation 306 Mid -Roof V11 r, 307 Metal / Lath / Stucco 308 Rough Electrical Residential 309 Rough Electrical Commercial 310 Electrical Meter Residential 311 Electrical Meter Commercial 312 Temp. Const. Meter 313 Rough Plumbing Residential 314 Rough Plumbing Commercial 315 Shower Pan SEE OVER FOR ADDITIONAL INSPECTIONS �lnc 'i�r7 ZrkCNiu,�cue!1f �'� Rough Inspection (continued) Date Inspector Initials Comments 316 Rough Mechanical Residential 317 Rough Mechanical Commercial 318 Boiler / Furnace 319 Hot water tank 320 Drywall screw and Nail 321 Moisture board / shower walls 322 Rough Grading 323 Miscellaneous - - 1 Final Inspections Date Inspector Initials Comments 402 Gas Meter Release 403 Final Electrical Residential 404 Final Electrical Commercial 405 Final Mechanical Residential 406 Final Mechanical Commercial 407 Final Plumbing Residential 408 Final Plumbing Commercial 409 Final Roof - - 1 410 Final Window/Door 411 Landscape/Park/Planning Inspections from these entities shall be requested one week in advance. For landscaping and parking inspections please call 303-235-2846 For ROW and drainage inspections please call 303-235-2861 For fire inspections please contact the Fire Protection District for your project. 412 Row/Drainage/Public Works 413 Flood plain Inspection 414 Fire Insp. / Fire Protection 415 Public Works Final 416 Storm Water Mgmt. 417 Zoning Final Inspection 418 Building Final Inspection Note: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building Inspection does not constitute authorization of occupancy. For Low Voltage permits please be sure that rough inspections are completed by the Fire District and Electrical low voltage by the Building Division. i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: t-! v (1- �7--" Job Address: 9 S o A ), v ct n S 4 - Permit Number: 'J o / -7 O -7 g (:�7 -7 ❑ No one available for inspection: Time `/ = 6 9 AM PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303 -234 - Date: ) a S / -? Inspector: _7-1) DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE _1�9�Building Inspection Division (303) 234-5933 Inspection line '(303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: ri (2-00 r_ Job Address:2q �{ I (��,.(� Z)T— Permit Number: Z.,U I-] d ❑ No one available for inspection: Time 1 `'j AM M Re -Inspection required: Yes No When corrections have been made, can fo e -inspection at 303-234-5933 Date: 10 (2- Inspector:' DO NOT REMOVE THIS NOTICE A City of Wheat Ridge Residential Roofing PERMIT - 201707897 PERMIT NO: 201707897 ISSUED: 10/02/2017 JOB ADDRESS: 2980 Newland ST EXPIRES: 10/02/2018 JOB DESCRIPTION: Residential Re -roof to install Modified Bitumen asphalt shingles with 29sq(3sq-pitched and 26sq-flat) pitch=2/12-4/12 *** CONTACTS *** OWNER (303)842-0402 CLEMENT D & JACQUELINE A BISAN SUB (303)552-4467 John Hess 150142 Urban Exteriors, LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,453.00 FEES Total Valuation 0.00 Use Tax 156.51 Permit Fee 172.60 ** TOTAL ** 329.11 *** COMMENTS *** *** CONDITIONS *** Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be required for both the midroof and final inspections. The 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the Homeowner. REGARDING ROOF VENTILATION: Roof ventilation shall comply with IBC Sec. 1203.2 or IRC Sec. R806. The installation of ridge venting requires the installation or existence of soffit venting. For calculation purposes, one hat or turtle vent equal to one-half of one square foot of opening. 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. Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be required, the 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the Homeowner. City of Wheat Ridge ��- Residential Roofing PERMIT - 201707897 PERMIT NO: 201707897 ISSUED: 10/02/2017 JOB ADDRESS: 2980 Newland ST EXPIRES: 10/02/2018 JOB DESCRIPTION: Residential Re -roof to install Modified Bitumen asphalt shingles with 29sq(3sq-pitched and 26sq-flat) pitch=2/12-4/12 I, by my signature, do hereby attest that the work to be performed shall comply with all accompanyingg approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am fhe 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 r attest that_._ ally authorized to include all entities named within this document as parties to the work to be performed tha a -to be pe o ed is disclosed in this document and/or its' ac�comp� ing approved plans and specifications. S�gpThinnit OWNER or CONTRACTORJCircle one) Date was issued based on the information provided in the permit application and accompanying plans and specifications and is he 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 originalpermrt fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. 6::�o Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Lagenia Reimer CWI / From: no-reply@ci.wheatridge.co.us Sent: Thursday, September 28, 2017 6:19 PM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Gina 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? T3�7,:1VAya1�11[AV5MANI[Q04 Property Address 2980 Newland St Property Owner Name Clement Bisant Property Owner Phone 303-842-0402 Number (enter WITH dashes, eg 303-123-4567) J 33 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 Bisant, Clement 2980 Contract.pdf CONTRACTOR INFORMATION Contractor Business Name Contractor's License Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone Number (enter WITH dashes, eg 303-123-4567) Contractor Address (Primary address of your business) Urban Exteriors, Ilc 150142 303-552-4467 3440 Youngfield St Ste 179 Wheat Ridge CO 80033 Contractor Email Address jennifer@urbanexteriorsllc.com Retype Contractor Email jennifer@urbanexteriorsllc.com Address DESCRIPTION OF WORK TOTAL SQUARES of 29 the entire scope of work: Project Value (contract _-72-59-- 715--7 tG�value or cost of ALL materials and labor) Are you re -decking the No roof? Is the permit for a flat Flat roof (less than 2:12 pitch), Pitched roof (2:12 pitch or roof, pitched roof, or greater) 34 both? (check all that apply) What is the pitch of the 2/12 FLAT roof? How many squares are 26 part of the FLAT roof? Describe the roofing material for the FLAT roof: Type of material for the FLAT roof.- If oof: If "Other" is selected above, describe here: ModBit Other (specify below) ModBitumen / What is the specific pitch 4/1 of the PITCHED roof? 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? Etc) 3 -Z asphalt shingles f/ Asphalt I house and garage 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. 35 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. 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 John Hess Email not displaying correctly? View it in your browser. 36 Urban Exteriors, LLC 3440i Street, Suite 179 g ' m Wheatheat Ridge, CO 80033 ` ��' Urban Exteriors 303.552.4467 ase. www.urbanexteriorstic.com Owner's Name-,*'Vf -S-e Insurance Company: 11 Address: rD17-W a Phone #46�) SY7— Se,ke City: State: Claim #: 0 " Phone #: Project Manager: Phone t/: Mobile #: _— Email Date: UWE, the Owner(s) of the premises described above authorize Urban Exteriors, Ilc, hereinafter referred to as "Contractor", to furnish all materials and labor necessary to roof and/or improve these premises in a good, workmanlike and substantial manner according to the following terms, specifications and provisions: I{ , a.Description of the work and the materials to be used: 5c-�_ 1cf �L✓ A INSURANCE: THE ONLY COST TO THE PROPERTY OWNER IS THEIR DEDUCTIBLE PLUS ANY UPGRADES CHOSEN OR ANY NON COVERED ITEMS "CHAT MUST BE REPLACED TO COMPLETE THE REPAIRS. THE CONTRACT BALANCE IS PAID BY YOUR INSURANCE COMPANY PER FINAL LOSS INVOICE. THIS AGREEMENT IS NULL AND VOID AND DOES NOT OBLIGATE ANY PARTY TO IT SHOULD THE INSURANCE COMPANY REFUSE COVERAGE UNDER THIS CLAIM OR SHOULD THE COVERAGE OFFERED BE INSUFFICIENT FOR CONTRACTOR TO PROPERLY DO THE WORK. THE SCOPE OF WORK WILL BE DEFINED BY THE INSURANCE COMPANY LOSS SHEET AND ALL REVISIONS THEREOF ANY ADDITIONAL WORK MUST BE SUBJECT TO A CHANGE ORDER AND/OR CONTRACT SIGNED BY THE PARTIES. b. Description of any areas that will NOT be worked on: This list of specifications maybe continued on subsequent pages (seepage number below). c. Payment Contractor proposes to perform the above work, (subj to any additions and/or deductions pursuant to authorized change orders), for the j- Total Sum of $ Down Payments Pif�ti d. Commencement and Completion of Work: Substantial commencement of work shall mean either the physical delivery of materials onto the premises or the performance of any labor shall be subject to any permissible delays as per provision (5) on the reverse side. Shingle Mfg, Type & Color: Labor Warranty: 5 yrs, transferrable - provided upon payment in full e. Acceptance: The contract is approved and accepted. I (we) understand there are no oral agreements or understandings between the parties of this agreement. The written terms, provisions, plans (if any) and specifications in this contract is the entire agreement between the parties. Changes in this agreement shall be done by written change order only and with the express approval of both parties. Changes may incur additional charges. Additional Provisions of This Contract Are On The Reverse Side And May Be Continued on Subsequent Pages. A copy of the labor warranty is available upon request. Urban Exteriors shall hold in trust any payment received from you until Company has delivered roofing materials at the site or has performed a majority of the roofing work on your property. You, the Buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See attached Notice of Cancellation form an explanation of this right. ALL CHECKS MUST BE MADE PAYABLE TO URBAN EXTERIORS, LLC. orae er, Signature date r`- 3 'r P Project Manager's Signature date I hereby grant urban Exteriors permission to speak with my insurance company for the purpose of resolving this claim. Urban Exteriors has permission to discuss my claim with my mortgage comnanv. if aonlicable.