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HomeMy WebLinkAbout3555 Lutheran Parkway (2018)i CITY OF WHEAT RIDGE V, Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office * (303) 237-8929 Fax INS�ECTjqllSll NOTICE-.,,,,, Inspection Type: ry") 1( Job Address: Permit Number: tai 0 L,1 10 # l i b A V cCr— I , C' " v (.�o Y%-� L) C!, I.J No one available for inspection: Time \ �� L° AM/PM Re -Inspection required: (Yeis, No When corrections have been made, call for re -inspection at 303-234-5933 Date: /'I Inspector: DO NOT REMOVE THIS NOTICE 44, CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: ? r Job Address: . i % - t� +�1 ' �t'e ,� xtf f /(o Permit Number: ❑ No one available for inspection: Time/t(_A-/ AM/PM Re -Inspection required: Yes (N)o When corrections have been made, call for re -inspection at 303-234-5933 Date: A f Inspector: )PT_ DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax yt-uu5I-- ya\JMI _I IN.$PECTION NOTICE, IV e L R,, v L Inspection Type: Job Address: t , �" i t: '" ►-, c ,n ; U Permit Number: X, J ._ - ' ? 'Z G .i L r I� 1 t .r ❑ No one available for inspection: Time j 1&0 AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: -\ ! "'� , �i Inspector: `~ DO NOT REMOVE THIS NOTICE City of Wheat Ridge Commercial Roofing PERMIT - 201803142 PERMIT NO: 201803142 ISSUED: 12/04/2018 JOB ADDRESS: 3555 Lutheran Pkwy W EXPIRES: 12/04/2019 JOB DESCRIPTION: Replace building coping cap with 24 ga. prefinished steel at perimeter; 580 if *** CONTACTS *** OWNER (303)422-9500 EXEMPLA INC SUB (303)288-2635 Robert Bechtholdt 021419 Douglass Colony Group *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 1 / Commr Vacant BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 16,995.00 FEES Total Valuation 0.00 Use Tax 356.90 Permit Fee 315.25 ** TOTAL ** 672.15 *** COMMENTS *** *** CONDITIONS *** In order to pass a final inspection on commercial elastomeric or similar type roofing, 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. 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 -roof inspections may be called in at the same time, 100 percent of the sheathing must be complete and 25-75 percent of the midroof may be complete. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. 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. City of Wheat Ridge ifs',.- »yam"rr Commercial Roofing PERMIT - 201803142 PERMIT NO: 201803142 ISSUED: 12/04/2018 JOB ADDRESS: 3555 Lutheran Pkwy W EXPIRES: 12/04/2019 JOB DESCRIPTION: Replace building coping cap with 24 ga. prefinished steel at perimeter; 580 if y signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications Dle building codes, an 11 applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized egal owner of the pr rty and am authorized to obtain this permit and perform the work described and approved in conjunction with mit. I further attest t I am legally authorized to include all entities named within this document as parties to the work to be tel and that all wor to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. <g'nature of OWA&R or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This.permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180_days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4, No work of an 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 permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable f,c e or any ordii4ice or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Btfilding Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. 0_�2 iC CHRISTOPHER MENGES ENGINEERING, INC. MECHANICAL & PLUMBING CONSULTING ENGINEERS February 12, 2019 Joe Gerber General Gerber Construction, Inc. 1600 Washington Avenue, Suite 3 Golden, Colorado 80401 RE: Advantage E.N.T. Lutheran Medical Office Building IV, Suite 160 Wheat Ridge, Colorado C RE, QNF,iR P �= 36005 I have reviewed the redlined as -built conditions both prior to construction, and after completion of the HVAC work for the above ref project. The installation is satisfactory, and it is acceptable for the flexible air duct runs to exceed the maximum 6 feet requirement in the mechanical specifications. That length limitation is a general guideline, and is not essential to meet a specific mechanical code requirement, since it is UL class 1 flexible air duct. Technically, the only limit is based on practicality of maintaining a reasonable air pressure drop throughout the system. Flexible air duct runs up to 10 feet will not compromise the performance of the system, and will meet the intent of the design. The air balance report, provided by Double T Balancing Company on 11/20/2018, demonstrates the final air flows are within acceptable tolerance in order to meet the design intent. Sincerely, Christopher Menges, P.E. President CHRISTOPHER MENGES ENGINEERING, INC. 6147 S. WINDERMERE WAY, LITTLETON, COLORADO 80120 (720) 333-6851 - WWW.MENGESENG.COM E S C REQUIREMENTS PLAN REVIEW REQUIREMENTS P B 0 V E ITIONS OF APPROVAL: E COMMENTS ON THE PERMIT DRAWINGS .E SUPPLEMENTAL REVIEW REPORT IFC AS AMENDED BY WEST JORK SHALL ADHERE TO THE :O FIRE RESCUE 1010912_ _ 016PERMIT No. 160925006 REVIEWER: M. Dean 'ED AND APPROVED PLANS AND PERMITS ISSUED TO ALL SUBCONTRACTORS r REMAIN ON SITE FOR THE DURATION OF NSTRUCTION. ROUGH AND/OR . INSPECTIONS MAY BE TERMINATED AND REINSPECTION FEES ASSESSED F PROVED PLANS ARE NOT AVAILABLE TO THE INSPECTOR UPON REQUEST. FINAL INSPECTION AND TESTING on to assist contractors, as well as our inspectors, in assuring final inspections go smoothly, we respectfully ask read and abide by the followingrtieasures: igh inspections for fire Safety systens Shatl be scheduled by that systems contractor. Rough inspections will no id-oIf until mechanical, electrical and plumbing are in place. Igh inspections must be completed and passed before any final inspection will be scheduled. (Unless the fire cent has approved fpr the rough and final to be done at the same time.) .e General Contractor's responsibility to ensure all rough inspections are completed, all pre-tests have been :ed, and any insutficiend0, discovered in the pre-tests have been corrected. As wetl, that all benchmarks on the rermit have been signed off except those pertaining to the final inspectionrlerant improvement . `scheduled by theeGeneral Contractor. ALLsafety systemabe on site at the time oflinspection. Th space must be ready ro turn the owner, or "prove in ready'. rors, glass and door hardware, for interior and exterior must be installed, and all flooring, carpet and painting mus ipteted. All construction trades must be complete and out of the space, amt the final clean-up has been completed. form, appropriately signed and dated by all contractors, shall be given to the WMFPD inspector at the start of the spection. pection Fees inspection - $300.00 -inspection - $600.00 I subsequent re -inspection is double the previous. )) e -inspection fees must be paid prior to tSiqnature: hdu5ng of the reinspe� ' 1 y 7 :neral Contractor (Company Name):neral Contractor Representative: int name: 0 Date: ippression Contractor (Company Name): uppmssion Contractor Representative: Date: rint name: Si nature: ire Alarm Contractor (Company Name): 'ire Alarm System Contractor Representative: Date: rrint name: Si nature: Zither Contractor (Company Name): Zither Contractor Representative: Print name: -go 15 0;� W l DO NOT REMOVE THIS SHEET. THIS SHEET MUST REMAIN A PART OF YOUR FINAL CONSTRUCTION DRAWINGS AND MUST REMAIN ON SITE FOR THE DURATION OF CONSTRUCTION. NO WORK RE UIRED CONFORMANCE FORM • A project that does not appear to need alterations and/or modifications to the Life Safety System(s) must be attested to using a • t I Wank Required Conformance Form". (A separate form shall be used for each Life Safety System.) This form can be found in the Contractor Portal under'Document Library'. • The System's compliance with the appropriately adopted code, as amended, will need to be verified during a physical inspection ,the project site by an appropriately trained and certified design contractor who will be responsible for the accurate completion of this form. • The inspection shall occur after the construction is completed and before the final inspection by Wes[ Metro is scheduled in case changes were made to the original plans. - • The person doing the inspection and signing this form must be the same person and be at leas[ NICET III certified for the s stem bein inspected or an en ineer with Ii sate desi d= ex erience. • Provide a copy of the most current System Record of Inspection and Testing for this building system. PERMIT CARD AND INSPECTION APPROVALS Mob/.Eyes log m8 4 W West Metro Fire Protection District 1 433 S. Allison Pkwy, Lakewood, CO 80226 (303) 989-4307 To schedule an Inspection go to www westmetrogre org. Occupant Name: Advantage ENT Job Number: 180925006 Tenant finish consisting of 3555 Lutheran Parkway Job Description: moving and relocating a few Atldress: Wheat Ridge. CO 80033 walls,adding some new walls, adding same new millwork and carpet and paint throughout. Permit Number: 180925006 Suite: 160 General Gerber Construction, permit Contacts: None Contractor: Inc. Joe Gerber 303-423-0123 303-885-0123 c Protect Cost: $42,500.00 Properly Use Type: Undefined (DEFAULT) permit Issued On: 10/9/2018 Inspections Required: Fire Alarm Final (REQUIRED: The number of devices and on site contractor contact Information is required in the notes sectionbelow).Tenant improvement Final (REQUIRED: Contact information for the onsite contractor is required in the notes box below) Permit Expires On: 101912019 Permit: Tenant Improvement - B Occupancy - ADDITIONAL INSPECTIONS INSP Kt INSP 02 INSP 03 INSP 04 REQUIRED FAIL PASS FAIL PASS FAIL PASS FAIL PASS Fire Alarm Permit Finat / zih Tenant Improvement Permit Fina1l1 - T�( /' T /` COMMENTS//n'.� ( INSPECTION COMMENTS Report By: CERTIFIED TEST, ADJUST, AND BALANCE REPORT Double T Balancing Company 609 W. Littleton Blvd. Suite 212 Littleton, CO 80120 Report: Test and Balance Date: 11/20/2018 Client Anderson Air 14807 W. 54th Drive Golden, CO 80403 Engineer Christopher Menges Engineering, Inc, FACILIBUILD www facillbuild_com Double T Balancing Company RE, BB CERTIFICATION PROJECT: 15183 —Advantage E.N.T. DATE: 11/20/18 SUBMITTED & CERTIFIED BY: DOUBLE T BALANCING COMPANY REGISTERATION NUMBER: 2631 CERTIFIED BY: Thomas Tunink CERTIFICATION EXPIRATION DATE: 03/31/2019 THE DATA PRESENTED IN THIS REPORT IS A RECORD OF SYSTEM MEASURMENTS AND FINAL ADJUSTMENTS THAT HAVE BEEN OBTAINED IN ACCORDANCE WITH THE CURRENT EDITION OF THE NEBB PROCEDURAL STANDARDS FOR TESTING, ADJUSTING, AND BALANCING OF ENVIRONMENTAL SYSTEMS. ANY VARAINCES FROM DESIGN QUANTITIES, WHICH EXCEED NEBB TOLERANCES, ARE NOTED IN THE TEST -ADJUST - BALANCE REPORT PROJECT SUMMARY. Double T Balancing Company Project. 15183 - ADVANTAGE E.N.T. Table Of Contents section Summary Data VAV-Fan Powered Box Page # Puivcrvd by favhft ddl Date. 11.,2012018 Page 2 of 4 %,ww facdY6udd corn N E BB Project Summary Double T Balancing company Project: 15183 - ADVANTAGE E.N.T. No deficiencies to report at time of balance. CJLVerL!d by fUCj,IHUI(dJ Date 11 2012018 Page 3 of 4 WA- (at dial( Corr Double T Balancing Company Project: 15183. ADVANTAGE E.N.T. VAV-Fan Powered Box Asset Area Served Design Max Coni Design Min Cool Design Fan CFAs Ak (max) o to RUX Coot CFM Min Coot CFM Fan CFM ;Heat) CFM design CFM CRA OD (Heat) 200 171 (E)FP81-40 2113 9e15 4Y, 100 108 9A5 956 70.211 Completed By: Anthony Short on 11M 0,12018 Asset Area Served Notes Diffuser Supply (GRD) (E)FPB 1.40 Ades.( A-= -R vad MFG Type Sire DESIGN CFM(T1 CFMt21 FINAL o to CFM CFM design (E)FP81-e0- N -A OD 8' 200 171 2113 IW 5 SGRD1 {E)FPS140• WA GO a' 140 170 136 971 SGRD2 (E)FPS1 t0• NA CD it 155 197 159 9s.6 G RD3 !OFPB1-40- N".4 CD d' 150 132 14.1 95.0 SGRD4 (E)FFB1-40•N+A CD 8` 140 176 138 139.6 SGRDS ;1=1FPB1-40• NA CO e' 200 136 SGRD6 Completed By: Anthony Short on 11;19,12018 Asset Area Served Notes Powered by Focrti8 W! Date; 11120!2018 Page 4 of 4 vnavr.fanl+buitd.com { Double T Balancing Company Nk ip f 3 [`f • O INSTRUMENT CALIBRATION REPORT MANUFACTURER MODEL SERIAL APPLICATION CALIBRATION DATE Dwyer D160-18" 345345 Duct Traverse Extech Extech Extech Shortridge Shortridge 380935 461825 850187 ADM -860 Air Foil 36" 971107686 Q669462 H196324 M00797 IPT36 VOA -700A A/C RPM Temp/Humidity CFM -Vel -Press -T Duct Traverse 11/1/2016 11/1/2016 11/1/2016 11/1/2016 Shortridge HDM-250 1WI4045 Press Diff 11/1/2016 1 Double T Balancing Company N1� "m o Abbreviations Symbol Description Symbol Description A/C Air Cond. - Split System Hz Hertz AHU Air Handling Unit KH Kitchen Hood Atm lAtmosphere LD Linear Diffuser BCU Blower Coil Unit Mfg Manufacturer BHP Brake Horse Power MUA Make Up Air Unit CD Ceiling biffuser MZ Multizone Unit CFM Cubic Feet per Minute Mm Moduline - Master CL Center Line Ms Moduline - Slave CRAC Computer Room Air Conditioner NA Not Applicable CUH Cabinet Unit Heater NG Not Given DD Direct Drive NIC Not in Contract DP Differential Pressure OA Outside Air EC Evaporative Cooler P Pump EF Exhaust Fan PSI Pounds per Square Inch EG Exhaust Grille RA Return Air EGRD Exhaust Grille/Register/Diffuser RD Round Diffuser EH Electric Heat RF Return Fan / Relief Fan EHE Electric Heating Element RG Return Grille ERV/ ERU Energy Recovery Unit RGRD Return Grille/Register/Diffuser ESP External Static Pressure RH Relief Hood FCU Fan Coil Unit RL Running Load FH Fume Hood RPM Revolutions per Minute FPB Fan Powered Box RTU Roof Top Unit FPM Feet per Minute SF Supply Fan FP VAV Fan Powered Variable Air Volume SGRD Supply Grille/Register/Diffuser Ft Feet SP Static Pressure Ft Hd Feet of Head SR Supply Register FUR Furnace SW Sidewall Grille GH Gas Heat TF Transfer Fan GPM Gallons per Minute TR Troffer HP Heat Pump Trav Traverse HX Heat Exchanger UH Unit Heater HP Horse Power UTO Unable to Obtain VAV lVariable Air Volume I FOR OFFICE USE ONLY I City of Date: dj yfl Wheatf k e 1 COMMUNITY DEVELOPMENT'Plan/P rmi #•l 1 1 M � � I )l Bui/ding 8 Inspection Services Division 7500 W. 29" Ave., Wheat Ridge, CO 80033 Pian Review Fee: Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: perm its(&ci.wheatridge.co.us Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. "* Property Address: 3 555 N L Property Owner (please print): L H R T why 121 � � bt t✓ Phone:.363'��'g50?J Property Owner Email; RD DGi%2 • SW N IJOVRL@ r r:L 18kI DGi✓, GDYYt Mailing Address: (if different than property address) Address: 313515 Lu 46lzon P( w V su i -k /30 'lvheat Ri r Ae . 0_0 � b03 Arch itect/Engineer: Architect/Engineer E-mail: Contractor: Uovo,.USS ('_0l 0 h Contractors City License: b "I Contractor E-mail Address: 0 6 i h -S Q 4D u!p ass Sub Contractors: Electrical: W.R. City License. # Other City Licensed Sub: City License # NONE Plumbing: W.R. City License # Phone: Phone: 303-a'10-9435 D n V • 0-0 /n Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form COMMERCIAL ❑ RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE NEW RESIDENTIAL STRUCTURECOMMERCIAL ROOFING COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ OTHER (Describe) _ (For ALL projects, please provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.) me_ J,c4 / W1 .e bui ld it O—Dpl l 0-&p Remove kai I da.male d copinI W $ It451,¢11 AlfW �4-IT),-. pre4i*5ked ske/ �,e f I l a+ p e,1 i m >° le-,. wa-J (s 58014 Sq. FtJLF .5 U 0 'f— Btu's Amps Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) It �119.AJ5,DD OVVNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT 1 hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. REPRECIRCLE ONE: (OWNER) NCor AUTHOZ NE) of (OWNER) (CONTRACTOR) PRINT NAME:-fihCl k C/N SIGNATI DATE: // gqr� U ZONING COMMMENTS Reviewer BUILDING DEPARTMENT COMMENTS Reviewer PUBLIC WORKS COMMENTS Reviewer- PROOF eviewer PROOF OF SUBMISSION FORMS Fire Department ❑ Received ❑ Not Required Water District ❑ Received ❑ Not Required Sanitation District [] Received ❑ Not Required DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION TYPE OF CONSTRUCTION SPRINKLERED OCCUPANT LOAD Building Division Valuation: $ DOUGLASS COLONY GROUP ROOFING FIELD WORK TICKET Project: Ventas MOB 4 Job Number: 50-050-2913 Warranty: 10 year Firestone Metal Finish Address: 3555 North Lutheran Parkway. Wheat Ridge, CO 80033 Roof System: New Coping Cap Job Size: 580 LF Deck Type: na Insulation Type Application Fastener/ Adhesive Layout Base Layer 2nd Layer 3rd Layer Cover -board Taper/Crickets Membrane Mil Thickness Size Application Side Lap Width Detail Application Per Firestone Details End Lap Width Detail Application Per Firestone Details Sheet Metal Sub: DCG Contact: Bryan Bangs 970.396.3011 Client Contact: Lillibridge Healthcare Roger Sandoval 303.653.3006 Job Specific Installation Instructions: Replace Coping Cap. Demo existing coping cap & leave in place existing cleat. DO NOT DAMAGE CLEAT in demo process. Replace with new 24ga prefinished standard color steel cap. 8/27/2018 Print - PhotoMaps by nearmap Date: Wed, 27 Jun 2018 Notes: Ii MOB 4 scale t... 207.2 FTN MOB 4 coping 580.3 FT http://maps.us.nearmap.com/print?north=39.76658740793302&east=105.08966439661839&south=39.766108576936695&west=-1 05.090838533614668zoom=21 &date=20180627 CITY OF WHEAT RIDGE Building Inspection Division �— (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax Inspection Type: Job Address: Permit Number: �E INSPECTION NOTICE s� (�. ❑ No one available for inspection: Time I A�Ny Re -Inspection required: es No *When corrections have been made, call f re -inspection at 303-2345933 Date: Inspector - DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303).237-8929 Fax INSPECTION NOTICE Inspection Type: 3R 1 AS628 D ,s Job Address:.3 `- v f h P/9/) P&IIV , l Permit Number: ?`0I90�6)0 r LJNo one available for inspection:,tTime/9 AM/PM Re -Inspection required: Yes /60 When corrections`) have been made, ca71%pr re -ins ection at 303-234-5933 Date: 1� /-//// Inspector: # DO NOT REMOVE THIS NOTICE City of Wheat Ridge N ;e Comm. Tenant Finish PERMIT - 201802610 PERMIT NO: 201802610 ISSUED: 11/02/2018 JOB ADDRESS: 3555 Lutheran Pkwy Ste 160 EXPIRES: 11/02/2019 JOB DESCRIPTION: Commercial tenant finish -removing and relocating walls, adding electrical, relocating HVAC, no plumbing work. New mill work, carpet and paint. *** CONTACTS *** OWNER (303)422-9500 EXEMPLA INC. SUB (303)423-0123 Joe Gerber 018128 General Gerber Const., Inc. SUB (303)423-5942 Justin Grosfield 020558 Grosfield Electric Co SUB (303)271-9568 Michael Anderson 019871 Anderson Air, LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 1 / Commr Vacant BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 43,344.41 FEES Total Valuation 0.00 Plan Review Fee 429.36 Use Tax 910.23 Permit Fee 660.55 ** TOTAL ** 2,000.14 *** COMMENTS *** *** CONDITIONS *** All roughs to be done at Framing Inspection. Approved per plans and red -line notes on plans. Must comply with 2012 IBC, 2017 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections. **Prior to final inspection approval - As-builts are required before approval of the Building Final Inspection and Certificate of Occupancy can be issued. City of Wheat Ridge Comm. Tenant Finish PERMIT - 201802610 PERMIT NO: 201802610 ISSUED: JOB ADDRESS: 3555 Lutheran Pkwy Ste 160 EXPIRES: JOB DESCRIPTION: Commercial tenant finish -removing and relocating relocating HVAC, no plumbing work. New mill work, 11/02/2018 11/02/2019 walls, adding electrical, carpet and paint. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications; applicable bui ding 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 pennrt. I f er attest that am legally authorized to include all entities named within this document as parties to the work to be performe that 1 work toe performed rs disclosed in this document and/or its' accompanying approved plans and specifications. Signature 9f R or CONTRAX ircle.one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This. permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a 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 permits ll not be construed to be a permit for, or an approval of, an violation of any provision of any applicable code or anykdinance or redilation 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. Lily of )E 9W heatdc� m.P C'0__)7MMUNiT-y DEVELOPMENT Building & Inspection Services Division 7500 W. 291' Ave., Wheat Ridge, CO 80033` Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(a)ci.wheatridge.co.us FOR OFFICE USE ONLY Date: L'/�> / Plan/Permit # 019"6 9. U i Plan Review Fee; L -y Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** • �4lCo� Property Address: L- 4^ e- fliv, f2 wY Property Owner (please print): o J,,e c' S, t4 J u a Phone: 3 0 - �f 22 - 5 ��O Property Owner Email: CO �.� e t. .5i r 440 v `x1 c� �� tk t b A � -e r C vx, Tenant (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: City State, Zip: Arch itect/Ennineer• 'T�e CTO 6CU's C Architect/Engineer E-mail: 4k e r �o �'L;-' P L ` ` ' Phone: 3 D3 - `3 GL( - s�- � �r 2- ContractorName: �=� r5s���'��- Imo- " k City of Wheat Ridge License #: f Phone: 30 �, ._ V,2-3 Contractor E-mail Address: tae C?g e of 1 4 i e c6e c - ` c " For Plan Review Questions & Comments (please print): CONTACT NAME (please print): I e- 63f' � �' ` Phone: 3 CONTACT EMAIL(please print): ',),,c3 v Sub Contractors (Must provide Wheat Ridge License No.): Electrical: C -s �: ,.; 14 E; i er.t c' Plumbing: Iv% Mechanical: 14rW e r y ° » 41 � W.R. City License #�� /� �� W.R. City License # W.R. City License # d( olqgll Other City Licensed Sub: Other City Licensed Sub: City License # City License # K COMMERCIAL ❑ RESIDENTIAL Description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. ` k ©s Sq. FULF 1q k 3 I UC C-41 ,--5 S 'S P �-t BTUs A /"-:� Gallons _ J2,/ /7 - Amps Squares_ Commercial Projects Only: Occupancy Type: 8 Construction Type: l 113 Occupancy Load: ;-o I S Project Value: (Contract value or the cost of all materials and labor included in the entire project) 3 I/Z, SI) C0 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record: that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLEONE: (OWNER) (CONT OR or (AUT' OR/Z REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): DATE % 17 �O Printed Mame: DEPARTMENT USE ONLY ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: 13 Reviewer: CONSTRUCTION TYPE: 6 BUILDING DEPA ENT MME TS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: 2 �/ Building Division Valuation: / ` .y/ Joe Gerber From: NoReply@mobile-eyes.com Sent: Tuesday, September 25, 2018 12:22 PM To: Joe Gerber Subject: Permit application accepted - West Metro Fire Protection District Your permit request for Advantage ENT at STE 160, 3555 Lutheran Parkway Wheat Ridge, CO 80033 has been accepted. The Job Number is: 180925006 Description: Tenant finish consisting of moving and relocating a few walls, adding some new walls, adding some new millwork and carpet and paint throughout. Thank you for submitting to West Metro Fire. Our typical review turnaround is approximately 2 weeks. If additional information is required, you'll receive a notice from the reviewer assigned, or a no -reply notice from Mobile Eyes. Please be sure to check your junk folder if you feel you are not receiving the Mobile Eyes notices and select "Not Junk". NOTE: Re -submissions shall only include the pages that are affected and additional pages that may be required for the needed corrections. Re -submission of full sets, unless specifically requested, shall result in the rejection of plans. --�7 &) / ? 0 g (0 / C-) LIMITED ASBESTOS CONTAINING MATERIALS SURVEY TULLIO ENVIRONMENTAL SERVICES 833 S. Vance St. Suite 102 Lakewood, Colorado 80226 (303)842-6361 roberttullio cz,ymail,com October 20`fi , 2018 General Gerber Construction, Inc. Re: 3555 Lutheran Pkwy. Building 9 Unit 160, Wheatridge , Colorado On October 17' , 2018, I Robert Tullio a certified state of Colorado Asbestos Inspector, Number 4585 did collect and submit for analysis 9 bulk samples for P. L. M. This report is for the sole purpose of remodeling the reception area and 2 offices and replacing the carpet. * Check foot notes LIST OF HOMOGENOUS AREAS Category II, Ceiling the white in color with a pitted texture located throughout on the ceilings, this area is accessible with a high potential for disturbance, in good condition approximately 1300 Sq. Ft. * (F) Class 7 sample number CT -001 through CT -003 Category I, Drywall tan in color with a smooth texture located throughout on the walls, this area is accessible with a high potential for disturbance, in good condition approximately 200 Sq. Ft. * (F) Class 6** sample number SMW 004 through SMW 006 Category III, Flooring gray in color with located throughout on the floor, this area is accessible with a high potential for disturbance, in good condition approximately 1300 Sq. Ft. * (F) Class 7 sample number FL -007 through FL -009 SUMMARY OF SAMPLED AREAS AND MATERIAL FOR P L M 1 bulk sample taken from the Ceiling tile sample number CT -001 I bulk sample taken from the Ceiling tile sample number CT -002 1 bulk sample taken from the Ceiling tile sample number CT -003 I bulk sample taken from the Reception area south office sample number SMW 004 1 bulk sample taken from the Reception area south office sample number SMW-005 1 bulk sample taken from the Reception area south office sample number SMW-006 bulk sample taken from the Flooring sample number FL -007 bulk sample taken from the Flooring sample number FL -008 bulk sample taken from the Flooring sample number FL -009 SUMMARY OF ANALYSIS OF SAMPLES Sample number CT -00 I contains No Asbestos Sample number CT -002 contains No Asbestos Sample number CT -003 contains No Asbestos Sample number SMW-004 contains No Asbestos Sample number SMW-005 contains No Asbestos Sample number SMW-006 contains No Asbestos Sample number FL -007 contains No Asbestos Sample number FL -008 contains No Asbestos Sample number FL -009 contains No Asbestos RECOMMENDATIONS AND SUMMARY None of the materials listed above are regulated asbestos containing building materials and do not need to be removed by a licensed asbestos abatement contractor. This is also a limited survey. If any additional material is found and is suspect all work must stop. Other areas behind walls and above ceilings and under floors were considered inaccessible and were not tested. If suspected materials are found during renovation or demolition activities then all work must stop and materials tested. If any of the materials do contain asbestos then a licensed asbestos abatement contractor must remove materials according to all Federal, State and Local regulations. The area then must be cleared before any other renovation or demolition activities can continue. ANALYTICAL PROCEDURES The samples collected were delivered to F.R.S. A National Voluntary Laboratory Accreditation Program (NVLAP) asbestos laboratory, located in Denver Colorado for analysis with a 5 -day turnaround time. All samples are archived for 30 days unless otherwise stipulated by the client. According to the Laboratory, the samples were analyzed in accordance with the E.P.A. Method 600/R 93/116. This is a limited asbestos survey. This is not a complete demolition survey. The laboratory reports are enclosed. Submitted by: // a Robert Tullio State of Colorado Asbestos Inspector 44589 ** Any surfacing material that is blown on such as fire proofing, texture or block filler may have associated over spray that is visible or inaccessible around the areas where it had been applied. *The quantities that are listed in the list of homogeneous areas are just approximations and should not be used for bidding purposes. Categories: I is Surfacing Material II is TSI III is Miscellaneous Class: 1 damaged or significantly damaged TSI 2 damaged friable surfacing ACM 3 significantly damaged friable surfacing ACM 4 damaged or significantly damaged friable miscellaneous ACM 5 ACBM with potential for damage 6 ACBM with potential for significant damage 7 any remaining friable ACBM or friable suspected ACBM If there is any construction debris that contains any amount of asbestos or is assumed to contain asbestos you must notify the land fill per the Hazard Communication Act. Such as roofing materials that are tar impregnated, weather proofing, floor tiles and mastic and any other OSHA material deemed to be non -friable. These materials must be kept non -friable you can not saw, sand, grind or in any other way pulverize said materials. Even if the material contains less then 1 % asbestos then OSHA standards and regulations apply. All materials greater than 1% are considered asbestos containing and regulated by OSHA, EPA, State of Colorado and NESHAP. Clientco Address: `5 - `` G1C�' c . City State. --- Zip: �' �-7 7 Telephone: FAX*:( y) Person to Contact: Altcmate Phone( FRS GEOTECH, INC. Bulk Chain of Custody 1441 W. 46t' Ave., Suite 14 Denver, CO 80211-2338 (303)477-2559 or (800)386-3136 FAX: (303)477-2580 e-mail:sze� Asbestos Mold Accept/ Sample Sample Reject Number Date u'C' 1. -- Rel 1. 2. FRS Lab No.: Pa of Job Description: P.O. #: Turnaround time reque to : Rush_ ]-day_ 5 -day Other: Return Samples *NOTE: Specifying a FAX number authorizes FRS Geotech, Inc. to FAX wuuucuuat Sample Description and Location F C-1 LO CnaI numoer. Received by Name, da , time): i{44 2. 110 00 co ..y CN r�+i x O Iva`i N M N U N f 7 M ct (6 M O M C O Q. 000 .S] a G 110 ..y G M a �t a d o W d O a av' o x J � 3 r J: d 7. bC z y G M C N V y Qom„ 4O O 1(, c U U a C CE G V) 0 9 2 0 G O 4 ua aA us sur cv� rn c> i c :.A �y K qI a� R M v; M m O 4fi O v p' T N N o�0 N O rE W r M O M C O CL C O O X Z v LI L y v �y K qI a� R N r 00 T v p' rE W r z �a v ►�+ N L y U V+ F M 0 a` N r 00 T m 4) F ro CO e E 2 0 4 a 1 9 a y d LO Gk w cn O c in co M x Nv In _� O N /r� w N C, n o r O 7 M V 0 m o c o o n �.x Z 1 v � � � y N O L L V 0. O = U s ", t7rn cj c °) m 4) F ro CO e E 2 0 4 a 1 9 a y d LO Gk w cn O c in N /r� w V 2 i f u c CG 1 z � � y N O L L V O = U s ", t7rn cj c °) � a U a m 4) F ro CO e E 2 0 4 a 1 9 a y d LO Gk w cn O c in t.0 no �. oil 00 ov OY�OO pe�� CD rrrm a y1)V (D m H p. r� m m P i aa� o' y N a•<� pw►C�.trJ C" O rr n O m oN, C C O N Y �,Aor o o a b 1-1 c ft poo -•, ro > o Coly d 00 O H r j�Jy � N 0 Y opo AO OZ w C m m 0 N S r` 1 n w P,m v� ►., .- cc Cr ... ee O. C QQ omm Twp yOv� rDn� m�� o 3 \1 w crap. H. yy �Aw C C L%`� ,00 y� z� Ormn Fn+ m p Z CD C ,Ct�rr ��, �, °��� off° O 0m CCS N a '•1 H m (7 C p fo 0fta 9 g s ~• W C) ^C O O W ~ rr ra O° a, o .. C C rA 'Ct efo CD \ F �� b� a cr n Q. r- 5 < C GEp car r- W to � O o C=i .� H ~ m O 9: w A� o + A ego �G 0 O !� Ir.- �•a A PO k C ti O w O O. cr t b rr TQ H n 0 r O a� CD o u W I a G o O 00 Q� PERMIT NO. 201801888 Y City of Wh6atRidgc BUSINESS LICENSE INSPECTION INSPECTION DAY/TIME.July 5, 2018 @ 1:00 pm INSPECTION DAY/TIM INSPECTION DAY/TIME BUSINESS NAME: Quest Diagnostics Clinical Laboratories, Inc. ADDRESS: 3555 Lutheran Parkway, Suite 130 Karrie Brickham (manager, may not be on-site but said staff will assist.) CONTACT NAME: QSQ FT Y3 OCCUPANCY TYPE OCCUPANCY LOAD CONSTRUCTION TYPE ❑ SPRINKLERED ❑ NON-SPRINKLERED Inspector Signature 7.5 e� Date o CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type:y/tip iC- Job Address: `55 L 0/11 Permit Number: 2c--/ : 00 ❑ No one available for inspection: Time .'00 AM`PM Re -Inspection required: Yes o, When corrections have been made, call for re -inspection at 303-234-5933 Date: _T S , t � Inspector: 4� DO NOT REMOVE THIS NOTICE PERMIT NO. 201800239 City of Wh6,atidue BUS LICENSE INSPECTION INSPECTION DAY/TIME Fri. June 15 @ 10:00 AM INSPECTION DAY/TIME 1,0 - t6 • 16 e--- ( 0 A INSPECTION DAY/TIME BUSINESS NAME: Elevation Dermatology ADDRESS: 3555 Lutheran Parkway Bldg 9 Suite 360 CONTACT NAME: Kimberly _( r 50 SQ FT _ z OCCUPANCY TYPE Q OCCUPANCY LOAD la Z CONSTRUCTION TYPE ❑ SPRINKLERED NO D Inspector Signature Cc'I�-,II Date ob O a m � CDb O Z 0. v' 0 N h w y CniJ C�r1 Cr1A o A '+ naW b M ►C n r CL MN 1° O -� � . C'" C m < ao n rr A O m�G d���v.7 'C CL 0 ft ee`e O Ct d Z @ a vA, 'ozo w O H nNwj� o 0 �. n m 0 (� to d m O m m v '� NtAy M LQ " m °Z n l?y Z �A �. A a O o nInrr .. �, y rr r�� o D•o n _ J "' omm yOw �0 ^^ g w a a a y 3 z MMM•����111 r Nw N ct C b d o e�e o v d ,y O M '.7 CZi l V � �R� ��� eft opJo O W N O W N M �� w 1--i z b p H w IH (D O t„ y o 0 Oy " w H 0 C S o rwr Ill r � x " At b ° b 00. 0 », .. a 1 °. w O m 7C O 5, ° �? ^w (D UQ ft C1 r O ° w EQ. ro a yrr o N o a 7 @ rr o y d A „ 0� 0 O o R C1. 0 CL e CD o X d fb ? ij I a a o CD O 00 A ✓ CITY OF WHEAT RIDGE Vr Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: y,�)-q F E G/, -//g Job Address: 35' 6 L j2t' �, i!2!1? %�k,,,T/ Permit Number: �O� 23 E ❑ No one available for inspection: Time W ' i AM/PM Re -Inspection required: Yes Ofor When corrections have been made, ce--iin�#sppeecttion at 303-234-5933 Date: (� Inspector: 1 �1 / DO NOT REMOVE THIS NOTICE ob O a m � CDb O Z 0. v' 0 N h w y CniJ C�r1 Cr1A o A '+ naW b M ►C n r CL MN 1° O -� � . C'" C m < ao n rr A O m�G d���v.7 'C CL 0 ft ee`e O Ct d Z @ a vA, 'ozo w O H nNwj� o 0 �. n m 0 (� to d m O m m v '� NtAy M LQ " m °Z n l?y Z �A �. A a O o nInrr .. �, y rr r�� o D•o n _ J "' omm yOw �0 ^^ g w a a a y 3 z MMM•����111 r Nw N ct C b d o e�e o v d ,y O M '.7 CZi l V � �R� ��� eft opJo O W N O W N M �� w 1--i z b p H w IH (D O t„ y o 0 Oy " w H 0 C S o rwr Ill r � x " At b ° b 00. 0 », .. a 1 °. w O m 7C O 5, ° �? ^w (D UQ ft C1 r O ° w EQ. ro a yrr o N o a 7 @ rr o y d A „ 0� 0 O o R C1. 0 CL e CD o X d fb ? ij I a a o CD O 00 A i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: L_ Job Address: S v .Aj+� ('K W 2 D Permit Number: 2 D ( L ❑ No one available for inspection: Time O -__ I Re -Inspection required: Ye N When corrections have been made, call for re -inspection at 303-234-5933 Date: ' i5, ( �Inspector: - 6 DO NOT REMOVE THIS NOTICE PERMIT NO. 201800239 City of Wh6,atidue BUS LICENSE INSPECTION INSPECTION DAY/TIME Fri. June 15 @ 10:00 AM INSPECTION DAY/TIME 1,0 - t6 • 16 e--- ( 0 A INSPECTION DAY/TIME BUSINESS NAME: Elevation Dermatology ADDRESS: 3555 Lutheran Parkway Bldg 9 Suite 360 CONTACT NAME: Kimberly _( r 50 SQ FT _ z OCCUPANCY TYPE Q OCCUPANCY LOAD la Z CONSTRUCTION TYPE ❑ SPRINKLERED NO D Inspector Signature Cc'I�-,II Date i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax z INSPECTION NOTICE Inspection Type: -31qq0 Job Address: SSSS L tom{ �-. PA/U l�W_Z # ,::f J o Permit Number: 201 g01 Z � 5- ❑ No one available for inspection: Time % / " -C' A PM Re -Inspection required: Yes (S' When corrections have been made, call for re -inspection at 303 -234 - Date: Inspector: Al1e," Act;/ DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE _:�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 3 62 9 3 % O �, Lr>/� 5� <��✓ Job Address: riihP.-C h Permit Number: ';1 oleo / P-3 ❑ No one available for inspection: Time i t -7 l 1 AM/PM Re -Inspection required: Yes /� No r When corrections have been made, cell for re -inspection at 303-234-/V —hl 5933 Date: -0/ �1 / ' Inspector: r DO NOT REMOVE THIS NOTICE 1! i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: ef0,014 P911) �/O Permit Number:O%0©115�3S ❑ No one available for inspection Time Re -Inspection required: Yes 602 _. When corrections have been made, call for re -inspection at 303-234-5933 Date: 5SOff Inspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge Comm. Tenant Finish PERMIT - 201801235 PERMIT NO: 201801235 ISSUED: 05/10/2018 JOB ADDRESS: 3555 Lutheran PKWY #210 EXPIRES: 05/10/2019 JOB DESCRIPTION: Commercial tenant finish for new entryway and new station and X -Ray area. Cap off (2) restrooms and convert to X -Ray area. Cap off exhaust fans. Provide power for Nexray equipment. *** CONTACTS *** OWNER (303)422-9500 LILLIBRIDGE GC (720)583-1679 Bruce Carpenter 160250 B C Builders, Inc. SUB (720)612-4522 Phillip A. Strait 018645 Strait Plumbing, Inc. SUB Crisman 019339 Crisman Electric, Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned SUBDIVISION CODE: 1 / Commr Vacant USE: UA / Unassigned BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 34,950.00 FEES Total Valuation 0.00 Plan Review Fee 362.08 Use Tax 733.95 Permit Fee 557.05 ** TOTAL ** 1,653.08 *** COMMENTS *** *** CONDITIONS *** Approved per plans and red -line notes on plans. Must comply with 2012 IBC, 2014 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections. v City of Wheat Ridge 4 Comm. Tenant Finish PERMIT - 201801235 PERMIT NO: 201801235 ISSUED: JOB ADDRESS: 3555 Lutheran PKWY #210 EXPIRES: JOB DESCRIPTION: Commercial tenant finish for new entryway and new Cap off (2) restrooms and convert to X -Ray area. Provide power for Nexray equipment. 05/10/2018 05/10/2019 station and X -Ray area. Cap off exhaust fans. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am legally 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. 30 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 originalpermit tee. 3. If this permit expires, a new permit may be required to be obtained. issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5, The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any ordininie 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. C ity Cif' W hCG at Building & Inspection Services Division HAY 0 1 2018 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 - --- Email: perm its(a-)ci.wheatridge.co.us FOR OFFICE USE ONLY Date: C -5-1d /1/0 Plan/Permit # Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 3 S S 5� U -ii- EkAt— QA RrySIA �f S u TC -2%0 Property Owner (please print): L�T 1, t,,,'T t -SR \ IJ Gti Phone: C 3> Li -z Property Owner Email: R0 Q G c R . S^tj Lo /A L Q W U- i300 %%Z� CC' . Com Tenant (Commercial Projects Only) JA [JL h6 t knLy aA (u Eagg A vN\-AUyk,L-i_ Property Owner Mailing Address: (if different than property address) Address: 3535 5 L, u) tt T: RAvj N KwA)c SoITI& I? D City, State, Zip: )rL1 Ntq T Zia 6-E- C.O 8'b© 3 3 Architect/Engineer: -TNC iZ T O CnR Ov j_ L. T b Architect/Engineer E-mail: -fq L%',' e i tta % 'Tp 69ou i'. CalnPhone: 363 Contractor: j� C.) i t, R S j1'N.L, City of Wheat Ridge License #: 1 (o 6-1 SO Phone: 16 -1'110 4� ?a-% (0�5 Contractor E-mail Address: t3Ruc_E . CAR�,C Q Cbwr\.CASi � NZT" For Plan Review Questions & Comments (please print): CONTACT NAME (please print): T�FZyCE CAZw i Ek Phone:_}�'� qVK -2-J\S CONTACT EMAIL(p/ease print): RQt.E CARPf, r►v l &L C�) Lo V+1_C}4S1. /vl Sub Contractors (Must provide Wheat Ridge License No.): Electrical: Plumbing: G/ n Mechanical: W.R. City License # W.R. City License # o/ O W.R. City License # cAkS. ► A r\„ F(IC M tC. ST f't+i 1��,v (3t� Cs. yy R1}-, Other City Licensed Sub: Other City Licensed Sub: City License # City License # 0i 6� 53q COMMERCIAL ❑ RESIDENTIAL Description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. %,Noi\ t2 0-0Wolkr To G -n -L I v-(, LST &T z o v1- A v, J�, X, kA ',t A (Z FA C'R 's e2iLoow.,S c o ' J "c'- T6 YKttiiv Ah SA Ca.A a c F £X hA,,,c? FAVS. PRovtoEE Pow to ro't ti�,w X kNsy Commercial Projects Only: Occupancy Type: Construction Type: i t AJ D ' Sq. FULF 'fl 12' BTUs Amps Squares Gallons Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ 3y, 4So- OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT 1 hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, casements or restrictions of record; that all measurements shown and allegations made are accurate; that 1 have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. 1, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLEONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): Xll.A._ Q. DATE: Printed Name: rJ QV C F, 1, CA IZf?G, AJT t o DEPARTMENT USE ONLY ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: RevieWx A,A.)� S) I PUBLIC WORKS COMMENTS: Reviewer: OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: City of WV h s at cconmomUNITY '� SUB -CONTRACTOR ACT O AUTHORIZATION. ''ORATION. FOR. This farm must he signed by each scab -contractor. SuhcontractoFs City of Wheat Ridge License number must be provided in the applicable space. 17his farm will not be acecpte d with missing information. Project Address: General Contractor:'L QtL 71,A_(_ I � 01 is C, Electrical , Electrical Sub -Contractor CompanyName: t 4 Phone #. State License #; 'Master #: `7f'� 4 heat ase #f: C; t j°eq€si"d field A//B .. t;n�-alurc c Authorized Agent Date I Plumbing Sub -Contractor t: nMpanY Name: S TtT �� State License # easter #; Wheat Riche License� , �-c.�i eeia c� f$er lei j Signature of Authorized agent Date ?Mechanical Contractor CompanyName: Phone: Wheat RidgeLicense-,#- (requ ired field) ) Signature of Authorized :agent Date REPORT ON THE RENOVATION SPECIFIC INSPECTION OF SUSPECT ASBESTOS CONTAINING MATERIALS AT: 3555 Lutheran Parkway Suite 210 Denver, CO 80033 PREPARED FOR: Mr. Bruce Carpenter BC Builders, Inc. 6595 W. 14th Avenue Suite 201 Lakewood, CO 80214 May 2018 Benesch Project # 00151723.00 qW' bW&ftnW-v%sch EXECUTIVE SUMMARY Benesch representative and State of Colorado Certified Asbestos Building Inspector Mr. Benjamin Tuthill was onsite May 7, 2018. Mr. Tuthill performed a renovation specific inspection of suspect asbestos containing materials (ACM) in Suite 210, 3555 Lutheran Parkway, Wheat Ridge, CO. Benesch collected 24 samples. The samples were delivered to an independent, accredited, third party laboratory for analysis by Polarized Light Microscopy (PLM). The following materials were determined to contain greater than 1% asbestos by PLM analysis and are ACMs per the EPA: • Asbestos was not detected in any of the samples The following materials were assumed to contain asbestos because they were inaccessible at the time of the inspection: None of the homogenous materials in the designated areas were assumed to contain asbestos. The following materials contain trace amounts of asbestos (1% or less): ➢ None of the sampled were determined to contain trace amounts of asbestos. Further details regarding the inspection, material types, laboratory results and recommendations, are provided in the following report. The purpose of this document is to identify asbestos containing materials within the facility. This document should be utilized as a means of identifying suspect asbestos containing materials within the building however, this asbestos building inspection report does not meet the requirements of a project design as described in Section III C Project Design of Colorado Department of Public Health and Environment (CDPHE) Regulation 8 Part B Asbestos. This document is not intended to be utilized for the purposes of an asbestos abatement scope of work or project design document and should not be utilized as such. TABLE OF CONTENTS 1. BUILDING 2. DETAILED BUILDING DESCRIPTION 3. NAME AND ADDRESS OF CONSULTANT PERFORMING THE INSPECTION 4. DATE(S) OF INSPECTION 5. SAMPLING STRATEGY 6. IDENTIFICATION OF HOMOGENEOUS MATERIALS 7. NAME AND SIGNATURE OF PERSONS PERFORMING SAMPLING 8. TYPES OF ANALYSIS PERFORMED 9. NAME AND ADDRESS OF LABORATORY PERFORMING ANALYSIS 10. RESULTS 11. PHYSICAL ASSESSMENT OF ASBESTOS CONTAINING MATERIALS 12. DISCUSSION 13. EXCLUSIONS AND EXEMPTIONS TABLE #1 ASBESTOS BULK SAMPLING SUMMARY DRAWINGS HOMOGENOUS MATERIAL LOCATIONS BULK SAMPLE LOCATIONS ATTACHMENTS ATTACHMENT #1 GRID FOR DETERMINING RANDOM SAMPLE LOCATIONS AND RANDOM NUMBER DIAGRAMS ATTACHMENT 42 CONSULTANT CERTIFICATIONS ATTACHMENT #3 LABORATORY RESULTS AND ACCREDITATIONS REPORT ON THE RENOVATION SPECIFIC INSPECTION OF SUSPECT ASBESTOS CONTAINING MATERIALS 1. BUILDING Suite 210 3555 Lutheran Parkway Wheat Ridge, CO 2. DETAILED BUILDING DESCRIPTION The building is part of the Lutheran Hospital Complex. It is a multi -storied commercial office building housing different medical clinics and laboratories. The inspection was limited to Suite 210. Finishes in that suite include drywall, surfacing materials/textures, ceiling tiles, vinyl flooring, baseboard and vinyl wall covering. The suite is currently vacant. 3. NAME AND ADDRESS OF CONSULTANT PERFORMING THE INSPECTION Alfred Benesch & Company 7979 East Tufts Avenue, Suite 800 Denver, CO 80237 4. DATE(S) OF INSPECTION Asbestos bulk samples were collected on May 7 2018. 5. SAMPLING STRATEGY Benesch performed a renovation specific inspection of suspect asbestos containing materials (ACM) in Suite 210, 3555 Lutheran Parkway, Wheat Ridge, CO. Samples were collected of materials that would be disturbed during the planned renovation activities as shown on The RTO Group, LTD drawings dated 5/22/18. Benesch performed the renovation specific inspection in general accordance with the guidelines of the Environmental Protection Agency (EPA), National Emissions Standards for Hazardous Air Pollutants (NESHAPS), 40 CFR 763 Subpart E - Asbestos Hazard Emergency Response Act (AHERA), the Occupational Safety and Health Administration (OSHA) 1926.110 1, and Colorado Department of Health and Environment (CDPHE) Regulation No. 8, Part B. Prior to collecting samples, the Benesch representative who is an EPA accredited and State of Colorado certified Asbestos Building Inspectors performed a pre -inspection walk-through of the spaces. Homogeneous materials and areas were identified. Per 40 CFR 763.86, samples of these materials were collected in a statistically random manner throughout the space. A random sampling grid and corresponding random number diagrams, utilized in the determination of the sample locations, have been attached at the end of this report. Reference Attachment #1 for Grid for Determining Random Sample Locations and Random Number Diagrams 6. IDENTIFICATION OF HOMOGENEOUS MATERIALS The following homogeneous materials were identified during the performance of the construction specific inspection: • Sink Undercoating — Grey/green sink undercoating on bottoms of metal sinks - (UCO1) • Adhesive — White adhesive associated with vinyl finish on wood composite countertops and millwork — (ADO 1) • Wall Covering — Grey vinyl wall covering with "striped" pattern and associated adhesive 2 • Floor Finish — Vinyl floor finish with "wood plank" pattern and associated adhesive - (FLRO 1) • Surfacing Material —Skim coat texture located behind WCO1 - (SMO1) • Surfacing Material — "knock down texture" present on CDW01 in Main Lobby - (SM02) • Drywall System —White drywall with associated joint compound and tape - (CDWO1) • Baseboard Adhesive —Adhesive associated with black vinyl baseboard - (BBA01) A total of 24 samples of suspect ACM were collected from these homogeneous materials. Reference Table #1 for Asbestos Bulk Sampling Summary Reference Drawings for Locations of Bulk Samples 7. NAME AND SIGNATURE OF PERSON(S) PERFORMING SAMPLING The EPA accredited and State of Colorado certified Building Inspector(s), identified below, performed the visual and tactile inspection of suspect asbestos containing building materials (ACM). Name Benjamin Tuthill Project Scientist III Signature Reference Attachment 42 for Consultant Certifications 4 8. TYPES OF ANALYSIS PERFORMED Asbestos bulk samples were submitted for analysis by Polarized Light Microscopy (PLM) in accordance with EPA -600/R-93/116, July 1993. 9. NAME AND ADDRESS OF LABORATORY PERFORMING ANALYSIS DCM Science Laboratory, Inc. 12421 W. 49th Avenue, Unit #6 Wheat Ridge, CO 80033 Reference Attachment #3 for Laboratory Results and Accreditations 10. RESULTS 10.1 Homogeneous Materials of Known ACM: The EPA has determined that any substance containing greater than 1% asbestos is considered an Asbestos Containing Building Material (ACM). The laboratory results show the following materials contain greater than I% asbestos and are ACM: • Asbestos was not detected in any of the samples. 10.2 Homogeneous Materials Assumed to be ACM: None of the homogenous materials in the designated areas were assumed to contain asbestos. 10.3 Homogeneous Materials Containing Trace (less than 1%) Amounts of Asbestos ➢ None of the sampled were determined to contain trace amounts of asbestos. 10.4 Homogeneous Materials where Asbestos was not detected: Asbestos was not detected in any of the following materials: o Sink Undercoating — Grey/green sink undercoating on bottoms of metal sinks - (UCO1) o Adhesive — White adhesive associated with vinyl finish on wood composite countertops and millwork - (ADO1) o Floor Finish — Vinyl floor finish with "wood plank" pattern and associated adhesive — (FLRO 1) o Wall Covering — Grey vinyl wall covering with "striped" pattern and associated adhesive — (WCO1) 0 Surfacing Material — Skim coat texture located behind WCO1 — (SMO 1) o Surfacing Material — "knock down texture" present on CDWOI in Main Lobby — (SM02) o Drywall System — White drywall with associated joint compound and tape - (CDWO 1) o Baseboard Adhesive — Adhesive associated with black vinyl baseboard - (BBAO 1) 11. PHYSICAL ASSESSMENT OF ASBESTOS CONTAINING MATERIALS AHERA specifies that the Building Inspector is to conduct a physical assessment of all known friable and assumed ACM as well as all known friable and assumed thermal system insulation (TSI). The physical assessment consists of assessing the condition of the material as well as the potential for future disturbance. Three (3) values are utilized when assessing the condition of an ACM: 1) Significantly Damaged 2) Damaged 3) Good A material is considered Significantly Damaged if at least one tenth or greater (or one quarter if localized) of the surface is crumbling, blistered, water -stained, gouged, marred or otherwise abraded. A material is considered Damaged if less than one tenth (or one quarter if localized) of the surface is crumbling, blistered, water -stained, gouged, marred or otherwise abraded. • A material is considered Good if there is little or no visible damage or deterioration. Determining the potential for future disturbance of a material is based on three factors: 1) Potential for Contact with the Material 2) Potential for Influence of Vibration 3) Potential for Air Erosion Following the assessment, the ACBM is placed into one (l) of seven (7) categories of condition and potential disturbance as shown in the table below: 0 12. DISCUSSION Asbestos was not detected in any of the samples collected. Planned renovations may be performed as general construction in accordance with all applicable requirements. 13. INSPECTION REPORT, EXCLUSION STATEMENTS & ASSUMPTIONS This report was prepared by Benesch at the request of, and for the sole benefit and use of Mr. Bruce Carpenter of BC Builders, Inc. (Client), subject to the limitations described in the report and in the agreement between Benesch and the Client. This report is intended for the exclusive use and reliance of the Client (and their assignees, if any) in the inspection and identification of asbestos containing materials associated with the building. Any use or reliance of this report by other parties is prohibited without the express written consent of the User and Benesch. This report is complete only as an entire document and no section is intended to be used separately. Any unauthorized use a third party makes of this report, or any reliance on or decision made on the basis of it, is the responsibility of such third party. The Client and Benesch are indemnified against any liability resulting from such third party use, reliance or decisions. CURRENT POTENTIAL FOR ASSESSMENT MATERIAL CONDITION DAMAGE (Low, VALUE (Surfacing, TSI or (Damaged, Moderate High Miscellaneous) Significantly Damaged Potential) or Good) Damaged or 1 TSI Significantly Damaged --- 2 Surfacing Damaged --- 3 Surfacing Significantly Damaged --- 4 Miscellaneous Damaged or --- Significantly Damaged TSI Moderate Potential 5 Surfacing Good for Damage Miscellaneous TSI Potential for 6 Surfacing Good Significant Damage Miscellaneous TSI Low Potential for 7 Surfacing Good Damage Miscellaneous 12. DISCUSSION Asbestos was not detected in any of the samples collected. Planned renovations may be performed as general construction in accordance with all applicable requirements. 13. INSPECTION REPORT, EXCLUSION STATEMENTS & ASSUMPTIONS This report was prepared by Benesch at the request of, and for the sole benefit and use of Mr. Bruce Carpenter of BC Builders, Inc. (Client), subject to the limitations described in the report and in the agreement between Benesch and the Client. This report is intended for the exclusive use and reliance of the Client (and their assignees, if any) in the inspection and identification of asbestos containing materials associated with the building. Any use or reliance of this report by other parties is prohibited without the express written consent of the User and Benesch. This report is complete only as an entire document and no section is intended to be used separately. Any unauthorized use a third party makes of this report, or any reliance on or decision made on the basis of it, is the responsibility of such third party. The Client and Benesch are indemnified against any liability resulting from such third party use, reliance or decisions. The purpose of this document is to identify asbestos containing materials present in the facility. This document should be utilized as a means of identifying suspect asbestos containing materials within the building however, this asbestos building inspection report does not meet the requirements of a project design as described in Section III C Project Design of Colorado Department of Public Health and Environment (CDPHE) Regulation 8 Part B Asbestos. 'This document is not intended be utilized for the purposes of all asbestos abatement scope of work or project design document and should not be utilized as such. Benesch represents that the services are performed (within the limits of the Scope of Work identified in the proposal), with the usual thoroughness and competence of the profession. No other warranty or representations, expressed or implied, is either included or intended in the report. TABLE #1 ASBESTOS BULK SAMPLING SUMMARY r w� U� z z z z z Awa z any w zap o �~ a A oar w� H a � Ln En � Ln �-+ � o o o izuo 3 3 3 as m ao P-4 E-4 m cu U Q Q C) Q Q Q ci a o 0 0 0 0 0 aw �z N N N N N N F 9Q� a u z F O O � A � W � z z � Q F CD o O Lr) M a E co cz F'Ez EZ'o, Ez>,c� > >,� > >,� > rs, o o a� o U >> � -v C7 >, 0 •b C7 >> 0 -o C7 A 'En 0.0UP Z a o m cno cd o W�o 3 L 3 3 3 o b o � o p O id 0 O 0 0 0Ln O O Cd cd co W z O ajo tw c aN �o c En cn W O O O N N N N N N N i rel MM W � N at - s a kn kn M 0 N a� a W v U z z z z z z w 04 U zoo A owe F N j O 1 1 N 1 1 A � � oCD oC> � oCD ., q -ow �--°ow �-�ou" 2 51 ���5 -c� o M 0 o 5t8 m i o cd a H c W W 00 Ln V] N N N N N N H� dw� U xa z z z z z z a, A w� z z z z zz 411 o o ; D a O 3 07 ccz y ai ,�,�;����,�,�;�vo y ul •o �n o cn -d �i o V) -o b C4�° b °n .° �° = cz 5 0 o' 33 Q 3 3 Q 3 3zz Qcz z m cd wz O b to bo to U Q Q Q Q Q Q a cn cn En Cl) 3 3 3 ¢ ¢ ¢ N N N N N N BULK SAMPLE LABELING & ACRONYMS Sample numbers are determined as follows: 21.0-UC01-01 210 — Suite 210 UC = Homogenous Material type (sink undercoating, surfacing material, drywall, carpet adhesive etc.) 01 = Consecutive Homogeneous Material # (i.e. the first type of sink undercoating) -01 = Consecutive Sample Number UC — Sink Under Coating AD — Adhesive FLR — Floor Finish WC — Wall Covering SM — Surfacing Material CDW — Drywall system — drywall, joint compound and tape BBA — Base Board Adhesive As part of the material description, each material has a code in parentheses such as (MM, NF, G). This code indicates the category of the material, friability and condition. The acronyms are as follows: MM — Miscellaneous Material SM — Surfacing Material TSI — Thermal System Insulation F — Friable NF — Non -Friable G — Good Condition D — Damaged Condition SD — Severely Damaged Condition The quantity of the materials is measured in square feet (fF) or linear feet Laboratory analysis of the samples determine whether the asbestos is greater than 1%. Sampled materials fall into one of the following categories: ❖ ND — Asbestos was Not Detected ❖ YES — The material contains greater than 1% asbestos by PLM analysis ❖ NO — The material does not contain greater than 1% asbestos, the material contains trace amounts of asbestos (1% or less) by PLM analysis ❖ Trace —Material was determined to be less than 1% asbestos and was point counted ❖ Not Analyzed — Progressive - Sample not analyzed due to progressive analysis on the material set. The laboratory was instructed to stop analyses on that material set if asbestos was detected Physical Assessment — The physical assessment value is a numerical value 1-7 assigned to each material based on the criteria presented in Section 10.0 Physical Assessment. If the material contains greater than 1 % asbestos and is an ACM, a value is assigned based on the table. If asbestos was not detected in the material (ND) the material was not assessed (NA) per AHERA. HOMOGENOUS MATERIAL LOCATIONS i i c� li 1 , r_ v - i } 1.i a Y L IN 711 4j all JAI .t -- - - - - 0 W _ <w _ -F C( Cz NFA i0i .Fz < m Z FC° C O (z Di U aFm � mp OO i< C>< CWz �iady O� V y C wr�apf L ON Vz KN ;w �-'IL VB (► •� 00 O Nm i>z uCOd J1� �� < O t LYi� ,�� NZ dW z �> fo ® WON < COi O N< � m� m0 a� m �� C N�Zi Z1 ti °ifO < Zn jZ N wNW V1 W < fd uz� (F�1 p i C 00 ; zw N ° WF C < �F 0a W W❑❑ Oi z-z�<i>( u1 O p W °- O z mm<i (mi >�i°°° >rc iw rc oN�� O of owc o�z � o 'INonir< ods op o 0 0 op�C; o� o< o ow oa a W O F wz ypN WJ� u,<° u WwCV 1 R Wwm Zw w w .�iumWJ �z ZW wiN w0 �m 1- OOCi CA O O? O�w °ia utas ° Cai, a UP °Rw °m C d U ''1 O O LU O6 ,I1 V N tZ U P O f n an < Fi x Ma I a m� p F OK <wZ Z OWZ 0 O V Z Ni W e W W F x <w >- i0 z< K� NI< iOz 'ti SLL N6 w z LLittD K z0 <i Di Om me pI =< y J pp ENLLw ;I d00< O iF Ui KN �L d='J Z4WQ ijJ pLLY.W pZ » N p O tiJNJ ; Z �F <� Jlf�; NF Tz NO FWO� i Wz4 OOf pa f> ?� Y z p d IdJNK w ?p QI w< UZ tt�� i �_F OOwx zY w p mhV� p XN m Vd az ii 4K iO4N i << Z �pz Na w< i < azNO d a2 <p OL Wmy m0 zN m mK K LLgpz� LLd ai - g O�fO J i0 �� �zp F <� <LL WZF a� 0 O d,wK NZOOw O WW < N pN V; Ox uW< wiw; J Oi Ow ry}<<N'm Z Nj Nf W>d NOd� 002 Za�orcx Od' -� m O Qa ZLL �'d a z mf mzt NpUW mJw� i >Oi� WiOp�' �Z O� OwF OJz OJ�w O Odp4 OVIdc OdG 00 O w O O OpF�; OF O� Ow Od Oz W F fx app aJm FJgwp E awrc� Erci�i Fws aJ a � f sJW az zd � IN Ip zm F na o�w oi° oiH o Wd�<IJ o� , oaw om rc a u rc omw�i od Ow om v< oQ O a I p Ll N M N q c Y 4 ry i z w z K aim OLr0 < Z WON 0KOI pNJ F JimJ �=wm ONwd O OOKi LWod h W < 3 .§ C/D Em I < m , ( I �f _ �■� ) Ia j � | |e)� | § \| Olt §§ § BULK SAMPLE LOCATIONS �n 0 00 ra ^ u O m w a O F a'( a'z NFj .. aZ< < l Z ZKO a' ZO lZ Di IU �Fm Ni Y �m or_„; zNF w0 y(j� WZ O O w Yi«u < �; mz Cw O UOC <IOi i <> JY Y O a i��aO >I uZ <d ® WON Wm �w m0 �C'^m u Izm WZ_pN iz m� O C W Z <z�0 i LLC <C is iu ( COI N mY mC aW m��aYa'' � zC [;ii zd ua ; o z ; p�10 Qv 'a <Fydjo t Yd0 N�OOF ; 2w j d O ON da W VZHJ O d� d< UW< NI N ZW; J Ozyaj ><<NN �Z .Z _ Z Z <ZCmU Z mE mid NO; m<Cz ; �i(OOC 'm m a w w LJW i0 0 I< uW L� Z �JO Z Uw Uw i0;� i iz ; > O > ;_ C U >� u R� >>Nwa Zpm ZjC Eat! iv IIV ZOj w w E F�N�� iz ti Ian w0 wo W OOKi J -a-Z Oyu at. uO LOZ O K�i� at! Odu Om C J Y Omw�� S OwC Oz am C< BJ Q aOC UJ W p v n < ATTACHMENT #1 GRID FOR DETERMINING RANDOM SAMPLE LOCATIONS AND RANDOM NUMBER DIAGRAMS 132' 60' 12' 60' 0 i'J►''�?i'I�f: ' i Sampling Sampling Sampling Sampling Sampling Sampling Area Locations Area Locations Area Locations 1 2 3 4 9 8 1 5 8 1 8 5 2 2 7 6 7 4 3 6 13 3 6 9 5 3 4 2 7 9 7 1 4 8 7 1 5 7 1 1 4 1 6 3 9 5 8 6 3 4 14 3 9 7 4 2 6 .. 2 8 9 8 5 2 4 1 1 7 3 6 4 3 5 1 6 2 9 6 9 9 2 7 15 9 2 $ 8 5 3 5 8 1 7- 4 1 6 1 8 5 7 3 4 8 1 3 5 9 3 10 8 1 6 16 2 5 9 2 7 4 2 g 4 7 1 6 6 4 3 5, 1 1 6 8 2 7 1 5 8 11 3 4 9 17 4 5 3 9 2 7 7 tE�2 1 9 6 7 4 3 7 1 9 6 1 5 12 2 4 5 2 9 8 6 $ 3 18 !w0i ATTACHMENT #2 CONSULTANT CERTIFICATIONS f to) 4 Q ' . cxi c,1 IDN,U N > CD U o to 4-' j sem+ N 0) La Q � � c CL X LU V u-. L, 06 C!!1 s.. o 3 � � ©yam (o 3 LLO U Z corn ,m U W � N O Q � U � Q O /--, Z C� CID N V z z � O U I-� (�U N b0 �h z (a E 'c o LLJ >V N LO r N c6 v O 9) v 00 C", LL' G7 V N c 'c O V U x c N N v v U U v w v � LF o o 06 N C N °' 4-1 z O c '7— -<� Q full L� U W � O z � U � Q O v U Z O N V z W I-� (�U N b0 �h z U c E 'c o LLJ bio � O N LO r v O 9) v 00 C", LL' G7 V 1103 1%4103 W O z 4V�O W Q vi v U Z O ,. rn L CL W I-� �j 2 �QU � O U c E 'c o co v 00 C", LL' G7 V N c 'c U NO c N N v U U v 06 W W Q vi M Z O ,. rn n W I-� W U � •-i v LL' G7 J c 'c 7� c v v ATTACHMENT #3 LABORATORY RESULTS AND ACCREDITATIONS 0 0 0 0 0 0 Cl 0 0 0 0 0 0 0 0 0 0 0 000 000 000 000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 10 10 o 0 0 0 0 0 0 0 0 0 0 Cl 00 00 00 0 0 t 221- 221- o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 v v v 0 0 0 0 0 0 0 0 0 0 0 0 12 1z 12 12 12 9 9 z z°R QZQ Qz° R 9 9 e v o D o e o 0 0 o e o 0 0 0 000 000 000 ono �n 0 o c; M 16 O 0� V li O N t-� 0 0 o (3+ N n of Ol O a 0 �a 0 v 0 w A z W a w 0 A 0 00 't CD O W U AQ �w U O 00 W Q o 7 zNo w U w U W o a ¢AZ QAO �A Uva W W w� °off �°off �°off O a3U 0 0 0 0 0 0 Cl 0 0 0 0 0 0 0 0 0 0 0 000 000 000 000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 10 10 o 0 0 0 0 0 0 0 0 0 0 Cl 00 00 00 0 0 t 221- 221- o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 v v v 0 0 0 0 0 0 0 0 0 0 0 0 12 1z 12 12 12 9 9 z z°R QZQ Qz° R 9 9 e v o D o e o 0 0 o e o 0 0 0 000 000 000 ono �n 0 o c; M 16 O 0� V li O N t-� 0 0 o (3+ N n of Ol oo 00 00 00 00 00 00 W 0 0 0 a 0 F V) W w 0 A CD w AQ �w U O a 7 U W w U U Z W o a ¢AZ QAO ¢AO vE"i 0 W W W °off �°off �°off O a3U w zx 7 w 94 w94 wzx wzx ara ¢aim ¢ai�i ¢cuci ¢aic� oo 00 00 00 00 00 00 0 0 0 0 0 0 CD AQ a 7 A Q d w o a o o a o 0 N N N N N N N 04 7 Mx 0 0 0 0 0 0 0 0 0 0 0 O o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 Wn 0 000 000 00 000 000 00a,0 O O O O O O O w O O 00 O O o0 O O O, 0 0 00 Cl 0 0 0 0 0 0 Cr, 0 0 O O H o 000 000 00 666 o00 0000 12 Iz 19 12 a i 000 000 00 000 000 0000 �n o O o 0 0 0 o o 0 0 Cl Cl O --� � N M o M� O M O M O (V M In O O O O O CID W W W O F d a Fw- d H d H n O uH 3�H 3UH X33 d fY1 U d GLl U Q fY7 d pa U d QY U d W u Q o0 00 w oo vi v� v'� vi vi vi 00 O 0 O w N M U W Q 0 w a w � Q o 00 U x�N O w w U w rn 3 R Q U V) 0 �i V) a w 0 0 0 a Q 0 0 0 0 0 0 0 0 0 0 0 O o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 Wn 0 000 000 00 000 000 00a,0 O O O O O O O w O O 00 O O o0 O O O, 0 0 00 Cl 0 0 0 0 0 0 Cr, 0 0 O O H o 000 000 00 666 o00 0000 12 Iz 19 12 a i 000 000 00 000 000 0000 �n o O o 0 0 0 o o 0 0 Cl Cl O --� � N M o M� O M O M O (V M In O O O O O CID W W W O F d a Fw- d H d H n O uH 3�H 3UH X33 d fY1 U d GLl U Q fY7 d pa U d QY U d W u Q o0 00 w oo vi v� v'� vi vi vi 00 O 0� O O N M 0 0 0 0 w w 3 3 3 V) 0 0 0 0 0 0 N N N N N N O M N O OO O o O O O O 0 0 O O O O O Cl O O O O O 0000 g0000 00000 00000 00� 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Cl 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 o rn x 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 rn x 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 o g o 0 0 o g --0 0 0 o g 0 0 0 z Iz Iz Iz Iz zzzz zzzzz zzzzz zz°zzz zzz 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1=1 0 0 0 0 --� N M 'IT N 10 N Q, V1 r- O M M O V1 N O O 1/1 ,n O F z N N a W Q W a W z ¢ 0 00 sr 0 O UW a Q Q a rx w w O O O H W m � U xwww�Q w rn z owzW F SwF" U¢ F F- < a a x x F a„W�w w 04 O v o z 3c�F3 3 3c�F X30 a dmUC] W oo ri v QmULIw 00 A dmUC] W 00 JA Qm 00 ri JA 0 w .. F oz0 W a U CIO (A W a Ow C4 F Wz C)0 w a m H � O F C4 W OFmv� Q Q N oo 00 00 00 0 m ° „ U w 0 ,A v n o m m W F z 0 a [W -dwQWO F U o z H o M W `a F w Ca C7 ¢ m O z Q o F F W } oO� F P� a0a'P�zva W � W mF 1 ¢ c3: w0 z Wa�cWy�LOv U '04 Q > d m a d ae a zo z w Ln Cl) R W V. ° O O U W d F z w U W a O OO O o O O O O 0 0 O O O O O Cl O O O O O 0000 g0000 00000 00000 00� 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Cl 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 o rn x 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 rn x 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 o g o 0 0 o g --0 0 0 o g 0 0 0 z Iz Iz Iz Iz zzzz zzzzz zzzzz zz°zzz zzz 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1=1 0 0 0 0 --� N M 'IT N 10 N Q, V1 r- O M M O V1 N O O 1/1 ,n O F z N N U W Q W a W z ¢ 0 00 sr 0 O UW a Q Q a O� 3 H w O a Q w w O O O H W m � U xwww�Q w rn z W L4 QQ SwF" U¢ F F- < a a x x F a„W�w w x v o z O OO O o O O O O 0 0 O O O O O Cl O O O O O 0000 g0000 00000 00000 00� 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Cl 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 o rn x 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 rn x 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 o g o 0 0 o g --0 0 0 o g 0 0 0 z Iz Iz Iz Iz zzzz zzzzz zzzzz zz°zzz zzz 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1=1 0 0 0 0 --� N M 'IT N 10 N Q, V1 r- O M M O V1 N O O 1/1 ,n Q F z N N 0 0 0 a Q Q a O� 3 H w O a Q 3 O F Fa., n A O Fxj O O H W a¢ as aGp;ww xwww�Q wF"��w wvwF"� SwF" U¢ F F- < a a x x Wa x x x Q x ¢ x x x ¢a x mU33 U333F 3c�F3 3 3c�F X30 dmUCa 00 dmUC] W oo ri v QmULIw 00 A dmUC] W 00 JA Qm 00 ri JA 10 t N N N 0 0 0 0 0 N N N N N F O u W W C? a w oz z0 U oz o ��D O w F w � � � U a F 0 w OF W v, 00 00 00 ,�. .�- 0 � � O o l� 00 n U W w F z x � w w v W F F F d w O wu QOQpa�p c„F°Fay W w� oO z vW F a a, U drxrxUa.G1 5 W r'' O O U W d F z w U W f1. 0 0 0 0 0 0 0 0 0 0 Cl 0 0 0 0 0 0 0 0 o0 0 o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O O o 0 2222 o O o o 2222 0 0 0 0 0 0 0 0 0 0 Cl 0 0 0 0 0 0 0 0 0 0 0 O o O a1 0 0 0 0; O CJ o T oO 0 0 0 0 0 0 02 rn 20 01 oo rn 200 000 0 0 0 0 0 0 Cl 0 0 0 0 0 0 0 Cl 0 0 0 0 0 0 0 0 0 0 d o 0 0 0 0 0 0 0 0 O o O O 22@2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 0 0 0 0 0 0 0 0 0> o 0 o v o 0 0 0 0 0 0 0 0 Cl Cl Cl 0 Cl o v, Cl 0 0 Cl 0 0 0 N O N 'D (V o� m O O vi 7 vi vj 0 0 vi V l- -+ N 10 - M N N n 0 0 A3F F W F w Q w a w Hx�Q Q " Qoa.3� O U W n .0 z F O � � U �QQx 3FF3 �Wx a, zww a o Q N Ln a w <muC) oo d a u oo um o Q 0 0 0 0 0 0 0 0 0 0 Cl 0 0 0 0 0 0 0 0 o0 0 o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O O o 0 2222 o O o o 2222 0 0 0 0 0 0 0 0 0 0 Cl 0 0 0 0 0 0 0 0 0 0 0 O o O a1 0 0 0 0; O CJ o T oO 0 0 0 0 0 0 02 rn 20 01 oo rn 200 000 0 0 0 0 0 0 Cl 0 0 0 0 0 0 0 Cl 0 0 0 0 0 0 0 0 0 0 d o 0 0 0 0 0 0 0 0 O o O O 22@2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 0 0 0 0 0 0 0 0 0> o 0 o v o 0 0 0 0 0 0 0 0 Cl Cl Cl 0 Cl o v, Cl 0 0 Cl 0 0 0 N O N 'D (V o� m O O vi 7 vi vj 0 0 vi V l- -+ N 10 - M N N n 0 0 A3F N M W F Hx�Q Q xx2Q Qzxz�A Qoa.3� aa.^zyF3 xQ¢x 3FF3 �QQx 3FF3 x¢xx 3F33 xx`�¢ 33�F x¢a 3F� N N <muC) oo d a u oo um o m z oo oo O N M U U U W W N N N N N x of x o x x x N M N N N N § t ®R /o§ <e /§/\ --- /\i\ E@2 \ co\\ �g \\ j ° \ \§ =oo { )( ) d\ o ) � )co \\ 0\\ r�- \\\ 2}/ 2728== J k 2 (\&22/ \ \\ \I \\(\tj Q \± °\ \/\�%\ jm M( )i)\/] j ® �Q )� ))\d§\ 2 ¥( 2ww \\/ / / u \ I \ / § )e} \zg y a\/ A k&d 2m \\ \\c \/\ § #\A d\2 \ A m ( Gn §E, G /&2 ~ § t ®R 'a' DCM .S -C- I -E - N - C - E 1ABon-VI-Ony, mac. 12421 W. 49th Avenue, Unit #6 Wheat Ridge, CO 80033 DCM Project No.: BE -CO B54 Client Job No.: Page f of BULK SAMPLE ANALYSIS PROCEDURES- DCM Science Laboratory, Inc, analyzes bulk asbestos samples following procedures developed by the McCrone Research Institute and in compliance with guidelines established by the Environmental Protection Agency (EPA -6041M4-82-020. 1982 and EPA -600/8-931116, July, 1993). Bulk samples are prepared for analysis using a 1OX-80X stereo microscope in a hepa filter hood which provides a contamination -free environment. The sample is then analyzed by polarized light microscopy (PLM) at 100X. When the sample consists of more than one layer, each layer is prepared and analyzed separately, Fiber and matrix materials are identified by the characterization of optical properties including color and pleochroism, form, cleavage, relief, birefringence, extinction, orientation, twinning, interference figure and other distinguishing features. Dispersion staining is also used to further aid in mineral identification. All percentages of asbestos, other fibers and non-fibrous constituents are calculated from the values obtained from analyses using the stereo and PLM microscopes, In-house and NIST standards as well as a chart prepared by R.D. Terry and G.V. Chilinger for "The Journal of Sedimentary Petrology", (Volume 24, pp. 229-234, 1955) provide a guide for estimating percentages. All samples are archived for six months unless other arrangements are made by the client. ACCREDITATION: DCMSL is accredited by NVLAP (since April 1, 1989). Our NVLAP Lab Code is 101258-0. DCMSL complies with NVLAP requirements unless otherwise noted. ENDORSEMENT: The results of this analysis must not be used by the client to claim endorsement by NVLAP or any agency of the U.S. Government. The analysis was performed by -, John Silverman. Analyst Ron Schott, Analyst Jason res, Analyst Data Ron Schott Laboratory Director NVLAP Lab, Code 101258-0 4DCM S—C-I-E•1ti-C•'E 12421 W. 4()14 Avenue. Unit "6 Wheat Ridge. CO 80033 (3 03 ) 463-8270 (800) 852-7340 (303) 463-8367 — fax Date;'rime Received_ �1( _ `f %DC? t`iL t"rrou ivo. 17 Field Data Sheet'Chain of Custody Samples Submitted By. Company: Aloed s,_4 Address: 77 7575 C• Contact: Phone: DCMSL Lo, No. Job/P.O.4 0015[��3 Project 'titlei_--'(�wc FBF k/4 Archive: Asbestos samples are archived for 6 months Cell: unless other arrangements are made. All other samples f,nlail:iFie�e�ct,•[ are archived for 3 months. Turnaround rime Requested: Z _Standard (3 to 5 Business Dati s) [ ) 2 I lour bush (Asbestos Only) K] 24 Flour Rush [ ] Other Proce ure equested: ASBESTOS DUST R. SILICA on -ii -ER SERVICE'S Bulk [x .l Standard IID [ ] Silica- Air NIOSH 7-500 [ ] Optical Microscopy -[ ] Progressive [ ] Silica - Bulk [ ] X-ra-v Diffraction - Scan/Search [ ] Point Count [ ] Silica - Bulk Respirable [ i X-ray Diffraction - C1ay'Bulk [ ] Other [ Deist - N10SI 10500/0600 [ } SEM Air [ ] NIOSI 17400 Other Analysis:--- [ ] OSHA ID -160 i [ } Other— — � —Air Client Sample No.: Sample Date vollirne Other Information I a.I+a-_scot- _ 0s10r711_8 - 01 -A! 7 219-FLRQI__6 _r7, 10 Zia L►/G d i j d3 Relingty' M Date/T' xue lAh VO Re s YivMv: Da 'Time DCMSL Field Data Shecst=Chain of Custody --- page ?cif Client Sample No,: Sample Date Air Volume Other Information 11 Wcol -11 12 142/0 S ` 0 % 15 _ Stu - 1 16l�r N1C- I7 'ZI09 - Ir? 18 ?-1& SA4&;t 18 19 210- 6PL 41 "tit 20 21 �6 ZI 22. ?-1 z - 33A i9t - 7- 26 ?7 ?8 29 30 31 2 33 34 3 s , Rel r, Received BN-,: Dates' ince t _"'1i c 10'`fi`� ZIT OF National Voluntary 4� R$ Laboratory Accreditation Program �y �A s Of SCOPE OF ACCREDITATION TO ISOIIEC 17025:2005 DCM Science Laboratory, Inc. 12421 W. 49th Ave., Unit 6 Wheat Ridge, CO 80033 Ms. Cindy Met%rd Phone: 303-463-8270 Fax: 303-463-8267 Email: Cindy@dcrosciencelab.com http://wjw,w.dcrosciencelab.com ASBESTOS FIBER ANALYSIS Bulk Asbestos Analysis NVLAP LAB CGDE 101258-0 Code Description 18/AOI EPA -- 40 CFR Appendix E to Subpart E of Part 763, Interim Method of the Determination of Asbestos in Bulk insulation Samples 181A03 EPA 600iR-93/116: Method for the Determination of Asbestos in Bulk Building Materials For the National Volunta L 6aratotAccreditafion Program Effective 2018-04-01 through 2019-03-31 Page 1 of I i CITY OF WHEAT RIDGE Building Inspection Division ^ , (303) 234-5933 Inspection line_��9r (303) 235-2855 Office • (303) 237-8929 F6fx INSPECTION NOTICE Inspection Type: Job Address:. 3-5-55 Permit Number: 0/Ko0/ y ❑ No one available for inspection: Time M Re -Inspection required: Yes rt No When corrections have been made, call for re -inspection at 303-234-5933 Date: % '!�5' /bF Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: qo y F-11vAL CLEC C bM M Job Address: 3555 L U_04 6.«I PAZ- W Permit Number: '2o ( g Oo / L/ ❑ No one available for inspection: TimeAM/PM Re -Inspection required: Yes No When corrections have been made, caff\for re -inspection at 303-234-5933 Dat �4— Inspe i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: a+`krWaIJ l F -3L_e Permit Number: ; �)b DeL ❑ No one available for inspection: Time�'...:: "y- AM/PM Re -Inspection required: Yes,,No-' When corrections have been made, call for re -inspection at 303-234-5933 Date: -:�' �?-> ' iF Inspector: AwG► 1 L-f+- DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: E iS Job Address: 3 ��_ I)_ L ,jfherrw Permit Number: `, o l g ool qy ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections ave been made, call for re -inspection at 303-234-5933 a Date: � i / Inspector: toT LO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE / Inspection Type: Job Address: 3555 )44+AwA_A( PermitNumber: ❑ No one available for inspection: Time Re -Inspection required: Yes ( Nom) When corrections have been made, call for re -inspection at 303 -234 - Date: ' ��1 ' )& Inspector:" DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: E iS Job Address: 3 ��_ I)_ L ,jfherrw Permit Number: `, o l g ool qy ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections ave been made, call for re -inspection at 303-234-5933 a Date: � i / Inspector: toT LO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE / Inspection Type: Job Address: 3555 )44+AwA_A( PermitNumber: ❑ No one available for inspection: Time Re -Inspection required: Yes ( Nom) When corrections have been made, call for re -inspection at 303 -234 - Date: ' ��1 ' )& Inspector:" DO NOT REMOVE THIS NOTICE City of Wheat Ridge s r r Commercial Remodel PERMIT -201800146 PERMIT NO: 201800146 ISSUED: 03/07/2018 JOB ADDRESS: 3555 Lutheran PKWY #360 EXPIRES: 03/07/2019 JOB DESCRIPTION: Minor renovations of existing medical suite; renovation includes new finishes, 1 new sink, and electrical for tenant equipment - 1,703 sq ft *** CONTACTS *** OWNER 303/422-9500 LUTHERAN HEALTH CARE ARCH (303)964-8282 JULIE POCHON RTO GROUP SUB (720)583-1679 Bruce Carpenter 160250 B C Builders, Inc. SUB (720)201-0629 Keith Crisman 019339 Crisman Electric, Inc. SUB (720)612-4522 Phillip A. Strait 018645 Strait Plumbing, Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 1 / Commr Vacant BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 49,000.00 FEES Total Valuation 0.00 Plan Review Fee 466.73 Use Tax 1,029.00 Permit Fee 718.05 ** TOTAL ** 2,213.78 *** COMMENTS *** *** CONDITIONS *** Approval from presiding fire department required prior to final building inspection sign -off. All roughs to be done at Framing Inspection. City of Wheat Ridge m Commercial Remodel PERMIT - 201800146 �3 PERMIT NO: 201800146 ISSUED: 03/07/2018 JOB ADDRESS: 3555 Lutheran PKWY #360 EXPIRES: 03/07/2019 JOB DESCRIPTION: Minor renovations of existing medical suite; renovation includes new finishes, 1 new sink, and electrical for tenant equipment - 1,703 sq ft I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with thispennrt. I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be performed and that all worlwto be performed is disclosed in this document and/or its' accompanying approved plans and specifications. 3 �-Z Signature of OWNER or CONTRACTOR (Circle one) Date I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not procee or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or gr,nting of a p it shall not be construed to be a permit for or an approval of, an violation of any provision of any applicably cde rnylman or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of W heat jjd,�e COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 2911 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 " Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(cDci.wheatridge.co.us FOR OFFICE USE ONLY Date: I/ )bjj� PlawPermit # QO v I tool Plan Review Fee. J 1 I „� J TP Building Permit Application Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. '** Property Address: SSS Lk-fld EZ& I V 'sf t00 Property Owner (please pry int)),: 2]5j FV_A1J --1 ELIM Phone: X22- 1SLD w Property Owner Email: Mailing Address: (if different than property address) Address: �j5 L(,� f� � ,� '. I City, State, Zip: �L� }-��'� �,�-53 Architect/Engineer— T r) Architect/Engineer E-mail: _`\u P.@ I!'17i G✓/l 111 �i�� C-1(�— SC%�% Contractor: —' Contractors City License #: Phone: 30 3 b 5 - �� 1 Contractor E-mail Address: For Plan Review Questions & Comments (please print): CONTACT NAME (please print): 0 Phone: CONTACT EMAIL(p/ease print): \ a_Li „Q @ 'tko 1^47"Nr. „-,i , r1. Sub Contractors: Electrical: q W.R. City License #Q CRXsMNN f -LC tJAtC, Other City Licensed Sub: City License # City License # Plumbing: Mechanical: W.R. City License # 01"ot'(pI4 S W.R. City License # SI PAt t f'S u MBI, N (r t'% Other City Licensed Sub: Complete all information on BOTH sides of this form (COMMERCIAL ❑ RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ OTHER (Describe) (For ALL projects, please provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.) H I KAOF- PU,1WVZ�4L OF- =,-.,CLS'-Q KJC. Sq. FULF Amps Btu's Gallons Squares Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) OWNERICONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER)CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): DATE: I DEPARTMENT USE ONLY ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: Building Division Valuation: $ From: Inspector -No Reply@ mobile-eyes.org Subject: West Metro Fire Protection District - Building Plan Review Results Date: January 12, 2018 at 3:18 PM To: taylor.garrett@lillibridge.com, julie@ther,,ogrouo.cor, This automatic email was sent to you by the West Metro Fire Protection District. If you have any questions or concerns please contact us at (303) 989- 4307. West Metro Fire Protection District 433 S. Allison Pkwy, Lakewood, CO 80226 (303) 989-4307 Occupant Name: Dr. Neyman Contractor: The R T O Address: 3555 Lutheran InspectionType: Plan Review - Tenant Parkway Improvement Wheat Ridge, CO 80033 Permit Number: N/A Inspection Date: 1/12/2018 Inspected By: Mark Dean 303-989-4307 Plan Type Original Pass Fail N/A Plan Review General [X] [ ] [ ] G.30 REVIEW Your plans have been approved and no permit is required. Follow FEES: this and the steps below to reconcile the associated invoice. 1. Select "Life Safety" under the Bill Type options 2. Enter invoice number #18011214505 3. Select the associated permit type from the "Permit/ Fee Type" drop down menu 4. Select "Construction Permit" in the "WMFR Acct#" drop down menu 5. Enter the Job Address 6. Enter payment amount of $75.00 7. Select Pay by Card to complete the transaction Once completed, send a copy of the invoice and you will be given further instructions on retrieving your approved plans. Your plans have been approved. Refer to the area above for further relevant information. 1A1--4- RA -4. E,;,_ O V VCJL IVICLI V t -11 1-V IICJI.UC Life Safety Plan Review Desk Status: Approved West Metro Fire Protection District 433 S. Allison: Pkwy, Lakewood. CO 84226 (343)989-4307 M Occupant Name: Dr. Neyman Contractor: The R TO Address: 3555 Lutheran Parkway InspectionType: Plan Review - Tenant Wheat Ridge, CO 80033 Improvement Permit Number: WA Inspection Date: 112.2018 Inspected By: Mark Dean 303-989-4307 Plan Type Original Pass Fag NFA Plan Review Floor 1 General lxj I (j G.30 REVIEW FEES: Your plans have been approved and no permit isreglrired.Foffowths and Me steps below to recorncJe the assocratedinvoice. 1. Select "bfe Safety" undar the Sff Type options #19011214505 Enter invoice number 3. Select the assoeWedpermrt type from the "Permrl/Fee Type" &ap down menu 4. Select "Con stnirlion Permit" in Me 'M4FR Acct#" drop down menu 5_ Entor the Job Add oss 6. Enter -payment amount of$75.00 7. Select Pay by Cavi go complete the transaction Once completed send a copy of the invoice hiom and you wiAbe given further instructions an retrieving your approved plans. Your plans have been approved. Refer to the area above for further relevant information. West Metro Fire Rescue Life Safety Plan Review De ,k Status: Approved