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3455 Lutheran Parkway (2020)
TESTING SYSTEM TABB Cl PROJECT LOCATION FLOW SPEED PAGE 14409 COMPLETE P.O. BOX 27706 MECHANICAL DENVER, CO. 80227 3NCING BALANCING, INC. FAX 303-761-1317 W. T PHONE 303-948-5429 L ENGINEER L CONTRACTOR CREW AMMETER J VOLTMETER INCLINED DRAFr GAGE DWYER 0-0.25" 0-0.50" 400" MACiNFH LIC GAGE 0-0.50" 0-1.0" 0-2.0" 0-4.0" 0-8.0" GENERAL INFORMATION LMC ASC GI SCOPE PROCESSING REVISED 3455 N. LUTHERN PARKWAY, SUITE 150, WHEAT BOULDER ASSOCIATES CATOR, RUMA & ASSOCIATES M -TECH MECHANICAL A.STRUBLE INSTRUMENTS USED ALNOR j SHORTRIDGE DAVIS TYPE LCA 6000 BIDDLE TYPE 9915 AMPROBE TYPE DIGITAL GAGE -30--+30 PSI 0-60 PSI 0-100 PSI GAGE DIFFERENTIAL BARCO 0-50" 0-100" 300" 500" 0-100' R ALNOR RS FLUKE TYPE 52 ETER ALNOR TYPE 530 PROJECT Tii'UDE 5200' FLOW HOOD CORRECT 1.10 APPLIED TO; AREA (K FACTOR STATIC PRESSURE CORRECTION 1.21 RECORDED PRESSURE READINGS ARE MEASURED X F.4 CORRECTED CO 80033 DATE NOVEMBER 2020 1 Certif��� 4 t3 G Anthony Stnabie r �vreran�ds�weermonanK. 7ABB S> BB3i9 8 DecamdwbeY3'1, 2020 �\ Pr .x.A: d?/351i0ei VELOCITY SUPPI: TOTAL TOTAL , INC. AIR SYSTEM RECAP SHEET PAGE 14409-1 ,MC ASC GI SCOPE PHOCNt�iNU ZONE OR REQ'D ACT'L % OF UNIT NO. MAIN CFM CFM REQ'D OSA REMARKS TB -22A 1-3 TB -22 4-5 EXHAUST 1 EXISTING 2-3 350 352 101 160 165 103 510 517 101 280 286 102 600 611 102 880 897 102 PAGE 2 2 3 4 PROJECT LOCATION FAN SYSTEM LMC ASC GI SCOPE PROCESSING PAGE NO 3455 N. LUTHERN PARKWAY -SUITE 150 DATE SUPPLY CONTRACTOR M -TECH MECHANICAL 14409-2 11-11-2020 BALANCER A.S. TEST 1 TEST 2 TEST 3 FINAL SIZE REQUIRED OPENING PLAN kerl AREA VEL CFM VEL o!o VE % VEL % VEL CFM % REMARKS TB 22A-1 24/24 1.10 91 100 40 44 90 99 99 100% OPEN 2 24/24 1.10 114 125 100 88 115 127 101 3 24/24 1.10 114 125 90 79 115 127 101 MIN 105 TOTAL, 350 352 -22-4 24/24 1.10 73 80 120 165 75 83 103 5 24/24 1.10 73 80 100 138 75 83 103 MIN 160 TOTAL 160 165 PROJECT LMC ASC GI SCOPE PROCESSING PAGE NO 14409-3 LOCATION 3455 N. LUTHERN PARKWAY -SUITE 150 DATE 11-11-2020 FAN SYSTEM EXHAUST BALANCER A.S. CONTRACTOR M -TECH MECHANICAL SIZE REQUIRED TEST 1 TEST 2 TEST 3 FINAL OPEI 4ING PLAN kC7I AREA VEL CFM VEL % % % VEL CFM % REMARKS EXHAUST 1 24/24 1.10 255 280 165 65 260 286 102 T(YrALI 1 280 286 PROJECT LMC ASC GI SCOPE PROCESSING PAGE NO LOCATION 3455 N. LUTHERN PARKWAY -SUITE 150 DATE FAN SYSTEM (E) EXHAUST CONTRACTOR M -TECH MECHANICAL 14409-4 11-17-2020 BALANCER A.S. SIZE REQUIRED TEST 1 TEST 2 TEST 3 FINAL OPE ING PLAN kCT'I AREA VEL CFM VEL % VEL % VEL % VEL CFM % REMARKS (E)EKH E2 12/14 1.10 273 300 140 51 275 303 101 E3 12/14 1.10 273 300 180 66 280 308 103 600 611 --TOTAL ADDU TABS C ASC GI SCOPE PROCESSING REVISED 3455 N. LUTHERAN PARKWAY -SUITE 150 WHEAT RIDGE, CO 30033 NOVEMBER 2020 ERTIFIED A BALANCING implete iCec r s Balancingl Inc. PO BOX 27706 DENVER, CO. 8W27 FAX 303-972-7453 PHONE 303-948-5429 i CITY OF WHEAT RIDGE Building Inspection Division (303)-.-Z34--593-3 inspection =line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: _ ` _ . i CrP �.c� r ,/ 46-0 Permit Number: -°? f` ❑ No one available for inspection: Time./ _1 -+��, AMIPMS Mr4• Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: Inspector: DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Permit Number: 71 7 C4_14 .5044;4_1 7 /-n M IJ No one available for inspection: Time AM/PM Re-InspectionRe-inspection required: Yes No When corrections have been made, schedule for re -inspection, online at: http://Www.ci.wheatridge.co.ushnspection Date: J, Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection.- tr` Job Address: Permit Number: ❑ No one available for inspection: Tirnda'SIM Re -Inspection required: Yes =No *When corrections have been made, s6hedule for inspection online at: httpYlwww. ci. wheatridge. co. uslinspWctiop A i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE 3/ Inspection Type: ?/G Job Address: ✓S;«.�_ �a Permit Number: ❑ No one available for inspection: Time iAM/PM Re -Inspection required: Yes ' No When corrections have been made, schedule for re -inspection online at: http://www. cL wheatridge. co. uslinspection Date: //- Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: -31G 3I_7 Job Address: Permit Number: G1 Z1-3, "f ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: h ttp://www. ci. whea tridge. co. us/inspection Date: (1- 7 Inspector: DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Permit Number:�i, " NA I _14k < - ❑ No one available for inspection: Time ASI/PM Re -Inspection required: Yes When corrections have been made, schezftle for re -inspection online at: httpJ/www.ci. wheatridge.co. uslinspectio _ o CITY OF WHEAT RIDGE. Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: -i l,!; Job Address: 575 j1/_ I Permit Number: `r, C_- f 2 / 11� T ❑ No one available for inspection: Time "AAM%PM Re -Inspection required: 'Yes No When corrections have been made, schedule for re -inspection online at: http://www. ci. wheatridge.co, uslinspection Date:Inspector: DO NOT REMOVE THIS NOTICE 44" City of Wheat Ridge _A� Commercial Low Voltage PERMIT - 202002239 PERMIT NO: 202002239 ISSUED: 10/29/2020 JOB ADDRESS: 3455 Lutheran Pkwy Ste 150 EXPIRES: 10/29/2021 JOB DESCRIPTION: Relocate two existing smoke detectors - 153 sq ft *** CONTACTS *** OWNER EXEMPLA LUTHERAN MED CTR SUB (720)544-1010 CHE PURA OLE KSANDR 202264 LEGACY FIRE & SAFETY LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: l / Commr Vacant BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 750.00 FEES Total Valuation 0.00 Use Tax 15.75 Permit Fee 36.70 ** TOTAL ** 52.45 *** COMMENTS *** *** CONDITIONS *** All work shall comply 2018 International Codes, 2020 NEC (if applicable), and ordinances adopted by the City of Wheat Ridge. Work is subject to field inspections. I, by my signature, do hereby attest that the work to, be performed shall comply with all accompanying approved plans and specifications, applicae building codes, and all applicable municpal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this�permrt. I further attest that I am leg ally authorized to include alI entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180, days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and��procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all requ�ired inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, anviolation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. From: no-reolv(alci.wheatridae.co. us To: CommDev Pets Subject: Online Form Submittal: General Permit Application Date: Wednesday, October 28, 2020 3:37:30 PM General Permit Application This application is exclusively for Scopes of Work that do not already have a specific form. YOU MUST ATTACH AN ELECTRONIC PAYMENT FORM IN ORDER FOR THE PERMIT TO BE PROCESSED. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. PROPERTY INFORMATION Is the property Commercial Residential or Commercial? Property Address Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123- 4567) 3455 Lutheran Pkwy, Surgical Care Affiliates 303-257-8548 Property Owner Email legacyfiresafety@gmail.com Address Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" CONTACT INFORMATION Submitting General Legacy Fire & Safety, LLC Contractor or Architect Contractor's License Number (This is a 5 or 6 digit number for the City of Wheat Ridge) 202264 Contract Phone Number (enter WITH dashes, eg 303-123- 4567) Contact Email Address Retype Contact Email Address DESCRIPTION OF WORK Detailed Scope of Work - Provide a detailed description of work including mechanical, electrical, plumbing work occurring, adding/removing walls, etc. 7205441010 achepura@legacyfiresafety.net achepura@legacyfiresafety.net Relocate two existing smoke detectors. Square footage of 163 scope of work Location of work 1st floor (backyard, on roof, etc) Project Value (contract value or cost of ALL materials and labor) Upload Engineer letter, other documents on 8 1/2" x 11 " Upload Asbestos Report if triggler level is met per CDPHE regulation. Upload Drawings 11" x 17" or larger $750.00 Field not completed. Field not completed. SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit has been issued and posted on the property. I certify that I have Yes been authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying for oleksandrChepura Permit Email not displaying correctly? View it in your browser. ® CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address:'`i Permit dumber: ❑ No one available for inspection: Time! 606 AM/PM Re -Inspection required: Yes N..°> When corrections have been made, schedule for re -inspection online at: httpJ/www. ci. wheatridge. co. uslinspection Date:-,-� �,�.{-'•- Inspector: 6i DO NOT REMOVE THIS NOTICE A 41 CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: — 314,-e 1-'Itzl Z 31 7 l?X, Job Address: Permit Number: J No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: http://Www.ci.wheatridge.co.uslinspection Date:/C,-?C,,- -?�r, Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE V, Building Building Inspection Division (/ (303) 235-2855 Office INSPECTION NOTICE., Inspection Type: JobAddress:i�� Permit, Number: 15� Y j ��A "i ❑ No one available for inspection: Time "' _" /PM -Re-Inspection required: Yes ( When corrections have been made, sca du/e for re-� pecti online at: http✓/www.ci.wheatridge.co.uslinspect" Date " spe t DO NOT RC VE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: C)tJ � Job Address: 3 Permit Number: t ° O a ❑ No one available for inspection: Time �' AM/pM j Re -Inspection required: Yes f When corrections have been made, schedule for re -inspection online at: httpJ/www. ci. wheatridge.co.usvinspection Date: i' ('" Inspector: 'L:> r DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type:`." Job Address: Permit Number: ❑ No one available for inspection;_Tme Re -Inspection required: Yes'F No . When corrections have been made, s d le for re -inspection online at: http://www.ci. wheatridge. co. ugfinspe ' tion D�te'4 sp -_ i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: Permit Number: - ~-� L- v—j D 1 ❑ No one available for inspection: Time AM/PM Re -Inspection required: *When corrections have been made, schedule for re -inspection online at; http✓/www,ci.wheatridge.co.us inspection Date: i �` "� `' Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: r 1 Job Address:`-� Permit Number: d0d U U 1 +� 0 ❑ No one available for inspection: Time °- AM/PM Re -Inspection required: Yes N When corrections have been made, schedule for re -inspection online at. http✓/www.ci. wheatridge.co. uslinspection Date: i D -rr' Inspector: DO NOT REMOVE THIS NOTICE 1* � 4 i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: ��f� �� ►� 1< �- `d Permit Number: irl ./1 '1 ll ❑ No one available for inspection: Time "` f`'�' AM/PM z Re -Inspection required: iYes <Nd When corrections have been made, schedule for re -inspection online at: h ttp ✓/www. ci. wheatridge, co. usrnspection Date. ` 1 `' - :4t Inspector: DO NOT REMOVE THIS NOTICE e s City of Wheat Ridge 7 4 Y Comm. Tenant Finish PERMIT - 202001215 PERMIT NO: 202001215 ISSUED: 08/27/2020 JOB ADDRESS: 3455 Lutheran Pkwy Ste 150 EXPIRES: 08/2.7/2021 JOB DESCRIPTION: Existing office and storage room being converted to scope processing and scope clean room inside of ambulatory surgery center. The Surgery Center at Lutheran Sq ft. 165 *** CONTACTS *** OWNER EXEMPLA LUTHERAN MED CTR GC (303)242-1583 ALEX G SZAKAL 202192 RAM COMMERCIAL BUILDERS LLC SUB (303)650-4000 STEVE KUGLER 021460 MTECH MECHANICAL SUB (720)318-0929 BLAKE HOSTETLER CODY STERLING 202197 COLORADO ELECTRICAL AND SMART *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 1 / Commr Vacant BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 60,000.00 FEES Total Valuation 0.00 Plan Review Fee 526.53 Use Tax 1,260.00 Permit Fee 810.05 ** TOTAL ** 2,596.58 *** COMMENTS *** *** CONDITIONS *** Approval from presiding fire department required prior to final building inspection sign -off. All roughs to be done at Framing Inspection. A. printed copy of the permit and city stamped on-site plans must be available on-site for the first inspection. Approved per plans and red -line notes on plans. Must comply with 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. 6 A e City of Wheat Ridge Comm. Tenant Finish PERMIT - 202001.21.5 PERMIT NO: 202001215 ISSUED: 08/27/2020 JOB ADDRESS: 3455 Lutheran Pkwy Ste 1.50 EXPIRES: 08/27/2021 JOB DESCRIPTION: Existing office and storage room being converted to scope processing and ,scope clean room inside of ambulatory surgery center. The. Surgery Center at Lutheran Sq ft. 165 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 le�g�ally authorized to include alI entities named within this document as parties to the work. to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This. permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalenmt fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting 91 a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicabl"de or any ordigance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. From: no-reDlvC&ci.wheatridae.co.us To: CommDev Permits Subject: Online Form Submittal: Commercial Interior Remodel/Tenant Finish Date: Monday, June 29, 2020 12:51:06 PM Commercial Interior Remodel/Tenant Finish Application for Commercial Remodel/Tenant Finish This application is for Commercial Remodels and Tenant Finishes. Do not being work until the permit has been issued to the General Contractor. Required to Submit Proof of Submission to Fire Department Proof of Proof of Submission -West Metro Submission to Firef9251f86cdO8631faa17034bb13635ee380fa949456084f9958f5367bf6Oe888 Ddf Fire Department Begin Application PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303- 123-4567) Property Owner Email Address Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" 3455 N. Lutheran Parkway, Suite #150, Wheat Ridge, CO 80033 Sara Colvard 720-708-8268 Sara.Colvard@scasurgery.com Electronic Payment Form - Revised 5-1-20 Fillable 202005011620013849 202006081141368198.Ddf APPLICANT INFORMATION Contact Name of Person Submitting Application What is your role in the project? Contact Phone Number (enter WITH dashes, eg 303-123- 4567) Paula Sullivan Architect 720-339-8056 Contact Email psullivan@boulderassociates.com Address for Plan Review Questions Retype Contact psullivan@boulderassociates.com Email Address DESCRIPTION OF WORK Is this for a new No tenant? Business Name The Surgery Center at Lutheran of Tenant Detailed Scope Existing office and storage room being converted to scope processing and scope of Work - clean room. Provide a detailed description of work including mechanical, electrical, plumbing work occurring, adding/removing walls, etc Location of Work Square Footage Area of Work Being Inside of Ambulatory Surgery Center 165 SF Performed Asbestos Report Field not completed. - if applicable Construction 2020-06-11 Lutheran Scone Processing - Full Set - Stam end odf Plans scanned on 11'x17" or larger Project Value 60,000 (contract value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that work may not begin on this property until a permit has been issued and posted on the property. I certify that I have been authorized by the legal owner of the property to submit this application and to perform the work described above. Yes Yes Yes I attest that Yes everything stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying Paula Sullivan for Permit Email not displaying correctly? View it in your browser. 0 Occupant Name Address Permit Number: Plan Type Pass Fail N/A Plan Review General West Metro Fire Protection District 433 S. Allison Pkwy, Lakewood, CO 80226 (303) 989-4307 Surgical Care Affiliates (TI) Contractor: Boulder Associates Architects 3455 Lutheran Parkway InspectionType: Plan Review - Tenant Wheat Ridge, CO 80033 Improvement N/A Inspection Date: 6/23/2020 Inspected By: Mark Dean 303-989-4307 Original [x] [ ] [ ] G.30 REVIEW Yourplans have been approved. Follow this Link and the steps below to reconcile FEES: your in voice. 1. Select "Life Safety" under the Bill Type options #20062314508 2. Enter invoice number 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 $258.00 7. Select Pay by Card to complete the transaction Once completed, you are no longer required to send us a copy of your payment receipt. It is your responsibility to retain a copy for your records. Your payment will be processed within (1) business day after it was made and has posted to our Heartland account. Once payment has been confirmed, a link to the reviewed plans will be emailed to the contact listed on the permit. Please be sure to check your junk mail folder if you're anticipating a link email from our office. Your plans have been approved. Refer to the area above for further relevant information. West Metro Fire Rescue Life Safety Plan Review Desk Status: Approved City 1 DEVELOPMENTWh6at COMMPUNiTy SUBCONTRACTOR AUTHORIZATION FORM Electrical Subcontractor This form must be completed & signed by the ELECTRICAL SUBCONTRACTOR performing electrical work on site. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: 3KS5 N. b o 11-PIA L:81-') Y2L General Contractor: FORM WILL NOT BE ACCEPTED WITH MISSING INFORMATION Company Name: - - Contact Phone Wheat Ridge Contractor License #: ao at\0t: i (required field) State License #: Master License Printed Name of Authorised Agent Signatur6Authorized Agent Bate `SAW �• c City Of `� Wheat- idge COMMUNITY DEVELOPMENT SUBCONTRACTOR AUTHORIZATION FORM Mechanical Subcontractor This form must be completed & signed by the MECHANICAL SUBCONTRACTOR performing mechanical work on site. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: 4455 N Lutheran Pkwy Suite 150 General Contractor: RAM Commercial Builders FORM WILL NOT BE ACCEPTED WITH MISSING INFORMATION MTech Mechanical Technologies Company Name: Group, Inc. Contact Phone #: 720.602.4848 Wheat Ridge Contractor License #: 021460 (required field) Brianna Alps 8/24/2020 Date n City of Wheat j,pdlge COMMUNITY DEVELOPMENT SUBCONTRACTOR AUTHORIZATION FORM Plumbing Subcontractor This form must be completed & signed by the PLUMBING SUBCONTRACTOR performing plumbing work on site. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: 3455 N Lutheran Pkwy Suite 150 General Contractor: RAM Commercial Builders FORM WILL NOT BE ACCEPTED WITH MISSING INFORMATION MTech Mechanical Technologies Company Name: Group, Inc. Contact Phone #: 720.602.4848 Wheat Ridge Contractor License #: 021460 (required field) State License #: PC.0003205 Master License #: MP.00178917 Brianna Alps Printed Name of Aigthorized Agent 8/24/2020 Agent Date n City of Wheat j,pdlge COMMUNITY DEVELOPMENT SUBCONTRACTOR AUTHORIZATION FORM Plumbing Subcontractor This form must be completed & signed by the PLUMBING SUBCONTRACTOR performing plumbing work on site. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: 3455 N Lutheran Pkwy Suite 150 General Contractor: RAM Commercial Builders FORM WILL NOT BE ACCEPTED WITH MISSING INFORMATION MTech Mechanical Technologies Company Name: Group, Inc. Contact Phone #: 720.602.4848 Wheat Ridge Contractor License #: 021460 (required field) State License #: PC.0003205 Master License #: MP.00178917 Brianna Alps Printed Name of Aigthorized Agent 8/24/2020 Agent Date 1� N a _ $4 a 00 y L Q H m O Q y u t-) ,o c O rr� Q H S�+ . -H PL4 krl O U Q pFQ ON U A O O N ro 11 ^d c y UI O Q Ooo � (d > U W b v �4 41 4-4 Ej r ^ 1 b CC O M 4 W � �{/ p O �'� F w U O q �I v' U N CO O H •.•I O 3 o." 3 x „ G O > o O0 . � 4 Q u] El 3 U �IU w N44 Q c,�IQ o n~ c a b a'U.cd ro arc cood b U Q�oUA4 ro q 1' V �b 14GNU ro 0 v dU c� O r v a� �ro3�nq Q w A 4. o way` y a fl w A z o b a w kn Wo UaOa x e o= USM a o° G W � � z vHi roCc 0 ro o a Q A" O W 1° o O > to > W �, cv ro w CIA C to E C W U F � o N 44 Q U 7 e0 d Qui r,� W Sa N y C 30Q;QO v O O a �' F a.; OUwo.w u N a DET 1 R BAL NCE, TESTING, ADJUSTING AND BALANCING REPORT PROJECT LILLIBRIDGE MANAGEMENT OFFICE SUITE 120 3455 LUTHERAN PKWY WHEAT RIDGE, CO ARCHITECT HORD CAPLAN MACHT, INC. ENGINEER BELLMAN ENGINEERINCy, INC. CONTRACTOR WRAY MECHANICAL SYSTEMS Submittal Date: JUNE 5, 2020 SUPERVISOR: A� Steven White, CTAB Professional 6679 S. Kit Carson Street . Centennial, Colorado 80121 ' (303) 798-0355 Testing, Adjusting and Balancing of Mechanical Systems Vali K19 w CS 0 ul 0 f4k � LL 0 0 cs 0- ts CS cs z 43 S3— z cs Cl 4.4 cs 10 X s <3 co 0 IS 4-1 41 sm VA �Lb CSU -cs 4J ?, cs A. cs 0 1 4-j C0 uj *VM4 k4 Z cis LL, WWAft 4j k4 LL error 4j -5Z Pp 41 Vali K19 w K19 w DELT AIR BAL NCE, LIC. INSTRUMENT LIST AIR -DATA MULTIMETER Used to measure CFM at all types of grills, registers and diffusers by using appropriate size "curtain" to capture all of the air being discharged or exhausted. Pressure readings and pitot tube traverses can also be taken with this instrument. The 16 point averaging VELGRID provides velocity readings at HEPA filters, bio -exhaust hoods, coil banks, filter banks and many more general face velocity applications. All air flow readings are corrected to local density. Temperature readings can also be measured. The supplier of this instrument is SHORTRIDGE INSTRUMENTS, INC. TACHOMETER RPM readings are taken with a PIONEER PLT5000 contact/noncontact laser tachometer. VOLT/AMP METER A FLUKE 335 TRUE RMS CLAMP METER which measures volts, amps and ohms. Read-out is digital. MAGNEHELIC GAUGES Pressure readings are taken with these instruments supplied by DWYER INSTRUMENTS, INC. Ranges are from 0.50" W.C. to 5.0" W.C. HYDRONIC MANOMETER A ALNOR HM -650 meter is used for differential and gage water pressure readings. Read-out is digital. All instruments represent the best instrumentation available, are new or have been calibrated in accordance with manufacture's requirements. Additional information on all instrumentation is available upon request. The data on the following pages represent final measurements for each system. All measurements were made using manufacturer's recommended procedures for each instrument. The systems have been adjusted and balanced utilizing the best field measurement procedures While maintaining industry standards. Systems are set to the optimum operating condition that could be achieved from the design, equipment and installation. 6679 S. Kit Carson Street . Centennial, Colorado 80121 . (303) 798-0355 Testing, Adjusting and Balancing of Mechanical Systems DELT 1 R BAL NCE, LIC PAGE 11 RECAPSHEET PROJECT LILLIBRIDGE MANAGEMENT OFFICE SYSTEM I BRANCH/ZONE DESIGN (CFM) MEASURED (CFM) % 1 ADDRESS AK NOTES EXISTING VAV-1 350 360 103 N/A N/A 6" SEE NOTES EXISTING VAV-43 550 585 106 4-43 740@33.5 10" EXISTING VAV-60 745 765 103 1-60 815@18.4 16" TF -1 422 495 117 SNGL SPD DIRECT DRIVE EXISTING EX 100 105 105 6679 S. Kit Carson Street ' Centennial, Colorado 80121 ' (303) 798-0355 Testing, Adjusting and Balancing of Mechanical Systems DELT 1 R DAL tri NCE, PROJECT AIR DEVICE TEST REPORT J, LILLIBRIDGE MANAGEMENT OFFICE PAGE 2 DATE 6/4/20 BY STEVE WHITE LOCATION M-100 SIZE SYSTEM EXISTING AREA SERVED AIR DEVICE FLOW HOOD AK DESIGN CFM INITIAL FINAL No. TYPE SIZE CFM CFM CFM CFM HEAT CFM % VAV-1 1 CD 2424 1.0 175 180 180 103 2 CD 2424 1.0 175 115 180 103 TOTAL 1 1 350 360 103 VAV-43 1 CD 2424 1.0 70 95 75 107 2 CD 1 2424 1.01 145 215 1551 107 3 CD 2424 1.0 150 215 160 107 4 CD 2424 1.0 185 215 195 105 TOTAL 1 550 1 1 5851 106 VAV-60 I CD 2424 1.0 140 135 140 100 2 CD 2424 1.01 60 70 65 108 3 CD 2424 1.0 115 125 1201 104 4 CD 2424 1.0 40 60 40 100 5 CD 2424 1.01 95 115 100 105 6 CD 2424 1.0 95 110 1001 105 7 CD 2424 1.0 95 100 95 100 8 CD 2424 1 1.01 1 051 105 105 100 TOTAL 1 1 745 1 1 1 765 103 * - MANUALLY OPENED VAV DAMPER. CONTROLS TO BE INSTALLED. 6679 S. Kit Carson Street ' Centennial, Colorado 80121 ' (303) 798-0355 Testing, Adjusting and Balancing of Mechanical Systems DELT 1 R BAL NCE, LLC. PROJECT EQUIPMENT DATA TEST REPORT LILLIBRIDGE MANAGEMENT OFFICE UNIT DATA Make TWIN CITY FAN & BLOWER Model # T500 Serial #, DATE CODE 91 A31 H Type CEILING MOUNT TF Rating 422 CFM @ 0.25" STARTER DATA Make MOTOR HAS BUILT-IN Model # THERMAL PROTECTION Size INITIAL Rating RPM Set Point DIRECT DRIVE Reqd Htr. NOT GIVEN Rating NOT GIVEN TEST DATA CFM 495 Volt 118 RPM INITIAL FINAL RPM Effie. DIRECT DRIVE Amps NOT GIVEN 1.7 NOT GIVEN PAGE 3 DATE 6/4/20 BY LOCATION SYSTEM STEVE WHITE M-100 TF -1 MOTOR DATA Make BROAN-NUTONE LLC HP NOT GIVEN RPM 815 Ph 1 Effie. NOT GIVEN S.F. NOT GIVEN Frame NOT GIVEN Amps 1.7 Volts 120 DRIVE DATA Motor Drive DIRECT DRIVE Motor Bore nn `�P Fan Drive Fan Bore Belt Size No. Belts Drive Change TEST DATA IN OUT nn `�P Filter Heating Cooling Fan ATMOSPHERE ATMOSPHERE - - 6679 S. Kit Carson Street ' Centennial, Colorado 80121 ' (303) 798-0355 Testing, Adjusting and Balancing of Mechanical Systems __.._...._. _ ...__.__—.._. ..._...... __. (E} EXRAUS' FAN & LOUVER TO REMAIN _.. - E 9 a i _.......... �. -- -T - - :7-77-74 a -- i E i L sae FLEM r , 9PFAKsMftQ iss jj �. Q i45 -, - iR p DEMO (E) EVMr DUCTWORK & GRILLE REPIkCE MfR RAP (E) 5 € ._, a` GMUE W/%UNQ to3T TOILET (E) VAV 1-93, 8 f INLET'-, 32 MMl HYaRONIC HEA .g__. 4 k.. J .. ._. 3 _- - - .,... .�. i .. r (f� 12J12< : -HALL -- v ( �-_- -------- � ; s•k (gam ':•-� �- _---�--- __ ��------------- -- [R r s 2 -___— -- 10/8 Ev E NEER ! a RELOCATE (E) 157AT " i d :.. 95 fr�5 FOR (E) VAV SMUG _-:_:....... - ........... (El ELE,--MC.At RDOK jELI CUORDPATE MAL LOCATION � WYTH ELECT EQUt WNW HALL.".---^w-•---- [s1Jsari ...G...'. MANAGER - a> Sj bz i 40 tNUIWTENA CE c TECH 12L/9 (?,/12 115 — --' DEMO)T TRANSFERGMUE GRILi� ice• .E _ .. 115 j 29D r (R M ^ ` r EEi Ek HA ....... _ . ° ..... .....3 .3 nwxtrRK rtrt B DEW EkkOUST r, UI 50 ! r 8-0 140 s�Q175 p' _z ) ........... ...... ....... ... 6 L�"k if f CONFERENCE •.i. ;- iMAfTi;tl ECEPN --.._ . ...... Eco 3 I i _ _ .: • . ' f 1 i s CAP (E) RUNOUT r i i S i k t Ld (E) VAV €-63, 8"k INLET, 1.5 RMI ELECTRIC HEAT C (E) 20j16 L_— ------------- — (E) 30/20 S.A. A i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office _:�9r INSPECTION NOTICE Inspection Type: Job Address: Permit Number: o2 o,-�O b0 1 \ T ❑ No one available for inspection: Time ' AM/PM Re -Inspection required: es No When corrections have been made, schedule for re -inspection online at: http://www. ci. wheatridge.co. uslinspection pf Date:_ -1-4 — 0,1 Inspector: )— DO NOT REMOVE THIS NOTICE M i y A c M r o O „ 00 :j U y cl OL d Q E- \/ o mm° w Ol ri d LS m o rd > U ►a oo m W 1 'd ��.0 QOOocp 4.)W a w Ea O NEa o �s �UO� w6 m 4-4 q O w a' CW C) b m H r o oo r t? p x ro I� w x Q �i +� �' civ i� LA W 0 i bl o (do N>-o3�v " 4.) P4 0 44 N o ai A d m Gti o ro N c �-C AYND C 41 bbA U M V ro M, U 3s 3zn0 r w ooa� � � o m -L ro� CT�II " _tip'�z`p a a, ro w ra'. m 0. O O U ca .e L + U v' `' z H o O_ u OO O O rr� rZANa z rtwH mO ro #t;Lo o 4 U zzoa� W� uN a H a� OUaaw °' � PERMIT NO. 202001054 City Of at Rjde g BUSINESS LICENSE INSPECTION INSPECTION DAY/TIME AT B r I INSPECTION DAY/TIME INSPECTION DAY/TIME BUSINESS NAME: SCL Health - Neurosurgery ADDRESS: 3455 Lutheran Parkway Suite 285 CONTACT NAME: Katie 2,032 SQ FT OCCUPANCY TYPE Z� OCCUPANCY LOAD I I CONSTRUCTION TYPE { �PRINKLERED ❑ NON-SPRINKLERED Inspector Signature Date i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address:y� Permit Number: 2-0? 00 0 r. 4r) C /C �-p '09 r ❑ No one available for inspection: Time /O �g Re -Inspection required: Yes When corrections have been made, schedule for re -inspection online at: http://www.ci. wheatridge.co. ueinspection Date:(eJ'/ ,?® Inspector: DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: ' L4 Permit Number: a ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes (Al� When corrections have been made, schedule for re -inspection online pt: http://www.ci.wheatridge.co.uslinsp ct/0 -ispector: ��'-q i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: 3 F 1 Job Address: y ,.S`S Lc� ��� i-�i�L�v S*/zo Permit Number: Z02-" G'o © .5 y ❑ No one available for inspection: Time "!';04, Re -Inspection required: ,- Yes' No When corrections have been made, schedule for re -inspection online at: httpYAvww. ci, wheatridge.co, uslnspection Date: Inspector:` DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division `. (303) 235-2855 Office INSPECTION NOTICE � __.--_.,,Inspection Type: M Fj f El F-) F Job Address: Permit Number: - I w! ❑ No one available for inspection: Time Re -Inspection required: es" No �. When corrections have been made, schedule for re -inspection online at: http✓/www.ci. wheaatridge.co. uslinspection Date: 6, !� Inspector: 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: Job Address: Permit Number: ❑ No one available for inspection: Time. AM/PM y Re -Inspection required: Yes No *When corrections have been made, call for re -inspection at 303-234-5933 a Date: L Inspector:_^ DO NOT REMOVE THIS NOTICE BELLMAN ENGINEERING, INC. MECHANICAL CONSULTING ENGINEERING May 29, 2020 Roger Sandoval Lillibridge Healthcare Services RE: Lillibridge Management Office Space 3455 W. Lutheran Parkway Suite 120 Wheat Ridge, CO Mr. Sandoval, This letter is in response to the inspection comments received by the City of Wheat Ridge concerning the transfer fan, TF -1, located in the IT room. To clarify, this fan is not an exhaust fan, and is intended to transfer warm air from the room into the plenum space during unoccupied hours when the AC is in night setback. Since the fan is not an exhaust fan, section 501.3 of the 2012 IMC is not applicable, and the air is not required to be discharged to the outdoors. Please feel free to contact me if further clarification is needed. Regards, Jeffrey Digitally signed by Jeffrey Bellman, Bellman, P.E. P.E. Date: 2020.05.29 08:48:00 -06'00' Jeff Bellman, P.E. BELLMAN ENGINEERING, INC. 1120 SECREST STREET GOLDEN, CO 80401 (720) 334-1033 PHONE GAG c�— J 0() av 0 0 L�'-ne' Majick ENGINEERING Client: Stefan Feulner From: Majick Engineering, LLC Date: April 10th, 2020 Subject: Site Observation/Beam Retrofit Address: 9595 West 38th Avenue Wheat Ridge, Colorado 80033 Site Conditions: • Foundation and floor framing observed in basement utility room • Roof was observed through ceiling access in first floor ceiling 630 E. A1V HER$TAVE. ENGLEWOOD, CO 801.1.3 (720) 612-2444 On April 7th, 2020 Majick Engineering provided a structural site observation at the request of Stefan Feulner at the single-family residence located at 9595 West 38th Avenue, Wheat Ridge, Colorado 80033. The purpose of the site observation was to visually observe the current condition of the existing structure and provide a structural analysis for the existing basement beam. The existing beam shall be retrofitted to meet current code requirements. The following are the structural changes to the existing framing: 1. The existing structural beam consisted of (3) 2x8 sawn lumber with two spans of 10 feet 3 inches and 10 feet. Based on the evaluation the beam does not meet current code requirements. The maximum span per table R602.7(2) for a (3) 2x8 center beam is 6 feet 10 inches. The beam shall be retrofitted to allow for the existing layout to remain. Structure General Information: • The single-family residence consists of a single -story wood structure with a walkout basement, built in 1952. The building is a traditional wood framed structure supported on a concrete masonry unit (CMU) foundation. The roof pitch was observed to be a standard 4:12 with asphalt tiles. The existing structure was observed to be in moderate condition. • The roof framing was observed to be a framed roof system with 2x6 top and bottom chords. Collar ties were observed at 48 inches on center. Kickers were observed at the exterior wall and interior location above the existing steel post. Due to the framing of the roof and location of the kickers, the basement beam does not experience roof snow loading. • The floor framing was observed in the water closet. The floor framing was observed to be 2x8 sawn lumber joists at 16 inches on center. The 2x8 floor joists were supported on the CMU foundation and interior center wood girder beam. The wood beam was observed to be (3) 2x8 sawn lumber supported at the exterior foundation and interior steel post. • The exterior walls were assumed to be 2x4 sawn lumber at 16 inches on center. The exterior siding consisted of a lightweight siding. The interior walls were assumed to consist of 2x4 sawn lumber spaced at 16 inches on center. • The existing foundation was observed in the water closet and utility closet. The foundation was observed to be CMU which was assumed to be unreinforced. The foundation was assumed to be supported on a shallowing footing system. Previous retrofitting in the form of helical piers was installed to stabilize previous foundation movement. Design Criteria: • 1 RC 2018 Design Loads: • Ground Snow = 42.9 psf • Roof Snow Load = 30 psf • Roof Dead Load = 15 psf • Wind Load = 135 mph (Ultimate) Exposure= C (Trees/Shrubs/Adjacent structures of similar height) Structural Observation: Floor Dead Load = 15 psf Floor Live Load = 40 psf Interior Wall Dead Load = 12 psf During the site observation a (3) 2x8 wood beam was observed based on pictures provided by the client and a small hole made in the basement finishes. The beam was analyzed and compared to allowable spans and determined to be inadequate and therefore requires strengthening. Based on the structural analysis under the current condition the existing beam was determined to be deficient for both strength and serviceability. The existing beam under current code loading requirements is overstressed by a factor of 2.5. The current imposed loads consist of both roof and floor dead load, and 11t floor live load. The deflection limits are also exceeded. The live load deflections were determined to be L/310, lower than the required L/360. The total load deflection is L/180 which is less than L/240, which is industry standard. Therefore, the existing beam requires retrofitting to provide adequate capacity and stiffness to support the existing floor and roof framing. Structural Recommendations: The existing structure's wood (3) 2x8 girder beam shall be retrofitted with (2) % inch thick by 7 inch ASTM A36 steel plates per the attached drawings. The plates shall be attached to the existing wood beam with % inch diameter, ASTM A307 bolts or equivalent at 16 inches on center, staggered top and bottom, with a 2 -inch minimum edge distance per the attached drawing. The plate shall have (2) % inch diameter bolts at each end. The existing beam supports are adequate for the beam and do not required additional retrofitting. The existing shear capacity of the beam meets current code criteria and therefore the plates are not required to go beyond the face of supports. Both of the girder beam spans required retrofitting. The new plates are required to be continuous for each span. Reference the attached details and Appendix A for additional information. Structural Conclusions: The existing beam was deficient in the current configuration, requiring strengthening. The finch beam was determined to provide adequate strength and stiffness to meet current code requirements. It is the professional opinion of Majick Engineering that the wall removal and retrofitted beam improve the existing condition and do not negatively impact the structural integrity of the existing residence. The above is based upon: Site visit with limited visual observations performed on April 7th, 2020. No destructive or non-destructive testing was performed. Majick Engineering is not liable for any hidden deficiencies that lead to failure or any incurred damage. Conclusions and recommendations are based on accepted industry standards and no warranty is either expressed or implied as to continued structural integrity of the property. • Recommendations and dimensions based on visual observations and field measurements. • Geotechnical design information and foundation information were not provided; therefore, Majick Engineering does not take liability for structural failure, out of plane displacement, damage due to settlement or foundation failure. • Opinions stated in this letter are subject to change if conditions, accessibility, or visibility from time of inspection change or if additional information becomes available for consideration. For any questions or concerns please contact Majick Engineering, LLC at 720-612-2444. Thank you, Ian McQuade, P.E., S.E. Majick Engineering, LLC Appendix A WOOD FRAMING REFERENCE STANDARDS: Conform to: (1) IRC -2018 International Residential Code (2) NDS - "2015 National Design Specifications (NDS) for Wood Construction" (3) APA PDS - 97 Plywood Design Specification (revised 2010) (4) APA Report T98-22 - "Nail Penetration and Framing Specific Gravity Factors for Shear Walls and Diaphragm" IDENTIFICATION: All sawn lumber and pre -manufactured wood products shall be identified by the grade mark or a certificate of inspection issued by the certifying agency MATERIALS: SAWN LUMBER: Conform to grading rules of WWPA, WCLIB, or NLGA. Finer jointed studs acceptable at interior wall only. All sawn lumber shall be Hem -Fir #2 grade or better. TIMBER CONNECTORS: Shall be "Strong Tie" by Simpson Company as specified in their latest catalog. Alternate connectors by other manufacturers may be substituted provided they have current ICBO approval for equivalent or greater load capacities and are reviewed and approved by the SER prior to ordering. All manufacture recommendation shall be followed. Where connectors straps connect two members, place one half of nails or bolts in each member. Where straps are used as hold-downs, nail straps to wood framing just prior to drywall application, as late as possible to allow would to shrink and building to settle. Premature nailing of strap may lead to strap buckling and potential failure, which structural engineer shall not be liable for failure. Where connectors are in exposed exterior applications in contact with Preservative treated wood (PT) other than CCA connector shall be either batch hot -dipped galvanized (HDG), mechanically galvanized (ASTM 8695 Class 40 or greater) or zinc galvanized with 1.85 oz/sf. FASTENERS: (nails, bolts, screws, etc) attaching timber connectors (joist hangers, post caps and bases, etc) to PT wood shall have similar corrosion resistant. Verify suitability of the fastener protection/coating with the wood treatment chemical manufacturer/supplier. Provide washer under the heads and nuts of all bolts and lay screws bearing on wood. All nails 12d and smaller shall be full length common unless noted otherwise. 16d nails may be 16d sinkers unless noted otherwise. Nail straps to wood framing as late as possible in the framing process to allow the wood to shrink and the building to settle. Premature nailing of the strap may lead to strap buckling and potential finish damage. Fasteners shall conform to R602. Unless noted on plans, nail per table R602.3(1) of the IRC. Unless noted otherwise all nails shall be common. Alternate nails may be used but are subject to review and approval by the Structural Engineering. Substitution of staples for nailing of rated sheathing is subject to review by the structural engineer prior to construction. LAG BOLTS/BOLTS: Conform to ASTM A307 and IBC Sec. 2304.10. ENGINEERED WOOD PRODUCTS (Versa -Lam): The following materials are based on lumber manufactured by Boise Cascade and were used for the design as show on the plans. Laminated Veneer Lumber (LVL): Conform to ICC ES Report No. ESR -1387, Fb = 2800 psi, Fv = 285 psi, E _ 2000 ksi NAILING REQUIREMENTS: Provide minimum nailing in accordance with IBC able 2304.10.1. "Fastening Schedule" Except as noted on drawings. Nailing for roof/floor diaphragms/shear walls shall be per drawings. Nails shall be driven flush and shall not fracture the surface of sheathing. STANDARD LIGHT FRAMING CONSTRUCTION: Unless noted otherwise on plans, construction shall conform to IBC sec. 2308 "Conventional Light -Framed Construction". MOISTURE CONTENT: Wood material used for this project shall have a maximum moisture content of 19% except for pressure -treated wood sill plates. Refer to Testing and Inspection for verification of these limits. STRUCTURAL STEEL DESIGN STANDARDS: Structural Steel for this project is designed in accordance with American Institute of Steel Construction (AISC) Structural Steel for this project is designed per: AISC - "Manual of Steel Construction, 14th Ed." REFERENCE STANDARDS: Conform To: 1. IBC 2018, Chapter 22 - Steel. Herein referenced as IBC. 2. AISC348-04/RCSC -"Specification for Structural Joints using ASTM A325 or A490 Bolts" by "Research Council on Structural Connections" (RCSC). Herein referenced as RCSC. 3. AISC -"Specification for Allowable Stress Design (ASD), Single Angle Members (1989)." MATERIALS: Structural Bars & Plates (PL)....................................ASTM A36 Fy = 36ksi Pipe Section.............................................................ASTM A53 Fy = 35ksi Nuts...........................................................................ASTM A563 Washers................................................................ ASTM F436 Bolts............................................................. ASTM A307 FABRICATIONS: 1. Conform to AISC "Code of Standard Practice" (2000), Section 6 "Shop Fabrication and Delivery", Section 8 "Quality Assurance" and Sec M2 and M5 of the applicable specifications. 2. Structural Welding and associated inspections and qualifications conform to the AWS D1.1 and applicable WELDING notes above. 3. The fabricator shall maintain detailed fabrication & erection quality control procedures per IBC Sec 1704.2.1 that provides the basis for inspection control of the workmanship and ensures that the work is performed is accordance with Code of Standard Practice, the AISC Specification, and the Contract Documents. 4. Special Inspector shall review the procedures for completeness and adequacy relative the code and the work. This review may be waived if the Fabricator is approved per IBC Sec. 1704.2.2. ERECTION: 1. Conform to AISC "Code of Standard Practice" (2000), Section 7 "Erection", Section 8 "Quality Assurance" and Sec M4 of the applicable specifications. PROTECTIVE COATING REQUIREMENTS: 1. SHOP PAINTING: Conform to AISC Specification Sec. M3 and AISC Code Sec. 6.5 unless a multi -coat system is required per the project specifications. 2. INTERIOR STEEL a. Unless Noted Otherwise do not paint steel surfaces i. Concealed by the interior building finish. -f-" y a� � LMC . NEURO CLINIC 3455 LUTHERAN PARKWAY - SUITE 285 WHEAT RIDGE, CO 80033 TESTING Complete PO BOX 27706 ADJUSTING Mechanical DENVER, CO. 80227 TABB CERTIFIED Balancing, Inc. FAX 303-972-74' S3 SYSTEM BALANCING PHONE 303-948-6429 INSTRUMENTS USED FLOW HOOD ALNOR SHORTRIDGE PAGE 14211 TESTING COMPLETE P.O. BOX 27706 ADJUSTING MECHANICAL DENVER, CO. 80227 SYSTEM BALANCING BALANCING, INC. . . ........... FAX 303-761-1317 . . ......... TABB CERTIFIED 0-0.50" 400" PHONE 303-948-5429 0-0.50" 0-1.0" 0-2.0" 0-4.0" 0-8.0" GENERAL INFORMATION -30--+30 PSI 0-60 PSI 0-100 PSI . . . ...... .... . ..... .... ------- PROJECT LMC NEURO CLINIC .. .. ......... . .... . LOCATION 3455 LUTHERN PKWY, SUITE 285, WHEAT RIDGE, CO 80033 .. . ....... . .... ARCHITECT TREANOR HL FLUKE MECHANICAL ENGINEER CATOR, RUMA & ASSOCIATES ALNOR SHEETMETAL CONTRACTOR LUTHERAN MEDICAL CENTER BALANCING CREW A.STRUBLE ..... ........... I .......... - DATE MAY 2020 INSTRUMENTS USED FLOW HOOD ALNOR SHORTRIDGE ANEMOMETER DAVIS TYPE LCA 6000 SPEED INDICATOR RIDDLE TYPE 9915 AMMETER / VOLTMETER AMPROBE TYPE DIGITAL ........ ... - .. ........ .. . INCLINED DRAFT GAGE DWYER 0-0.25" 0-0.50" 400" MAGNEHELICGrAGE 0-0.50" 0-1.0" 0-2.0" 0-4.0" 0-8.0" PRESSURE GAGE -30--+30 PSI 0-60 PSI 0-100 PSI . . . ...... .... . ..... .... ------- PRESSURE GAGE DIFFERENTIAL BARC'00-50" 0-100" 300" 500" PYROMETER ALNOR THERMOMETERS FLUKE TYPE 52 MICROMANOMETER ALNOR TYPE 530 ce (ANSI Anthony Struble BH®681515 //j December 31, 7020 C, Supt -11 PROJECT ALTITUDE 5200' FLOW HOOD CORRECT 1.10 APPLIED TO. AREA (K FACTOR) X VELOCITY STATIC PRESSURE CORRECTION 1.21 RECORDED PRESSURE READINGS ARE MEASURED X CORRECTED COMPLETE MECHANICAL BALANCING, INC. AIR SYSTEM RECAP SHEET PAGE 14211-1 JOB: LMC NEURO CLINIC ZONE OR REQ'D ACT'L % OF FUNCTION UNIT NO. MAIN CFM CFM REQ'D OSA REMARKS PAGE SUPPLY FPB -2-51 1-7 840 853 102 2 SUPPLY FPB -2-52 8-9 650 655 101 2 SUPPLY FPB -2-53 10-13 800 809 101 2 SUPPLY FPB -2-54 14-17 900 919 102 2 TOTAL 3190 3236 101 COMPLETE MECHANICAL PROJECT LMC NEURO CLINIC BALANCING LOCATION 3455 LUTHERAN PK -WY -SUITE 285 FAN SYSTEM (E) SUPPLY CONTRACTOR LMC SIZE REQUIRED TEST 1 TEST 2 TEST 3 PAGE NO 14211-2 DATE 05-28-2020 BALANCER A.S. VEL CFM % 80 TOPENING PLAN ACT'LAREA.1VEL . ........... . ..... CFM VEL %'VEL, % FPB -2-5 I - 1 24/24 1.10,�_7� - 85 80 104 1 2124/24. __7 1 1.10 155170 101 160 104 3 24/24f 1 0'j109 95 120 100 92, 4 24/24i 1.10! 123 135 140 114 5 24/241 1.10 173 190 180 1 1 04 6 24/24 1.10 36 40 .... . ........ 351 96� 7 24/24 1.10 91 100 95 1051 TOTAL 840 FPB -2-52-8 24/24 1.10 3501 ........ .... ... .. 385 ........... ...... . 270 771 9 4'SLT 1.10 241 ............ .. 265 190: 79 TOTAL 650' ........... ------ . . ..... . ... -P13-2-53-10 F 24/24 1.10 177 1951 195 110� 11! 24/24 1.10 182 200 190 105: . . ..... .. .. 12! 24/24' 1.10 182 200 180 99 ....... . .. 13i 24/24 1.10 186 205 210 113 TOTAL:z 800 ... .... .. ..... FPB -2-54-14j 24/24 1.10, 250 t 275 400;160 15124/24 1.10 250 275 400 z 160: 16'24/24 1.10 159 .t 175 . ................. 360,226 17 24/24 1.10 159 175 3601226 .... . ....... TOTAL900: . .. . . .......... PAGE NO 14211-2 DATE 05-28-2020 BALANCER A.S. VEL CFM % 80 88 104 155 171 . . ...... .. .. . 100 110:: --l' ..- 1211,101 -- --- -- - t - 7 1 25� 138� 102 175 193z� 101 35 �11-1111-11 . 39� -- — ----- 96 - - - ---- -- 95 105 105 z 853 350 385 100 245 270 102 655 180 198 102 1801 198 99 1851 204 102 190 209 102 160, 809 101 100% OPEN MIN 490 1I EAT 400 100% OPEN MIN 260 HEAT 320 260Z 286: 104 255 281 102 100% OPEN 160 176 101 160, 176 101 MIN 360 919 HEAT 360 uj Lu Lu 0 $4 d.'gg Axa r an �s z$ e;g; a °s6c �i z Jill p� y��� g$Y S¢i ggg�}� §¢g� 4�$gyY 8� �4�d "3q��d YB6 B8i 5 555€ E€ O BS "§Y e84S& i i 69009 00'3001H 1V3HM S9Z mins'AMNd N"3Hl0l N 5949 OINI-10 min3N 2i31N30 -I` OI(13W N"3Him € ➢� def sy� ¢ - . . 9,: x W �0000000©oo©ooa000 0�1 �oo0000©0000000000 X00©00110001108®0�! a 5 �000a0000a0000000 moi X1101111111111111 . 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L2 Permit Number: c-, U L) \ ! U s ❑ No one available for inspection: Time U 0`1 AM/PM Re -Inspection required: Y� No When corrections have been made, call for re -inspection at 303-234-5933 0 Inspector: t?l DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE _1�9rBuilding Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 0 P C. (2- C f, Job Address: _ q C � j k, C o t)^ e a 2 5 Permit Number: d 0 -)- C_.) 0 b C) ( I l_w + ❑ No one available for inspection: Time , s AM/PM Re -Inspection required: Y?s No When corrections have been made, call for re -inspection at 303-234-5933 Date: -� `� ` Inspector: DO NOT REMOVE THIS NOTICE Engineering Solutions Since 1959 CAT©R RUMA www.caTorrum-corn & ASSOCIATES, CO. SERVICES May 21, 2020 Mechanical Electrical Plumbing City of Wheatridge Building Division Fire Protection 7500 W 29th Avenue Technology Denver, CO 80033 Architectural Lighting Commissioning RE: SCLH - LMC - MOB III - Suite 285 LOCATIONS HVAC Installation Denver Metro - CO CRA #2019-517 Cheyenne - WY Boise - ID To Whom it May Concern: The project scope at SCLH Lutheran Medical Center - MOB III - Suite 285 was modified whereby existing diffusers were relocated, and sound boots were added as required to accommodate the architectural modifications. The approach should have no impact on HVAC as previously designed. Sincerely, Cator, Ruma & Associates, Co. e�/44-zo 7%� Chuck Rogge, PE, LEED AP Associate/Mechanical Engineer cc: Jackie Rudko, File - Cator, Ruma & Associates Mike Hagan - TreanorHL Dwayne Gaeddert - SCLH LMC By: email CFR/sm P:\SCLH\LMC\MOB III\2019-517 Suite 285\Sup-Docs\2019-517.LTR.HVAC Install.2O2OO521.docx 896 Tabor Street o Lakewood, Colorado 80401-4700,:,303.232.6200 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: _ `� d -A L r^2 t Job Address: S A, y o77� Permit Number: 0 061 1 \_k V ❑ No one available for inspection: Time'O-h' .; AM/PM Re -Inspection required: ?Yes`� No When corrections have been made, call for re -inspection at 303-234-5933 Date: '�; 2 _L ' ? u 1' Inspector: DO NOT REMOVE THIS NOTICE e 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,° Y -n,4 A C Job Address: Permit Number: ac>a 0 U U \ \ ! p va' � r✓� � C� r � ,,� � tJ �v `` ,�21" ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Dater'�o ��t4 Inspector: DO NOT REMOVE THIS NOTICE 1* � 4 i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE r Inspection Type: y Job Address: Permit Number: A110 _j 71 a 74 7711 ❑ No one available for inspection: Time �M `_� Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: �' Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type:396q ZCX::tVG 1-4 GEL C)E Job Address: htiY4 Permit Number: 2C747) .-L 41 k ❑ No one available for inspection: Ti AM/PM Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: http✓/www.ci.wheatridge.co.usdnspectpn ctor 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: I^^ '� o-� f ( Job Address: '3 0-• r I 'a Permit Number: u :) U (:) 11 1 ❑ No one available for inspection: Time 1 '� AM/PM Re -Inspection required: Yesl No When corrections have been made, call for re -inspection at 303-234-5933 Dater' Ly Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address: :, 10 Permit Number: L4 ❑ No one available for inspection:_Tim PM Re -Inspection required: Yes When corrections have been made, schequle for re -inspection online at: http✓/www.ci.wheatridge.co.uslinsp�ctionJ 0 i CITY OF WHEAT RIDGE 91 Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Q V'j y Job Address: >` L a C� n Permit Number: i , \ 1-4 �Q t ❑ No one available for inspection.: Time 1 AM/PM Re -Inspection required: Yes t Noy When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co, uslinspection Date: `4 Inspector:` DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE v Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: -��- Job Address: -2)/-4,_ T:'� b' Permit Number:��`�- r ❑ No one available for inspection: Ti Re -Inspection required: Yes No When corrections have been madf http://www. ci. wheatridge. co. u-qfinsp • Date• •tripe PM for re -inspection online at: i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: -'e ' Q Job Address: `� Sr e3��lc n V KV { Permit Number: 0 OIL _,. ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes �V When corrections have been made, schedule for re -inspection online at: http://www. ci. wheatridge. co. uslinspection Date: Inspector: '� A DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: P. ry- � Job Address:"'{ Permit Number: r ,v Ci l,..j -F- ❑ No one available for inspection: Time ' 17,,-A, AM/PM Re -Inspection required: Y6` No When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. uslinspection Date: L '-? 'I_YyT v Inspector: k�_ DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE %-- I_ -It Inspection Type: -c---� Job Address: Z Permit Number: A y. ❑ No one available for inspection: Timetll/M Re -Inspection required: Yes When corrections have been made, 4cbedule for re -inspection online at: http.11www.ci.wheatridge.co.usl,nspe ion Da �" Inspector• e r A i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office _1�9� INSPECTION NOTICE Inspection Type: o Vn�� Job Address: Permit Number: Q (D h U Tyt i L i "ix) )10k -, s Sa—iI c c vj (K l r1 ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes, No When corrections have been made, schedule for re -inspection online at: http✓/www. cL wheatridge. co. uslinspection Date: ` '> = ; Inspector: -) DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: Job Address:���; Permit Number: C-, Do ❑ No one available for inspection: Time AM/PM Re -Inspection required: es No When corrections have been made, schedule for re -inspection online at: http://ww ci. wheatridge.co. uslinspection Date: W —;-1 10 Inspector: t--_7_) DO NOT REMOVE THIS NOTICE 1* � 4 i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: ►� i-�1' Job Address: Permit Number: v ❑ No one available for inspection: Time -71 3 AM/PM Re -Inspection required: Y(s) No *When corrections have been made, schedule for re -inspection online at: http://www,ci whe trldge o.ushnspection Dates ,"'�'�� L Inspector DO NOT REMOVE THIS NOTICE City of Wheat Ridge Comm. Tenant Finish PERMIT - 202000544 PERMIT NO: 202000544 ISSUED: 03/27/2020 JOB ADDRESS: 3455 Lutheran Pkwy Ste 120 EXPIRES: 03/27/2021 JOB DESCRIPTION: Commercial tenant consisting of demolition of in -suite walls, flooring and two sinks. New interior walls for new offices including HVAC, electrical and fire alarm. *** 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. Square footage: 2,032 *** CONTACTS *** OWNER (720)304-8940 EXEMPLA LUTHERAN GC (720)583-1679 BRUCE CARPENTER 160250 BC BUILDERS, INC. SUB (303)973-7435 STAN STONE & JAMES NEILL 202057 ELECTRITECH, INC SUB (303)292-1116 WRAY MECHANICAL 018977 WRAY SHEET METAL, 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: 125,000.00 FEES Total Valuation 0.00 Plan Review Fee 840.65 Use Tax 2,625.00 Permit Fee 1,293.30 ** TOTAL ** 4,758.95 *** 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 - 202000544 PERMIT NO: 202000544 ISSUED: 03/27/2020 JOB ADDRESS: 3455 Lutheran Pkwy Ste 120 EXPIRES: 03/27/2021 JOB DESCRIPTION: Commercial tenant consisting of demolition of in -suite walls, flooring and two sinks. New interior walls for new offices including HVAC, electrical and fire alarm. Square footage: 2,032 I by in signature do heattest 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 alI entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4, No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all 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 cod�y ordinance Qr 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. ity of 1or' W hea.-t P jd .,,. MUNi1"Y DEVELOP EN - Building & Inspection Services 7500 W. 2911 Ave., Wheat Ridge, CO 80033 Office. 303-235-2855 " Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(a_Dci.wheatridge.co.us FOR OFFICE USE ONLY Date: PlanlPermit # LA0 o Plan Review Fee: r CLQ Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 3455 Lutheran Pkwy #120 Wheat Ridge, CO 80033 Property Owner (please print): Lillibridge Healthcare Services Phone: 303.422.9500 Property Owner Email: brian.stock@lillibridge.com (Commercial Projects Only) Lillibridge adwhesMailing Address: (if different than property address) City, State, Zi Architect/Engineer Altus Architechural Studios Architect/Engineer E-mail: operations@altusstudios.com Phone: 402.334.2422 Contractor Name: BC Builders, Inc. City of Wheat Ridge License M 160250 Phone: 303.945.4479 Contractor E-mail Address: Bruce@bcbuilders.co Tenant Name Property For Plan Review Questions & Comments (please print): CONTACT NAME (please print): Kevin Montano Phone: 720.583.1679 CONTACT EMAIL(p/ease print): Kevin@bcbuilders.co Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: ElectriTech Plumbing: Straight Plumbing Inc. Mechanical: Wray Mechanical Systems W.R. City License # 202057 W. R. City License # 018645 W. R. City License # 018977 Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields, if applicable. OCOMMERCIAL ❑ RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. The tenant finish of 3455 Lutheran Pkwy #120 consists of the demolition of in -suite walls, flooring and two sinks. The remodel will include new interior walls creating more offices. This update includes updating the existing HVAC, electrical and fire alarm. Most hardware will remain the same while installing new flooring and paint. Sq. FULF BTUs Gallons Amps Squares For Solar: Kw # of Panels Requires Structural For Commercial Projects Only: Occupancy Type: B Construction Type: II -B Sprinklered x Yes No Occupancy Load: ?1 Square Footage: 2,032 Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ 125,000.00 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER)CONTRACTOR or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): DATE: 3/2/2020 Printed Name: Bruce Carpenter ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer. PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: 2 20. Z La Building Division Valuation: , 0 01 00 City of Wheat.idgc�, C,OMMUNiTy DEVELOPMENT SUB -CONTRACTOR AUTHORIZATION FORM This form must be signed by each tor. This form will not he accepted with missing information. Subcontractor's City of Wheat Ridge License number must be provided in the applicable space. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: 3455 Lutheran Pkwy #120 General Contractor- RC Builders, Inc. Electrical Sub -Contractor Company Name: ElectriTech State License #: Permit #: Phone 4: 303,913.7435 Master #: Wheat Ridge License #: 202057 — (rc�quired ficio) Date Signature of Authorized Agent Plumbing Sub -Contractor Company Name: Strait Plumbing Inc. — Phone #. 720.6114522 State License #- PCO001782 Master #- MP000179138 Wheat Ridge License #: 018645 Signature of Authorized Agent Mechanical Contractor ("required field) 03/07/2020 Date Company Name: Wray Mechanical Systems phone: 301292.1116 Wheat Ridge License 4: 018977 -irt(luired field) 3/2/2020 Signature of Authorized Agent Date City of WheatI�idge COMMUNITY DEvELOPM,NT SUB -CONTRACTOR AUTHORIZATION FORM )y c Contractor, his form must be signed , or. This form will not be accepted with missing information. Subcontractor's City of Wheat Ridge License number must he provided in the applicable space. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: 3455 Lutheran Pkwy #120 General Contractor,. BC' Builders, Inc. Electrical Sub -Contractor Permit #: Company Name: ElectriTech Phone #.- 303.913.7435 State License #: eel, 4100 a q 0 .- Master #: PIC, 06--2- 06,2-Y Wheat Ridge Llcense Date Signature Of Ai horizoA Agent Plumbing Sub -Contractor Company Name: -Strait Plumbing Inc. 11 1 Phone #: 720,612,4522 State License #: %Vheat Ridge License #: 01804 � Z, Signature of Authorized Agent Master N: Date I Mechanical Contractor I Company Name: Wray Mechanical Systems phone: 3031.292.1116 NN heat Ridge License 3/2/2020 Signature of Authorized Agent Date Opt WCity of h6at1��c� VV C cnm�omm -1 11NITY [)[-VF-,LOPMFNT SUB -CONTRACTOR AUTHORIZATION FORM This form trust c signed by cacti sub -contractor. This forin will not be accepted with missing information. Subcontractor's City of Wheat Ridge License number must be provided in the applicable space. Subcontractor's insurance and license must be tip to date prior to perinit issuance. Pro . till 20 ject Address: 34��,5 Lutheran Pkv,'N'' General Contractor: BC Builders, Inc, Electrical Sub -Contractor Company Naine: FICCUITech W — State License #: Wheat Ridge License 4:20205-17 Si-naturc of Authorized A<Ycnt Permit #: l'h3anc n: 303,913.74 3> Master #: Date Plumbing Sub -Contractor Company Name: Strait Plumbing Inc, Phone #: 720.612.4522 State License 'Master kN"heat Riche License 4: 0] 8645 Signature of Authorized Agent t., Mechanical Contractor C:0 m Date I Wriv Mechanical Systems Pholle: 303,29111 '16 t Vidge License 4: 018977 -3 /2 2020 r)f:, tithorized Agci�t Date r,o 3/2/2020 Address: Print Preview Permit Application - Print Preview Addr/Street: 3455 Lutheran Parkway City/State: Wheat Ridge CO Zip Code: 80033 owner. First Name: Rodger Last Name: Sandoval Business Name: Lillibridge Healthcare Sevices Phone: (303) 422-9500 Phone AH: (303) 653-3006 Cell Phone: (303) 653-3006 Fax: Addr: 3555 Lutheran Parkway Suite: City/State: Wheat Ridge CO Zip Code: 80033 Email: rodger.sandoval@lillibridge.com Occupant: Building: Occupant: Vacant Suite: 120 Property Use Type: Commercial Job: Job Type: 2 Existing Building/ Tenant Improvement Sq Ft: 2,032.00 Cost: $125,000.00 Desc: The tenant finish of 3455 Lutheran Pkwy #120 consists of the demolition of in -suite walls, flooring and two sinks. The remodel will include new interior walls creating more offices. This update includes updating the existing HVAC, electrical and fire alarm. Most hardware will remain the same while installing new flooring and paint. Comments: https://www.mobile-eyes.com/PA_PrintPreview.asp 1/1 s/t/ MARK INSPECTIONS, INC. ASBESTOS INSPECTION & TESTING AGREEMENT Please read both pages of this agreement carefully Agreement Date: 3-3-20 Client Name: B C Builders, Inc. ("Client") Mailing Address: 6595 W 14th Ave, Ste 201, Lakewood, CO 80214 Daytime Phone:( ) Inspection and Testing Date: 3-3-20 Address of Property to be Inspected: 3455 Lutheran Parkway, Suite 120, Wheat Ridge, CO Inspection Fee: $350.00 This Agreement, made and entered on the agreement date indicated above, by and between the Client and Mark Inspections, Inc., a Colorado corporation located in Englewood, Colorado. ("Mark Inspections") Mark Inspections will provide the following services to Client: (1) visually inspect and sample building materials at the subject property to check for asbestos containing materials; (2) have the following asbestos tests performed on the building material samples: Test Type: asbestos testing PLM- 30 samples @ 20.00 $600.00 Total Price For Tests: $600.00 TOTAL DUE: $950.00 and (3) provide a written report of Mark Inspections' visual inspection observations and explanation of laboratory test results. The inspection and testing will be in accordance with the standards and practice of the Colorado Department of Public health and Environment Air Pollution Control Division (CDPHE) and the Environmental Protection Agency (EPA). Having read and fully understanding this Agreement, I hereby agree to be bound by the Agreement and authorize the inspection and testing of the Property. Payment in full is to be received within 30 days of the agreement date. Client Signature Mark Inspections, Inc. P.O. Box 1082, Englewood, CO 801590-1082 (303) 653-7583 Mark Inspections, Inc. P.O. Box 1082 Englewood, Colorado 80150-1082 (303) 653-7583 March 4, 2020 Kevin Montano B C Builders, Inc 6595 W. 14th Avenue, Suite 201 Lakewood, CO 80214 RE: Asbestos Testing PLM— Project #BCL120- Lillibridge 3455 Lutheran Parkway, Ste 120, Wheat Ridge, CO Dear Mr. Montano: On March 2, 2020, random samples of building materials at the above referenced address were taken and tested for asbestos content per client request. The samples were submitted to REI Lab, Inc. for analysis via EPA 600/R-93/116 Method using Polarized Light Microscopy. Guidelines used for the inspection were established by the Environmental Protection Agency (EPA) in order to comply with the Air Quality Control Commission Regulation No. 8, Part B "Emission Standards for Asbestos." Field Information was organized as per the AHERA (Asbestos Hazard Emergency Response Act) concept of Homogeneous Area. A Homogeneous Area is defined as a suspect material of similar age, appearance, function, and texture. If damage is extensive enough that the homogeneous areas cannot be defined, samples will be randomly obtained per functional space. Each material was grouped together as a specific Homogeneous Area or obtained from a specific functional space, sampled, and then assessed for condition. The number of samples of surfacing material, such as drywall texture, is dependent on the square footage of the drywall to be removed. Due to the square footage of the textured wall material to be removed in the north east/west hallway of the unit, less than 1,000 square feet, the Homogenous areas textured wall materials will require at least three samples of each type according to AHERA. Due to the square footage of the textured wall material to be removed in the south north/south hallway and adjacent rooms of the unit, less than 1,000 square feet, the Homogenous areas textured wall materials will require at least three samples of each type according to AHERA. All materials sampled have been slated for demolition. Consequently, invasive techniques may have been utilized to obtain or clear areas of suspect (Asbestos Containing Materials) ACM. Material quantities are approximate as exact amount of demolition may vary depending on a number of factors such as success of dry -out, extent of smoke damage, etc. Consequently, for these types of environments we recommend the contractor verify exact material Page 2 amounts. Any materials not tested but mentioned in this report are non -suspect materials (wood, metal, plastic, rubber, or glass). Mark Inspections, Inc. adheres to the AHERA recommended guidelines for sampling frequency of homogeneous materials. However, we reserve the right to conduct additional sampling procedures after the initial bulk sampling lab results are received if warranted. Mark Inspections, Inc. makes every effort to comply with the regulations associated with renovation type environments. Scotie of Work - This survey was requested as the result of future remodeling in Suite 120 at the address listed above. One suspect material involved in the demolition scope provided by the onsite contractor is considered to be a surfacing building material: white compound. Drywall, paint, white compound, joint compound, tape; gray/white ceiling tile; beige/tan adhesive; black mastic, gray/multi-colored tile with gray/white debris; tan adhesive, gray cove base; tan adhesive; tan adhesive, tan tile; yellow resinous material; beige paint with tan paper, colorless adhesive, white compound with beige paint; colorless resinous material, and gray granular cementitious material are to be considered miscellaneous building materials. These building materials were used on the interior of the suite. No additional suspect materials were observed which are slated for removal. This survey was characterized by a close visual inspection of all accessible affected areas. All materials sampled have been slated for demolition by the onsite contractor. Suspect materials have been sampled and inventoried. The suspect materials which are slated for removal, their corresponding locations, and bulk sampling lab results can be found in the following material classification section. The actual lab report is also attached to this report. NORTH SIDE OF Suite 120 - MISCELLANEOUS MATERIALS: Wall building system components North East/West Hallway NON -FRIABLE- all designated materials to be materials to be removed Miscellaneous materials- white compound, drywall, white joint compound, tape, and paint 1) North East/West Hallway- south wall, left of doorway to north/south hallway: 1" off of east wall, 5" off of floor (sample #113CL120) Sample was negative for asbestos containing materials (non -ACM) 2) North East/West Hallway- south wall, above lockers: 1" off of east wall, 18" off of ceiling (sample #2BCL120) Sample was negative for asbestos containing materials (non -ACM) Page 3 SURFACING MATERIALS: Walls, untextured drywall North East/West Hallway Non -FRIABLE- approximately 450 square feet of material with potential for significant damage Surface Materials: none Miscellaneous materials- drywall and paint 3) North East/West Hallway- east wall, left of doorway to north/south hallway: 10" off of south wall, 52" off of floor (sample #3BCL120) Sample was negative for asbestos containing materials (non -ACM) 4) North East/West Hallway- south wall, above lockers: 60" off of east wall, 5" off of ceiling (sample #4BCL120) Sample was negative for asbestos containing materials (non -ACM) 5) North East/West Hallway- south wall, above lockers: 45" off of west wall, 24" off of ceiling (sample #5BCL120) Sample was negative for asbestos containing materials (non -ACM) MISCELLANEOUS MATERIALS: Ceiling tiles Suite 120, north side NON -FRIABLE- all designated materials to be removed Miscellaneous materials- gray/white ceiling tile 6) North East/West Hallway- along south wall (sample #6BCL120) Sample was negative for asbestos containing materials (non -ACM) 7) North East/West Hallway- center of hallway (sample #7BCL120) Sample was negative for asbestos containing materials (non -ACM) MISCELLANEOUS MATERIALS: Cove base mastic Suite 120, north side NON -FRIABLE- all designated materials to be removed Miscellaneous materials- white compound, paint, beige/tan adhesive 8) North East/West Hallway- along north wall (sample #8BCL120) Sample was negative for asbestos containing materials (non -ACM) 9) North East/West Hallway- next to south doorway (sample #9BCL120) Sample was negative for asbestos containing materials (non -ACM) Page 4 MISCELLANEOUS MATERIALS: Gray floor tiles Suite 120, north side NON -FRIABLE- all designated materials to be removed Miscellaneous materials- black mastic, gray/multi-colored tile with gray/white debris 10) North East/West Hallway- northwest corner (sample #10BCL120) Sample was negative for asbestos containing materials (non -ACM) 11) Northeast Office- entry (sample #1113CL120) Sample was negative for asbestos containing materials (non -ACM) SOUTH SIDE OF Suite 120 - MISCELLANEOUS MATERIALS: Wall building system components South North/South Hallway and adjacent rooms NON -FRIABLE- all designated materials to be materials to be removed Miscellaneous materials- white compound, drywall, and paint 12) South North/South Hallway- west wall: 1" off of south wall, 5" off of floor (sample #12BCL120) Sample was negative for asbestos containing materials (non -ACM) 13) Room 120-127- south wall: 1" off of east wall, 7" off of floor (sample #13BCL120) Sample was negative for asbestos containing materials (non -ACM) SURFACING MATERIALS: Textured walls South North/South Hallway and adjacent rooms Non -FRIABLE- approximately 850 square feet of material with potential for significant damage Surface Materials: white compound Miscellaneous materials- drywall and paint 14) South North/South Hallway- east wall: 62" off of south wall, 17" off of floor (sample #14BCL120) Sample was negative for asbestos containing materials (non -ACM) 15) Room 120-126- west wall: 21" off of north wall, 54" off of floor (sample #15BCL120) Sample was negative for asbestos containing materials (non -ACM) Page 5 16) South North/South Hallway- north wall: 10" off of east wall, 20" off of ceiling (sample #16BCL120) Sample was negative for asbestos containing materials (non -ACM) MISCELLANEOUS MATERIALS: Ceiling tiles Suite 120, south side NON -FRIABLE- all designated materials to be removed Miscellaneous materials- gray/white ceiling tile 17) South North/South Hallway- center of hallway (sample #17BCL120) Sample was negative for asbestos containing materials (non -ACM) 18) Room 120-125- center of room (sample #18BCL120) Sample was negative for asbestos containing materials (non -ACM) MISCELLANEOUS MATERIALS: Black cove base mastic South North/South Hallway NON -FRIABLE- all designated materials to be removed Miscellaneous materials- white compound, paint gray cove base, tan adhesive 19) South North/South Hallway- next to north entry doorway (sample #19BCL120) Sample was negative for asbestos containing materials (non -ACM) 20) South North/South Hallway- left of Room 120-126 doorway (sample #20BCL120) Sample was negative for asbestos containing materials (non -ACM) MISCELLANEOUS MATERIALS: Tan cove base mastic Rooms 120125 and 120-126 NON -FRIABLE- all designated materials to be removed Miscellaneous materials- tan adhesive 21) Room 120-126- east wall (sample #21BCL120) Sample was negative for asbestos containing materials (non -ACM) 22) Room 120-125- east wall (sample #22BCL120) Sample was negative for asbestos containing materials (non -ACM) Page 6 MISCELLANEOUS MATERIALS: Tan floor tiles Suite 120, south side NON -FRIABLE- all designated materials to be removed Miscellaneous materials- tan adhesive, tan tile 23) South North/South Hallway- next to north entry doorway (sample #23BCL120) Sample was negative for asbestos containing materials (non -ACM) 24) Room 120-125- southwest corner (sample #24BCL120) Sample was negative for asbestos containing materials (non -ACM) MISCELLANEOUS MATERIALS: Flooring Room 120-127 NON -FRIABLE- all designated materials to be removed Miscellaneous materials- yellow resinous material 25) Room 120-127- northeast corner (sample #25BCL120) Sample was negative for asbestos containing materials (non -ACM) 26) Room 120-127- southwest corner (sample #26BCL120) Sample was negative for asbestos containing materials (non -ACM) MISCELLANEOUS MATERIALS: Vinyl wall covering Rooms 120-125 and 120-126 NON -FRIABLE- all designated materials to be removed Miscellaneous materials- beige paint with tan paper, colorless adhesive, white compound with beige paint 27) Room 120-125- east wall (sample #2713CL120) Sample was negative for asbestos containing materials (non -ACM) 28) Room 120-126- east wall (sample #28BCL120) Sample was negative for asbestos containing materials (non -ACM) MISCELLANEOUS MATERIALS: Mop sink Room 120-126 NON -FRIABLE- all designated materials to be removed Miscellaneous materials- colorless resinous material, and gray granular cementitious material 29) Room 120-126- along west wall (sample #2913CL120) Sample was negative for asbestos containing materials (non -ACM) Page 7 30) Room 120-126- along north wall (sample #30BCL120) Sample was negative for asbestos containing materials (non -ACM) SUMMARY- NO ASBESTOS in the building materials tested As stated in the attached report, REI Lab, Inc. indicated that the above building material samples were determined to be negative for asbestos containing materials and therefore determined not to require asbestos abatement according to the Colorado Department of Public Health and Environment (CDPHE) guidelines. The information in this report pertains to the areas to be remodeled in Suite 120 at the above referenced address only. Mark Inspections, Inc. has made every effort to survey and randomly sample all affected suspect building materials associated with this project. However, in some cases hidden or patched in building materials may be present which were not readily observed. If during the demolition a new type of material in quantities that exceed acceptable trigger levels for removal is discovered due to visual obscurity or change in project scope, it is recommended additional inspection and sampling be employed. Sincerely, Mark Peltz, Building Inspector Colorado Certification No.:16310 Mark Inspections, Inc. Asbestos Consulting Firm Reg. No. ACF: 18001 Reservoirs Environmental, Inc Effective April 02, 2018 Reservoirs Environmental QA Manual Q:\QAQC\Lab\Reservoirs Environmental QA Manual.doc R E� B Reserrvoirs Environments/, Inc. T - March 03, 2020 Mark Peitz Mark Inspections, Inc. 4610 S. Pennsylvania St. Englewood CO 80113 Dear Mark, Subcontractor Number: Laboratory Report: RES 457939-1 Project WRO. #: BCL120 Project Description: None Given Reservoirs Environmental, Inc. is an analytical laboratory accredited for the analysis of Industrial Hygiene and Environmental matrices by the National Voluntary Laboratory Accreditation Program (NVLAP), Lab Code 101896-0 for Transmission Electron Microscopy (TEM) and Polarized Light Microscopy (PLM) analysis and the American Industrial Hygiene Association (AIHA), Lab ID 101533 - Accreditation Certificate #480 for Phase Contrast Microscopy (PCM) analysis. This laboratory is currently proficient in both Proficiency Testing and PAT programs respectively. Reservoirs Environmental, Inc. has analyzed the following samples for asbestos content as per your request. The analysis has been completed in general accordance with the appropriate methodology as stated in the attached analysis table. The results have been submitted to your office. RES 457939-1 is the job number assigned to this study. This report is considered highly confidential and the sole property of the customer. Reservoirs Environmental, Inc. will not discuss any part of this study with personnel other than those of the client. The results described in this report only apply to the samples analyzed. This report must not be used to claim endorsement of products or analytical results by NVLAP or any agency of the U.S. Government. This report shall not be reproduced except in full, without written approval from Reservoirs Environmental, Inc. Samples will be disposed of after sixty days unless longer storage is requested. If you have any questions about this report, please feel free to call 303-964-1986. Sincerely, � by Andrew !r Jeanne Spencer President P:(303) 964-1986 5801 Logan St, Suite 100, Denver, CO 80216 1-866-RESI-ENV F.(303) 477-4275—reilab.com Reservoirs Environmental, Inc. Reservoirs Environmental QA Manual RESERVOIRS ENVIRONMENTAL INC. NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 457939-1 Client: Mark Inspections, Inc. Client Project Number / P.O.: BCL120 Client Project Description: None Given Date Samples Received: March 03, 2020 Method: EPA 600/11-93/116 - Short Report, Bulk Turnaround: Rush Date Samples Analyzed: March 03, 2020 Effective April 2, 2018 Q:\QAQC\LAB\Reservoirs Environmental QA Manual.tloc ND=None Detected TR=Trace, <1 %Visual Estimate Trem/Act=Tremolite/Actinolite Client Sample Number L A Sub Y Physical Part E Description R (%) Asbestos Content Mineral Visual Estimate (%) Non Asbestos Fibrous Components (%) Non - Fibrous Components (%) 1BCL120 A White tape 6 ND 95 5 B White compound w/ gray paint 6 ND 0 100 C White joint compound 7 ND 0 100 D White compound 11 ND 0 100 E Pink/tan drywall 70 ND 20 80 2BCL120 A White compound w/ gray paint 20 ND 0 100 B Pink/tan drywall 80 ND 20 80 3BCL120 A Pink/tan drywall w/ gray paint 100 ND 32 68 4BCL120 A Pink/tan drywall w/ gray paint 100 ND 37 63 5BCL120 A Pink/tan drywall w/ gray paint 100 ND 32 68 6BCL120 A Gray/white ceiling tile 100 ND 60 40 7BCL120 A Gray/white ceiling tile 100 ND 55 45 8BCL120 A White compound w/ white paint 15 ND 0 100 B Beige/tan adhesive 85 ND 0 100 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1%. R 303-964-1986 5801 Lagan street, Suite 100, Denver, CO 80216 1-866-RESI-ENV 1=: 303-477-4275 vrv+w.reilab.com ?age 1 of 6 Reservoirs Environmental, Inc. Reservoirs Environmental QA Manual RESERVOIRS ENVIRONMENTAL INC. NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 457939-1 Client: Mark Inspections, Inc. Client Project Number / P.O.: BCL120 Client Project Description: None Given Date Samples Received: March 03, 2020 Method: EPA 600/R-93/116 - Short Report, Bulk Turnaround: Rush Date Samples Analyzed: March 03, 2020 Effective April 2, 2018 Q:\QAQC\LAMReservoim Environmental QA Manual.°oc ND=None Detected TR=Trace, <1%Visual Estimate Trem/Act=Tremol ite/Actinolite Client Sample Number L A Sub Y Physical Part E Description R (%) Asbestos Content Mineral Visual Estimate Non Asbestos Fibrous Components Non - Fibrous Components 9BCL120 A White compound w/ white paint 15 ND 0 100 B Beige adhesive 85 ND 0 100 1OBCL120 A Black mastic 6 ND 0 100 B Gray/multi-colored tile 94 ND 0 100 11BCL120 A Black mastic 7 ND 0 100 B Gray/multi-colored tile w/ gray/white debris 93 ND 0 100 12BCL120 A Tan/gray drywall 40 ND 30 70 B White compound w/ gray paint 60 ND 0 100 13BCL120 A White compound w/ gray paint 30 ND 0 100 B Pink/tan drywall 70 ND 20 80 14BCL120 A White compound w/ gray paint 15 ND 0 100 B Pink/tan drywall 85 ND 25 75 15BCL120 A White compound w/ gray paint 10 ND 0 100 B Pink/tan drywall 90 ND 20 80 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1%. P: 303-964-1986 5801 Logan Street, Suite 100, Denver, CO 80216 1-866-RESI-ENV F. 303477-4275—.reilab.com ?aye 2 of 5 Reservoirs Environmental, Inc. Reservoirs Environmental QA Manual RESERVOIRS ENVIRONMENTAL INC. NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 457939-1 Client: Mark Inspections, Inc. Client Project Number / P.O.: BCL120 Client Project Description: None Given Date Samples Received: March 03, 2020 Method: EPA 600/R-93/116 - Short Report, Bulk Turnaround: Rush Date Samples Analyzed: March 03, 2020 Effective April 2, 2018 Q:\QAQC\LAB\Reservoirs Environmental QA Manual.doc ND=None Detected TR-Trace,<1 % Visual Estimate Trem/Act=Tremolite/Actinolite Client Sample Number L A Sub Y Physical Part E Description° R (%) Asbestos Content Mineral Visual Estimate (%) Non Asbestos Fibrous Components Non - Fibrous Components 16BCL120 A White compound 15 ND 0 100 B White compound w/ gray paint 35 ND 0 100 C Pink/tan drywall 50 ND 30 70 17BCL120 A Gray/white ceiling tile 100 ND 60 40 18BCL120 A Gray/white ceiling tile 100 ND 55 45 19BCL120 A White compound w/ off white paint 20 ND 0 100 B Tan adhesive 40 ND 0 100 C Gray cove base 40 ND 0 100 20BCL120 A White compound 10 ND 0 100 B Tan adhesive 45 ND 0 100 C Gray cove base 45 ND 0 100 21BCL120 A Tan adhesive 100 ND 0 100 22BCL120 A Tan adhesive 100 ND 0 100 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1%. R 303-964-1986 5801 Logan Stmet, Suite 100, Denver, CO 80216 1-866-RESI-ENV F: 303 477-0275-reila°.com ?age 3 of 5 Reservoirs Environmental, Inc. Reservoirs Environmental QA Manual RESERVOIRS ENVIRONMENTAL INC. NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 457939-1 Client: Mark Inspections, Inc. Client Project Number / P.O.: BCL120 Client Project Description: None Given Date Samples Received: March 03, 2020 Method: EPA 600/R-93/116 - Short Report, Bulk Turnaround: Rush Date Samples Analyzed: March 03, 2020 Effective April 2, 2018 Q:\QAQC\LAB\Reservoirs Environmental QA Manual.doc ND -None Detected TR -Trace, <1 %Visual Estirnzte Trem/Act=Tremolite/Actinolite Client Sample Number L A Sub Y Physical Part E Description R (off) Asbestos Content Mineral Visual Estimate Non Asbestos Fibrous Components Non - Fibrous Components 23BCL120 A Tan adhesive 4 ND 0 100 B Tan tile 96 ND 0 100 24BCL120 A Tan adhesive 4 ND 0 100 B Tan tile 96 ND 0 100 25BCL120 A Yellow resinous material 100 ND 0 100 26BCL120 A Yellow resinous material 100 ND 0 100 27BCL120 A Colorless adhesive 30 ND 0 100 B Beige paint w/ tan paper 70 ND 40 60 28BCL120 A Colorless adhesive 20 ND 0 100 B White compound w/ beige paint 80 ND 0 100 29BCL120 A Colorless resinous material 20 ND 0 100 B Gray granular cementitious material 80 ND 0 100 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1%. P: 303-964-1986 5801 Logan Street, Suite 100, Denver, CO 80216 1-866-RESI-ENV F: 303-4771275-rediib.com Page 4 ai 5 Reservoirs Environmental, Inc. Reservoirs Environmental QA Manual RESERVOIRS ENVIRONMENTAL INC. NVLAP Lab Code 101896-0 TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number: RES 457939-1 Client: Mark Inspections, Inc. Client Project Number / P.O.: BCL120 Client Project Description: None Given n...,, c -,.,,..los Received: March 03 9090 Effective April 2, 2018 Q:\QAQC\LAB\Reservoirs Environmental QA Man-Ldoc a,,,N,a..� ..vv......... ���� Method: EPA 600/R-93/116 - Short Report, Bulk rND=None .._ Detected TR -Trace, -1 % Visual Estimate Turnaround: Rush Trem/Act-Tremolite/Actinolite Date Samples Analyzed: March 03, 2020 Client L Asbestos Content Non Non - Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components E Description ' Estimate Components R 30BCL120 A Colorless resinous material 30 ND 0 100 B Gray granular cementitious material 70 ND 0 100 TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1%. / r � ✓ Fi�eapoCei:s Analyst / Data QA P: 303-9641986 5801 Logan Street, Suite 100, Denver, CO 80216 1-866-RESI-ENV F: 303-4774275wvnv.reilab.com Page 5 of 5 Reservoirs Envimnmer�l, Inc ERsdive AP60ZMII Reservdrs EmimnmenbloA Manuel 0:10AAOCLLabWeservdn Envimnmemel DA Manual laeT Reservoirs Environmental, Inc. RES Job #: 457939 SUBMITTED By INVOICE TO CONTACT INFORMATION SERIES Company. MARK INSPECTIONS, INC. Company: MARK INSPECTIONS, INC. Contact MARK PELTZ __._._._._.._........_.._._......_._.._.....__•__...................................... _._.._... ._..__.._._._.__._._..__._._._._................. ...... ............. .............. _...... -1 PLFA RUSH ....._.._._._._._.._._.._•_•_._.___._.._._•__•__.._._.._._._._._.._._.._. Atltlress: 4610 S. PENNSYLVANIA S7. Atldrass: 4610 S. PENNSYLVANIA ST. Phone: (303) 653-7583 .._._._._._.._._.._.___.__._._.._.___._.____..._..__...._._..____._.._._..__.._._._r._..__.._._._._._.......................................... ..._._.._._._._._._._.._._....._.___._.._._._._._.............................. Fax: ................ —_.._.___._.._---- _.......... .... ........... ..... .......... ..__._.------- .__.._._._._.___._.._...................................... ENGLEWOOD, CO 80113 ................................................................... ENGLEWOOD, 0080113 Cell: 'PRIOR FOR SAME DAV TAT Project Number and/or P.O. #: 803/120 Final Data Deliverable Email Address: _._._.._._._.__._._...__...__._._._.._._._._._._._..__.._._._._._..__.._._..____._.._._..__._.__.._._. _.._._._. _ .._._.._._.__._.._._.._._._. Project Description/Location: NONE GIVEN MARK@MARKINSPECTIONS.COM ASBESTOS LABORATORY HOURS: Weekdays: lam - 7pm & Sat, Sam - Spm REQUESTED ANALYSIS VALID MATRIX CODES LAB NOTES PLM / PCM I TEM DTLRUSH PRIORITY STANDARD Ar _ A Bulk _ 8 ..._................_ i 9Dust N j ' c e - ' is 9 3 0 ! B = p i 5- =. D i Food - F _._ e ni.P '-� ..-._'Soe ='.S ..'.'.- _ .-'._Paint. _. Surface .SU, ~ Swab SW - - t- ---._............_ CHEMISTRY LABORATORY HOURS: Weekdays: Sam -Spm Dust RUSH PRIORITY STANDARD 'PRIOR FOR SAME DAV TAT e �r� 1 i m's =I " O j Tape i Wipe =W '�'�' NOTICE REQUIRED Metals RUSH PRIORITY STANDARD_DW n 0 8 ............ i i I i3 i I �Ba` 'E #m'3m, ; ___ Waste Water=WW _.._ Organics* SAME DAY RUSH PRIORITY STANDARD _p -_ ! _ j ! '• �! a vei ! $ `g; s a ve "ASTM E1792 approtl wpe media only" _ i MICROBIOLOGY LABORATORY HOURS:. Weekdays: Sam -spm a, m I 8 g S o „m! EIN a, ; e 3 m! e! g € fd- € 3 Viable Analysis" PRIORITY STANDARD "TAT DEPENDENT ON aPEEDOFMICR061AL OROWtN ! 8 8.=_ i Medical Device Analysis RUSH STANDARD cO of °ioi a! 3 ! ! ! Mold Analysis RUSH PRIORITY STANDARD f �N�u - i ml E"Turnaround $!qa p° I nguaranteed. times establish a laboratory priontg subject [o laboratory volume and are not Laboratory Analysis Additional fees appt for afterfiours, weekends and holidays.'; '11E farSpecial o i ` - i Instructions: IN s� s a 5, � i�! 4 E l� H i € i� Instructions Client Sample 10 Number (sampbrogmua!baanpae} ASBESTOS CHEMISTRY MICROBIOLOGY 7 1803/720 gti i i i i i i 03'03/20 '- ._ -. _._.._.._....._._.._................ 2 2SCL120 X I 03/03/20 i � � .---._...,_.-,. 3 3SCL720 % i I i i i i i i .._._:-._.._._.1-._:_...._._.._.__.:._...:-._._........ _._._i._._.._.._ i g 03/0320 1 ._ _ _ __ --------- _ _ _._._.._._ _ _ «_03103/20 7 _._._._....._._.._._.__._.. _ --------- 4 4BCL120 X! ! i ! i i i i �.. IS i - _..................... _....... 5 5803/720 %i�•.., :.._.. B ~-03103/20 i _._- ._...._ ._.:..._.«• -_.__. ._:.-..._. _,_._.._._.._._..__._._._.. ----------- 6 6BCL120 ...... ...... _.:_._«.....:._._.._._._.:-_�__._.._._._._._:.... X .._._!.......... *_._i._...t._._.._._._.:._...*_._._.._._.._..__f._._t..... 03/03/20 *._.�-._._.___._.._....._ ........ T._._.._.t_._e t -r ._,-_-.-..-_ 7 7BCL720 X ......_ ! t_.___._.t__«_...:_._.._._._.t._..t_._._....._._.._._t._�.---- 03!03/20 ._ ._ _ _..*_._._._.._._.._._.._.___.. 6 8603/120 X ' i i ! i i g._.?-. 03103/20_T. : -_. , .. 9 9803/720 X ! , i ! ' : p ! ..._._.___._.q_._t._...t._._.._._._.{....*_._._.._._.._._._t._._«.-.._.._._*._._.._.+_._B._.«._*.�03/0_3/20_*._..-._.._._.._._.._._.._._._._._._._ i : e 0310320 1 10 IOBCLI20 : ! i X i i ! I ......_t__.._._.r._.1._...t_.___._._.t._.ti_._._.._..__._._t._._1.._..._.._._.._._.._.t_._B ' __'_ ___ T _t ------0 4� 4-._.__..____._.._._._._._..__ i _ ! ' ' ' ._._._.. 77 11803/720 X i ! I 1 i i 72 12803/120 X ' ` I i ' ' ' i t_._..__.t_._......y...._..__._.t._....-._._.._._. _._._t._._1.._.. ' B 0310312_0 *""B"'4"" -1'--03/0320_T._...1_.._._....._._._._....._ ,_�._.. 13 13BCLI20 % i REI w111anatyte bicarlirg sampbs basatl on ntortmtlon receiveE aM wdl not be responsibleforanasoromssiana n wkulatnm resul6rpfmnihe Naocurscyaforgirieldeta. BYcigniig, dlenVCOmpenyrepasen!afhea9reas ba!submission ofiMfdlv.irg samples farrequestetl arehsises intlirated on Mis Gein of CustoEy skell consilNa en eralvliral services e9reen1eM w6tl pavmelrttemnof NET 30 aeys. Failure tacvnphwithyaymmitwms maY rewtt' 15% itlh ire ect rtllarg �'-�- Relinquished By: r MARK PELTZ Date/Time: 03103/202015:56:13 Sample Condition: ACCEPTABLE - INTACT � � Received By: ._ ice!-_. HANNA MARTI Daterrime: 03/031202015:56:13 Carder: HAND P:(3(3)9(W1986 5601 Lagan St Suite 100, Denver. CCs(U16 1-666-RESI-ENV F:(=1)4n/ 5 Page1of2 -'ab.— O R. N. Emiiern ental, Inc Rani Emiion mental on Manua E— —.0102,2018 o:wnocueeWase".a,� Ear —reit on W- 1 -REQUESTED ANALYSIS VALID MATRIX CODES LAB NOTES 27 27BCL120 28 28BCL120 29 298CL1120 30 308CL120 �� of i s I c4 3? v Laboratory Analysis S i o f I EInstructions P(303)98 1i0m 5801 Wgen St,S.Ml00,0 r.00W218 1-881 F:(303)--4275 Pega2&2 ww kib— 'ASTM E f° g o i s Res Job#: 457939- C�Ei�6 Reservoirs Environmental, Inc. �'3 g! 3 i � Dust = F 0 i 9 � m j _._ _._... _d __ ___ _ _ .__._ _.._ �Soi!-5�.. e "�3 o' _ _ _ _ Paint. - P _ 5iiwe��si EBR u'' s � m s umace_ s_u swab = SW Ghent Sample ID Number isempleiD'srmislee°pique! CHEMISTRY MICROBIOLOGY 14 14BCL120 X ..._. .._ 15 15BCL120 X _._.S.Tape..�_.......... '"'"-_._WIPe.=. W. =f X • ..... L. .................... � « 0 Drinking. Water = OW_ 20 20BCLI20 o' 5S a a �s ': o 8 3viaa8 9 _.__.._._.._ Waste Water =WW _..__.._. 27 27BCL120 28 28BCL120 29 298CL1120 30 308CL120 �� of i s I c4 3? v Laboratory Analysis S i o f I EInstructions P(303)98 1i0m 5801 Wgen St,S.Ml00,0 r.00W218 1-881 F:(303)--4275 Pega2&2 ww kib— 'ASTM E f° g o i s Res Job#: 457939- �'3 g! 3 at g Submitted By: MARK INSPECTIONS, INC. N 3 B g s g ! E 903' 5iiwe��si EBR u'' s � m s 6ASBESTOS d e i c Viables i �' Ghent Sample ID Number isempleiD'srmislee°pique! CHEMISTRY MICROBIOLOGY 14 14BCL120 X 15 15BCL120 X 17 178CL120 18 ISBCL120 X • ..... L. .................... � « 19 196CL120 X : . __.._._.__._. _*._.._*.___._.._._._._._..t___*.._ 20 20BCLI20 x i '• i i «._. ' 21 21BCL120 X 22 22BCL120 X 27 27BCL120 28 28BCL120 29 298CL1120 30 308CL120 �� of i s I c4 3? v Laboratory Analysis S i o f I EInstructions P(303)98 1i0m 5801 Wgen St,S.Ml00,0 r.00W218 1-881 F:(303)--4275 Pega2&2 ww kib— A i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: _ '��J J Job Address: Permit Number: ❑ No one available for inspection: Time k i S " AM/PM Re -Inspection required: YesNb When corrections have been made, schedule for re -inspection online at: http://www.ci. wheatridge.co. uslinspection Date:. -T IN ,,� ' �� Inspector: DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: 0 � Job Address: Permit Number:��� L ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, schedule for re -inspection online at: http.lAvww.ci. wheatridge.co. uslinspection r` Date: Inspector: 1' DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE J Building Inspection Division r (303) 235-2855 Office INSPECTION NOTICE Inspection Type: IPNUMS Job Address:���11 Permit Numbe,Cllr, � 1 � r: O I TM y,nE!, C(yLei- ;l U✓�1 ❑ No one available for inspection: Time _a AM/PM Re -Inspection required: & No When corrections have been made, schedule for re -inspection online at-, httpYlwww.ci. wheatridge.co. uarinspection Date: ` ' !^' { ` t Inspector:t _ J DO NOT REMOVE THIS NOTICE 1, i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: .�r (� I�- ae-c-1 Job Address: 3r4!4_757 L.L) tZ-FQ Permit Number: 002 f � Z� 1► f tl Sri ❑ No one available for inspection: Tires' NI/ M Re -Inspection required: Yes , When corrections have been made, sc edule for re -inspection online at: http✓/www.ci.wheatridge.co.uslinspe tin _____� Date: i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE �� w Inspection Type: 2 Mge- 3 to 1 Job Address: ' iLI S S LAF7"r�,,j f9lcw tl jt�/QD Permit Number: ❑ No one available for inspection: Time 07oD #/PM Re -Inspection required: Yes When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. us4nspection / �' ?' t!�� Inspector: Date: ` DO NOT REMOVE THIS NOTICE Aff/&v69 ❑ No one available for inspection: Time 07oD #/PM Re -Inspection required: Yes When corrections have been made, schedule for re -inspection online at: http✓/www. ci. wheatridge. co. us4nspection / �' ?' t!�� Inspector: Date: ` DO NOT REMOVE THIS NOTICE e i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type:f v.r Job Address:�15 Permit Number: c-, U C) 1 1 tZ G PYtf` i 1 Yry t! 1 !, �e t �m !, a _� , M ❑ No one available for inspection: Time R? AM/PM Re -Inspection required: Yes No ki When corrections have been made, schedule for re -inspection online at: h ttp://www. cL wheatridge. co. uslinspection Date: Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE _:�9rBuilding Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Izo' NJ y Job Address: 3qS.5 L.VTEACA" L e6 --W12 Permit Number: ozjc)Op t • &12 "7r/— 60I ) s ❑ No one available for inspection: Time lrAM M Re -Inspection required: Yes (90 When corrections have been made, call for re -inspection at 303-234- Xjjx�_ . Dater Inspector: r DO NOT REMOVE THIS kOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: �301 — c 12042 .4M,,4_ Job Address: 2 5Z5: IK) /:,-M Permit Number: 7 �7-ono 116 ❑ No one available for inspection: Time C1 -__ A PM Re -Inspection required: Ye N When corrections have been made, schedule for re -inspection online at: http✓/www.cLwheatridge.co.ussfinspection P I Date: ' Inspector: DO NOT REMOVE THIS ZOTICE i CITY OF WHEAT RIDGE Building Inspection Division --- (303) 235-2855 Office INSPECTION NOTICE � Inspection Type: Job Address: Permit Number: When corrections have been made,,schedule for re -inspection online at: hftpYwww.ci.wheatridge.co.uslins ection� ,,,� Date") -Z � L -An - City of Wheat Ridge Comm. Tenant Finish PERMIT - 202000116 PERMIT NO: 202000116 ISSUED: 02/13/2020 JOB ADDRESS: 3455 W Lutheran Pkwy Suite 285 EXPIRES: 02/12/2021 JOB DESCRIPTION: Minor renovation to four exam rooms, offices, breakroom, reception and waiting area; new finishes to match existing, minor demoltion and construction of 2 new rooms. Tenant: Lutheran Medical Center Neuro Clinic *** CONTACTS *** OWNER (303)422-9500 LILLBRIDGE GC (303)425-4500 Dwayne Gaeddert 018018 EXEMPLA, INC. SUB (303)944-0205 MICHAEL L. SOLIDAY 018048 MICHAEL SOLIDAY SUB (303)946-0048 KEVIN M. DESLOOVER 021025 KMD ELECTRIC INC. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 1 / Commr Vacant BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 150,000.00 FEES Total Valuation 0.00 Plan Review Fee 945.46 Use Tax 3,150.00 Permit Fee 1,454.55 ** TOTAL ** 5,550.01 *** 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 - 202000116 PERMIT NO: 202000116 ISSUED: 02/13/2020 JOB ADDRESS: 3455 W Lutheran Pkwy Suite 285 EXPIRES: 02/12/2021 JOB DESCRIPTION: Minor renovation to four exam rooms, offices, breakroom, reception and waiting area; new finishes to match existing, minor demoltion and construction of 2 new rooms. Tenant: Lutheran Medical Center Neuro Clinic I, by my signature, do hereby attest that the work to be performed shall comply with all accompany ingg 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 ermit. I further attest that I am legs y authorized to include all entities named within this document as parties to the work to be performed, lid that 9,11 work to be ertOted is disclosed in this document and/or its' accompanying approved plans and specifications. Sigr atrfre o/Ottithlc iVVNE1Z/ or CONTRACTOR (Circle one) Date I, This peas isYrd based on the information provided in the permit application and accompanying plans and specifications and is subject 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 Budding Official and maybe subject to a fee equal to one-half of the originalpermit fee. 3, If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4, No work of 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, ruance or Uermit shall not be construed to be a permit for, or an approval of, any violation of any provision of any ble code ce or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of lheatldgic COMMUNITY DEVELOPMENT Building & Inspection Services 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permitsno ci.wheatridge.co.us I FOR OFFICE USE ONLY I Date: Plan/Permit # "Jo O P Plan Review Fee: Y q) h- )(n Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 3455 N Lutheran Pkwy. Suite 285 Wheat Ridge CO 80033 Property Owner (please print): Lillibridge - Roger Sandoval Phone: 303.422.9500 Property Owner Email roger.sandoval@lilibridge.com Tenant Name (Commercial Projects Only) Lutheran Medical Center Neuro Clinic Property Owner Mailing Address: (if different than property address) Address: Same as above Citv. State. Zi Architect/Engineer: TreanorHL - Michael Hagan Architect/Engineer E-mail: mhagan@treanorhl.com Phone: 303.250.5307 Contractor Name:�/���-i City of Wheat Ridge License #: 018018 Phone: 303.472.7383 Contractor E-mail Address: dwayne.gaeddert@sclhealth.org For Plan Review Questions & Comments (please print): CONTACT NAME (please print): Michael Hagan Phone: 303.250.5307 CONTACT EMAIL(please print): mhagan@treanorhl.com Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # to be submitted at receipt of plan review approval Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields. ❑X COMMERCIAL ❑ RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. The current use of this suite is in a Medical Office Building that includes office support for Lilibridge property managers. Previous functions of the suite include exam rooms, break room, conference & office/work spaces. This project consists of minor renovation to include (4) exam rooms, offices, break room and a reception and waiting area. The finishes within the suite are fairly new and will be preserved, new finishes to match. Minor demolition and some new construction of (2) new rooms. NO changes to life safety systems or egress, existing building utilities will be used and connected to for new programmed space. The Neuro Clinic is an outpatient examination and follow up office visit function and does not perform any procedures. Sq. Ft./LF Amps Squares BTUs Gallons For Solar: Kw # of Panels Requires Structural For Commercial Projects Only: Occupancy Type: B Construction Type: Iib Occupancy Load: 22 Square Footage: 2,192 Project Value: (Contract value or the cost of all materials and labor included in the entire project) 150,000 OR'NER/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 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. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) q6HiiiTO Signature (first and last name): _ DATE: 1-14-2020 Printed Name: Michael Hagan DEPARTMENT USE ONLY ZONING COMMMENTS: Reviewer:, BUILDING DEP ENT OM NTS: kl�141:1�0 PUBLIC WORKS COMMENTS: Reviewer: OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: — Ar Michael A. Hagan From: NoReply@mobile-eyes.com Sent: Tuesday, January 14, 2020 11:48 AM To: Michael A. Hagan Subject: Permit application accepted - West Metro Fire Protection District Your permit request for Neuro Clinic (TI) at STE 285, 3455 Lutheran Parkway Wheat Ridge, CO 80033 has been accepted. The Job Number is: 200114006 Description: Minor renovation for Tenant Improvements for an existing suite in a Medical Office Building on the Lutheran Medical Center campus. Thank you for submitting to West Metro Fire. Our typical review turnaround is approximately 5 weeks. You can now view where your plan review is at in the queue! Please click the link below: http://www.westmetrofire.org/1013/Plan-Review-Status BE ADVISED WE NO LONGER ALLOW WORK TO BE DONE PRIOR TO A PERMIT BEING ISSUED AND PLACED ON SITE. 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". If you check the status of your review through your Mobile Eyes Contractor Portal you may see a note that says "zoning checks not passed". This is not checked until a permit has been issued and fees have been paid. This is an internal way for us to keep inspections from being requested until the above has been completed. 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. L/L BL=ioloafoJd�^7JWbnnnPlxdboWgdd6'�-In^N2iZ6PDHJ»igxsa4AD3JM::Iu^ofoJgd=]Nf4bolIW86JSllfnf>ilo4/Wxoqu!#/0/n/I!ew/woo-al6006'1!ew//:sdlI4 'Ity cc SUBCONTRACTOR AUTHORIZATION FORM Electrical Subcontractor This form must be completed & signed by the ELECTRICAL SUBCONTRACTOR performing electrical work on site. Subcontractor's insurance and license must be up to date prior to permit issuance. 5 Project Address: 3-5 .i G. u�-t-h eat n� � rz�w �y 5 �, 2S5 General Contractor: FORM WILL NOT BE ACCEPTED WITH MISSING INFORMATION Company Name: .I�L• �J� 0�-��i�Contact Phone #:�"�q'(o—� Wheat Ridge Contractor License #: 21 D a5 (required field) State License Master License #: c: "q 7 Printed Name of An iz t ignature of Authori Agent 6d.P-1pied au(em(] of ?30 -?02,f , Date City of CC M`�Iheat i e f SUBCONTRACTOR AUTHORIZATION FORM Plumbing Subcontractor This form must be completed & signed by the PLUMBING SUBCONTRACTOR performing plumbing work on site. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address: "W,5 , Lu� �. �.,. General Contractor: Company Name: M ! C11Q C ) ago! 1 Jo V Contact Phone #-00-9 0ZO' Wheat Ridge Contractor License #:0180 148 (required field) State License #: PC DODO 77 7 Master License #: MP M 179 4'z 4 m l P.hae 0d v Printed Name of Authorized Age�— ._ I -80 -2020 d�tiiorized,Flgc Date A i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office _:�9r INSPECTION NOTICE Inspection Type: Job Address: Permit Number: o2 o,-�O b0 1 \ T ❑ No one available for inspection: Time ' AM/PM Re -Inspection required: es No When corrections have been made, schedule for re -inspection online at: http://www. ci. wheatridge.co. uslinspection pf Date:_ -1-4 — 0,1 Inspector: )— DO NOT REMOVE THIS NOTICE Engineering Solutions Since 1959 CATOR ;ROMA www.catorruma.com & ASSOCIATES, CO. SERMES May 21, 2020 Mechanical Electrical Plumbing City of Wheatridge Building Division Fire Protection 7500 W 29th Avenue Technology Denver, CO 80033 Architectural Lighting Commissioning RE: SCLH - LMC - MOB III - Suite 285 LOCATIONS HVAC Installation Denver Metro - CO CRA #2019-517 Cheyenne - wY Boise - ID To Whom it May Concern: The project scope at SCLH Lutheran Medical Center - MOB III - Suite 285 was modified whereby existing diffusers were relocated, and sound boots were added as required to accommodate the architectural modifications. The approach should have no impact on HVAC as previously designed. Sincerely, Cator, Ruma & Associates, Co. e�14-c-zo 7�4vj-- Chuck Rogge, PE, LEED AP Associate/Mechanical Engineer cc: Jackie Rudko, File - Cator, Ruma & Associates Mike Hagan - TreanorHL Dwayne Gaeddert - SCLH LMC By: email CFR/sm P:\SCLH\LMC\MOB III\2019-517 Suite 285\Sup-Docs\2019-517.LTR.HVAC Install.20200521.docx 896 Tabor Street- Lakewood, Colorado 80401-4700 o 303.232.5200 ki CATOR I RUMA & ASSOCIATES. CO. Mechanical Electrical Plumbing Fire Protection Technology Architectural Lighting Commissioning LOCATONS Denver Metro - CO Cheyenne - WY Boise - ID Enqineerinq Solutions Since 19:.,9 May 27, 2020 City of Wheatridge Building Division 7500 W 29th Avenue Denver, CO 80033 RE: SCLH - LMC - MOB III - Suite 285 HVAC Return Air Grille Installation CRA #2019-517 To Whom it May Concern: For the project at SCLH Lutheran Medical Center - MOB III - Suite 285, we have reviewed the location of the return air grilles as they were installed. The locations of the grilles will provide satisfactory performance of the HVAC system. Sincerely, Cator, Ruma & Associates, Co. (L - Dennis Rudko, PE Mechanical Principal cc: Jackie Rudko, Chuck Rogge, File - Cator, Ruma & Associates Mike Hagan - TreanorHL Dwayne Gaeddert - SCLH LMC By: email CFR/sm/ef P:\SCLH\LMC\MOB III\2019-517 Suite 285\Sup-Docs\2019-517.LTR.Return Air Grille Install.20200527.docx 896 Tabor Street o Lakewood, Colorado 80401-4700 - 303.232.6200