HomeMy WebLinkAboutPRJ99-0292 D99-0047 LEGAL/"'""J
TOWN OF VAIL DEPARTMENT OF COMMUNITY DEVELOPMENT
75 S.FRONTAGEROAD
VAIL, CO 81657
970479-2138
?16 NOTE: THIS PERMIT MUST BE POSTED ON JOBSITE AT ALL TIMES
MECIIANICAL PERMIT PCrMit #: MO2-0222
Job Address: 19,f4 STINBURST DR VAIL Status . . . : ISSUED
Location.....: VAIL VALLEY 3RD FILING LOT 2l Applied . . : 10116/2002
Parcel No...: 210109103030 Issued. . : 10124/2002
ProjectNo ' {(-\ta - oLlZ- Expires. .: 04/22/2003
OWNER WALI,ACE MINYONE M 1O/L6/20O2 PhONE:
I VERNON SMITH ASSOCIATES
PO BOX 810591
DALI,AS TK ?5381
Lricense:
coNrRAcToR coNcEPT MECHANTCATT, rNC LO/!6/2002 Phone: 970-949-0200
P.O. BOX 1165
AVON, CO
8L620
L,,icense r 189-P
APPIJTCANT CONCEPT MECI{ANTCAL, rNC L0/16/2002 Phonez 970-949-0200
P.O. BOX 1165
AVON, CO
4L520
I-,icense: 189-P
Desciption: RE-BLnLD /RE-PIPE BOILER PLANT RE-WORK COMBUSTION AIRE AND
FLU PERCODE
Valuation: $9.000.00
Fireolace Information: Restricted: Y d of Cas Appliances: 0 # of Oes Logs: 0 # of Wmd Pellet: 0
|l+'+|1t:}+|++*+|l+|1lt+|*+lt+|*||*|,l||*l.tt{*|i|'t|'llt't*.*|*||'t****+**.rFEESUMMY
S0. 00 Tolal Calculated Fees--> $228 . 00Mechanical---> 5180 . 00 Restuamnt Plan Review->
Plsn Check->
lnvestigation->
wilt call->
s4s. 00 DRB Fee------>
$0. 00 TOTAL FEES-.----> 5228 . 00 Total Permit Fee- > $228 - 00
S0. oo Additional Fees----->90. 00
Payments-.-___.--> 922I .00
RALANCE DUE-------> S0. 00
s3.00
IIEM: O51OO BUII-,DING DEPARTTTIENT
Lo/2L/2oo2 cdawis Action: AP
Item: 05500 FIRE DEPART!,IENI
CONDITION OF APPROVALCond: 12
(BL,DG.): FIELD TNSPECTIONS ARE REQUIRED TO CHECK FOR CODE COMPLIANCE'
Cond: 22
(BI-,DG.): COMBUSTION AIR IS REQUIRED PER SEC. 701 OF THE 199? t]MC, OR SECTION
701 0F THE 1997 rMC.
Cond: 23
(BL,,DG.): INSTALLATION MUST CONFORM TO MANUFACTITRES INSTRUCTIONS AND TO CHAPTER
10 OF THE 1997 T'MC, C}IAPTER 10 OF THE 199? IMC.
conf: -25
(BL,DG.): GAS APPIJIANCES SHALL BE VENIED ACCOR.DING TO CHAPTER I AND SHALIT
TERMINATE AS SPECIFIED I}T SEC.8O6 OF THE 1997 T]MC, OR CHAPTER 8 OF TIIE T997 IVTC.
Cond: 29
(BLDG.): ACCESS TO HEjATII{G EQUIPME}IT MUST COMPL,Y WITH CHAPTER 3 AND S8C.1017 OF
TIIE 1997 TJMC A}iID CHAPTER 3 OF THE 1997 IMC.
Cond: 31
(BL,DG.): BOILERS SHALL BE MOITNTED ON FIJOORS OF NONCOMBUSTIBLE CONST. UNLESS
I,ISTED FOR MOUliIrING ON COMBUSTIBI,E FIJOORING.
Cond: 32
(BLDG,): PERMIT,PITANS AIiID CODE ANAITYSIS MUST BE POSTED IN IiIECIANICAI, ROOM PRIOR
TO AN INSPECTION REQI]EST.
Cond: 30
(BLDG.): DRATNAGE OF MECHANICAI-, ROOMS COIITAINING HEATING OR HOT-WATER SUPPLY
BOfIJERS SIIAIJIJ BE EQUIPPED WfTH A FIJOOR DRAIN PER SEC. LO22 OF THE 1-997 UMC, OR
sEcTroN 1004.6 0F THE 1_997 rMC.
DECLARATIONS
I hereby acknowledge that I have read this appligation, filled out in full the information required, completed an accurate plot plan,
and state that all the information as required is correct. I agree to comply with the information and plot plan, to comply with all
Town ordinances and state laws, and to build this sfucture according to the towns zoning and subdivision codes, design review
approved, Uniform Building Code and other ordinances ofthe T
REQUESTS FOR INSPECTION SHALL BE MADE TWENTY.FOUR HOURS IN
OWNER ORCONTRACTOR FOR HIMSELF AND OWNEF
*1. * * +t * * * * * + * * {' * * * * * ** * * * * * i + 'l' '} r! * * +*'} * * * * *** * * * * * ** * * * '} + + * * ** * * * * * + * * +* + * * + * * * * * *** * * * * * * * + *
TOWN OF VAIL, COLORADO Statement
+* + +*** ** * * * ** + * * *** **+* +* t+x * * * ** ** * * ****** *** * t**** * * * ****+* +i * * * *******+++*+****** * f, ** + * *
Statement Number: R000003333 Amount: $228.00 LO/24/200201 r23 PM
Palment Method r Check Init: WC
Notation: Check *7244
Permit No3 MO2-0222 Type: MECHAIiIICAL, PERMIT
Parcel No: 21010 9103 03 0
Sile Address: 1944 SITNBITRST DR VAII
LocaLion: VAIIJ VAILEY 3RD FIIJING I,OT 21
TotsaI Feea: $228.00
This Payment: $228.00 TotsaI AL,L Pmtss: 9228.00
Balance3 $0.00
* ** * * * * * * * ***** +* * f * t * + * * + + + * * * * + ** i * * *** * * * * * * * ** * * * * * * ** * * {' * * * * * * * ** * * * + * * * * * * * ** * * * +,1' * * 'l *
ACCOUNTITEM LIST:
Account Code Description Current Pmts
MP OO1OOOO31113OO MECHANICAL PERI4II FEES 18O.OO
PF 00100003112300 PLAN CHECK FIES 45.00
WC OO1OOOO31128OO I,IILL CALL ]NSPECTION FEE 3.OO
t APPLICA T{OT BE
97 o - 4t s - zr4s lrnspecti6ifr -TVWN0FVtn
75 S. Frontage Rd.
Vail, Colorado 81657
,(
*K
D<
Permit will not be accepted without the following
draw
and Lo
and
-
Building Peimit #:
Mechanical Permit #:
CONTRACTOR INFORMATION
(a"eq fu*t.. fu Town ofVail Reg. No.:Contact and Phone #
|4aftosd ?yl-o?-oo
Contractor Signature:
coMpLFrE VAIUAIrON FOR MECHANTCAL PERMTT
MECHANTCAL: $ ?raoo=
Contad As ets Offie at 9Z0-328-9640 or visit for Patel #
Job Name:6 P,ot /D4eE Job Address: ! t T n e Azr-nTXF,1 P.<tiltu r
Yt'ts6o €.Oxr*ktV ?o7)'??r-spw
Address: biEC ert ao p, CO B o t t o
description of wffi-/Qfifi-''p4 ar:,rJ;;E;ZT /\2- P1;a4. ba+(e< p G-<-f,..I Pe'f od€.
WorkClass: New() Addition( ) Atterationf(J Repair( ) Other( )
) Exterior( ) Other( )Does an EHU exist at this location: yes ( ) No (
TypeofBldg: singl+familv( ) Dunrex!)d MurtFfamirv( ) commerciat 1 I iesu-rant( ) other( )
No. of ExisUng Dwelling Units in this building:No. of Accommodation Units in this building:?
Noffype of Fireplaces Proposed: Gas Appliancei ( ) car r-ogs | ) wood/peilet ( ) wood Burning (NoT ALLoWED)
Is this a @nversion t
********:********rr*{.'1.:r**f'FOR OFFICE USE ONLy************************sF: /everyone/forms/medrperm
/.n
...u, .CEPT MECHANICAL, lNC.
PLUMBING . HEATING . SYSTEM DESIGN
P.O. Box 1.165 Avon, Colorado 81620
Phone: (970) 949-0200
Far (970) 949-0300
"o."u*r.o"" l2.J oor./o- lr-atLSHEET NO.I
CHECKED BY DATE
PII
l
I
CONCEPT MECHAMCAL, INC.
PLUMBING . HEATING . SYSTEM DESIGN
P.O. BOX 1165 AVON, COLORADO 8r620 PHONE; (970) 949-0200 FAX: (970) 949.0300
JFffffffffipv
October 15,2002
Town of Vail
Community Dwelopment
75 South Frontage Road
Vail, CO 81657
RE: GoffResidence;1944 Sunburst Drive @ast Hal|; Vail' Colorado
To Whom It May Concern:
Submitted with this lett€r is a mechanical permit applicatioq boiler room sketch, and
equipment cut sheets for this project. We have been hired by the homeowner to re-build
an e*lsting boiler plant to make it .ote serviceable, functional, and meet basic aspects of
mechanical code.
The heat loss for the home is approximately 85,000 Btuh. Calculations are based on 70"F
interior temperature and -20o exterior design temperature.
Two boilers are installed rated at 378,000 Btuh input each serving the house heat, provide
energy for domestic hot water production, and provide energy for the mehirg of
approximately 2,200 square feet of project snowmelt. There is one I l9-gallon storage
tank with internal heat exchanger providing domestic hot water to the home.
Each boiler is power vented through the wall with 6" B vent materials to a Fields power
venter. Combustion air is served from a 28" x22" louver as shown on the attached
sketch.
Please do not hesitateto call with any questions. Thankyou.
Timothy J. Roseq P.E.; V.P./Secretary
Cc: Charlie Sherman; Sherman Construction
/e-7s-'oL
TOWN OF VArIJ
75 S. FROI\ITAGE ROADvArL, co 8L657
970-479-2L38
Description: NEW PLUI,IBTNG FOR REMODEL
FBE SI'}'MARY
DEPARTTTIEIfT OF COMMITNITY DEVELOPMENT
NOTE: THfS PERMIT MUST BE POSTED ON .,}OBSTTE AT ALL TIIIES
PLUIiIBING PERMIT Permit,P00-007s
Job Address: L944 SIINBITRST DR status...: rssIIED
Locatj,on. ..: a944 SIJNBURST DR Applied..: 07/20/2000
Parcel No..: 2101--091-03-030 rssued...: o7/28/2000
ProjecE .No. : PR,J99-0292 E)q)ires. . : ol/24/2OOL
TABER PLIJMBING & HEATING, TNC. PhONC: 970-870-1555
P.O. BOX 776342, STEAMBOAT SPRTNGS, CO 80477
TABER PLIJI{BING & HEATING, INC. Phone: 970-870-L655
P.O. BOX 776342, STEAMBOAT SPRINGS, CO 80477
I,'IA,LI,.A,CE MINYONE M
? VERNON SMrTI{ ASSOCTATES, PO BOX 810691, DAT.,LAS TX 75381
APPI,IEAI\:T
CONTRACTOR
O$INER
P]uEbing----->
Plan Check-- - >
Inveatigation>
will call---->
ReBtualanb Plan Revicrr- ->
TOTAL FEES. - - --
Total calculaeed Fces- - - >
Additional Fee6- -- - ---- ->
Total Pertdt Fee-------->
PayflentB-------
VaIuaLion:15,000.00
**.iir*itttti**
225 .OO
.00
3.OO
- 00
254.25 .00
2e4 .25
BAIANCE DUE-.. -
rtqm: .05100 BUTLDTNG DEPARTMEIiI'T Dept: BUTLDTNG Divisj-on:
07/20/2OOO TRT4 ACTiON: APPR APPROVEDIEbm:"05600 FIRE DEPARTUENT DepE: FIRE Division:
O7/20/2OOO JRM Action: APPR N/A
-..-,,,,-,.,,;, ,,**,r,,*,
CONDTTION OF APPROVAL
1. FIELD INSPECTTONS ARE REQUTRED TO CIIECK FOR CODE COMPI,IANCB.
'l**a.r***!rr***r* r**r*rrrr*f*'r*r***+t*t**tt*r*** *rr**i*Jtl**titl,
DECLARATIONS
f h.reby rcknorlodgc tshaL I har. lead chiE application, filled ouE in full th6 inforualion required, conpletsed an accurats6 ltlocplan, and 6tate Chat all the ilforuaeion prowided aE tequiled ie co!r6dt. I agree to conply rilh she infordaEion ana p1ot. Plan,
tso qonply t{lEh all, Tqvn ordinarces and Btsatse IavB, and to buitd Ehis structure accolding to bhs Torn'E zoning and gubdiwision
cod.s, doaign revicw approved, uniforB Building code and otshcr ordinanc€s of thc Town alplicablc bher.to.
RTQUESTS POR I}{SPECIIOIIS SMI,L BE UADE T'WENIC-FOT'R I{OI'RS IN XDI/ANCB BI AT oUR OFFICE FRoH e:oo }}l 5:00 Pfi
ll
SIGIIAT{'RE OF AND OIINER
TO9iN OF rrAl'., COLORA-DO Ala!.mnt
2e4.25 07t2etO0 ],.tLO
Ini!: arAR
glatdrlrt' [umb.r: EEC-0559 Anount:
Paym€nl ltolhoai: CK NocaEionr LLL5
P€mit No: p00-0o75 Typ€: B-pUitB pLIlli.tBING 9ERMI?
Parc.l Nor 2101-091-03-030
Sllte Addrc..: 194{ gITNBURST DR
Localion: 1944 St rBUnsT DR
2A4.25
.00
TotaL F6ea:
2A4-25 TolrL }IJIJ PmC.:This PaFGnE
aceounc coal€
Balanc6 |
PE OO10OOO31112OO PIJNBING PERMIT FEES
PF OotOOOO311?300 pr,AN CHECK FEES
tcc 00100003112800 ltrtl. cAtL rNsDEcTroN FEE
D6rcription
225.OO
55.25
3. 00
TOWN OF VAIL
75 S. FROIiMAGE ROADvArt, co 9t657
970-479-2L38
APPLICAI{:T
COT{TRACTOR
OI'INER
DEPARTI,IEIIT OF COMMI'NITY DEVELO
NOTE: THIS PERMIT MUST BE POSTED ON
PLT'MBING PERMIT
ilob Address: 1944 SITNBITRST DRtocat.ion...: 1-944 SIINBITRST DR
Parcel No. . : 2101-091-03-030Project No. : PRJ99-0292
TABER PLIJMBING & HEATING, INC.P.O. BOX 776342, STBAMBOAT SPRINGS,
TABER PLI'MBING & HEATING, INC.P.O. BOX 775342, STEAT4BOAT SPRTNGS,
V'IALLACE MINYONE M
co
SEaIus...: APPROVED
Applied..: 07/20/2000Issued...: 07/20/2000
E:cpires. . : 0L/L6/ZOOL
Phone: 970-870-L655
80477
Phone: 970-870-1655
80477
,JOBSITE AT
Permit. #:
AIL TIMES
P00-0075
co
t VERNON SMITH ASSOCIATES, PO BOX 810691, DAITITAS TX 75381
Descriptsion: NEW PLITMBING FOR REMODEL ValuaEion: 15,000.00
FEE SUI.IMARY
Pluubing----->
Plan Chack- - - >
Investigation>
will call---->
Ra6cuarant- Plan Review- - >
TOTAIJ FEES-----
225 .OO
-oo
3.OO
PeeB--------->
Dept: BUILDING Division:
284.25
.00
294.25
. oo
284.25
IICM: O51OO BUILDING DEPARTMENT /
O7/20/2OOO ,JRI4 ACTiON: APPR APPROVEDITEM: 05600 FIRE DEPARTMEIiTI07/2O/2OOO JRM Action: APPR N/A DepL: FIRE Division:
CONDITION OF APPROVAI,
1. FIEI.,D INSPECTIONS ARE RBQUIRED TO CHECK FOR CODE COMPLIAI'ICE.
****+*fit'rr*ara
DECI,ARATIONS
I hereby acknotrledge that r hav€ read lhis application, fill€d outs in full the infornalion lequired, conpl€ted an accuraco pLot
phn. rnd 6tat€ that. all th€ infomalion providcd aB requir€d is corrcc!. I agrcc to conply wilh thc inforr'atsion and p1ots p1an,
to couply rith all Town ordinanceg and 6t'atsc lar{s, and tso build !hi6 Etructsure accordinE to Ehc Toin'd zoning and subdiwieion
codc5, dcoign rcwic* approved, Itniform Building cod6 and och€r ordinences of the Toirn applicablo therebo.
REQITEST9 FOR INSpECTIONS SIIALL BE UADE TWBNTy-FOI R HOITRS IN ADI/ANCB BY TBLBPHONE AT /r79-213g OR AT OUR OFFICB FROl.l g:OO Att 5:OO P!.t
SIGIBTORB OF OhIER OR OCMTRACTOR POR HIMSETJF AND OWNER
\
AIIPLIC/ITIOr -..LL NOT AE ACCEPTED rF IIICOII{PLE\,..JR UIISIGNED
Prciect #z _
Building Permit #r
Plumbing Fermit #:
19
COT{TRACTOR IIIFORiIATION (1\ol 8ro-t(s<
ffiFxw-'nb,,tq TolYn of Vail Regglq.:o/4D - r Contact and Phone #'s:
Ctr/fu,r>g/l -gsZl
Contradorsignatu.,.r i^-lf,k' 4"X+.r.
++*******t*t**i*** *..* *+a*tl!r!r*++++++*++FOR OFEICE USE ONLY."**r***+**+l**rl*+++:r:*,.:!+ *+*++*.rt
F/eee4/u.e/fuft s/p|mbperm
UL2O2
75.S. Fronbge Rd.
Vail, ColoFdo 81657 lDl .0fl2
',con forhtd #
Parcet # (Required if no btdg- permit # is provided abore) F10 / - n 9/ - a3 *ajo
robNanr: Dil/A< K*nole/rob Mdress: /q44 I Sro7r,*5/ /e_
Leear Description | .o,, Z I larocr;l/Uetriu"i-j9 [i*r*o"'
owneoname: (kt $ lJ
Address: t144*5"^tA,qd* |/-pjrcne: SDitS -8IO-6{3
Erqineer: €pruf e6* )aall*z I Address?I? ilai.^ S{ CrrrqnAbAl6 ll etnne:q11 A@ -324
Debiled Oesggilon or p*,*,- gg[66ra,ta
I rigro'i'or^:b€e - ga-Ptul^^b (tLS ('tu{ee.toR)
woftcrass: Nerr( ) Ad!fion( ) Atreratnn( ) Repair( ) c/ci|ernr{ bmotal
Type of Eldg.: Singlcfamily 1f' Oupto, (V4'ttu|ti-furity ( ) Commercial ( ) Restaurdnt ( ) Odler ( )
ilo. of Exlsting Drvelling Units in this building: Z No. of Accommodation Units in this building:
Is this a corn'erslon ftom a tyood buming flreplace to an EPA Phase II device? Y6 (Vt No ( )
COIIIPLETE VALUATIOIT FOR pU,!IBING PERI,IIT (l-abor & tlated
PLUMBING: $s,6&
td t^t&r:64 awz gz 'lnf B;swLwts : '0.r rNrHd SNIIUfH t 9I.IISLN']d TEHUI : I.IDJ
TOWN OF VAIL
75 S. FRONTAGE ROADvArL, co sL657
970-479-2L38
DEPARTMENT OF COMMI]NITY DEVELOPMENT
NOTE: THIS PERMIT MUST BE POSTED ON .]OBSITE AT ALL TIMES
Permit #: 899-O272
Status...: ISSUED
Applied..: L2/28/L999
Issued...: 06/]-5/2000
E><pires - . = 12/I2/2OOO
Phone: 97Q-390-681-2
Phone: 970-390-68L2
ELECTRICA]-, PERMIT
.fob Address: 1-944 SIJNBIJRST DR
Locatsion. . .: L944-B SunbursE
Parcel No. .: 2l-0L-091-03-030
Projects No. : PIu99-0292
APPLTCAI\TT
COI\TTRACTOR
OIVNER
DescripE.i-on:
NETSON ELEETRIC, INC.
P.O. BOX 45, AVON, CO
NELSON ELECTRIC, INC.
P.O. BOX 45, AVON, CO
WALI,ACE MINYONE M
8L620
8L620
? VERNON SMTTII ASSOCIATES,PO BOX 810691, DALT,AS TX 75381
ELE TRIC FOR INTERIOR REMODEI,ValuaE,ion:7,000.00
EIecclica1- - - >
DRB Fee
:nve6!igation>
lvlIl call-- - ->
TOTAL FEES- - - >
TotaL Calculated Fee6--' >
AddiEionaL Fees--------->
Total Perruil Fee-------->
Pa]rmen! E - -' '- - -
t29 . OO
.oo
129 . OO
129 . OO
BALANCE DUB- -- -
126 . O0
.00
.00
3.OO
L29 .OO
* *ttr * t t t i t t t * *t + * 'r * t * *
Item: 06000 ELECTRICAL DEPARTI4EIIil| Dept: BUIL,DING Division:L2/28/L999 KATITy Action: APPR Approved per-KwItbma"05600 FrRE DEPARTMENT -DepE: FrRE Division:L2/29/L999 KATIIY Action: APPR N/a
*J**rtr*tirtrii
CONDITION OF APPROVAI,
1. FIELD INSPECTIONS ARE REQUIRED TO CHECK FOR CODE COMPLIANCE.
DBCI,ARATIONS
I hereby ecknorledge thac I hawc rcad uhis application. fill.d o\rt in fuLl the inf,ofination required, corlpletcd an accurate plot
plan, and stato that al,1 thc inforuation provided aa required iE cot!6cL. I aglec uo conply wibh th(! informaEioa and Plot pfa.n,
co corttrrly xith alL !orn! otdirlanceg and 6taue 1air6. altd tso build thiE strucbure according !o thc To*n's zoning and subdivision
codea, de6i9n r.vier approwcd, Uniforn Building code arrd oche! ordinances of thc Town applica.ble thereto.
REQUESTS FOR INSPEEIIONS SHAIJL BE MADE TWEIVE-POI'R HOT'RS IN ADVANCE BY
**tl**l*rtt**t**I*ttt*tlla!t*!l!a.t*atrlrt*t*t!l*rlta:l*r.l****a*ta!t*atrlt*tat
TOm[ OF VAf&, COIJoRADO ,.gtatennt
*tl******i**i***t****lt***tt*****tl**li************t it*******ll***ti
gtatemnt Nutrber: REc-0642 emount: 129.00 06/1,5/00 Lf ?O4
Paynent llethod: 1075 Notation 3 NELSON ELECI?IC Inlt: dN
Pemit No 3 899- 02?2 Tlpe : B-ELEC ELECIRICAL PERUIT
Parcel No: 2101-091- 03 - 03 O
81te Addre66 r 1944 SIINBIJRBT DR
LocaLion: 1944-8 SunburBt
Total Fees: 129. OO
Tbis Payu|ent 129.00 Total AIJtrr Pnte: 129.00
Ealance: .o0
tt********r*t**t!} tt***t*********t*tt*****t*******!}**tilt****r*t***
Accoutrt Code DeFcrlption Amount
EP 0o10o0031114oo ELECIT,ICAL PRI'IIT FEBg 125.00
tfc 00100003112800 TIILII cAIfi nrspEcrloN FEB 3.00
lDtttqdreo, pezrnil-bq cc-n*rac+s--
*b*
3/u)oo
NOTIFICATION OF APPROVED PERMIT STATUS
Contractor: NELSONELECTRIC.INC.
Address: P.O. Box 45
Avon. CO 81620
DatePermitwas epplied fior: W Permit #t-899-W2-
Plan CheckFee:-NLBalance due:
Job address:
s129.00
| 944 Sunhursf Drive
Owner: MinvoneWallace
Job description: Electric for interior remodel
rT wAs APPLIED BOR" BUT EAS NOT BEEN PAID rOR NOR SIGNEIT FOR Tm COITE ON
EI(PrRED PERMITS REQUIRES US TO COLLECT THE PLAN CnECK X'DE IF APPLICABLE
THIS W[T. AXTECT IHE ISSUANCI OT PERMITS IHATYOUAPPLY F1OR IN TEE
x'uTURE. IF YOU HAVE DONE TffE WORK WITflOUT TEIS PERMIT WE ARD REQUIREII
TO CHARGE A DOUBLE T'EE. WE ARE ALSO PLACING A LOCK ON YOUR CONTRACTOR
LICENSE WHICH WILL PREVENT YOU X'ROM GETTING ANOTHER PERMIT UNTIL IEIS
IS RESOLVEI'.
Please cill 479-2139 or come into our office at your earliest convenience to let us
know how you would like to proceed. Thank you.
TOI,IIN OF VAIL
75 S. FROI{:TAGE ROADvArL, eo 81657
970-4'19-2L38
APPLICANT
CON'TRACTOR
OWNER
Electrical--->
InveBtigation>
wi 11 caLl---->
TOTAL FEES- - - >
DEPARI'IVIENT OF COMMI'NITY DEVELOPMEI{:T
NOTE: THIS PERMIT MUST BE POSTED
ELECTRICAL PERMTT
,Job Address: 1944 SUNBIIRST DR
Location. . .: L944-B Sunburst
Parcel No. . : 2l-01--091-03-030
Project. No. : PRJ99-0292
NELSON ELESIRIC, INC.
P-O. BOX 45, AVON, CO 81620
NEI-,SON EITECTRTC, rNC.
P-O- BOX 45, AVON, CO 81620
WALI,ACE MINYONE M
T VERNON SMITII ASSOCIATES, PO BOX 810591,
Nonrro z/zslcF,
ON .]OBSITE AT ALL TIMES
Permit #: 899-0272
StaLus...: APPROVEDApplied..: L2/28/L999Issued...: 12/28/L999
Extrrires. . : 06/25/2OOO
Phone: 970-390-68L2
Phone z 970 -390-58L2
DALI,AS TX 75381-
DCSCTiPIiON: ELECTRIC FOR INTERIOR REMODEL Valuation:7, 000 . 00
FEE ST]I'iMARY
126.00
.00
.00
3.00
129 . OO
Total Calculated Fees- - - >129 .00
Additsional Fees---------> .0o
Total Pcrmil Fee-------->
Payments--------
BAL.ANCE DUE----
129 ,00
,00
129,00
ILEM: O6OOO ETEETRICAL DEPART'IVIENT DCPT: BUILDING DiViSiON:l2/28/L999 KATIIY Action: APPR Approved peiKwITbM: 05600 FIRE DEPARTME}fT .DEDT: FIRE DiViSiON:t2/2e/L999 KATHY Act.ion: APPR N/a
CONDITION OF APPROVAL
1. FIELD INSPECTIONS ARE REQUIRED TO EHEEK FOR CODE COMPLIANEE.
*******a*i**a**
DECI,ARATIONS
I hereby acknowLedge thats I have read lhiB application, fitled out in full the infonnation required, compleled an accurat.e plot
plan, and stale that all lhe i.nfomaCion prowided aE required is cof,rect. I agr€e to comply with the information and plot p1an,
tso comply nith all Town ordinances and slate 1a$8, and tso build tshiB stluctsure accoriling to tshe Town's zoning and subdivigion
codc6, dcsign teview approwed, Unifonn Building codc and other ordinances of lhc town applicabl.c theletso-
RBQUESTS FOR INSPECTIONA SHAIL BE MTDE TIIENTY-FOUR HOURS IN AD.\IANCE BY TEI,EPHONE AT 419-2L38 OR AT OT'R OFFICE PROI4 A:OO AM 5:OO PM
SIO}IATURE OF OWNER OR COIITRAEIOR FOR HIMSELP A].ID OWNER
,,lr)
TOWN OF VAIL CONSTRUCTION 6/?ro,
Pidnn -ozq?-
PERMIT APPLICATION FORM
ilil?,:five,
Job Name:
Building ( )
Legal Description:
Owners Name:
Architect:
Plumbing ( )
Lot Block
Contact the Eaole Countv Assessors -Offrce at 970-328-8640 for Parcel #
Parcett ZlOl - bql-a9 -oro
P€rmit #
Job Address:
(,
Subdivision
Phone#
Phone#
Dare: I?-l 2'.6 / q?
2alla, 17'
Description ofJob:
Work Class: New ( )Alteration )rl
Number of Dwelling Units: I
Number and Type of Fireplaces: Gas Appliances
BIIILDING: $
PLUMBING $
Town of Vail Reeistration No.
Additional ( )Repair ( )Other( )
Number of Accommodation Unils:
Gas Logs
VALUATIONS
ETFCTRTCAL: $ 1&d0- oTHER: $
MECHAMCAL $ TOTAL $
Address:
Phone #
WoodlPellet
General Contractor:
CONTRACTOR INFORMATION
Address:
Town of Vail RegistrationNo. El'\Cl-gaa Phone #
,.,44 Etectricaf Contrrctor,tU-tt.r, E &.-Tt: - Address:
tv
Town of Vail Registration No. L .1.7 - E Phone #q4o- 3q.o' tbt-tz-
Plumbing Contractor: _
Town of Vail Resistration No.Phone #
Mechanical Cotrtractor:
FOR OFFICE USE
TYPE GROUP SO. FT. VALUAT]ON BUILDING:
SIGNATURE:
ZONING:
SIGNATURE:
CLE.AN UP DEPOSIT REFUND TO:
***COD[ BOOKS ARE AVAILABLE FOR PTIRCNA.SE UPON RTQ{IEST***
TO[{N OF VAIL
75 S. FROMTAGE ROAD
VAIL, CO 81,657
970-479 -2a38
DEPARTT4ET\IT OF COMMI]NITY DEVELOPMEI{T
NOTE: THIS PERMIT MUST BE POSTED ON iIOBSITE AT ALL TIMES
ADD/ALT MF BUILD PERMIT Permj-t #: 899-0305
.JOb AddrESS: 1944 SIJNBIJRST DR
Locatsion . . .: L944 SIINBIIRST DR
Parcel No. .: 2L0l--09L-03-030
Project No. : PItiI99-0292
SEaEus. .
AppIied.
fssued..$rpires.
ISSI]ED
LL/19 /L999
L2 / 08 /L999
06 / 05 /2OOO
APPLICAI{:T
COMTRACTOR
OhINER
Occupancy: R3
Type Construction: V
Tlpe Occupancy:
Valuation:
TIENING HOME REPAIR &
P.O. BOX 89, BOND, CO
LIENING HOME REPAIR &
P.O. BOX 89, BOND, CO
WALLACE MINYONE M
coNsTRuc
80423
CONSTRUC
80423
Phone:
Phone:
970-6s3-9922
970-6s3-9922
TX 7538L
*of wood/Pa11ec t
B VERNON SMITH ASSOCIATES, PO BOX 810591. DALI,AS
Description:
COMPLETE II.ITERIOR REMODEL AND ADDITION
Single Family ResidenceN .I1|pe V Non-Rat.ed
L27,OO0
FilcDlace Infolmation: Restricted: Y #of
Add sq Ft,: 682
ca6 Applianceg: l*of Gaa Log6:
FEE SUMMARY
Building----->
PIan Check- -- >
Inv6stigation>
wiIl call---->2, 10{.50
codea, deeign rewiew approved, Uniform Building Code and other oldinanccg of the Town aPPIi
FROM g:00 A.tl 5:00
s48 .00
.00
f.o0
- o0
100.o0
102.30
500.o0
Reatuarant Pfan Review- - >
DRB Fee--------
Recreacion fee---------- >
cl€an-Up Depoait-------->
ToEaIcalcufatedFees---> 2,104,50
Additsional FceE---------> .0o
Total PenEiE Fee--------> 2, L0+.5o
Pavrrenta - - -- - - -
--"-."...::l::":::::;-::;;;;;;"i...,-.-.1:ll1;il,"...,.THll,lT;::::;:;;;;;;l-,.,,.,....-;::,".
Item: 051-00 BUILDING DEPARI14EI,ff Dept: BUILDING Division:1"L/I9/L999 JRM ACtiON: NOTE PI.,ANS TO .fRM-1r'/19/L999 JRM Action: APPR APPROVE D,JRMITbM:.O54OO PLANNING DEPARTMEIfT DCPL: PI,ANNING DiViSiON:LL/1,9/L999 ,fRM Action: NOTE PLANS TO A.O:
L2'/07'/'L999 AocHs Action: AppR flnallv approved!!IEbm,'05600 FIFIE DEPARfl,IENT . 'bepL: FIRE Division:\t/a9/\929 JRM Acrion: ApPR N/AITbM:.O55OO PUBLIC WORKS DEDT: PUB WORK DiViSiON:1-I/L9/L999 .lRM Action: APPR N/A
See Page 2 of this Document for any condiEions that may apply to this permit.
DECLATATIONS
I her€by acknolrledge thats I have read tshis application, filled ouf in fu1I bhe infor(lalion requirod, compleced an accurate Plog
p1an, and slat.e that aLl the infomatsion provided as rcquired is corlect. I agree to comply Bith lhe infomagion and plot plan,
to codply wiLh all Tonn ordinancos and stat.e 1aw6, and to build this gtruchu-e accolding to lho To!,n's zoning and Eubdivision
Ie thereto.
REQUESTs FOR INSPECTIONS SHALL BE MADE TViENTY-FOUR HOURS IN AD\IANCE BY TELEPHOM
Sond Clean-Up Depo6it !o: LIENING HM REPAIR SICIIATT'RE OF OWNER OR CONTR.A(.TOR FOR HIMSELF AND OWNER
********************************************************************************
CONDITIONSPermit #: 899-0305 as of 12/08/99 Status: TSSIIED
***********************************************tr********************************
PeI.Tnir Tfpe: ADD/ALT MF BUILD PERMIT Applied: LL/1,9/L999
Applicant: LIENING HOME REPAIR & CONSTRUC Issued: L2/08/L999
970-653-9922 To Erqpire z O6/0s/2000
ilob Address:Location: 1944 SIJNBIIRST DR
Parcel No: 2101-091-03-030
Description:
COMPI.ETE IIITERTOR REMODEL AIiID ADDIT]ON
Condit,ions:
].. FIELD INSPEqfIONS ARE REQUIRED TO CHECK FOR CODE COMPLIANCE.
2- ALL PENETRATIONS IN WAL,LS,CEILINGS,AND FI-,OORS TO BE SEALED
WITII AN APPROVED FIRE IVIATERIAI,.
3. SMOKE DETEEIORS ARE REQUIRED IN ALL BEDROOMS AND EVERY STORY
AS PER SEC-310.6.1 0F TIIE r-997 tBC.
4. FTRE DEPARTMEIVT APPROVAL IS REQUIRED BEFORE ANY WORK CAN BE
STARTED.
5. PTJBLIC WAY PERMIT REQ'D.SEE LEONARD FOR REQUIREMENTS ASAP
ttr*tratttrtrt.rtrrtrrr.rrttaf *r*rtttitr.'t.art'rrttatttnta*tatttrarttt
tordf oF var!, @IJoRlDo 9trtrult
Sgrtaurc lfuEbct ! RIC-0597 llounb 3
Pryr.nE I.chod ! 1151 Notrtion:
2, 10a,50 t2/otl99 LL?a3
liGning hoEe rr Inltl i'll
Pcllit No! 899-0305 Tltr.: A-ttF
. P.rc.I fo! 2101-091-03 -O3o
glt. lddtr.t ! 19{{ gItXBUnST DR
loc.tion 3 19aa A$fBfrRgf DR
IDD/TT'T XF BOII.D P8R
IlNir P.)nr.nt
2,104.50
2. t0{.5 0
.00
llotal Pcc! !
2, to?.so togrl .ttJ! P|!Br!
Balanga:
lccoune Cod.
aP 00100003111100
DR 00100003112200
PE 00100003112300
rD D2-DEPO8
Rr 1110000311r700
r{c 00100003112800
DGrcription
BUIIJDING PERUTI FEES
DE9Iq[ RlvIEW FSBS
PIJAII CHECK TEBS
CTJEIT'UP DEPOSTTS
R'8EEITIOTI ?EEg
IIII;L CEI;IJ IIISPECTION PIg
lDount
8{8.00
10 0, 00
551.10
500.00
102 .3 0
3.O0
TOWN OF VAIL CONSTRUCTION PERMIT APPLICATION FORM
Contact the Eagle County Assessors Office at 970-32g-A640 for parce! #
Date:Pennit #
Job Name:
Buildiog Q$Plumbing () Electrical ( )
LegalDescription: rot Zl aurck .26Filins < ?- Subdivision
. | ,l
Owners Name: lcll ll*cz Address:
J
Arclutecr: Lle€ACp '€/L Address:
Description ofJob:
Work Class: Ne.w ()Alteration 0{Additional ( )Repair ( )
Number of Dweffing UUts: tr-.cp le>e
BIIILDING: $
NunberandTypeofFireplaces: Cas Lppfiao"., Z F^rt^€gs GasLogs ,-+@*"r--s.-,/
VALUATIONS
'.?ELECTRICAL: S /5.eC OTHER: 5 4O,&nTOTALSre
General Contracton erd!
zzrorvnorVairRegisrrarionNo. /,zO-A pnon"* V70 - 6{3-7122 0lol- bo5
Electrical Contractor:
Torvn of Vail Regisuauon No.
pfumbing contractor, frf-<,L F/- I { 4to},Address:
Torvn of Vc,il Regisrration No.Phone #
' ' ' //, PtF.da^^aa,"",, fo. &r+ a? 6-*'4 C. 8o'tz3
Address:
Phone #
A,
illechanicef Contracror: {aB ttl .<o Zt
'f
or'. rr oi \',rrl llcgisrr:rtion \o.
rca;,ur"rr, /444 fr S,^qBt"p.s( /e-
Mechanical ( ) Other ( )
Phone#
Other (
Number of Ac commodation Units:
;_rE1?
CONTRACTOR INFORMATION
A<idress:
Phone "
FOR OFF|CE USE
BUILDING:
SIGNATU
ZQNING:
qq - oolt1
-/SIGNATU
TO:
FROM:
DATE:
SUBJECT:
Read and acknowledged
Position or Re lationship
ALL CONTRACTORS CURRENTLY REGISTERED WITH T}TE TOWN OF VAIL
TOWN OF VAIL PUBLIC WORKS AND COMMUNITY DEVELOPEMENT
JANUARY I, 1999
CONSTRUCTION PARKING AND MATERIAL STORAGE
CODE S2-10: ITEPOSITS ON PUBLIC WAYS PROHIBITED
A. Unlawful deposits: Subject to subsection C thereof, it is unlawdrl for any person to litter,
track or deposit, or cause to be littered, tracked or deposited, sand, gravel, rocks, mu4 dirt,
snow, ice, or any other debris or material upon any street. sidewalk, alley or public place, or
any portion thereof.
B. Notice; Abatement: The Director of Public Works may notifu and require any person who
violates or causes another to violate the provision of subsection A hereof, or who has in the
Director's employment a person who vrolates or sruses another to violate the same, top
remove such sand, gravel, rocks, mud, dirt, snow, ice or any other debris or material within
twenty four (24) hours after receipt of said notice by the Director of Public Works. In the
event the person so notified does not comply with the notice within the period of time herein
specifred, the Director of Public Works, or other autJrorized agent. may cause any such sand'
gravel, rocks, mud, dirt, snow, ice, debris or any other material to be removed from any street
or alley at the expense of the notified.
C. Exceptions: The provisions of subsection A hereof shall not be applicable:
t . Within the immediate area of any construction, maintenance or repair project of any
street or alley or of any water main, sewer main, electricity line, gas line, telephone line
or any appurtenanc e thereto;
2. fo dJposits of sand, dirt or materials necessary for the protection of the public safety; and
3 . To public areas designated for the dumping or depositing of said materials.
D. Summons; Penalty: As an alternative to the notice for removal provided in subsection B
above, any
person who violates or causes another to violate the same, may be issued a summons to
appear before the Municipal Court of the Town for said violations, and upon being found
guilty oru violation hereunder be punished as provided in section l-4-l of this code.
E. ilotice; Penalty: It is unlawful for any person to fail or refuse to comply with the notice of
the
Director of Public Works as provided in subsection B hereof, and any such person shall, in
addition to payment of the expense of removal incurred by the Director of Public Works, as
provided in-subsection B hereot, upon being fbund guilt-v ofa violation hereundeg be
punishable as provided in section 14-l ofthis code. (1997 code: ordinance 6 (1979)
(i.e. contractor or owner)
TOWN OF VAIL
Department of Community Development
75 South Frontage Road.
Vail, Colorado 81657
970-479-2t38
FAX 970-479-2452
BUILDING PERMIT ISSUAIICE TIME TRAME
Ifthis permit requires a Town of Vail Fire Deparbnent Approval, Engineer's @ublic Works)
review and approval, a Planning Deparhnent review of Health Departnent review, and a review
by the Building Departnent, the estimated time for a total review may take as long as three (3)
weeks.
All commercial (large or small) and all multi-family permits will have to follow the above
mentioned maximum requirements. Residential and small projects should take a lesser amount of
time. However, if residential or smaller projects impact the various above mentioned
departments with regard to necessary review, these projects may also take the three (3) week
period.
Every attempt will be made by ttris deparunent to expedite this permit lrs soon as possible.
I, the undersigned, understand the Plan Check procedure and time frame. I also understand that if
the permit is not picked up by the expiration date, fhat I must still pay the Plan Check Fee and
that if I fail to do so it may affect future permits that I apply for.
Agreed to by:
Project Name:
Date:
Work Sheet was turned into the Community Development Dept.
{j u"t"uo" ro
TO:
FROM:
DATE:
RE:
JOB NAME:
DATE:
MEMORANIIUM
ALL CONTRACTORS
TOWN OF VAIL PUBLIC WORKS
JANUARY I. 1999
WHEN A *PUBLIC WAY PERMIT: IS REQUIRED
PLEASE ANSWER TI{E FOLLOWING QUESTIONNAIRE REGARDING T}IE NEED FOR A*PTJBLIC WAYPERMIT':
1. Is this a new residence? YES
2.
3.
4.
5.
6.
Is demolition work being performed
public properly? YES
Is any utiiity work needed? YES
Is lhe driveway being repaved?
Is a differ€nt access needed to the site other than the existing driveway? YES Nox
Is any drainage work being done that affects the Right-of-Wa1 easemenk, or public property?
YES- $ No--
1
8.
Is a "Revocable Right-of-Way Permn" required? YES No-x-
No--x-
t\6l5f. use of the Right-of-way, eas€ments or
YES
- No-l-
d No-
YES NO-J*
If you answered YES to any of these questions, a "Pubiic Way Permit" must be obtained.
"Public Way Permit'' applications may be obtained at the Public Work's ofice or at Conmunity
Development. If you have any questions please call Leonard Sandoval from Public Wofts at,t79-2198.
AND ANSWERED AII TIIE ABOVE QUESTIONS.
A. Is the fught+f-Way, easements or public propety to be used for saging parking or fenciry?YES Nox_
B. If NO to 8A, is a parking staging or fencing plan re4uired by Comnunity Dwelopment?
' 4*./,d. d
companyName -A;J=
2.
4.
l.
5.
PUBLIC WORKS PER]VIIT PROCESS
How it relates to Building Permits
Fill out our check list provided with a Building Permit Application.
If yes was answered to any of the questions then a'?ublic Way'' is required. You
can pick up an application at either Community Development, located at 75 South
Frontage Road or Public Works, located af 1309 Vail Valley Drive.
Notice sign offs for utility companies. All utilities must field verify (locate)
respective utilities prior to signing application. Some utility companies require up
to 48 hours notice to schedule a locate.
A construction traffic control/staging plan must be prepared on a separate sheet of
paper. An approved site plan may also be used. This plan will show locations of
all traffic control devices (signs, cones, etc.) and the work zone, (area of
Constructioq Staglng, etc.). This plan will expire on November lst and will need
to be resubmitted for approval through the winter.
Sketch of work being performed must be submitted indicating dimensions (lengttl
width and depth of work). This may be drawn on the traffrc control plan or a site
plan forthejob.
Submit completed application to the Public Work's office for review. If required,
locates will be scheduled for the Town of Vail Electricians and Irrigation crew.
The locates take place in the moming, but may require up to 48 hours to perform.
The Public Work's Construction Inspector will review the application and
approve or disapprove the permit. You will be contacted as to the status and any
requirements that may be needed. Most permits are released within 48 hours of
being received, but please allow up to one (l) week to process.
As soon as the permit is processed, a copy will be faxed to Community
Development allowing the "Building Permit" to be released. Please do not
confuse the "Public Way Permit" with a "Building Permit" which is to do work
on a proj ect itself.
NOTE:
The above process is for work in a public way ONLY.
Public Way Permits are valid only until November 156.
A new Fublic Way Permit is required each year if work is not complete.
6
TO$IN OF VAIL
75 S. FROTiTTAGE ROADvArL, co 8L657
970-479-2L38
Occupancy:q4)e ConstrrucLion:I]pe Occupancy:
Valuation:
Fireplaca Infomation: ReEtsrict€d:
95.OO
DEPARIIIENT OF COMMUNITY DEVELOPI4EIiIT
NOTE: THIS PERMIT MUST BE POSTED ON iIOBSITE AT ALL TIMES
Permit. #: D99-0047
Status...: ISSiTEDApplied..: LL/L|/L999
Issued...: lL/L9/1999
Expires..: 05/17/2000
APPLIEANT I,IENING HOME REPAIR & CONSTRUCP.O. BOX 89, BOND, CO 80423
CONTRACTOR TTENING IIOME REPAIR & CONSTRUE
P.O. BOX 89, BOND, CO 90423
OWNER WALLACE MIIiIYONE M
t VERNON SMITII ASSOCIATES, PO BOX
Description:
PARTIAL DEMO FOR REMODELING
DEMO. OF PART/ALL BI'DG.
Job Address: l-944 SUNBT RST DR
Location. ..:, L944 SITNBIIRST DR
Parcel No. .: 2101-091-03-030
Project, No. : PRir99-0292
R3 Single Family Residence
V 1--HR ?ype V l--Hour
5, 000
#of, Gas AppLianc.E i
Add sq Fr:
*Of 6aE Logs:
Phone: 970-653 -9922
Phonez 970-553-9922
810691, DAT.,LAS TX 75381
*of wood/Pallcts !
PEE SI]TiIUARY
Building- - -- ->
Plan check---> 61,?s
. oo
3.OO
ReaCuaratrt PIan Revi.w- - >
DRB Fee--------
C16an-Up DepoBit---- - - -->
TOT.e,t FEES-----
ToEal CalculaCed Fees--->
Additioaal Fees--------->
ToEal Pellnie Fee-------->
Paymrnca - - - - - - - -
BAI,ANCA DUE- - --
Invest.igat.j.on>
will calL---->
.00
20.00
.o0
100.00
279.78
279.75
.00
279.75
279.75
Dept: BUILDING Division:
Dept: PLANNING Division:
FIRE DEPARTIIEI TJRM Action: APPRPUBLIC WORKSJRM AcLion: APPRENVIRONMENIAL HEAITHJRM AcTion: APPR
LTQUORJRM Accion: .A.PPR
Dept: FIRE Division:
Dept: PIJB WORK Divisi-on:
Dept: HEALTII Division:
Dept: CI-,ERK Division:
See Page 2 of this Document for any condiLions Lhat may apply to this permiE,.
DECLARATIONS
I hcrsby acknot Ledgc uhat I hav. !6ad this application, filled out in f,u1l lhc inforoauion requircd, cdplet.d art .ccurrt! PIot
pla!, and 6!atc t'hat' all tshe infomaeion providod aa requir€d iE corr.cg. I rglce !o co|trply with lhc infoluation and Plot plan,
t'o coEply rrith all Town ordinancag and eeabe lawE, .nd to bqild Ehia st'ructuro according !o thc Toen'E zoning and dubdiviEion
codc6, design review approved, t niforq Bqilding code and ocher ordinarlces of, the TorI! appli.cablo theretso.
REQUESTS T.OR INSPECTIONS SI{AIJL BE MADE TWENTY- FOUR HOT'RS IN AD\IANCE BY TEI,EPHONE AT 4?9-2133 OR AT OT'R OFFICE FROM g:OO Il'I S:OO PTII
ILem:05100L1-/L8/L999Item:05400
L1, / 1.8 /L999Item:05600
tL/1,8 /1999Item:05500
1,L /L8 /1,999Item:05700tL/L8/t999Item:05900Lt/L8/L999
BUTLDING DEPARTMEI\TTiIRM ACIiON: APPR APPR JRMPI,ANNING DEPARIT4ENTJRM ACTiON: APPR OK PER AO
N.A
N/A
N/A
N/A
gend Cleatl-Up Depo6its To: LIENINS HOME RBPAIR
********************************************************************************
Permit #: D99-0047 SEatsus: ISSIIED********************************************************************************
CONDITIONS
as of LL/19/99
Permit l)4pe: DEMO. OF PART/ALL BIIDG.
Applicane: LTENING HOME REPAIR & CONSTRUC
970-653 -9922
Applied: LL/LS/L999
rssued: Ll/L9/L999
To E:<pire. o5/L7/2o0a
,fob Address:
tocation: 1944 SITNBITRST DR
Parcel No: 2101-091-03-030
Description:
PARTIA]. DEMO FOR REMODELING
Condit,ions:
1-. TTIIS PERMIT IS GOOD FOR ASBESTOS ABATEMENT ONLY. AII
ASBESTOS ABATEMENT CBRTIFICATE SHOWING THE AREA FREE FROM
ASBESTOS IS REQUIRED PRIOR TO AIiIY FURTHER WORK OCCT'RING ON
lgIS SITE. IF FIJRTHER QUESTIONS ARISE, COIillTAqT THB VAIL
FIRE DEPARIIT{EIVT AT 479-2250.
2. FIRE DBPART!,IEMf APPROVAI IS REQUIRED BEFORE ANY WORK CAN BE
STARTED,3. FIELD INSPECTIONS ARE REQUIRED TO CIIECK FOR CODE COMPLIANCE.
ttaattrrtrtat!ltaatittttrattall,attaittita*itttat'ratttta,rt!|itaa.ttraaltt
I(frf Ol \rllt., @LR.IDO 8r.cmr
itrrtrtr*tattar'rraa*atritrraifi Jrra*i*.arrrtttoira't raft rrartttta
ttrtlEnB Iurb.r: REC-0S93 lnounr r 279.79 LLlL9l99 Ott77
PrymnE U.thod: C. tH foerelon: LIIIINO lDtll RIP hlr,3 Jtr
P.:nd.t f,o3 D99-001? Tltr.: t-DE@ DEto. Ot PTRIAIJ! E!
P.r€.l Lo: 21O1-Ot1-O3-O3O
3lC. ldd!..r: 19al $ loRltf ttr,
locrElon: 19at gulBltRgl m,
logrl Fcaa ! 2?9,75
Ihir PrlrlrnC 279 .7a !ot.l ilr hBa ! 2?9.75
8rlaDc.! .0O
rlltitttttrrria.iartrtaa+itrttt||a'ttJaaaattattttttrrtatat|at'.rtt!rttartt
lccount Cod. Ir..cripElgn lDun'g
BP 00100003111100 BltMnIo DtRt{tt tEtg 95.00
DA, 00100003112200 DEgIeg Rlt'Ear tEAg 20.00
Pr oo1oooo311230o P!rl{ cflrcIc rEBg 61.?5
lD D2-D!POS Cr.rNtOP DEPOATTS loo.Oo
rc 00100003112400 rII.& clrrll rlfaPEcrrd ttE 3-oo
7zr ? , - o zrL
TOWN OF VAIL CONSTRUCTION PERMIT APPLICATION FORM
INX'ORIVIATION MUST BE COMPLETE OR THE A}PLICATION WILL BE RE.IECTEII
Contacttne Eagle County Assessors Office at 970-328-8640for Parcel #
Job Address:
Building ( )Plumbing ( )Electrical ( )Mechanical ( )Oner6Y-/6ta.a
Pb
Legal Description: Lot Ll Block itinp 3 - Subdivision-
Date: // / /6 /qq Permit #
Job Name:(k t<4t-*roAF
Architect:x*",",V6F-'f //s84 /sFuC pnon"+
Description of Job:
Work Class: New ( ) Alteration ( )Additional ( )Repair ( )
Number of Dwelling Units:Number of Accommodation Units:
Other ( )
Number and Type ofFireplaces:Gas Appliances
Torvn of Vail Regisnation No.
ElssDjsg-esulr@,r:
Town of Vail Resistration No.
Mcchanical Contractor:
Town of Vail Reeist-ration No.
Gas Logs r -Wootl/Pellet
VALUATIONS
ELECTRICAL: $
TOTAL $
BUILDING: $
PLI,JMBING $MECHAMCAL$
General Contractor: L taMlMGr
Town of Vail Registration No . l4-* Phone #
Electrical Contractoi:Address:
Phone #
Address:
Phone #
Address:
Phone #
FOR OFFICE USE
BUILDING:
SIGNATURE:
ZONING:
SIGNATURE:
CONTRACTOR INFORMATION
97o -<^s -aaz{
Dg
CLEAN UP DEPOSIT REFUND TO;
TO:ALL CONTRACTORS CIJRRENTLY REGISTERED WTITI TI{E TOWN OF VAIL
TOWN OF VAIL PT]BLIC WORKS AND COMMTINITY DEVELOPEMENT
JANUARY I, 1999
CONSTRUCTION PARKING AND MATERIAL STORAGE
FROM:
DATE:
SUBJECT:
CODE $2-10: DEPOSITS ON PUBLIC WAYS PROHIBITUI
A. Unlawful deposits: Subject to subsection C thereof. it is unlawful for any person to litter,
track or deposit, or cause to be littered, tracked or deposited, san4 gravel, rocks. mud" dirt,
snow, ice, or any other debris or material upon any street, sidewalk, alley or public place, or
any portion thereof.
B. Notice: Abatement: The Director of Public Works may notiff and require any person who
violates or causes another to violate the provision of subsection A hereof, or who has in the
Director's employment a person who violates or causes another to violate the same, top
remove such sand, gravel, rocks, mud, dirt, snow, ice or any other debris or material within
twenty four (24) hours after receipt of said notice by the Director of Public Works. In the
event the person so notified does not comply with the notice within the period of time herein
specified, the Director of Public Works, or other authorized agent, rnay cause any such sand,
gravel. rocks, mud, dirt, snow, ice, debris or any other material to be removed from any street
or alley at the expense ofthe notified.
C. Exceptions: The provisions of subsection A hereof shall not be applicable:
l. Within the immediate area of any construction, maintenance or repair proj ect of any
street or alley or of any water main, sewer main. electricity line. gas line. telephone line
or any appurtenance thereto;
2. To deposits of sand, dirt or materials necessar,v for the protection of the public safety; and
3 . To public areas designated for the dumping or depositing of said materials.
D. Summons, Penalty: As an alternative to the notice for removal provided in subsection B
above, any
person who violates or causes another to violate the s:rme, may be issued a summons to
appear before the Municipal Court of tlre Town for said violations, and upon being found
guilty ofa violation hereunder be punished as provided in Section l-4-1 of this code.
E. Notice; Penallv: It is unlawfirl for any person to fail or refuse to comply with the notice of
the
Director of Public Works as provided in subsection B hereof, and any such person shall, in
addition to payment of the expense of removal incurred by the Director of Public Works, as
provided in subsection B hereof. upon being found guiltl'of a violation herzunder, be
punishable as provided in Scction l-4-l ofthis Code. (1997 Code: Ordinance 6 (1979)
Read and acknowledged by:
Position or Relationship to Project:
Date:
(i.e. contmctor or owner)
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Septenrber 30, 1999
Maxim Report No. 9910137
Prepared by
Maxim Technologies, Inc.@
2650 18th Sfteet
Denver, Colorado
"Providing Cosf-Effective So/ufions fo Clienfs Nofionwi{e,'
r)
2650 l Sth Streel
Denver, Colorado 8021 1-3932
Telephona: (303' 480-0144
Facsimile: (3031 480-3660
Ltl Rur-nc-e P-mtoar-E
4{il
COMPREIIET{SIVE PR,E-RENIOVATION/PARTIAL
DNVIOLTION ASBESTOS ST]RVEY
19448 ST]NBURST DRTVE
vNL, COLORADO
Prepared For:
Paradise Design
P.O. Box 89
Bond. Colorado 8M23
FF{91 -ozI2'
Environmental Scientist
Environmental Scientist
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E)G'CUTIIIE SI'MMARY
I Maxim Technologies, Inc.6 Maxin) was retained by Paradise Desrgn to perform asbestos
inqpection services of the residential structure located at l94/rB Sunbuni Drive in Vail.I Colorado.
I
Maxim conducted a pre-renovation/pafiial demolition, comprchensive asbestos inspection and'
I tqpbng of the site structure on September 23, 1999. The inspection was conducted by anI Asbestos Hazard Emergency Response Act (AHERA) accredited and State of Colorado certified
building inspector.l-r pive homogeneous are:ls of suqpect asbestos containing materials (ACMs) were identified in the
. portions of the structure which would be impacted by the planned renovation at this site. All
I nve homogeneous areas were sampled and submitted to tle laboratory for analysis.T
. None of the homogeneous areas sampled were identifred by the laboratory as asbestos containing
I materials. Maxim concludes that no asbestos containing materials will be impacted by the- planned renovationipartial demolition at this site.
Privileged and Confidential Mrxim Report No. 9910137 Page No. i
1.0 II{IT.ODUCTION
1.1 Purnose and Orsanization of Repoft
At the request of Mr. Fred Liening of Paradise Design, and as described in our proposal dated
August L6, 1999, the objective of this comprehensive asbestos survey is to deteit the presence
of asbestos-containing materials (ACMs) in and on portions of the site structure to be impacted
by the planned renovation at the site structure. Thii report includes the results of the physical
inspection, sampling, laboratory analysis, quantities, and locations of the ACMs at thtdme ofour inspection.
L.2 Site Descriotion
The site being assessed consists of the residential structure located at Lg44B Sunburst Drive inVail, Colorado. The site structure (19448 Sunburst Drive) is part of a two-unit residential
duplex. The original construction date of the site structures is 19g2.
On September 23, 1999 Maxfun Technologies, Inc.@ inspector, Mr. Craig Bmno observed, and
sampled five homogeneous areas of suspect ACMs at the site residence. Suspect ACMs
observed on the exterior of the structurc were limited to non-friable tar impregnated roofing
felts, which were not sampled. The building description is as follows:
Residence:I tro story wood frame residence, including a partialy finished
lower leveVbasement. The exterior walls are comprised of wood.
The roof is a pitched wood truss system with a wood deck, covered
with wooden shake shingles. A small crawlspace is present under
the residence. The interior floor finishes include wood parquet
flooring, stone tile, and carpet, installed over plywood or concrete.
The interior wall finishes include painted and textured gypsum
board. The ceiling materials include finished gypsum board-with
texture and spray-on ceiling texture. The heating systern is
comprised of a forced air, nafural gas furnace. The fumace is
located the basement. The heat distribution svstem was observed to
be uninsulated metal ductwork. Fiberglass insulation was observed
between the walls and ceiling beams. No attic space is present. No
insulation was observed on the domestic water system.
2.0 COMPREIIENSTVEASBESTOSSI]RVEY
2.L General
A comprehensive survey for the presence of asbestos-containing materials (ACMs) in and onthe building located at 19448 Sunburst Drive in Vail, Colorado, was conducted by Maxim
Technologies, Inc.@ The survey was conducted on september 23, 1999 by Mr. craig-Bruno ofMaxim, Asbestos H?u;ard Emergency Response Act lnrGnal-Accredited and State oi Coloradocertified Building Inspector, (certificate No. 124429974). This survey included observation of
Privilegcd and Confi dential Maxim Report No. 9910137 Prge No. 1
the building, sampling and testing of various suspect ACMs. All interior and exterior spaces
of the building which would be affected by the planned renovation were visually inqpected.
Comprehensive AIIERA guidelines were generally followed in obtaining a representative number
of samples. AIIERA sampling protocols for surfacing materials arc at least three samples for
materials constituting less than 1,000 square feet, at least five samples for 1,000 to 5,000 square
feet and at least seven samples for areas greater than 5,000 square feet. For thernial system
insulation (TSD, thrc€ samples per homogenous area are collected. Miscellaneous materials are
collected in a manner sufficient to deterrnine tlte presence or absence of ACM.
2.2 Sampline Methods
Samples were obtained by physically removing a small portion (approximately one square inch)
of the material using a sharp instrument. All layers of the material sampled were penetrated,
and the disturbance of the adjacent material was kept at a minimum. The sample was then
placed into a labeled container and sealed. The sampling instrument was then wiped to remove
materials which could contarninate the next sample. Each sample was labeled identifying the
sample number and location. All samples were logged onto the field data sheets which contain
a brief description of the sample areas, inspector identification, date of inqpection and a
description of the material sampled.
2.3 AnallticalMethodology
The samples were collected and sent along with chain-of-custody forms to be analyzed for
asbestos content to FRS Geotech, Inc. (FRS), 1441 West 46th Avenue, Denver, Colorado. The
analytical procedure used by FRS for the bulk samples was the EPA Method No. 600/R-93/116,
Polarized Light Microscopy with Dispersion Staining. The laboratory results and chain-of-
custody forms are presented in Attachment A.
2.4 Results
A total of six homogeneous areas of suspect ACMs were identified in the portions of the
structure to be affected by the renovation, all of which were sarnpled. The homogeneous zueas,
descriptions, material locations, sample numbers and analytical results are listed below.
Homogeneous Area M3.l Sheetrock with texfure walls and ceilings - sampled in the
garage, the laundry room and the kitchen M3.IA,B,C) - No
asbestos detected.
Homogeneous Area S1.l Spray-on ceiling texture - sampled in the garage, the lower level
bedroom, and the lower level hallway (S I . 1A,8, C) - No asbestos
detected.
Homogeneous AreaMl6. I Grout under ceramicibrick tile - sampled in the lower level
hallway (M16.1) - No asbestos detected.
Privileged 8nd Confidentisl Msxim Repon No. 9910137 PageNo.2
Homogeneous Area F5.l
Homogeneous Area T2. I
Adhesive under parquet flooring - sampled in the kitchen (F5.1)
- No asbestos detected.
Foam insulation under hot tub and on hot tub pipes - sampled in
the crawlspace (72.1) - No asbestos detected.
3.0 CONCLUSIONS
Maxfun concludes tiat no asbestos containing materials arc present in the portions of the
structulE to be impacted by the planned renovation at l9MB Sunburst Drive, in Vail, Colorado.
4.0 RECOMMET\DATIONS
Since no asbestos conaining materials were identified in the renovation area at this site, no
response action is required with respect to ACMs for tlte planned renovation at this site.
5.0 LMITATIONS
This comprehensive pre-renovation/partial demolition asbestos r€port was prepared for Paradise
Design. This report has been prepared to provide inforrnation concerning the types and
quantities of asbestos containing materials present in or on the portions of the building located
at 19448 sunburst Drive, in vail, Colorado which would be impacted by the planned
renovation. The conclusions of this r€port are professional opinions based upon visual site
observations, interpretations of laboratory sampte analysis and our understanding that the site
structure is planned for renovation and parfial demolition. ff you have any questions regarding
this report or if you need additional information, please contact us at (303) 480-0144.
Maxim Report No. 99t0137 Page No.3Privileged and Confidential
ERS GEOIECE, II{C.
1441 If- 46t.h Avenue, Suite 14
Denver, CO 80211-2338
laalyres (percents determined by
Sample Number: M3.1A*
Laye! Percett: 100
Asbestos Minerals :
AInosite
Anthophyllite I
Chrysoti"1e
Crocidol it e
Trenolite-Act ino]-ite
TOTAIT ASBESTOS IID**
Other Fibrous Materials:
Phone: 303/477-2559
800/386-3136
Fax:303/477-2580
Frsrft.'ns oF Ettr_ll lQEEs4tls slltpr.E lr|l".vsrs Fw
por.lE?zEfr "-T(:s.r rrcrl.tscoev (Ir?.rat ?!r-600/e-q?/1'r s
Client : lled-r4 lech"'ologier
Project ID:194tlB Sulburst, Vai]., @, pO* 1944B Sutburst, vail
Sansle Number
M3 . 1A*
M3 . 1A rAl
M3.1A l'Bl
M3 . 18*
M3 . 18 tAl
Percent Samplelsbestos Date Descriotion
llD** 09/23199 Sheetrock lrith texture. caraoe
lD** 0q/23l99 twhite and tan sheetrockl
m*r. 09123 / 99 fWhite texture with inseparable Daintl
llD** 09,/23199 Sheetlock with texture. Laundry rm
liID*). 09 /23 / 99 f white and tan sheetrockl
Lab No. :103975
Page: 1 of 3
visual estimation)
M3.1A rAt M3.1A t'Bl M3.18* M3.18 rAl
100 901n90
Fiblous Glass
Ce lLuLo se
Synthet ic s
Other:
![D* *
1
15
Nonfibrous Material 85 g4
* Composite analysis (multi]-ayered sample, see** ND means N t.ected.
llD**ltD** ![D**
1l
15Tra..o ( l *
85 84
individual J-ayer analyses) .
Analyst:DaXe:09/29/99
FRrS @OTECB, UtC.
1441 tl. 46th Avenue, Suite t4
Denver, Co 80211-2338
Irayes Percent :
Asbestos Minerals :
Amosite
Anthophy11it.e
Chrys otile
Crocido f it e
Tremo Iite-Act ino Iit e
TOIAIJ ASBESIIOS IID**
Other Fibrous Matexials:
Fibrous GIass
Ce l luIo se
Synthet ic s
Other:
RESII?.,FS oF Etttttt tltE slFos sarrp".r rta".vsrs Fv
DO?,rEJtF.a\ ?.I(:tr'r rrTcRarscopv aDr{) Ept-6o0/fR-q? /1 .r 6
Phone:303/471-2559
800 / 38 6-313 6
Fax: 303/4?7-2580
Lab No.:103975
Page: 2 of 3
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Client : !lari.o, lechao log:Las
Project ID:19{{B SuDbu.sst, VaJ.l, CO, pO* 1g4{B Suaburst, VaiJ.
Sample Nwnber
M3.18 tBt
st_. t A
M3.1e* ND** 0gl23l99 Sheetrock with textu".e- Kitchen
M3 . lC IAI NDr* 09/23/99 fwhite and tan sheetrockl
M3.1C rBr I{ID** 09,/23l99 fWhite texture with inseoarable paintl
NDr.* 09/23/99 Sprav-on ceiling texture, Garaoe lwhitel
laal'yces (percents determined by visual estimation)
sanple Number: M3.18 rBr M3-1c* M3.1c rAr M3. r,c tBr sl-r-A
Percent SampleAsbegtos Date Descriotion
rc** 09/23/99 [!{hite texture with inseparable paintl
100 100YU10
llD**
Trace (1?
lIDrt rt
Trr,..a <1*
lgD** ND**
T-a r-a <1* Traca (1*Trace <l-*
Nonfibrous Marerial- 99 95
* Corposite analysis (multilayered sampLe, see** ND means Detected.
t
Analyst.:
99
Iayer analyses) .
84
individuaL
Fd
Date:09/29199
FRS GEOEECS, rlrc.
1441 W. 45th Avenue, Suite 14
Denver, CO 80211-2338
Phone: 303/47?-2559
800/386-31.35
Fax: 303/471-2580
Lab No. :103975
Page: 3 of 3
ElsDT.'rrs oF rttT.t l-entsr'rcls slF".E lm".vs?s P?
po?.rt"zrn t.rcE|tt r.Tcaasaopv (P?.r) Epr-60o/e-q?r1 'l 6
Client : llari.n Techaologles
Project ID:19{48 Suabu'rst, Vsi1, CO, PO* 19448 SuDburlt, VaiI
Sample Nurnber
:!t ttl
s'l 1e
M16.t
!-)- L
a2 -l
Aaalyses (percents deternined by
Sample Nunlcer: 51 . 18
Perc€rt Sanple
Asbestos Date Description
l{[)** 09/23/99 Spray-on ceiling texture. lst fI bedroom
llD** 0q/23l9q Spray-on ceilina texture- Hallway lwhitel
w** 09/23/99 Grout under cerarn-ic tile, Ha1lwav fqravl
tID** 09/23/99 Adhesive under parguet fLoorina. Kitchen
rb=cwn l
liID** 09/23/99 Foam insulation on hot tub piges. Crawl- sgace
visual estimation)
s1. Lc F5.1 T2.7
Irayer Percent:
Asbestos Minelals :
amosite
Anthophyllite
Chrysot i).e
Croc ido Ii-te
TremoI ite-Act inolite
100
r[o:[ar. AsBEsros !fD**
Other Fibrous Uaterials :
Fibrous GIass
Ce]-lulo se
cr'- | h ar- i ^<
Other:
Nonfibrous Materia].
* composite analysis
100 100 100 100
ND**llD**!tD** !lD**
Trace (1t Trace <1t
100 99
(muLtilayered sample, see
99 100
Iayer analyses).
100
individual-** ND mearts N
Analyst :7
,cted.
DaLe:.09/29/99
ItS Gcotccb, Incltl,ll West {5th .trvc. , Suitc 1{
Deavcr CO 80211-2338
This report is concerned
submitted to and tested by FRS
only with results of
Geotech, Inc.
1-303-477-2559' 1-800-386-3135
L-303-177-2580 Fl:(
tests perfonned on sarnples
Bu]-lt Srryl1e lnalJt ica]- PEoc.dulegBulk samples of construction materials ale analyzed according to the t4ethod forthe Determination of Asbestos in BuLk Building ltateriafs (EPA,/500/R-93 / LI6', which the
EPA reco! nends as t,he I'preierred substj-tute'r to the old Intetim Aethod. In areas
where the "new" Uethod is silent, FRS follows the "ol-du Interim Mexhod and/orspecific rulings issued by the various regulatory agencies.
Each separable layer or portion of the sanple is individually analyzed andleported, aLong lrith each Iayer's volurne percent as a part of the total- sample.Additionally, an arithmetic composite for the total sanple, as received by the 1ab, isreported for layered sarnples. Information on the nature and quantj.ty of materials atthe sanpling site, which is unavailabl"e to FRS, nust be used by the client to
determine wheehe! or not this arithmetic composite of the sanple is representative ofthe material-s, as they exist in place. This sane .lnformation nust be used by theclient to determine nhether or not any layered material-, as it exists in place, shouldbe t,reated as severaL different materials or as a composite matelial .
Each sample layer is prepared and analyzed in refractive index oi.l-s that arecertified by the manufacturer, Cargille Laboratories. Refractive indices are measuredby the Di-spersion Staining, Becke Line, or Oblique Illumination methods, according towhich method is most applicable to the sample naterial. Asbestos content is reportedas a percent of the sample, and is a visual estimation based upon gross sanpleexanination and cornparisons uith published cau-bration charts during PI.M analysis,
Srq,].e AshingAshing is a preparatory procedure carrj-ed out to eLiir"inate many interferents and
asbest,os "look-alikes.rr A portion of the sample is placed in a furnace at 500 degreesCelsius for between 1 and 4 hours; the actual t irne vari.es according t.o sample type.
The amount of asbestos present in the original sample is calculated, based upon theweight loss due to ashing. If the sarnple had a 50t weight loss, and the visualestimation of asbestos present was 20*, the amount of asbestos reported would be 10?.A1l ashed samples are so noted on the Final Report.
l{on-Asbestifo::a Amphibo].a liinaraLsParticles of NOlt-lslBESIIFORlt anthophyllite, tremolit.e, and actinolite withIength to width ratios equal to or exceedj.ng 3:1 and overall lengths greater than 5
rnicrons are occasionally detected in sorne bulk samples. Illhile such particles do meetthe "o1d" legal definition of fj.bers, they do not neet the cl-assical definition of
asbestos because they do not occur as bundLes of parallel fibers (often exhibiting
spLayed ends), matted nasses of individual. fj"bers, or long, flexible, and,/o! curvedindividual fiber.B. The majority of mineral fibers in a sarrple must display thesecharacteristics as well as exhibit a lenqth to width ratio of at least 20:1 for themineral to be designated "asbestos. " Th6se guidelines are specified in the "Nerd"Method: EPA/600,/R-93/116. Our Final Report refers to non-asbestiforrn anthophylfite,tremolite, and actinolite as either "Non-asbest. trem./actin, ", or "Non-asbest.anthophyl-. ", whichever is appropriate.
AIl laboratory tests are perforrned according to rigid QA/QC guidelines, andanalytical results are traceable to known reference sEandards and procedures. Inaddition to the legal reguirement that 10? of all samples received be re-analyzed, FRS
Geotech re-analyzes aI-l- samples for which a trace to 3t asbestos is reported.
The New Method (EPA/600/R-93/:.761 conrains the folloHing Suggested AcceptableError Table for PL!4 analyses with quantification by visual estimate over 100 fielcis of
view :
Area1 Percent Asbestos Acceptabfe Range of Asbestos RePorted
It >0t to 3?
5t LA to 9t
10?5t to 15t
20t (or more)plus or ndnus 10t
.ctient: H4 vfr jE!449!9_aE!
6/ tT
PLM Chain of Custody FRS Lab N". t031i{
Address: .Z( 5O FRS Geotech, Inc.
1441 W. 46th Ave., Suite 14
Denver. CO 80211-233
Paee-,LofJL
Job Description:
t 614 tlG S' vt-tB t-tgt 7'City
State
Accept/ Sample
Reject Number
i'13. t A
14/ 6, /
F5'. /
Ti/
Contact: C/24tC(if differcnt from above)
Sample
Date
\Ri-.-.-r---
VC
St.rl ^ / t.- .v/zi/7''1 sl4fr/--.'---.7-
t
I
1/,:::,lif
-i/23;'1'7
--r-;--a,
?,/zs fif
....----.---:
.
r/o/rq
303 | 477 -?S 59 or 8001386-3 1365 VA/L. CO.
P.O. #:-!1"y,6 au^;81,l7|r. Ve,LFAX: 3031477-2580
Turnaround Requested:
Rush- l-day- 3-day.-K 5day-
Returu Samples_
Sample Description
T-7rurE
ilr-Qe,,atG €l.ttr:C.,:
tr ,i2'. t3; )y'c,-".,1
d'd'-i't^-tj /
Gtic uI' ,1r,rr.i).r.-
'.f!///t-N,41,:r- f,:(r.t',.,t;,!-, X t -!,,t-.:
!\) a(r '."r29 PdEt Cxl't-^''L l"t,
(Ptrl:^e +r,tilc.r.'zE B,u (,,{3:,F nrrxo;)
Telephone
FAX: (3t1
Relfqqshed-Iv $"lame, dat9, timp):
r.{ _.-.-:,,}L': - ^-.}- ?/Z'l/,f?G
copies with samples (Yellow copy to be returned with Report). Pink copy for Client's Records,