HomeMy WebLinkAboutB09-0003Development Review Coordinator
75 South Frontage Road
Vail, CO 81657
Phone: 970 - 479 -2128
Fax: 970 -479 -2172
' Inspections. 970- 479 -2149
TIi'
BUILDING PERMIT APPLICATION
Separate Permits are required for electrical, plumbing, mechanical, fireplace, etc
Project ALddress( Project #
C \ i� DRB# _F1 -
C-1- li t -�-�
•
—_. 1 Z- .... ........ .. . .
Cont for Information Building Permit #: 00
Company: 5�((Y� M 1 4 b 12 E5t L�V�LO DO�i=1`l+ Detailed Description of Work: Klic r-
Company Address: pp F�Ox SS°l
City: WC)LCC ri State: CO Zip: B) (0,55 Contact Name: 'n Rjo 2CKC'_.q`A 1 r
Contact Ph: 'YtV " O Cpl, -1 Cell:
E -Mail: b06. olrchck- rA44�) 6A- MC','%L. C0rv%
Town of Vail Contractor Registration No: 10
X
Contractor Signature (required)
Property Information
Parcel #: 2101 I Z'2 0 5 0 0 5
Legal Description: Lot # Cl Blk # v1 ,, I
Subdivision: rZlb � ovzt Four P� l4 d II ION
Job Name: ALLY t� PX-G IDI: tic I-
Owner Name: A L L.E- I.1
Mailing Address:
(For Parcel # Contact Eagle County assessors Office at 970 - 328 -8640 or
visit www.eaglecounty.us/patie)
Valuations (Labor & Material)
Building $
Plumbing $
Electrical $
Mechanical $
Total $
'A2•r000 _—
`T �XDo
51, ooa
CWb6►J k �AN1�-Y Cr��,s, 5(N►�5
�Pz cd c6{ S, F2X -k Ti LE
C
(Use additional sheet if necessary)
Architect ( ) Designer ( ) Engineer ( )
Phone:
Fax:
E -Mail:
Work Class:
New ( ) Addition ( ) Remodel ( repair ( ) Other ( )
Work Type:
Interior ((Exterior () Both ( )
Building Type:
Single - Family ( ) Two - Family (Multi- Family ( )
Commercial ( ) Townhome ( ) Other ( )
# & Type of Existing Fireplaces: Gas Appliances
Gas Log ( ) Wood /Pellet ( ) Wood Burning ( )
# & Type of Proposed Fireplaces: Gas Appliances ( )
Gas Log ( ) Wood /Pellet ( ) Wood Burning ( )
Does a Fire Alarm Exist: Yes ( ) No
Monitored Alarm: Yes ( ) No(
Does a Fire Sprinkler Svstem Exist: Yes
Date Received ' I u~ U r"
n JAN 1 3 2004
+ I sql. I '�_ I TOWN OF ti!All
?�Orf - 0 0�---Z-'
JAN 13 2009 �j
TOWN OF VAIL
ASBESTOS INSPECTION AND SAMPLING REPORT
4394 Streamside Cir., Vail, Colorado
Presented to:
Bob Borchardt
P.O. Box 559
Wolcott, CO 81655
Performed by:
Mr. Cody Wittman
DS Consulting, Inc.
PO Box 6864
Avon, CO 81620
DSC Project #953
January 12, 2009
DS Consulting, Inc.
Unmatched Credentials. Superior Results.
Town of Vell
OFFICE COPY
EXECUTIVE SUMMARY
On January 6, 2009, Mr. Cody Wittman of DS Consulting, Inc. (DSC) performed an
inspection and limited asbestos sampling at 4394 Streamside Cir. Vail, Colorado, in order to
identify potentially hazardous friable and non - friable asbestos containing materials (ACM)
within a portion of the above - referenced, single- family residence. Mr. Cody Wittman
performed asbestos bulk sampling of various surfacing materials on sheetrock in a total of
twelve (12) locations in all four bathrooms in the residence. All twelve (12) bulk samples
were analyzed by Reservoirs Environmental, Inc. with all twelve (12) laboratory results being
non - detect for ACM (see Appendix A for laboratory results).
R
I. Introduction
A limited inspection and bulk sampling for ACM was conducted at 4394 Streamside Cir.,
Vail, Colorado, by Mr. Cody Wittman on January 6, 2009, at the request of Mr. Bob
Borchardt. Mr. Wittman is a Colorado State Certified inspector, and has EPA Accreditation
#15425 (see Appendix B for a copy of certificate). The purpose of the inspection was to
identify, sample and assess potentially hazardous friable and non - friable ACM in a portion of
the single- family residence where some remodeling will occur.
II. Structural Design
The structure is a wood - framed, single - family home.
III. Sampling and Analytical Procedures
The inspection and assessment were conducted by an EPA and AHERA accredited Inspector
qualified by experience, education and training in the recognition of potential ACM and
approved bulk - sampling techniques. The asbestos bulk sampling was conducted on suspect
ACM with a limited number of bulk samples being collected in the residence.
The inspection and assessment were performed in accordance with Environmental Protection
Agency / AHERA recommended procedures. These procedures call for the visual inspection
of the area of concern and collection and analysis of representative bulk samples of suspect
material.
Some minor destructive sampling was conducted. Walls, columns and perimeter pipe chases
were not broken into in order to locate and quantify suspect ACM. It should be noted that
additional ACM might be located in other inaccessible areas.
Random bulk samples, representative of the suspect asbestos - containing building materials
(ACBM) of each homogeneous area (HA), were collected according to the guidelines
published as Environmental Protection Agency (EPA) Final Rule: Title II of the Toxic
Substances Control Act (TSCA), 15 USC, Sections 2641 through 2654 and in compliance
with 40 CFR, Part 763. Representative sampling is based on the following criteria:
1. The distribution of the suspect material throughout the HA.
2. The suspect material's physical characteristics and application.
3. Random sampling patterns determined for each HA.
Suspect materials sampled and analyzed should be considered to be representative of
materials in each HA if-
1. They exhibit similar physical characteristics; and
2. The application of the sampled material can be correlated to the application of
unsampled material.
2
Bulk samples collected were analyzed utilizing the EPA's Method for the Determination of
Asbestos in Bulk Building Materials (EPA 600/R/116, July, 1993) and the McCrone Research
Institute's The Asbestos Particle Atlas as methods references.
Analysis of the bulk samples was performed on the "date reported," as listed in the bulk -
sample analysis report.
IV. Notes on Report Format
Suspect materials alike in appearance and application were sampled as HAs. Suspect
materials were divided into three classifications:
1. Surfacing material: sprayed or troweled onto structural building member.
2. Thermal systems insulation: any type of pipe, boiler, tank, or duct insulation.
3. Miscellaneous: other suspect materials, including flooring, ceiling tiles, insulation,
and finishing materials.
Condition assessments were performed by the accredited inspector at the time of inspection.
Condition assessments are listed in the following section. Ratings of "good," "damaged," and
"severely damaged" are meant to indicate the overall condition of the material.
A material in "good" condition has no visible damage or deterioration, or showing only very
limited damage or deterioration.
A material in "damaged" condition has the following characteristics:
• The surface is crumbling, blistered, water - stained, gouged, marred or otherwise
abraded over less than one -tenth of the surface if the damage is evenly
distributed (one - quarter if the damage is localized).
Accumulation of powder, dust or debris similar in appearance to the suspect material on
surfaces beneath the material can be used as confirmatory evidence.
A material in "severely damaged" condition has one or more of the following characteristics:
The surface is crumbling or blistered over at least one -tenth of the surface if
the damage is evenly distributed (one - quarter if the damage is localized).
One -tenth (one - quarter, if localized) of the material is hanging from the
surface, deteriorated, or showing adhesive failure.
Water stains, gouges, or mars are over at least one -tenth of the surface if the
damage is evenly distributed (one - quarter if the damage is localized).
Accumulation of powder, dust or debris similar in appearance to the suspect material on
surfaces beneath the material can be used as confirmatory evidence.
3
Response- action recommendations for asbestos containing HAs are also listed in the
following section. Recommendations may be for more than one HA, if materials are alike.
Recommendations are either "general" or "immediate." An immediate recommendation
indicates an imminent hazard exists and should be addressed as soon as possible.
V. Inspector Comments
No ACM was identified during the bulk sampling conducted at 4394 Streamside Cir., Vail,
Colorado. A total of twelve (12) bulk samples were collected from the above- referenced
residence. All twelve (12) bulk samples were reported as non - detect for asbestos (see
Appendix A for laboratory results of bulk samples).
VI. Asbestos- Containing Homogeneous Area Descriptions and Sample Locations
The following section contains sampled HA descriptions and as well as sample locations
where bulk samples were collected. Percent - asbestos content for each sample indicated can
vary depending on sample locations, homogeneity of the materials, and type of application.
The following samples were collected from the single - family residence 4394 Streamside Cir.,
Vail, Colorado on January 6, 2009:
Homogeneous Area #01
Homogeneous Area #01
Material Description: White /red/black wall
covering; Tan/pink drywall; White compound
w/ white paint
Material Description: Yellow mesh;
White /red wall covering; White compound w/
white aint; Tan/ ink drywall
Material Classification: Surfacing Material
Material Classification: Surfacing Material
Material Location: Master bathroom
Material Location: Master bathroom
Material Condition: Good
Material Condition: Good
Material Quantity: N/A
Material Quantity: N/A
Sample #: 9530SMA1 -1
Sample #: 9530SNUI -2
Composition: Non - detect; Non - detect; Non-
detect
Composition: Non - detect; Non - detect; Non -
detect; Non - detect
Immediate Recommendation: NONE
Immediate Recommendation: NONE
4
Homogeneous Area #01
Homogeneous Area #02
Material Description: White compound w/
white paint; White /red/black wall covering;
Tan/white drywall
Material Description: White paint w/ white
compound; White compound w/ white paint;
White compound; White/blue /red wall
covering; Tan/white drywall
Material Classification: Surfacing Material
Material Classification: Surfacing Material
Material Location: Master bathroom
Material Location: Third level bathroom
Material Condition: Good
Material Condition: Good
Material Quantity: N/A
Material Quantity: N/A
Sample #: 9530SMAI -3
Sample #: 9530SMA2 -1
Composition: Non - detect; Non - detect; Non-
detect
Composition: Non - detect; Non - detect; Non -
detect; Non - detect; Non - detect
Immediate Recommendation: NONE
Immediate Recommendation: NONE
Homogeneous Area #02
Homogeneous Area #02
Material Description: White paint w/ white
Material Description: White paint w/ white
compound; White compound w/ white paint;
compound; White compound w/ white paint;
White compound; White/blue /red wall
White compound; White tape; White joint
covering; Tan/white drywall
compound; White/blue /red wall covering;
Tan/white drywall
Material Classification: Surfacing Material
Material Classification: Surfacing Material
Material Location: Third level bathroom
Material Location: Third level bathroom
Material Condition: Good
Material Condition: Good
Material Quantity: N/A
Material Quantity: N/A
Sample #: 9530SMA2 -2
Sample #: 9530SMA2 -3
Composition: Non - detect; Non - detect; Non-
Composition: Non - detect; Non - detect; Non -
detect; Non - detect; Non - detect
detect; Non - detect; Non - detect; Non - detect;
Non - detect
Immediate Recommendation: NONE
Immediate Recommendation: NONE
Homogeneous Area #03
Homogeneous Area #03
Material Description: White compound w/
white paint; White /green wall covering;
Tan/white drywall
Material Description: White paint w/ white
compound; White /green wall covering;
Tan/white drywall
Material Classification: Surfacing Material
Material Classification: Surfacing Material
Material Location: Second level bathroom
Material Location: Second level bathroom
Material Condition: Good
Material Condition: Good
Material Quantity: N/A
Material Quantity: N/A
Sample #: 9530SMA3 -1
Sample #: 9530SMA3 -2
Composition: Non - detect; Non - detect; Non-
detect
Composition: Non - detect; Non - detect; Non -
detect; Non - detect
Immediate Recommendation: NONE
Immediate Recommendation: NONE
Homogeneous Area #03
Homogeneous Area #04
Material Description: White compound w/
white paint; White /green/multi- colored wall
covering; Tan/white drywall
Material Description: White paint; Tan/brown
wall covering; Tan/white drywall
Material Classification: Surfacing Material
Material Classification: Surfacing Material
Material Location: Second level bathroom
Material Location: Main level bathroom
Material Condition: Good
Material Condition: Good
Material Quantity: N/A
Material Quantity: N/A
Sample #: 9530SMA3 -3
Sample #: 9530SMA4 -1
Composition: Non - detect; Non - detect; Non-
detect
Composition: Non - detect; Non - detect; Non -
detect
Immediate Recommendation: NONE
Immediate Recommendation: NONE
Homogeneous Area #04
Homogeneous Area #04
Material Description: White tape; Tan/brown
wall covering; White compound; White joint
compound; Tan/white drywall
Material Description: White paint; Tan/brown
wall covering; Tan/white drywall
Material Classification: Surfacing Material
Material Classification: Surfacing Material
Material Location: Main level bathroom
Material Location: Main level bathroom
Material Condition: Good
Material Condition: Good
Material Quantity: N/A
Material Quantity: N/A
Sample #: 9530SMA4 -2
Sample #: 9530SMA4 -3
Composition: Non - detect; Non - detect; Non-
detect; Non - detect; Non - detect
Composition: Non - detect; Non - detect; Non -
detect
Immediate Recommendation: NONE
Immediate Recommendation: NONE
VII. Recommendations
The laboratory results of the potential ACM sampled at 4394 Streamside Cir. Vail, Colorado,
indicated that no bulk samples were reported as positive for asbestos. Therefore, no abatement
activities are recommended at this time.
DSC recommends that when ACM is removed/abated, that only a Colorado- licensed asbestos
abatement contractor using personnel trained in the handling of ACM be allowed to conduct such
activities using appropriate methods (HEPA- filtered vacuuming, wet cleaning methods,
respiratory protection, protective clothing, personnel decontamination, negative -air enclosures, air
monitoring, etc.).
7
APPENDIX A
BULK SAMPLE ANALYSIS
REI LAB Reservoirs Environmental, Inc_
January 8, 2009 Laboratory Code: RES
Subcontract Number:
Laboratory Report:
Project Description:
Dave Sinkbeil
DS Consulting, Inc.
3247 S. Indiana St.
Lakewood CO 80228
Dear Customer,
NA
RES 166440 -1
953
4394 Streamside Cir.
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 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 166440 -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,
Jeanne Spencer Orr
President
Analyst(s):
Paul D. LoScalzo Wenlong Liu
Paul F. Knappe Rich Wegrzyn
Michael Scales Adam Humphreys
Nancy R. Adams Scott Klaus
P: 303 - 964 -1986 5801 Logan Street, Suite 100 Denver, CO 80216 1- 866 -RESI -ENV
F: 303 - 477 -4275 www.reilab.com
Page 1 of 4
RESERVOIRS ENVIRONMENTAL, INC.
NVLAP Accredited Laboratory # 101896
TDH Licensed Laboratory # 30 -0136
TABLE PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME
RES Job Number:
Client:
Client Project Number / P.O.
Client Project Description:
Date Samples Received:
Analysis Type:
Turnaround:
Date Analyzed:
RES 166440 -1
DS Consulting, Inc.
953
4394 Streamside Cir.
January 6, 2009
PLM, Short Report
3 -5 Day
January 7, 2009
Page 2 of 4
Analyst: NRA
Client
Sample
Number
a
ID Number
L
A Sub
Y Physical Part
E Description ( %)
R
Asbestos Content
Mineral Visual
Estimate (%
Non
Asbestos
Fibrous
Components
on-
Fibrous
Component
N
9530 SMA 1 -1
EM 370090
A White /red /black wall covering 15
ND
90
10
B Tan /pink drywall 35
ND
20
80
C White compound w/ white paint 50
ND
0
100
9530 SMA 1 -2
EM 370091
A Yellow mesh 5
ND
98
2
B White /red wall covering 15
ND
90
10
C White compound w/ white paint 25
ND
0
100
D Tan /pink drywall 55
ND
15
85
9530 SMA 1 -3
EM 370092
A White compound w/ white paint 10
ND
0
100
B White /red /black wall covering 20
ND
90
10
C Tan /white drywall 70
ND
15
85
9530 SMA 2 -1
EM 370093
A White paint w/ white compound 10
ND
0
100
B White compound w/ white paint 10
ND
0
100
C White compound 10
ND
0
100
D White /blue /red wall covering 20
ND
90
10
E Tan /white drywall 50
ND
15
85
9530 SMA 2 -2
EM 370094
A White paint w/ white compound 10
ND
0
100
B White compound w/ white paint 10
ND
0
100
C White compound 10
ND
0
100
D White /blue /red wall covering 20
ND
90
10
E Tan /white drywall 50
ND
15
85
ND =None Detected
TR= Trace, <1% Visual Estimate
Trem - Act = Tremolite- Actinol ite
Note: Further analysis by TEM is recommended for organically bound material (i.e. floor tile)
if PLM results are <I %.
Data QA
RESERVOIRS ENVIRONMENTAL, INC.
NVLAP Accredited Laboratory # 101896
TDH Licensed Laboratory # 30 -0136
TABLE PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME
RES Job Number:
Client:
Client Project Number/ P.O.
Client Project Description:
Date Samples Received:
Analysis Type:
Turnaround:
Date Analyzed:
RES 166440 -1
DS Consulting, Inc.
953
4394 Streamside Cir.
January 6, 2009
PLM, Short Report
3 -5 Day
January 7, 2009
Page 3 of 4
Analyst: NRA
Client
Sample
Number
a
ID Number
L
A Sub
Y Physical Part
E Description
R
Asbestos Content
Mineral I visual
; Estimate (%
Non
Asbestos
Fibrous
Components
on-
Fibrous
Component
N
9530 SMA 2 -3
EM 370095
A White paint w/ white compound 10
ND
0
100
B White compound w/ white paint 10
ND
0
100
C White compound 10
ND
0
100
D White tape 10
ND
97
3
E White joint compound 10
ND
0
100
F White /blue /red wall covering 15
ND
90
10
G Tan /white drywall 35
ND
15
85
9530 SMA 3 -1
EM 370096
A White compound w/ white paint 15
ND
0
100
B White /green wall covering 20
ND
90
10
C Tan /white drywall 65
ND
15
85
9530 SMA 3 -2
EM 370097
A White paint w/ white compound 10
ND
0
100
B White /green wall covering 20
ND
90
10
C Tan /white drywall 70
ND
15
85
9530 SMA 3 -3
EM 370098
A White compound w/ white paint 15
ND
0
100
B White /green /multi - colored wall covering 20
ND
90
10
C Tan /white drywall 65
ND
15
85
9530 SMA 4 -1
EM 370099
A White paint 5
ND
0
100
B Tan /brown wall covering 20
ND
90
10
C Tan /white drywall 75
ND
15
85
ND =None Detected
TP= Trace, <l% Visual Estimate
Trem - Act= Tremolite- Actinolite
Note: Further analysis by TEM is recommended for organically bound material (i.e. floor tile)
if PLM results are <l %.
Data QA
RESERVOIRS ENVIRONMENTAL, INC.
NVLAP Accredited Laboratory # 101896 Page 4 of 4
TDH Licensed Laboratory # 30 -0136
TABLE PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME
RES Job Number:
RES 166440 -1
Client:
DS Consulting, Inc.
Client Project Number / P.O.:
953
Client Project Description:
4394 Streamside Cir.
Date Samples Received:
January 6, 2009
Analysis Type:
PLM, Short Report
Turnaround:
3 -5 Day Analyst: NRA
Date Analyzed:
January 7, 2009
Client
a
L
Asbestos Content
Non
on-
97
Sample
ID Number
A Sub
Asbestos
Fibrous
Tan /brown wall covering
Number
ND
Y Physical Part
Fibrous
Components
C
E Description
Mineral visual
Components
N
100
R
; Estimate (%
D
White joint compound
9530 SMA 4 -2
EM 370100
A
White tape
10
ND
97
3
B
Tan /brown wall covering
15
ND
90
10
C
White compound
15
ND
0
100
D
White joint compound
15
ND
0
100
E
Tan /white drywall
45
ND
15
85
9530 SMA 4 -3
EM 370101
A
White paint
10
ND
0
100
B
Tan /brown wall covering
25
ND
90
10
C
Tan /white drywall
65
ND
15
85
ND =None Detected
TR= Trace, <1% Visual Estimate
Trem - Act= Tremolite- Actinolite
Note: Further analysis by TEM is recommended
for organically bound material (i.e. floor tile)
• if PLM results are <I %.
Data QA
Due Date: - C1
Due Time: 750 /
'� -�` Reservvlrs Env /ronmenta /, /nC_
5801 Logan St Denver. CO 80216 • Ph. 303 964 -1986 • Fax 303- 477 -4275 • Toll free .666 RES -ENV
Pager : 303.608 -2098
S 166440
INVOICE TO: (IF DIFFERENT) CONIACI INFORMATION:
Company PS GNS ULT(N� �NC Company contact (� n_ /c- S I Q I-gE 1 G Contact
Address: 1 ?�J'1 S- - /N Address Phone 1, r`YG r Phone
Fax _ _ Fax
_ -- Uellipager , - %Q 1 _ r ( 1 Ceu /page
Project Numoer and(or P C a „� Final Data Deliverable Email address
Project Descnpncn:, crat:on CADj (�_4 T)SCO NS J 1- 7-1 r J G 1 ^K . G�
ASBESTOS LABORATORY HOURS: Weekdays: lam - 7pm
REQUESTED ANALYSIS
VALID MATRIX CODES
LAB NOTES:
LM 4 PCNI I TEM _ RUSH (Same Day) _ PRIORITY (Next Day) STANDARD
&
Air =A Bulk = B
(Rush PCM = 2hr. TEM = 6hr.)
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Dust = D Paint = P
Soil = S Wipe = W
Water = DW
CHEMISTRY LABORATORY HOURS: Weekdays: 8am - 5pm
Metal(s) I Dust — RUSH _ 24 hr. _3 -5 Day
T,
RCRA 8 !Metals &Welding "Prior notification is
N
!
Waste Water = WW
RUSH — 5 day __ 10 day required for RUSH
Fume Scan / TCLP —
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Other = O
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Organics _ 24 hr. — 3 day —5 Day
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Special Instructions: CAt-L �fi✓L W �/ T3
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Client satmple ID number Sample ID's must be unique)
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Number of samples received: (X (Additional samples shall be listed on attached long form.)
NOTE: RE wdl analyze incoming samples based upon information received and will not be respons,ble for errors or emiss.ons r car.u7at ons resulting from the inaccuracy of original data By signing cl:enticompany reprasentatve agrees that submission of the
Touovnng samples Tor requested analysis as in d:cated on this Ohara of Custody shall constitute an analyticai services agreement w8h payment terms of NE? 30 days.. failure to comply with payment terrs —By result Ina 1.5% monthly interest surcharge
aJ
Relinquished By: �►, +j Date,Time G o� L. Sample Condition- On Ice Sealed Intact
Laboratory U Tomp (F°) Y/N YIN Y 1
Received By: Date;Time Carrier
Results ntact Page P ne Email Fax Date Tinlie Initials C ntact Page Phone Email Fax Date Time Initials
Contact Page hone Email Fax Date Time Initials Contact Page Phone Email Fax Date Time Initials
APPENDIX B
CERTIFICATE
STATE OF COLORADO
ASBESTOS
CERTIFICATION*
Colorado Department of Public Health
and Environment
Air Pollution Control Division
This certifies that
Cody Wittman
Certification No: 15425
has met the requirements of 25 -7 -507, C.R.S. and Air Quality Control
Commission Regulation No. 8, Part B, and is hereby certified by the
state of Colorado in the following discipline:
Building Inspector*
Issued: 6/13/2008
Expires on: 6/13/2009
4ed Auth A CD Representative
This certificate is valid only with the possession of a current Division- approved training course
certification in the discipline specified above.
f .T .,
17
\� \��t/� h 1 i� f 55 5 \ ^o va 44 1, a i` ✓SS�%�, 1 m°ug�,/ _ M
�\�� `�'•r'riiiid�' �\ �: ffi?i� � � \ ji�j•� 4�StP��Sh�ti.. � �� � �a�.j�.�� �—. �9
************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
TOWN OF VAIL, COLORADO Statement
************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Statement Number: R090000059 Amount: $1,897.74 01/22/200901:01 PM
Payment Method: Check Init: LC
Notation: 49347 /SUMMIT
FOREST DEVL
-----------------------------------------------------------------------------
Permit No: B09 -0003 Type: ADD /ALT SFR BUILD PERMIT
Parcel No: 2101 -123- 0500 -5
Site Address: 4394 STREAMSIDE CIR W VAIL
Location: WEST UNIT
Total Fees: $1,897.74
This Payment: $1,897.74 Total ALL Pmts: $1,897.74
Balance: $0.00
************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ACCOUNT ITEM LIST:
Account Code Description Current Pmts
-------------- - - - - -- ------------------------ - - - - -- ------ - - - - --
BP 00100003111100 BUILDING PERMIT FEES 650.75
PF 00100003112300 PLAN CHECK FEES 422.99
UT 11000003106000 USE TAX 4 9s 820.00
WC 00100003112800 WILL CALL INSPECTION FEE 4.00
----------------------------------------------------------------------- - - - - --
NOTE: THIS PERMIT MUST BE POSTED ON JOBSITE AT ALL TIMES
TOWN OF VAII
Town of Vail, Community Development, 75 South Frontage Road, Vail, Colorado 81657
p. 970.479.2139, f. 970.479.2452, inpsections 970.479.2149
ADD /ALT SFR BUILD PERMIT
Permit #:
B09 -0003
$650.75
Project #:
PRJ09 -0011
Job Address: 4394 STREAMSIDE CIR W VAIL
Status ..
ISSUED
Location......: WEST UNIT
Applied ..:
01/13/2009
Parcel No....: 210112305005
Issued.
01122/2009
Restuarant Plan Review
Expires ...
07/21/2009
OWNER ALLEN, CHARLES & AMY 01/13/2009
Investigation------------ - - - - ->
$0.00
2260 BLUFF CT
- - - - -> $0.00
CEDAR HILL
TX 75104
Payments ------------------------------- >
APPLICANT SUMMIT FOREST DEVELOPMENT, 101/13/2009 Phone: 970 - 926 -2567
PO BOX 559
- - - - -> $1,897.74
BALANCE DUE ------------------------ >
WOCOTT
CO 81655
License: 103 -A
CONTRACTOR SUMMIT FOREST DEVELOPMENT, 101/13/2009 Phone: 970 - 926 -2567
PO BOX 559
WOCOTT
CO 81655
License: 103 -A
Description:
INTERIOR REMODEL: UPGRADE KITCHEN, BATHROOMS, NEW CABINETS,
TILE, PLUMBING FIXTURES
Occupancy: IRC
Type Construction: IRC
Valuation: $51,000.00
Total Sq Ft Added: 0
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
FEE SUMMARY "' xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Building Permit Fee ------ >
$650.75
Will Cal Fee ---------------------
> $4.00
Total Calculated Fees ------------- >
$1,897.74
Plan Check--------------- - - - - ->
$422.99
Use Tax Fee --------------------- > $820.00
Additional Fees------------------ - - - - ->
$0.00
Add'I Plan Check Hours ->
$0.00
Restuarant Plan Review
- - - - -> $0.00
TOTAL PERMIT FEES--------- - - - - ->
$1,897.74
Investigation------------ - - - - ->
$0.00
Recreation Fee------------
- - - - -> $0.00
Payments ------------------------------- >
$1,897.74
Total Calculated Fees---
- - - - -> $1,897.74
BALANCE DUE ------------------------ >
$0.00
xxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxx xxwxxxxxxxx rxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx +......+ xxx.. :xxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxx+ xxxxxxxxxxxxxxxxxxxxxxxxx. xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
DECLARATIONS
I hereby acknowledge that I have read this application, 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 structure
according to the towns zoning and subdivision codes, design review approved, International Building and Residential Codes and other ordinances of the Town
applicable thereto.
REQUESTS FOR INSPECTION SHALL BE MADE TWENTY -FOUR HOURS IN ADVANCE BY TELEPHONE AT 970.479.2149 OR AT OUR OFFICE FROM
8:00 AM - 4:00 PM.
S ature of Owner or Co ractor / Date
Print Name
bld_alt_construction_perm it_041908
APPROVALS
Permit #: B09 -0003 as of 01 -22 -2009 Status: ISSUED
Item: 05100 BUILDING DEPARTMENT
01/21/2009 JLE Action: AP
Item: 05600 FIRE DEPARTMENT
01/15/2009 drhoades Action: AP
See the Conditions section of this Document for any that may apply.
bld_a It_co nstruction_perm it_041908
CONDITIONS OF APPROVAL
Permit #: B09 -0003 as of 01 -22 -2009 Status: ISSUED
Cond: 12
(BLDG.): FIELD INSPECTIONS ARE REQUIRED TO CHECK FOR CODE
COMPLIANCE.
Cond: 16
(BLDG.): (SFR) SMOKE DETECTORS ARE REQUIRED PER SECTION
R313 OF THE 2003 IRC.
Cond: CON0010536
NO STRUCTURAL MODIFICATIONS APPROVED
bld_alt_construction_perm it_041908
Development Review Coordinatc
75 South Frontage Roar
Vail, CO 8165;
Phone: 970 - 479-2128
Fax: 970- 479 -2452
Inspections; 970 -479 -2149
Transmittal Form
Revision Submittals:
1. "Field Set' of approved plans MUST accompany revisions
2. No further inspections will be performed until the revisions are approved & the permit is re- issued.
3. Fees for reviewing revisions are $55.00 per hour (2 hour minimum), and are due upon issuance.
Permit #(s) information applies to
10 • ••
Project Address:
Attention:
Hb,N 5 recR,m_5_Ir>& CIr. W.
Contact Information
Company: LkYY%M t+ �-o QE- :ST Dr-V.
Company Ph: `K(o' 25e,? Fax: 9 7.(o - ES 87
Contact Name: &n b ?7o rck a,r(�t
Contact Ph: �9C-000Z% Cell: 390 -C p2_%
E- Mail: t?�b,bO `Chot.cd4 ho�AJ(LAL •COM
Town of Vail Contractor Registration No:
/\
Signature (required)
Revised ADDITIONAL Valuations (Labor & Materials)
(DO NOT include original valuation)
Building $�
Plumbing $
Electrical $
Mechanical $
Fire Sprinkler /Alarm $
Total $
Revisions
() Response to Correction Letter
_attached copy of correction letter
O Deferred Submittal
() Other
Description / List of Changes:
gEPL)gGE a^1E �NINdo� 4 oNr-
1
���IO door
]P_-EV tic t d ec (c�
O__oL Fir cE &IL10ce
(Use additional sheet if necessary)
v Date R
00 a —
4 -,b (..� 2
I
f,4AR 13 7009
, J
TOWN OF MAIL
TOWN OF VAIL, COLORADO Statement
Statement Number:
R090000282 Amount: $536.35 04/02/200912:48 PM
Payment Method:
Check Init: LC
Notation: #9410 /Summit
Forest Development
-----------------------------------------------------------------------------
Permit No:
B09 -0003 Type: ADD /ALT SFR BUILD PERMIT
Parcel No:
2101 - 123 - 0500 -5
Site Address:
4394 STREAMSIDE CIR W VAIL
Location:
WEST UNIT
Total Fees: $2,434.09
This Payment:
$536.35 Total ALL Pmts: $2,434.09
Balance: $0.00
*************************************************************
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ACCOUNT ITEM LIST:
Account Code
-------------- - - -
Description Current Pmts
- --
BP 00100003111100
------------------------ - - - - -- ------ - - - - --
BUILDING PERMIT FEES 119.00
PF 00100003112300
PLAN CHECK FEES 77.35
UT 11000003106000
USE TAX 416 340.00
NOTE: THIS PERMIT MUST BE POSTED ON JOBSITE AT ALL TIMES
MWNou
Town of Vail, Community Development, 75 South Frontage Road, Vail, Colorado 81657
p. 970.479.2139, f. 970.479.2452, inpsections 970.479.2149
ADD /ALT SFR BUILD PERMIT Permit #: B09 -0003
Project #: PRJ09 -0011
Job Address: 4394 STREAMSIDE CIR W VAIL
Location......: WEST UNIT
Parcel No....: 210112305005
OWNER ALLEN, CHARLES & AMY 01/13/2009
2260 BLUFF CT
CEDAR HILL
TX 75104
APPLICANT SUMMIT FOREST DEVELOPMENT, 101/13/2009 Phone: 970 - 926 -2567
PO BOX 559
WOCOTT
CO 81655
License: 103 -A
CONTRACTOR SUMMIT FOREST DEVELOPMENT, 101/13/2009 Phone: 970 - 926 -2567
PO BOX 559
WOCOTT
CO 81655
License: 103 -A
Description:
INTERIOR REMODEL: UPGRADE KITCHEN, BATHROOMS, NEW CABINETS,
TILE, PLUMBING FIXTURES
Occupancy: IRC
Type Construction: IRC
Status .. : ISSUED
Applied . . : 01/13/2009
q
Issued... „4 : �� yIZ40
Expires ...: 07/21/2009
Valuation: $68,000.00
Total Sq Ft Added: 0
FEE SUMMARY
Building Permit Fee ------ > $769.75 Will Cal Fee --------------------- > $4.00 Total Calculated Fees ------------- > $2,434.09
Plan Check--------------- - - - - -> $500.34 Use Tax Fee --------------------- > $1,160.00 Additional Fees------------------ - - - - -> $0.00
Add'I Plan Check Hours -> $0.00 Restuarant Plan Review - - - - -> $0.00 TOTAL PERMIT FEES--------- - - - - -> $2,434.09
Investigation------------ - - - - -> $0.00 Recreation Fee------------ - - - - -> $0.00
Payments------------------------ - - - - -> $2,434.09
Total Calculated Fees--- - - - - -> $2,434.09 BALANCE DUE------------------ - - - - -> $0.00
DECLARATIONS
I hereby acknowledge that I have read this application, 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 structure
according to the towns zoning and subdivision codes, design review approved, International Building and Residential Codes and other ordinances of the Town
applicable thereto.
REQUESTS FOR INSPECTION SHALL BE MADE TWENTY -FOUR HOURS IN ADVANCE BY TELEPHONE AT 970.479.2149 OR AT OUR OFFICE FROM
8:00 AM - 4:00 PM.
ignature of Owner or Contractor ate
Print Name
bld_alt_constru ctio n_perm it_041908
+ f!#* R## fiRRR# Yf4R* RRRrtrt# i### RRRRY+!## RRR## R## fff!**# R# RrtrtRR####!## i#* RRRrtrtrt# ffffiiR, RRRRRR# Y# f!! RRl RrtrtY#+##!## fiRRrtrtrt# rt*#!***# Rrtrtrtrt# ifi*! fi* RRRrt# Yf# i*! RlRRrtRYYYi # #! # * # *RRRRrtrt # # # #iH **
APPROVALS
Permit #: B09 -0003 as of 04 -02 -2009 Status: ISSUED
### rtf+###,,, firt+#+,*!!!## rtrtY#+ Yl R#, RRrtrt++#*# RRR# Rrtrtrtrt# rt#### ff,##„} RRrtrtR+++# i!!!!#!„ RRrtrtrtrt##!##,*„ RRrtrtrtfi##**!# RRrtrtrtrtY#!!l fiRRfiRrtrtrtrt## ii!*** rtrtrtrtrt# Y+## # +,Rfi #rtrtrt # + * *i + *R #fR *RRrt # * +lf +!
Item: 05100 BUILDING DEPARTMENT
01/21/2009 JLE Action: AP
03/17/2009 cg Action: AP APPROVED REVISIONS
Item: 05600 FIRE DEPARTMENT
01/15/2009 drhoades Action: AP
Item: 05400 PLANNING DEPARTMENT
03/25/2009 bgibson Action: AP plans routed to C -4
*#*#************ i#!! i* f, fifirtrtrtrt#### f!! R,* RRrtrtYrt+#+ f** R! R# RRfifirtrtrtrt### f## iiii## RRRRRrtrtrtrtY++#!! R! R## RRRrtrtfYtff#* Rl RRrtrt+ rtrt##++#!!,* Rrtrtrtrtrt##!!#,l fifiRRRrtrtrt### * * * #f * * * * * * * * *** * * * *iYR * * ** * ***
See the Conditions section of this Document for any that may apply.
b Id_a It_co n st ru ct i o n_pe rm i t_041908
CONDITIONS OF APPROVAL
Permit #: B09 -0003 as of 04 -02 -2009 Status: ISSUED
Cond: 12
(BLDG.): FIELD INSPECTIONS ARE REQUIRED TO CHECK FOR CODE
COMPLIANCE.
Cond: 16
(BLDG.): (SFR) SMOKE DETECTORS ARE REQUIRED PER SECTION
R313 OF THE 2003 IRC.
Cond: CON0010536
NO STRUCTURAL MODIFICATIONS APPROVED
Cond: CON0010599
The adjacent duplex owner shall replace their deck rails to
match this proposal.
bld_alt_ construct ion_perm it_041908
U4-15-2012 Inspection Request Reporting Page 1
9:16 am Vail, CO =City Of
Requested Inspect Date
Inspection Area
Site Address
A/P /D Information
Activity: B09 -0003 Type: A -BUILD
Const Type: Occupancy:
Owner: ALLEN, CHARLES & AMY
Contractor: SUMMIT FOREST DEVELOPMENT, INC.
Monday, April 16, 2012
JRM
4394 STREAMSIDE CIR W VAIL
WEST UNIT
Sub Type: ADUP
Use: IRC
Phone: 970 - 926 -2567
Status: ISSUED
Insp Area: JRM
Description: INTERIOR REMODEL: UPGRADE KITCHEN, BATHROOMS, NEW CABINETS, TILE, PLUMBING
FIXTURES
Requested Inspection(s)
Item: 90 BLDG -Final
Requestor: SUMMIT FOREST DEVELOPMENT, INC.
Comments: FOLLOW UP
Assigned To: JMONDRAGON
Action: Time Exp:
Comment: bee condition adjacent deck
KIP- �kv
Requested Time: 04:00 PM
Phone: 970 - 926 -2567 -or- 970 -390-
0627
Entered By: JMONDRAGON K
Inspection History
Item: 30 BLDG - Framing
** Approved **
02/18/09
Inspector: JRM
Action:
AP APPROVED
Comment:
LOWER LEVEL MASTER BATH APPROVED
05/08/09
Inspector: shahn
Action:
AP APPROVED
Comment:
framing for new door /header in low level.
letter for 8x4HSS ok.
Item: 50 BLDG - Insulation
** A proved **
02/18/09
Inspector: JRMp
Action:
AP APPROVED
Comment:
Item: 60 BLDG - Sheetrock Nail ** Approved **
03/13/09
Inspector: JRM
Action:
AP APPROVED
Comment:
05/12/09
Inspector: JRM
Action:
AP APPROVED
Comment:
Item: 70 BLDG -Misc.
** Approved **
04/27/09
Inspector: shahn
Action:
AP APPROVED
Comment:
footer rebar ok.
04/28/09
Inspector: shahn
Action:
AP APPROVED
Comment:
foundation wall rebar ok.
Item: 90 BLDG -Final
* Approved **
06/05/09
Inspector: MH
Action:
COND APPROVED /CONDITIONS
Comment:
See conditions on adjacent deck
Item: 534 PLAN - FINAL C/O ** Approved
06/12/09
Inspector: bgibson
Action.
AP APPROVED
Comment:
QV /
REPT131 Run Id: 14370