HomeMy WebLinkAboutDemo PermitGarfield County
i Gtdinmunity Development Department
108 8th Street, Suite 401
'",1 3 [i .l[J2hten*ood springs, co 81601
! ,r r_.{'!i. (9701945-8212
www.ga rfieldcountvco,gov
$
$It
S*\
-\\\$
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercial/Multi-Family I Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
I Residential (SF, Duplex or Townhome)Reroof
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
Property Owner:
Mailing Address:
;rt Phone: tfiO t 6/[' i/59 (
J
Email Address 0
Contractori Phone: (_)
Mailing Address:
Email Address:
Architect:Phone:
Mailing Address
Email Address:
Engineer:Phone: ( )
Mailing Address
Email Address:
Manufactured Home lnstaller:Phone: ( )
Mailing Address
Email Address:
PROJECT DETAITS
Describework: fuA,rt old lautrt
Job Address:L
Assessor's Parcel Number:
Sub.Lot _ Block _
Owner's Valuation of Work:(Property Size (Sq. Ft. or Acres)Lq,
Sq. Ft. of Building:110 0 Height:# of Floors: 'L
o
Class of Work:New Remodel/Alteration flnooition
Garage Attached Detached
f
I
PROJECT DETAILS CONTINUED
Septic:f,WTS Community
Type of Heat:Natural Gas Propane
Driveway
Pcrmiti
Authoriw. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
Legal Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for
purposes of inspections by the Building Division.
Other Permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
(3) another permit required for use on the property identified above, e.g. State or County Highway/ Road Access
or a State Wastewater Discharge Permit.
Void Permit. A Building l,ermit becomes null and void if the work aurhorlzed ls not commenced wlthln 180 days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
Other
CERTIFICATION
Electric
Permit #:
NOTICE
I hereby certify that I have read this Application and that the information contained above is true and correct. I
understand that the Building Division accepts the Application, along with the plans and specifications and other data
submitted by me or on my behalf (submittals), based upon my certification as to accuracy. Assuming completeness
of the submittals and approval of this Application, a Building Permit will be issued granting permission to me, as
Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by the Building Division. ln
consideration of the issuance of the Building Permit, I agree that I and my agents willcomply with provisions of any
federal, state or local law regulating the work and the Garfield County Building Code, OWTS regulations and
applicable land use regulations (County Regulation(s)). All County development requiring a permit, except for
residential uses are subject to Article 7 of the Land Use and Development Code. I acknowledge that the Building
Permit may be suspended or revoked, upon notice from the County, if the location, construction or use of the
structure(s) and facility(ies), described above, are not in compliance with County Regulation(s) or any other
appiicabie law.
I hereby grant permission to the Building Division to enter the property, described above, to inspect the work. I
further acknowledge that the issuance of the Building Permit does not prevent the Building Official from: (1) requiring
the correction of errors in the submittals, ifany, discovered after issuance; or (2) stopping construction or use ofthe
structure(s) or facility(ies) if such is in violation of County Regulation(s) or any other applicable law. Review of this
Application, including submittals, and inspections of the work by the Building Division do not constitute an
acceptance of responsibility or liability by the County of errors, omissions, or discrepancies. As the Owner, I
acknowledge that responsibility for compliance with federal, state and local laws and County Regulations rest with
me and my authorized agents, including without limitation my architect designer, engineer and/ or builder.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required information which is correct and accurate to the best of my knowledge,
[,-10 - Ls
Pro Date
t ?-
Owner Print
USE ONLY
"#;"X"il &tlb /77 flM 5 n n SLE o z*;?e q'zrc
Adjusted Valuation:Plan Check Fee:Permit Fee:
-C<i oo Manu. Home Fee:
-t-€
Misc. Fees
-
BP No;
T>rrvrq4j+L
OWTS No:Total Fees:
a5.oo
Fees Paid:
's,oo
Balance Due:J4--
Setbacks:OCC Group:Const. Type:'"'(t'
(ft,',"t , gc6%
BUILDING / PTANNING DIVISION
Signed Approval Date
ASBESTOS ABATEMENT NOTIFICATION and PERMIT APPLICATION FORM
FEE MUST ACCOMPANY THIS FORM. INCOMPLETE APPLICATIONS WILL BE RETURNED.
C-olorado Department
of PublicHeal&
and f,nl'ironment
Submit form to:
Permit Coordinator
Colorado Dept. of Public Health
and Environment
APCD-IE-B1
4300 Cherry Creek Drive South
Denver, CO 80245-1530
Phone:303-692-3'100
Fa\:. 303-782-0278
asbeslos@state.co.us
Public and Commercial Building, School, and Single-F amily
Residential owettlno: > 260 LF or 160 SF or a S5-qallon drum
Courtesv Notice
Non-Public Access Notice
Notice
3O-Dav P&C/SFRD Perm|t
90-Day P&C/SFRD Permit
365-Dav P&C/SFRD Permit
Phase of Multiple
Phase Permit #
$0
$80
$80
$400
$800
$1200
$80
code 100
code 105
code110ll I
code 1901292
code 165/267
I code 177 ] Ll
Single Family Residential Dwelling (SFRD)
> 50 LF or 32 SF or a 55-gal. drum, but < 260 LF or 160 SF or a S5-gallon drum
Courtesv Notice
Non-Public Access Notice (Opt Out)
Notice
30-Dav Permit
90-Dav Permit
365-Dav Permit
Notice or Permit Transfer
$0
$60
$60
$1 80
$300
$420
$55
code 200
code 205
code 210
code230ll I
I code 290 I Ll
code 265
I code 1 80/280 ] Ll
Buildinq Owner
Owner Name
Contact
Street Address
Zip code
Fax#()
Disposal Site
Landfill Name
Street Address
Zip code
CDPHE Use Only
Approved by:
PM req'd?
N W
Date lssued
State
State
City
City
Postmark or Delivery date
Form of Payment & #
Record #
Telephone #()
Permit #
Abatement Site
Building Name
Specify location in the building where work will take place (e.9. floor, room, wing, etc.)
Street Address
Zip code
Cell Phone #()
Project lnformation
End Date
End Time
AM PM
Check the day(s) of operation: Sun MTUWThFSan n! nnn
Type of ACM: TSl, Texture, VAT, etc.
55 gal. Drums
County
Square Feet / Type
Building Contact
Start Date
Start Time
PM
AM
City
Emergency?Ytl Ntl
Linear Feet / Type
Abatement Contractor
Company Name
Street Address
Zip code
Fax#()
CO. Cert #
Project Personnel
CO Project Mgr. Name
CO Project Designer #
CO Project Designer Name
CO Project Designer #
Registration #
A.M.S. Name
CO A.M.S. Cert #
State
Project Supervisor
Consulting Firm Name
City
Telephone #
t)
Cell Phone #()
Cell Phone #()
Cell Phone #(t
describe below the work practices and procedures to be employed in conducting the abatement of asbestos. BE
ceiling tile, TSl, etc.)" Use another page if necessary
to .s.
Fom: AANPAo8 Rev.0l/30/2008
Asbestos PermiUNotice Application Form lnformation and lnstructions:
1. There is a 10 working-day advance notification requirement for permit applications. Day 1 is the 1't business day following the
postmark or hand-delivery date. (Working Day means Monday through Friday and including holidays that falls or any of the days
Monday through Friday.)
2. lf you wish to request a deviation from Colorado Regulation No. 8, Part B, a Variance Request Form must be completed and
submitted to the Division with a $50 review fee. Variances rnust be submitted on the Division's form to be accepied.
3. Please be specific on the types of materials to be abated and the work practices to be used
4. All spaces must be filled in on the permit. lf the information is not applicable, please write N/A. Incomplete information may result in
a delay in processing the application, which may delay your project.
5. ln the "Abatement Site" box, we must have a building contact telephone number on the permit application before it can be processed
This must be someone other than the GAC or its employee who can provide the Division access to the site if the GAC is not on site.
6. lf there needs to be modifications to the notice after the application has been submitted, notify the Asbestos Unit by fax at 303-782-
O278 or e-mail at asbestos@state.co. us before the end of the next regular state business day following the modif cation. Project
modifications include changes in scope of work, AMS, superuisor, the scheduled work dates or.scheduled work times. Please use
the PermiUNotice Modification Form.
7. Supporting digital photographs or documentation may be e-mailed to: asbestos@state.co.us
8. Prior to the start of any asbestos abatement in an area of public access of a non-school building, in which the amourt of asbestos-
containing material to be abated exceeds 1,000 linear feet on pipes or 3,000 square feet on other surfaces, a Project Designer
certified under Regulation No. 8, Part B, shall develop a written project design.
9. Prior to the start of any asbestos abatement in a school building in which the amount of friable asbestos-containing material to be
abated exceeds 3 linear feet on pipes or 3 square feet on other surfaces, a written project design shall be developed by a Project
Designer certified under these regulations, in accordance with paragraph IV.G.7 of Regulation No. 8, Part B.
1C. A Project Manager is required on all projects where the amounts of friable asbestos-containing materials to be abated exceed 1,000
linear feet and/or 3,000 square feet. The Project Manager requirement may be waived; please see section lll.B.E of the CAQCC's
Regulation No. 8, Part B, for more information.
11. All provisions of larvs and ordinances governing this type of work shall be complied with whether specified herein or not. Abatement
permits or approval notices appearing to give authority to violate or override the provisions of any other laws or crdinances shall be
invalid. Furthermore, abatement permits or approval notices issued in error or based upon incorrect information supplied to the
Division shall also ce invalid.
Fomr AAWAo8 Rw. 0l/30/2008
GENERAL INFORMATION
ON ASBESTOS
What rs Asbestos?
Asbestos is the name given to a number of naturally occurring minerals that have been
mined for their useful properties such as thermal insulation, chemical and thermal stability,
and high tensile strength. The types of asbestos that are regulated are: Chrysotile,
Amosite, Crocidolite, Anthophyllite, Tremolite, and Actinolite. Asbestos deposits can be
found throughout the world and are still mined in South America, Australia, Canada, South
Africa, and the former Soviet Union.
Why is Asbesfos a hazard?
Asbestos is made up of microscopic bundles of fibers that may become airborne when
disturbed. lf these fibers get into the air, they can be inhaled into the lungs where they
may cause significant health problems. Researchers still have not determined a "safe
level" of exposure but we do know that the higher the concentration of fibers and the
longer the exposure, the greater the risk of contracting an asbestos-related disease. Some
of these health problems include:
Asbestosis - a lung disease that causes scarring of the lungs. Eventually, this
scarring may become so severe that the lungs cannot function. The latency period
(meaning the time between the exposure and the onset of disease) is often 25-40
years.
Mesothelioma - a cancer of the lining of the lung and chest and/or the lining of the
abdominal wall. Asbestos exposure is one of the few causes of this cancer. The
latency period for mesothelioma is often 15-50 years.
Lung Cancer- Lung cancer can be caused by exposure to asbestos. A person has
a much greater chance (50 to 84 times greater) of developing lung cancer if they are
exposed to asbestos and they smoke. Cancer of the gastrointestinaltract can also be
caused by asbestos exposure. The latency period for these cancers is often 15-30
years.
Despite the common misconception, elposuretoasbestos fibers does not cause
headaches, upper respiratory irritation or other immediate symptoms. As mentioned
above, the effects often go unnoticed for 15-50 years.
When is Asbesfos a hazard?
Asbestos-containing materials (ACM) in good condition should not pose a hazard to building
occupants. lf these materials can be maintained in good condition, it is recommended that
they be left alone and periodic surveillance performed to monitor their condition. lt is only
when ACM is disturbed or the materials become damaged that it becomes ahazard. When
the materials become damaged, the fibers separate and may then become airborne. ln the
asbestos industry, the term 'friable' is used to describe an ACM that can be reduced to
powder by hand pressure. 'Non-friable'means an ACM that is too hard to be reduced to
powder by hand pressure. Mechanical grinding, sanding and dry-buffing are some ways of
causing non-friable materials to become friable.
cotoRAoo
Revised 3/24ll 5 1tffi
Where Can Asbesfos Be Found?
Asbestos was, and still is, used in building materials for a variety of reasons. Asbestos
fibers are incredibly strong and have properties that make them resistant to heat, chemical
damage and insulate against electricity as well as adding durability to a product. Asbestos
was added to thermal and acoustic insulation, fireproofing, roofing products and flooring.
Some of the more common products that may contaln asbestos lnclude:
Wasn't Asbesfo s Ban n ed?
There are common misunderstandings about an Environmental Protection Agency (EPA) ban
on ACM products or uses from 1989. Many sources incorrectly report that all asbestos-
nnntaininnnrnr{rrntcharrahaanhannar{ ln4OO'l fhallQ triffh/^irnrrif(^nrrrf nf Annaalc
'''.vl-'l'lllvv.v.lvl,rt,},vglv
vacated much of the so-called "Asbestos Ban and Phaseout" rule and remanded it to the EPA.
Thus, much of the original 1989 EPA ban on the U.S. manufacturing, importation, processing,
or distribution in commerce of many asbestos-containing product categories was set aside and
did not take effect. Six asbestos-containing product categories are still subject to the 1989
asbestos ban. However, EPA has no existing bans on other asbestos-containing products or
uses. Products manufactured in other countries may also contain asbestos and can be
imported into the United States.
EPA does NOT track the manufacture, processing, or distribution in commerce of
asbestos-containing products. lt would be prudent for a consumer or other buyer to
inquire as to the presence of asbestos in particular products. Possible sources of that
information would include inquiring of the dealer/supplier or manufacturer, refer to the
product's "Safety Data Sheet" (SDS), or consider having the material tested by an
accredited laboratory before installing it in your building.
For More Informatian, please contact:
Asbestos Compliance Assistance Group
Phone: (303) 692-3100
Fax: (303) 782-0278
Toll Free: 1-800-886-7689
Web page: wunv. colorado.qov/cd phe/asbestos
Email address: cdphe.asbestos@s
aOLORAfro
Acoustical Plaster Decorative Plaster Joint Compounds
Adhesives and Mastics Ductwork Flexible Fabric Connections -aboratory Gloves
Asphalt Floor Tile Electric Wirinq lnsulation -aboratorv Hoods/Table Tops
Base Flashing Electrical Cloth Packing Materials (for wall/floor
renetrations)
Blown-in lnsulation llectrical Panel Partitions Pipe lnsulation (corrugated air-cell,
rlock, etc.)
Boiler lnsulation llevator Brake Shoes Roofinq Felt
Breaching lnsulation
Carpet Backinqs
ilevator Equipment Panels
:ire Blankets
Roofing Shingles
Soacklino Compounds
Caulkino/Putties =ire Curtains Sorav-Applied lnsulation
Ceilinq Tiles and Lav-in Panels Fire Doors Taoino Comoounds (thermal)
Cement Pipes ;ireoroofino Materials fextured Paints/Coatinos
Cement Sidinq =loorinq Backinq Ihermal Paper Products
Cement Wallboard ieatinq and Electrical Ducts y'invl Floor Tile
Chalkboards Hiqh Temperature Gaskets /invl Sheet Floorinq
Construction Mastics (floor tile, carpet,
oeilinq tile. etc.)
High Temperature Paper Products Vinyl Wall Goverings
Coolinq Towers HVAC Duct lnsulation Wallboard
Revised 3/24115 2 tlv
STATE OF COLORADO
Bill Owens, Governor
Dennis E. Ellis, Executive Director
Dedicated to protecting and improving lhe health and envlronment ol the people of Colorado
4300 Cherry Creek Dr. S, Laboratory Services Division
Denver, Colorado 80246-1530 8100 Lowry Blvd.
Phon6 {30s} 692-2000 Denver, Colorado 80230-6928
TDD Line (303) 691-200 (303)692-3090
Located in Glendale, Colorado
http;//www. odphe.6tate. oo. us
Colorado Department
ofPublicHealth
andEnvironment
BUILDING RENOVATION AND DEMOLITION
WHAT YOU NEED TO KNOW!
Are you Remodeling, Renovating or Demolishing?
You are subject to Statg,qn4 FPderal Regulations reqqifinqinspection for asbestos. Avoid penalties and
delays: have your project inspected for asbestos by a Cotorado-certifled asbestos building inspector before
commencing work.
It is illegal to improperly disturb asbestos cantaining materials!
Asbestos can be found in these and other common building materials: Ceiting textures, vinyl floor coverings
and mastic, boiler and pipe insulation, healing and cooling duct insulation, ceiling tile, rooflng products,
clapboard shingles, etcetera. These materials are regulated; a certified asbeslos inspector can determine
which materials contain asbestos and which are regulated. Buildings ot any age may contain asbestos; even
those newly built may have asbestos-containing materials,
Far ALL Renovation Projects:
" Buildingsof any age may contain ashestos; even those newty built may have asbestos containing
material$.. lnspection: the structures/components to be disturbed musf be lnspecfed for asbesaos by a state-
ceftified asbestos inspector. Contaci CDPHE or go to ourweb site for a current list of Asbestos lnspectors
http:{www.,sdple,state.co.UF/ap/a-sbeshom-asp or Asbestos Building lnspector Consulting firms can be
found in ihe yellow pages section of most telephone books, under the heading -Asbestos Consulting and
Testing".
' lf the amount of asbestos-containing material to be disturbed exceeds the following trigger levels than an
abatement contractor must remove the material.o Trigger levels means amounts of material as follows:. With regard to single-family residential dweltings, the trigger levels are 50 linear feet on
pipes, 32 square feet on other surfaces, or the volume equivalent of a S5-gallon drum.
' With regard to all areas other than single-family residential dwellings, the trigger levels are
260 linear feet on pipes, 160 square feet on other surfaces, or the volume equivalent of a
55-gallon drum.r A certified removal contractor (GeneralAbatement Conttactor) must remove asbestos-containing materials
that are regulated or may become regulated before they are disturbed by renovation or demolition
activities. Contact CDPHE or go to our web eite for a current list of General Abatement Contractors
httB;l{WW.W.odph.-e.state.co.usiap/asbeshom.asp or Contractors can be found in the yellow pages section of
most telephone books, underthe heading 'Asbestos Abatement".o Notification: A written notification to CDPHE, payment of a notification fee and tan {10} working day
waiting period is required before the removal (abatement) of regulated asbestos containing materials.
Page 1 of 3
J:\Asbeibs and Lead Unlts\Asbeshs Foms\CDPHARenovsdon and Demolltlon.doc
' Regulated asbestos-containing waste material must be disposed of at an approved asbeEtos wastedisposat site.
lemalition$, Destructive Salvage , House Moving
lf y9u. demolish, perform destructive salvage, fertorm de-construction, Furn, destroy, dismanle, dynamite,implode' knock down, lovel, putt down, pulveiize, raze, tear Jowrr, ffi;k ;i of'l' gtructure or struc-turalcomponents 9r y9u move a house you are subiect to State and Fedeial negulations evon when there lr NOasbostos in thc frcillty.
Prior to Demolition:
' lnspection: the building must_be lnspec!1d.fo1.aqficgtos by a state-cerlified asbestos inspector. contact
9DPHE or go to our web site for a current list of Asbestos lnspectors
orAsbestosBuiIdinglnspectorConsultingfirmscanbe
found in the yellow page section ot most telepnone books, under the- heauing ,nibestos ionsu}irg ,rdTesting".
' Asbestos Removal (if neeessary) rnust be perlormed by a colorado-certified GeneralAbatementconlractor. Any'asbestos conlaining materialthat is friaLte orwillbe made friable ouring dema,litionactlvltles must be removed prior to dlemolition. Removal, in accordance wilh Regulation-No. e, ii iequireo irthe amount of asbestos-containing material that is friable or wilt become friable o-uring demolition exceedsthe trigger tevels.
" Ng!|flgqligt!-of Deryplit!9LFo,rm must be submitted to the cDpHE, even if no asbestos rr{as foundduring.the lnspection, payrnent or a notification fee and t"n itolworking day walting period is requiredbefore the demolition can proceed.
Duing Demolitisn:
' Recycling of materlals, such as concrete or woocl, that are bondecl or contarninated with asbestps-containing maierial (Aci\/l), such as floortile or masiic, is t'+or permitied." Demolition of a building that has non-friahle asbestos containing. VAT ortar-impregnated roofing materialsremalning musi be completed without eausing tho asbestos-coritaining nrateriate t6 b*.o,nu friable.Concfete floors covered lvith floor tile shall be femoved in gg !6rrna caa{innc .a ha^^ihr^ ^^---L!- -
as crushing, pneumatic jacking, etc. ormaterials containing rr;J;to'r*;;',;"fiJil"iiir'rr*' L'rPsr':rlronssucn
n when imploding or burning a structure, ALL ashestos-coni"ining material, regardless of quentity, must beremoved prior to demolition.
F*r Nlare lntsrrnation, please conta#t:
Asbestos Compliance Assistance Groun
Asbeetos and Demolition permit Coordinator
Fhune: (303) 694-9100
Fax: (303) 782-0ZTB
Tall Free: 1-8fi0-SB6-2689
Web.page: L_pltqUry_c
Hmait acjdress: Asneqtqs@gJ-Al g, qo..U$":
All asbestos abaterneni and demolition permit applicaiion forms are ar,,ailable from our web site or by caltingthe asbestos program.
I{AVE YOUR PRO"JHCT INSPECTHD BY A COLORADO.CHRTIFIED ASBESTI)$
B UI I-DI I\iG I |{SFECTOR BffiFORfr YOU BHGIN
cafi !"esugt in rensnetnry ponaltie.s and project rJetaysVio{mtlon mf ashestos r@sulstions
J:\Asbesbs and L€ad unrsBsbesbs Forms\Corruo**** I39rf,"?o?13
STATE OF COLORADO RENOVATION/DEMOLITION
FACT SHEET
Prior to ANY renovation or demolition in any public and commercial building that may disturb
greater than the trigger levels of a suspect asbestos-containing material (ACM), an inspection
must be performed to determine if abatement is required.
Trigger Levels
Single-family residential dwelling - 32 square feet
(SFRD) 50 linear feet
The volume of a 55-gallon drum
All other areasexcluding a SFRD - 160 square feet
260 linear feet
The volume of a 55-gallon drum
Individuals performing these inspections shall be State of Colorado certified Building
Inspectors.
The inspection, sampling and assessments of the suspect materials must be performed as
required by Colorado Regulation No. 8, Part B.
Buildings, or those portions thbreof, that were constructed after October,72, 1988 shall
be exempt from inspection requirements IF an architect or project engineer responsible
for the construction of the building or a State of Colorado certified Building Inspector,
signs a statement that no ACM was specified as a building material in any construction
document for the building or that no ACM was used as a building material in the
building.
Building Inspectors must be independent of the General Abatement Contractor (GAC)
who will be abating any asbestos found.
Abatement, in accordance with Regulation No. 8, is required if the amount of ACM that
will be disturbed in connection with the renovation exceeds the trigger levels.
ANY ACM that is friable or will be made friable during demolition activities MUST be
removed prior to demolition. Removal, in accordance with Regulation No. 8, is required
if the amount of ACM that is friable or will become friable exceeds the trigger levels.
A permit for abatement of friable ACM or demolition of a building, or a notice for the
removal of non-friable ACM, must be applied for and received from the Division prior to
commencing the activity.
o Abatement and Demolition application forms can be obtained from:
r www.cdphe.state.co.us/aplasbeshom.asp
o Completed applications, along with the requisite fee, can be submitted to:
o Permit Coordinator, CDPHE, APCD-SS-BI, 4300 Cherry Creek Drive S.,
Denver, CO 80246-1530, (303) 692-3100 by mail or in person
There is a 10 working day waiting period from the postmark or hand-delivery date to start
work on a project requiring a permit or notice.
a
a
a
a
a
a
a
a