HomeMy WebLinkAboutFile Documents.1315 Sage Ct.0082-2021-BRES (18) -0F•co
mi."' 'cam :'� Submit form to:
Perm
, O T, DEMOLITION NOTIFICATION APPLICATION FORM CooiradoDeptator ofPublic
1, APPLICATION FEE MUST ACCOMPANY THIS FORM Health and Environment
/876" APCD IE-B1
INCOMPLETE APPLICATIONS WILL BE RETURNED 4300 Cherry Creek Drive
Colorado Department (Notice will be mailed to the demolition contractor unless specified otherwise) Denver,CO 80246-1530
of Public Health Phone 303-692-3100
and Environment Fee:$50+$5 per 1000 ft2 of area to be demolished=$ 55.00 eAea0FER 78
sbeStbsestate.co.us
(See instruction#1 on reverse side)
Company Name: I Building Name
Jim Iglehart Construction Garage
Street Square rootage of footprint of facility or portion of facility to b6 2iemolished
o _ _ 617 West Main Street 1,133 SQ.FT.
15 City. Stale: Zip Code: Street — -
2 Aspen CO 81611 .i 1315 Sage Court
OTelephone a Fax# CO City: County: i Zip Code:
U (970)379-5990 (970) 925-5485 c Aspen Pitkin f 81611
C Project Manager. Cell Phone# '-' ( Proposed Start Date i Proposed Completion Date
— o Jim Iglehart (970) 379-5990. •o t 11/10/21_ L 2/1o/22 _ _
:X I certify that the Certified Asbestos Building Inspector has informed me E : Method/Means of Demolition:
a about any remaining asbestos-contaicing materials in the facility to be ai
E demolished. 0
ry Si natu X wrecking 0 Burning' 0 Implosion 0 Moving 0 Other,specify:
p g i Print Name:
Jim Iglehart
Landfill R i ng Buil mg Debris:
Pitkin County Solid Waste J rBuming requires additional authorization—Please call(303)882-3100 and ask
to sneak to the Open Burning Permit Coordinator
General Abatement Contractor(GAC) Owners Name:
N/A c Matt Johnson
o m 2ki' CDPHE Asbestos Permit# Total Quantity of Asbestos Removed O Street
d o 3 -i 1315 Sage Court __ _
.o m C Date Removal Completed Telephone# C_ i City: State: Zip Code:
a at U ( ) Aspen CO. 8161.1.
Type(s)of Asbestos-Containing Material Removed: 1 COContact's Name. Telephone#
Matt Johnson 817 709-8694
With my signature below, I certify that I possess current AHERA accreditation and spate of Colorado certification as
`o an Asbestos Building Inspector. I also certify that I have thoroughly inspected the facility to be demolished, as listed
v in the Demolition Site block above, sampled all suspect materials,had all samples analyzed for the presence of
. asbestos by a NVLAP-accredited laboratory,and have determined that no Regulated ACM exists anywhere in the
c = facility." I also certify that I have informed the owner/operator of the facility or the demolition contractor that any
in o asbestos-containing material allowed to stay in the facility must remain non-friable during demolition. Specify type(s)
y ro of ACM remaining, below: (check appropriate box(es)):
d rE
tot ❑Vinyl asbestos floor tile(VAT)❑VAT mastic❑Tar/asphalt impregnated roofing❑Asphaltic pipe coatings
mi v ❑Spray-applied tar coatings DO Caulking ❑Glazing❑Other,specify:,
o Signature:(In Blue Ink) Prirted Name.
v .%ems- �4 � 8 e r 8q 4-r - -- -
Date of Final Inspection CO Cert# Expration Date Telephone# I Cell Phone#
i 01-1/0I /1da-) ?- iC3 aq/9-s/ao2! I (6170) c1Io -zroo (WO) 611. 11,3
I verity that all refrigerants from air conditioning/refrigeration appliances have been properly recovered in accordance with AQCC Regulation No.
15(for information on CFC requirements call 692-3100).I further verify that all luminous exit signs(containing radioactive matenal)have been
L.
G disposed of in accordance with 6 CCR 1007-1 subpart 3.6.4.3(for information on luminous exit sign requirements call 303-692-3320).
C r. f l
10 rD /0 CHECK THE APPROPRIATE BOX:
3 3 ° ❑ Building Owner v 1 X Contractor D Other I Date 8/24/2021
m d �
U =
Signature: ' Print Name
- ` ---- - - .;.__... -. m_Jim 1 lehart
. g
THIS Box IS FOR CDPHE USE ON LY:
Postmark or Hand DeliveryDate: ((y�� / APPROVED Code: x initial-310
ail 3 to! r�U a I fI Approved By: r 1 ❑ ❑transfer-380
I
Form of Payment&# 174573476-$55 I Permit#: 21P15235D I Record# 172697 Date Issued: 09/15/2021 I
•Regulated asbestoscontalning materials means(a)friable asbestos-contalnino matenal,(b)1 Cateoon I nonfriable ACM that has become friable (c)
Category I nonfriable ACM that will be or has been subjected to sanding,grinding,cyang,or abrading or(d)Category It nonfriable ACM that has a high
probability of becoming or has become crumbled,pulverized,or reduced to powder by the forces expected to act on the material in the course of
demolition or renovation operations regulated by this regulation. Note Asbestos-containing sheet vinyl and linoleum must be property
abated/removed prior to demolition. RECEIVED
Form oNAar APPROVED 01,30/011
11/30/2021
By SEK at 9:26 am, Sep 09, 2021 ASPEN
BUILDING DEPARTMENT