HomeMy WebLinkAboutpitkin.bldg.273502307100 (2015)
Dj-
Hrkin County
HP qj- 2(;`;C-Ommwn�ty
3EE sJ d 2UI5
Goner: unitt veiOp eni
ELECTRICAL PERMIT APPLICATION 3
PITKIN COUNTY COMMUNITY DEVELOPMENT
130 S Galena S€ Third Floor Aspen CO 81611
INSPECTION LINE 970-920-5532 PH: 970-920-5526 FX- 970-920-5439
>+�I3L. 00&, PCzF
PERMIT NO. (Office Use Only)
JOB ADDRESS
-,,-50 HLJY 92- n � + Z
OWNER F PHONE
vC17U 3a - 3 !a I
ELECTRICAL CONTRACTOR MAILING ADDRESS PHONE
3032.x) SO
"'N,
BUILDENCGP0ERMIT
OCCUPANCY GROU
ELECJ�ICAL VALUATION
SQUARE.F OTAGE
p
USE OF BUILDING
COMMERCIAL
D RESIDENTIAL
CLASS OF WORK
❑ ADDITION
I KALTERATION
❑ NEW
1 ❑ CONSTRUCTION
❑ SOLAR
❑ OTHER
SERVICE
DESCRIBE WORK IN DETAIL (For additions, alterations, indicate type, number and location of source of circuits)
AJd
e
-1rte4 LEI) �–`- r
r
�II
I rr
C� d G Q : c..c. l ,�— v�t`1 : c 3 a _ e
5
OW NERIAPPLICANT: The undersigned applicant to personally perform electrical work on the described properly or residence hereby certifies, as a condition of issuance
of such permit, that the above described property or residence is owned by the applicant; that the applicant is not engaged in the business of construction or remodeling: and
such property is not intended for sale or resale. nor is it rental property (occupied or to be occupied by tenants, whether transient or permanent) nor will it be genefelly open
to the public. It is understood that compliance with these assurances is a condition of the issuance of an electrical permit to the applicant pursuant to the provisions of C_R.S-
Section 12-23-111 (2) (as amended), nd that failure to comply herein will be grounds for revocation of the electrical permit or any certificate of occupancy issued with respect
to the property or residence des
Owner/Applicant Date:
PAYMEN ITKIN COUNTY USE TAX
Use Tax
Permit Fee
Double
The General Contractor or Owner Builder is required to pay a Use Tax Deposit to Pitkin County
(.5%) on the building permit valuation at time of issuance- All sub -permits pulled under a building
@
f
permit are paid by this deposit payment and should not pay Use Tax. Stand alone sub -permits are
$
$ f P5, C C'
$
required to pay a Use Tax Deposit to Pitkin County (.5%) Deposit 5% of 50% of project
Approved by Fire Marshall ❑
valuation.
Project Valuation (includes labor) 3
Date:
Exempt: Exempt Organization
Approved by HPC ❑
Exempt ID Number
Property liens may be placed on the owner's and/or the contractor's property
Date:
when Use Tax is not paid.
ELECTRICAL CONTRACTOR
Building De artme t Acceptance
For all work done under this permit, the permittee accepts full responsibility for compliance with the
National Electric Code and County resolutions, and/or state laws, whichever applies. Permit
subject to revocation or suspension for violation of any governing same- An accepted final
Approved By:
electrical inspection shall be obtained prior to using the electrical system. A final electrical
inspection II be requested thin 49 hours after completing an electrical installation.
Y
Date:
S E)at6 I
Permit Validation
Date
Recjeipt#
Total
C'l
P q 11-11 I
�to 2�(a
� 1 is.
Print ame
I &C3
RJ
,DC OLIUQ
I
��V*
APR X10;;
FOR c4"f
Pitkin County
APR 2G 2016
Community Development
L
01362016+1'-�-
EWTn
AP;r2 6;
r
F[�
Pitkin County
APR 26 2M
COM munity llevel opmen[