HomeMy WebLinkAboutpitkin.bldg.273717207095 (2004)?a,2-V
ELECTRICAL PERMIT APPLICATION 3
COMIPITKIN COUNTY W
970 / 920-5526/ \
970 / 920-5532 Inspection Line
AUNITY DEVELOPMENT DEPARTMENT CITY OF ASPEN D
130 South Galena 970 / 920-5090
Aspen, CO 81611 970 / 920-5448 Inspectjon Line
1 -- A A- 1(01, AR 1 v-
I bIP /\PERMIT NO. /
JOB ADDRESS (# AND STREET)
0-151
OWNEA ug-L L»L U.9£,cj _4«40.4-,PHONE 463 -155 3 ,
379-9///
MAILING ADDRESS ONE COLO. LIC #
,#441.305 E £1; 114 ;(4 f / 2 9 3133
BUII-DINGRMIT # OCCUPANCYGROUP $ ELECTRICAL VALU SQUARE FOOTAGE
j %00 00
USE OF BUILDING COMMERCIAL E RESIDENTIAL,,
, CLASS OF WORK E ADDITION ALTERATION U NEW E CONSTRUCTION SERVICE U OTHER
DESCRIBE WORK IN DETAIL (FOR ADDITIONS. ALTERATIONS. INDICATE TYPE, NUMBER AND LOCATION OF SOURCE OF CIRCUITS:
ELECT*AL CODLARACTR PHI
21£0 0,·nill, 4- aL.enni.<».4£44...e.AL
OWNER/APPLICANT: The undersigned applicant to personally perform electrical work on the described property 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 generally open to the public. It i: understood that compliance with these assurances is a condition of the issuance of an electrical permit to the applicant pur-
suant to the provisions of C.R.S. Sectior 12-23-111 (2) (as amended), and that failure to comply herewith will be grounds for revocation of the electrical permit or any
certificate of occupancy issued with respect to the property or residence described.
Applicant:Date:
USETAX PERMIT FEE DOUBLEPAYMENT OF PITKIN COUNTY USE TAX
MONTHLY OR OUARTERLY RETURNS WILL BE SUBMITTED
DEPOSIT METHOD' r/; of 1 % OF MATER ALS VALUATION PAID NOW AT ISSUANCE, A FINAL REPORT ON
TOTAL ACTUAL MATERIALS COST MUST BE FILED WITHIN 90 DAYS OF SUBSTANTIAL COMPLETION
OF WORK AND/OR ISSUANCE OF CERTIFICATE OF OCCUPANCY.
$
APPROVED BY FIRE MARSHAL
$ 37.50
DATE
MATERIALS VALUATION $
EXEMPT: EXEMPT ORGANIZATION
RESALE STATE AND PITKIN
APPROVED BY HPC DATE
ANYONE WHO USES AND/OR CONSUMES MA-ERIALS AND FIXTURES IN Pm<IN COUNTY lS SUBJECT TO
THE 5% USE TAX.
PROPERTY LIENS MAY BE PLACED ON THE OWNER'S AND/OR THE CONTRACTOR'S PROPERTY WHEN
THE USE TAX iS NOT PAID.
NOTICE
BUILDilp{3EPARTMENT ACCEPTANCEFor al work done under this permit, the permittee accepts full responsibility for compliance with .
the National Electric Code, the City 01 Aspen ordinances, and all other county resolutions, city ordi-APPROVE DATE nances, state laws, whichever applies. Permit subject to revocation or suspension for violation ofany ed final electrical inspection shall be obtained prior to using )/0 1-1770 9
the inspection shall be requested within 48 hours after complet-
ing PERMIT#(LIDATION /1 1
laws,#59pming same. An accept
el*irical bystepfi,I,al electriq4
L---DATE /RECEIP't #TOTAL
SIGN OATE
. 1 Fla'+84 /0/37/01 1(tue % 57.ID
PAINT NAME
WHITE-FILE COPY YELLOW-APPLICANT
CONTACT NAME/PHONE NUMBER: