HomeMy WebLinkAboutB15-0065 Elevator Inspection.pdfNorthwest Colorado Council of Governments
ELEVATOR PERMIT APPLICATION
Permit# / 0/ I & I Jurisdiction t OUJ ,j or: v A I(... Building Official :r~ Mo #J ORA wJ
Totalfee f215·0Q ~d 7 /-Lf~ Receipt# C~
Plan Reviewed and Approved by ~ ~ Date Issued ~/ 2
This section to be completed by N~CCOG Permit Expiration Date {;.?/,!~/£
** Permits ex Ire in one ear for new installations and six months for alterations **
**All the following must be completed by the elevator contractor**
Inaccurate, illegible or missing Information wlll cause a delay in the application process.
Please complete a separate application per conveyance.
Jurisdiction Building Permit# 81S .. G)O" (:;' State of Colorado Conveyance ID# N ~
Job Address 223A Beaver Dam Rd Vail.CO 81657
Job Name Gore Creek A
Job Malling Address 233A Beaver Dam Rd Vail, CO 81657
Job Phone# 303-623-7433 Email
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Elevator Company __ M_or_ni_ng_s_t_ar_E_le_v_at_or ________ State License Number ___ c_c_-1_·_1 s __
Malling Address 16165 Cliffrock Ct Colorado SPrings, C) 80921
Phone # ___ _,7_,1.;;,.9 ... .s...,3 .... 5 .... z...,g ... e..,._ ____ _ Email richai:d@m&ele"ator com
Unit # 110215-02
__ X_ New Installation-Circle one (HYP -RHYP -Traction -Lift -Dumbwaiter -Other LU/LA )
___ Alteration (unit cannot be returned to seJVice until inspected and approved by NWCCOG)
Cab modifications require submission of Material Safety Data Sheets (MSDS)
Describe work ___ P_ro_v_id_e_a_n_d_in_sta_I _ne_w_e_le_v_at_o_r ___________________ _
NOTICE
I hereby certify that I have read and examined this application
and know the same to be true and correct. All provisions of laws
and ordinances governing this type of work wlll be complied with
whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions
of any o r sta~f I I law regulating construction or the
perform e st ctlon .
. · u t 1{'/1r:..
Signature of owner
PAYMENT
Check: Make p yable to NWCCOG.
Date
Date
CC in~ n//SiPj below for Credit Card Authorization.
Cre~d·t~rd.· all Cora Winters at 970-468-0295 x114 to give
. . ~ er ;_1'7-11'
Signature Date
New IN&IALLATION FEES
Passenger or freight elevator, LULA, escalator, moving walk:
Up to and Including $50,000 of valuation = $375.00
Over $50,000 of valuation= $375.00 plus $7.00 for each
$1,000.00 or fraction thereof over $50,000.00
Lift, Dumbwaiter or private residence elevator:
Up to and including $20,000 of valuation = $275.00
Over $20,000 of valuation= $275.00 plus $4.00 for each
$1,000.00 or fraction thereof over $20,000.00
MAJOR ALTERATION FEES:
Fees for major alterations shall be as set forth in Table 3-A of the
Uniform Administrative Code or Table 1-A-see Current Fee Schedule
on NWCCOG.org website Elevator Inspection Program page.
VALUATION __ 1_8 ...... 5_74 ____ __,....; '.,;w.·::: __
rv1"
TOTALFEE __ ~_I~~-~-~~
11.:;
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Conveyance plan review and field inspections will be conducted by NWCCOG Elevator Inspection Program. Plans will be su~itted to . . ' '
NWCCOG for review and approval. Schedule inspections by emailing NWCCOG at Elevator@NWCCOG.org. ..,._,,_ ,.,,. , ..