HomeMy WebLinkAboutElevator PermitNorthwest Colorado Council of Governments
CONVEYANCE PERMIT APPLICATION
Permit # W? Jurisdiction 1q" Q �Building Official l� /O�e4fp
Total Fee 9 15-0 °I Date Paid � ,-2/ tjfr Receipt # --riU 3 0 6 v7 Gi Y
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Permit Approved by :d.,na.,, -4 � r.� Date Issued v3/„-� ;led 3
This box to be completed by NWCCOG Permit Expiration Date
"Permits expire in one year for new installations and six months for alterations"
A separate Permit Application is required for each conveyance.
Job Address 678 Schooner Lane, Carbondale, CO 81623
Job Name Stirling Ranch, LOT 26
Job Mailing Address Last Ridge Development Corp. 1720 Wazee #5D, Denver, CO 80202
Job Phone # 720-670-8129 Email gmanchester@lastridgedev.com
Elevator CompanyC010rado Custom Elevator 8, Lift state License Number CC-1-7
Mailing Address 416 29 Road Grand Junction CO 81504
Phone # 970-245-4472
Emailoffice@coiocustomIift.com
NEW INSTALLATION (ALL items in this box required)
_Conveyance Unit/Serial #:
(N/A for residential)
_State of Colorado Registration ID# CP_---
(N/A for residential)
_Jurisdiction Building Permit # BLRE-09-21-7134
_Is this for Passenger or Freight? Passenger
Is this for Commercial or Residential? Residential
_Circle one: Hydraulic o ed Hydraulic Traction/Electric — Lift — Other
Plans/Drawings submitted with this Permit Application Elevator Status Panel Yes
ALTERATION — Detailed Scope of Work must be submitted with this Permit Application
Unit #
State of Colorado Registration ID# CP_ _-_ _
The conveyance cannot be returned to service until inspected & approved by NWCCOG. No TCO's issued for major alterations.
NOTICE
1 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 will 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 other state or local
law regulating construction or the performance of
construction.
02/23/2023
Licensed Contractor signature Date
PAYMENT
Check: Make payable to NWCCOG.
Credit Card or Electronic Check - pay online at
www.nwcoog.org/programs/elevator-inspection-
program
I Revised 12/14/2022 1
Passenger or freight elevator, Lift, LULA, escalator, moving walk: Up to and
including $50,000 of valuation = $500
Valuation $50,000-$199,999=$500 plus $20 for each $1,000 or fraction thereof over $50,000
Valuation $200,000 & up=$3,500 plus $10 for each $1,000 or fraction thereof over
$200,000
Private residence elevator:
Flat Fee = $750.00
ALTERATION OR MODIFICATION FEES
Up to & including $10,000 of valuation = $350
Total valuation of $10,001 - $25,000 = $500
Total valuation $25,001 & up = $500 plus $20 for each $1,000 or fraction thereof over
$25,001.
VALUATION per contract with owner 18000.00
TOTAL FEE 750.00
Conveyance plan review and field inspections will be conducted by NWCCOG Elevator
Inspection program. Schedule acceptance inspections by emailing
NWCCOG at Elevator@NWCCOG.org. An approved Permit does not
Constitute approval on final inspection.