HomeMy WebLinkAboutVARIANCE WAIVER REQUEST FORM - COMPLETEC O L O R A D O Division of Professions and Occupations
�/ Department of State Electrical Board
® Regulatory Agencies
Division of Professions and OccWattons
VARIANCE REQUEST FORM
(Deadline for submission is 20 days prior to the Board meeting)
Date: qL tr
Check one ❑ Homeowner ❑ Contractor Registration / Master #
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REQUESTING PARTY INFORMATION (Relationship to Property owner) Annr-,L�4e-og�
Name
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PROPERTY INFORMATION
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Permit # m> rAtz-o -03-z�-4
Property Owner,4
Property Name
Property Address
Mailing Address i q
City
attach copy) Permit Date GzlCIZ2:�,G
if school, school name)
*Email Address (preferred method of
Code Section(s) to be considered
Description of variance requested (summary required) `iUP:�LLY-g 14 enkoZ tJA.
Reason for request (summary required)
Please provide a sketch and dimensions for review, when applicable.
§ 12-115-107 C.R.S., gives authority to the State Electrical Board to: "review and approve or disapprove requests for
exceptions to the national electrical code in unique construction situations where a strict interpretation of the code
would result in unreasonable operational conditions or unreasonable economic burdens, as long as public safety is not
compromised."
The Content of this application must not be changed. If the content is changed, the applicant may be referred to the
Colorado State Attorney General's Office for violation of Colorado Law.