2008-07-10_REVISION - M1978143 ‎(4)‎

• Permit No: M1978143
• IBM Index Class Name: REVISION
• Doc Date: 7/10/2008
• Doc Name: Preliminary adequacy review response
• From: Environment, Inc.
• To: DRMS
• Type & Sequence: AM1
• Email Name: SSS
• Media Type: D
• Archive: No

Grand County BUifding Department
Contractor Verification
PLEASE READ AND FILL IN ALL NUr rSERED SPACES THAT APPLY
'ou are required to list all contractors and subcontractors employed on this project.
there is any change in contractor or subcontractor you must notify this department in writing (Change in Contractor Verification Form) To
.void any delays in the progress of your project you must notify this department immediately if there is any change in the information provided
elow If this department is not notified in a timely manner a STOP WORK order will be placed on the job and the project will be SHUTDOWN
nfil the proper information is turned into this department and verified NOTE. This department CANNOT supply you with the license number
r tha rnnirartnr Ynu must nhtain that infnrrnatinn frnm that nercnn nr nPrsnns.

IODAY'S DATE BUILDING PEPMR NUMBER
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OWNER NAME R`""
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>- LEGAL DESCRIPTION
_ LOT NUMBER
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8LOCX NUMBER,
MEE1S AND 60lJIYDS
SU VISION NAME y
1 1 1?0 W-•
56N ?` TOWN IP RANGE
?- I JOB ADDRESS: i F o 9 t-.r CI fr,-e ?4• erP rp0 (/-r9
5. 1 OFNFRAI _ C'C)f`fTRAC'TOR-
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CIIY? 1 STATEy OLPJr PH, J GRAND COUNTY LICENSE NUMBEP. GCBD VERGICATION
3. FOOTER/FOUNDATION CONTRACTOR T,4 ??_lf{j?ia.-?}a -1 frC

7. 9 o 31 07 qy 0 ,5,0 0z L
CITY STATE ZIP T? PHONE _ GRAIJO COUNTY LICENSE NUMBEP. GCBD VERIFiCIdION
FRAMING CONTRACTOR:

? C o/ o o e'? 2- 7N o _
CITY ' STATE ZIP PHOIJE GRAND COUNTY U(CLNSE NUMBER GCBD VERIFICATION
x. ROOFING CONTRACTOR: /r _--_--
_ ??ye r S
CITY STATE 0103
ZIP " C 88 2 7J,301
PHONE GRAND COUNTY LICENSE NUMBER GC8D VERIFICATION .
?. PLUMBING CONTRACTOR: OW,%c e

CITY STATE ZIP PHONE GRAND COUNTY LICENSE NUMBER GCBD VEP.IFICATiON
D, ELECTRICAL CONTRACTOR: f 'r " e x, ,3.3

CITY STATE ZJP PHONE CRAIJD COUNTY LICENSE NUMBER GCBD VERIFICA110N
_
I. MECHANICAL CONTRACTOR:
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CITY STATE ZIP PHONE GRAI•ID COUNTY LICEN NUMBEP GCBD yERiPUiiON
2 INSULATION CONTRACTOR: 19g.

CITY STATE LIP PHONE GRAND COUNTY UCENSE 14UMBER GCBD VEPIFICATION
3 DRYWALL CONTRACTOR: E% ?c•' C i"
CITY ASE ZIP PHONE GRAND COUNTY LICENSE NUMBER GCBD VERIFICATION

5Y .SIGNING YOU ARE CONFIRMING ALL A80VE INFORMATION IS TRUE AND AGREE TO NOTIFY THIS DEPARTMENT OF ANY CHANGES