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Grand County BUi(ding Department <br />Contractor Verification <br />PLEASE READ AND FILL IN ALL NUI?MERED SPACES THAT APPL Y <br />'ou are required to list all contractors and subcontractors employed on this project <br />there is any change in contractor or subcontractor you must notify this department in writing (Change in Contractor Verification Form) To <br />-aoid any delays in the progress of your project you must notify this department immediately if there is any change in the information provided <br />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 SHUT DOWN <br />nfil the proper information is tamed into this department and verified NOTE: This department CANNOT supply you with the license number <br />f the contractor. You must obtain that infomiafion from that person or persons <br /> t: -.?.??.. .. c.._:..,' tit:.. ::.;..... <br /> T Y'S DATE BUILDING PERMIT NUMBEP. - :: OFFfBE. E73NL?? :- :::' : ''"": _•?. ' --i, <br />?• - f, nk no <br /> OWNER NAME MARM ADDRESS <br /> lv SOV 1?9 2.20 <br /> <br />-41 _ CITY <br />STATE <br />ZIP - <br />PHONE <br />5. LEGAL DESCRIPTION <br /> LOT NUMBER 8L0 X NUMBER SIGN NAME <br /> OR MEETS AND BOUNDS i 1 <br />- Po W- <br /> 1 SECTION I _T TOVM IP RANGE <br />. JOB ADDRESS: o <br /> <br /> a. it <br />- -i. L. - - - <br />5. GENERAL CONTRACTOR: 8 ? <br /> I _ 0,6 g <br /> f7 C vii P" 0 S-r <br /> CI ATE Z1P PHONE GRAND COUNTY UCENSE LMIMBEP. <br />GCBD VERIPIWION <br />I j <br />FOOTER/FOUNDATION CONTRACTOR T a <br />y / <br />• <br /> ,,, <br />! <br />% <br /> ,03'2 /e.•r I,- 0 'foLi 1970S73-1-0-7-90 C O o 0 <br /> CITY STATE ZIP PHONE GRAND COUNTY UCENSE NUM?P GCBD VERIFICATION <br />7. FRAMING CONTRACTOR: ! <br /> a ,, ,, <br />r <br /> C o/ o o ? e82-78 d <br /> CITY STATE ZIP PHONE GRAND COUNTY UCENSE NUMBER GC8D VEMFICATIONi <br />?. ROOFING CONTRACTOR: <br /> <br /> r o / a3 ' 0 88 z 7830 ___ <br /> CITY SIATE ap PHONE GRAND COUNTY LICENSE NUMBER GC8D VEPIFICATION <br />?. PLUMBING CONTRACTOR: o u/ nc e <br /> u wt <br /> CITY STATE ZIP PHONE WAND COUNTY LICENSE NUMBER GCBD VERIFICATION <br />3 ELECTRICAL CONTRACTOR lk <br />54 <br />. : -1 e- ., <br />j <br />,,10 F <br /> eq f 4,61yoll - 2,33 gad <br /> CITY STATE Zip PHONE GRAND COUNTY UCENSE NUMBER GLT3D VER :1CATION <br />I. MECHANICAL CONTRACTOR: <br /> CITY STATE ZIP PHONE GRAND COUN UCE NUMBER GCBD VERIFICATION <br />Z INSULATION CONTRACTOR: 19,q. <br />?, hl C <br /> ?- c t 4t'J c <br /> MY I STATE Zip PHONE GRAND COUNTY LICENSE NUMBER GCBD VERIFICATION <br />3 DRYWALL CONTRACTOR: 14 C <br /> <br /> CITY ATE ZIP PHONE GRAND COUNTY UCENSE NUMBER I Or-80 VERIFICATION <br />u?¢o ro e5nuronen eeean ?.ra.,.m? .,..? <br />BY SIGNING YOU ARE CONFIRMING ALL ABOVE INFORMATION IS TRUE AND AGREE TO N077FY THIS DEPARTMENT OF ANY CHANGES