HomeMy WebLinkAboutFile Documents.1130 Black Birch Dr.0073-2021-BCHO (3) ADDRESS: 1 130 Black Birch PERMIT NUMBER:
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT CONTACT SHEET ''ITYOFASPEN
FOR PLAN REVIEW QUESTIONS
Name Andrew Dillon Phone —• • • E-mail • • • •g • g • • •
FOR INSPECTION QUESTIONS
Jim - 1— ' —• •, � • I I. •
NameGohery Phone E-mail
OWNER
Name • • Phone Cell Phone • •
Addres 1401 Ballinger St City Ft. Worth State TX ZIP 76107
E-mail Address John@depermian.com
OWNER'S AUTHORIZED AGENT
Ryan Walterscheid - — —- - •
NamePhone Cell Phone
Mailing 210 E Hyman #202 City State ZIP81611
Address
E-mail Address rwalterscheid@forumphi.com
APPLICATION BEST CONTACT
Name Andrew Dillon Phone Cell Phone —• • •
Mailing 210 Hyman #202 City State State CO ZIP 81611
Address
E-mail Address adillon@forumphi.com
ARCHITECT OR DESIGNER OF RECORD
Forum Phi: Ryan Walterscheid - — - •
Name Y Phone Cell Phone
Mailing 210 E Hyman #202 City Aspen State CO ZIP 81611
Address
E-mail Address rwalterscheid@forumphi.com
CIVIL ENGINEER OF RECORD
Name Phone Cell Phone
Mailing
Address City State ZIP
E-mail
Address
STRUCTUAL ENGINEER OF RECORD
Name Phone Cell Phone
Mailing
Address City State ZIP
E-mail
Address
GENERAL CONTRACTOR
Koru: Jim Gohery —• •
Name Phone Cell Phone 1— A
Mailing 2551 Dolores Way
Address City Carbondale State CO ZIP 81623
E-mail Address jim@korultd.com
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 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. It is my responsibility to review the
approved plans and any comments that are contained thereon and see that the structure and/or project is built in compliance with all applicable codes.
Additionally,I understand that I am responsible for ensuring that all sub-permits associated with my project are submitted to the City in compliance
with the approved Master plan set.I understand that the City does not review sub-permits for compliance with the master plan set
Contractor 2021-10-19
Signature Date r ��
❑ Check if yo are a tested ow er builder(single-family homes only).You must take a test and complete the owner'jkiul"Idi'ng affioravTt.L
(CITY USE ONLY) Owner builder approved by: Date: Affidavit on�file $ 0
( CITY OF ASPEN October2020 130 S. GALENA ST I ASPEN, CO 81611j
BUILDING DEPARTMENT