HomeMy WebLinkAboutFORM VH Life Safety Inspection ApplicationUpdated 07/2021
Town of Estes Park
Vacation Home Life Safety Inspection Application
Vacation Home Physical Address:
Owner Name:
Mailing Address:
(Street) (City) (State) (Zip Code)
Email Address: (please write legibly) Phone:
Property Manager/Local Representative:
Email Address: (please write legibly) Phone:
Number of Bedrooms (per Larimer County Assessor Data and Vacation Home License Application)
Identify Sleeping Areas other than Bedrooms (den, office, family room, etc)
Description of Work: 2015 IRC AMENDMENT Section 327 LIFE SAFETY SURVEY
I the homeowner, or Property Manager acting on behalf of the homeowner, certify the information on this application
is true and correct. I understand by signing and submitting this application, I agree to have the above property
inspected by the Building Official to ensure compliance with local ordinances, state and federal laws as well as
building codes. Additionally, I understand that I am responsible for any fees associated with this application.
Signature: Print Name Date:
(Homeowner/Property Manager)
***OFFICE USE ONLY***
Permit Fee: $200.00
County Tax: $0.00
Building Official: Date: Total: $200.00
LSI Checklist
Initials: Date: Issue permit number: VHLS: EXPIRES:
Email handouts/permit number to Owner/PropMgr/Town Clerk
Inspection Scheduled (Calendar/Laserfiche/Town Clerk/CD-VHLS Database)
Inspection follow up to Owner/PropMgr/Town Clerk (via Laserfiche)
Final Inspection Scheduled (Calendar/Laserfiche/Town Clerk/CD-VHLS Database)
Results of Final Inspection entered in Laserfiche
Issue CO to Owner/PropMgr/Town Clerk/Property File
Field Approved for Certificate of Occupancy by: Date:
RETURN TO: townclerk@estes.org, Town Clerkâs Office, P.O. Box 1200, Estes Park, CO 80517