HomeMy WebLinkAboutPERMIT 870 Moraine Ave water service replaced 2016-09-13Received !Jilt
'Received By
f;R, nrievq,
vi,,01,
Town of Estes Park "I N r
JO cidq emu . Number -
Application for 'Miscellaneous Permit Application Expire
• . .
Department of Building Safety 170 MacGregor Avenue PO. Box I MI Estes Park, CO 80.51.7
General Information & Inspection Eine. (970) 577-37.26 ".` FAX (.9711) 586-0249 * ,...!:::2!!!sj.....„227..!!!4,1, Permit Expires /
)b Address:
Owner Name:
Address:
e - Qv. o gy.0 rg) Rood,s,
V\r‘01(1-c-Le_ Akf e
(street)
contractor/Appficant: 11 Me 6LAcct'
Address:
tp4fE 'KAce
(Sam*
(City'
Phone: 44-2,—Lick3a_
Town License 14:
0_o
(State)
(Zip (ode)
Phone: —Cli%Lfq
e ar-A
(City)
(Slat .) (Zip Code
0 Long-term Residential (>30 day
0 Short -ter
Residentia 0 days)
mmercia
1
O Replace Furnace
O Replace Boiler
0 Replace Hot Water Heater
CI Minor Plumbing
O Minor Remodel
0 Fireplace Insert — circle one: Gas, Wood,
0 Gas Line ft.).
0 Replace Windows.
L=1 Install Air Conditioning
0 Temporary Structure Use
Time Period
Pellet; t131 Other
Description of Work:
Valuation (Total Cost of Material & Labor):
certtFy this application is floc andcorrect and agree to perform thc work described according to plans/specifications submitted, reviewed and approved, and comply with
local. ,ordinances, state and federal laws as well as building codes, I. certifythat 1 have the property owner's authority and permission to apply for this permit Additional I y,
UNDERSTAND THAT I AM RESPONSIBLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW, PERMITS, INSPECTIONS AND OTHER.
FEES ASSOCIATED WITH "IRIS APPLICATION. Note: he work aiithorized by this permit requires the building be provided with smoke alarms. complying
with municipal codes.
Signature
DateiLiJ Print Name ‘Ae4
Inspection Checklist:
0 Address Posted
0 Contractors Licensed
El Permit. Packet Available
0 Safe Access
ensus
"ons
*** Office Use Only ***
El Equipment Access
0 Equipment Listed
0 Equipment Clearances
0 Pan and Drain
uctiun r ,pc:
)cc.
y:
0T8z'P'
0 (]as Pipe
0 Vent
0 Combustion Air
Permit Fee:
o Smoke Detectors.
o Rough Inspection
Final Inspection r'c
County Tax:
e
adding 0fficit
a
Total :
the Counter Page 1 of 1
Revised 3129/2.012 - C13
JOB AI)DR
OWNER:
CON'TR ACTC)I
DESCRIPTION
FAILURE TO ("OMPLY WIT
1NSP CT!ON REC IIRD
NY OE IWI" C Id.FQ1IIREMENTS' ON THE FRONT OF THIS CARD MAY I)EiAY INSPF('HONS
._._......_._ m.-_......_._ __._..�--_-
F
I'DI]NI1A7'I(:)IV
5ST
aMS /
5'E
�.,
SITE REQUIREMENTS
FOOTINGS / PIERS
LIFER GROUND FOOTING
SETBACK CERTIFICATE FOR PLANNING
SETBACKS FIELD INSPEC "PION
FOCINDATION WALL
UFER GROUND FOUNDATION WAIL..
ELEVATION CERTIFICATE FOR PLANNING;
ELEVATION — FIELD INSPECTION
DAMP PROOFING / WATER PROOFING
FOUNDATION DRAIN
RADON SYSTEM PASSIVE ONLY
INTERIOR PADS / FOOTINGS
UNDERGROUND WATER SERVICE q
PLUMBING UNDERSLAB
FOUNDATION WALL. INSULATION -'1 ? tI 11'
HYDRONIC SYSTEM UNDERSLAB
UNDERSLAB INSULATION
SEWER (SANITATION DEPT)
EXTERIOR MEMBRANE SYSTEMS
SHEAR WALLS / HOL.I) DOWNS
AIR INFILTRATION BARRIER
WATER RESISTIVE BARRIER
WINDOW INSTALL/FLASHING
SI"'C7CCO / STONE LATH
MIDROOF
BUILDING ROUGHS
GAS PIPING ROUGH
FLUE VENTING ROUGH
DUCT ROUGH
PLUMBING ROUGH
FIREPLACE ROUGH
HYDRONIC PIPING mmT
ECTRICAL ROUGH
E IRE BLOCKING / FIRE STOP
FRAMING
RAFTER / WALL / FLOOR INSULATION
DRYWALL
SHOWER PAN LINER
TOWN AND NON TOWN ENTITIES APPROVAL FOR OCCUPANCY / USE
ELECTRICAL FINAL.
PLANNING DEPARTMENT
SANITATION DEPARTMENT
WATER DEPARTMENT
PUBLIC WORKS
COUNTY WILDFIRE
LIGHT & POWER
FIRE DEPARTMENT
DIVISION OF BUILDING SAFETY FINAL APPROVAL
PLIJMBINGFINAL I
4r (
HVACFINAL
ROOF FINAL FINAL,
�.,
BUILDING FINAL
EVDC
EP MC
IMPORTANT TELEPHONE NUMBERS
Inspection Requests
970-577-3731
Utility Locate
800-922-1987
Xcel
800-772-7858
Planning Div
970-577-3721
Water Depart
970-586-3608
State Electr:ica➢
970-577-3589
Bui1ding Safety Dav
970-577-3722
Public Works
970-577-3588
Fire Dept
970-577-0900
EP Sanitation
970-586-2866
UT Sanitation
970-586-4544
Count Wildfire
970-498-5303
X:1BuildingDept\Foams\R3 U1_SOGN-OFF GARD.docx.
Received Date:
0 It 4 I( (41
Per -mot Number
/''"-- f.
Received By:. --
Address:
74) 1)/1.49-vit LAA--C---
jr,I1
,i,..,A: ,,, i .•-: i i , mi.,
970.577-3726
PO BOX 1 200 170 McGregor Ave
Estes Park CO 80517
WATER SERVICE LINE INSTALLATION
AFFIDAVIT OF COMPLIANCE
Town of Estes Park 'Division of Butlidong Safely
The following conditions must be met before submitting an Affidavit:
The contractor shall be pre -approved by the Chief Building Official
The work shall be authorized by the appropriate permit
The work shall be associated with an approved system
The affidavit shall be on a form provided by the CBO
Check the statements that apply:
The Division has pre -approved the Water Service Line to be completed without Division inspection,
The installing contractor shall complete and sign this affidavit.
The affidavit shall be left in the permit pack at the jobsite.
The work and conditions described on the permit I approved plan matches the field installation.
Size and type water service line matches the permit or approved plan.
Location is as per site plan (if not, contractor MUST update site plan at Town Hall),
Trench depth is not less than 5' deep; bedding provides a solid and continuous support; piping does not
rest on rock; the backfilll is free from construction material broken concrete, frozen chunks and debris.
Where the water line crosses a sewer line, the water line is sleeved with an approved material a minimum
of 10' in either direction from center line of sewer pipe, P2905.4 Amend (IPC 603.2 Amend, 703.1 Amend)
Tapped by Water Department.
(OPTIONAL) Photos of the ongoing installation have been provided.
With my signature I verify the (discipline) installation was performed in accordance with the manufacturers'
installation specifications, Chapter 29 of the 201 5 URC, Chapter 6 of the 2015 IPC and II release the Town of Estes
Park from all liability*,
Contractor Signature
Date:
Company Name:
CLiii-ri-
(7; I . 4
44,4
r. t.,4(6,
1 .4("C:
Town Business License Number:
51
'A ContractorsAffidavit of Compliance shall not ekempOt work from corrections if the building official determines the work does not comply with the provisions of this code.
Date Requested I
Date Inspected 7.=
JOB ADDRESS
REQUESTED BY
CONTACT INFO.
Permit#
Inspector c—r—
ui ding Division
(;)
TOWN LIC. #
TYPE OF INSPECTIONS
- Cala z#,
•
LL
T
TIL
When corrections have been made, call for re -inspection: 970-577-3731.
General questions: call 970-577-3726.
$100.00 Re -Inspection Fee Assessed Li