HomeMy WebLinkAboutPERMIT 461 Big Horn Dr, water line 2017-10-30 (now 370 Big Boulder)Received Date
Town of Estes Park Permit Number M-
Received By Application for Miscellaneous Permit Application Expires I-
Department of Building Safety 170 MacGregor Avenue P.O. Box 1200 Estes Park, CO 80517
Information (970) 577-3726 * Inspection Line (970) 577-3731 * FAX (970) 586-0249 * wryerw.estes,9ra
Permit Expires
Job Address: Wl / t i &Ir Oaio t I?,
Owner Name: NO 2 .wet t,,c, Phone: ''" RP —°
Address: 161 16QQcrtio I-1 £s i-ES p waezh° /40, 0 0 S i 7
(Street) (City) (State) (Zip Code)
Contractor/Applicant: EA o.,i fa.Town License #: O Phone: 5 c46 ,-2. i SS 6
•
Address: /t (,,, 0 6c2V64( Z312, e51-63 . 4rtI. C0 . P05/ 7
(Street) (City) (State) (Zip Code)
&Long-term Residential (>_ 30 days) 0 Short-term Residential (< 30 days) 0 Commercial
• Replace Furnace • Gas Line ( ft.)
• Replace Boiler • Replace Windows
• Replace Hot Water Heater • Install Air Conditioning
• Minor Plumbing • Temporary Structure Use
❑ Minor Remodel Time Period
❑ Fireplace Insert — circle one: Gas, Wood, Pellet; • Other
Description of Work: "Y—Lv LA . I A-rCO- I , N
Valuation (Total Cost of Material & Labor): $ ), c '
I certify this application is true and correct and agree to perform the work described according to plans/specifications submitted, reviewed and approved, and comply with
local ordinances, state and federal laws as well as building codes. 1 certify that I have the property owner's authority and permission to apply for this permit. Additionally, I
UNDERSTAND THAT 1 AM RESPONSIBLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW, PERMITS, INSPECTIONS AND OTHER
FEES ASSOCIATED WITH THIS APPLICATION. Note: The work authorized by this permit requires the building be provided with smoke alarms complying
with municipal codes.
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Signattut°cC-�;�°~" ^ Date l0 ' a 1 7 Print Name 0. .`,s[.`ss Mrs wawa r Gt
*** Office Use Only ***
Inspection Checklist:
❑ Address Posted 0 Equipment Access ❑ T & P 0 Smoke Detectors
❑ Contractors Licensed 0 Equipment Listed 0 Gas Pipe 0 Rough Inspection
❑ Permit Packet Available 0 Equipment Clearances 0 Vent 0 Final Inspection
❑ Safe Access 0 Pan and Drain ❑ Combustion Air
Comments:
Permit Fee:
Census #
Construction Type:
Occupancy:
County Tax:
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-Building O cjal
Date
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U:1Building Division\Forms-LogslApps,Permits_IRC_MisccMiscellaneous\Miscellaneous 2012.03.29.doc