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HomeMy WebLinkAboutPERMIT 1250 Acacia Dr Unit D6 Water Heater 2011-06-01;970+586+8349 # 1/ 1 Offic Co ° Town of Estes Park Py Permit Number M - 06-01-11;09:19AM; Received Date eo 1 L-0 • 0 / Received By .// Application for Miscellaneous Permit Application Expires ....1. Department of Building Safety 170 MacGregor Avenue P.O. Box 1200 Estes Park, CO 80517 Zv t General Information & Inspection Line (970) 577-3731 * FAX (970) 586-0249 * www.r_sWsa4t...coni, Permit Expires moor Job Address: (A510 4C-6-e-- i as T,‘ ,./--1,4, c2 5.3 14 JS---ao I Owner Name: Z-Y 41-, c 1,4-6Y-Ne-r•i—S" Phone: 58 4c.- N-- I ( Address:, 1P...5-0 Co fy,, RJR •I 4-7 r ;:'_y e-- 6 4-e-S_ P.c-r, v C_s AS 17 Contractor/Applicant:ro Address:11D a MG (Street) (City) (Stale) (Zip Code) Town License #x3~7 q Phone: 6-8 to-g 1 5.5 ,c_k '4 (4' . rk /-_,JA re-...(54-. 1X-t'\ 7 -1- (4--- .<,, -k--e,.i. tvr---t ,--- 6.0 gtt_517 • (Street) I (City) (State) (Zip Code) IQ Long-term Residential (Z 30 days) 0 Short-term Residential (< 30 days) 0 Commercial Water Heater -. circle one: Gas, Wood, - 0 Gas Line 0 Replace 0 Install Air ( ft.) Windows Conditioning Structure Use • Replace Furnace 0 Replace Boiler a Replace Hot • Minor Plumbing CI Minor Remodel 0 Fireplace Insert im Temporary Time Period Pellet; 0 Other Description of Work-Qs , g i ck_c—e-- %.,-S aA--- ( V\ •e-9---*e-,r 1 r‘ ‘t" Z A- Valuation (Total Cost of Material & Labor): $eiP / /I '''. I certify this application is true and correct and agree to perform the work described according to Minis/specifications submitted, reviewed and approved, and comply with local ordinances, stato and federal laws as well as building codes. I certify that I have the property owner's authority and permission to apply for this permit, Additionally, I UNDERSTAND THAT I AM RESPONSIBLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW, PERMITS, INSPECTIONS AND OTHER FEES ASSOCIATED WITH THIS APPLICATION. Notes The work authorized by this permit requires the building he provided with smoke alarms complying with multi 'r1 codes. Signature Date 6-$ t-I( Print Name aeca 4._( I_ se *** Office Use Only *** Inspection Checklist: O Address Posted 0 Equipment Access 0 T & P 0 Smoke Detectors 0 Contractors Licensed 0 Equipment Listed 0 Gas Pipe 0 Rough Inspection 0 Permit Packet Available 0 Equipment Clearances 0 Vent 0 Final Inspection 0 Safe Access 0 Pan and Drain 0 Combustion Air Comments: Permit Fee; v . ,3 Census # ti 3 -7 Construction Type: Occupancy: County Tax: , , , t. - Lk ..., Building 09Tiat Date 7 41A Yi /4,-- - — 6'; 0 / - ( I A Total: -2_ .., , 15__MOKE ALARMS ARE RE I MED** Mervenkomm dev\BuildingWorms\Annliclions1Over the Counter Page 1 of 1 Revised 7/14/2006 CB