HomeMy WebLinkAboutPERMIT 1250 Acacia Dr All Upper Units 2011-07-29Offic6,
Received Date Ze)//. z z Town of Estes Park eqc"); Permit Number M- Z rg"/
Received By Y. Application for Miscellaneous Permit Application Expires 1-2 fir-zdr Z
Department of Building Safety 170 MacGregor Avenue P.O. Box 1200 Estes Park, CO 80517
General Information & Inspection Line (970) 577-3731 * FAX (970) 586-0249 * w vs.estesnet_com permit Expires'' Z Z -74.7/3
Job Address: /511 /4 50 Ac4ciA ei< 4 -5 4i 7: /C • .s. 4 7/ fe/A-5-6/ 7 i 7 8/43 -‘ 4i I / / / i
Owner Name: Afe*-- ieo 0 e- /4/0.4#(07,0*7 ei\-tr, I Phone: s'ist6- 0A/6
Address: / Z 50 A cAci' ox 6,< 1.5-,,,' ce., soT .i?
(Street) (City) (State) (Zip Code)
Contractor/Applicant: /.17/1/ , `6 # Town License #: 1278 Phone: S'ieC46 gt.
Address: etc OA -4,14 r ,5 ,--, Z-Z", C 0 gsoci7
(Street) (City) (State) (Zip Code) .
ErLong-term Residential (> 30 days) 0 Short-term Residential (<30 days) 0 Commercial
0 Replace Furnace Is Gas Line ( ft.)
0 Replace Boiler 0 Replace Windows
0 Replace Hot Water Heater U Install Air Conditioning
0 Minor Plumbing • Temporary Structure Use
0 Minor Remodel Time Period
0 Fireplace Insert — circle one: Gas, Wood, Pellet; Erother
Description of Work: s-"vp ..,e, I. a° /V 5ir/, 0 of .* 7 tY F7eA 3 (*".-NK /It C ,___.
a,F 'Pt e/t,--+ ; T S . /g 44., at I or o L)
Valuation (Total Cost of Material & Labor): S r-) i i 0 . s•-•"‘ ....
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1 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. I certify that 1 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. Note: The work authorized by this permit requires the building be provided with smoke alarms complying
with municipal codes.
Signature , RI //Print Name ////1.:•cA AALcit/t,
*** Office Use Only ***
Inspection Checklist:
0 Address Posted 0 Equipment Access 0 T & P 0 Smoke Detectors
0 Contractors Licensed 0 Equipment Listed 13 Gas Pipe 13 R Inspection
0 Permit Packet Available fiViL'ilfdt&V 0 Equipment Clearances 0 Vent inal Inspection
El Safe Access 0 Pan and Drain 0 Combustion Air (2,..ir 711f 0 (raj
Comments:
Permit Fee: /S3 •
Census # Construction Type: Occupancy:
County Tax: X 1 r
Date Buildifficial t
_.... Z
ng Official
7.4//.04?",0 / Total : / 13 • e9
zss"-cie 41-47,vatz ,Aipe/icn;w .1'452 /e/7 ---
Servera'xonn dev‘Builciin,/`,Forms'Applications'Over the Counter Page 1 of 1 Revised 7/14/2006 - CB
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