HomeMy WebLinkAboutPERMIT M-168-04 Water Heater 550 Marigold 2004Received Date / Z """1. 0 -""Ci Town of Estes Park
Permit Number A/7'16' g`10
Received By Application for Miscellaneous Permit 6) /aF/
Department of Building Safety 170 MacGregor Avenue P.O. Box 1200 Estes Park, CO 80517
General Information (970) 577-3731* Inspection Line (970) 577-3731 * FAX (970) 586-0249
7/1 y
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Job Address: •,,.., --) c.) # iiie A//) er /ea//9t/
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Owner Name: DON Ria -,.,OR,DIIN Phone:
Address: 550 \ Alp WoimerviLt4
(Street) (City) (State) (Zip Code)
).. ,
Contractor/Applicant: CXtd iirCha q aillefeerayy. (02-p, Town License #: 4>45--b Phone: /6),2
0
,
Address: 14)0 , / //0( LWe tr (z/7///(5- co ?e.9 57 7
(Street) (City) (State) (Zip Code)
CS( Residential • Non -Residential
o Air Conditioning Installation
0 Gas Line ( ft.) 0 Reroof
0 Gas Log Installation Roof
0New Furnace Installation #
0" New Water Heater Installation 0 Reroof
(Commercial
Classification
of Squares
— Pitched Only)
A B C N
(Residential)
of Squares
• Temporary Structure Use #
Time Period 0 Siding
Damage
0 Demo Structure • Windows
0 Fire/Water
o Drywall
• Other
Description of Work:
1' A)5 rau— olu Detnom -irliv .--,c 5 W A 'rer hieby re/ ;
Valuation (Total Cost of Material & Labor): $
00
I certify this application is true and correct and agree to perforrn 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, 1
UNDERSTAND Tij4T 1 AM RESPONSIBLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW, PERMITS, INSPECTIONS AND OTHER
FEES ASSOC1AT WITH, 9S APPLICATION.
U,-W) AY /
Signature (G, / /jg /067t/f Date ")?,20-1*Print Name / )/\, I,v1\_
\ 1/ *** Office Use Only ***
Staff Comments:
Permit Information
Fee
Permit Fee:
Census #
County Tax:
ill 0
Building Official Date
'
72 — 7- (.7
Total :
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Revised 3/12/04