HomeMy WebLinkAboutPERMIT D-14-19 3110 S St Vrain Ave, kitchen demo 2019-11-14Received Date
Received By
Town of Estes Park
Demo Application / Permit
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 * www.estesnet.com Permit Expires
Permit Number D-
Application Expires
�t9
Job Address 31. I a . aw 4 5' ,
Owner Name: SA.mbIZA
Address:
Parcel #:
► , w Phone:
Contractor:
Address:
(Street)
o S S-r.
% .. (Street)
❑ Long-term Residential t? 30 days)
(City) (State) (Zip Code)
1?/9s
(City) (State) (Zip Code _a,
0 Short-term Residential (< 30 days) Q Commercial
Town License #: 9 Phone: - ?4;1 ... I
Note: A Demo Permit does not authorize any work in or on public right-of-ways, wetlands, floodplains, or other
properties - separate additional permits are required.
Note Separate permits required for each address, each lot, or each owner.
Description of WgorNk — w
11/4 iTC..1A-C—PJ (Jep".-C7 k_cr S
CoiGftAt..r- — t.�l C.S
Valuation (Total Cost of Material & Labor): $ )G Ca
Inspection Checklist / Signoffs
0 Owner's Permission The following applies only to Demo of entire building:
0 Address Posted 0 Sanitation District — abandon / vacate sewer
❑ Contractors Licensed 0 Health Department — abandon / vacate septic
❑ Permit Packet Available 0 Water Department — abandon / vacate water
❑ Food / Drink — notify Health Department 0 Light & Power — abandon / vacate electric
❑ All Debris Removed 0 Xcel — abandon / vacate gas
❑ All Drainage
0 Limits of Disturbance
❑ Buildin . Department — Final Inspection
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. 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
ASSOCIATED WITH THIS APPLICATION.
Contractor ID Owner
Staff Comments:
Building Official
0 Owner's Agent
Print Name
*** Office Use only ***
Date
0 Tenant
Application Information
permit Fee:
$50/building
Total :
"%"",Scrverticolint aik y.,lltrittlinefnrms AI+hlicritions"sOw ` the Counter Page 1 of 1 Revised 5/10/2006 - SA