HomeMy WebLinkAboutPERMIT AC M-214 3501 Fall River Road 2019KtUMVJiL)
SEP 26 2019
:Received Date
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Town of Estcs Park Permit Number M-2 /-1°?
Received By Appication for Miscellaneous Permit Application Expires
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ucpacnidhrrBflfMlng Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,CO 80517
General Information &Inspection Line (970)577-3726 *FAX (970)586-0249 *win.estes.orc Permit Expires ./24/LO
Job Address:3501 Fall River Rd.
Owner anie:Della Terra Phone:970-5664842
Address:3501 Fall River Rd.
(Street)(City)(State)(Zip Code)
Contractor/Applicant:Fort Collins Heating and Air To’n License #:5 fl2—Phone:910-484-4552
Address:208 Commerce Dr.#4 Fort Collins CO 80524
(Street)(City)(State)(Zip Code)0 Long-term Residential (30 days)0 Short-term Residential cc 30 days)Commercial
0 Replace Furnace 0 Gas Line (ft.)0 Replace Boiler 0 Replace Windows0ReplaceHotWaterHeater0InstallAirConditioning0MinorPlumbing0TemporaryStructureUsc_______________0 Minor Remodel Time Period
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0 Fireplace Insert —circle one:Gas,Vood,Pellet;0 Other
Description of Work:Replace Fitjitsu Split System
\‘aluation (Total Cost of Material &LaborL:S
10,907.03
I certify this application is true and correct and agree to perrorns the work described according to plans/specifications submitted,reviewed and approved,and comply withlocalordinances,slate and federal laws as well as building codes.t certify that I have Ilse property owners authority and pennission to apply for tisis permttim.Additionally.IUNDERSTANDTHATIAMRESPONSIBIEFORANYFEESOREXPENSESINCURREDFORPIANREVIEW,PERMITS,INSPECTIONS AND OILIERFEESASSOCIATEDWItHTHISAPPLICATION.Note:The work authorized by this pernsit requires the building be provided wiih snmolce alarms complingwithIn0nicipalcodes.
Signature Anianda Elder Date 7(13/19 Print Name Amanda Elder
***Office Use Only ***
Inspection Checklist:
U Address Posicd U Equipment Access U T &P U Smoke Detectors
U Contractors Licensed U Equipment Listed U Gas Pipe U Rough Inspection
U Permit Packet Available U Equipment Clearatices U Vent U Final Inspection
U Safe Access U Pats and Drain U Combustion Air
Comments:
.4PermitFee:f 95 25
Census #Construction Type:Occupancy:
I
CounflTax:‘t3 3
Building 0 cml /Date •%////f Total:
**SMOKE ALARMS ARE REOUIRED**
I CR?67019
devauflthn&Tornss’ApplicationsOver the Counter Page 1 of I :—4 ;\Revised 129/2012-CB
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