HomeMy WebLinkAboutPERMIT Wood Stove M-0163 3501 Fall River Rd 2011-01-17JAN-li—EU]](NON)15:59 3cc.P.001/002
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IRectived Date .Town of Estes Park Permil Number M-.QjJ ‘5zUoApplicationforMiscellaneousPermitApplicationExpires12iL
Department or Building SaFely 171)MacGregor Mtnur P.O.linK 1201)ltsliss Part CO 80517 2-0 ‘tGeneralInformation&Inspection Line 1970)577.373!‘a FAX (970)586.0249°wtnr.ettcIwI,çp7p Permit Expires ..7 iL_
job Address.Ql coILB.Qr Rd Fa.Qfl5 RtUCiLCødyt 0003Q L
Owner Name:.ftQLSZ Phone:5 -LI .
Address;i Rd ...(Street)(City)(State)(Zip Code)
Contractor/Applicant:\,jçri ..3 SI)PPLI Town License #:L ‘16 Phono:_.’i
Address:JjCe)RrC-tStD9 ..-r CoLJ5 ct.’
(Suect)(City)(State)(Zip Code)
C Long-temi Residential (?30 clays)$Shod.ftnn R&denthl (<30 days)C Commercial
C Replace Furnace C Gas Line C ft.)
C Replace Boiler C Replace WindowsCReplaceHotWaterHeaterCInstallAirConditioning
C Minor Plumbing C Temporary Structure lJse_..
.Q Minor Remodel Time Period
___________________________
‘ftFireplace Insert —circle oat:Gas,C ,Pdllet C Other
Description of Work;J-aaa\Tn,.iits ?ubrc(9okaa.ri Lxi CCCI sOut
Vniuauon (Total Cost orMatertu]&Labor)$-
xcrury his appliention lit tnicaitd eurteat intl agree to ptr(urtn the work deacrlbd accordIng to p;ansuitpeetlleatlous rtubrnjltect,reviewed and appt’vvtd,and comply withtotalurdinances,traic and (etleral lawn an welt as bqit$Lngcodes,I ectilfy [hut I have the pmperty ownar’s authority an4 penninnien to apply (or thia permit.Additionally,IIJNDItRSTAJ4DThATLAMKESPONSUILEP0KAFYFEESOREXPENSESJfTJRR1jDFORPlANREVIEW,PERMrn,INSPItCflQNS AND OTHERFEltSASSOCIATEE)WITH TIllS APP!JCATION,Nult:The ‘work authorized by dun permIt requires (lie building he provided with smoke i*lnrmn complyingvILlimanIcodes.
signuniEd -Date LI42_?M.Print Nam&€flf?S@i X
***Office Use Only **
Inspection Checiclisu
C Address Posted C T &P C Smoka DetectorsCContractorsLicensedCGasPipeCRoughInspectionCPermitPualcetAvailableCVentCFinalinspectionCSafeAccessCCombustionAir
PertnlL Fee:t :3.‘L’
County Tax:
10 I 2)
Total:
C Equipment Access
C Equipment Listed
C Equipment Clearances
C Pan and Drain
ALARM S ARE REQ U1RED