HomeMy WebLinkAboutPERMIT Gas Fireplace M-0164 3501 Fall River Rd 2011-01-17JflN—17—flh1(tlUN)15:59
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hteceh’ed Date J .01.‘1 Town of Estes Park Permit Number I
9’-’Application for Miscellaneous Permit
Department urBuilding Safety 170 Ri[iictregor Avenue P.O.Rnk 1200 Ltus Purk,CO 80517 10 ItGenerallnfortnutlon&Inspection Line (970)577-3731 e FAX (970)5s60249r ivwn.rcresnet.vop Permit Expires 7r_li
JobAddre (-l%t’t 3gup000ooL -
Owner ...Phone:_P -
Address:gQj .\\Rt .r •j....(Street)(City)(Slate)(Zip CoLic)
Contractor/Applicant:1ELE Town License #:(“6_Phone:
Address:I’1CI cwi;cr’r COLI.INJS
-.(Street ICityj (Sttuc)(Zip Cede)
-.C Lung-term Residential (30 days)Short-tenn Residential (<30 days)C Cc,mmercial
C Replace Furnace ID Gas Line (It.)
ID Replace Boiler C Replace Windows
EDReplace Hot Water Heater C Install Air Conditioning
EDMinor Plumbing C Temporary Structure Use_______________
C Minor Remodel Time Period
___________________________
‘irepiace Insert —circle on Gas,Wood,Pellet;Other
Description of Work:Zs4&\\c-eo4 ‘.(0ToscCi to.-t-%*octe_.
Valuation (Total Cost cifMateriul &Labor):$$
I certify Utla uppiicalinñ is true and auritel and agree to perform (be work dcHbed nccmdlng to plnnthpecliicatlunn submitted1 reviewed ned approved.tutU comply with
Lacil ordinanam,state and federal laws an well an building coder,I certify that I hac the property owner’:authority and permission to apply (or this permit.Adctltlonnhly,IIjNpimStiNnThAT1AMl*spoNsmu FOR flV FI*S OR EXrtr’isuS UCUiL1dtb P0k PlAN RSVrnW,r1RvIrrs,INSPECrIONS &rt OThERSEESASSOCIA’J’El)WITH TEnS APPLICA’L’ION.Nolet The work uuthirIzcd by thin permit rtqntrn (he building hç provided with smoke alarms complyingvithtaoIatcodes.
iiitc Print Nanic -.
**4:Office Use Only ***—.
I
Inspection Checklist
C Mdresn Posted C Equipment Access CT &P C Smoke Detectors
C Contractors Licensed IDEquipment Listed C Ons Pipe C Rough Inspection
C Permit Pucket M’ailnbie ID Equipment Cbarances C Vent C inni Inspection
C Safe Access C Pun mid Drain C Combustion Air
Comments:
Permit Fee:
ecupancy:
Date
County Taxt 9 .73
Total:lie-fl
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SETBACKS
FOOTING UFFER GROU
FOUNDATION DRAIN PIPE /RADON
DAM?PROOFING/WATER PROOFING (FOUNDATION BASEMENT WALLS)
PLUMBING UNDERGROUNLLIINSIDE BUILDING)
SEWER SERVICE &UNDERGROUND OUTU)E OF BUILDING LSAN DIST)
WATER SERVICE
ROUGH MECHANICAL
ROUGH PLUMBING
ROUGH GAS
FIREPLACE
ROUGH ELECTRIC (STATE INSP.)
ROUGH BUILDNG
EXTERIOR WALLS (VENEER)&OPENINGS
FIRE BLOCKING /FIRE STOP
ROOF MU)Fll’TAL
ROUGH INSULATION
DRYWALL
fRINKLER (STATE CERT INSF
DOUN’Y1 WLDF!RE
___
FINAL ELECTRIC (STATE -
___________
FINAL JOB COMPLETED ?t’/
____—
ALL scious )3i R(iST CLkANG fl-/3.B THE ECEL4WTG)AY.INSPECTIONS CAN ONLY HE REQUESTER)BY THE CONTRACTOR FERFOR1TG THE WOR
TO BE INSPECTED.ALL IHSPECTON REQUESTS MUST INCLUDE THE CONTRACTOR’S NAME AN “\TOWN LICENSE NUMBER.,JOB ADDRESS,TYPE OF INSPECTION(S),AND PERMIT iarMBER
FAILURE TO COMPLY WITH ANY OF THESE REQUIREMENTS MAY DELAY INSPECTIONS..\JJ
Revised 11/03/2005 -SA