HomeMy WebLinkAboutPERMIT 1041 Acacia Dr Windows 2011-08-02Received Date Wil.05. 02.— Town of Estes Park gfI py Ce Permit Number Ai- 62-59 - f 1 Li
Received By CAt`" Application for Miscellaneous Permit Application Expires
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 * a a a .estesnet.coni Permit Expires Imo-
Job Address: ) 0 '1 / /1 C kg C , ----9 g"-- 2.:5 - 51 -2J 1 \ 00 t-
Owner Name: c„,52 / /,/ 7314 L-7,1 // Phone: ,7G9 - C-$4- - Z- /6 $
Address: 5 ,z, AL- c - 0577
Contractor/Applicant:
Address: 1 23 2c--) /I
(Street) (City) (State) (Zip Code)
5/7/y,a. /1 /0,,, if ,',,,,, ,,,,,,,,-,1 /..1/7 ,,,z- Town License #: to?'? Phone: 30) -;'S - yz.. 50
2./C7-ZZ ,; t./2._ 5 027 . 3 ,:, /,/z 4A)/Z,,2 e0 /. 9 -, D 2 3 ?
(Street) (City) (State) (Zip Code)
t(Long-term Residential 30 days) 0 Short-term Residential (< 30 days) 0 Commercial
Water Heater
- circle one: Gas, Wood,
( ft.)
Windows
Conditioning
Structure Use
• Replace Furnace • Gas Line
El Replace • Replace Boiler
• Replace Hot I Install Air
0 Minor Plumbing
0 Minor Remodel
0 Fireplace Insert
0 Temporary
Time Period
Pellet; 0 Other
Description of Work: ,,/ A , /0 ., )A) 6/r. cz),.0
, 5. IAA t i-1_ A r-76, C-rD 0---- LA v.-(t. (.0 YL t:_w_.-ft__
Valuation (Total Cost of Material & Labor): $ .— e
5 , ',6 {)
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
FEES ASSOCIATED WITH THIS APPLICATION. Note: The work authorized by this permit requires the building be provided with smoke alarms complying
with municipa od
,------/
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Signature Date 5- -2-- // Print Name /70 / /' / CIZ / ‘..7 v---1 17-7
*** Office Use Only ***
Inspection Checklist:
0 Address Posted 0 Equipment Access 0 T & P 0 Smoke Detectors
0 Contractors Licensed 0 Equipment Listed 0 Gas Pipe 0 Rough Inspection
0 Permit Packet Available 0 Equipment Clearances 0 Vent 0 Final Inspection
0 Safe Access 0 Pan and Drain 0 Combustion Air
Comments: Permit Fee: 1 2-S 2---
Census # Construction Type: Occupancy: County Tax: Z-0
Building Opcial Date
, A_ h(/‘ ,t\--.
Total :
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**SMOKE ALARMS ARE REQUIRED**
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Revised 6/13/2006 - CB