HomeMy WebLinkAboutPERMIT 500 Big Thompson Restroom Remodel 2013-03-13Office
Received Date .Town of Estes Park Copy PermitNumberM-72/-/3
Received By .Application for IVliscellaneous Permit Application Expires i/’/2C ‘
Department of Building Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,CO 80517
General Information &Inspection Line (970)577-3726 *FAX (970)586-0249 *www.estes.org Permit Expires
_____________
Job Address:SOO lTaJ qE sis Pi?a Cc)
Owner Name:V’FIR i..i-ii Phone:-.5?-‘7
Add ress://z Cf 2 7
(Street)(City)(State)(Zip Code)
Contractor/Applicant:\/&i6 tcl-k Town License #:3(.Z Phone:97O-zz7-Q
Address:(1st LiL6 O C)
(Street)(City)(State)(Zip Code)
LI Long-term Residential (30 days)LI Short-term Residential (<30 days)9Commercial
O Replace Furnace LI Gas Line (ft.)
LI Replace Boiler LI Replace Windows
LI Replace Hot Water Heater LI Install Air Conditioning
LI Minor Plumbing LI Temporary Structure Use________________
LI Minor Remodel Time Period
__________________________
LI Fireplace Insert —circle one:Gas,Wood,Pellet;LI Other
Description of Work:
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Valuation (Total Cost of Material &Labor):$Oo
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 tius permit.Additionally,I
UNDERSTAND i’lIAT I AM RESPONSIBLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW,PERMITS,INSPECTiONS AN1)OTI-IER
FEES ASSOCIATED WITH THIS APPLICATION.Note:The work authorized by this permit requires the building be provided with smoke alarms complying
with municipal codes.
Signature IdtSlt “)-DateEi3Print Name _JJ&i*lfliJ /4JL6
***Office Use Only ***
Inspection Checklist:
LI Address Posted LI Equipment Access LI T &P LI Smoke Detectors
LI Contractors Licensed LI Equipment Listed LI Gas Pipe LI Rout -Inspection
LI Permit Packet Available LI Equipment Clearances LI Vent nal inspection jC11
LI Safe Access LI Pan and Drain LI Combustion Air 3J)-
Comments:Permit Fee:/1/.25
Census Construction Type:Occupancy:
County Tax:
Builyffli Date
Total:-
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**SMOKE ALARMS ARE REQUIREI)**
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