HomeMy WebLinkAboutPERMIT 517 Big Thompson Ave Backflow 2011-05-08coG
ReceivedDate tQt(o5.O Town of Estes Park “Y PcrnñtNurnbcrM_________
ReceivedB3’Application for Miscellaneous Permit Apjlicatioii Expires iO-I
Deparinicut of Building Salèty 170 MacCregor Aveisuc P.O.Box 1200 Eslus Park,CO 80517
Ceneral Inlorniation &Inspection Line (970)577-3731 ‘1’FAX (970)586-0249 *www.estesnet.com Permit Expires —
Job Address:72 g 2$ii1
Owner Name:EoQ(’iY1tiM-4J ocôI,-rt
Address:577 37
(Street)(City)(State)(Zip Code)
ERTL MECHANICALContractor/Applicant:1773 wildfire iw Town License #://Phone:/2’
Estes Park,CO 80517Address:
(Street)(City)(State)(Zip Code)
El Long-term Residential (30 days)El Short-term Residential (<30 days)commercial
D Replace Furnace D Gas Line (ft.)
D Replace Boiler D Replace Windows
D Replace Hot Water Heater El Install Air Conditioning
El Minor Plumbing El Temporary Structure Use_______________
El Minor Remodel Time Period
_________________________
El Fireplace Insert —circle one:Gas,Wood,Pellet;El Other
Description of 2 p&v1 Crn7 -p-
O N C-jt7 M%Z7 t497
‘vhluation (Total Cost of Material &Labor):$r
I certify this application is tme and conect and agree to perform the worlc 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 ANI)OTHER
FEES ASSOCIATED WITH THIS APPLICATION.Note:The work authorized by this permit requires the building be provided with smoke alarms complying
with municipal s.
signature Date//Print Name
_________________________________________
(.***Office Use Only ***
Inspection Checklist:
El Address Posted El Equipment Access El T &P El Smoke Detectors
El Contractors Licensed El Equipment Listed El Gas Pipe El Rough Inspection
El Permit Packet Available El Equipment Clearances El Vent El Final Inspection
El Safe Access El Pan and Drain El Combustion Air
Comments:
Permit Fee:i ‘L
Census #Construction Type:Occupancy:(/37 County Tax:1-
Building 0 icial Datef (
Total:
**Mfl K F RMS-kRFi1tIQ1TRED **
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