HomeMy WebLinkAboutPERMIT 2365 Arapaho Rd Water Heater 2009-12-0312-03-09;09:52AM;
Received Date
;970+586+9249 # 1/ 1
Co) Copo °G Town of Estes Park 443, Permit Number M- 0
Received By Ctli\ Application for Miscellaneous Permit Application Expires - Lo t°
Department of Building Safety 170 MacGregor Avenue P.O. Box 1200 Estes Park, CO 80517
General Information & Inspection Line (970) S77-3731 " FAX (970) 586.0249 4` www.eitehriet.COM
Job Address:. .5 /.0.5 ..,,roi_Dy.,..1,,D AR ,,,a__A 3 4 a./ i _ ac —ar>
Owner Name: .1-Ael r r, i A - .,...- o -ki,„ f ---k- Phone: 303 .-Itol - 1 t, gi
Address: 11 43 7 ( &) , bre, IP 1 L 1,3,--c., Co go a 7
Contractor/Applicant -41-'7re
Address: iik
(Street) (City) (State) (Zip Code)
c-h Town License #: 31 Phone:5-34- P(95
ha • • a . i _e:s-4-e ,„ zP -- Cz St-2 S/7
(Street) ty_)_ (State) (Zi Co: ?mile
': Long-term Residential (> 30 days) Li Short-term Residential (< 30 days) 0 Commercial
0 Replace Furnace
Water Heater
- circle one: Gas, Wood,
( ft.)
Windows
Conditioning
Structure Use
. Gas Line
N Replace Boiler a Replace
Replace Hot
0 Minor Plumbing
1p Minor Remodel
mg Install Air
0 Temporary
Time Period
Pellet; 0 Other N Fireplace Insert
Description of Work:"--t-
-1- v%Sit-a-t k M 6-4 C, c.,p__-cz 5C> ---zt• i. \-ess
1 /4,00.-4-er h ea.4-e...r, i.A.-,1-, P V C.- ---Cl.t.A_... _
Valuadon (Total Cost of Material & Labor): $
67 0 /7/° ..mmie
I certify this application is true and correct and agree to perform the work described according LO planalsrPiricadous submitted, reviewed mid approved, and comply with
local ordinances, state and federal laws as well as is codas. I certify that I have the property owner's authority and permission to apply for ibis permit. Additionally, I
UNDERSTAND THAT I AM RESPONSMLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW, mamas, INSPECTIONS AND OTHER
FEE.S ASSOCIATED WITH THIS APPLICATION. Note: The work authorized by Ibis permit requires the building be provided with smoke alarms complying
with municipal code*
Signaturr(4\ cg-... 1 ,,,,) t ,,;(2.„.„.7 t mac 0.- 344 Print Name _C,.),er,_NIB,Ccae,cL,L.k.1.—____
** Office Use Only ***
Inspection Checklist:
U Address Posted 0 Equipment Access 0 T & P 0 Smoke Detectors
0 Contractors Licensed 0 Equipment Listed 1:1 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: 1 361.7.
Census It q 174 Construction Type: Occupancy:
County Tax:
P-I •
Building 7iTini / Date
416-1A A4/1/...___ 1_- 3-0 Total : I (40 3. 55
**SMOKE ALARMS ARE REQUIRED**
Permit Expires 5-17 -201 1
MiLryop- komulevanildinaTormslApplicationslOver the Counter Pago I of 1
Revised 7/14/2006 - CB