HomeMy WebLinkAboutPERMIT 800 Big Thompson Ave Remove & Install Gas Line 2011-06-2206/22/2011 08:07 9705883198 MOUNTAIN VALLEY PLUM PAGE 01/01__
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Ruedved Date
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Town of Estes Park O,G Permit Number M-jL t U
Received By —Application for Miscellaneou.s Perm t Apolication Ipircs
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Department of BuildIng Stfely 170 MacGregor Avenue P.O.Box 1200 Estes Paris,CO SOS 17
General lnrormatlon &Ttmpeetlon Line (970)577-3731 FAX (70)586-0249 t yw.cstesnct.com Permit Expires
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Job AddresciOO 3s vlo9
Owner Name;.____Co_.Phone:Y
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Add ress;1 o42J (ate)(Zip Code)
Contractor!Applieant:[own License #:%53_Phonc:_SjjQR
Address;-SM .-
(Street)1).....iS!ate (Zip Code)
o Long term Residenlial (30 days)0 Short-term ResidentIal (<30 days)0 Commercial
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0 Replace Furnace Line (O ft.)
o Replace Boiler U Replace Windows
o Replace Hot Water Heater 0 Install Air Conditioning
o Minor Plumbing U Temporary Structure Use --
0 Minor Remodel Time Period
O Fireplace insert —circle one Gas,Wood,Pellet;0 Other
DcscripiionofWork:e/.-;nSJ-L Mt”oo4.&c,wo:itts%Eoo
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Valuation (Total Cost of Ivlal:erial &Labor):$SYO —
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I cord fy thht upplicitilon is ti-tic and correct and agree to pci-Ic rn the worlc ticre ritcd accord op to piensispern 9catton.sabre Lied,rc ewcd and tippruved anti cturnpt y wii:It
local ordinoncas,state and reddri laws at well as building codes.1 cei’ril that I have the properly owners authority and permission to apply for this perlnil.Additionajly,I
UNDERS1-AND THAT JAM RESPONSIBLE iOl ANY FEES OR EXPENSES INCuRRED FOR PLAN REViEW,PERMITS,INSPECTIONS ANDOTHfl
FEES ASSOCIATED WITH THIS APPLICATiON Nnta The woi’k authorized by ibis permit requires iht biiidiiig he provided with sniocaIniis umply’n
usitli municipal en cc ____._tt v2 -
Signature -
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._a/Otit.ejL Pt’lniN:iive e.fl OfflccLscOy\Z-
Inspeci.ion Checklisi,:
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S SCon,hu top kit
Commentst
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-—Permit.fee:
-i4,.5”-
Censu,s #Construction Type:roccupancyt
>7 I
County Tax:
tIulIdingOfli I Date
thUS!
&/gz-//l Total ----
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the Counter Puge I of I Revised 7/14.’200f,-(‘B