HomeMy WebLinkAboutPERMIT 1650 Big Thompson Ave Backflow 2013-08-02nspe0f
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Town of Estes Park COP’Permit Number M-I.-
Received By 1 Application for Miscellaneous Permit Application Expires
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Department of Building Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,CO 80517Genera!Information &Inspection Line (970)577-3726 *FAX (970)586-0249 *www.estes.org Permit Expires /Za i 3’
.iob Address:/‘,_-O j(‘/‘i.-J
OwnerName:4/zie /JC
Address://,5()
(Street)(City)(State)(Zap Cddc)
Contractor/Applicant:tT-5 /‘/)it FLait Et5 .ZL7K.Town License#:7’2 9Phone:
Address:j7’‘4//J3 p-1)q 7t ,
(State --(Zip dade)D Long-term Residential (30 days)D Short-term Residential (<30 days)Commercial
O Replace Furnace 0 Gas Line (ft.)O Replace Boiler 0 Replace WindowsOReplaceHotWaterHeater0InstallAirConditioningMinorPlumbing0TemporaryStructureUse________________0 Minor Remodel Time Period
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0 Fireplace Insert —circle one:Gas,Wood,Pellet;0 Other
DescriptionofWork//7Uc jj
Valuation (Total Cost of Material &Labor):S
inspection Checklist:
Address Posted
Contractors Licensed
Permit Packet Available
E Safe Acccss
(‘oniments:
D Equipment Access
Equipment Listed
Equipment Clearances
Pan and Drain
Gas p
Vent
Conibustioa Air
S’1QJJALARMS JQiJ
PA Li)-c
Received Date £c913 .
Phone:
(t?c)
(Street)(City)
Signature
c;tify this application is true and correct and agree to perform the work described according to plans/specifications sirbnntted,reviewed and approved,and comply withInca,ordinances,state and federal laws as well as building codes.I certi that!rave the property owners authority and pemission to apply for this permit Additionaly.ILNDFRs’rAxD THAT l-AH RESPONSIBLE FOR ANY FEES OR EXPENSES tNCCRRED FOR PLAN REVIEW,PERN’IITS,L\SPECTIONS AND OTHERFEESASSOC’LkT-EI)‘JTH THIS APP ATION.Note;The work authorized by this permit requires the buitding be provided with smoke storms complyingwithmunicipalcodes,
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C Smoke DeeTttj
Permit Fee:
Census Construction l’ype:—Occupancy:
County Tax:/7.7Q
Budding Official
‘Fota I :/42--
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