HomeMy WebLinkAboutPERMIT 500 Birch Ave Furnace 2005-06-22@6/21/2665 11:51 9762299983 NCA
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Town of Estes Park
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JeeeIvedBy -Application for Miscellaneous Permit
Department of Huildiiig Safety 110 MacGregor Avenue P.O.BOX 1200 Estea Park,CO 80517
General Information (970)577_373J*Inspection Use (970)5774731 *FAX (970)5864249
Job Address 2500 ELrCn St —
Owner Namet\Dhfl/JQ&flfltr t”J’ckq5tr Yhone:•,
Address:5131 cJvia Dc cM
Contractor/Applicant:h\C.,tELT_Y,C F+C —Town License #:
______PhoneRbQZS”23”
Address:ÔLZ hknOfiQ--V&j-Cd[(fls (a pg
—(S -City)—ec -(Zip Code)
C]Residential —--I]Non-Residential
Cl Air Conditioning Installation
0 Gas Line (ft.)
0 Gas Log Installation
%New Furnace IllStallatiOn
El New Water Beater Installation
C Temporary Structure Use_____
Time Period
_______________
C Demo Structure
O Reroof (Commercial —Pitched Only)
Roof Classification A 13 C N
#of Squares______
O Reroof (Residential)
#of Squares
O Siding
o Windows
O Fire/Water Damage
O Drywall
O Other
Office Use Only ***
Staff Comments:Permit Information
Fee
Permit Fee;I4
j.)r &.ii -CouyTw Z&.&
Buildl4OMebi ate -l’otsl //
Received Date frz S Permit Number
/111.2.—?_c
Description of Woric:‘T pIrxcc.FCt.rrinj..
I certify this application is tnie and correct and agree toperibem the work described according to plans/specifications submitted.reyWwed and appmvecl,and comply with
beat ordinances,state and federal laws as well as building codes.AddItionally,1 UNDERSTAND THAT I AM RESPONSIHçE F RAYflES OR EXPENSES
INCU FOR PLAN W,PERMITS,INSPEUrIONS AND OTHER F TED WITH THIS APPLiCATION
signatp OiOtt L.htcier.