HomeMy WebLinkAboutPERMIT 540 Birch Ave Replace Sheetrock, Insulation, Doors, Windows 2011-03-28IIocei’et1Date Zo’.c-.z Town of Estes Park Permit Number M-O19’ii
Received By Application for Miscellaneous Permit Application Expires o-Department of Building Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,CO 80517 O tGeneralInformation&Inspection Line (970)577-3731 *FAX (970)586-0249 *www.estesnet.com Permit Expires
Job Address:,Y’1,.-4 .,S /
OwnerName:J///t’Phone:-7/
Address:(6 ‘S/7
(Street)(City)(State)(Zip Code)7Zo 2XC &L
Contractor/Applicant:47’c Town License #:/1(10 Phone:7d 6?2S
Address:()/çy c35/cDjc (c (5
(Street)(City)(State)(Zip Code)
LI Long-term Residential (30 days)LI Short-term Residential (<30 days)Commercial
EJ Replace Furnace LI Gas Line (ft.)
LI Replace Boiler LI Replace Windows
LI Replace Hot Water Heater LI Install Air Conditioning
LI Minor Plumbing LI Temporary Structure Use________________
LI Minor Remodel Time Period
___________________________
LI Fireplace Insert —circle one:Gas,Wood,Pellet;LI OtherDescrrk:j5 frJf%4 Lew,31 N.c.LPC.co v .L)øc)O L..
‘4-5Mio DOQs’23 t(.1OLL)).
Valuation (Total Cost of Material &Labor):$00
I certify this application is true and correct and agree to perform the work described according to plans/specilications submitted,reviewed and approved,and comply withlocalordinances,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,IUNDERSTANDTHATIAMRESPONSIBLEFORANYFEESOREXPENSESINCURREDFORPI,AN REVIEW,PERMITS,INSPECTIONS AND OTHERFEESASSOCIATEDWITHTHISAPPLICATION.Note:The work authorized by this permit requires the building be provided with smoke alarms complyingwithmunicipalcodes.
signature D-_C5L4i.-Date 3 Z Print Name C’t -L.S (+q
***Office Use Only ***
Inspection Checklist:
LI Address Posted LI Equipment Access LI T &P LI Smoke Detectors
LI Contractors Licensed LI Equipment Listed LI Gas Pipe LI Rough Inspection
LI Permit Packet Available LI Equipment Clearances LI Vent LI Final Inspection
LI Safe Access LI Pan and Drain LI Combustion Air
Comments:Ffiwt4C1 .4fPILc-i)/-ti,finit Fee:
Census #Construction Type:Occupancy:
4 7 County Tax:
Building Orficial Date
!‘Z Cl f Total:(30.
**SMOKE ALARMS ARE REQUIRED**
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