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HomeMy WebLinkAboutPERMIT 629 Birch Ave Repair Water Damage 2011-02-22office _______ Town of Estes Park Copy Permit Number M -c.J,- Received By c.Long-Term Residential Application /Building Permit Department of Building Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,CO 80517 Application Expires - General Information and Inspection Line (970)577-3731 •FAX (970)586-0249 •www.estesnet.com NOTE:Use this Form for Long-term Residences 30 days or more.Permit Expires ____________ Job Address:a?13 )‘-“/(Condo:No LI Yes;Lot Size: _________sf/ac Lot:—Block:Subdivision: ____________________________________________ Parcel #:________________________ Owner Name:(t y/Phone:.so’3 Address:)-7,’(A)I L<j)k Cy j 9-L,#)o-’,/1 (Street)(City)/‘State)(Zip Code) Contractor:y)7.:(h(V/tL .&i Town License#:/?7 Phone:i 7o ‘fff/r’Y/ Address:(/1 tIT i h ft ?9 /i f24k (e 97/‘/;—7 7 (Street)j (City)(State)(Zip Code) The Following Applies to New Work Only —Complete all that apply:C New Building LI Alteration C Addition Master Plan# Plumbing Involved:LI No ‘es —State and Town Licenses Required;Plumbing Fixture Worksheet Required. Fixtures:LI Add LI Relocate.keplace LI Demolish Water Service:LI Existing LI New -#of Meters:.Meter Size:inches Electric Involved:LI No EYes —State &Town License Required.State Permit and Inspection Required. Service:Existing LI New:LI Overhead LI Underground;#of Meters:;Meter Size:amps;Temp Meter:LI No 0 Yes Type of Heat:i Gas Furnace Fuel Gas Involved:ri No LI Yes —Qualifications and System Sizing Required. LI Electric LI Boiler Type:Natural Gas LI LPG #of Gas Appliances /Outlets: Building #Floors Basement (sO I St Floor (sfl 2”’Floor (sf)Garage /Carport (sf)Porch wi Roof Deck wlo Roof Height:Fin Fin J )1 Fin Ji Attached AL (sO (sO)Ft.I Unfin ‘‘Unfin________Unfin ‘Detached 1V’ Job Description:4 1t_t’i ..F ‘—i i...5 .- Total Valuations (Labor &Materials)x,&Oi-,2- I certify this application isfrue and correct and agree to pd’orm the woth described according to plans/specifications submitted,reviewed and approved,and comply with local ordinances,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,I UNDERSTAND THAT I AM RESPONSIBLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW,PERMITS,INSPECTIONS AND OTHER FEES ASSOCIATED WITH THIS APPLICATION. 1LContractor C Owner C Owner’s Agentc:. __________________________ Date/(Print Name /2’))d4 e//.JIgIIatuLc — L ***Office Use Only *** Job Description:Application Information Q4 1i-L (7..(.(’e-L rt,Approved Disapproved Fees Public Works ApQlicable IType of Occupancy Class(es):Water Coae(s):Cñnstruction:,____ Light &Powerc4d-riqic, Occupant Load(s):Floor Load(s):Load: Planning Variances:Fire Department Building ‘3‘j I. Setbacks I FronW Rear River Plan Review Zoning Hazards ICensus #County lax OpCeoWildfireFloodL.j Certificate of Occupancy DateBuilding?fflcial 2-i-l”(L Total L)Q1fr4’ Received Date ‘10 1..01_.1t’ Building Use(s):LI Owner /Residence LI Rental —30 days or more LI Accessory Dwelling Existing use:/?eS ic Proposed use:i X’;#of New Dwellings: ______ ;#of New Kitchens: _____ Sewer:.Estes Park Sanitation LI Unner Thompson Sanitation LI Private Septic —Renuires Applicant to first go to the Health Department. C Tenant I \\Servera\commdev\Building\Forms\Applications\Building Page I Revised 7/14/2006-CB