HomeMy WebLinkAboutPERMIT 750 Black Canyon Dr Interior Remodel 2015-06-24(Stret)(City)(State)(Zip Code)
Email address (REQUIRED):9cz-C5T9L24--tZY J-)’,*
The Following Applies to New Work Only —Complete all that apply:U ‘New Building $flilteration C Addition Master Planl$
BuildinR Use(s):-Owner/Residence C Rental —30 days or more C Accessory Dwelling
Existing use:Proposed use:;if of New Dwellings:if of New Kitchens:
Sewer:C Estes Park Sanitation C Upper Thompson Sanitation C Private Septic —Requires Applicant to first go to the Health Department.
Plumbing Involved:C NoYes —State and Town Licenses Required;PlurrjbIng Fixture Worksheet Required.
Fixtures:C Add %Relocate C Replace U Demolish Water service:,,Jxisting C New 1*of Meters:.Meter Size:inches
Electric involved:C No $Ves —State &Town License Required.State Permit and inspection Required.Temp Meter:%No C Yes
Service:,%‘Existing C New C Overhead ‘Underground Uof Meters:Meter Size:—amps;Phase Voltage
________
Type of Heat:Gas ‘Fumace Fuel Gas Involved:C No C Yes —Qualifications and System Sizing Required.
C Electric C Boiler Type:C Natural Gas C LPG Uof Gas Appliances /Outlets:_______
Building Height:U Floors Basement (sf)1’Floor (sf)2M Floor (sf)Garage /Carport (sf)Porch w/Roof Deck w/o Roof
Fin
_________
Fin
__________
Fin
__________
Attached
_______
(sf)(sf)
Ft.Unfin Unfin Unfin Detached
Job 9ption:I Total Valuations (Labor &Materials)Ar&.P&u1aocCt
have submitted the Minimum Submittal checklist for Residential Construction Plans-2009 IRC with this applicItion.
Received Date 5Ct -zq Town of Estes Park
Office
Copy
Received By -Long-Term Residential Application/Building Permit
Division of Building Safety 170 MacGregor Avenue P.0.Box 1200 Estes Park,CO 80517 Application Expires
____________
General Information (970)577-3726 •FAX (970)585-0249 •www.estes.org
NOTE:Use this Form for Long-term Residences 30 days or more.Permit Expires
____________
Permit Number 8-/o129
Job Address:?ScO J’,1-cc}<cZ-,c_yoL)Dz Condo:WNO C Yes;
Lot:—Block:__Subdivisionr’t_A c_K_X2AJJ/,d26&Tr
Owner Name:OOA)tLJt3&4
Address:7527 -cc C &:)575y ca.,
Lot Size:
____________sffac
Parcel#:35244-9!-04Z
Phone:72O -,9_7q3e
(Street)/(City)(State)(Zip Code)
Contractor:k’flJL,.47Lt_cZ,AjSr Town License #2 /55 Phone92t’-z27—do?a
Address:/9/5 cat’t c6t x /Z°7 é3 rs ?c’5-/7
C5?7
I certify this application is true and correct and agree to perform the work 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 RESPO?IBLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW,PERMITS.INSPECTIONS AND OTHER FEES ASSOCIATEO WITH THIS
APPLICATION.Contractor D Owner C Owner’s Agent C Tenant
Dat 2/5 Print Name 77/EZ,e,zo,(o—
Job Descriptton’.1
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