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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 / X:kBuiklingl)epIWormsandRcfcrtnces_.13uil&gA&atin’iBuilding\Long-trrm Residential Building Pennil\l.crng-trrnt Residential Building Permit 21111 APPROVl;l).tt.Rei.d611412012-KT