HomeMy WebLinkAboutPERMIT 850 Black Canyon Ave Gas Line 2011-03-25Mar 25 11 06:49a Westover Construction 970-577-8462 p.13ce
CoP’!Received Date C).05.Town of Estes Park Permit Number M-Oj u••••Received By O—Application for Miscellaneous Permit Application Expires 9-l-Department of Building Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,CO S0517GeneralInformation&Inspection Line (970)577-3731 *FAX (970)586-0249 *www.estesuetcom Permit Expires 0i -i 3JobAddress:1a)n-.-(c-i 3-o
Owner Name:l(\A-P k C-.Sft’4 /-‘C Phone:
____________________
Address:QZ5 &&YoN i2 STE-c Pxp(Street)(City)(State)(Zip Code)
Contractor/Applicant:COTLCfl3\f Town License #:Phone:q
Address:COCJ j2 ‘()77(Street)(City)LSrate)(Zip code)Long-term Residential 30 days)U Short-term Residential (<30 days)El Commercial
C Replace Furnace .tas Line (72’ft.)C Replace Boiler C Replace WindowsDReplaceHotWaterHeaterCinstallAirConditioningCMinorPlumbingCTemporaryStructureUse________________C Minor Remodel Time Period
__________________________
,i?ire.plaee Insert —circle one Wood,Pellet;C Other
Description of Work:c-Liwt Fc-4 Qt7P FtFJ9
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Valuation (Total Cost of Material &Labor):$
+_ooo(certify thts applicatom is true and correct and agree to perform (he work described according to plans/specifica:ioos submitted,reviewed and approved,and comply withlocalordinances,state and federal Iaw as well as building eode,I cerIiiy that I have the property owners authority and permission to apply for this permit.Additionally,IUNDERSTANDTHATIAMRESPONSIBLEFORANYFEESOREXPENSESINCURREDFORPLANREVIEW,PERMITS,INSPECTIONS AND OTHERFEESASSOCIATEDWITHTHISAPPLICATION.Ncte:The work autliorirvd by this permit requires (he building be provided with smoke alarms complyIngwithmunicipalcodes.
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Office Use Only ***
Inspection Checklist:
C Address Posted C Equipment Access C T &P C Smoke DetectorsCContractorsLicensedCEquipmentlistedCGasPipeCRoughInspectionCPermitPacketAvailableCEquipirentClearancesCVentCFir.al lospectionCSafeAccessCPanandDrainCCombustionAir
Comments:
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--‘Permit Fee:
Census #Construction Type:Occupancy:q County Tax:03BuildingOfliclaliDate/I//-/(Total:q 7
ARE REQUIRED**
‘‘Servem\comm dev\Buflding\FormsppIicationstO-ver the Counter Page of]Revised 7/14/2006 -CB