HomeMy WebLinkAboutPERMIT 901 Black Canyon Dr Demo 2017-08-24€1 22-I‘cq
Received Date *“7/c/24 Op lown of Estes Park Permit Number
n3 car Application for Miscellaneous Permit Application Expires______
Department of Building Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,CO 80517
Information (970)577-3726 *Inspection Line (970)577-3721 *FAX (970)586-0249 *w444V.estes.OrC Permit Expires
_____________
Job Addressz?&/4
Owner Name:#W /‘Jorp,y-c4’Phone:77&-w—c3
Address:96”3a c&Zk.Th-tss w 7
(Street)F (City)—(State)(Zip Code)
Contractor/Applicant:f<.CAJ.134CC I’LSY Town License #/25T_Phone:97’Z7749
Address:2c,9,k3t,O,YLLk Pc /207 &5-Z5 e-fo 2 7
(Street)(City)(State)(Zip Code)
Long-term Residential (30 days)El Short-term Residential (<30 days)C Commercial
El Replace Furnace El Gas Line (ft)
El Replace Boiler SReplace Windows /
El Replace Hot Water Heater C Install Air Conditioning
,,$‘Minor Plumbing El Temporary Structnre Use_______________
El Minor Remodel Time Period
___________________________
El Fireplace Insert —circle one:Gas,Wood,Pellet;C Other
Description of Work:J’0 r’-t ‘zA4et r ,3 /c27 .zL’
Valuation (Total Cost of Material &Labor)1t,c,.c,
I certit 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,slate 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.Note:The work authorized by this permit requires (he building be provided with smoke alarms complying
with mini
_____________________Dat
fl17Print Nan*_P0 it t-A’
***Office Use Only ***
Inspection Checklist:
C Address Posted Li Equipment Access LI T &P Li Smoke Detectors
C Contractors Licensed Li Equipment Listed Li Gas Pipe Li Rough Inspection
C Permit Packet Available Li Equipment Clearances Li Vent Li Final Inspection
C Safe Access Li Pan and Dram Li Combustion Air
Comments:
Permit Fee:50 ct
Census #Construction Type:Occupancy:
County Tax:
Build .DatecZiDiZaJ?cE—//Total:Go .
r /
AUG 242011
BY Cr&
U:\Building Division\FormsApptications\OTC\MisceIIaneous\MisceIIaneous 201 2.03.29.doc