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HomeMy WebLinkAboutPERMIT 120 Boyd Lane Replace Water Service 2015-02-19Field Copy Received Date ,OC, Town of Estes Park Permit Number M- 02.5 /5 Received By ("4( Application for Miscellaneous Permit Application Expires Department of Building Safety 170 MacGregor Avenue P.O. Box 1200 Estes Park, CO 80517 General Information & Inspection Line (970) 577-3726 * FAX (970) 586-0249 * www.estes.org Permit Expires 6 /1/i.< Job Address: ? 2 (.2$ /3IN Li./ • Owner Name: b it_6-1:-.. N & A 1._E- y Phone: 4 9 76 2,'d ._4•Z:z(.. Address: 1 21 e)oy A L 4; ' Ee TES PIIP 1( d o 80,0577 Contractor/Applicant: Address: 9.41S- IN' (Street) (City) (State) (Zip Code) # Q.743-Ye;., .-M 61P 1,1 E LYCA ki A tl' Olu / Lam- Town License 5 : la Phone: iL, i A.; e I v 13 E./7 11 nt L.- i,,-) j5 /-;.5 PAP X C CU rob-77 (Street) (City) (State) (Zip Code) 4 0 Long-term Residential (> 30 days) 0 Short-term Residential (< 30 days) 0 Commercial Water Heater - circle one: Gas, Wood, 0 Gas Line 0 Replace 0 Install Air ( IL) Windows Conditioning Structure Use • Replace Furnace • Replace Boiler • Replace Hot • Minor Plumbing • Temporary Time Period Pellet; 0 Other • Minor Remodel • Fireplace Insert Description of Work: Valuation (Total (Total Cost of Material & Labor): $--- vo — 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 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 the building be provided with smoke alarms complying with municipal c . , Signature 41_ - tr° 0 i,-6‘. (ek ‹,. „---, Date 2/i ci /1/6—Print Name 8///911 2), 6 i,t 0 ic a- *** Office Use Only *** Inspection Checklist: 0 Address Posted 0 Equipment Access 0 T & P 0 Smoke Detectors 0 Contractors Licensed 0 Equipment Listed 0 Gas Pipe 0 Rough Inspection 0 Permit Packet Available 0 Equipment Clearances 0 Vent Final Inspection ‘ 0 Safe Access 0 Pan and Drain 0 Combustion Air Of I Comments: Permit Fee: 85. 25 Census # Construction Type: Occupancy: County Tax: 63. / Z Byikli rkg-Ottic i a I --- Date 9- 2474.5-Ageti Total: 09/.37 **SMOKE ALARMS ARE REQUIRED** IP 11_3 0 2Q.15 703 702 VVI \\Setvera \comm dev‘Buildi_itTorms\Applications\Ovei the Counter Page 1 of 1 Revised 3/29/2012 - CB • 1 I Offs E J !J1.1 JiIQ4 r..Ai -49 < o v.rr 44 .„1 .14')4 4rt • t c- ,ro 44 t.t `14 d .4M 800 1117 Cr.ic22 Of/ SIR 6 I 833 C ErADE)©, • drj./7 vie, pa Q -at