HomeMy WebLinkAboutPERMIT 139 Boyd Ln Vacation Home Life Safety 2019-01-03of Estes Park PerinitNuinberVHLS
Vacation Home Life Safety Survey Application
vision of Buihling Safety 170 MacGregor Avenue P.O.Bo 1204)Estes Park,CO 80517
ttion (970)577-3739 Inspection Line (970)577-3722
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Owner Name:fY1AVLL J\S_Cjt4mr
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Phone:2SSz9 :iEUt
Address:Zo 5&Jt__LLLPDS
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Address:
(City)(Slate)(/17 Code)
Email address:
______________________
(Ieae wiie Itbl
Number ol’bedrooms (as per Larimer County Assessor data and Vacation Home Registration form)
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Identify sleeping areas other than bedrooms (den,office,family room.etc)--
Description of Work:2015 IRC Section 327 LWE SAFETY SURVEY
icertify this application is true,correct acid will comply with local ordinances,state and federal laws as vell as building codes.
I certify tint 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 thispermitrequiresUbuihliiigbeprovidedkitsmokealarmscomplyingwithmunicipalcodes.
Signature Print Name cdi/-Date
Permit Fee:$200.00/_3_/County Tax:$0.00
Building OfFicial:Datc:Total;
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$200.00
***Office Use Only
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I-Tome:Field Approved for Certificate of Occupancy —
Vacaicor.Home:Special Conditions —______________-—
Large Vacation F-I rue:
Approved by:Dale:
fficoLaDy
[mail address:
Applicant:
_____
--Phone:
(S[Feet)
Town Business License #:
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