HomeMy WebLinkAboutPERMIT 1850 Bradley Ln Insulation & Drywall 2013-11-20Received Date \\—Q Town of Estes Park 9j Permit Number M-AL3 \
By Application for Miscellaneous Permit Application ExpiresDepartmentofBuildingSafety170MacGregorAvenueP.O.Box 1200 Estes Park,CO 80517 -General Information &Inspection Line (970)577-3726 *FAX (970)586-0249 *www.estes.org Permit Expires
Job Address:frC L3 -(L j-rc vZ ‘s7 7
OwnerName:(—j-L ‘“Phone:‘17cS77’/SI,
Address:/‘-cc L;y /ti i-s1j .2i’i 7 7(Street)(City)‘(State)(Zip Code)
Contractor/Applicant:tk (c)’t /“Town License #:%Phone:‘7 .227-’K
Address:]7’?i/d’-t /,5kc /‘1v .t ‘/7(Street)
‘(City)(State)(Zip Code)tl long-term Residential (?30 days)ID Short-term Residential (<30 days)El Commercial
ID Replace Furnace 1]Gas Line (ft.))El Replace Boiler ID Replace WindowsIDReplaceHotWaterHeaterElInstallAirConditioning 4ElMinorPlumbingElTemporaryStructureUseIDMinorRemodelTimePeriod
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El Fireplace Insert —circle one:Gas,Wood,Pellet;Other
DescriptionofWork:-y.i iiI i9I-y4”-/7:k:c7-;fP-/)i/.t 1t\ckcs
Valuation (Total Cost of Material &Labor):$4f
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t certify this applioutior.is true and correct and aee to perform the work described according to plans/specifications submitted,reviewed and upproved,and comply with
local ordinances,state arid 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 INCURREI)FOR PLAN REVIEW1 PER’41TS,INSPECTIONS AND OTHERFEESASSOCIATEDWITHTHISAPPLICATION.Note:The work authorized by this permit requires the building be provIded with smoke alarms complying
with municiphi codes,.(
Siame /fl,te It 4rint Name /4vJ ,/11T
_____
Office Use Only ***
Inspection Checklist:
El Address Posted ID Equipment Access IDT &P ID Smoke DetectorsElContractorsLicensedCEquipmentListedCGasPipeCRough[nspectionCPemiitPacketAvailableCEquipmentClearancesCVentDFinalInspection )A)I 3CSafeAccessCPanandDrainCCombustionAir jComments:
1PermitFee:-csCensus#Construction Type:Occupancy:
County Tax:\tZ--
DateBldincial%/—tii3 Total:
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l’age I of I Rised 52112012-CB
Received Date ——V
Received By
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PertuitNumber ‘‘V\_
TOWN OF EsTEs PARK
Department of Building Safety
OWNER’S ACKNOWLEDGEMENT FORM
If a commercial or residential project includes demolition or renovation work,the property
owner(s)must contact the Colorado Department of Public Health and Environment to obtain
either a State Demolition Permit or a State Asbestos Abatement Notification/Permit.
The Colorado Dept.of Public Health and Environment
4300 Cherry Creek Drive South
Denver,CO 80246-1530
Phone:303-692-3 00
Fax:303-782-U278
e-mail:ww .cdphe.state.co.us
This form must also be completed and signed by the owner prior to issuance of a Town of Estes
Park Building Permit.
(owner)agree to contact the Colorado Department
of Public Health and Environment to determine the state requirements for any work on my
property located at (address):L
I understand that I am accepting fu Illegal responsibility for all Colorado State requirements and
liability associated with the project.2-i &tL
Signature of’Owner
Address
(970)577-3726 P.O.Box 1200 170 MacCregor Avenue Estes Park,CO 80517
City Stat Zip
Date
•?-77_g/
Telephone
Sers en 3 biiikbngdepr l1andonts Owner Acknowledgement Form Owner Ack&n kd1ement Form (demo and hestos APPROVED.doc Revised 4 I 12 KT