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HomeMy WebLinkAboutPERMIT 398 Bristlecone Ct Heat & Boiler 2012-08-09Received Date ( Town of Estes Park 0" Miscellaneous„1 t�, Pcrmit Number M- Reccivtd A y �'� �°`� Application for Permit Application Expires partmcnt of Building Safety 170 MacGregor Avenue P.Q. fax 1200.Estes Park, CO 80517 General Inform ation & inspection Line (970) 577.3726 * MAX (970) 5864249 * www.e ittr.orl' Pcrmit £xpir Jub Address: i r Owner Name: Address: ,,3 Phone: - 382 1354...S (City) (tote) - Contractor/Applicant: elmorLetsNU q i9Town Ltccnac #: �C:�Thoae. Address: if.. tirk edge. e . , (trcco Street) . 0 1:4ng-term Residential ;30 days) ❑ Replace Furnace © Replace Boiler 0 Replace Hot Water Heater O Minor Plumbing o Miner Remodel La�e..I co pig (Zip Code) -b[e7 d'1. J7 (State) (Zip Codo) Short-term Residential (c 30 days) 0 Commercial O Gas Line ( ft.) Cl Replace Windows CI Install Air Conditioning O Temporary Structure Use Time Period O Fireplace Insert —circle one: Gast Wood, Pellet; krOther .Description ofWork: ,mot 4fi'r4 i1 yet i /.relit Ae q Sys' kt.• * 7 44,44 ltint./Moa6o+ i r‘,/[ikr►t#S4-i 6 Valuation (Total Cost ofMaterial &.Labor): 5 /Tj soy I certify this opp motion is true and correct and agree to perform the work described according to plans/epeeificati one submittal. reviewed and approved, and comply with local ordinances, sago and federal laws as well as building coda. I certU' that l have the property owner's authority and permission to apply for this permit. Additionally.' UNDERSTAND THAT! AM RESPONSIBLE FOR ANY FEES OR EXPENSES INCURRED FOR FLAN REVIEW. PERMITS, INSPECTIONS AND OTHER FEES ASSOCIA'rKu wrrH THIS AMU t'A! ION. Note: The work authrirized by this permit requires the banding be provided with smoke alarms complying with municipal coda. Sianoture tars 7. fps. Print Noma ul ,ta (.Li. Gait n eA *** Office Use Only *** Inspection Checklist: 0 Address Posted 0 Contractors Licensed 0 Pcrmit Packet Available 0 Safe Access Comments: Census a CI Equipment Access 0 Equipment Listed 0 Equipment Clearances 0 Pan and Drain elT&P 0 Gas Pipe ❑ Vcnt Cl Combustion Air 0 Smoke Detectors 0 °R h Inspection,., 0° ins! Inspection'" Pcrmit Fee: $utjdin8 Osliciid Construction. Type: Occupancy: County Tax: Date Total : 11Servcrttl a AL replications \Ovar the Counter ARE RE() Page 1 of 1 Revised 3/29/2012 - CB tiT'd 6t 2098E :01 :WOJIJ 9i`o :60 2102-6-9fl11