HomeMy WebLinkAboutPERMIT 1700 Brodie Ave Backflow 2017-03-14omce
Receivedflate 2oj1’-3-/J Town of Estes Park C°PV
PermitNumber M-(Y16 /1
Received By JL&J Application for Miscellaneous Permit Application Expires
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Department of Building Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,CO 80517
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iç 1GeneralInformation&Inspection Line (970)577-3726 *FAX (970)586-0249 *www.estes.org Permit Expires
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Job Address:1700 Brodie AtL
Owner Name:Community Church of the Rockies Phone:5864404
Address:1700 Brodie stes Park CO 80517
(Street)(City)(State)(Zip Code)
Contractor/Applicant:Mountain Valley Plumbing &Heating,Inc.Town License #:453 Phone:970-586-1085
Address:854 Dunraven Street,Estes Park,CO 80517
(Street)(City)(State)(Zip Code)
U Long-term Residential (?30 days)Li Short-term Residential (<30 days)Li Commercial
U Replace Furnace Li Gas Line (ft.)
Li Replace Boiler Li Replace Windows
Li Replace Hot Water Neater Li Install Air Conditioning
Li Minor Plumbing Li Temporary Structure Use________________
Li Minor Remodel Time Period
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Li Fireplace Insert —circle one:Gas,Wood,Pellet;R Other
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UPJIIT_Cl_ncrr
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Description of Work:UAPPROVED -
PlRED
Replace backflow preventer
Valuation (Total Cost of Material &Labor):$600.00 NOTES;
certify this application is true and correct and agree to perform the work described according o plans/specifications subrnite.4 Lcomply
local ordinances,slate and federal laws as well as building codes.I certi’that I have the property owner’s authority and permission to apply for this $,erutit.Additionally,I
UNDERSTAND THAT I AM RESPONSIBLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVTEW,PEnlcrrrs;INSI’ECTIONS 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 codes,
Signature Thm Snnnpnharp Date 2P9i9fll7Print Name Thr Snnn,nh.rp
***Office Use Only ***
Inspection Checklist:
Li Address Posted Li Equipment Access Li T &P Li Smoke Detectors
Li Contractors Licensed Li Equipment Listed Li Gas Pipe Li Rough Inspection
Li Permit Packet Available Li Equipment Clearances Li Vent Li Final Inspection
Li Safe Access Li Pan and Drain Li Combustion Air
Comments:Permit Fee:Z(eZ 5’’
Construction Type:
Countf Tax:/q5
Total:
**5MOI(j ALARMS ARE REOUIREW
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Census #Occupancy:
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