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HomeMy WebLinkAboutPERMIT 1690 Brook Ct Furnace 2013-10-10Qce Received Date -‘--,o Town of Estes Park Permit Number M-5 -J: Received By 1(Application for Miscellaneous Permit Application Expires_4//’2’/4DepartmentofBuildingSafety170MacGregorAvenueP.O.Box 1200 Estes Park,CO 80517 /General Information &Inspection Line (970)577-3726 *FAX (970)586-0249 *www.estes.ore Permit Expires /f ,Job Address:/L”<1 c)rc’,cC ‘4. OWnerName:‘L(f Phone:-2((-77 Address:/6 ‘L)co c P’-(Street)(City)(State)(Zip Code) Contractor/Applicant:&r-yc .l2(ci-i-te t-s9 Town License #:7/ti Phone:56j V5c,b Address;/Erf’-c Pc.Ce)s7(Street)(City)(State)(Zip Code)0 Long-term Residential (30 days)C Short-term Residential (<30 days)C Commercial -Replace Furnace C Gas Line (ft.)LI Replace Boiler C Replace WindowsElReplaceHotWaterHeaterLIInstallAirConditioningCMinorPlumbingCTemporaryStructureUse________________C Minor Remodel Time Period __________________________ LI Fireplace Insert —circle one:Gas,Wood,Pellet;LI Other Description of Work: P-’’cLr.lcE C 1cw’t’e €‘4’-(c-4y -E(o Valuation (Total Cost of Material &Labor):$ I certify this application is true and correct and agree to perform the work described according to planslspeciñcations submitted,reviewed and approved,and comply withlocalordinances,state and federal laws as well as building codes.I certii that I have the property owner’s authority and permission to appiy for this permit.Additionally,1 UNDERSTAND THAT I AM RESPONSIBLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW,PERMITS,INSPECTIONS AND OTHERFEESASSOCIATEDWITHTHISAPPLICATION.Note:The vork authorized by this permit requires the building be provided with smoke alarms complyingwithmuiiicipalcodes. Signature Date fc/rc 43 Print Name r j ***OffIce Use Only *** Inspection Checklist: LI Address Posted C Equipment Access 0 T &P 0 Smoke DetectorsLIContractorsLicensedCEquipmentListedCGasPipeDRoughInspection0PermitPacketAvailableCEquipmentClearancesCVent‘Final Inspection YtI J C Safe Access C Pan and Drain C Combustion Air .1Comments: —Permit Fee:‘,25’Census #Construction Type:Occupancy: County Tax:7.5BuildingfIle’Date -/Total:s 9o.7 MJAi4fMS .“,‘age I of I Re’,ised 5/2112012 -C13