HomeMy WebLinkAboutPERMIT 1212 Brook Dr Deck 2013-06-20Received Date li..20 Town of Estes Park
Received By Long-Term Residential Application/Building Permit
Division of Building Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,Co 80517
General Information (970)577-3726 ‘FAX (970)586-0249 www.estes.org
NOTE:Use this Form for Long-term Residences 30 days or more.
Job Address:/2 /1 p
Lot:BIock:_Subdjvjsjon:Ttv
OWnerName:Poç i4i/i4 ?9
Address:i2 R I )Z’(7(/3 Is_
,_-(Street)(City)
Contractor:(o-c-’t.47&-
______
Email address (REQUIRED):
Permit Number &452
Application Expires i2-2321)13’
Permit Expires 1—5-)5
,o
(Zip Code)
The Following Applies to New Work Only Complete all that apply:El New Building C Alteration C Addition Master Plan#
B[ding Use(s):Owner I Residence El Rental —30 days or more 0 Accessory Dwelling
Existing use:Proposed use:;U of New Dwellings:;It of New Kitchens:
Sewer:El Estes Park Sanitation Upper Thompson Sanitation 0 Private Septic —Requires Applicant to first go to the Health Department.
Phimbine Involved:No 0 Yes —State and Town Licenses Required;Plumbing Fixture Worksheet Required.
Fixtures:El Add C Relocate C Replace El Demolish Water Service:‘xisting C New -II of Meters:.Meter Size:inches
Electric Involved:El No C Yes —State &Town License Required.State Permit and Inspection Required.Temp Meter:C No C Yes
Service:El Existing C New El Overhead El Underground #of Meters:
_______
Meter Size:amps;Phase __.__Voltage
Type of Heat:C Gas C Furnace Fuel Gas Involved:C No C Yes —Qualifications ad System Sizing Required.
El Electric C Boiler Type;C Natural Gas C LPG It of Gas Appliances /Outlets:
—51,,lidBuildingHeight;It F1oors Basement (sf)1 ricor 1sf)2 Floor (sf)Garage /Carport (sf)Porch w/Roof DecK w/o Roof
Fn F
________
Fin
________—
Attached
______
(sf)(sf)
Pt,Unfin_...__Ursfin Unfin
_______—
Detached__
JQ.bDescription;I Total Valuations (L bar &Materals)J<JI14,’J Pi rCK b Is a
.ivu sjb”ited the Minimum Submittal Checklist for Residential Contrction Plars-20D9 PC with this a;:i ca:o
certify this application is true and correct and agree to perform the work described according to plans/specificatons submitted,reviewed and approved,and comnly with
nra!ordnances,state end federal laws as we”as building codes,I certify that I have the roperty owner’s athort and pernisso-i to apiy for this permit.Additionaly,I
UNDERSTAND TH M RESPONSIBLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW,PERMITS,INSPECTIONS AND OTHER FEES ASSOCIATED WITH THIS
APPLICATION.C C tractor C Owner C Owner’s Agent C Tenant
______
Dare 4d Pr,ltName f A
n..:I.h....I t.ar.......,_..aur......_lena Resicknijal Building I’cnnittlong-term Residential Building Ikimi,2011 AI’PR(IVI,1).ttw.Revised
oftice
COPY
Address:
Condo:Lio El Yes;Lot Size:/jz2oZ 9c
—Parcel #:2 (?ia-i /70/a
Phone:Q74 ‘C16c1 9
)2 flsra/(a.(/fJ 4r/(
(Street)(City)
-(State)(Zip Code)
Town License #:I (it’Phone:7,o -—‘2”ti I
(State)
611412012-
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