HomeMy WebLinkAboutPERMIT 576 Audubon St Boiler 2019-04-04ReceIved I)ate
________
ReceVéBt :Lt::iDçr
flY
LPP94 2113-Town of Estes I
—Application for Miseellai
tment of Building SaFety 170 tscCrcgor Avenue PA).Box I
aformation &Inspection line (970)577-3726 FAX (970)l
Office
Copyark Permit Number M-O35 —g
cous Permit Application Expires
OO Estes Park,CO 80517
S-0249 *www .estes.ortj Permit Expires 7 30 /
JobAddress__57(c’Auokvon tr-,E1 CO &S(7
OwnerName:Jpkp P onz-a RQ’ocobt€Tri.st Phone:9 Q—9fl -5S °
Addres____3S CE CapA-cJ Or Rcw+law r Gsoa9
(Street)(City)(State)(Zip Code)
ContractorI4pplicat:?rv4ecJ ‘PLarr b”3 own License #:1S2 Phone:9’io-!
I 9SAddress:QSQtnncke 5+-,LCn1-1 A EFto ?OS/7
(Street)(C y)(State)(Zip Code)
C Log-term Residential (?30 days)U Short-term Residential <30 days)U Commercial
C Replace I urnace C Gas I ‘inc (ft.)‘‘RIace I oiler U Reph e Windows
U Replace I Lot Water Heater C Insta Air Conditioning
U NUnor P1 imbing C Temp Irary Structure Use________________C Minor Ri model Time Period
U Fireplace Insert—circle one:Gas,Wood,Pellet;C Othet
Description of Work:‘O,a
Valuation (Totl Cost Material &labor):$(cX3O
I certify this applic4tion is and correct and agrte to perfotrn the work described accordng to planr specifications submitted,reviewed and appmvcd.and comply withlocalordinances,sttc and federal laws as well as building codes.I ccn’t that I have the property ow cr’s authority and permission to apply for this pennit.Additionally,IUNDERSTANDATIAIRESPONSIBLEFORANYFEESOREXPENSESINCURREDF)R PLAN REVIEW,PERMITS,INSPECTIONS AND OTHERFEESASSOCIAUWITTInSAPPLICATION.NoIc;Thc work authorIzed by thl permit qulrca the buildIng be provided with smoke alarms complyingwithmunicipalcci.
SIL’nalure “t Ct/<..LJL -Date /yi trnni Name J c4ru 734—I_Ur
***Office Use Oniy
Inspection Cheklist:
C Address Pos4ed U EquIpment Access C T &P U Smoke DetectorsCContractorsiccnseiUEquipmentListedUGasPiURoughInspection
U Permit Packet AvaiL ble D Equipment Clearances U Vent C Final InspectiollCSafeAccessIUPanandDrainUCombutionAir
Comments:—
.Permit Fee:
Census #ç,flFCOA1c2-)j’’County Tax:7 ZOO
Building Official Datei Total:¶3(5tZS
V
vloKE ALARMS ARF
\Servencomm dev’Build w’.Forms\Aoolications’()ver the (‘otintcr
REQIJIRED**
O9 2Oi’
Revised 3’22Ol2 -(‘IIPageIofI