HomeMy WebLinkAboutPERMIT 1070 Camelot Ct Furnace & AC 2019-08-29I
RECEIVED
AUG 292019
Received Date
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Town of Estes Park Perniit Number M-O
RqciyçQpy AppiLcatlon br Miscellaneous Permit APpICaLOIIEXpres
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r ------..--.--cpnrent-nf-BnI1dt ig Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,CO 80517
Job Address:
wwwaorcl’erinit EXPfrCS1L2&JI3
Owner Name;L\k Phone;
___________________
Address:kOO CamO\O C\.Uv411 Ess?c&b OS\1-(Stitet)(City)(State)(Zip Code)
Contractor/Applicant:
_____________________________________Town
License #:
_______PhVP)AS1.2414tO
Address:St’4 dkie thn @cOS
(Street)(City)(State)(Zip Code)
Long-term Residential (30 days)U Short-term Residential (<30 days)U Commercial
Replace Furnace 0 Gas Line (ft.)
C Replace Boiler U Replace WindowsoReplace[lot Water Heater Install Air Conditioning
O Minor Plumbing U Temporary Structure Use___________o Minor Remodel Time Period
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O Fireplace Insert —circle one:Gas,Wood,Pellel;U Other
t,ec\,Ojfl \g
1Q\Nti:‘b\o,j evkftb’\fi peed,aø Pfr
Valuation (Total Cost of Material &Labor):$
I certify this iptilicatiun is true and correct ‘ut agree to pcrlbnn tie scout dcu-it,cd according to ptauis/spccifleatuouuc sthuiuittcd,reviewed :l,Rt approved,and conuphv wilt,local ootuuia,uccs.stale usut tedmal laws as welt as tsttildiuig codes.I entity thai I have the auopcrty osruicr sultuorily and pci nlission to apply Fr this pcoiuit.Artdutiouuahly.ItJNDERS’l’ANt)lhtAl’I AM RESPONSIBLE FOR ANY FEES OR EXPENSES tNCIJRREI)FOR PLAN REVIEW,PERMITS,tNsI’Ec’rlONs ANt)OTHERFEESASSOCtATEDWillI‘ll IS APPLI CATI ON.Note ‘Ftie wo k aUt liorized lay this tic rail I rcqu I ci tite t Id to hue provided will,s oke ala iii en in plyt a
Date L9 PuuiiI Namjfl
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***Office Use Only ***
Inspection Checklist:
C Address Posted 0 Equipment Access 0 1 &P 0 Smoke Detectors0ContractorsLicensed0EquipmentListed0GasPipe0RoughInspection0PermitPacketAvailable0EquipmentClearances0Vent0FinalInspectionCSafeAccessUPanandDt’ai:i -0 Combustion Air
Comments:
Permit Fee:
t-:zCensusCotistrttctioiiType;Occupancy:
County Tax:
J.,,-BuikBaci Date
Total:53 /,
**SMO ALARMS ARE REOUIRE1P
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