HomeMy WebLinkAboutPERMIT 541 Chapin Ln Supply Lines DATE UNKNOWN_____
Town of Estes Park Permit Number M-
Application for Miscellaneous Permit Application Expires______
Department of Building Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,CO 80517
General Information &Inspection Line (970)577-3731 FAX (970)586-0249 ‘s .estesnet.coiu Permit Expires
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JobAddress:.5”//(L//L/...J’L.
OwnerName:Phone:97 :3q9
Address:5/(’Lip,.()c5’7
(Street)(City)(State)(Zip Code)4i J i -
Contractor/Applicant:/(V L1 csic Town License #:
Address:C 1i42J’)
(Street)(City)(State)(Zip Code)
C Long-term Residential (30 days)C Short-term Residential (<30 days)C Commercial
C Replace Furnace C Gas Line (ft.)
EJ Replace Boiler EJ Replace Windows
C Replace Hot Water Heater EJ Install Air Conditioning
E1ciinor Plumbing C Temporary Structure Use_______________
C Minor Remodel Time Period
C Fireplace Insert —circle one:Gas,Wood,Pellet;C Other
DescriptionofWork:£c1ci \j ii I L I vt.c,c-4L
C vC vtC
Valuation (Total Cost of Material &Labor):$C C
I certify this application is true and conect and agree to peiform the work described according to plans/specifications submitted,reviewed and approved,and comply with
local ordinances,state and federal laws as well as building codes.I certify that I have the property owner’s authority and permission to apply for this permit.Additionally,I
UNDERSTAND THAT I AM RESPONSIBLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW,PERMITS,INSPECTIONS AND OTHER
FEES ASSOCI TED WITH T!.u PPLICATION.Note:The work authorized by this permit requires the building be provided with smoke alarms complying
Date//PdntName
E
IL
***Office Use Only ***
Inspection Checklist:
C Address Posted C Equipment Access C T &P C Smoke Detectors
C Contractors Licensed C Equipment Listed C Gas Pipe C Rough Inspection
C Permit Packet Available C Equipment Clearances C Vent C Final Inspection
C Safe Access C Pan and Drain C Combustion Air
Comments:Permit Fee:
Census #Construction Type:Occupancy:
County Tax:
Building Omdl Date Total:
**SMOKE ALARMS ARE REQUIRED**
Received Date
___________
Received By
VServerp’omm dev\BuildinForrns\Appl iation\O’,ci the Counter Page 1 of I Revised 6/13/2006 -CB