HomeMy WebLinkAboutAPPLICATION 561 Chapin Ln Unit 2 Fireplace 2011-11-11Received Date LC u Town of Estes Park CoPY Permit Number M-03u,-(I
Received By ci—Application for Miscellaneous Permit AppUcation Expires c-9
Department of Building Safety 170 MacGregor Avenue p.o.Box 1200 Estes Park.CO 80517 Zo l”
General Information &Inspection Line (970)577-3731 *FAX (970)586-0249 *½’n.estesnet.com Permit Expires c-‘
JobAddress:5/sI Cv Lx.
OwnerName:JOy’,(iQ-L Phone:970 -S77-99fl
Aitiress:(k I (\..
(Street)l,(Cky)(State)(Zip Code)
Contractor/Applicant:A-€o..*uJ€‘5k1G1jQtkwn License,,hone:
Address:C2SNO fl’5-f.“30*bK
(Street)(City)(Slate)(Zip Code)
EWtong-term Residential (30 days)0 Short-term Residential (<30 days)U Commercial
o Replace Furnace LI Gas Line (ft.)
o Replace Boiler C Replace Windows
0 Replace Hot Water Heater LI Install Air Conditioning
o Minor Plumbing LI Temporary Structure Use —
o Minor Remodel Time Period
____________________________
1U’Vireplace Insert —circle one:Gas,Pellet;LI Other
Description of Work:‘j,Q ivvS(4 ifl4C QA(tx cicerkRc
Valuation (Total Cost of Material &Labor):$33 0q 1 U
I certify this application is true and correct and agree toperform the work described accordingto plans/specifications submitted,reviewed and approved,and comply with
local ordinances,state and federal laws as well as building codes.I ceni that I have the propertyowner’s authority and permission loapply for this permit.Additionally,I
UNDERSTAND THAT I AM KKSPONSIBI,E FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW,PERNIITS,INSPEC[IONS AND OTHER
FEES ASSOCIATED WItH TIllS APPLICATI(Th.Note:The work authorized by this permit rcquircs the building be provided with smoke alarms complying
with municipal odes.
_______
Signature ,z,
______________________
Date ±!ii.iL Print Name (‘eq.“‘B03-fv\&C.
Office Use Only
Inspection Checklist:
El Address Posted I]Equipment Access LI T &p El Smoke Detectors
o Contractors Licensed LI Equipment Listed 0 Gas Pipe 0 Rough Inspection VJOfl.4L 0
O Permit Packet Available 0 Equipment Clearances 0 Vent 0 Final Inspection A’tM4 1
O Safe Access 0 Pan and Drain 0 Combustion Air ‘ñnv twjr7oM.t’X’f
Comments:M.6Z1II417a&IX g 7.2-5ermttree:g
Census 1$
y
Construction Type:Occupancy:County Tax:i7
DateBuilding07SA_—/‘/(..//Total:‘1o7 7’-
**SMOJ(E ALARMS ARE REOUIRED**
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