HomeMy WebLinkAboutAPPLICATION Vacation Home Life Safety Inspection 301 Kiowa Dr 2024-08-19"RECEIVED
Town of Estes Park
Vacation Home Life Safety Inspection A^plicatlbrf 9 ?oz4
Vacation Home Physical Address: ^O/ !<l^lJ/t QfZ ^<^ -^^ CQ SC)5~/7
Owner Name: \'^r'\<^r\ ^?\
Mailing Address: ^C0\ ^ ^I^SB^C^ T^{? AfO^Y. J~/l
(Street L (City)t (State)
S-QD-^}
(Zip Code)
Email Addressjv i^A C\ } HcftC 67^"9 ^ ^/l^/l < 60,0^ fDtease write leaiblv) Phone.$7^~ 6^ (330($
Property Manager/Local Representative: _/0/'IV^^ I Y^Trf\<^/^
Email Address: <^-^^£^^J^^^<^ ^^ ^(t)]/V\ (please write legibly) Phone:<^^ ^/^ ~7/(r//<7
Number of Bedrooms (per Larimer County Assessor Data and Vacation Home License Application) <
_dA_Identify Sleeping Areas other than Bedrooms (den, office, family room, etc)
Description of Work: 2015 IRC AMENDMENT Section 327 LIFE SAFETY SURVEY
I the homeowner, or Property Manager acting on behalf of the homeowner, certify the information on this application
is true and correct. I understand by signing and submitting this application, I agree to have the above property
inspected by the Building Official to ensure compliance with local ordinances, state and federal laws as well as
building codes. Additionally, I understand that I am responsible for any fees associated with this application.
. Print Name ^//\J ^Af^ pate: ^,161rrSignature:(?f/
***OFFICE USE ONLY***
Building Official:Date:
Permit Fee:
County Tax:
Total:pl-PQD^n\W7A^\^[{^o
$200.00
$0.00
$200.00
LSI Checklist
Initials:Date:Issue permit number: VHLS: Q^- TJL\ EXPIRES:
Email handouts/permit number to Owner/PropMgr/Town Clerk
Inspection Scheduled (Catendar/Laserfiche/Town Clerk/CD-VHLS Database)
Inspection follow up to Owner/PropMgr/Town Clerk (via Laserfiche)
Final Inspection Scheduled (Calendar/Laserfiche/Town Clerk/CD-VHLS Database)
Results of Final Inspection entered in Laserfiche
Issue CO to Owner/PropMgr/Town Clerk/Property File
Field Approved for Certificate of Occupancy by:Date:
RETURN TO: townclerk^estes.org, Town Clerk's Office, P.O. Box 1200, Estes Park, CO 80517
Updated 07/2021