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HomeMy WebLinkAboutPERMIT 435 Columbine Ave Furnace 2008-11-0348/30/2088 02:37 9705883190 MT VALLEY PAGE Di Received bate ______ Town of Estes Park Permit Number M 2 Recchvslsy Application for Miscellaneous Permit ApplltlonEPiresS3i,2S Department of Building Safely 170 MacGregor Avenue P.O.Box 1200 Estee Park,CO 80517 1 General Intorniation &Inspection LIne (970)577-3731 •FAX (970)586O249*www.estesnet.com Permit Ecplres 0 JobAddress:43 %u...-LTjjço OwnerName:f.%w P. Address:y A (‘c) (Stroct)(.ily)(Stare (Zip Code) Contractor/Applicant:dy /4M1J;s7.town License #: Address:?64’C Co ___ (Street)(City)(Stale)(Zip Code)_ U Long-term ResIdential (30 days)l-51i&t-term Residential (<30 days)‘C Comrnercal Furnace U Gas Line (ft.) U Replace Boiler C Replace Vindows o Replace Hot Water Heater C Install Air Conditioning O Minor Plumbing U Temporary Structure Use________________ O Minor Remodel Time Period ___________________________ o Fireplace Insert —circle one:Gas,Wood.Pellet;C Other Description of Work;t1 Valuation (Total Cost of Material &Labor):$SYoS &C’ I certify Iltie 4ppliutiotI i true and correct ard ogroc to perform the work described accordinB to plan1speciticiorions submitted,reviewed and approved,arid comply with local ordinances,state and fedetat laws as well as buildiii codee,I certify that I bow the property owner’,authority md permission to apply for this peniiiL Additionally, UNDERS’EAND’FHAI I A RECFOMIBLE FOR ANY rEjS OR EXPENSES INCURRED FOR PLAN REVIEW,PERMITS,INSPECTIONS ANT)OTHER FEES ASSOCIATED W1T14 THIS APPLICATION,Note:The work authorized by this permit requires the building ho provided with smoke alarms complying with municipal codel. Signature /7€tT paw /qAØ Print Name ______________________ ***Office Use Only *** Inspection Checklist: Address Posted C Equipment Access C T &F C Smoke Detectors C Contractors Liccnsed C Equipment Listed C Gas Pipc C Rough Inspection U Permit Packet Available C Eqiiipttient Clearances C Vent C Final Inspection C Safe Access C Pan sad Drain C Combustion Air Commen Permit Fee:a Z S Censats I Construction Typo:OccupaDevi ,County Tax: Tot fl t.to **SMOKE ALARMS ARE REOU1RED** \\5ervem\çpnmi_dev\fiuj(jygoj\nntjcatj\ç the Counter Page I Revise4 71142006.CO