HomeMy WebLinkAboutPERMIT 241 Courtney Ln Water Heater 2019-05-20Receit/edDate Town of Estes Park rermitNuniberM-Ic3i9
Receikedliy (,Application for Miscellaneous Permit Application Expires
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epartrnent ot Building Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,CO 80517
General Information &Inspection Line (970)577-3726 *FAX (970)586-0249 *www.estes.oru Permit Expires g
Job Address:9 g ccrbtQej t
OwnerName:Lgvn tL VOl Phone:Q3 ‘75 —?c)
Address:5p /11jL>1 &14?(Vt •_2)‘79Y
(Street)3 (City)(State)(Zip Code)
Contractor/Applicant:L-Vi_Cv*c.et ed”Town License #:139 Phone:-Q1)
Address:13 O ii [c Rfrt Co 3oWz’
(Sircet)(City)(State)(Zip Coae)
U Long-term Residential (30 days)U Short-term Residential (<30 days)C Commercial
o Replace Furnace Qfas Line (-?ft.)
Q,Replace Boiler U Replace Windows
1Replace Hot Water Heater C Install Air Conditioning
o Minor Plumbing 0 Temporary Structure Use________________
o Minor Remodel Time Period
________________________
o Fireplace Insert —circle one:Gas,Wood,Pellet;C Other
Description of Work:QAJ9 Qt 4a?-J /e 5 Li_LL4-.V ttJt_f
-Q&)r&ay4e%
Valuation (Total Cost of Material &Labor):$
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I certil’tins application is tme and correct and agree to pcrfornlthe 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 certilSt that I have the property owner’s authority and pemlission lo apply for this permit.Additionally,I
UNDERSTAND THAT I AM HESPONSIRLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW,PERMITS,INSPECTIONS AND OThER
FEES ASSOCIATE ITFI THIS APPLICATION.Note:The work authorized by this permit relluires the building be provided with smoke 3larms complying
with municipal cod J
/
Signamre I Date ‘‘10 /%rinc Name €5
***Office Use Only ***
hspection Checklist:
C Address Posted C Equipment Access U T &P U Smoke Detectors
U Contractors Licensed U Equipment Listed U Gas Pipe U Rough Inspection
U Permit Packet Available C Equipment Clearances U Vent U Final Inspection
U Safe Access U Pan and Drain U Combustion Air
Comments:Permit Fee:t f//75
Census #Construction Type:Occupancy:
County Tax:19BuildingOffijL4DateTotal:12-9
V**5(j ALARMS ARE REOUIREIY.&n !
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