HomeMy WebLinkAboutPERMIT 261 Courtney Ln Gas Line 2018-01-22Received Date
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Town of Estes Park C Permit Number M_______
Received By Jci”J Application for Miscellaneous Permit Application Expires 7 114
Department of Building Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,CO 80517
7Information(970)577-3726 *Inspection Line (970)577-3731 *FAX (970)586-0249 *www.estes.org Permit Expires
____________
Job Address:‘W ‘fn ‘//t;n ,°
OwnerName:/)L ,,7ç,C Phone:-cc 7-?OIV
Address:
(Street)(City)(State)(Zip Code)
Contractor/Applicant:52A,4 /7%M 1.O C Town License #1°/5/Phone:’-1i’.&-7
Address:7’)J7J L1h J ,
(Street)(COy)(State)(Zip Code)
C Long-term Residential (30 days)C Short-term Residential (<30 days)C Commercial
C Replace Furnace áGas Line (7J ‘ft.)
C Replace Boiler C Replace Windows
C Replace Hot Water Heater C Install Air Conditioning
C Minor Plumbing C Temporary Structure Use________________
C Minor Remodel Time Period
___________________________
C Fireplace Insert —circle one:Gas,Wood,Pellet;C Other
DescriptionofWork:fi7’/-1-.r j,
ft.v i Llr u’A,>
Valuation (Total Cost of Material &Labor):$,,7))
I certify this application is true and correct and agree to pertbrm the work described according to plans/specifications submitted,reviewed and approved,and comply with
lDcaJ ordinances,slate and federal laws as ell as building codes.]certify that I have the property owners authority and permission to apply for this permit.Additionally,IUNDERSTANDTHATIAMRESPONSIBLEFORANYFEESOREXPENSESINCURREDFORPLANREVIEW,PERMITS,INSPECTIONS AND OTHER
FEES ASSOCIATED WITH THIS APLICATtON.Note:The work authorized by this permit requires the building be provided with smoke alarms complying
with municipal codes./
Siature z Date 2 2 Pnl Name /f -I
***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 Airf j.•,cC
Comments:
Permit Fee:2-9.ca
Census #Construction Type:Occupancy:
County Tax:(
Date
St,tB/Total:&f 5/57_s
vfrII
jAN 2 3 2U18
BY
U:\Building Division\Fomis-Logs\AppsPermits_IRQMIsC\Miscdllaneous\Mtscetlaneous 20120329.doc
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