HomeMy WebLinkAboutPERMIT 261 Courtney Ln Fireplace 2018-03-07c\.Q:‘,
ReceitdDa(e’k’f7 Town of Estes Park Number M-LT7H (t
ReceivedBy jLJ Application for lVliscellaneous Permit Application Expires c7_I
Department of Building Safety 170 MacGregor Avenue P.O.Box 1200 Estes Park,CO 80517 ?..7 IInformation(970)577-3726 *Inspection Line (970)577-3731 *FAX (970)586-0249 *www.estes.org Permit Expires
____________
Job Address:Z’t O&t’r4ity t-a445(
Owner Name:E’rba’wt ,41c_V f-F-Phone:3c€—¶S’t .—&9’I
Address:L.t COj(’tk(5€L//-‘4 eeies 13-cV
(Street)(City)(State)(Zip Code)
Contractor/Applicant:dk(fr-j1%(Wki4 jjestt.Aitt 1k Town License #:31 Phone:3JZZ’iZt5L
Address:l’r’?’40 Ø\4/LLJ G’-LJ-i td CC)s-&t 2r)
-(Street)(City)(State)(Zip Code)
gLong-term Residential (30 days)U Short-term Residential (<30 days)C Commercial
C Replace Furnace C Gas Line (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
___________________________
-‘,aEieplace Insert —circle one:Gas,Pellet;C Other
Description of Work::vu4 L(NeGi &P4 woc4 VtSCr4 Stte iC il-ltD -ca4
.ry .4Dut p/act.
Valuation (Total Cost of Material &Labor):$/Sc..c 0Z)
I certii this application is true and correct and agree to perform the 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 certify that I have the property owner’s authority and permission to apply for this permit.Additionally,I
UNDERSTAND THAT I AM RESPONSIBLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW,PERMITS,INSPECTIONS AND OTHER
FEES ASSOCIATED WITH THIS APPLICATION.Note:The work authorized by this permit requires the building be provided with smoke alarms complying
with municipal codes.
/?/Ib.,Name
Lest 1N r‘***Office Use Oniy
Inspection Checklist:
C Address Posted El Equipment Access El T &P El Smoke Detectors
C Contractors Licensed El Equipment Listed C Gas Pipe El Rough Inspection
El Permit Packet Available C Equipment Clearances C Vent C Final Inspection
El Safe Access C Pan and Drain El Combustion Air
Comments:
Permit Fee:64-o
Census #Construction Type:Occupancy:
County Tax:
Buildin c42&1/JJ6-Date S-7-/t Total:6s.12-
V
I MR 07 218
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U:\Building Division\Forms-Logs\Apps_PecmitsJRCMisMisc.etlaneous\MiscelIaneous 2012.03,29.doc