HomeMy WebLinkAboutPERMIT 875 Crabapple Ln Leaking Pipe 2015-04-07Office
Received Date 1a 7 Town of Estes Park COPY Permit Number M- 1Yadr7 5
Received By c<re Application for Miscellaneous Permit Application Expires /O/4/49/5'
Department of Building Safety 170 MacGregor Avenue P.O. Box 1200 Estes Park, CO 80517
General Information & Inspection Line (970) 577-3726 * FAX (970) 586-0249 *11%%N%.esies.org Permit Expires 7A/2a5.---
Job Address3. 7 5 ett.,10 0,pp it_ ic(4A-c,
7 0 - 1 / 0 -6s Owner Name: tia.,In C.-e_ .731-c,(..) Ir's, Phone: '7 c7 ,
Address: / 6.G 4 JS 4-, r-t_. S-4- 6,-4-1 ;c..Pe? 11-k 7,1%5—
(eifeet) (City) (State) (Zip Code)
/ ii-S Contractor/Applicant: A rAs Iric... )ice 6 ie6 Fack ntlivi.rFown License #: c./.2t- Phone: 070--S(66-34K
Address: ic.v. 4 Sb-T-11.00-?‘"," /Lk__ z6.1,-s Pkrif... Co '0 5-1-7-
(Street) (City) (State) (Zip Code)
EI Long-term Residential (..?. 30 days) Short-term Residential (< 30 days) 0 Commercial
• Replace Furnace • Gas Line ( ft.)
13 Replace Boiler a Replace Windows
• Replace Hot Water Heater • Install Air Conditioning
p..Minor Plumbing LI Temporary Structure Use
• Minor Remodel Time Period
• Fireplace Insert — circle one: Gas, Wood, Pellet; • Other
Description of Work:
q)2-iCi Cs- ie CJ.C4 7. pc.
Valuation (Total Cost of Material & La r)- $ 60
113 '------
I certify 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.
VW 5.-- , 571-e Signature- Date Print Name /1-/-/C ---/t
*** Office Use Only ***
Inspection Checklist:
0 Address Posted 0 Equipment Access 0 T & P 0 Smoke Detectors
0 Contractors Licensed 0 Equipment Listed 0 Gas Pipe Dough Inspection 1 /
El Permit Packet Available 0 Equipment Clearances 0 Vent inal Inspection 6T--;11 ,1(,)
0 Safe Access 0 Pan and Drain 0 Combustion Air /.4) Std (ACC/4
Comments: Permit Fee: .2 5 . 50
Census # Construction Type: Occupancy:
County Tax: 0.45
Building Offi ' . Date
Total : Alt 23.95 air
a
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** ARE REQUIRED**
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