HomeMy WebLinkAboutAPPLICATION Vacation Home Life Safety Inspection 610 Landers StTown of Estes Park
Vacation Home Life Safety Inspection Ap
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SEP 032024
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Vacation Home Physical Address: tfllO (jWk^S- S+ E^ P^r<t Crt S^H
Owner Name: O.h^l X/ 1^!^ T^l.hAtDP^- 0^^ ^0^^ f^P^:€.S
Mailing Address: 1^?) 90 St-/' v
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(Street)(City)-h f\IE IrMi-n
(State)(Zip Code)
Email Address: iTli 0(1^(11^?^ 0 ^/T)^_/J. ^please writeleaiblv) Phone: ^^-fc^-^/17r7
^'"''^tYn ^to/TTnProperty Manager/Local Representative:
Email Address: b^S-ti WUO^. ^.01 • CP^(please write legibly) Phone: c|'70--S>c^0 "
&Number of Bedrooms (per Larimer County Assessor Data and Vacation Home License Application)
Identify Sleeping Areas other than Bedrooms (den, office, family room, etc)
Description of Work: 2015 IRC AMENDMENT Section 327 LIFE SAFETY SURVEY
I the homeowner, or Property Manager acting on behalf of the homeowner, certify the information on this application
is true and correct. I understand by signing and submitting this application, I agree to have the above property
inspected by the Building Official to ensure compliance with local ordinances, state and federal laws as well as
building codes. Additionally, I understand that I am responsible for any fees associated with this application.
Signature,
(1-fomeowner/Pfvfpe^ Manager) (
Print Name m'ind\j n»ltzjf7)p^Date:
***OFFICE USE ONLY***
Building Official:Date:
Permit Fee:
County Tax:
Total:
$200.00
$0.00
2000to^ ^3 |7D2^ C^:-^ 12^^ XfO $200.00
LSI Checklist
Initials:Date:Issue permit number: VHLS: f)-ZO-7^ EXPIRES:
Email handouts/permit number to Owner/PropMgr/Town Clerk
Inspection Scheduled (Calendar/Laserfiche/Town Clerk/CD-VHLS Database)
Inspection follow up to Owner/PropMgr/Town Clerk (via Laserfiche)
Final Inspection Scheduled (Calendar/Laserfiche/Town Clerk/CD-VHLS Database)
Results of Final Inspection entered in Laserfiche
Issue CO to Owner/PropMgr/Town Clerk/Property File
Field Approved for Certificate of Occupancy by:Date:
RETURN TO: townclerk(a)estes.orci. Town Clerk's Office, P.O. Box 1200, Estes Park, CO 80517
Updated 07/2021