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HomeMy WebLinkAboutPERMIT 220 Davis St Boiler 2019-07-29OFF?CC Copy RccdvedDate 772_/t0!Town of Estes Park PcrmitNumberM-us3-(‘I Received By CL-k--Application for Miscellaneous Permit Application Expires I//5/j9 Department of Building Safety 170 MacGregor Avenue P.O.Box 1200 Fates Park,CO 80517 // General Information &Inspection Line (970)577_3726*FAX (970)586-0249 *svww.eslvs,stre Permit Expires 7/L //9 JobAddress:jJt’s b Pco 2osVJ Owner Name:¼/7tre + ______________ Address:¾IDLY N&gL’2 5+-era-n TY 11O I (Sti&t)(City)(State)(Zip Code) Contractor/Applicant:‘o 4-cci1JPL License #:(gsPhone:(a—(‘iS Address:q0 (O7yj2AC&S,/Lni-4-A -Uf’Co &OSI’) (Street)(Cily)(State)(Zip Code) U Long-term Residential (?30 days)El Short-term Residential (c 30 days)El Commercial o Replace Furnace El Gas Line (ft.) Boiler U Replace Windows C Replace Hot Water Heater U Install Air Conditioning O Minor Plumbing 0 Temporary Structure Use________________ U Minor Remodel Time Period _____________________________ El Fireplace Insert —circle one:Gas,Wood,Pellet;El Other Description of Work: 31f2’7 Valuation (Total Cost of Material &Labor):S (s—o certify this application is true and correct and agree to pertbrm the work described according to planaIspeciflcalions submifled.reviewed and approved,and conipty with local ordinances,state and fcdeiat laws as well as building codes.I cerliry list I have the propeny owner’s authority and permission lo apply ror tins permit,Additionally, UNDERSTAND TIIAT I AM RESPONSIBLE FOR ANY leErS OR EXPENSES INCURRED FOR PLAN REVIEW,PERMITS,INSPECTIONS AND OTHER FEES ASSOCIATED VITII [HIS APPLICATION.Now:[he work authorized by Ibis pernit requires the building he provided with smoke alarms complying with municipal codes. Signature <Dale______Prthl Na’i E_c ***Office Use Only *** Inspection Checklist: U Address Posted El Equipment Access El T &P El Smoke Detectors El Contractors Licensed 0 Equipmer.t Listed El Gas Pipe El Rough Inspection El Permit Packet Available El Equipment Clearances El Vent El Final Inspection El Safe Access El Pan and Drain El Combustion Air Comments:Permit Fee:‘2_,S.25 Census #Construction ‘Fype:I Occupancy: j 2 .Boildinal_Date / Coun Tax: Total: 7 **S14OKE ALARMS ARE REQUIREO I JUL 2 2019 WScrvcraomns dev\ltuilding\Forms-Applicaiiotwt)ser the Counter Page I of I Revised 3/29/2012 —CF