HomeMy WebLinkAbout1250 BROADVIEW RD1 /2 50 Broad view Rd i
. I omce Received Date ·26)'~ -/0 -02 Town of Estes Park copy permit Number M- /50 -/5 4r l Received By af Application for Miscellaneous ~ermit Application Expires 3,4/ /=,4 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 * www.estes.org Permit Expir~g€727&2* --Ii----- Job Address: /250 320#Op'/au 820 Owner Name: 2Flze,/ 51,4,€22£-DE-2 Phone: 970 - 6256 - 5-93' T Address: 393 Fk£6FECT~ 667-07*6 6r £5725 ~2-6 40 2 DEV-? (Street) (City) (State) (Zip Code) Contractor/Applkant·. E)•262 3kf/774 (50,usz- Town License #: /23 7 Phone: 970 -3*70 -39 72 Address: 4470 /48 y 26, 63:725, 064*6/ CD Be) Sl -7 (Street) (City) (State) (Zip Code) *Long-term Residential (230 days) O Short-term Residential (< 30 days) O Commercial PERMIT CLOSED ¤ Replace Furnace ¤ Gas Line ( I ft.) 1 U APPROVED O Replace Boiler O Replace Wind{Avs 08te - O Replace Hot Water Heater O Install Air Co,Idi*Nik--- Date - THDRADON O Minor Plumbing O Temporary Stidevt ure use- 1,0,23 hite O Minor Re]nodel Time Period r -- 0 Fireplace Insert - circle one: Gas, Wood, Pellet; R'Other €574,4-40,;»222---73*e,5;:6£--9 Description ofWork: 12.EPAt R. WATkNL DAMA€,6 nl EASE,~>tENrE - C_Dew w au- ~ i usuc..-77023 Valuation (Total Cost ofMaterial & Labor): $ ,26)00 EE 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 wei! as building codes. 1 certify that I have the property owner's authority and permission to apply for this permit. Additionally, 1 UNDERSTAND THAT I AM RESPONSIBLE FOR ANY FEES OR EXPENSES INCURRED FOR PLAN REVIEW, PERMITS, INSPECTIONS AND OTHER FEES ASSOCIATE~ WITH THIS APPLICATION, Note: The work authorized by this permit requires the building be provided with smoke alarms complying with municipal co~)6~ Signature ~~/Pl DattiO,/1/, i Print Name IP# Al 51,t & r,4 *** Office Use Only *** Inspection Checklist: ¤ Address Posted 0 Equipment Access OT&P O Smoke Detectors O Contractors Licensed O Equipment Listed O Gas Pipe p *6ugh Inspection 0 Permit Packet Avai table O Equipment Clearances O Vent Sktinal Inspection 0/f~ 1 1 - 12-2,1 O Safe Access O Pan and Drain O Combustion Air \ 1 4+ Comments: Permit Fee: u 9,25- 45 j'e~ Census # Construction Type: Occupancy: County Tax: 6.00 i Building efficial, Dote 4. _ls14+226%666/ Total: * 75.25 *)19 -10 -07_ **SMOKE ALARMS ARE REQUIRED** 13_114 2-0 gi joiol UnrveraICfmimI{125.rtmitalne\Forms\Al}DIi€hilIW&62;·1112 (fountet- 1 Page I of I Revised 5/21/2012 - CB
