HomeMy WebLinkAboutpitkin.eh.264334100002 (1988) (Fireplace Registration)ASPEN*PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
WOODBURNING DEVICE PERMIT APPLICATION
OWNER NAME - -UAN ���N\ C�� OWNER PHONE # (H) �Z - `����
//,, (0)
OWNER MAILING ADDRESS ��` V V LX)A�`�` ~z•
(Street or Box) (Ci y) (Zip)
JOB ADDRESS Z ZZZ
LEGAL IjE"Saii IONIJ
Parcel ID #
�r
(for officeuse only)
ARCHITECT NAME AND ADDRESS aokc)
CONTRACTOR NAME AND ADDRESS
IS THIS APPLICATION PART OF A VARIANCE?�
Variance Name
USE CLASSIFICATION•
Single Family Home,_ Duplex Multi -family Other
Remodel New Construction k_
DESQRIBE_ pEVICE.%,TO BE. INSTALLED (Jsticlu
IST WHi E DEVICES WILL BE LOCATED IN BUILDING\
r )
Co
LIST FIREPLACES AND STOVES (type and tota]) numbrer) I BUILDING,
OTHER THANA DEVICES i TO ,BE INSTaLED I-y�Q D CI c�C
WILL GAS LOGS BE INSTALLED IN ANY OF THESE DEVICES? .-7 Tri
NOTE: This permit application is to determine compliance with
applicable woodburning regulations only. Approval indicates that
the installation as described above by the applicant complies
with City and/or County woodburning regulations. A Building
Permit is also needed for installation, relocation, or alteration
of any woodburning device. This permit application is subject to
the following conditions:
I hereby certify 'that I have read and examined this application
and know the same to be true and correct. All provisions of laws
and ordinances governing woodburning devices will be complied
'th whether specified h,ein or not.
Signature of Owner or Authorized Agent Title
Environmental Health Dept. Approval Date
Original:Health Dept. Blue:Building Dept. Green:Applicant
130 South Galena Street Aspen, Colorado 81611 303/925-2020
ASPEN*PITKIN 0
ENVIRONMENTAL HEALTH DEPARTMENT
WOODBURNING DEVICE PERMIT APPLICATION
OWNER NAMEeOWNER PHONE # (H)1-
OWNER MAILING ADDRESS
JOB ADDRESS
LEGAL DESCRIPTION
Parcel ID
(0) P-0��
(Street or Box) (City) J _ ( Zip)
(f or
ice use only)
ARCHITECT NAME AND ADDRESS � �i- x� U ''C'A 1C -%4u' &'Ceazy
CONTRACTOR NAME AND ADDRESS
IS THIS APPLICATION PART OF A VARIANCE?
Variance Name
USE CLASSIFICATION:
Single Family Home2 Duplex
Remodel
DESCRIBE DEVICES TO.BE IN
Vt
Multi -family Other
New Construction L---1
(include make and model numbers)
LIST WHERE DEVICES WILL BE LOCATED IN BUILDING
LIST FIREPLACES AND STOVES (type and tgtal number) IN BUILDING,/
OTHER THAN VICES TO BES INSTALLED r P[ / Y1 O
A-) -4 7 1-'.. i'7 /t_4 \.J d do -
WILL GAS LOGS BE INSTALLED IN ANY OF THESE DEVICES? '�Xs
kA -
NOTE: This permit application is to determine compliance with
applicable woodburning regulations only. Approval indicates that
the installation as described above by the applicant complies
with City and/or County woodburning regulations. A Building
Permit is also needed for installation, relocation, or alteration
of any woodburning device. This permit application is subject to
the following conditions:
I hereby certify that I have read and examined this application
and know the same to be true and correct. All provisions of laws
and ordinances governing woodburning devices will be complied
with nether s ifed erein or not.
Signature of Owner or Authorized Agent Title
Environmental Health Dept. Approval Dake
Original:Health Dept.
B1ue:Building Dept. Gxeen:Applicant
130 South Galena Street Aspen, Colorado 81611 303/925-2020
Applicant Name _
Property Owner _
Property Address
Schedule Number From Maiking
Type of Structure:
el
L. Single Family Home Duplex Townhouse
Commercial/Office Vacant Lot
Number of fireplaces?
Number of gas log fireplaces?
Number of fireplace inserts? 222ki,4
Type? Catalyst? _
Number of woodstoves?
Type? Catalyst?
Number of coal burning devices?
Number of gas fireplace appliances?
Your signature
Please fold inside out, seal and return both portions
of this postcard as soon as possible. Thank you.
Oir records show we have not
yeL received a fireplace
registration form from you for
the property listed on the
front of this postcard.
Perhaps there has been a
change of ownership, or
perhaps you own more than one
piece of property and we did
not receive a form for each.
To help you determine which
property this form refers to,
please check the legal
description on the front of
this postcard.
Even if this property is
an office or a vacant lot, or
has no woodstove or fireplace,
this form must be returned.
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Aspen
Environmental Health Dept.
130 S. Galena
Aspen, CO 81611
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