HomeMy WebLinkAboutpitkin.eh.264501300003 (1987) (Fireplace Registration)ASPEN*PITKIN
ENVIRONMENTAL HEALTH DEPARTMENT
Permit # 000(7 —7 1
WOODBURNING DEVICE PERMIT APPLICATION
OWNER NAME , �'yJ �Iw �� OWNER PHONE # (H)
(0)
OWNER PALLING ADDRESS
Igo 7c G9 ( SQA (E C I
(Street or Box) (city) (zip)
A . ,N . 1 If1
JOB ADDRESS _ Btu
PARCEL ID # 2'6 qS_
LEGAL DESCRIPTION N
• 6 o —0
t, e- . , I
ARCHITECT NAME AND ADDRESS
CONTRACTOR NAME AND ADDRESS
IS THIS APPLICATION PART OF A VARIANCE?
Variance Name
IS THIS A: 1' DUPLEX,
SINGLE FAMILY HOPE,
(CIRCLE ONE)
IS THIS A: (REMODEL�OR NEW CONSTRUCTION?
DESCRIBE; DEVICES YOU WA T 0 INSTALL
f an ) (� e,I",JT cw.fl l� �c
(\J
MULTI -FAMILY, OR OTHER?
(CIRCLE ONE)
ing make d model
numbers, i y r J --
LIST LOCATIONS) OF DEVICES
LIST OTHER FIREPLACES AND STOVES (TYPE AND TOTAL NUMBER) IN
BUILDING BESIDES ONE(S) TO BE INSTALLED N�-+�a
(o
WILL GAS LOGS BE INSTALLED IN ANY OF THESE DEVICES? �
PQvA Date l ( 7
Application Received by a�iv, Date /(-� �-r
Application Approved by
NOTE: This 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, moving, or alteration of
any woodburning device. The permit is also 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 whether specified herein or not.
Signature of Owner or Authorized Agent
Title
130 South Galena Street Aspen, Colorado 81611 303/925-2020