HomeMy WebLinkAboutB11-0167 voidProject Street Address: �\
(Number) (Street) (Suite #)
Project #: My `n- -n(.
DRB #:
Building/Complex Name:
B Q� �vvJ
Building Permit #: — O� �O
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Lot #: Block # Subdivision:
Contractor Information
Business Name:
Work Class: New ( ) Addition ( ) Alteration
Business Address: -,,c Cam°
Type of Building:
City State: C Zip: VU_ 'Z �
Single - Family 6eT Duplex( ) Multi - Family ( )
Commercial ( ) Other( )
Contact Name:
Work Type: Interior ( ) Exterior (1) Both ( )
Contact Phone:
Contact E -Mail: %2
Valuation of
Work Included Plans Included Work
Contractor Registration Number:
Electrical ( )Yes ( )No ( )Yes ( )No
X
Mechanical ( vJYes ( )No (r/�Yes ( )No b 4!%eCL
Plumbin Yes No Yes No
g ( ) ( ) ( )Yes )
Building ( )Yes ( )No ( )Yes ( )No
Owner wner's Represent ve =Reuired) q
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Project Information
Owner Name: 1 ;i;�o,t` 3>.41r-� e
�,
Parcel #: '�f1� L � ti? , I Vpo 1
(For Parcel #, contact Eagle County Assessors Office at (970- 328 -8640 or visit
Value of all work being performed: $ �I�C
(value based on IBC Section 109.3 & IRC Section 108.3)
www.eaglecounty.ustpatie)
_
Electrical Square Footage
Detailed Scope and Location of Work: I k C 5
(use additional sheet if necessary)
For Office Use Only:
Fee Paid:
Date Received:
�� v
JUN 0 7 2011
Received From:
Cash Check #
CC: Visa / MC Last 4 CC # exp date:
TOWN OF VAIL
Auth #
O1- Jan -11