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APPLICATION WILL NOT BE ACCEPTED IF INCOMPLETE OR UNSIGNED
Project #:
Building Permit #:
l Electrical Permit #:
970-479-2149 (Inspections)
TOWN OF VAIL ELECTRICAL PERMIT APPLICA
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1 81857
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Parcel # (
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Job Name:
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�� Job Address. a ��
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Legal Descri
Block: F�Iing:
Subdivision:
Own Name
Address:
Phone: r33 _
Engineer:
Address:
Phone:
Detailed descr
'
ption of work:
0& c V � - -C
Work Class:
New () Addition ( ) Remodel ( )
Repair Temp Power ( ) Other ( )
Work Type:
Interior ( ) Exterior Both ( )
:] Do:; an EHU exist at this location: Yes ( ) No ( )
Type of Bldg.:
Single-family ( ) Duplex ( ) Multi- family (
j Commercial ( ) Restaurant ( ) Other ( )
No. of Existinc
Dwelling Units in this building:
No. of Accommodation Units in this building:
Is this 22rmi
for a hot tub: Yes No
Does a Fire Al trm Exist: Yes( ) No ( Y
Does a Fire Sprinkler System Exist: Yes( ) No
SQ. FEET FOR NEW BUILDS and VALUATIONS FOR ALL OTHERS (Labor & Materials)
AMOUNT OF SO -FT IN STRUCTURE:
ELECTRICAL VALUATION: $
CONTRACTOR INFORMATION':
Electrical Contractor: Town of Vail Reg. No.: Contact and Phone #'s:
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371 K4 3tcalf Road
P0 Box 1620
Avon, o 81620 WAGNER ELECTR
970-9j.9-6161
Fax 00-949-4339
Fax
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Fax Pages:
Ph* e: Date: l �.
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