HomeMy WebLinkAboutB12-0173 withdrawn 07:" ilk Department of Community Development
75 South Frontage Road
TOWN OF VAIL ;: van, co s1s57
kill Tel: 970 - 479 -2128
' www.vailgov.com
Deve Review Coordinator
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t Project #:
- ��►1�sT D� � �� J L - O ZZ t-
Project St reet Address: ,
(77S DRB #:
(Number) (Street) (Suite #) 151 20 r CO/117 ' c t l � Building Permit #:
Building /Complex Name: P l,
Contractor Information Lot #: Block # Subdivision:
Business Name: __ 1_ r u _1;
Work Class: New ( ) Addition ( ) Alteration ( )
Business Address: (BSI e....c:29 _ ''}- - 4
City - Toa -1 _ State: (..-C2 Zip: eZ20.. 17-_ Type of Building: '
Single - Family ( ) Duplex ( ) Multi - Family ( )
Contact Name: 4/,_5773 //7777/ cam- Commercial ( ) Other ( )
3 - 8233 - - — - --
Contact Phone: � -- - -- - - - - -- --
Work Type: Interior ( ) Exterior ( ) Both ( )
Contact E -Mail: / ,77 /GVr
E- CL, 5 't« , Le_a✓/-7 Valuation of
I hereby acknowledge that I have read this application, filled out Work Included Plans Included Work
in full the information required, completed an accurate plot plan,
and state that all the information as required is correct. I agree to Electrical ( )Yes ( )No ( )Yes ( )No
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical ( )Yes ( )No ( )Yes ( )No
the town's zoning and subdivision codes, design review ap-
proved,
International Building and Residential Codes and other Plumbing ( )Yes ( )No ( )Yes ( )No 7c
ordinances of the n ap•licable thereto.
Building ( )Yes ( )No ( )Yes ( )No
X � 05//4 � / Value of all work being performed: $
Owner /Owner's Representative Signature (Required)
(value based on IBC Section 109.3 & IRC Section 108.3)
Electrical Square Footage
Applicant Information Detailed Scope and Location of Work:
S
Applicant Name: V--- L ✓ALICC Lc70
Applicant Phone: l
Applicant E -Mail: 5ATA,1/4_' Q l at..) 0
Project Information U I 1 — (/)71" /A-) L `"
Owner Name:
Parcel #: 2_(0 1 ^ DC 2 -- O 00) - Go
(For Parcel #, contact Eagle County Assessors Office at (970- 328 -8640 or visit —
www.eaglecounty.us /patie) E C L� V
(use additional sheet if n • a •
For Office Use Only: Date Received: MAY 0 7 2012
Fee Paid: iii
Received From:
Cash Check # TOWN OF VAIL , i
CC: Visa / MC Last 4 CC # exp date:
Auth #
15- Mar -2012