HomeMy WebLinkAboutB12-0274 Building Permit Application revised.pdfTOWN OF VAIC
Project Street Address: (Number) (Street)
Building /Complex Name:
Department of Community Development
75 South Frontage Road
Vail, CO 81657
Tel: 970 - 479 -2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
(Suite #)
Contractor Information
Business Name: SC_ C,Tlis • 't"a�^'� Pi�^D
Project #:
DRB #
Building Permit*
Lot # Block # Subdivision.
Business Address 1143 �-, 1- [ S }reew� *'L(I Work Class
City kC &t-c- I State. L° zip_ Dkt.-A I
Contact Name. S rte. V" -
New ( Addition (0 Alteration (0
Type of Building:
Single - Family" Duplex 0 Multi- Family (�
Commercial (Q Other O
Contact Phone: `i"1 °' °l°l ° H 813
Contact E Mail 1 - 1' ` �s�-``1 O` LJYV%
Work Type: Interior
Exterior Both dQ
I hereby acknowledge that I have read this application, filled out
Valuation of
in full the information required, completed an accurate plot plan,
Work Included
Plans Included Work
and state that all the information as required is correct. I agree to
Electrical es ONo
Yes ()No O Om"
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according to
Mechanical (es ®)No
Yes (No L6iJ�
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other
Plumbing Yes ®jNo
Yes ONo �i2, QtiU
ordinances of the Tow cable thereto.
Building Yes ()No
es �N= (12Co8 Gro
/�
X
Value of all work being performed.
$ L ' 06
Owner /Own e r e ignature (Required)
(value based on IBC section 109.3 & IRC
Section 108.3
Electrical Square Footage
_ (- 4_V56}__ [�
Applicant Information
Applicant Name: `V-N- s I
Applicant Phone 5-) o . '326 • 3 -� 0 0
Applicant E -Mail: S SS k-w+P- • G4rV S
Project Information
Owner Name: D0 C. w.,w
Parcel #: x-10 3 t 2Z 1 son
(For Parcel #, contact Eagle County Assessors Office at (970- 328 -8640 or visit
www.eaglecounty.us/patie)
For Office Use Only:
Fee Paid:
Received From:
Cash Check #
CC: Visa / MC Last 4 CC # exp date:
Auth #
Detailed Scope and Location of Work:
T—, Nit— — ST'awr s k N V �_C F7n,r-I-'<
(+ CS 1, O erne -c-
(use additional sheet if necessary)
Date Received: