HomeMy WebLinkAboutB12-0309 APPLICATIONDepartment of Community Development
0 76 South Frontage Road
TOWN OF VAIL' Vail, CO 81657
Tel: 970 -479 -2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
Project Street Address:
(Number) (Street) (Suite #)
Building /Complex Name: F/rZ; 5 � %` +
Contractor Information
Business Name:
Business Address:
Project #:
DRB #:
Building Permit #:
Lot #: Block # Subdivision:
Work Class: New a Addition (o Alteration (
City State: Zip: Type of Building:
/ Single- Family i0 Duplex 0 Multi - Family
Contact Name: I,c� ILf , r�J'lYl 'c eG� Commercial 0 Other
Contact Phone: 47 9 d 2
Contact E -Mail: L J,_�1/a 1'4 +'Gh1 -4(4 , cepu_
Work Type: Interior 0 Exterior 0 Both
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 Yes �)No yes
Qf
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 t�, Yes k^)No Yes
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other
Plumbing Yes 0No Yes
al No
ordinances of the Town applicable thereto.
Building 1QYes ONo OYes
ONo
X
Value of all work being performed:
$ in 0
Owner /Owner's Representative Signature (Required)
(value based on IBC Section 109.3 & IRC Section 108.3)
Electrical Square FootageaC
-�
Applicant Information
Detailed Scope and Location of Work:
R
1 /
Applicant Name: 75—,,,, j
Applicant Phone: 4
Applicant E -Mail: %I/ I �� V�tr f�ft?�I •' Cc
Project Information
Owner Name: T +--a�J6F -_ UA _
Parcel #:21,01 - C:Fl 0/ — nl Z
(For Parcel #, contact Eagle County Assessors Office at (970328.8640 or visit
www.eaglecounty.us/patio)
For Office Use Only:
Fee Paid:
Received From:
Cash Check #
CC: Visa / MC Last 4 CC # exp date:
Auth #
(use additional sheet if necessary)
Date Received: