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HomeMy WebLinkAboutB12-0374 APPLICATION�M L�cti PIPPIN i M%Z OVER:�'�",�� ;kt.r TOWN OF VAII ` Department of Community Development 75 South Frontage Road Vail, CO 81657 Tel: 970 -479 -2128 www.valigov.com Development Review Coordinator BUILDING PERMIT APPLICATION (Separate applications are required for alarm & sprinkler) Project Street Address: Project #: (Number) (Street" ) (Suite #) Building Permit #: ��d 37 — ' Building /Complex Name: //�� Contractor Information Lot #: 7 Block #_1L Subdivision:,[✓ 1 Business Namei"lc -s Business f7x, $ Work Class: New ( Addition 0 Alteration (0, \sl Address: City State: 4016 Zip: Type of Building: �� ► Ti" S 0 Single- Family 0 Duplex 0 Multi - Family (Oj Contact Name: Commercial 0 Other Contact Phone: 9 7 Q 3 7 4 U 7 Contact E -Mail: p^a � ,Work Type: Interior © Exterior () Both I* 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 comply with the information and plot plan, to comply with all Town Electrical ®Yes �No ®Yes oNo as �� ordinances and state laws, and to build this structure according to Mechanical Wes �)No Yes }� QNo 1 q ' 1 olo the town's zoning and subdivision codes, design review ap- proved, international Building and Residential Codes and other Plumbing eyes ONo eyes ; -- 0Nc 231 100 ordinances of the Town applicable thereto. Building Wes No JWes ()No. ®�Q X . Value of all work being performed: $ (05 1) DDC) Owner /Owner's Representative Signature (Required) (value based on 113C Section 109.3,& IRC Secion 108.3) Electrical Square Footage Applicant Information , Detailed Scope and Location of Work: /!o / Applicant Name /hJS40 6,�h*0047_7 L Le-- � td� ,`� � �tR /✓ (� (__�1 �3 �� Applicant Phone: 170 0 0 7 76 fOp ApplicantE- Mail: TT Project Informapon e° 1 Owner Name: /f0 hi-A AT 71R 11$G 1T,C ' Parcel #: 2– / 0 I./ '..' Z I / U 6 T (For Parcel #, contact Eagle county Assessors Office at (970 - 328640 or visit w .eaglecounty.uslpatie) For Pal Use do Fee Pai Received From: Cash Check # CC: Visa/ MC Last 4 CC # exp date: Auth # (use additional sheet if necessary) Date Received: 0�) TOWN OF VAIL 08/16/2012 RECEIVED 12- Mar-2012