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HomeMy WebLinkAboutB12-0376 APPLICATIONwSg. HE ' ,.. flT-. i;�r - Department of Community Development 0 75 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: �� I J�$ >r/ Project #. Y j D "70 9 �J !� �L.UA� iN� Oi�.'*%N/13 l QIM DRB #: QP_8ir�OQI grLJ (Number) (Street) (Suite #) nn J Building Permit #: ��X - 0 3 � Lo Building /Complex Name: % /� Contractor Information )) �� I Lot #: / Block #—L Subdivision:1113 ,• BusinessName;�H%&Lxo,4 Q, ilo,44/ 7E-•1-C f Work Class: New Addition �Aleration Business Address: /0 6 J o X 4 � $ C) City Y 'g-; [ State: 4:�010 Zip: Type of Building: Multi - Family Single - Family 0 Duplex (0 Contact Name: ��.-`��a'7 �) -�� 0 � Commercial () Other t0j Contact Phone: 9 J rQ' 3 7C � i7 Contact E -Mail: L� .iih� rp% 14 r .GO ,Work Type: Interior © Exterior ® Both is I hereby acknowledge that I have read this application, filled out in full the information required, completed an accurate plot plan, Valuation of Work Included Plans Included Work and state that all the information as required is correct. I agree to Electrical ®Yes ONo ®Yes ONo 3 0 `� 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 ( >o ®Yes ) ONo the town's zoning and subdivision codes, design review ap- proved, International Building and Residential Codes and other Plumbing @)Yes ONo MYes GNo 31) 19 OD ordinances of the Town applicabiBuilding Wes ONo JWes ONo '8 1,�) O (D0 X. Value of all work being performed: U 9, 00_0 Owner /Owner's Representative Signature (Required) (value based on 19C Section 109.3,& IRC Section 108.: Electrical Square Footage -u Applicant Information l �7, ! 7 L- Z-e Detailed Scope and Location of Work-. L fc Applicant Nam,' rr4�`Q,� 41�,Lo - t a`� �% i2 /✓ U J c_a q),,) Applicant Phone: / / 0 3 %' U 0 76 � Od t % 5 �' ott � — 4 4 (( ^ / Applicant E Mail: �- � Sf O ,S a � �/ii a/ �i�Qlt l rU Y _> L d / / U A,-) ; 0 S C� �3 _ r Project Informs 'on Owner Name: /v,VL< -R f .lAU$G,iT, /'7 r Parcel #: 2- L U .I . f _? 12- / / U 6 Y' (For Parcel #, contact Eagle Coucfij Assessors Office at (970-32M649 or visit w .eaglecounty.us / patie) For Office Use Only: Fee Paid: S .558. 25 Received From: Cash Check # CC: Visa/ MC Last 4 CC # exp date: Auth # (use additional sheet if necessary) Date Received: TOWN OF VAIL 08/16/2012 RECEIVED 12- Mar -2012