HomeMy WebLinkAboutB12-0497 expired�
� ,,
��
���,11�J 0F UAi1. '
Department of Community Development
75 South Frontage Road
Vail, CO 81657
,� Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
BUILfliiVG PERMIT APPLICAiION
(Separate apolications are required for alarm & sprinkler)
Yrojec Street Address: Project #: - (�
i g�� �S/1�-�.1S-�L��K- � DRB #: � (� - —
�; (Num r) (Street) (Suite #) (�
/�f Building Permit #: � lo� fJ� i�
; Building/Compiex Name: /C LD
n Contractor Information Lot #: Block # Subdivision:
` Business Name: /i �^ ���5 7�2 tX'_TI(�,� ---____ ___ ____.__ .�____-_--_ _ __ _.__________
', Business Address:
�5 yD ��t/ S% Work Class New ( ) Addition ( ) Alteration ( ,Y )
�ea�m..��. � ,�. �_____ . e. �_.. _ ,. _ n. we__d_n. ..��_._ .... . _�.r.._� ., .__.._...
�! City ���,����Ub,� State: _� Zip: '�z��.�_�� i Type of Building: j
,y� 1 Single-Family (,� ) Duplex ( ) Multi-Family ( ) `
Contact Name: // //4 �� i/g � �I�/ ; ;
r- ; Commercial ( ) Other ( ) �
i Contact Phone: � � � '- � � `��� 3 = - - ---- :- _ __ --- �
.,_.._ _..J
� �* ; Work Type: Interior (x) Exterior ( ) Both ( ) �
Contact E-Mail: %%'J / / i�3�3��� G,tyl��� ,( ��+y„ �
-� , ��� _�_.�_..___..._._.________ ..-__� E
__ _ ____ __ -_ _.... __ .. _
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
ordinances and state laws, and to build this structure according to
the town's zoning and subdivision codes, design review ap-
proved, Intemational Building and Residential Codes and other
ordinances of the Town applicable thereto.
X
Owner/Owner's Representative Signature (Required)
es
Mechanical ( )Yes ,(-�t�l� ( )Yes ( )No
v � �
Plumbing ✓t�e�s ( )No ( )Yes ( )No ._��_
Building es ( )No ( )Yes ( )No �
.__.�_..�..__C'<� _-_______.___.__�__.._..______..________��__
Value of all work being performed: $ �
�value based on IBC Section 109.3 8 IRC Section 108.3�
Electrical Square Footage
; Applicant Information � Detailed Scope and Location of Work: J�� /n���)��f-
/� f
; Applicant Name: f//�� //� �!'Z�V !��' I�L,q-C� � �[ST//i�� �J /3 �
Applicant Phone: ��_�C( —q ��� � ' s V/��Ol.�19� S
/�� , p
i Applicant E-Mail: /%%/QJ%�/�/g ���/h/4iL � `-C7i!'� �_ ��Lf� �b lL /l� �r (� �%i(ZLu� �
I /—
Project Information� � � �i�/U � �7��2�5
Owner Name: %1'�i �1,iZ 1a
-�' Parcel #: Z. � ��y � f��� �
;(For Parcel #, contact Eagle County Assessors O� e at (970-328-8640 or visit
` www.eaglecounty.uslpatie) ��
_ ___ . .. __... _ . _ _ . ___ _ ... __.. _ _ . . . ._ _ _ ...' (use additional sheet if necessa )
For Office Use Only:
Fee Paid:
Received From:
Cash Check #
CC: Visa / MC Last 4 CC #
Auth #
exp date:
ry
__ __ __ __ _ __
Date Received: n � � C� � � �
��)
SEP 21 zU1Z
�
TOWN OF VAIL
*******************************************�************************************�**********+
TOWN OF VAIL, COLORADOCopy Reprinted on 01-03-2013 at 13:50:19 Ol/03/2013
Statement
**************+******************************************************+**********************
Statement Number: R130000003 Amount: $57.86 Ol/03/201301:50 PM
Payment Method:Credit Crd Init: DR
Notation: VISA MATT
GIBSON
---------------------------------------------------------------
Permit No: B12-0497 Type: COMBINATION BLDG PERMIT
Parcel No: 2103-143-1500-1
Site Address: 2883 KINNICKINNICK RD VAIL
Location: TIMBER CREEK LODGE [7NIT A-1
Total Fees: $166.11
This Payment: $57.86 Total ALL Pmts: $57.86
Balance: $108.25
*********************************+**********************************************************
ACCOUNT ITEM LIST:
Account Code
--------------------
PF 00100003112300
Description Current Pmts
------------------------------ ------------
PLAN CHECK FEES 57.86
------------------------------------------------------------------
TOWN OF UAIL GOM DEU
75 S FRONTA6E RD.
V�IL� CO 81657
979-479-2324
TERMINAL I.D.� 2002
FIERCHRNT k:
UISA
�t�tt��tt��t9338t
MAIL ORDER
8A1CH; 800633 INU:00�002
pUTH:003465
JpN 03a 13 13:43
TOTAL �57.86
CUSTOI�R COP4
r, j
�- �'�� ��- -� ���
�