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DRB110260 Plans
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HomeMy WebLinkAboutD13-0003 APPLICATION.pdf Department of Community Development
75 South Frontage Road
TOWN CFO 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: Project#:
~11 ev C", 5•Z 4-ft/
DRB#:
(Number) (Street) (Suite#)
Building/Complex Name: I'7'z., Building Permit#:
Contractor Information/� � Lot#. Block# Subdivision:
Business Name: .z.z ,:�p G 'c.� c
Work Class: New 0) Addition(�) Alteration(>�
Business Address: 3-9 3
City ice•.+� State: c� zip: Sfi 6 c'c, Type of Building:
Single-Family Duplex Multi-Family�)
Contact Name: i�lis- �L �iZ•x ,.� Commercial 0 Other 0)
Contact Phone: Zo y 3
y( j Work Type: Interior Exterior Both
Contact E-Mail: /�Ci�J wS & o
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 )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 QYes ®)No ©)Yes ONO
the town's zoning and subdivision codes, design review ap-
proved,International Building and Residential Codes and other Plumbing Yes O)No DYes QNo
i ordinances of the Town applicable thereto.
Building (D)Ies ®)No (Dyes ®)No Gam.Ga
X C`��/1 _� Value of all work being performed: $ B
Owner/Owner's Representative Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage
Applicant Information- , '^^- Detailed Scope and Location of Work: ti217e"Q✓/Z
Applicant Name: t--1�t���1 Fork dr
Applicant Phone: LJI -1 Zq/7 CD ff � +r
o . Jo
t
Applicant E-Mail: C111-
s'
Project Information
Owner Name: r�
Parcel#: 2dA
(For Parcel#,contact Eagle County Assessors Office at(970-328-8640 or visit
www.eagIecounty.uslpatie) 6
I
(use additional sheet if necessary)
For Office Use Only:
Date Received:
Fee Paid:
Received From:
Cash Check#
CC: Visa/ MC Last 4 CC# exp date:
Auth#
15-Mar-2012