HomeMy WebLinkAboutB13-0101 APPLICATION.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIL A 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: A q(r> Project#:
L' 2 tiN i I Llw &J_dkL 10
(Number) (Street) DRB#
(Suite#)
Building/Complex Name: ��J ; (:c, (l Building Permit#:
Contractor Information Lot#: Block# Subdivision:
Business Name: 1 AI cX&_ FN��C-1
Business Address: 1 (2il Work Class: New Addition Alteration
City State:.()Zip:&C Type of Building:
Contact Name: ��+
� cki-e Single-Family 0 Duplex(0 Multi-Family(
—7 Commercial(0 Other
Contact Phone: � 1��j��Q — �,�j��Q
Contact E-Mail: i t o Coo-) Work Type:. Interior 0 Exterior Q Both 19
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
comply with the information and plot plan,to comply with all Town •,Yes ONo Yes ONo 18000
ordinances and state laws, and to build this structure according to Mechanical E)Yes to"")No PJYes QNo 5000
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Plumbing IllZiYes ONo Yes ( }No 55000
ordinances of the Town applicable thereto.
Building GYes ONo GYes oNo 295000
Value of all work being performed: $ 353000
Owner/ wner's presentative Signature(Required) (value based on iBC Section 109.3&IRC Section 108 3)
Electrical Square Footage
Applicant Information Detailed Scope and Location of Work: Increase size of
Applicant Name: (2) bedrooms, relocate master bath, add sloped roof,
Applicant Phone: relocate powder room.
Applicant E-Mail:
Project Information
Owner Name:
Parcel#: I t)
(For Parcel#,contact Eagle County Assessors Office at(970-528-8640 or visit
www.eaglecounty.us/patie)
(use additional sheet if necessary)
For Office t Ise Only:
Fee Paid: Date Received:
Received From:
Cash Check #
CC: Visa/ MC Last 4 CC# exp date:
Auth #
12-Ku-2012