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HomeMy WebLinkAboutB13-0128 application Qepartment vf Comrttunity I]e�efapment 75 5vuth Frontage R�ad ��i�11� �� VA{� >: �a�r, co s�s�7 7e1: 97U-479-2�f 28 www.�ailgo�.com ❑e�elap►nent F2e�iew Cvardinator BL1ILD�N� PERlVIIT APPLICAT��N [Separate applications are required for alarm &sprinkEer} . _....------------ ---------... ... :Projeot 5treet Address: Praject#: PR,113-0107 `��� � . ,� ; :�;� ,�•� ❑RB#: [Number} {5treet (Suite#} �'��" � L � I,� � � � Building Permit� B13-0128 BuildinglComplex Narr�e:]`i��l��� L��G'�t-�L�?���[f��(� :L f Cvntra�tor Enformation Lat#: 81ock# Subdi�isian' __.. � � . `; i � Susiness i�ame: • ' ��� {�?��: .C�1-f._ Business Address: ��?c ���7� Work Class: New{�} Additia�i��} Alteration{�} r -------... ------.. ....---•---••.............. ... �� .�.. City�S� l Stake: [.� Zip:���� Ty�e of 8uilding: L }� Single-Family(�} ❑uplex��j Multi-Fami[y{� :Confa�f Name� c���� ���C�'� f 7 �- . - Commercial{� ather[�) ;contact Pnone: �� ��-'. . ���iG' � �G.'� _._.. . -- ... .. . ,� "� , � � � . Wark Type: Interior{�} Exterior(�Bath[al •.Contact E-Mai�: �t4 v�l C�Y� 'Cr��'��i(- �d�Yl •�}�"4 - ••••••- _.. . . ... ... ............ I hereby a�knowledge that I ha�e read th9s applicatian,fi3[ed out ; Vafuation af; in full the infarma�ion required,completed an a�curate p{at plan, Wark�RCluded Plans In�Euded Work [ and state that all the information as requirecf is ovrrect. 1 agree ta .` --- •• - - :Ele�trical ��1'es ( N❑ (�Yes [�N❑ : comply with the information and p3of p�an,to r.ompiy wPth afI�fnwn s """ ordinances and state laws, and ta build this strucfxire according to :Mechanical {�Yes �}No {�Yes {�N❑ �. the tawn's zaning and subdi�ision cades, design re�iew ap- ; pro�ed, Internationa!Building and F2esidential Codes and ather F plumbing �Yes �}No �Yes (�Na _� ' ordinances af the Tflwn ap}�licahle thereto. : i Building Yes No { Yes No :.................................................�..................�....................._�...................._�.... .. � �: ��� : X ;Value of aE�work heing performed: $ V �-{�:a_� DwnerJDwner's Representati�e 5ignature[Required} ':[�alue hasod aa 1BC Seclion 10�.3&IRC SeCion ios.s} ' ti ! ��e�tri�al Square Foofage ��--' 1' i � A��licanf Informa�ion �, pe'�ailEd Scope aRd Locatian af Work: � r i ���j � •�PPI9cant Name: �.�..��`�i'-��� �ri����L�i•����- — —�; �C:L�f`..� t L`�k��� ����~�� - • ��, ' i' �'+PPlicant Phone:� [�-• �.� �l ; ^" =� � �] � :Applicant E-Maif:,_ ? �13���Y.'G�"�±!���`�; p'�'1.�����-��� - - Proje�t Infarmation� �i�a � '�_, Qwner Name: �f���� �!LL.��,��'L7`-,J����VL ' . �"� i tJ ! Par�e�#:�4 i�[_' � i � " U�Z.���r� 4 � "7 � " {For Parccl#,contact Eagle Gounfy Assessars O�ce at{970-328-8B40 vr visif � �� ��I�� Ay�� www.cag[ecou nfy.us Ipati e} _.:..-::_.__-:::_- . .� ''!(use adciitionaf sheet if necessary} For QfFcc L sc Om7ti: llare I�er.eived; Fee�aid: Rer.,eived Fram: , Received �� ��k'` ' By Lynne Campbell at 12:12 pm,Apr 29,2013 CC' Usa 1 N!C �ast 4 CC# exp date' f��� a� �Af�' Auth#