HomeMy WebLinkAboutB13-0325 APPLICATION.pdf Department of Community Development
# 75 South Frontage Road
TOWN OF VAIL Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
LoP6eVT1Co,,.;,D0 BUILDING PERMIT APPLICATION
[A�gT �arate applications are required for alarm &sprinkler)
Project Street Address: Z_ Project
(Number) (Street) (Suite#) DRB 9:
()I%,
Building/Complex Name:�0 e Building Permit#:
Contractor Information Lot#: Block ft Subdivision:
::Business Name: &r.�3
1 business Address: Work Class. New(0) Addition(0) Alteration(0))
State:CO Zip: '01"Z' Type'ity i
C e of Building:
Single-Family(0) Duplex(0 Multi-Family
Contact Name: Z;�7AD
Commercial I& Other(o)
l Contact Phone:
Work Type: Interior(a Exterior(C) Both (0
Contact E-Mail:
&MOLKLAfAlek0e c0r01
I hereby acknowledge that I have read this application,filled out i Valuation of
in full the information required,completed an P5216rate plot plan, 1 Work Included Plans Included Work
and state that all the information as requireoliff correct. I agree to Electrical (QDY—es No (*Wye 0
comply with the information and plot pf�pl, comply with all Town
and state that a"the information 'required e m m as
h�ein information and plot comply with
is structure re a,
comply ce with '0 P' plan
ordinances and state laws, and to build is structure according to
i !Mechanical
the town's zoning and subdivision code , design e ap- ( Yes No ( Yes (ONo E)CO
proved,Inter dential C e a d other Plumbing eyes ONo
or i nation I
r *Yes ONO
ordina
Building (nyes (&No Oyes ()No
qpffc o
Value of all work being performed:
i Owni)rlQwper"s Representative Sign d) (value based an GO Section 109.3&lRC Section 108.3)
Electrical Square Footage
Applicant Inform I Detailed Scope and Location of Work:
I Applicant Name- 1 y1 A e-M Ce 4) T J rt
kD �
Applicant Phone: 7-61-314 7 -T-1
L) 61
Applicant E-Mail: b k_Yrt0_XL.;J Ct (0) a V a VA e- P W k t, o
Project Information 4 k
Owner Name: & D AA\
+-110
Parcel M
(For Parcel 9,contact Eagle County Assessors Office at(970-32"640 or visit
www.eaglecounty.us/patie)
(use additional sheet if necessary)
For Office Use Only: Date Received:
Fee Paid:
Received From:
Cash Check#
CG. Visa/ MC Last 4 CC# exp date:
Auth #
2013-Feb 01