HomeMy WebLinkAboutB13-0393 APPLICATION.pdf 0 Department q of Community Development
75 South Frontage Road
TOWN �f ���t >: 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#:
DRB#:
(Number) (Street) }} (Suite#)
Building/Complex Name: Building Permit#
Contractor Information f l Lot#: Block# Subdivision:
Business Name::D C,. (�- C
Business Address: fa ba g y II Work Class: New(a) Addition (0) Alteration( )
City A V0,\ State: C () Zip: �_CJ LJ Type of Building:
71 t Single-Family(o Duplex(o Multi-Family(W)
Contact Name: ���� /-�r+�.C1-��C�✓�
q Commercial (0 Other(Q)
Contact Phone: 1 70 J�_76-02&
-02
Contact E-Mail:6Cu"a -4 rzyi s y, e6� t coV4w G fd�✓L Work Type: Interior T�( Exterior((D Both(0
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 ( es ((( No ( es (C)No 15 ov,60
comply with the information and plot plan,to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical (r' Yes 3No Yes IrIN
the town's zoning and subdivision codes, design review ap- �`'` 760:06 proved, International Building and Residential Codes and other Plumbing (tYes i�Na ( Yes No
ordinances of the Town applicable thereto. ul
Building (i Yes 6)No ()Yes ()No �q
Value of all work being performed: $ 0
O nw erlOwner's Representative Signature(Required) (value based on 18C Section 109.3&IRC Section 108.3) L/
Electrical Square Footage f7
Applicant Information Detailed(Scope and Location1 of Work: 4 t
Applicant Name: p
Applicant Phone: l z v�77 L it � ` �`` CL L�.r�.�. wy(( �,,e LJ4,l � F t" S[keV-,�, �/'0�✓
Applicant E-Mail:grsszd �t�i a,4c -%s N�(,14ba
J ' Cd►^'� f� I I J
Project Information
Owner Name: _ :L-V_0 aL)ST T
Parcel#: r� r � >C 1�G � d 5` - ���1��istE, is n�-�' P; ►u� �4 a�1,�;+�1 �ii
ff i
(For Parcel#,contact Eagle County Assessors Office at(970-328$540 or visit l/r"e'-I�tir� l ✓1 y� W 1
www.eaglecounty.uslpatie)
(use additional sheet if necessary)
For Office Use Only:
Date Received:Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp date:
Auth #
2013-Feb 01