Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutB13-0395 APPLICATION.pdf Department of Community Development
0 75 South Frontage Road
TOWN OF VAIL Vail,CO 87657
Tel: 970-479-2728
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm& sprinkler)
Project Street Address: Project#_
(Number) [Street] CRS#:
(Suite#)
BuildinglComplex Name: - 4 0 1 Al uilding Permit#:
Contractor Information OLT v A l t Tot#: Block# Subdivision:
Business Name:
�1`'
Business Address Work Class: New0 Addition o Alteration
City State Zip: Type of Building:
Contact Name:
3JC I — Single-Family 0 Duplex Multi-Family
Commercial 00 Other
Contact Phone: l
Contact E-Mail: t.1
�L - r.4r`�I crib, , �ir Work Type: Interior
0 Exterior M Both
1 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 comply with the information and plot plan, to comply with all Town y f
ordinances and state laws, and to build this structure according to Mechanical Cs �}No es (DNo
the town's zoning and subdivision codes, design review ap-
proved.International Building and Residential Codes and other Plumbing 0Yes ONo Yes i No
ordin of the Town applicable thereto.
Building ( Yes oNo }Yes ON6�6`-
s �tl&
Value of all work being performed. $ O
Owner/Owner°s Re esentative Signature(Required) (value Rased on IBC section 109.3&IRC Section 108 3)
Electrical Square Footage
Applicant Information Detailed Scope and Location of Work:
Applicant Name lL�
Applicant Phone:
Applicant E-Mail:
Project Inform
Owner Name: atic a a ��s 4 �
Parcel# / J 6 9� _106 _q
(For Parcel#.Contact Eagle County Assessors Office at(970-325-11640 or visit
www.saglecou nty..uslpatle)
(use additional sheet it necessary)
For 0Mee I.se Only:
Fee Paid: (late Received:
Received From:
Cash Check #
CC: Visa/ MC Last 4 CC# exp date:
Auth #
12-luiur-2012