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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