HomeMy WebLinkAboutD13-0016 APPLICATION.pdf Department of Community Development
0 - 75 South Frontage Road
TOWN OF VAIL Vail, CO 81657
-- Tel: 970-479-2128
www.vailgov.com
�J Development Review Coordinator
BUILDING PERMIT APPLICATION
r rYr, Y F1 - n I (Separate applications are required for alarm & sprinkler)
Project Street Address: Project#.
(Number) (Street) (Suite#) DRB# py
Building/Complex Name: DO L_ i\R 1 S Building Permit#
Contractor Information Lot# Block# Subdivision
Business Name. i,�`r C-0,V)5 1 WxC+o,',, G
Business Address: 1 ZQ W I LL(jLa_)-�32/GC Q11, Work Class; New 10 Addition (0 Alteration (0
City (L- State'I -S�+ Zip: r Type of Building:
`
Contact Name �(k ��}c4 k l �(-e Single-Family 0 Duplex 0 Multi-Family 1:17
: !�-k�- ��yt ��,
Commercial 0 Other()
Contact Phone: q 1 a 4 C1 9 C1 2-46
Contact E-Mail iy\Akl<k c - Yvtm�Irl rC�l,7(onsro�ac e Work Type: Interior WExterior 0 Both 0
I2UUP, r�ei1)
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
comply with the information and plot plan, to comply with all Town Electrica! OYes )No OYes ONo
ordinances and state laws and to build this structure according to Mechanical ( Yes 0)i OYes l�No
the town's zoning and subdivision codes design review ap
proved, International Building and Residential Codes and other Plumbing Yes Q)No Yes �No
ordinances of the Town applicable thereto
Building OYes (DNo OYes ONo
Value of all work being performed: $
Owner/Owner's Representative Signature(Required) (value based on IBC Section 109 3&!RC Section 108 3) J
Electrical Square Footage /
Applicant Information + I Detailed Scope and Location of Work: n
Applicant Name: (--P l,4, to , 14 z yvu
Applicant Phone: I q
t y �(��( Z`� CJ+l-F�CIS M (>�
Applicant E-Mail:1�_K k
Project Information
Owner Name: ar-A 21 5 �2c�PRf Duv►1�( L L�
Parcel#: I! 1 ` 2 ��' (?3.6
(For Parcel#,contact Eagle County Assessors Office at(970-328-8640 or visit
www.ea glecou nty.uslpatiei
(use additional sheet if necessary)
I,or 01'liee t se oilIY
Fee Paid: Date Received:
Received From;
Cash Check #
CC: Visa/MC Last,; CC# exp date:
Auth #
12-Mar-2012