HomeMy WebLinkAboutB13-0485 APPLICATION.pdf Department of Community Development
0 75 South Frontage Road
TOWN OF VAIN 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#:
M#N'�SYtTN i iAP�`/t
DRB#:
(Number) (Street) (Suite#)
Building/Complex Name: oyalziacm K 60 Ou l Building Permit#:
Contractor Information Lot#:_Block# Subdivision:
Business Name: —rW c, ti L Lc
Work Class: New 0 Addition Alteration
Business Address:.�p �c9� �8 r�°
City F VO IJ State: ill Zip: /p' C) Type of Building:
Contact Name:
-a— Single-Family o Duplex(O Multi-Family
�r'1-'.y �f'�11
Commercial (0 Other 0
Contact Phone: R70 3 i�, LA-3o l
Contact E-Mail:�4�P z"rar�S wQ.i 1��,,,p�,Y��,��a coa
Work Type: Interior Exterior(o 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 {®Yes Q)No Yes
No
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical ()Yes )No OYes ( No
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Plumbing ( Yes No OYes (®jNo
ordinances of the Town applicable thereto.
Building Yes 0)No OYes ONo
X Value of all work being performed: $ -74,066- 00
Owner/Owner's Representative Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage d Aip
Applicant Information Detailed Scope and Location of Work:
Applicant Name: K#J p!4 W rl G i 4-t
Applicant Phone: *13 ° _152 �t�u���4t3tN�b�444cob
Applicant E-Mall: C-Ttoi . JAW FILI
Project Information
Owner Name: (�[f j�l-F 1 RAf-0 _ '
Parcel#: 11CS 111 L-501`_ V �� �°
(For Parcel#,ccontact Eagle County Assessors Office at(970-328-8640 or visit ' .
www.eaglecounty.us/patie) ,.
(use additional sheet if c s ei r�� An+�1�
1��v Ac.�s
For Office Use Only: J"72—
Fee Paid: Date Received: GEd�� t1fv �a(�w�'
`
Received From: f e��Sn�� � +
Cash Check# ( AcGart VG(Ns7 /
CC: Visa/ MC Last 4 CC# exp date: Jr
Auth #
12-Mar-2012