HomeMy WebLinkAboutB13-0488 APPLICATION.pdf 0 Vail,Department of Community Development
75 South Frontage Road
TOWN OF VAIL� co $1s57
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm&sprinkler)
Project Street A ddress- Project#:
�— ' Q- IY G-1,,�1 1�'1-�— DRB#:
(Number) (Street) (Suite#)
Building/Complex Name Building Permit#::
Contractor Information Lot#: Block# Subdivision:
Business Name:�ry���r-x- l�ii RO i
( 0 ( 2CLU V-1 Work Class: New( ) Addition( ) Alteration( v)"
Business Address: \
City \1 rx 1 State:S�? Zip: Type of Building:
Single-Family( ) Duplex( ) Multi-Family( )
Contact Name: 11
Commercial( �-Other( ) T 1��711 C� ac L A�4
Contact Phone:
Contact E-Mail: Work Type: Interior( ) Exterior( ) Both( Vl
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 ( )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 ( )Yes ( )No
the town's zoning and subdivision codes, design review ap-
provefInt tion Building a esidential Codes and other Plumbing ( )Yes ( )No ( )Yes ( )No
ordin ble ereto.
Building ( )Yes ( )No ( )Yes ( )No
F
X Value of all work being performed: $ ;
Ow / r es Signature(Required) (value based on IBC Section 109 3&IRC Section 108.3) i
Electrical Square Footage
Applica nfo ation Detailed Scope and Location of Work:
Applicant Name:
Applicant Phone: - l 1 ri [-'
Applicant E-Mail
Project Information��
Owner Name: r�
Parcel#:Q\n f1 a
(For Parcel#,contact Eagle County Assessors Ci tt%at(970-328-8640 or visit
www.eaglecounty.us/patie)
(use additional sheet if necessary)
For Office Use Only:
Date Received:
Fee Paid:
Received From:
Cash Check#
CC: Visa/ MC Last 4 CC# exp date:
Auth #
2013-Feb 01