HomeMy WebLinkAboutB13-0490 APPLICATION.pdf i
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Department of Community Development
75 South Frontage Road
TOWN OF MVAL Vail, CO 81657
Tel: 970-479-2128
www,vailgov.com 1
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
Project Street Addre�:� On Project#:
(Number)4it)
(Street} (S ite DRB#. � ✓ U _
1 - • /� } Building Permit#:
Building/Complex Name: ��'�✓i �GW� T"'�"Y'^ � •
Contractor Information Loll: Blnck# Subdivision: F V
",,Q�A.ct.4,) Cf,
Business Name; _ ......... .......�..._...
Business Addr ss• _ �[J a j "�AsMnNw Work Class: New 5() Addition( ) Alteration( }
,,
City ssW
State; Zip: $•01 Z 0 Type of Building:
�. Single-Family( ) Duplex( ) Multi-Family{ )
Contact Name: 8 w Commercial Other( )
Contact Phone:
Contact E-Mail: r m S Q aC G y t /+-• C6 W Work Type: Interior( } Exterior( ) Both
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I hereby acknowledge that 1 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
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-
proved, International Building and Residenti YCodes and other Plumbing ( )Yes ( X)No ( )Yes ( )No
ordinances of the Town applicable thereto.
Building ( ; Yes ( )No ( )Yes ( )No t`( +
X Value of all work being performed: $ rbS 6 .00 I
Owner O ner-s Representative Sign re(Required) (value based on IBC Section 1D9,3 8 IRC Section 108.3)
Electrical Square Footage 65
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Applicant Information n Detailed Scope a d Lo ation of Work: S
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i Applicant Name: u
Applicant Phone; 303 —73
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Applicant E-Maik .r A V-6 5,e (ACC b frt I+ Co vj-�
Project Information rya g�• �y�
Owner Name: Js
Parcel tk 0 tj ° 0000
(For Parcel#,contact Eagle County Assessors Office at(970-328-8640 or visit
IIC www.vaglecounty.uslpatle)
(use additional sheet if necessary)
For Office Use Only:
Fee Paid:
Date Received:
Received From:
Cash Check#
CC: Visa / MC Last 4 CC# exp date:
Auth # ;
2013-Feb 01