HomeMy WebLinkAboutB13-0542�--. _. �
� Department of Community Development
75 South Frontage Road
` % � Vail, CO 81657
T�W� �F Va�� � �% Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
Project Street Add Project#: ���� � � ���7 G
� , ��� � %��---- �" �
��C� ��� �-- = DRB#:
(Number) (Street) (Suite#) �.: /5 r-
,_f � � Building Permit#: `�� �� �v `�� �
Building/Complex Name:�-o� f � 6^`�'�---
Lot#: Block# Subdivision:
Contractor Information
Business Name: i=�' I t?6 %k'�.F'��� �' �'���'" �
/, / / Work Class: New( ) Addition ( ) Alteration(�')
Business Address: �C//.���O��r>�(
� Zi ��� Type of Building:
City ? � � '+ �tate: P� Du lex Multi-Famil �
Single-Fami�y( ) p ( ) Y(�)
Contact Name: � � Commercial( ) Other( )
z
Contact Phone: "
� J` U ' �Work Type: Interior(� Exterior( ) Both ( )
Contact E-Mail: . . /"- , — � / �a+-r , ,�
Valuation of
I hereby acknowledge that I have read this application,filled out Work Included Plans Included Work
in full the information required,completed an accurate plot plan,
and state that all the information as�equired is correct. I agree to Electr'ical OYes (�)No OYes ONo -E}
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 6�
the town's zoning and subdivision codes, design review ap- 9 Yes � No Yes No ��
proved, International Building and Residential Codes and other Plumbin ( ) (� ) � � � �
ordinances of th applicable thereto. guilding (j�)Yes ( )No ( )Yes ( )No
�
X :Value of all work being performed: $���— �
Owner/Owner's Representative Signa'�ure(Required) ''�,(value based on IBC Section 109.3 8 IRC Section 108.3�
t
Electrical Square Footage
__. .. ,
Applicant Information Detailed Scope and Location of Work:
Applicant Name:�-�'1�✓����li�nL��� 5 7`7 c , ,�1 � � ` , �
Applicant Phone:�7(�'�.�y ��Cj� l G L'✓Ll��� �L /�Sl� -
Applicant E-Mail: �%vYl,�,a ��,^l�a�� ��67����U7'il��s� > ��
Project Information_.,. �� /
Owner Name: (��c.J✓� � �c%t� l
Parcel#: ��� � ����,.T������)
(For Parcel#,contact Eagle ounty Assessors Office at(970-328-8640 or visit
www.eaglecounty.uslpatie) �
(use additional sheet if nec � ^ � p 3�111
�� 3�V!
1\ n !.�
For Office Use Only: Date Received:
D ��
Fee Paid: ��� Q� 2��3
Received From:
Cash Check#
CC: Visa/ MC Last 4 CC# exp date: '�'(jWN OF vA�`"°
Auth #
2013-Feb 01