HomeMy WebLinkAboutB13-0266 application ..# ,:r;
Department of Community Developmen#
75 South Frontage Road
�'OWN i�F VAlL� vai�, co s�ss7
Tel: 97D-479-2128
www.vaiigov.com
Development Review Coordinator
` �`�`�� ��`��`� � ����BUILDING PERMIT APPLICATION
� ��$�� � °��� (Separate applications are required for alarm&sprinkler)
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Project Street Address: Project#:
'" �, �'� �,l' ^lyl '1'l�I�t �GifJAi?-
DRB#:
(Number) (Street) (Suite#)
, � ' � / „ Building Permit#:
Building/Complex Name: �•�'l(%S�i�s a�i,a� �1���'i���t��`'
Contractor Information Lot#: Block# Subdivision:
r , �.
Business Name: �'V � �� 'i r • L � , ���,�,,����j�-���
� Work Class: New� Addition�) Alteration�j
Business Address: � u � �
�
City�-�i' _State: C.� Zip:� Type of Building:
/�� Single-Family�) Duplex� Multi-Family�
Contact Name: ? � -�� !U fti,:i-�"
Commercial � Other�)
Contact Phone: �� �L� ���� rC ��_."�a
Contact E-Mail: v''• �' "^ � I� �1f'�S " ,Cf " ' �ieY�.,
Work Type: Interior Q) Exterior�j Both a
c�b-r...
I hereby acknowledge that I have read this application,filled out Valuation of
in full the information required,completed an accurate plot plan, Work Inclu ed Plans Included Work
and state that all the information as required is correct. 1 agree to Electrical �Yes � )No Q)Yes Q)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 (�jYes �)No Q)Yes OjNo
the town's zoning and subdivision codes, design review ap-
proved,International Building and Residential Codes and other Plumbing Yes �No �Yes �jNo
ordinances of the Town applicable thereto.
Building Yes Q)No �Yes O)No
+ � �, ` � � �n.
X �°�v��. •��� � Value of all work being performed: $ � � �� ��
Owner/Owner's Representative Signature(Required) �value based on IBC Section 109.3&IRC Section 108.3�
Electrical Square Footage
Applicant Information . Detailed Scope and Location of Work:
appr�ant N�me� j���. " ,,� �.,� ",i;�r i�. ,. �:��t�ic,�.,. �.,� �.,
Applicant Phone: � ' �ri 1�=�.'a � ��(��7'l I'�1 Cd`"y���Q..YY���'',�.�
Applicant E-Mail: �-�" (�C� ��tf�yil�G-�j� �'',� _���.> �'°l�` �S�i°"' j;�;r�' ��J�-'�
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Proj}t'I�nformation �,� �r ��'�3 ��{�� �.;�t�tvs�,�� �°,,�+� �.���"��! "°��` ��'�; �`(�r��
i �ca;� `� _ - ��Ci`� i��%°� � .,� ��j ,��j
Owner Name: �� X" 1�: ,�t��z� C� ����'° 1�1' �f"" �``�l
Parcel#: ��i�'�b'1�a.�.?`J (":'�,�` d'�;�T �p 1� i'` j'
(For Parcel#,contacf Eagle County Assessors Office at(970-328-8640 or visit s'`�� ���C' (`��Il��n+'+t"�4�1� `' � ��.�`'" �-1 l� l3t�C"" �dt�'l �`���
w�vw.eaglecounty.ustpatie)
{us� L{ C�'��" f'��.e�,a�a.��,L""� Y ��I��._ ly��'�� _��G�1 -�'�;3..�
dd�tic�fial sheet'�necessary)
��� �`�a G����.��>t �� �►v� —'��ii— ��--t�e�(; u�5�
For Office Use Only: •
Fee Paid: Date��L��d � �'��1��"n��� - �.� ,i,��r �t�ii`Gfi'�I�(-���
Received From:
Cash Check#
CC: Visa/MC Last�4 CC# exp date:
Auth #
15-Mar-2012