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HomeMy WebLinkAboutB14-0155�. Department of Community Development , 75 South Frontage Road TOWN QF VAtL� vai�, co s�ss� Tel: 970-479-2128 www.vailgov.com Development Review Coordinator BUILDING PERMIT APPLICATION (Separate applications are required for alarm &sprinkler) Project Street Address: Project#: ��� ,� — U � �� 181 West Meadow Drive DRB#: (Number) (Street) (Suite#) �( � _ � ��S Building/Complex Name: Vail Valley Medical Center Building Permit#: Contractor Information Lot#:C�"�Block# Subdivision:U v � �—� Business Name: Encore Electric, Inc. Business Address: 2107 West College Ave Work Class: New(Q) Addition�j Alteration (� City Englewood State: CO Z�p; 80110 Type of Building: Pete Palm ren Single-Family�) Duplex(Qj Multi-Family(Qj Contact Name: 9 Commercial(Qj Other� Contact Phone: 970-471-0015 Contact E-n+�ai�: pete.palmgren@encoreelectric.com Work Type: Interior Qi Exterior Q Both� 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 �i Yes Q)No QYes aN0 Si89,000 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 Oi )No �Yes �i No ' the town's zo ' g and subdivision codes, design review ap- proved,Inte at nat Building and Residential Codes and other Plumbing �Yes QjNo �Yes �No ordinance of t own app' ble thereto. Building QYes allo QYes QNo X Value of all work being performed: $ 189} �U�" Owne�`I ner's Represe ive Signature(Required) '(value based on IBC Section 109.3&IRC Section 108.3� Electrical Square Footage Applicant Information Detailed Scope and Location of Work: Applicant Name: Pete Palmgren Switchgear Replacement at Vail Valley Medical Center Applicant Phone: 970-471-0015 Applicant E-Mail: Pete.palmgren@encoreelectric.com Project Information Ryan Magill Owner Name: Parcel#: ��G'� — �7 � ~(�lC� �� (For Parcel M,contact Eagle County Assesaors Office at(970-328-8640 or vfaft www.eaglecounty.us/patle) (use additional sheet ff necessary) For Oftice Use Only: � � � � �/ � Fee Paid: Date Received: j� U Received From: i;�� � � ��'�t} Cash Check# CC: Vsa/MC Last 4 CC# exp date: A�m # TOWN OF VAIL „..__,�„ ********************+***************+********++********************************************+ TOWN OF VAIL, COLORADO Statement ****++************************************************************************************** Statement Number: R140000461 Amount: $3, 606. 69 05/01/201409:50 AM Payment Method: Check Init: CG Notation: ck 2442 Encore Electric ----------------------------------------------------------------------------- Permit No: B19-0155 Type: COMBINATION BLDG PERMIT Parcel No: 2101-071-0101-3 Site Address: 181 W MEADOW DR VAIL Location: Vail Valley Medical Center Total Fees: $12, 740.94 This Payment: $3, 606. 69 Total ALL Pmts: $3, 606. 69 Balance: $9, 133.75 ***********+*************r*************************************+**************************** ACCOUNT ITEM LIST: Account Code Description Current Pmts -------------------- ------------------------------ ------------ PF 00100003112300 PLAN CHECK FEES 3, 606. 69 ----------------------------------------------------------------------------- ',�