HomeMy WebLinkAboutB15-0436 � Department of Community Development
/ , � 75 South Frontage Road
rowN aF vA«� ��—' Vail, CO 81657
Tel: 970-479-2139
www.vailgov.com
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BIJ.�NG PERMIT APPLICATION
( eparate applications are required for alarm &sprinkler)
' Project Street Address: �� Project#: V �-�� "�''� - ��7��
; �g (.;�-�t� w►��G� �� 5 G �
; DRB#: � " 1SG ��
! (Number) (Street) (Suite#) �.(7^
Building Permit . � 1 S-�S 7�' �( ��� ` ��
; Building/Complex Name: ���� v t L���� �� _
I Contractor Information � Lot#: Block# Subdivision:
Business Name: �� �J� ���� ° �-- ----�---� +
�� Work Class. New( ) Addition ( ) Alteration (1ir'"�;
Business Address: � t 5� , �'{� �. �
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;City�(����j State: G� Zip: � 3�.., {Type of Building:
� � �Single Family( ) Duplex( ) Multi-Family(� �
,Contact Name: C'� �`llC� �
i Commercial ( ) Other( )
Contact Phone: �iI I 19 5 �j �--` _ _ "_ .
_ . _.
--_ - _ _ _.
�-1 ,� Work Type: Interior(�xterior( ) Both ( )
Contact E-Mail: � �`�L5 l?-1���2�!^`'1 � � �l�' r- -_ _ i
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�, 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 required is correct. I agree to 'Electrical (�-�(es ONo (. es ONo �J U '
comply with the information and plot plan,to comply wifh all Town I
ordinances and state laws, and to build this structure according to �Mechanical OYes ONo OYes ONo
the town's zoning and subdivision codes, design review ap- `
' proved, Intemational Building and Residential Codes and other �Plumbing OYes ( }No OYes ONo
ordinances of the Town applicable thereto. �Building ( )Yes ( )No ( )Yes ( )No
, �i _._�_.....T_,.�...�.�.._.__r__...,.m____ _�..___..�_..___.______..._.._._..._.
',� X ' 1 Value of all work being performed: $ {���
� (value based on IBC Section 109.3&IRC Section 108.3�
Owner/Owner's resentative Signature(Re uired) � � Q� ,
��_� � Electrical Square Footage t
;Applicant Information j Detailed Scope and Location of Work: ��r� .n l ,Qi �
;ApPlicant Name: � � A-� p� �'r ��1�5 �-- l�o �rZ C�.�_
Applicant Phone: ' ,y J���� �
� ✓�LL lQ..l3 6sv? •�
Applicant E-Mail: ;
Project Information
Owner Name:
Parcel#:
(For Parcel#,contact Eagle CounTy Assessors Office at(970-328-8640 or visit
www.eaglecounty.uslpatie) , '-
� " °' ""° ` " (use additional sheet if necessary)
For O�ce Use Only: ,
FeePaid: __.._ _.__._ . ____ _ _ ____.._. __. __ _ ....._...
Received From: Date Received:
Cash Check#
CC: Visa/MC Last 4 CC# exp date:
Auth #
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