HomeMy WebLinkAboutB16-0022 Department of Community Development
./ 75 South Frontage Road West
TQWN OF VAIL ` \ van, co s�ss�
Tel: 970-479-2139
\ www.vailgov.com
BUILD PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm, Sprinkler&Public Way)
Project Street A dress: � Project#: ��—O�S 7
�_ ��• �-Io►JS��F.ka l:�L , ZU
(Number) (Street) (Suite#) DRB#:
BuildinglComplex Name:�+Jb��K—�p�� �r� q Building Permit#: ��� `�� ��
Project Information: ���� ��� �� Lot#:�Block#� Subdivision:��ll` L�-� �(1. �j
Owner Name•
Parcel# 2.��� —Q�P3"3� —(�2.�
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New(t�) Addition((�'-) Alteration(�)
www.eaglecounty.uslpatie)
Contractor Information
Type of Building:
'l /� Single-Family(�) Duplex(� ) Multi-Family(�)
Business Name: 1`�\(=',� l �icy-py.�T �c�.�� Commercial(�) Other(�`)
Business Address:�b �e f � �
City �i4 C�L,� State: � Zip:�� Work Type: Interior(�j Exterior((��) Both(C�`')
Contact Name: �[L/�"C�- ��E�.1�(...E,
Contact Phone: 1�d " 3 3— 2-�j'2� Valuation of
1" L n a Work Included Plans Included Work
Contact E-Mail: �c.���_'�.m(�S f 1,«L�Q(�1+��� •c on�
., 0 2 0� �
I I hereby acknowledge that I have read this application,filled out in full the MeChanical (�Yes (�)No (�)Yes (�jNo �
information required,completed an accurate plot plan,and state that all �^' �
the information as required is correct. I agree to comply with the infor- Plumbing �)Yes (�)No (t�)Yes (�No ' �i d�.
mation and plot plan,to comply with all Town ordinances and state laws, —T—
and to build this structure accordin to the town's zonin and subdivision Q
codes,d sign review approved,In ernational Building and Residential Building (�fYes (�)No (�Yes (�)No a�b�Q.
Codes d oth ordinances of the Tow a icable thereto.
Total Value of all work being performed: $ �� C�b�,—
X (value based on IBC Sedion 109.3 8 IRC Sedion 108.3�
O er/Owner's Representati ' nature(Requi d) Detailed Scope and Location of Work: 1,��11v aE�.
Applicant Information ^�.
'� \. I �A S+`��.. `c�AY MF �`A�r�F�S �1..0 S`E�
Applicant Name:( )OI�I W,E Q tJ E�-
Applicant Phone�`�� — � ^ � 3 - � ��� C��/��,,, � ��,��
, c��'cQ L..a-e�F �--�t lil.rC..�i �/�e—l`�
Applicant E-Mail: f 2-3 � ' .C.aN�
Additional Authorized ProjectDox Users �"-�� ��+�►�s [�-� S
Full Name:
E-Mail:
Full Name:
(use additional sheet if necessary)
E-Mail:
(use additional sheet if necessary)
Date Received:
For Office Use Onl � (L '� ` � �
y� �-7 , � L� l� 1�, � �e� �� � _�' �
Fee Paid: �� / • i1 ' �
Received From: '`! I i �
Cash Check# ��� � " �o�i� ��
��
CC: Visa/ MC Last 4 CC# exp date: .,, ' .
Auth # n A� �1
Rev.2015-Dec �'�.*l°�� °�`�� \�`�!�-