HomeMy WebLinkAboutB16-0230 Application Department of Community Development
75 South Frontage Road West
TOWN OF VAIL i11.' Vail, CO 81657
441 S Tel: 970-479-2139
/ www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm, Sprinkler&Public Way)
Project Street Address:
a42. S?2UCE w•At--� d-•3 Project#:
(Number) (Street) (Suite#) DRB#: at Vio '" 1f9.22 0 �\ 1�f
Building/Complex Name: P1GAl-Ov J 5(14b(JiSto tJ 31" Building Permit#: —816-0P 3()
, Project Information: t Lot#: Block# Subdivision:
Owner Name: PAUL 01 11061,4
Parcel# 21011 222 3 OU I
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New( ) Addition ( ) Alteration (1C)
www.eaglecounty.us/patie)
Type of Building:
Contractor Information
Single-Family( ) Duplex( ) Multi-Family(X)
Business Name: Wow 6 J Lnit. (r- Commercial ( ) Other( )
Business Address: Eo- eO)< %7
City G&e State: CP Zip: £t( 3 I Work Type: Interior( ) Exterior(X) Both ( )
Contact Name: i-(1,4 PACAC
Contact Phone: g Cl - )_ 1--;k•Z(p Valuation of
Work Included Plans Included Work
ContactE-Mail: vor e llinatL, c.A„A
I hereby acknowledge that I have read this application,filled out in full the Mechanical ( )Yes ()()No ( )Yes ( )No
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 ( )Yes ( )No
mation and pl. .Ian,to comply with all Town ordinances and state laws,
and to build is • -- re ac,ordin. to the town's zoning and subdivision
codes, des•n r:�+iew a.in) d,I ational Building and Residential Building (')Yes ( )No (,Yes ( )No .b
• Codes an.oth-T ordinan e- 'f t- n applicable thereto.
X -�' � /ti
Total Value of all work being performed: $ Q-
`_ (value based on IBC Section 109.3&IRC Section 108.3) ;
Owners er's Rep -sentative Signature (Required)
Detailed Scope and Location of Work:
Applic- - Informati•n
1 -C.y.,. eibctvts IO t=4,4-WW '4-
Applicant Name: P' L. c)(
Applicant Phone:
Applicant E-Mail:
Additional Authorized ProjectDox Users k0 S'V n �� � c ��S c I 0,L,14(._ �� itie
Full Name: + W::-00 6t M0 IQA tL ..."'''..r
E-Mail:
Full Name: (use additional sheet if necessary)
E-Mail:
(use additional sheet if necessary) Yom`
Date Received:
For Office Use Only: D E v I ,'I "
Fee Paid:
Received From: 1 ''U(1 i / 2016
Cash Check#
CC: Visa/MC Last 4 CC# exp date:
Auth # 1 TOWN OFVAL
Rev.2015-Dec __ `� "` ""-