HomeMy WebLinkAboutB16-0058 application Department of Community Development
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75 South Frontage Road West
TOWN OF VAIL Vail, CO 81657
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm, Sprinkler&Public Way)
Project Street Address: Project#:
V D() \I a6\:2.ae.Ce-ei0 Uta pr AV 1
(Number) (Street) _ ( (Suite#) DRB#:
Building/Complex Name?4 t V �1C,A V Building Permit#:
Project Information: CC `` Lot#: Block# Subdivision:
Owner Name: c)J V
Parcel# ; 1 O 1 -- (at{- - 0 3-- )0°1
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New( ) Addition( ) Alteration (X
www.eaglecounty.us/patie)
Contractor Information Type of Building:
��,11 �t Single-Family( ) Duplex( ) Multi-Family
Business Name:r, 11 we Irl" Coves-��r u c v l(Commercial( ) Other( )
BusinessrAddress: [W.O �(a2 t 0ySC.�V".
City t--i ^('d` S State: Zip: 21.(Q 3 L Work Type: Interior('() Exterior( ) Both( )
Contact Name:}& A CAlld-�C Jt_1ivc,V�Ic�G7.gN A.b ry is
Contact Phonh O O-1 7 SI rot 7(gyp17-Q&q' Valuation of
Work Included Plans Included Work
Contact E-Mail:eV JVlS OCt 1 (.\V`atv.` X05.(.I.Gorki
I hereby acknowledge that I have read this application,filled out in full the Mechanical ( )Yes ( )No ( )Yes ()6No g
information required,completed an accurate plot plan,and state that all lie. ()
the information as required is correct. I agree to comply with the infer- Plumbing (; _)Yes ( )No (,;,)Yes ( )No 1 0
mation and plot plan,to comply with all Town ordinances and state laws,
and to build this structure according to the town's zoning and subdivision T/�
codes,design review approved,International Building and Residential Building ( )Yes (°>)No ( )Yes (-<)No xx��
Code and other ordinances of the Town applicable thereto. crz2
Total Value of all work being performed: $ 1 iib
X t/`-!✓"- (value based on IBC Section 109.3&IRC Section 108.3)
Owner/O*iF r s Representative Signature(Required) Detailed Scope and Location of Work: ' 1c 1( a.
Applicant Information
Applicant Name: tl t-112 { 5 L csaA.aJ `(
Applicant Phone:6n0 -3 3, "'0--61 D--
Applicant E-Mail: e-L-_Sa1. ✓ d� - tSV . CU VV
Additional Authorized ProjectDox Users
Full Name:
E-Mail:
Full Name:
(use additional sheet if necessary)
E-Mail:
(use additional sheet if necessary)
Date Received:
For Office Use Only:
Fee Paid: _ ______________
Received From:
- - ------ -- —
Cash ___ _ Check # — _
CC: Visa / MC Last 4 CC # ___ _ exp date: ___ ___
Auth # —_ —
Rev.2015-Dec