HomeMy WebLinkAboutB16-0069.pdf Department of Community Development
(° . 75 South Frontage Road
TOWN OF VA1L' Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
Project Street Address: Project#:
UCt,i I ( d-
(Number) (Street) (Suite#)
DRB#:
0(9,(-Iybikt (N Building Permit#:
Building/Complex Name:
Contractor Information Lot#: Block# Subdivision:
Business Name: tQE`l{h/lit,l (G,(
Work Class: New 0) Addition Q) Alteration ]
Business Address:
City State: CO Zip: 8((031 Type of Building:
Single-Family ) Duplex 0) Multi-Family a
Contact Name: //�rt1G`�rt t Commercial Other(1))Contact Phone: CGiC> ( 4.
Contact E-Mail: I ark.v ram_6(_,h.0A .( .1-'6\ _Work Type: Interior 0) Exterior 0 Both0
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 ()Yes O)No O)Yes 0)No
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical Q)Yes No ()Yes 0No I. 10010 "
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Plumbing Q)Yes O)No Q)Yes DNo
ordinances of the T. n-app cable thereto.
hh Building ()Yes O)No O)Yes Q)No
'M LI'� Lr. :)23 ((o Value of all work being performed: $1 -t 0 UU,0 0
Own- /Owner's `epresenta 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 d me(k_wu-( (IJ LLC c Vta,IA6 1�
( t 6Lu f 0Ot ��
- f 0
Applicant Phone: Cts)3 . �-LtG�Ct (A.�(� IJ i i ( (
Applicant E-Mail: (/@ Y (.44.V\V\At Cl�cvttii cuJ,G
Project Information
Owner Name: .0-Quo 0, /�
Parcel#: owl(�I O a — Lp(((��—0a4 U I `J
(For Parcel#,contact Eagle County Assessors Office at(970-328-8640 or visit
www.eaglecounty.us/patie)
(use additional sheet if necessary)
For Office Use Only: Date Received:
Fee Paid:
Received From:
Cash Check #
CC: Visa/ MC Last 4 CC # exp date:
Auth #
15-Mar-2012