HomeMy WebLinkAboutB16-0456.pdf Department of Community Development
75 South Frontage Road West
Vail, CO 81657
TOWN O F VA I L '' Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm, Sprinkler& Public Way)
Project Street Address: Project#:
950 Red Sandstone Rd. #8
(Number) (Street) (Suite#) DRB#:
Building/Complex Name: Potato Patch Cluc Building Permit#:
Project Information: Lot#: Block# Subdivision:
Owner Name: John & Charlotte Kimberlin Revocable Trust
Parcel#2101-063-06-008
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New(( ') Addition(( ') Alteration ((• )
www.eaglecounty.us/patie)
Contractor Information Type of Building:
Single-Family((• ) Duplex r) Multi-Family(( )
Business Name: R& H Mechanical
Commercial(( ) Other(( )
Business Address: PO Box 810, 825-A Chambers Ave
City Eagle State: CO Zip: 81631 Work Type: Interior((i') Exterior(C) Both (('')
Contact Name: Debbie Cary
Contact Phone: 970-328-2699 Valuation of
Work Included Plans Included Work
Contact E-Mail: debbiec@randhmechanical.com
I hereby acknowledge that I have read this application,filled out in full the Mechanical (('-)Yes (( )No (C)Yes (C)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 (C)Yes ((—)No (C)Yes (C)No
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
codes,design review approved,International Building and Residential Building ()Yes (( )No (r)Yes (C)No
Codes and other ordinances of the Town applicable thereto.
Total Value of all work being performed: $16,250.00
(value based on IBC Section 109.3&IRC Section 108.3)
Owner/Owner's Representative Signature(Required) Detailed Scope and Location of Work:
Applicant Information
Remove Boiler and Water Heater and Replace with
Applicant Name: Debbie Cary
Applicant Phone:
970-328-2699 New KBN 211 and Squire 80
Applicant E-Mail: debbiec@randhmechanical.com
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