HomeMy WebLinkAboutE16-0258 application.pdf Department of Community Development
75 South Frontage Road West
TOWN OF VAI!` Vail, CO 81657
Tel: 970-479-2139
www.vailgov.com
ELECTRICAL PERMIT
Electrical Permit Submittal Requirements Including Heat Tape Installation
_Floor plan/Site plan showing proposed work _Occupancy Group listed on plans
_Load Calculations and one-line diagram when loads or circuits are being added _Building Type
NOTE:For Multi-Family and Commercial buildings—plans and calculations must be prepared by a Colorado Licensed Electrical Engineer
Project Street Address:
}-}orn &f'. Project#:
(Number) (Street) (Suite#) Building Permit#:
Building/Complex Name: EI LQ_ Oa5
Electrical Permit#: 0
Project Information: ''//
Owner Name: -7-(3/,---)r,-7-(3/,---)r, 0Y U� ,I Lot#: Block# Subdivision:
Parcel# ,6'4 , Oel
(For Parcel#,contact Eagle County Assessors Office at(970)3284640 or visit Define Scope and Location of Work:
www.eaglecounty.uslpatie)
Contractor Information ) ;
Business Name: Tr.kCtS c L 1 - r� 5� �� 15
Business Address: t) �7� ,Jc. r aSLi-goI-. f U
City ()if_.V Ws- State:/ Zip: T!(,J+)
Contact Name: U6 4\ 0G-I h!'err
Contact Phone: `)70 `�cv -3 iOS
Contact E-Mail: cVln �r'rOicSC LrelA�c.1y�, (use additional sheet if necessary)
J
I hereby acknowledge that I have read this application,filled out in full the Includes Temporary Service: (C)Yes 04 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-
mation and plot plan, o comply with all Town ordinances and state laws, Work Class:
and to build is stru re according t• he town's zoning and subdivision
codes,desi.j revi: :pp .ve� Inte 'Itional Building and Residential New O Addition(r) Remodel(C Repair(C
Codes and her a -s o the ,wn applicable thereto. Other(C)
0 ner/Ow -r's Representative Signature(Required) Type of Building: Single-Family(0- Duplex(0
Ap• •ca Information Multi-Family(('^) Commercial(cT) Restaurant((
Other(X) 64 re 4- ni rhe sclV,4t-
Applicant Name: �,,. . ... .. ..
Provide BOTH square footage of area of work
Applicant Phone: AND Valuation(Labor&Materials)
Applicant E-Mail: Amount of SQ Ft.: ri14
Additional Authorized ProjectDox Users Electrical$ .DS-0 6) -
Full Name:
E-Mail:
Date Received:
Full Name: II /� %�
E-Mail: (C3'l D`� V 'l.�- AA-S�
For Office Use Only: (
Fee Paid: 1 6
1 .
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# Auth #
Rev.2015-Dec