HomeMy WebLinkAboutE16-0158 Application.pdf Department of Community Development
75 South Frontage Road West
Vail, CO 81657
TOWN OFTel: 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:
f�//� Project f#:
(Number) (Street) �! (Suite#) Building Permit#:
Building/Complex Name: &Del rne/ e4€(//Ort Electrical Permit#:
Project information: n ,e �D�
Owner Name: (�iy� Lot#: Block# Subdivision:
Parcel# 2/Q.3J R/ma?)5
(For Parcel 4,contact Eagle County Assessors Office at(970)328-8640 or visit Define Scope and Location of Work: L'nrr/Lv
www.eaglecounty.usfpatie) � S�
Contractor Information 4- avyt,. 24�
• _Z'- rra, DVer e 74v 3
Business Name: f Q!?ZP S ice�.70 2"ie.. �
.-
Business Address: PJ 136x 3,7//3 O�FYe
City Ea1,e. State: L'4 Zip:S:743
Contact Name: D41v .n 14 4.s
Contact Phone: q70^, Q --3 riga
1 additional sheet if necessary)
Contact E-Mail:�h?D1'1 �S p���J'✓LG��d�yrll��1.tl _ ....
I hereby acknowledge that I have read this application,filled out in full the Includes Temporary Service: I`"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-
mation and plot plan,to comply with all Town ordinances and state laws, Work Class:
and to build this structure accordin. p the to 's zoning and subdivision r�
codes,design revr .roved,I• e atio : ,tuilding and Residential New p`(' Addition(C) Remodel(1) Repair(C)
-Codes and er ordi anc,so - own :..livable thereto. Other(r)
Owner/O . Representati e Signature(Required) Type of Building: Single-Family(( Duplex((
Applica ormation Multi-Family(`) Commercial(C) estaurant((
I-� OtherJ IIZ/.rri.f7'I �irf
Applicant Name: _ Da.(/e, -�- _.. ._..-.
Provide BOTH square footage of area of work
Applicant Phone: OIC[ SSq 57�Z, AND Valuation(Labor&Materials)
Applicant E-Mail: et • sg• e,. I, e.1?1 � Amount of SO Ft.:
Additional AuthorizedProjectDoxUse Electrical$:
Full Name: 751-437S L2�GG —
E-Mail:
Full Name: 44:41.4. l ,ve
Date Received:
.�
E-Mail: I/AAA. /dole S e V 47 11,11
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# Auto #
Rev.2015-Dec