HomeMy WebLinkAboutB16-0500 Application.pdf Department of Community Development
75 South Frontage Road West
Vail,CO 81657
TOWN OF VAIL°
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electncal,Alarm, Sprinkler& Public Way)
1452,-1
roject 152 y StreetAddress: WThz G o o Project#:
(Number) (Street) {� (Suite#) DRB#:
Building/Complex Name: I tr vER. i 5 _ Building Permit#: "-Oa)O
Project Informati n: 5 1140 L7>I &5 LL
S{ �� / Lot#: Block# Subdivision:
Owner Name: LSC 1 IA
jL-
I * 2101— 12 L -- I I -DQ,I,
(For Parcel M,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New((%) Addition(Q) Alteration(Q)
www.eaglecounty.usipatle) R EIADDLF K ITc%4cf.
Contractor Information Type of Building:
—i� Single-Family(0) Duplex(0) Multi-Family(X)
Business Name: J H CoNS?e j AcTet O J Commercial(0) Other(0) CQP(DO 5
Business Address: -f Q ,P x 34 D J
City El(ii.(=. State: C,n Zip: $((�31 �Work Type: Interior(X) Exterior(Q) Both(0)
Contact Name: TE F F FZE—y n E ET�MA,J S
Contact Phone: -1-} d 310 3-3-3-°1 Valuation of
Work Included Plans Included Work
Contact E-Mail: VA I L S I c K l4 C.0
Mechanical (Z+Yes No (/')�Y P I DQO,
I hereby acknowledge that I have read this application,filled out in full the ) � (()Yes (QjNO !,/
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 ( 1)Yes (Q)No (Q)Yes (Q)Noo 4666 o0
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 Building �q,Yes (0)No ^^Yes ^^No Z5/r �
codes,design review approved,International Building and Residential lac) (C (C7 (Q
Codes •• ser o •inances of the Town applicable thereto.
11 Total Value of all work being performed: a $_
X . � d/1 (value based on IBC Section 109.3&IRC Section 108.3)
Owner/Owner' ''ep -s ntative Signature(Required)
Detailed Scope and Location of Work:
Applicant Information
R+R.THE KiT - .NCFt ttvETS .
Applicant Name:
1ZEWMp2, r)F N fbRp t\ Si4r J "
Applicant Phone: R�- CNC GO/ 1-t 2" 1--at-1 cork U •w iTlt
Applicant E-Mail: RY U-. -%e s t bi_s.
Additional Authorized ProjectDox Users
Full Name: q P (J( e- J s T'e e
F_ Mail: N/`}N)›P.t 44, To pm.fi✓� 'l LO'D€
Full Name: RF ,'Czt<- 570-NC. ( - %7t
(use additional shpet if necessary)
E-Mail: r l Q fL')) k c 1 R`L p(MC-f Imo/ t—?. czYS K
(use additional sheet if necessary) A-_2_ S73 tsrt.
Date Received:
For Office Use Only
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp date:
Auth #
Rev.2015-Dec