HomeMy WebLinkAboutB17-0018.pdf di. '
. J- i ��I eepartment75 ofSouth CommunityFrontage DevelopmentRoadWest
TOWN OF VAIL I Vail, CO 81657
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical, Alarm, Sprinkler& Public Way)
Project eet Address
I ct mA b�_ 216„ Project#:
(Number) (Street) (Suite#) DRB#:
Building/Complex Name: j/a,,J :.r ,+,..t 1)trTo,,jrrJ„ ,40B uilding Permit#: 1-1 —00 1
Project Information: Lot#: Block# Subdivision:
Owner Name: A A C. 4 ASL K i i-7_.
Parcel# 1O l b`1 II?'! U 1 7—
(For
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New( ) Addition ( ) Alteration `k
www.eaglecounty.us/patie)
Contractor Information Type of Building:
Single-Family( ) Duplex( ) Multi-Family(>4.,
Business Name: 3 Ec.- t,_,v KZ._ R V f 6. E_rC.S f A C Commercial ( ) Other( )
Business Address: Pe-)Pac,k /6,4(-)
City E ArG-L,s State: 60 Zip: 1, 3. ( Work Type: Interior(X) Exterior( ) Both ( )
Contact Name: e'4 L tiewr Z._.
Contact Phone: 7 Ca- . 10 L „:,--1, Valuation of
/ Work Included Plans Included Work
Contact E-Mail: ., t •(4+2..rM r 5 i C e l.A.,.4-, r I .0 op" , �
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I hereby acknowledge that I have read this application,filled out in full the Mechanical ( )Yes (�C)No ( )Yes ('}No !/J
information required,completed an accurate plot plan,and state that all - T/�/�,
the information as required is correct. I agree to comply with the infor- Plumbing ( Vo ( )Yes ($)No 7•-7vU
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 l Z p��
codes, design review approved,International Building and Residential Building () )Yes ( )No DC)Yes ( )N
Codes and other ordinances of the Town applicable thereto.
Total Value of all work being performed: $ /��'Z(.(J
X „44 d�� ort u (value based on IBC Section 109.3&IRC Section 108.3)
Owner/Oe epres: .tiv: gnature(Required)
Detailed Scope and Location of Work:
Applican In ormation �a.vYt-v"-i14t-tAA
Applicant Name: ,nli ' n
0,41,( /YL,G"Yt L)4-FYU4<.1 (LAZI SAY/ l•Fli+' c-
Applicant Phone: 7U 3.1 d _623 M ( v
ApplicantE-Mail: J I bu'LickrS l6UC(2CAA vvt.ctitl •C4M n , ,- /"��C0 � �6.�I��J - �26&J Q� gb
��
Additional Authorized ProjectDox Users '( �)� }` ^"^""' —' ' � ���""i
Full Name: JJ\ ft/La AA.4 --3 LA:AL c-� (�aC,t:7' J
E-Mail: 010 V Q. .-a.te/14.t v.Caivl, - - 6.t 33c0 ReS
Full Name: (use additional sheet if necessary) 1Y r'�.c���t
E-Mail:
(use additional sheet if necessary)
Date Received:
For Office Use Only:
RECEIVED
Fee Paid:
Received From: td 0 7 2017
Cash Check#
CC: Visa/ MC Last 4 CC # exp date: Town of Vail •
Auth #
Rev.2015-Dec