HomeMy WebLinkAboutB17-0028 Application.pdf ,
t k "° - Department of Community Development
75 South Frontage Road West
TOWN n VAIt Vail, Co 81657
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm,Sprinkler& Public Way)
;Project Street Address:
Project#:
(Number) (Street) (Suite#) DRB#: 1 301
Building/Complex Name: .ri, IAI\ Cir-s2 - Building Permit#: 6 i-0Jo2S-
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Project Information: /�, - t. Lot#: Block# Subdivision:
Owner Name: 01 f 1/V► 494/Pg-Okitl-
Parcel# Z I 0`3 I 1 S c>c)3 ;.__.._
•(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit !Work Class: New( ) Addition ( ) Alteration (K
www.eaglecounty.us/patie)
i Type of Building:
Contractor Information
I �,'�./l Single-Family( ) Duplex( ) Multi-Family(X)
Business Name: I\I t {'n�1N\--e-4"- � - ,Commercial ( ) Other( ) I
Business Address: PO Sri 2-3 _ _ :-:•• _..� _--.-'_=-_. .
City t,,l ( State: ( Zip: 0 / i Work Type: Interior( ) Exterior( ) Both(
t
Contact Name: F k I FL. 1\- 2,l t,e4.---\
Contact Phone: 940 10 Of 1 ( Valuation of
�� Work Included Plans Included Work
Contact E-Mail: �l k L�,q12 I NkA)Jc/-Qy��'/�y�--- ' �,
I hereby acknowledge that I have read thisiapplibatio114"ri,'fifled o ufi II tFie Mechanical ( ' Yes ( )No ( )Yes (�ONo ` Y✓-'Lr''''
' 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 / 'Yes - - x1Yes '/.1s-lo `-
mation and plot plan,to comply with all Town ordinances and state laws, ( (` ( ( - J ,~'
and to build this structure according to the town's zoning and subdivisions_= ..-
codes, design review approved,International Building and Residential 1 Building ( )No ( )Yes ', ;/No' =-e✓
' Codes and oth r ordinan eseof the Town applicable thereto. t --7
/' / Total Value of all work being performed: $ -( Ii'd l
X (value based on IBC Section 109.3&IRC Section 108.3) i
Owner/ wner's Represen a ive Signature(Required) 1SS
I Detailed Scope and Location of Work: Rig c..)z- . � w
1 Applicant Information 1
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S4/k I Ice (.�/��..�v -v� �v„�.5 �I�s��t @�;p 1���
Applicant Name: mow ' I� t flc(_ (71/1-5
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i Applicant Phone: v k) 3O v�t( t ��V 1VO Z l�J-"/ 15 R�2 b �KC�
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Applicant E-Mail: INA t -Arifv &' i Vo-ti 44 ; 'r -,-, 1%-,e_ 1 �c(`
Additional Authorized ProjectDox Users 440-144
/° G�� A�II I►nS W I �.. r��f1i�II int v� h 'S
Full Name: Sri (&-V DVl 111€ ( ti -vt( S los)
E-Mail: , I'14/\✓ ✓{ r5 5 p 'c
1
Full Name:
(use additional sheet if necessary)
E-Mail:
1
(use additional sheet if necessary) j.-..._ . ....-.._.
II Date Received:
For Office Use Only:
RECEIVED
Fee Paid:
Received From: i-EB
Cash Check# `� 2017
CC: Visa/ MC Last 4 CC# exp date: Town of Vail
Auth#
Rev.2015-Dec