HomeMy WebLinkAboutB17-0017_application.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIL Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
WATER HEATER PERMIT APPLICATION
(REPLACEMENT ONLY)
(This permit is applicable to one and two family dwelling units only)
Project
Project#:
Street Address:
450_6211 Ni\NCLIL, G6 fe, \)i. 4t. /4-- -91/40LIBuilding Permit#:
•
(Number) (Street) (Suite#) Lot#: Block# Subdivision:
, .
Contractor Information
1 Work Class: Alteration( ) Work Type: Interior( )
Business Name: tOlof acto be_lta, rilochaniem . --- —i
I Type of Building: Single-Family(VD-1710ex( )
Business Address: C0056 6 60,6elifte Ael 0165' ,---= ----- -- -- ---- ------------ ----------------- -,,
i Joint Property Owner Approval ( ) Yes ( ) No
• City r11e54 State: (1.2. Zip: /55.20(0 _1
Water Heater Type ( )Gas (.4Electric
Contact Name: ebb:,
1 Number of Appliances I
Contact Phone: 1360(.0r-CA 2- 6213
, Cut Sheets Included ( )Yes ( )No
. Contact E-Mail: Coperviii46 0 cl e 1-IA Mt CIAO i 041• r--------- _
even .1 Veni Location Photograph Included ( )Yes ( ) No
P )
. x ' (when applicable)
IP, l' -,i • - -------...-----1
----1
Ownede, ner's Representative gnature(Require ,Submittal Checklist Complete/Attached ( ) Yes ( ) No
Applicant Information 1 Plans Included ( )Yes ( ) No 1
Applicant Name: Leineroidp Oan,Cia '
' Detailed Scope and Location of Wprk: Ate tact. !
_ . _50 gallon titerki C viCeker i
Applicant Phone: d86(.0-62:94Z: 4215 .
1 Ltkee I/ o ttiokv6 }
Applicant E-Mail: eOpftY/116 0 Cie 144 olgthaaieta..
COO, 1 ..5dOV - edoritiet-t
Project Information
I (use additional sheet if necessary) 1
Owner Name:
- ----1
_..,•_.•••• • •
Parcel#: L
• 1(For Parcel tt,contact Eagle County Assessors Office at(970-320-8640 or visit Plumbing value of work being performed: $ 1 1 1 i
www.eaglecounty.us/patio)
For Office Use Only: Date Received:
Fee Paid:
Received From:
Cash Check # _
CC: Visa / MC Last 4 CC # exp date;
Auth #
06-Jun-Il