HomeMy WebLinkAboutE16-0240.pdf I6 JOL /
Department of Community Development
75 South Frontage Road West
TOWN OF VAIL; Vail, Co 81657
Tel: 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:
`76i Gri45(6\67 v,X i1 Project#:
(Number) (Street) j � (Suite#) Building Permit#: �! 6- 1n�O (
�`�Building/Complex Name: t Electrical Permit#: i 6 ` 0 O_� /O -
Project Information:
Owner Name: // Lot#: Block#—
Subdivision:
Parcel# 9 1 6 1 91 6 (P C I
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit H Define Scope and Location of Work:
www.eaglecounty.us/patie)
„--— . __-.. „, k oc,e. (Ai i r i 11\- 7,
Contractor Information
1
Business Name: r\ d'er -I' 1 (
/21'6, tw
/v cl
Business Address: i
7Q e
City if LL Y\ State: Zip:e?,4
Contact Name: 6. k 1�-
Contact Phone: 7 `.V
Contact E-Mail:`.74./ i ___ � Y1 9 0
use a it al sheet if necessary)
I hereby acknowledge that I have read this application,filled out in full the Includes Temporary Service: (C)Yes (T)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 str « re according to the town's zoning and subdivision
.- New(C') Addition(C') Remodel fair(C
codes,design r=. -w apprnued la : ':naFBtiildir�g aad ntial
Codes and . -r ordinan - . '•ewnapplicable -reto. Other(c)
X
Owne 'wner's Represen ative Signature('-•uired) , i Type of Building: Single-Family(C) Duplex(f
App cant Information Multi-Family commercial(C) Restaurant(C)
Other( ')
Applicant Name:
Provide BOTH square footage of area of work
Applicant Phone: AND Valuation(Labor&Materials)at
Applicant E-Mail: ,Amount of SQ Ft.: L (9 0
Additional Authorized ProjectDox Users L706.6 dam'
Electrical$:
Full Name:
E-Mail:
Date Received:
Full Name: V
E-Mail D
For Office Use Only: OCT 3 1 2016
Fee Paid: 1
J
Received From:
Cash Check# TOWN OF VAIL
CC: Visa/MC Last 4 CC# Auth # -
Rev.2015-Dec