HomeMy WebLinkAboutB15-0083_B15-0083_1428095580.pdf Department of Community Development
75 South Frontage Road
TOWN OFT. Vail,CO 81657
Tel:970-479-2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm&sprinkler)
Project Street Address: Project#:
131'o 11--c) ® 1
DRB#:
(Number) (Street) (Suite#)
;`` c,_
Building Permit#:
Building/Complex Name:
Contractor Information Lot#: Block# Subdivision:
Business Name: 5,(2-, ►o....1 �U c_.
Work Class: New 0 Addition 0 Alteration(0
Business Address:
City State: Zip:
Type of Building:
� Single-Family 0 Duplex 0 Multi-Family 9
Contact Name: YCommercial 0 Other 0
Contact Phone: "SI)0 CO--1-1.1%,i9 - l
Contact E-Mail: C.V) 615Re-151)l atk%va)rn Work Type: Interior 9 Exterior C) Both C)
I hereby acknowledge that I have read this application,filled out '�` Valuation of
in full the information required,completed an accurate plot plan, Work Included Plans Included Work
and state that all the information as required is correct. I agree to Electrical Yes OiNc0Yes ONo
comply with the information and plot plan,to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical OYeso QYes ONo
the town's zoning and subdivision codes,design review ap-
proved,
7
International Building and Residential Codes and other Plumbing Yes ONo °Yes ONo /0 0 Cl
ordinances of the Town applicable thereto.
Building Yes ONoYes No .5-0❑
XSPA) Value of all work being performed: $ 0 V e
Owner/Owner's Repr entative Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3) '
Pt-
Electrical Square Footage
Applicant Information
n r,,L,, r Detailed Scope and Location of Work-
Applicant Name: eiPet� rf't-"' " ' e rtC82_, -00 -I-c Sry r it
Applicant Phone: Q_] rl .
Applicant E-Mail- e,L�
Project Information {, _ V �`�" � 41 YI1%(
Owner Name: al ►O Pel rk 4r Gy
Parcel#: 2I0 3 - I Z-l - I f -OM
1
•(For Parcel#,contact Eagle County Assessors Office at(970-328-8640 or visit
www.ea glecou nty.uslpatie)
(use additional sheet if necessary)
For Office(fisc Only:
Date Received:
Fee Paid:
Received From:
Cash Check #
CC: Visa/ MC Last 4 CC# exp date:
Auth #
12-Mar-2012