HomeMy WebLinkAboutB15-0018_B15-0018_1423691640.pdf Department of Community Development
75 South Frontage Road
TOWN OF V►4lL ` 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#:
748 Potato Patch Drive A
DRB#:
(Number) (Street) (Suite#)
Building/Complex Name:
Vail Potato Patch Fil. 2 Building Permit#:
Contractor Information Lot#: Block# Subdivision:
Business Name: R& H Mechanical
Business Address: PO Box 810 825-A Chambers Ave
Work Class: New 0) Addition ,) Alteration 0)
City Eagle State: CO Zip: 81631 Type of Building:
TiffanyBakker Single-Family 0) Duplex 0) Multi-Family 0)
Contact Name:
Commercial (a Other 0)
Contact Phone: 970.328.2699
Contact E-Mail: tiffanyb@randhmechanical.com Work Type: Interior O) Exterior 0 Both
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 ®i )Yes ®)No ®)Yes ®)No 1000.00
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical 0Yes ®)No ®)Yes ONo 4400.00
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Plumbing ()Yes ®)No OYes ONo
ordinances of the Town applicable thereto.
Digitally signed by Tiffany Bakker Building Q)Yes ®)No )Yes ®)No
Tiffa ny Ba kker DN:cn=Tiffany Bakker,o=R&H Mechanical,ou,
email=tiffanyb@randhmechanical.com,c=US
X Date:2015.02.1113:17:05-0700' Value of all work being performed: $ 5400
Owner/Owner's Representative Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage 100
Applicant Information Detailed Scope and Location of Work: Replace existing
Applicant Name: Tiffany Bakker humidifier and ventilator with Nortec RH2
Applicant Phone: 970.328.2699
Applicant E-Mail: trbakker@outlook.com
Project Information David Knuepfer
Owner Name:
Parcel#: 2101-063-15-014
(For Parcel#,contact Eagle County Assessors Office at(970-328-8640 or visit
www.eaglecounty.us/patie)
(use additional sheet if necessary)
For Office Use Only: Date Received:
Fee Paid:
Received From:
Cash Check#
CC: Visa/ MC Last 4 CC # exp date:
Auth #
15-Mar-2012