HomeMy WebLinkAboutB15-0175_B15-0175_1432309380.PDF Department of Community Development
75 South Frontage Road
TOWN OF WillVail, 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: 1 r x Project#:
1` It ilti
(Number) (Street) J_ (Suite#) DRB#:
I „y /'' f Building Permit#:
Building/Complex Name: H l H t,tf 1;
Contractor Information _ 'tf Lot#: Block# Subdivision:
Business Name: - , I PE j () íj : ( .ck.)
Business Address: _ � ,
Work Class: New aAddition 0 Alteration 0
_ 3
City OW i at). State. ` , Zip �% 1 , Type of Building.
Contact Name: Single-Family(�j Duplex(C) Multi-Family E'tt
— - C ,
Commercial 0 Other
Contact Phone. Ivy � „% -j �
Contact E-Mail: t.: 11 ,, , CI
Work Type: Interior Exterior Both
0
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 I
and state that all the information as required is correct, I agree to Electrical ()Yes 6No ()Yes rNo
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical OYes )No °Yes ONo
the town's zoning and subdivision codes, design review ap-
proved, International Buildin• and Residential Codes and other Plumbing , Yes ONo ()Yes OJNo T
ordinances of ,, •wn •,@,cable thereto.
,-. ( h Building Yes �No Yes �No
X w
4.�b!. ii/ Value of all work being performed: $ 1 h} f O
�'
Owner/Own 's Repres . ive Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage
Applicant Information Scope and Location of Work:
Detailed
Applicant Name: f)ft (
— _ J
Applicant Phone: ' 1 r
A1f, < Kir s
E g
Applicant E-Mail: 1 w - 9 1,:coRK To
Project Informationfla .- t 1)0t1/4311‘,
Owner Name: ( ci, F 4 lit !kali i
Parcel#: � j
(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:
Fee Paid: Date Received:
Received From:
Cash Check#
CC: Visa/ MC Last 4 CC# exp date:
Auth #
12-Mar-2012