HomeMy WebLinkAboutB15-0355_B15-0355 REV1 transmittal_1444839420.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAII . Vail, Co 81657
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm &sprinkler)
Protect Street dress: Project#: ?R.-) /5--- G'S ,(, ,
L -)---)e(.+ .c ALL... [ lac L 4-51 vA.-
DRB#:
(Number) (Street) (Suite#)
Building Permit#: fj/, -L-- 5
Building/Complex Name:
Contractor Information Lot#: Block# Subdivision: ` ,
Business Name: fr i s, ti/C.e S (7.& f.:41-r-�cit 11171 ..................... — -
\--) Work Class: New( ) Addition ( ) -Alteration( ,r.
Business Addreg
Nk7 GG
J Type of Building:
�J G \ State: ��"� Zip: �E-'-h.,��
Single-Family( ) Duplex(' 9-.Multi-Family( )
'Contact Name: tir a-,; ^�_r S Commercial ( ) Other( ) '
Contact Phone: - —--
Work Type: Interior( ) Exterior ) Both( )
Contact E-Mail: Ti !7.74-1.'c �ci. G e i.C6 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
and state that all the information as required is correct. I agree to Electrical ( )Yes ( )No ( )Yes ( )No
comply with the information and plot plan,to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical ( )Yes ( )No ( )Yes ( )No
the town's zoning and subdivision codes, design review ap-
•
proved, International Building and Residential Codes and other Plumbing ( )Yes ( )No ( )Yes ( )No r
ordinances of the Town applicable thereto.
Building }Yes ( )No (-4Yes ( }No' (c .
XrP
L_ _ _. Lez,--:, Value of all work being performed: $
G
Owner/Owner's Representative Signature(Required) (value based on IBC Section 109.3&1RC Section 108.3)
Electrical Square Footage
Applicant Information Detailed Scope and Location of Work:
Applicant Name: 1 C r.',,_ RP X i- K S'eroo=
Applicant Phone: .*-77) .l 5i i �!U,3]� , .� [
Applicant E-Mail: ')C`:S•- C r, .• ( t'b5. /� p ,
r% ri
7/-0
Project Information � i �yfr / ark I, Q.7ry L,-t_Q'_ �
Lit
f7-1
Owner Name: ()'�c (-_.c-',-'1-4'1;�i(. �i1G e..K1S7n ) iL: Jt- i]FrCYk
Parcel#: Va c=ti,d J L (� cc. '--
[For Parcel#,contact Eagle County As ssors Offlce►at(970-328-8641:
970-328-864 or visit •
www.eag l ecou nty.uslpati e)
(use additional sheet if necessary)
Fur Office Use Only: Date Received:
Fee Paid:
Received From:
Cash Check#
CC: Visa!MC Last 4 CC# - exp date:
Auth#
2014-0901