HomeMy WebLinkAboutB15-0411 Permit Application Department of Community Development
75 South Frontage Road
WOF � 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#:
W. 60a. Creek AOC A
(Number) (Street) (Suite#) DRB#:
Building Permit#:
Building/Complex Name:
Contractor Information /� Lot#: Block# Subdivision:
/�
Business Name: C 3 / J�Di3�-:r(
r 3v 1 1 S� /JAG Work Class: New 0Addition 0j Alteration (0
Business Address: fp 1
City 40-ve.adt State: CO Zip: ®Y)3 Type of Building:
Single-Family 0 Duplex 0 Multi-Family 0)
Contact Name: Commercial 0 Other 0
Contact Phone: 3o 3 7/s' SW
Contact E-Mail: f►^�,c y +c Gv q' /- refect C0041 Work Type: Interior® Exterior 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
comply with the information and plot plan, to comply with all Town Yes �)No Yes ONo
ordinances and state laws, and to build this structure according to Mechanical ( Yes O)No I) Yes ONo
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Plumbing Ores ONo ()Yes ONo
ordinances of the Townlicable thereto.
Building °Yes ONo °Yes ONo
X le.-af-all work being performed: $ 31,oc — g
Own- awner's Represent. ignature (Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage
Applicant Information Detailed Scope and Location of Work:
Applicant Name:
Applicant Phone:
Applicant E-Mail:
Project Information I��
Owner Name: Cf7.. rc, ( e v'
Parcel#: 2/0 3 - ih'• =7 3
(For Parcel#,contact Eagle County Assessors Office at(970-328-8640 or visit
www.eaglecou nty.uslpatie)
(use additional sheet if necessary)
For Office Use Only: Date Received:
Fee Paid:
Received From:
Cash Check #
CC: Visa I MC Last 4 CC # exp date:
Auth # .
12-Mar-2012