HomeMy WebLinkAboutB15-0468_B15-0468_1449680460.pdf &IVO
(°:.41)
Department of Community Development
75 South Frontage Road
TOWN OF VA�i. Vail, CO 61657
Tel: 970-479-2139
www.vaitgov.corn
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
Protect Sheol Address: Prgecl#
is
(Number) (Street) (SuiteI) ORB
Building/Complex Name:1] t__ Building Permit -
Contractor Information Lel Block I Subdivision
Business Name-Z"1(P 6u7 rn L+)
Business Addresre t .l 7 S3C (p ] tui-na.430 Work Class. New( ) Addition{ 1 Alteration l 7t
City ___ FAC"`
_ State:CO Zip- [SACO/ Type of Building:
Contact :lClA PJF _A Single-Family( ) Duplex[4`r`] Multi-Family( 1
[ `-�'_ Commercial 11C) Other( 1
Contact Phone: t
Contact E•Mair eflpirerA_Ict .. rrkli). J v3 Work Typo: Interior( ) Exterior{ ) Both I 1
t hereby acknowledge that t have read this application.filled out
in full the information rewired.completed an accurate plot plan, Valuation of
and state that all the information as required is correct I agree tea Work Included Plies included Work
comply with the information and plot plan.to comply with all Town Electrical
laEil
ordinances and state taws, and to build this structure according to e
i �1ros t o ledki submit
the ltawnslsa nktg and subdivision codes, design review ap- clsl permit
proved,Internalises'Building and Residential Codes and other �_
ordinances of the Town applicable thereto Mechanical ()[]Yes ( No (• )Yes ( )No _
Plumbing (7L)Yes ( }No ( )Yes ( )No
x N= RAS (OeA/C4eS-ied--
O • r r s Representative Signature(Required) Building ( )Yes ( No ( )Yes ( ]No
Value of all work being performed:
Applicant Informationp (+mow caeca an SC Secr�109 3 8 IRC S. on ct� Ice 3]
-[
Applicant Name C .ti � _ Detailed Scope and Location of Work ` II
Applicant Phone. C 1 T l -3 I Cr r y►'s4.�� , f.o.lins rtA film• t t'►c+
Applicant E-Mas ■ • .. ., _ I
Pro}ect Informatio Cr r
Owner Name:
Parcel N.dlr.)!C� {�`tC ( CI it
IF or Parrot P.contort Eavo County AysriIOn Office al l97O-121d15.t0 or visit
www.esyrecounty.iseMelie 1
tuse arid•lionat sheat d necessary/
For tsftlec Use Ont+
Fee Paid: Daly Kcccivcd:
Received From:
Cash Check it
CC: Visa I MC Last R CC a exp date:
Auth a _
Rev 2015-Oct