HomeMy WebLinkAboutB16-0012_B16-0012_1454437500.pdf Department of Community Development
75 South Frontage Road
TOWN ( 1 ( `` Vail, CO 81657
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
Project Street Address:
•r Project#:
. 7 1/1)0 j rho, v ✓j (rleoe-f'
(Number) (Street) DRB#:
(Suite#)
Building/Complex Name: Building Permit#:
Contractor Information Lot#: Block# Subdivision:
Business Name: /99 9 f'�f ^ci r-i'/ rn
Business Address: f�/0 4444104 r C" 7/' e I / Work Class: New((" ) Addition ( ) Alteration ( )
City �i �r( � State: 6,0 Zip: � 3Z Type of Building:
Single Family( ) Duplex(ft) Muiti-Family(C)
Contact Name: 4/74
Contact Phone: Op) 670 - z,
Commercial (C:) Other(C))
Contact E-Mail: .� "' ;
r'f "'"d4'G1/4i&7 '73i -7 r,,,n,/ , , Work Type: Interior') Exterior(CA Both (C)
I hereby acknowledge that I have read this application, filled out
in full the information required,completed an accurate plot plan, Valuation of
and state that all the information as required is correct. I agree to Work Included Plans Included Work
comply with the information and plot plan, to comply with all Town Electrical
ordinances and state laws, and to build this structure according to (( Yes ( )No Please submit
the town's zoning and subdivision codes, design review ap- electrical permit
proved, International Building and Residential Codes and other application.
ordinances of the Town applicable thereto. Mechanical (C)Yes (72.)No ( ')Yes )No
X „/ vPlumbing (Yes (2)No (Yes .� )No
Building ((`:)Yes h)No )Yes (C)NoOwner/ er's Represents e Signature(Required)
Value of all work being performed: $ 3/NV -
Applicant Information (value based on IBC Section 109.3&IRC Section 108.3)
Applicant Name: ' Ye. i, Detailed Scope and Location of Work:
Applicant Phone. C o) 6-1 S 9 0 a v.9/ ° i'148/'10/- /J1
Applicant E-Mail: CI S Hca In VY1 (- r 0. A-4,, -2 ✓//74
c") r n fit- • c a`yt^
Project Information
Owner Name: V0Cr /1e'
Parcel#: 7.10 - /Z- _ — bra
(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 #
Rev. 2015-Oct