HomeMy WebLinkAboutB15-0223_B15-0223_1435349100.pdf12-Mar-2012
Project Street Address:
__________ ______________________________ ___________
(Number) (Street) (Suite #)
Building/Complex Name: ________________________________
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
Project #: __________________________________________
DRB #: ____________________________________________
Building Permit #: ___________________________________
Lot #: ____ Block #____ Subdivision: ___________________ Contractor Information
Business Name: ________________________________________
Business Address: ______________________________________
City ______________________ State: _______ Zip: ____________
Contact Name: _________________________________________
Contact Phone: _________________________________________
Contact E-Mail: _________________________________________
I hereby acknowledge that I have read this application, filled out
in full the information required, completed an accurate plot plan,
and state that all the information as required is correct. I agree to
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according to
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other
ordinances of the Town applicable thereto.
X___________________________________________________
Owner/Owner’s Representative Signature (Required)
Applicant Information
Applicant Name: ________________________________________
Applicant Phone: ________________________________________
Applicant E-Mail: ________________________________________
Detailed Scope and Location of Work:
(use additional sheet if necessary)
Work Class: New ( ) Addition ( ) Alteration ( )
Type of Building:
Single-Family ( ) Duplex ( ) Multi-Family ( )
Commercial ( ) Other ( )__________________________
Work Type: Interior ( ) Exterior ( ) Both ( )
Project Information
Owner Name: ________________________________________
Parcel #: ___________________________________________
(For Parcel #, contact Eagle County Assessors Office at (970-328-8640 or visit
www.eaglecounty.us/patie)
Value of all work being performed: $______________
(value based on IBC Section 109.3 & IRC Section 108.3)
Electrical Square Footage ______________
For Office Use Only:
Fee Paid: _________________________________________
Received From: ____________________________________
Cash _________ Check # ___________
CC: Visa / MC Last 4 CC # _________ exp date: ________
Auth # _________
Date Received:
Work Included Plans Included
Valuation of
Work
Electrical ( )Yes ( )No ( )Yes ( )No __________
Mechanical ( )Yes ( )No ( )Yes ( )No __________
Plumbing ( )Yes ( )No ( )Yes ( )No __________
Building ( )Yes ( )No ( )Yes ( )No __________
Department of Community Development
75 South Frontage Road
Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
5123 Black Bear Lane
Howard-Levaggi Remodel
Local Restoration, LLC
1003 Main Street
Minturn CO 81645
Jeff Armistead
970-471-0618
localrestorationllc@gmail.com
Tim Howard (Owner)
1-303-918-1882
thoward@indra.com
5123 Black Bear Lane LLC
2099-182-25-002
Split Level Residential Condo
5000
2000
5000
25000
37000
100
Demolition of some
interior walls, re-locate some existing electrical,
re-work laundry, shower plumbing, update new bath
cabinetry, tile, flooring, drywall, paint
Tim Howard Digitally signed by Tim Howard
DN: cn=Tim Howard, o, ou, email=thoward@indra.com, c=US
Date: 2015.06.25 15:01:49 -06'00'