HomeMy WebLinkAboutB15-0416_B15-0416 Application_1445369460.pdf 10
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Department of Community Development
75 South Frontage Road
TOWN OF n Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
it Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm&sprinkler)
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II Project Street Address: Project#.
f-3V51) V+���Il!\lu\4CY� C 1 Yom. 1}t
DRB#:
(Number) (Street) (Suite#)
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Building/Complex Name: Building Permit#:
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{ Contractor Information Lot#: Block# Subdivision:
Business Name ."7- 1-2__- __
Work Class: New 0 Addition 0 Alteration(6
Business Address
City State. Zip Type of Building:
['InYG+-
Single-Family 0 Duplex le'• Multi-Family 0
Contact Name: ��
Commercial 0 Other 0
Contact Phone: '-6,0 S -7-) '{-
I
•
Contact E-Mail v- l!!a SAF•-IAA' S• CC N Work Type: Interior 0 Exteriorc`" Both 0
I hereby acknowledge that I have read this application,filled out Valuation of
Work Included Plans Included Work
n#ull the information required,completed an accurate plot plan,
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and state that all the information as required is correct. I agree to Electrical ()Yes rNo OYes ONe
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 ONoYesN❑
the town's zoning and subdivision codes, design review ap-
proved International Building and Residential Codes and other Plumbing Yes ONo Yes ONo
if ordi noes of the Town applicable thereto.
Building gYes ONo ,Yes ONo 3(Pi a 0 b
X Value of all work being performed: $ 369 DUl)
Owner/Owner's resentative Signature(Required) (value based on IBC Section IN 3 8 IRC Section 108.3)
'` Electrical Square Footage /7Ift'
Applicant Informations + _(� DetailedlScope and Location of Work:
Applicant Name. --L 1�L—' /'")t'C1j1 Gzc `:`d, _ 1- ' & i r15114/-7
' ( TY Applicant Phone: 1 !. ' / /2
Applicant E-Mail.
Project information
Owner Name: 15 �4 fz!U it?
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Parcel#: �} ) 2}-1 O3 04
i. tor Parcel#,contact Eagle County Assessors Office at(970-328-8640 or visit
www.e a g i ecou n ty.uslpat ie)
(use additional sheet if necessary)
For{lftiee Else Only:
Date Received:
Fee Paid:
Received From:
Cash Check
CC: Visa/ MC Last 4 CC # exp date:
Auth#
i
12-Mar-2012