HomeMy WebLinkAboutB15-0471_B15-0471_1450737840.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIL0")
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm &sprinkler)
Project Street Address: Project#'
l..a..J rnF .3—Ku
ORB#:
(Number) (Street) (Suite#)
vI41 U �1 h' t rr s�,t
Building Permit#'
Building/Complex Name: h� t ll
Contractor Information Lot#: Block# Subdivision:
Business Name: Dirt'LA.(an..1 i � ,cel .Sytr;tL1
Business Address: 170 L 4(.ec �2 Work Class: New( ) Addition{ ' ) Alteration(
City C p f�,r+ '
State: �4 Zip: �►� 7 Type of Building:
Contact Name: Single Family( ) Duplex( ) Multi-Family(t )
rJ Commercial(5C) Other(( }
Contact Phone: r-TG - 3 TI, - C]L-ka.3
Contact E-Mail:- E. ‘N(10,„E., @ lg MS c USA}=CO ' Work Type: Interior{(es) Exterior(r) Both(' )
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 (i iYes (r')ivo Please submit
ordinances and state laws, and to build this structure according to electrical permit
the town's zoning and subdivision codes, design review ap- application.
proved, International Building and Residential Codes and other
ordinances of the Town applicable thereto. Mechanical {tT}Yes (t k)Yes (;�}No
X Plumbing ( }Yes (--)No ((—)Yes (' )No
Owner/0 er's Representative Signature(Required) Building (( }Yes C )No C)Yes ({. )No
Value of all work being performed. $ 50r )i, b r `y
Applicant Information (value based on IBC Section 100.3&iRC Section 108.3)
Applicant Name: Detailed Scope and Location of Work:
Applicant Phare: RE.lik ACE
ri t t4 a S i
kt-
Applicant E-Mail: 3 R E Mcg E
fl SLE F4:i 1-k k E ‘36—
Project
6Project Information
Owner Name: 10 f Q 110 10 [3 1i-utI NIE E�Lw AP
Parcel#: 0) 10 tD .11(..) 101 4. CU+,tu A e, t t 4 ,d OIC
(For Parcel Si,contact Eagle County Assessors Office at(970-328-8640 or visit �GE
www.eaglecounty.uslpatie) (441 IN `k' ; I
(use additional sheet if necessary)
For Office Use Only-
Date Received:
Fee Paid:
Received From:
Cash Check #
CC: Visa/MC Last 4 CC# exp date:
Auth #
Rev. 2015-Oct