HomeMy WebLinkAboutB16-0006_B16-0006_1453233240.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIL Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm &sprinkler)
Project Street Address: Project#:
1864 Glacier Court A
Number DRB#:
(Number) (Street) (Suite#)
Building Permit#:
Building/Complex Name:
Contractor Information Lot#: Block# Subdivision:
Business Name: Jerry Sibley Plumbing, Inc
Business Address:
PO Box 340 Work Class: New 0) Addition 0) Alteration 00
City Minturn State: CO Zip: 81645 Type of Building:
Kristena Wyatt
Single-Family 1) Duplex e) Multi-Family 0)
Contact Name: Y
Commercial 0 Other O)
Contact Phone: 970-827-5736
Contact E-Mail:jspinc@vail.net Work Type: Interior} Exterior 0 Both 0
I hereby acknowledge that I have read this application,filled out Valuation of
in full the information required,completed an accurate plot plan, Work Included Plans Included Work
and state that all the information as required is correct. I agree to Electrical °Yes O)No O)Yes O)No
comply with the information and plot plan,to comply with all Town
coo
ordinances and state laws, and to build this structure according to Mechanical ()Yes O)No O)Yes O)No Z3100v
the town's zoning and subdivision codes,design review ap-
proved,International Building and Residential Codes and other Plumbing ()Yes O)No °Yes O)No
or inances of the Town applicable thereto.
Building ()Yes O)No O)Yes O)No
X Value of all work being performed: $ i3 6/)
p0_
Owner/Owner's Representative nature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage
Applicant Information Detailed Scope and Location of Work:
Applicant Name: Same as above Replace existing boiler with a
Applicant Phone: Lochinvar KBN400
Applicant E-Mail:
Project Information Martin &Vicky Keisch
Owner Name:
Parcel#: 2103-122-04-037
(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: Date Received:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp date:
Auth #
15-Mar-2012