HomeMy WebLinkAboutB16-0075.pdf Department of Community Development
75 South Frontage Road West
TOWN GF VAI[' Vail,CO 81657
Tel: 970-479-2139
wwwr.vaixgov.corn
BUILDING PERMIT APPLICATION
(Separate appl4cations are required for Elecincal,Alarm. Sprinkler S Public Way)
Project Street Address! Pr/ea#:
1{16 5;6m.4 441l At r. -719-7
umber) {Street] (Suite/0 DR5
Building/Complex Name; £+Qwj ilia--ti.t Building Permit#.
Project In Formation: - Lot#; Block# Subdivlston
Owner Name: It'd r1 1[ f)
Parcel ix l�` y
(Far Parcel T.coobrl Eagia CourrtyAsitosAas affrcayrl PICT B-$�d4 or wicit Work Class: New( ) Addition.( reitiori�)
veyn .■agicvuniy.,iErvitie)
Contractor Information Type of Building:
{{�
Sing!e-FFirnrly{ ) Duplex( } Multi-Family ()
Baseness Name: f ? + 14P5 r_ COr* nercial ( ) pater )
Business Adoress:•2306 5 C r f o f 4Riad'
City,D.--1•1-e-, Slate: CP Zip: 0 Zz 2 Work Type; intariar4 Exterior{ I Bcah(
Contact Name-
co. tact Phone: ?- 7, - 7Fgc, valuation of
4 Work Included Plans Included Work
Clxd�cl Mail: rti rA 136 1 d 6,'s 1.4C-CD
hereby aclotowlecge vv.'I have feats 1 5 epplitaiien.felled 44'r in furl the WO—L -Ka i'?55Yt35 ( }filo (}Yes ,No _
infortralian required,completed an accurate pror pian. end slate;hal ori
the information as required is carred, t agree Va comply with the infor Plumbing r ' Yes ( 1N0 ( Yes ( )No
maw and poi plan.to comply with all Town ordinates and state laws.
and to biiIQ:his structure according to the i;edirrs.zoning and suhdiadston
codecs,design review appro,red-Intemataona Buiidurg aro Resideniial Building { }.Yes ( }No pOYes ( iftio
Codes and other artinances of the Town applicable thereto.
Total Value of all work being performed: $ Of ,
otal
:•. ar.IBSa 1 n i' &FRC i-cer.3}
i�y,rr}gr�►. _ 's RApresen igroa#tyre(Required} Deladed Scrape and Location oI Work' Mie �i t7vk�n ,
Applicant Information
T-AS4-11 ICJ c.,J-kr j c‘r‘,..6 .
Applicant Name: .w. Y r a f i
Applicant Phone: 193- !f ' ??56. '1. ,II)cl,� , P . QO
ApplfrantE-Mail' cc+.r. fid,-t �icfi t`.fiv\ I � � `Qtr" —.
Additlone[Authorized ProJectDox Users 4P Gam.
Furl Name.
E-Marl:
Full Name' _ (SEE adC,hona.5hee7rf nes ga'yr
E-Mai I.
(usaaJd-a•driai Sl*et if nemssiary}
Date Received:
Far Office L+ie(}nh..
Fee Paid:
Received From:
Cash Check #
CC: Visa 1 MC Laest 4 CC# , exp crate:
Audi 4
Rev 2015-Der.