Loading...
HomeMy WebLinkAboutB16-0095.pdf Department of Community Development 75 South Frontage Road West TOWN OF VAIL Vail,CO 81657 Tel:970-479-2139 www.vailgov.com BUILDING PERMIT APPLICATION (Separate applications are required for Electrical,Alarm,Sprinkler&Public Way) Project Street Address: Project#: o-` rc� s�to E �,,[lfr; (Number) (Street) (Suite#) DRB#: Building/Complex Name: 4"114111e- ?f Building Permit#: Project Informatiof WV I,� Lot#: Block# Subdivision: Owner Name: ialt Oi�'� /1 / Parcel# -tO I '©63 ' I 0 (For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New(r) Addition(Q) Alteration( www.eaglecounty.uslpatie) -i�t _0(23 ( ' �p 1.1 Contractor Informatio 'Z Type of Building: e �A 4 Single-Family( ) Duplex( ) Multi-Family( ) Business Name: /�"" ;`L Commercial(''') Other(C) Business`Address:/ 2-Lit ( • f rp 4a_1 e Ake City J"l State: ep Zip: 43(Pv+ Work Type: Interior( •1 Exterior( ) Both( ) Contact Name: j)CW' 11 Contact Phone:_ 9 ' Cf-fro . .S0137-- Valuationof Contact E-Mail: okei.� (10 Work Included Plans Included Work I hereby acknowledge that I have read this application,filled out In full the Mechanical C.)Yes ( lNo ( )Yes ( )No information required,completed an accurate plot plan,and state that all the Information as required is correct. I agree to comply with the infor- Plumbing ()Yes ( ')No ( )Yes )No matron 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 approved,International Building and Residential Building C)Yes ( `'}No ( )Yes (C)No Codes and other ordinances the Town applicable thereto. Total Value of all work being performed: $ "Ki-Vr,`) X r^". (value based on IBC Section 109.3&IRC Section 108 3) Owner/Owner's Representative Signature(Required) Detailed Scope and Location of Work: Applicant Informati nn ` Applicant Name: Applicant Phone: 70 M... Applicant E-Mail: CO ,�w Additional Authorized ProjectDox Users Full Name: E-Mail: Full Name: (use additional sheet if necessary) E-Mail: (use additional sheet if necessary) Date Received: For Office Use Only: Fee Paid: Received From: Cash Check# CC: Visa/MC Last 4 CC# exp date: Auth # Rev.2015-Dec