HomeMy WebLinkAboutB16-0190.pdf Department of Community Development
75 South Frontage Road West
Vail, Co 81657
TOWN OF Mi. Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm,Sprinkler&Public Way)
Project Street Address: Project#:
Sof\bur34
(Number) (Street) (Suite#) DRB#: )DAB No-00 7E5
Building/Complex Name: Building Permit#:
Project Information: Lot#: Block# Subdivision:
Owner Name: '.e• (AV\
Parcel# 2\()l()9 0.6 (
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New( ) Addition ( ) Alteration"(--,K)
)
www.ea g l ec o u nty.usipati e)
Type of Building:
Contractor Information
I Single-Family( ) Duplex(-744 Multi-Family( )
Business Name: ,-W ?Do t kc w‘ S I('L Commercial ( ) Other( )
Business Address: po 0 22-\ -
City z` e� J State: Co Zipl: (Sl(03 > Work Type: Interior( ) Exterior ) Both ( ) s,
Contact Name: 'fob-c
Contact Phone: 110 - 7 1- ic2..ci Valuation of
Work Included Plans Included Work
Contact E-Mail: t^cA-+-b 0'1\C i -'j @ v-‘co` ,co a
I hereby acknowledge that I have read this application,filled out in full the 1 Mechanical ( )Yes ( )No ( )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
mation 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 Yes .5 1Q'd CK�
codes, design review approved,International Building and Residential Building OYes ( )No ( )No
Codes and other ordinances of the Town applicable thereto.
Total Value of all work being performed: $ 2O)O(7Gt °c>
X — (value based on IBC Section 109.3&IRC Section 108.3)
Owner/Owner's Representative_a••- • - (Required) Detailed Scope and Location of Work:
Applicant Information Co t_lr'
Applicant Name: PO6M4 i� min,".J w \�
\ct .� Ort2 - 41,
I Applicant Phone: CC'70 t' 293
b1,6 c_14, .c\c�
;Applicant E-Mail: rcts,-)bvi1t0- ,co
Additional Authorized ProjectDox Users -
Full Name:
E-Mail:
Full Name: I(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