HomeMy WebLinkAboutelectrical_12.pdf • !. Department of Community Development
75 South Frontage Road West
OF VAILt
TOWN 3 Vail, COsus
• Tel: 9704791-2139
www.vallgov.com
ELECTRICAL PERMIT
E]ectriG 1 Permit Su1}rrnittn1 Requirement. Including Heat Tape Installation
.F€port plan i Site plan showing proposed wo;k —Occupancy Group fisted on plans
—Load Calculations and one-line diagram when loads or circuits are being added —Building Type
NOTE: For Multi-Family and Commercial buildings—plans and calculations must be prepared by a Colorado Licensed Electrical Engineer
Project Street Address-
c A Jf0 A Procat#
(Number) (Street) (Suite#) Building Perm it#: .._
fBuilding/Complex Name:
Electrical Permit#:
Project Information: -
Owner Name: - - / f/ {, - Lot. Block# Subdivision'
Parcel it
{For Pared#,contact Eagle County Meessom Otte at{g70)328,8640 or visit Define Scope and Location of Work;
www.eaglecou nty.uslpatlel
... . . ._.-,.--- 1 / D 724 Foe,
Contractor Information
Business Name: i , itin i t tEI _5%m/0-x6,
4/�� '� � �� i
/Cm
Business Address: O Rd I9 -
1 CitY- l state: d zip= zoriki
Contact Name: /47,1711/4y '
Contact 7" - y......ContactPhone= }_
Contact E-Maii:RX-440,,‘,6°aq. , Cf X 7- . 1e.112 , .use additional sheet if neoessa ry)
I hereby acknowledge that I have read this appIicatianr filled out in full the Includes Temporary Service; { }Yes K.) No
Information required,completed an accurei=plot plan, and state that all
the information as required is correct. I g.gree to comply with the infar- 1 "x
matzoh and plot plan,to comply with ell Town ordinances and state laws, I Work Class:
and to build this structure according to the town's zoning end subdivision
codes,.design review approved, International Building and Residential New( ) AdOionN Remodel (I ) Repair ( )
Codes and rdErtances of the T applicable thereto. Other( )
Owner/Owner'sR rztive .ignature :Required}
Type of Building: Single-Family Duplex{ )
Applicant Information `Multi-Family 1( ) Commercial ( ) Restaurant( )
gory-45 Other( )
.-.. ---
Applicant Name:
Provide BOTH square footage of arca of work
Applicant Phone_ - - �AND Valuation (Labor& Materials)
Applicant M iL Amount of SO FL; 963 9
4)
Additional AUthorizeid Projectoox Users Electrical : d
Full Name;
E-Mail:_
Date Received:
Full Name:
E-Mail= y.�.
I
1 For Office Use Un)yv
Fee Paid:
Received From:
Cash Check,
CC: Visa I MC Last 4 CC# - - Auth
{ y-2015-Dec