HomeMy WebLinkAboutB16-0199.pdf Department of Community Development
75 South Frontage Road West
TOWN OF VAGI. 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 Addr ss:
770 -) Project#.
(Number) (Street) t'-') [, (Suite#) DRB#:
Building/Complex Name: /o f,A, 7,,,,,t2-, -7,7,1,-4,,4....K5 Building Permit#:
Project Information: / - ,t� Lot#: Block# Subdivision:
Owner Name: C �.A d //vds? LCL
Parcel# .2/0f -063-/`7- O/.�
(Fo•Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New(C') Addition (er) Alteration ((--- )
www.eaglecounty,us/patie)
Type of Building:
Contractor Information
/[ Single-Family(C) Duplex(C) Multi-Family(0?-)
Business Name: 4iitico , / 5 Z-e: Commercial (C) Other(C)
Business Address: al YC/ .$ L)144ler .S1 0W
i
City ( e+r' 'rmi'', / State: (" Zip: F"//) Work Type: Interior(C) Exterior r) Both (( j
Co itact Name: Ger e a A k
Co itact Phone: _.5)t'� -15-- 77?5_ Valuation of
,g ' Work Included Plans Included Work
Coitact E-Mail: Fe.A( A4r-,; ,5$:s, /11Lel Aiv>'.--. te,,.,,.
Mechanical l`t' )Yes (C)No ( )Yes C '.f''4'"
I hereby acknowledge that I have read this application,filled cutin full the � ( }Nv
in`ormation required,completed an accurate plot plan,and state that all
the information as required is correct. I agree to comply with the infor- S''' e).47 '
Plumbing ((?)Yes --- `
motion and plot plan,to comply with all Town ordinances and state laws,
and to build this structure _ording t 1,own' zdning and subdivision �, ,
codes, design review approv 'rite tonal ,tiding and Residential Building 0)Yes (C)No ((' 11Yes (C)No /YyrrJ�`
Codes and other ordina of t."Tow p able thereto.
(--`77.-- • Total Value of all work being performed: $ f rD, G`'�
X (value based on IBC Section 109.3&IRC Section 106.3)
Owner/Owner's Representative Signature(Required) Detailed Scope and Location of Work:
Applicant Information // `` y //. i /
Applicant Name: G37:CJ /.5ed++rt5 C 9
Applicant Phone: ?`'_� 23- 7775- //�� �� 2'.21) '
f
Applicant E-Mail: 'E=-vis /u,-tceJ--A014r.. yt,nV-e7, (inn
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:
Recaived From:
Casi Check #
CC: Visa/ MC Last 4 CC# exp date: -
Auth #
Rev.2015-Dec