HomeMy WebLinkAboutElectrical Permit Application#6 Signed.pdf Department of Community Development
75 South Frontage Road West
Vail, CO 81657
TOWN Tel: 970-479-2139
www.vailgov.com
ELECTRICAL PERMIT
Electrical Permit Submittal Requirements Including Heat Tape Installation
_Floor plan/Site plan showing proposed work _Occupancy Group listed 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:
fa , Y Wv ) fe0 7 Project#:
umber) (Street)
(Suite#) Building Permit#:
Building/Complex Name: /; g i /,. '_ 1,r Alf,
Electrical Permit#:
Project Information; Lot#: Block# Subdivision:
Owner Name: -- .--1 r- ---
Parcel# '2-1 12- 04-(X)
(For Parcel#,contact Eagle County Assessors Office at{970)328-8640 or visit Define Scope and Location of Work:
www.eaglecounty.uslpatie)
obi) at-ri,g:1- WV.-g-t-A-V--2-___
Contractor Information
,
Business Name: v' r.._; , __l ,r....,r...... 1(1_, 4
Business Address:2_ 1 ac-- Cy R-a • ,f •••, . Ad MP
City t titA-r ,�. State: Zip: __,11,..75-2-- : , _ , ./.4-- . .I.is-t' _ w1 "/-,1116 ■i rtor
Contact Name:
Contact Phone: --0 04 (72_- -
• ` (u � -tonal sheet if necessary)
Contact E-Mail: �,,�J /. f I.Y_ �. . ,., . SII
I hereby acknowledge that 'a e read this application,filled' in full the Includes Temporary Service: ( )Yes ( O
information required,completed an accurate plot plan, and s..te that all
the information as required is correct I agree to comply with the infor- 1
mation and plot plan,to comply with all Town ordinances and state laws, Work Class:
and to build this structure according to the town's zoning and subdivision New( ) Addition( emodel (repair( )
codes;design review approved,International Building and Residential l
Codes and o .'r:ces of the Town applicable thereto. 1 Other( )
t �
/ Type of Building: Single-Family( ) Duplex( )
Owner/ Amer's Pte. -se ive ignatu e(Required)
Applic nt Information ` `Multi-Family(commercial( ) Restaurant( )
Other( )
Applicant Name: f� `_.......__...............-
Provide BOTH square footage of area of work •
Applicant Phone: C9 )4 2-' p ,,AND Valuation (Labor&Materials)
Applicant E-Mail: 1. .7j.,"
4_C� g Amount of SQ Ft: l�
Additional Authorized R►+ Users ? i�
jectDoxElectrical$: I X67(2�. O
Full Name:
E-Mail:
Date Received:
Full Name:
E-Mail:
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# Auth #
Rev.2015-Dec