HomeMy WebLinkAboutElectrical Permit Application#4 Signed.pdf Department of Community Development
75 South Frontage Road West
TOWNOF � '. Vail, CO 81657
- Tel: 970-479-2139
• - www.vailgov.com
ELECTRICAL PERMIT
Electrical Permit Submittal Requirements Including Heat Tape Installation
I _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:
` s(a`` _ Project#:
I umber) (Street) (Suite(Suite#)
Building Permit#:
Building/Complex Name: ', ea-'.1"1:- J, 4: �'r#-;..�.. Electrical Permit#:
Project Information:
Owner Name• fr- 11 -01 1 ,1,z v 0 : Lot#: Block# Subdivision:
Parcel# (2- (94(1Y2)4
(For Parcel#,contact Eagle County Assessors Office at(870)328-8640 or visit Define Scope and Location of Work:
www.eaglecounty.usfpatie)
Contractor Information /�" �
Business Name: !_'11 .. .4! i r• .rift. �... '' `'�� Z � L/ /�
/ 1V
Business Address: ...w P. i ,, h flit r_ , i/�'Jt /... . k , 4 °� 0.4'----
CityJ1ii` J State: 0-0 .Zip: -3,11., .-2.--
Contact
tContact Name: o.
4rPYHO-S
Contact Phone:
e
04—(92:2-13
Contact E-Mail: %,, .. . ��„!/ I ,.Y r.4, ' , . . . . .,,#j/ (u anal sheet if necessary)
I hereby acknowledge that .a read this application,filled , in full the Includes Temporary Service: ( )Yes (
information required,completed
a ed an accurate plot plan,and .te that all
the information as required is correct. I agree to comply with the infor-
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 zoningand subdivision
codes;design review approved,International Building and Residential New( ) Addition(v}-emodel (-Repair( )
Codes andr ord' noes of the Town applicable thereto- Other( )
Xff-
..�
Ownerlowne?s Repres five Signature(Required) - Type of Building: Single-Family( ) Duplex( )”
Applicant InformatiMulti-Family(e-Commercial( ) Restaurant( )
Applicant Name: a T 1, s Other( )
0(� � �} �_® (Provide BOTH square footage of area of work
Applicant Phone: I 4 ! AND Valuation(Labor&Materials)
Applicant E-Mail: mid_ _ `' A s `_r . : Amount of SQ Ft.: )
Additional Authorized ' •jectDox Users °
Full Name: Electrical$: ��
E-Mail:
Full Name: Date Received:
E-Mail:
For Office Use Only:
Fee Paid: -
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# Auth #
Rev.201.5-Dec