HomeMy WebLinkAboutB16-0247.pdf Department of Community Development
-,4
75 South Frontage Road West
i Vail, CO 81657
TOWN OF VAIL A Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical, Alarm, Sprinkler&Public Way)
Project Street Address: Project#:
(Number) (Street) (Suite#) DRB#:
Building/Complex Name: 6.- 1-V.-E.-/Arie t VE Du CLit.4- , Building Permit#:
Project Information: Lot#: Block# Subdivision:
OwnerName: 1.-) PGU 1.1 E.71.-ii Y.-0 Pb 1-/
Parcel# V' ' .1.1- .4' ".. '' - • e , ro,
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New( ) Addition(X') Alteration ( )
www.eaglecounty.usipatie) aiogi do_p_ct y, c„:,)
Type of Building:
Contractor Information
Single-Family( ) Duplex(/) Multi-Family( )
Business Name: c2,1,k)-- 4MET oik.... i ??/ 1 ea,ki i C) Commercial ( ) Other( )
AT Col-Li , I-t-C.,,
Business Address: yo, ?koeUM
City 1.2, ,c't /P State: CD Zip: ea/ Work Type: Interior( ) Exterior( ) Both (A
Contact Name: '-'-')-T?le, GA N'OLV /4( 1.-- _
Contact Phone: -1-1-1) - <-11.,("g- cuci i Valuation of
Work Included Plans Included Work
Contact E-Mail: TEiDs Q, (CCM U-•k")"- \,/eLOP YV1 6./U Th., US
I hereby acknowledge that I have read this application,filled out in full the Mechanical (X)Yes ( )No (X)Yes ( )No l Z,dOTD
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 (X)Yes ( )No (K)Yes ( )No i tl,SOD,
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
codes, design review approved,Internatio,;*ii.tuilding and Residential Building (X)Yes ( )No (x-)Yes ( )NoS- 0
Codes and goer ordina es of th-Town zppticable thereto.
.eityi Apiii- 7
Total Value of all work being performed: $ '-'5 ,1 , -1- 50 ,
AryAlAss#.,4..LAIIII, (value based on IBC Section 109.3&IRC Section 108.3)
3,,/ .
Owner/iowner's p -presentative Signature(Required)
Detailed Scope and Location of Work:
Applicant Information
V-e-fkt et/ t -to Xi e ri 6-'1' LA.21 ru"A/114.15 ) Mel
Applicant Name: 5-TENIE S4NI2oVA I- . 4..13 ..e A--(v-i rv-. AAA- st_pfv DA
Applicant Phone: 17,_0 • I-11g 0(01 I
2.1 2.0 GF 1 i ty+Ak 3 6-0 S'F
Applicant E-Mail: e--fr e.,A1V5 a,I Lain i.-0 ev aL berm.epit5.v1 .0
Additional Authorized ProjectDox Users 1,11 i to) - % A;5 11€A• .,e fWC'51N 1 Aire v 1 Dr
Full Name: AQ.,IA H 51 1,51 EL yet v+i 41 •
E-Mail:St)e Att(3 t tbiou_OeNmLoevv, Elvis- vs
Full Name: (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