HomeMy WebLinkAboutElectrical Application_12.pdfDepartment of Community Development
75 South Frontage Road West
Vail, GO 81657
TeJ: 970-479-2139
www.vailgov.com
ElECTRICAL PERMIT
Electrical Permit Submittal Requirements Including Heat Tape Installation
_Roar plan I Site plan showing proposed work
_Load Calculations and one-fine diagram when loads or circuits are being added
_Occupancy Group listed on plans
_Building Type
NOTE: For Multi-Family and Commercial buildings-plans and calculations must be prepared by a Colorado Licensed Electrical Engineer
Pr2-iect Street Address: .,~ &~.{-J,-\ ~o:;; ~,_,"t fU ~lst_ -k!=-[~ Project#: _____________ _
{Number) (Street) (Suit~ #J ' Building Permit#; ____________ _
{ vt-f-.r-VL•>--h~"' { : Electrical Permit#: Building/Complex Name:
---------------------Project Information:~ ~
OwnerName: ~w~, ~r,.........._
Parcel# z-t. C9 I -ebLf -o-l -19 c:f
~ J: Lot#: ___ Block# __ Subdivision:
(For Parcel#, contact Eagle Gounfy Assessors Office at {970)328-8640 or visit oevn~ Scope and LOQ?iion of Work: ~www===.e=a-gl=ec=o~~ID¥=-·-uru~p-m-·e=)===-===========================4 ,k/~ ~~~
Contractor Information ,
Business Name: _=rg_"-. .....:t=-"-b~~-----------
Business Address:----------------
City _________ state: ___ Zip: ____ _
Contact Name: ------------------
Contact Phone:------------------
Contact E-Nlail: -----------------
(use additional sheet if necessary)
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I
{ ) No I hereby acknowledge that l have read this application, filled out in full the Includes Temporary Service: { ) Yes
information required, completed an accurate plot plan, and state that ail
the information as required is correct. I agree to comply with the infor-lr1 ----------------------,
mation and plot plan, to comply with all Town ordinances and state laws, Work Class:
New ( ) Addition ( ) Remodel ( ) Repair { )
~ <>nd othei:._ordin ces fthe To applicable thereto. Ofuer( ) ______________ ~-------------
and to build this~structure ac~o ing to the town's zoning and subdivision ~des,. design review ag ove ; International Building and Residential
I~ ..
O~..;':.rn.: .. "~J8 Representative Signature (Required) Type of Building: Single-Family ( ) Duplex ( )
Multi-Family ( ) Commercial ( ) Restaurant ( ) Applicant lnfonnation L ~ ~ R 1 J !Ofuer ( ) _____ _
AppHcantNanie: ~ V't_v(_._ f~~-~~~=-~-~~~~~~~~~=~
0 , . , · ~ Provide BOTH square footage of area of work
Applicant Phone: 11-o "-f't ·5' ' W 6?.--z.-'I AND Valuation (Labor & Materials)
Applicant E-Mail: ~ ~ .( t;5 .j{~~ Q.ov-tf'0!Nt · ~.~mount of SQ Ft.: ~ o :z1?
Additional Authorized ProjectDox Users ! Electrical $:._...:?-o::::..:::...r-~tr_UcY...:::.. ___________ _
Full Name: ------------------
E-Mail:. ___________________ I·
Date Received: Full Name: _________________ _
E-Mail:
For Office Use Only:
Fee Paid:-----------------
Received From: ______________ _
Cash Check# ____ _
CC: Visa I MC Last 4 CC # Auth :fl: ___ _
Rev. 2015-Dec