HomeMy WebLinkAboutE16-0186.pdfDepartment of Community Development
75 South Frontage Road West
Vail, co 81657
Tel: 970~479"2139
www.vailgov.com
ELECTRHCAL PERMIT
Electrical Permit Submittal Requirements Including Heat Tape Installation
_Floor plan I Site plan showing proposed work
_Load Calculations and one-line diagram when loads or circuits are being added
_Occupancy Group listed on plans
_Buifding Type
NOTE: For Multi-Family and Commercial buildings-plans and calculations must be prepared by a Colorado Licensed Electrical Engineer
Project Street Address:
?_,)J-wd ! f'c,,0; 1-eoc( C\' -Project#: ________________ ~
{Number) (Street) (Suite#) ' Building Permit#: _____________ ~
: Electrical Permit#: -------------~
Building/Complex Name: Jl\ t-=c W~ \-\-$r-J
Projecf:lnformation:1 ::7:t ~NC.......
owner Name: __ ....,~__."""'-'r='-'-=~-~~-~~~----Lot#: __ Block# __ Subdivision: _______ _
Parcel# .£1 \ () \ CYtd--3 2?. \ \ ~
(ForParcel'lJ, contaci:Eagie [;aunty Assessors Officeat{970)328-864D orVisit
www.eagleco:mtY.us!patie)
Define Scope and Location of Work: _______ _
f--Contractor Information , '
/I <1 X ~" IA. .rH k_ · -/ &!<;.-\ ~ r---J..Sl --\ 6 m...o_\ c"'-Business Name: (/Jpye_z$ b rec".X\-\C ~....,_.___,___ _ __;oCA.J-"--1-,~--"'""'---'-'~=-'--_,_,, --'WJ1-------'-'-~~
Busines_;"Address: ·p b~Yf Sl3 L( :~N~'·~eve>_-__ C&_\j~-~<N<C_~~>~·------
Gity (; \ ( psu yv..,_ state: Cd Zip: 8 \ (c'? ·1 .
eontactName: 'D>-'1e_ H-esca~& lau.tf w< ti be cc:d0c:ed
GontactPhone: 1::/0 96C[ 6cts-s-. · NO A-t>bl..~t~ ~o.J
Contact E-Mail: Lof?:S<> e__\eds'\ca'@? s~~\,{b\A;.::.,J_us_e_ad~dit_io_n_aJ_s_h_eet_rr_n_ec_es_s_a_ry_) __________ _,
I hereby acknowledge that l have read this appfication, filled out in full the Includes Temporary Service: ( ) Yes
information required, completed an accurate plot plan, and state that all
the information as required is correct. I agree to comply with the infor-1 Work Cla"'"." mation and plot plan, to comply with all Town ordinances and state laws, """"'
( ) No
and to build this struc::ture according to the town's zoning and subdMsion
codes,-design review approved, InteitJational Building and Residential New ( ) Adcfrtion ( ) Remodel Q6' Repair { )
Oilier( >------~------~ Cor:ljS):~other ordinances of the To'Wn applicable thereto. x ,u_cyA /i...v7_ 14
Owner!Owner's Representative Signature (Required)
Applicant Information
Type of Building: Single-Family ( ) Duplex ( )
Multi-Family}() Commercial ( ) Restaurant ( )
L
]Orner( )~--------Applicant Name: ;;.:· ~--~-~~~-~~~~~~-~~=~='"1 ! Provide BOTH square footage of area of work
Applicant Phone:----------------I AND Valuation (Labor & Materials)
ApplioantE-Mall: I Amount ofS9/'t:_~_LJ_lJ_C_J ________ _
Additional Authorized ProjectDox Users ; Electrical $: ~ / S / OQd
Full Name: ------------------,__ ___________________ ___.
E-Mail:____________________ Ii
Date Received:
Full Name: ------------------
E-Mail:·--,------------------
For Office Use Only:
FeePrud=~---------------
Received From:---------------
Cash Check# ___ _
CC: Visa/ MC Last 4 CC# ___ _ Auth# ___ _
Rev. 2015-Dec