HomeMy WebLinkAboutE17-0030 Application.pdf Department of Community Development
4_ 75 South Frontage Road West
Vail, CO 81657
TOWN OF VAIL ve
Tel: 970-479-2139
www.vailgov.com
ELECTRICAL PERMIT
Electrical Permit Submittal Requirements Including Heat Tape Installation
Floor plan 1 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:
-1 S
3C - e_ o Project#:
(Number) (Street) � (Suite#) Building Permit#:
�
Building/Complex Name: .110_171N-�r 1N-` - i..A a- a �'/
Electrical Permit#: w
Project Information:
Owner Name: ��e_AL,O, C � .` Lot#: Block# Subdivision:
Parcel# \f7 l cDl '( -07-C?D p
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Define Scope and Location of Work: f)t).i-:r4L
www.eaglecounty.us/patie)
OYi2 w' rS Ff 1 O Nwicw (TewsAL
Contractor Information
0.-A-764O� r 0—Cr— ���6��i �i�s
Business Name:
Business Address: 155 `5Ok.) ti cPcio C'i' �0 (-X-2GOrrS Pea. c!on)s.e.
City State: (7() Zip: B I 5-1
Contact Name: A-o ._e t4-a4& .)
Contact Phone: 6k-10.) 3 8 9- f!o 9 3
(use additional sheet if necessary)
Contact E-Mail: u pFftfSG a�lla CC�z.�r
I hereby acknowledge that I have read this application,filled out in full the Includes Temporary Service: (Q Yes (X) No
information required,completed an accurate plot plan,and state 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 zoning and subdivision New(0) Addition(�) Remodel( Repair(0)
codes,design review approved,International Building and Residential
Codes and other ordinances of the Town applicable thereto. Other(0)
X
Owner/Owner's Representative Signature(Required) Type of Building: Single-Family( Duplex(Q
1 i Multi-Family(C) Commercial(% Restaurant(0
Applicant Information
n ^ Other C)
Applicant Name: <1�� fi, Jvf�xltay i`
/ 11
Provide BOTH square footage of area of work
Applicant Phone: (et 71) 3 - /6V-3 AND Valuation(Labor&Materials)
Applicant E-Mail: A.r0/44-0-r6aL t/ G.e /l Amount of SQ Ft.: 9II0 SQ Fr
Additional Authorized ProjectDox Users c
Electrical$: C70 0.
Full Name:
E-Mail:
Date Received:
Full Name:
E-Mail:
For Office Use-Only: RECEIVED
Fee Paid:
Received From: MAR 21 2017
Cash Check#
CC: Visa/ MC Last 4 CC# Auth # Town of Vail
Rev.2015-Dec