HomeMy WebLinkAboutB16-0409.pdf Department of Community Development
75 South Frontage Road West
Vail, CO 81657
TOWN OF Tel: 970479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm, Sprinkler& Public Way)
Project Street Address: Project#:
963 _ Lions Ridge Loop
(Number) (Street) (Suite#) DRB#:
Building/Complex Name: Breakaway West Building Permit#:
Project Information: Lot#: Block# Subdivision:
Owner Name: Breakaway West Association
Parcel#2103-014-07-059
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New(C)) Addition(C)) Alteration ((•))
www.eaglecounty.uslpatie}
Contractor Information Typo of Building:
Single-Family(n) Duplex(n) Multi-Family(( ))
Business Name: Nedbo Construction
Commercial (n) Other(C))
Business Address: PO Box 3419
City Vail State: CO Zip: 81658 Work Type: Interior(n) Exterior(i:,) Both (C))
Contact Name: Warren Krok f
Contact Phone: 970-845-1001 Valuation of
warren nedbo.com Work Included Plans included Work
Contact E-Mail: @
I hereby acknowledge that I have read this application,filled out in full the Mechanical (n)Yes ( )No (C)Yes (*)No
information required,completed an accurate plot plan, and state that all 5,OD0
the information as required is correct. I agree to comply with the infor- Plumbing (' ))Yes ({))No (C)Yes ((i)No •
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 -. 215,000
codes, design re iew approved,International Building and Residential Buildingn•)Yes (*)Yes (n)No
Codes and oth ordinances of the Town applicable thereto.
•
Total Value of all work being performed: $220,000
X / (value based on IBC Section 409.3&IRC Section 108.3)
Owner/Owner's Representative Signature(Required) Detailed Scope and Location of Work:
Applicant Information
Existing pool for complex was leaking and has already
Applicant Name: Nedbo Construction
Applicant Phone:
970-845-1001 been removed. New fiberglass shell pool is to be
nedbo.com installed to replace old pool
warren@nedbo.com
E-Mail: @
Additional Authorized ProjectDox Users
Full Name:
E-Mail:
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