HomeMy WebLinkAboutB16-0495_electrical application_1481657760.PDF Department of Community Development
75 South Frontage Road West
TOWN OF VAIL A Vail, CO 81657
Tel: 970-479-2139
www.vailgov.com
ELECTRICAL PERMIT
Electrical Permit Submittal Requirements Including Heat Tape Installation
_Floor plan/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:
C.A, 12ciac,e Project#:
(Number) (Street) (Suite#) Building Permit#:
Building/Complex Name: F V' S°14 5,p t^3 Electrical Permit#:
Project Information:
Owner Name: J
��^ ✓4 b pv tbv, Lot#: Block# Subdivision:
Parcel# 2-101 0/ ( 2-2-001
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Define Scope and Location of Work: let 4- Ju
www.eaglecounty.us/patie) 1 f
Contractor Information tti r re iU C efe 6 L C pf i+al
Business Name: _(d<, 12-„tit cl ct,tr,�
f,b h
Business Address: 1101J;1(c,4�ln ship A-2.04
City Erit,ilc,rjs State: CD Zip: V632
Contact Name: /11.k / 1e,++,e/I
Contact Phone: e/7 p- 0'7 I — 0101
Contact E-Mail: �' ky-t�,,CQ eG
Tr �� 41,Dh j Gbdn (use additional sheet if necessary)
I hereby acknowledge that I ha e read this application,filled out in full the Includes Temporary Service: (C)Yes L 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(C) Addition (C) Remodel (X Repair O
codes,design review a.proved,International Building and Residential
Codes and other o nc e Town applicable thereto. Other O
X / Type of Building: Single-Family(C Duplex(
Owner/Own ,-. Representative Signature(Required)
Appli t Information Multi-Family(( ) Commercial, Restaurant(`)
Other(�
Applicant Name:
Provide BOTH square footage of area of work
Applicant Phone: AND Valuation (Labor&Materials)
Applicant E-Mail: Amount of SQ Ft.: /(/V
Additional Authorized ProjectDox Users
Electrical $: pCJC/
Full Name:
E-Mail:
Full Name: Date Received:
E-Mail:
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC # Auth #
Rev.2015-Dec