HomeMy WebLinkAboutB16-0501_Application_1482421200.pdf Department of Community Development
75 South Frontage Road West
D. Vail,CO 81657
TOWN OF
Tel:970-479-2139
www.vallgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm, Sprinkler&Public Way)
Project Street Address: Project#
109
(Number) (Street) (Suite#) DRB#
,y�
Building/Complex Name: 1�legft t+ #k SS!wig l�u,I �,3 Building Permit#:
Project Information: Lot# Block# Subdivision:
Owner Name: R ,___ i.
Parcel# c 101 06 y 08 ciol
(For Parcel p,contact Eagle County Assessors Office at(9701328-8640 or visit Work Class: New((`) Addition( ;) Alteration(0)
www.eegiecounty.uslpatiel
- — �
Contractor Information
Type of Building:
Single-Family( )) Duplex(0) Multi-Family(0)
Business Name: f_titf l a cAlu �t...mt CAL ��C - Commercial(k) Other(0)
Business Address' 170 1+°i�. t 1 - ,
City Gle si.rv4 _ Y State _09 Zip' t 621 Work Type: Interior( ) Exterior(Cd) Both(n)
Contact Name. ligt
Contact Phone C110—37G-ova3 Valuation of
Work Included Plans included Work
Contact E-Mail: M 5oF m•
I hereby acknowledge that I have read this application.filled out in full the Mechanical ( )Yes (r)No ( )Yes (C)No 80/1-118,
Information required.completed an accurate plot plan,and state that all
the information as required is correct. I agree to comply with the infor- Plumbing i })Yes (C,)No (C)Yes (r)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
codes,design review approved,International Building and Residential Building (3)Yes (C)No (C)Yes (C)No
Codes and other ordinances of the Town applicable thereto, .
Total Value of all work being performed: $_ '� t{ie. "
X (value based on IBC Section 109.3 d IRC Section 108 3)
Owner/Owner s-ttepresentative Signature(Required) Detailed Scope and Location of Work:
Applicant Information
aiiocut. 1 e�,1Ai It A 4.l 4'
►
,tom
Applicant Name rti t�S �bo,,E ' --
I ,.. . 6.1+ NM (0 HF
Applicant Phone — --
Applicant E-Mail c� Sk..c'a`rkEtk- fk 612)4fj,
Additional Authorized ProjectDox Users Wet"' I. •° 411 i 416.8 'i''1.
Full Name. fQf Jt t ,{ % VELA SO(/ , r.
E-Mail;
Full Name:
(use additional sheet if necessary)
E-Mail.
(use additional sheet if necessary)
Dale Received:
Far Office Use Only.
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp date:
Auth #_ _
Rev 2015 Dec