HomeMy WebLinkAboutB17-0049.pdf Department of Community Development
75 South Frontage Road West
TOWN OF VAIL 1 Vail, CO 81657
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm, Sprinkler&Public Way)
Project Street Address: l Project#:
(Number) (Street) II.. 'eq(Suite#) DRB#:
BuildinglComplex Name: l 9 L�h r4-
r M `�5 Building Permit#:
Project Informatio Lot#: Block# Subdivision:
Owner Name:/ J' i n R. ,,(j p
Parcel# t;/-f°rlDi-4V /7 L/_S i�l(�'c4 j
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New(t Addition (C) Alteration (C' )
w v.eaglecounty.uslpatie)
Contractor Information Type of Building/
Single-Family(CV) Duplex (C) Multi-Family(C
Business Name: VCx.1'1 Oa S'40. n /30.f1
611 Commercial(C) Other(C)
Business/Address: .74 C(CC/(1iaSJ ACee j )2 lar;7
ems{
City 4)(,,-fit. ' State: ( ,g Zip: /(v3Work Type: Interior(C) Exterior(C) Both (c-r✓F
Contact Name: ifl7 ,/L 6e i
Contact Phone: f /4°- / ��7 Valuation of
Work Included Plans Included Work
Contact E-Mail: 0714r/C- e ikE 1 eG1 fieG'� C��3 ,�
I hereby acknowledge that I have read this application,filled out in full the Mechanical (`V)Yes (C)No (O/Yes (C)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- Plumbing es (r)No ( s (r)NQ /5o, 4'
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 r/Yes (C)No (C'Yes (C)No3,O(“,
Codes and other ordinances of the own applicable thereto.
Total Value of all work being performed: $3,h 2/n,,O
X ‘, e ezez (value based on IBC Section 109.3&IRC Section 108.3)
Owner/Owner's Repres to a Signature Ired)
Detailed Scope and Location of Work:
Applicant Information ] pp
Applicant Name: ah ALI e fl/4, A i pr1 it a n
Applicant Phone: L) % ' 3 ? --0 ;5 E
( 1 //J/1.:1['.it 04.) G` * e&) re6fSe 'feiy,�c.c
Applicant E-Mail: ( 11'/3n it te. e�j' Fide 1 0 GGri-1
Additional Authorized ProjectDox Users
----
Full Name: /p SCC%��,
E-Mail: -k ',J e /ti. I (itch 1'1
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