HomeMy WebLinkAboutB17-0053_B17-0053_1490375460.pdf Department of Community Development
75 South Frontage Road West
TOWNOF VAiL 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: 1 Project#:
Z�14-0 (_\ ...vv`n h kV. l..
(Number) (Street) (Suite#) DRB#:
Building/Complex Name: 1..-1i I QS ZSE cLlkA [-Q- Building Permit#:
Project Information: • _ Lot#: Block# Subdivision:
Owner Name: VH, '�4 Vuv �-C�o c&So`-t 1G uti,7
Parcel# Z(0 3 - 141 - 17 0 0
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New( ) Addition (C) Alteration(i- )
www.eag lecou nty.uslpatie}
Contractor Information �f
Type of Building:
l` Single-Family(g) Duplex(C ) Multi-Family(C
Business Name: V O0,:,\til .S'k-o �c�J,Al E -t-S Commercial (C ) Other(C)
Business Address:D uZy ECav-"Q-DS Iccg4S el R7.b7._
City '3;ifataF E .. iwc State: Zip: 16 kb 3Z- Work Type: Interior(( ) Exterior(C) Both (I
Contact Name: &IA NO Cjc .PA.d42.-W.
Contact Phone: °110- 3 31.- (21. 3'c) Valuation of
Work Included Plans Included Work
Contact E-Mail: \4tkkiNt V o IC�S4 owl • COtM
I hereby acknowledge that I have read this application,filled out in full the Mechanical )Yes (C)No (K)Yes (C)No "I C)00
information required,completed an accurate plot plan,and state that all
the information as required is correct. I agree to comply with the infer- Plumbing )Yes (C)No (( )Yes (Co) p ko 00
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 Yes ( )No (##11Yes ( )No "(DO
Codes an/.ther or.'nances of the Town applicable thereto.
Total Value of all work being performed: $t(��7 OtDD
X (value based on IBC Section 109.3&IRC Section 108.3)
Owner/Owner's Representative Signature(Required) Detailed Scope and Location of Work:
Applicant information }} M1
Applicant Name: Uro
Applicant Phone: 6110 -3 3 t -(.p(( 30
Applicant E-Mail: Lx ".p0.-•\)0•ilL wj c-p1M. C.O n^
Additional Authorized ProjectDox Users
Full Name: k..k. )J" CD l V1�2.�Lt
E-Mail: ck-a- -A r 1t."6,-a C-`f Ate.c*ys . C6tM1
Full Name: T rb1 (use additional sheet if necessary)
E-Mail: -re it ®`)O- Q- kO,l�t . C OVA
(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-Dee