HomeMy WebLinkAboutD15-0001_D15-0001 Application_1426791720.pdf Department of Community Development
75 South Frontage Road
TOWN OF SAIL' Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
oto Cp/ a.
PERMIT APPLICATION
(Separate applications are required for alarm &sprinkler)
Project Street Address: Project#:
2-Z-3 1� Utz- &M. (2--k
DRB#:
(Number) (Street) (Suite#)
BuildinglComplex Name:Gov't- �
s Sl u S Building Permit#:
�.
Contractor Information + ` Lot#: Block# Subdivision:
Business Name: V L-'.\ C .k.s v,.\ I 3 . tAtrs
Business Address: 250C\ tDw P4Lo5 ccess iZ� ct A -Work Class: New(0 Addition (0 Alteration (0City State: C Zip: a UP 2. Type of Building:
Single-Family 0 Duplex 0 Multi-Family a
Contact Name: h'f"G Commercial 0 Other 0)
Contact Phone: CVO
Contact E-Mail: l ti V C 451-0 • C Oen,. Work Type: Interior() Exterior() Both ()
I hereby acknowledge that I have read this application,filled out Valuation of
in full the information required,completed an accurate plot plan, Work Included Plans Included Work
and state that all the information as required is correct. I agree to Electrical ()Yes l )No ()Yes ONo
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical ()Yes ONo °Yes ()No
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Plumbing ())Yes ���)No i°Yes ( )No
ordinanc of the Town applicable thereto.
Building ()Yes , 'No ()Yes ONo
X ailek-- - Value of all work being performed: $;LY-kOU 0
Owner/Owner's Representative Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage
Applicant Information Detailed Scope and Location of Work:
Applicant Name: G4 re. CrvQ {� Yr ice• r,,1�_i„l- � k1k c C R.X tS ,
tu 'y -`
Applicant Phone: 3 22.9 ^ {`{bft 4k �(U. � � a2.LtX
Applicant E-Mail:
Co c1144
wta iT tr c optA Qr t,eQvu t 'S
Project Information 1 1 rI Act f1,6 . 1
Owner Name: �c�of_Cf.t-tlL ero e.r 11.--e-S LLL. .
Parcel#: 210 " X2 '"00 "1
(For Parcel#,contact Eagle County Assessors Office at(970-328-8640 or visit
www.eaglecounty.uslpatie)
(use additional sheet if necessary)
For Office Use Only: Date Received'
Fee Paid:
Received From:
Cash Check #
CC: Visa/ MC Last 4 CC# exp date:
Auth #