HomeMy WebLinkAboutB16-0321 Application.pdfTOWMOF®
Department of Community Development
75 South Frontage Road West
Vail, CO 81657
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical, Alarm, Sprinkler & Public Way)
~~eet~ress: c ~~f) # V: ...:..:::&d.~~.:JL-_ ( :2D0f> _ re~ _r -----'Q_......___
· (Number) (Street) (Suite #)
: Building/Complex Name: R--2w bvme>:5
; Project lnformationr 1 s/· , )
Owner Name: J;:['J<:, ~')I!' _C.j
, Parcel# ~ J 0 / ... ·Df>'A -3 j "'QO :A
(For Parcel #, contact Eagle County Assessors Office at (970)328-8640 or visit
www.eaglecounty.us/patie)
Contractor Information
Business Address: -+--"-.c.....-'>~-.,..._'"""".:>..---"'....<...;"""'"....:...:::'"""'"--:--:.....,..,....,..o/
City ...J.J...I.....o4..L..l..'---=~--
Project#:------------------
DRB #: 7118 !So c..f??
Building Permit#: t1/(p · 0, ~ /
Lot#: Block# __ Subdivision:--------
:Work Class: New (Q) Addition®) Alteration <0)
Type of Building:
Single-Family (0) Duplex (0) Multi-Family (0)
'Commercial (0) Other (0) fc;vv h ba J,6~e
Interior{()) Exterior (C) Both rJ:gj
Contact Phone: ---1--L-~~-./....-J.~--.~.;;;;::o.-1-_,_,.L.J...L-:--
Contact E-Mail: --'=¥-~'-r'"--"'-f-'>-""""'....,.=-::=b'"'"""'""-"""""'".........:"-'....u...'-L.,j..,.._, om Work Included
~)Yes
Valuation of
Plans Included Work
(C)No~b~ ts 1 I hereby acknowle e that I have read this application, filled out in full the
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,
and to build his structure according to the town's zoning and subdivision
codes, de · n review approved, International Building and Residential
Codes a t er ordinances of e To licable thereto.
E-Maii:...LL...l.J,..I....L!~-+:'~j>-!l..a.JL~::::...L!~~f-ll.___..:l..lJ.~I..l..lo.<:.......lo....~...o~
Mechanical {C!)No (~Yes
Plumbing Q\)Yes (0)No (Q\}Yes (C)No -i/:(;o /L. .
, Building ~Yes (C)No ~Yes (C)No~8:00 k ;
! Total Value of all work being performed: ~ ,·/t~~q~
; (value based on IBC Section 109.3 & IRC Section 108.3) I
·------------------·····------·-----------------------·--1
. Detailed Scope and Location of Work: ---=----.----. f'
Full Name: i ----------....><...--------1 (use additional sheet if necessary)
'E-Mail: ___________________ _
: (use additional sheet if necessary)
Date Received:
;:: ~:c:e_u_s_e _o_n_Iy_: __ cJ<i!.......J.-~..S.a.~A--=._{j_L_L{--1--------
Received From: ______________ _
cash Check# ____ _
CC: Visa I MC Last 4 CC # ___ _ exp date: ___ _
Auth# ___ _
Rev. 2015-Dec