HomeMy WebLinkAboutB17-0081.pdf --' Department of Community Development
75 South Frontage Road West
Vail, CO 81657
TOWN OF VAII
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm,Sprinkler&Public Way)
Project Street Address:
3S LI gest✓el— 1!n{^e� Kdouo ''1 Project#:
(Number) (Street) (Suite#) DRB#:
� t
Building/Complex Name: r1 Building Permit#:
Project Information: Lot#: Block# Subdivision:
Owner Name: keV+
Parcel# ZI O I. - 0-7 1 - l S - t:,"3 15.
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New( ) Addition(0) Alteration(0)
www.eaglecounty.us/patle)
Contractor Information Type of Building:
Single-Family(0) Duplex 6) Multi-Family 0)
Business Name: (-111- card ASSL>Ci G+eS Commercial(0) Other co
Business Address: Z-7 7 S Mot:v\ Sipe e;-
City E.a{,,JOti,-ekS State: Ca Zip: Work Type: Interior(0) Exterior(O Both
Contact Name: CCAS`( (��^►n�cJLW'Gt Yl ///���
Contact Phone: Q`l b ,-lig5- 70-74 Valuation of
Contact E-Mail: C cA.i,l (.1.1g 6.„,.14- • CA Wl Work Included Plans Included Work
I hereby acknowledge that I have read this application,filled out in full the Mechanical ()Yes (ONo (OYes ONo 3I LS101
information required,completed an accurate plot plan,and state that all ��S j Oy0
the information as required is correct. I agree to comply with the infor- Plumbing °Yes ONo °Yes (ONo
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 0Yes ONo °Yes (ONo 3) I 1 b1 oap
Codes and other ordinances of the Town applicable thereto.
Total Value of all work being performed: $ 3) Sc7a)64t)c7
X (value based on IBC Section 109.3&IRC Section 108.3)
Owner/Owner's Representative Signature(Required) Detailed Scope and Location of Workl eAx ( M1 \ €. :Sj'i hs
Applicant Information
Applicant Name: G t`� (3rvt e y►1�y1
All
re)repitt e., 1A1:4-In ntiA/ it-1Act I,or C -
HI l ()cid ;Dv\nel00-i oh 'f?`ahne li✓�Adzil..�S/
Applicant Phone: 9-7/D - 7O 7� '"LL c+ I > >
Applicant E-Mail: Ca.�lco t.11jc'�pltii 1-v •Colin ear• ??h+�i►eS 1 v�"1 • ��ins 511CS r�'1�ClnahtCCnd Sys4t
Additional Authorized ProjectDox Users �I(n tl��� Sy .W\ ,tr d SCCLP ado( nu,/
1
Full Name: L( (-c L: keJ.Q
E-Mail: Lit 1. € to is CrV
Full Name. (.b6 St e P i e h O 15 (use additional sheet if necessary)
E-Mail hab kta;I+ • C.,av►,
(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