HomeMy WebLinkAboutB17-0104_B17-0104_1492008600.pdf AFIN Department of Community Development
75 South Frontage Road West
TOWN OF 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:
(p,3
Gare- Creek.
lir; ✓� Project#:
(Number) (Street) (Suite#) DRB#.
Building/Complex Name: S t ll z.Thest-"k Look a Building Permit#:
Project Information: Lot#: Block# Subdivision:
Owner Name: Soh F r,f Ck
Parcel# Zlol -01sZ- la- 00h
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New(0) Addition(0) Alteration(0)
www.eaglecounty.us/patle)
Contractor Information Type of Building:
Single-Family(0) Duplex(0) Multi-Family(0)
Business Name: I-' 011ie( ASS 0d C(> Commercial(Qj Other(0
Business Address: Z7M cwt, r S4 Irrce-t-
City EC:4%A/CAMAS lS State: C.6 Zip: I 6 3Z_ Work Type: Interior 3 Exterior ft BothContact Name: CC�trt ( NA4�?@ Mtn L\
r
Contact Phone: 9-10 -4 4 S -->--7a Valuation of
Work Included Plans Included Work
Contact E-Mail: (Ai bLA'14 cc�YY\
I hereby acknowledge that I have read this application,filled out in full the Mechanical 0Yes ONo ( Yes ONo ZO JOb
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 °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 ( Yes ONo (I Yes (ONo. !Zcz, OZ>
Codes and other ordinances of the Town applicable thereto.
Total Value of all work being performed: $ / LI Di 04->-
X (value based on IBC Section 109.3 8 IRC Section 108.3)
Owner/Owner's Representative Signature(Required) Detailed Scope and Location of Work: RevnOLe c rie4
Applicant Information melc.ce Concreic Oec k Dia s-fot-i'v-S
Applicant Name: Carl g r 1,10•Qe Wtc, �\ 1
Reet^,a- Si-�1..d wrc•1 S4 eel ns ncedleci
Applicant Phone: 9 7 0 - y4/ b - 7f cc-76
Ree
Applicant E-Mail: COL r( ) (4 ctp In - C V11 Rt ok ce Co-cre-4ew///�')e tt S'fc,,Mn pro,/ ca tic r-e4'C
Additional Authorized ProjectDox Users Reaiekce ✓►tetct.� kefAcICnti E , U/( P'\Qn'ICl't' 11�
Full Name: 4(- L ;nOl -fA C41711 Q.'1nS4ct1I Showk-eI1 51 Aefr -tom ex;st�K�
E-Mail: (n I rr o1 Lt i Ls <<4 ' c Irv\ 61 le r'
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