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HomeMy WebLinkAboutB16-0158.pdfTOWN OF~~ 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) Project Street Address: . .1 )V W. L> mstteqr\ Cg.· )D"t · (Number) (Street) (Suite#) Building/Complex Name: Va I\ s~ ' Project lnfonnation: ·{ ~ 1 ~5 ~\~ G\ A k:tf'SC •0wnerName: Cc1ssgb tQ«J) fy ·Parcel# Zjc5,fCJG, ;!/ (ZOC57 (For Parcel#, contact Eagle County Assessors Office at (970)328-8640 or visit • www.eagtecounty.us/patie) Project#: _______________ _ ORB#: ___________ -="" ____ _ Building Permit#:_~~l~(;~~-O_l_5~<6~--- Lot#: Block# __ Subdivision:------- . Work Class: Addition ( ------, ) Alteration ~) j New( . Contractor Information . Type of Building: _ ~ i_ Single-Family ( ) Duplex ( ) Multi-Family <:1 ) ' Business Name: N~ e tY>Q t~ CQ>12ttUCTOf") LL L+commercial ( ) Other ( ) ______ '\ ___ _ : Business Address: 'F:' Q .~ !\Dee, . • City G~ J t'V\ State: CO Zip: B) (p 3 ~ Work Type: Interior 9() Exterior ( ) Both ( ) === =~~---~-=·-.-=----------·--' • Contact Name: lee A\\ e.m crn c.--·-·-.-·~ ... -==~·-~-----=-······--~-~-----~----~------~- ; Contact Phone: 9)0 -~1-(£ -08CJC5 ; Contact E-Mail: a\ \ errJat1 ~ ee @Yle=fu? Cl I } • ( f1Yl1 Work lnduded Plans lnduded Valuation of Work I hereby acknowledge 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 this structure according to the town's zoning and subdivision codes, design review approved, International Building and Residential Codes and other ordinances of the Town applicable thereto. 'Full Name: ----------------- E-Mail: __________________ _ Full Name: ---------------==---:~::::·d-it-io-na-1-sh-e-et_if_n-ece_ss_a_ry_) ---7.,,..l..._<·_··~-·-\1_ ... -.-:i-.. ~-/-)-.. -i-- ,,,,..·· For Office Use Only: j I ,~ s·1 · .. :01 Fee Paid: _________ .., _____ _ Received From:-------------- Cash Check# ___ _ CC: Visa I MC Last 4 CC # __ _ exp date: __ _ Auth# __ _ Rev. 2015-Dec Mechanical ( )Yes )No ; Plumbing t:;X)Yes )No : Building ... _t2v~~~-~ .... _J~? )Yes )Yes )Yes )No )No Q. Cf:;{) }No -!JfJ cr;;Q , .. ,._,_, ____ .... ,. -._ .. _ ... _~·~·~··~---~"'I f Total Value of all work being performed: $ 45, f!X2l5 '. (value based on IBC Section 109.3 & IRC Section 108.3) Date Received: ~©~OW~ MAY 1 0 2016 ~ TOWN OF VAIL