HomeMy WebLinkAboutB16-0221.pdfTOWNOFS?J
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:
, :?fe £ krcsf !t!d V(ul
; (Number) (Street) (Suite#)
'Building/Complex Name: Ji,'7tj.,&, ~ly lzoJ?!Je. -~--,.o~-----;+-~~~~-
; Project Information:
i Owner Name: Mr' bi'"LLUL 'l=(ab.Sc::.11'\
Parcel # ~ l 0 I D :::f \ \ 3 0 L. 4
(For Parcel#, contact Eagle County Assessors Office at (970)328-8640 or visit
www.eaglecounty.us/patie)
Contractor Information
i Bus;ness Name /ilihi fy,-f[,,.,,p:g, ad ,,p,, &c
i Business Address: PU -.e3u.k /_ i) 7 If
c;1y £{!. & State: &, z;p: /f'/66 I
. Contact ~me: & b .]3';:::. b ~ ')'.::0tf'i
, Contact Phone: f1o 1 f9o <011/...S
:contact E-Mail: rwr-rob~V\,s,..::..'\ ~MW:..{. WI""\
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
! Cod" and othoc ocd;"a"re' of the~~ th~ceto 'xiWm'/:T uJ ~~
; Owner/Owner's Representative Signature (Required)
Project#:------------------
DRB#: _____ -=o------------
Building Permit#: __ b-=c_...:...(_,_G_-_0--=~o....=------
Lot#: Block# __ Subdivision: _______ _
Work Class: New ( Addition ( Alteration (v'J
Type of Building:
'Single-Family ( ~uplex ( ) Multi-Family (
Commercial ( ) Other (
, Work Type: Interior ( ./{. Exterior ( ) Both ( )
Work Included
/
Mechanical (/)Yes )No
'Plumbing )Yes )No
Building )Yes )No
Valuation of
Plans Included Work
)Yes
)Yes
)Yes
)No 6250:J ~-
)No
)No
: Total Value of all work being performed: $ B~ 5"" oa :=i
: (value based on IBC Section 109.3 & IRC Section 108.3) i
I. I
· Detailed Scope and Location of Work: _______ _
~D '~tqce. iw-:. ~l./er-..J. cJ ... J-Vt l/i,,h Eff.'--/eu__c.....,
Applicant Name: ,, 5;-b ill/)~') So •1 ' /' I 1J \
Applicant Information
--9=-"'-:i."---,-'"-'J?~o"'-"---..."-1--'=-;-'11'-s;------/io l..../q::... tore 11o0-i-t< A fl k .f: /C/>,)/.!f c.g
! Applicant Phone: -~7~ u-~~-~)~~--IO __ ?-_______ _ ~nu U-J VVif-/-/ hu t, I Cf/ v<J(. f-0 -1-u.ro
· 1;1 91( c-lfi~ \2 .. ?L \ C'()-:\.
Applicant E-Mail: VW(( \ob\"' Su•'") ~J VV"\a..:._ (. C OVV"I
• Additional Authorized ProjectDox Users I
Full Name: -------------------
•E-Mail: ____________________ _
'Full Name: -------------------(use additional sheet if necessary)
E-Mail: ____________________ _
' (use additional sheet if necessary)
For Office Use Only: <l/-'-{ / ;)__ _ .S-(} .
Fee Paid: ______ ;];!_~-----------
Received From: ______________ _
Cash Check # ____ _
Date Received:
D r~J~ :~~ z:fir~~ ~
CC: Visa / MC Last 4 CC # __ _
Auth# ___ _
exp date: ___ _ TOWN OF Vt\I~---
Rev. 2015-Dec