HomeMy WebLinkAboutE16-0178 Application_2.pdfDepartment of Community Development
75 South Frontage Road West
Vail, GO 81657
Tel: 97D~479"21a9
www. vailyov.com
ELECTRllCAL PERMIT
Electrical Permit Submittal Requirements Including Heat !ape lnstallai:ion
'-~Floor plan! Site plan showing proposed work _Occupancy Group listed on plans
~Load Calculations and one-line diagram when loads or circuits .are being added __Buifding Type
NOTE: For Multi-Famlly and Commercial buildings-plans and calculations must be prepared by a Colorado Licensed Electrical Engineer
P!oject Street ~dress: i
51<1s s. ,~~~fd LU loi Project#:
{Number) (Street} (Suire#) ' Building Permit#: tSl Le . QJlll s
Building/Complex Name: ~-tlU)\Dd : Electrical Permit#: 22-l\o·O}'l~
Project Information:
Block# Owner Name: . Lot#: ----Subdivision:
Parcel#
(For Parcei #, contact Eagle G:ounfy Assessors Office at (970)328-864-D or Visit Define Scope and Location of Work: www.eag)eco~.uslpafie) · ~~cchl Uatt-~C.J~ Contractor Information ' uv?(}_~ ili9C'ch 11\3 --r ecs\~~ ~\c_ -r
Business Name:
Business Address: vo BO)( ·z.c;L. ' de» ) c.JG <::::.
Gity fu 0 (.\\ 1£ state: ~ Zip: <6\ ld-\q
Gontact Name: V\.{1\J~ Yv\ ka. ~<;.
.Gontact Phone: c:rt-o ~z.::t 53CSO . ·1-e-s\Q.vc:(,\@ S 1\t\c,·, \., C.QJVV\. (use additional sheet if necessary) · Contact E-Mail:
I hereby acknowledge that I have read this application, fflled out in full the Includes Temporary Service: ( )Yes {>qNo infonna.fion required, completed an accurate plot plan, and state that all
the infonnai:ion as required is correct. J agree to comply with the infor-1 Work Glass: mation and pfot plan, fo comply with -all Town ordinances and state Jaws,
and to build this structure according to the town's zoning and subdMsion New { ) Adartion ( ) Remodel 00 Repair { ) """""dVapptl-al r;Jdlng ami--Codes and o· r rdinances f~~:ppli le thereto. Other ( )
X A..... . Type of Building: Single-Family ( ) Duplex( ) Owner!O ?s Representative ~ature (Requifeco
Applicant Information L Multi-Family'<f] Commercial ( ) Restaurant ( )
f Other ( )
Applfcant Name: ' -'Provide BOTH square footage of area of work
Applicant Phone: ~AND Valuation (Labor & Materials)
Applicant E-Mail: 1 Amount of SQ Ft: -~C( L\
Additionai Authorized Projecf:Dox Users ; EleGfrical $: 5'2-CO.-C:iD
Full Name: t
i E-Mail: tre ReceJverl, Full Name:
E-Mail:
For Office Use Only:
fee Paid:
Received from:
Cash Check#
CC: Visa J MC Last 4 cc # Auth#
Rev. 2015-Dec