HomeMy WebLinkAboutB16-0379 Application.pdfTOWN OF~ Department of Community Development
75 South Frontage Road
Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler) , .. __________ ------------------~-----------------------------------------------------------------------------. ! P~ect Street Address: (}
: 2 0 6' East bJo ~ s heAot c,ll.Je3(} J.
i (Number) (Street) (Suite#)
!
: Building/Complex Name: _.._v/,_,_A.&..;.rv..;.....:.+,~A:..;;.@)+-e=--{J.........,o ..... t_,_fl/""-"t--
: Contractor Information
;BusinessName: '/:/t'()b Yll/ovtvfffl/1; "£v1/Je~.t,
! Business Address: P 8 fBoK ;}.._ 1-J 3 OJ
!city EJw14-&.J.'5 State: Co Zip: 0J&3d..
Contact:Name: D AUtaf /Co~ be/
Contact Phone: q 1 {3J -3 7 b -'-fO cJ f?
Project#:----------------
DRB #: '])~~ • 0 3(.o\.Q
Building Permit#: ~ ·03 7 q -
Lot#: Block#___ Subdivision:--------
:Work Class: New 0 Addition 0 Alteration ~
Type of Building:
Single-Family Q Duplex 0 Multi-Family ~
Commercial 0 Other Q, ____ "'""_ ------
'
Contact E-Mail: 0Pttl e. kG/2 bJ e... G YVJ14d, co 01 i Work Type: Interior@ Exterior 0 Both 0
I hereby acknowledge that I have read this application, filled out
in full the information required, completed an accurate plot plan, Work Included Plans Included
and state that all the information as required is correct. I agree to i:Eiectrical @Yes 8-"-, ~No ®¥es e-.~ -~~o
comply with the information and plot plan, to comply with all Town , "'.''iJ7 '!!9
ordinances and state laws, and to build this structure according to :_:Mechanical @Yes Q>No @Yes ONo
the town's zoning and subdivision codes, design review ap-··
proved, International Building and Residential Codes and other :; Plumbing ~Yes QNo @Yes QNo
ordinances of the Town applicabl theret _ 1:
Valuation of i
. Work !
' ,.
!5"'ao,o&
3goo,oq
;X . ~
; Owner/Owner's Representative Signature (Required)
i
):Building @Yes QNo @Yes QNo 11bPQOq> r· ------------------------------~-------------------~ l
1 Value of all work being performed: $ 3;::} q O{];,. 0 ~~
f: (value based on IBC Section 109.3 & IRC Section 108_3) l ~ . c:::@r= , z I t Electrical Sqwar-e Feet:e§e :f • J 1
~ ----------___ ,_ --. -
j Detailed Scope and Location of Work: De ~ o 1 F7 00/!_? t'
i OoofL~. f'vb -rShov--cr( 1,/e,, (-;a.:a)I!Lc.-, f,q?f 8tti~
i Applicant Information
i Applicant Name: Oa L/J J.
1 J I 7 1 I
:Applicant Phone: q 7 e -3 2 t ~ LfO q ~ r s Av 11-"> tlle.w i)J ft lis,. We ·'rh3YJ fA A 11.; eJ 1 ft'!i J. >Q_/ I
! Applicant E-Mail: fJ&vek.::Jlt. h-c:.-1 f!..-b m oi /, c..o~ rl/ew WJtt#tlw-'1 -rc;l,de-e. tvew Uwz2.STJ;QI vl1
iProjectlnlormaUon {;, J / f1 /) ;
1 {Vlove-He},pr1l-c:-~ h:-q/e-q hz VfiA?t.Of.l:; ~ao~
iOwnerName: [JtO rt. SA l-JCet!ecfO 1 ... , 11 1 .!J, ,/ L · :.r; c-i ' ; ivc &.V 11(!,/J lt41l?r:? I IV~~ <'VAn In e.-~; lfi'J; -;:> 1JO~e4'..
i Parcel#: 1 I 0 I 0 b 3 I 0 0 2'd--•' '/ ± I , n c I +-L /-1 J) I ' (For Parcel #, contact Eagle County Assessors Office at (970-328-8640 or visit 1, IlL c ·I e.. l A-tv (J!( () ~ ~ ~ I 0 we~ II I ( c eJ {) -L:J
: ~11aglecounty_us/patie) f I I I
For Office Use Only:
Fee Paid: ----+-----='-'----'=-------~
Received From: --T------------::::...=--
Cash Che
CC: Visa / MC Last 4 CC # ___ _ exp date: __ _
Auth# ___ ~
·. (use additional sheet if necessary)
DateRec ,·~=~~~~WI~ n
0 g n SEP l .~ 2016
TOWN OF VAIL
12-Mar-2012