HomeMy WebLinkAboutE16-0244.pdf /3/h 3V
Department of Community Development
__,T)'-.- S) 75 South Frontage Road West
TOWN OF VAI!' Vail, CO 81657
Tel: 970-479-2139
www.vailgov.com
ELECTRICAL PERMIT
Electrical Permit Submittal Requirements Including Heat Tape Installation
_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 _Building Type
NOTE:For Multi-Family and Commercial buildings—plans and calculations must be prepared by a Colorado Licensed Electrical Engineer
Project Street Address:`77 o W , co ns keeL'.i (7c - cam / Project#:
(Number) (Street) (Suite#) Building Permit#: ,61L2 -039 O
Building/Complex Name: `i
Electrical Permit#: �� I
Project Information: t..) Q
Owner Name: 1 -.(\-.. . Lot#: Block# Subdivision:
Parcel# /D7� ..9 /7 L)3 ;
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Define Scope nd Location of Work:
4w
ww.eaglecounty uslpatie)
W, f/ 7
Contractor Information / -/
Business Name: ,z< e=-7 //' _
Business Address: i), )r 1362X .9K/
City Aj1fiL) A / State: Zip: (6,.. <9
Contact Name: '' (-N. _/
Contact Phone: �� - ( 631
use additional sheet if necessary)
Contact E-Mail: ilKe4-2,(l -/C_ CC 0/61/f0tc( Ylcrico
I hereby acknowledge that I have read this application,filled out in full the Includes Temporary Service: (C)Yes
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 plo,pla ,to comply with all Town ordinances and state laws, Work Class:
and to build tr s s cture according to town's zoning and subdivision New(r') Addition {,,Remodel(C p (.._)
codes,de j,. pved,Int ation Building and Residential / Repair
Codes a 7• e� r - • icable thereto. Other(C) \
X Type Single-Family ) C�
Duplex
Ow er/a ner's -epresentative Signature(Required) YP of Buildin • ( p ( '
Multi-Pam' Commercial(C' Restaurant((
Applicant Information
Other r')
Applicant Name:
Provide BOTH square footage of area of work
Applicant Phone: AND Valuation(Labor`or&Materials)
Applicant E-Mail: Amount of SQ Ft. .J D 0
Additional Authorized ProjectDox Users !�/l5 (OO -
Electrical$: 7 ' / /
Full Name:
E-Mail:
Date Received:
Full Name: (,,, ----.
E-Mail:
For Office Use Only: ' '
Fee Paid: ,. I -�
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# Auth #
Rev.2015-Dec