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HomeMy WebLinkAboutB16-0289 Application.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: q C> 5 R 6D 5Atv jY) Tbl'-'C: fZ-b l.QA (Number} (Street} (Suite#} Building/Complex Name: 5AI'Il>1/tJ.NF: )o Project Information: '":TI:>JJJd 1 "' ""· v 1'6 rz.s Owner Name: _ --::J D·--\ tt _ J:;;u: d.:; \,"....g..,c" ' Parcel# 'Zto3ol '-!C>tD?...l (For Parcel#, contact Eagle County Assessors Office at (970)328-8640 or visit www.eaglecounty.uslpatie) Contractor Information Business Name: 1CoB;AJ)o7J PLVM8/AJZ: i 1/E:A.i;AJt; Business Address: ...!P....::D::..___o,8~oX:.__.:.:IS::.:c.::.:·lf...._ _________ _ City CAGU5 State: Cb Contact Name: Du.ul.At-J Rof>1~Sc,v Contact Phone: Cflo 68B-o21s Zip: 8/C3t Contact E-Mail: dvv-c.a"' rz> b1 f'9JWto..t' /. ~ 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 Jaws, 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. X~= (]._ Owner. wner's Representative Signature (ReqUired) Applicant Information Project#:------------------ DRB#: _____ ~-------------~-~~--- Building Permit#: 61 l o-O:JJ-Cf Lot#: Block\ __ Subdivision: _______ _ l ····--------, ' '.: i Work Class: New ( Addition ( Alteration {)() 1 i ! ~~-~-.. -""'"~-~-----·-~-----~--=-<·--·,_~ ~__..~----~~--~ ----------·-·-· ·--~~ I Type of Building: : j Single-Family ( ) Duplex ( ) Multi-Family <)<.) j Commercial ( ) Other ( ) __________ _ i ! L.. ~· ·--~ -·~----__ ., __ _j I ~ ! Work Type: Interior ()() Exterior ( ) Both ( ) , . .1.-=~==o====~"-~=~~===~=o=~~~~~=~=:=~--! ~ I ~ Valuation of j j Work Included Plans Included Work 1 'I I . J /' a I ~Mechanical ()()Yes )No ()()Yes )No ll1 o fit· ID j !;;~ ::: ::: :::: ::: Total Value of all work being performed: $ //,6 '1']. lo (value based on IBC Section 109.3 & IRC Section 108.3) 1 ! Detailed Scope and Location of Work: ~fLAC/tv6 I i /?oJL-61'-AND bJor VJAT5'!2. IIGA/6R IN QS4LPL Applicant Name: I ' , sPAcE tJo-t C~hc.r~i"-9 oo-±5/ck.. Applicant Phone: -----------------1 () CJ Applicant E-Mail: 1----4.\/u..:f..<~-¥\~J-i~· Al1:cJ.f-=-' -------------- Additional Authorized ProjectDox Users / ____________________ _ Full Name: 1---------------------t E-Mail: 1--------------------- Full Name: ! (use additional sheet if necessary) E-Mail: j 1 : (use additional sheet if necessary) 1----------------------i~ Date Receive n ~ © ~ ~ 'WJ ~ n I~ JUL 28 2016 ~ For Office Use Only: Fee Paid: - Received From: ______________ _ Cash Check# ____ _ CC: Visa I MC Last 4 CC # ___ _ exp date: __ _ Auth# ___ _ Rev. 2015-Dec U L u TOWN OF VAIL