HomeMy WebLinkAboutB16-0080.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)
r ----------------..-----------------------.... • Project Street Address:
I 5 I 7 V c.u i //<,../I< y 0n1 v F
(Number) (Street) (Suite#)
.· Building/Complex Name:--------------
Project Information:
Owner Name: (f.nQJ>,fG-1¢N PtloPl!fl:T'l J,,J,(...
Parcel #di 0 I 0 71 O I O O '2
Project#:------------------
DRB#:------------,-------
Building Permit#: _3_,__.'-'-f-=b'------O"'--O~@)..__· ~----
Lot#: Block# __ Subdivision: _______ _
· (For Parcel#, contact Eagle County Assessors Office at (970)328-8640 or visit : Work Class: New ( Addition ( Alteration ~ )
www.eaglecounty.us/patie)
Contractor Information
Business Name: _J ~ FF L v!2. ~ '-'I L D ,. fl s I A:I '-
• Business Address: ~P_a~' P~,,~c.y..--~l_b~&~o ________ _
• City E AG, L f.. State: lv Zip: ':!l '-'l) (
· Contact Name: _._""'\ E.._f:.___,~_--__.,,k.._J _,,.v._1_,_· .... =z.~---------
Contact Phone: _'1 .... "'_,7'-""p_r_--:r_.._,,_.'1_,,0'-·-· ... l.._~-=-~---1-=-;, ______ _
: Contact E-Mail: J \ b v, I d 1/€.. v ~. i "-lii:o;,~ •.;,,f 1-1A ,. 1 L G Ot!'· ...
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
Codes and other ordinances of the Town applicable thereto.
Type of Building:
Single-Family ( ) Duplex<)() Multi-Family (
! Commercial ( ) Other ( ) __________ _
==-=--·
! Work Type: Interior ()() Exterior ( ) Both (
Work Included Plans Included
Mechanical ( )Yes ( K)No ( )Yes ("'){)No
Valuation of
Work
0'-·11 )No I QL>0<2..--v1 Plumbing (~Yes ( )No ()<.)Yes
Building ( )Yes S>{)No (-../.)Yes )No / 0 1 ()tJv~" ----·------·· ------------------~---~----!
Total Value of all work being performed: $ ~QDOcY';J:.)j
(value based on IBC Section 109.3 & IRC Section 108.3) ) •
--------------~~-----~[
i Detailed Scope and Location of Work: M .ft IV /...JfV{_ t... .
J.,/ ·"'· .. -r-. • i h4b. -aW~ AJ.t,,, ..... ~-'i Applicant Name: ~--l; \} J....., .Jr,'-, • ~ ·' IJ ",r;.~ ,. 1 _ . -1 ,..., ,_ 1_ 1 -~ • . 11,.,, ,. :I._~,,.,_.ef 2 "' :#dfo..<:..P 'I'~ ~~?:/ ~t.l&v/ Applicant Phone: ...., & 1v ~ J Iii> ::> A . , ,t J /
Ap
•Applicant E-Mail: j l b v~ Ide v"-t k ( i'"jYk o1 I',-" c; ... r f, C .,.,.,,~, ~~) /hby,) kA..I f /}Vt.,) ,/~fi?'1
Additional Authorized ProjectDox Users . _...,,c ... ·~-~-C..--. -----------------
. Full Name: -------------------
•E-Mail: ____________________ _
. Full Name: -------------------
.. E-Mail: ___________________ _
I (use additional sheet if necessary)
!
For Office Use Only: 1J t) Lf /_ "'3'
Fee Paid: _____ :p~~Cl" __ V __ ' ______ _
Received From: ______________ _
Cash Check# ____ _
CC: Visa I MC Last 4 CC # ___ _ exp date: ___ _
Auth# ___ _
Rev. 2015-Dec
(use additional sheet if necessary)
Date Recei
~~~ow~ n
APR U ~-' 2016 U
TOWN OF VAIL