Loading...
HomeMy WebLinkAboutB16-0316.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: ] '10 Po hJo P"-J' Vi d r\'f'-VJ~~~ ~I (Number) (Street) (Suite#) Building/Complex Name:------------- Project Information: Owner Name: 1'1 Or-fll\ A'" S 4~ t C Parcel# 2-\0 I Ob3 a I 03=r (For Parcel #, contact Eagle County Assessors Office at (970)328-8640 or visit www.eaglecounty.us/patie) Contractor Information Business Name: --'E"'-l_k_L_S_t_r_'_'_~ l.::....~_LJ,,___ ____ _ Business Address: __,_~_o _ _i,___o_i.-_S_c_,1_1_'1 ________ _ City \.l c v \ State: C.D Zip: e I ~)6 Contact Name: __ G_\_Q.._~_,,___,,,E"--'o-=-+¥--------- Contact Phone: _9_'_l_O_::_Y_l_l_-_3._4_9_5' ____ _ Contact E-Mail: Cl..k_ Q:.b y [J <> I~@\£ ~h g}0 • (0 ~ I hereby acknowledge that I have read this applic!tion, 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 Code d er ordinances of the Town applicable thereto. Applicant Information Project#:------------------ DRB#: _____ -===:--------,---=---r--- Building Permit#: __ ~_D=· ~l__.b=--~-0~~3~/_b __ ... _ Lot#: Block# __ Subdivision: _______ _ Work Class: New ( Addition ( Alteration ( Type of Building: Single-Family ( ) Duplex ( ~ulti-Family ( Commercial ( ) Other ( cc.c·c··cc. · ..... c ... c .... cc·_,_,_/·'-··"--·' '~'·-· .. c c .. ~c .. ·c .. •.·. c.c.cc Work Type: Interior(•./)' Exterior ( ) Both ( Valuation of Work Included Plans Included Work Mechanical )Yes )No )Yes )No Plumbing )Yes )No )Yes )No Building c-<3Yes )No (.....1-Yes )No e ooa Jlr• Total Value of all work being perform-ed: -~-~--:;;~~.-, (value based on IBC Section 109.3 & IRC Section 108.3) ----------------------· Detailed Scope and Location of Work: _______ _ \~f \~Ll gi~rc2J~ door h ~c>d•/ Applicant Name: :{1(~ ~~~ [ <l~ \2 C Ii_~~ Applicant Phone: ~ L~\\ j·J;:k. ~ \) \ [iQ< S N;-1-1 Applicant E-Mail: \, L " • Additional Autho-r-iz-ed-P-ro-je_c_tD_o_x_U_s_e_rs ________ L~I) rec. ( j Ix \AJ! ~\ ~ (~ J l AJ-101 Full Name:-\ --'--"0,_.,_7 _ _,,,o"'-c.__.S-'>-~"~'c~,,_I _________ _ E-Mail: ___________________ _ Full Name: ------------------ E-Mail:. ___________________ _ (use additional sheet if necessary) For Office Use Only: \:: qq , (?> \ Fee Paid:---------~~------- Received From: ______________ _ Cash ___ _ CC: Visa I MC Auth # ----+- Rev. 2015-Dec (use additional sheet if necessary) • Date Received D ~©~DW~~ AUG l 5 2016 l I J I'-' ,,,....,/ ' TOWN OF VAl_b__ !..-.----------