HomeMy WebLinkAboutB16-0309.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: .< ~S9 &!M'\QN\i L4f0ts __
(Number) (Street) (Suite#)
Building/Complex Name: v Ari L H GJ, o:tt rs
Project Information:(":
OwnerName: ~~ ~eNJ[' ·
Parcel# OZ. I 0 3)1 lt 0 3 qq1
(For Parcel #, contact Eagle County Assessors Office at (970)328·8640 or visit
www.eaglecounty.us/patie)
Project#:-----------------
DRB#: ______ ==-=---,....-----=----=:--
Building Permit#: ___ '"_?; ___ ..... \ ...... fu_-_· _0~3 __ 0_Cf-1--
Lot#: Block# __ Subdivision:--------
Work Class: New (Ci) Addition (C) Alteration (C)}
Contractor Information Type of Building:
£ A. ~ Ji , 1 ,.1 Single-Family (C":) Duplex (C":) Multi-Family(\:)
Bu';"ess Nameo (;""-P ~ d!f W "''tf:L 11( Comme"';al ( (' ) Othec ( G)
Business Address:;!. pt_ l}/_ -~lo~PD
City kJ?,u/~ State: Cd Zip: ?ftb 3d: Work Type: Interior (l·} Exterior (l) Both (C)
Cont: ct Name: J?o}:°('·l) t I [ ~J2rv \ \.
Contact Phone: q'1J2,-Cf,] /"" 05' b 7
Work Included Plans Included
Valuation of
Work
Contact E-Mail: wr{})'L Lkk Q ~C/6-i; >1 Lt
I hereby acknowledge that I have read this application, filled out in full the Mechanical ;6(ves (\:)No i/ves (C)No 710(20
('•)Yes (C)No (C)Yes (C)No
information required, completed an accurate plot plan, and state that all
the information as required is correct. I agree to comply with the infor-Plumbing
mation and plot plan, to comply with all Town ordinances and state laws,
and to build this structure cording to the town's zoning and subdivision
codes, design review app ved, International Building and Residential Building ('.)Yes (0)No (\:)Yes (C)No
Codes a e ordinan s of the Town applicable thereto.
Applicant Name: -----------------
Applicant Phone:-----------------
Applicant E-Mail:-----------------
Additional Authorized ProjectDox Users
Full Name: ------------------
E-Mail: ___________________ _
Full Name: ------------------
E-Mail: ___________________ _
(use additional sheet if necessary)
For Office Use Only:
Fee Paid: ________________ _
Received From: ______________ _
Cash Check # ____ _
CC: Visa I MC Last 4 CC # ___ _ exp date: __ _
Auth# ___ _
Rev. 2015-Dec
Total Value of all work being performed: $ rJ ,fiJl!f) qp
(value based on IBC Section 109.3 & IRC Section 108.3) 1
Detailed Scope and Location of Work: Jn echu ;lu../flG?hfl
~{: +wv 4.dv.Jed--er
(use additional sheet if necessary)
TOWN OFVA\L