HomeMy WebLinkAboutB14-0103 application.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIL Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
Project Street Address: Project#:
/(0 5—b � )'&(-- 2"D6.6.- +-t_ 4\2/6,
DRB#:
(Number) (Street) (Suitee#)
Building/Complex Name: G�///��/� �e3
e Yl�/ dS Building Permit#:
Contractor Information Lot#: Block# Subdivision:
Business Name: 'J(�7 s --774---h.,./2's-ed ,q-16-
/1'/3 Ccs r(-2i / st- Via!(/ Work Class: New Addition Alteration ��
Business Address:
City1G�72 State: Go Zip: p/&g/ Type of Building:
Single-Family() Duplex 0 Multi-Family
Contact Name: ,4"6-6C.ia._ n4 vfJ Commercial(0 Other 0
Contact Phone: q ,20-7. 6. 7.:::,I--
Contact E-Mail: a��e...e- ,Ssfc� , C,:y�,r, Work Type: Interior 0 Exterior 0 Both 0
I hereby acknowledge that I have read this application,filled out Valuation of
in full the information required,completed an accurate plot plan, Work Included Plans Included Work
and state that all the information as required is correct. I agree to Electrical ( Yes O)No °Yes ®No r,"/a oc%
comply with the information and plot plan,to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical ()Yes ®)No °Yes (1 No
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Plumbing Yes ONo Yes ( No `7l c 0 D
ordinances of the Town applicable thereto.
���� Building '4Yes O)No )Yes l DNo S 5, O o o
X ( -�G�lr,� 4G1• ..) -- Value of all work being performed: $ a5/6- 1),00:
Owner/Owner's Representative Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage /alof(5.e. 6-,„'mac'
Applicant Information i Detailed Scope and Location of Work:
Applicant Name: ��iirj Ot(20,4A5� �.c)L4s: )y) /f/i -/dl'- /J 4/ keii4--5-'de-1
Applicant Phone: C7. 5 -'2 • ";3-1--9-- i
Applicant E-Mail: (� e 5SZ.4e<_ , ,
Project Information .
Owner Name: _ T � tii/Sam
Pace #. / te
Parcel DC SG l/ b OS
(For Parcel#,con ct Eagle County Assessors Office at(970-328-8640 or visit
www.eaglecounty.us/patie)
(use additional sheet if necessary)
For Office Use Only:
Fee Paid: Date Received:
Received From:
Cash Check#
CC: Visa/ MC Last 4 CC# exp date:
Auth #
12-Mar-2012