HomeMy WebLinkAboutB14-0129.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIL 3 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#:
/y JLh/ 6r-eCrOi dl
Number (Street) DRB#:
(Number) (Suite#)
Building Permit#:
Building/Complex Name:
Contractor InformationLotLot#: Block# Subdivision:
-E r-
Business Name: � 'Vl ld i Y' i (.(6-0 C.
Business Address: Work Class: New(Jj Addition OD Alteration(O}
City State: Zip: Type of Building:
Contact Name: Ske_ �-
Single-Family 0 Duplex .10 Multi-Family(0)
��
Commercial 0 Other 0
Contact Phone: 471 -1 D 37 LP lc-5 31-P
Contact E-Mail: kp S RE. bu,oS Work Type: Interior O Exterior O Both ;o
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 i�„Yes O)No ,Yos ONo /t {)-1-rt)
comply with the information and plot plan,to comply with all Town t
ordinances and state laws, and to build this structure according to Mechanical g�Yes O)No es ONo 2Qc�
the town's zoning and subdivision codes, design review ap-
proved,
<'`
International Building and Residential Codes and other Plumbing !I Yes ONo Yes ONol, R
ordinances of the Town applicable thereto.
nI Building pes 0)No Yes ONo j(,{L�OD
X P ✓ Value of all work being performe : $s I Al 3�Dtr�
D
Owner/Owner's Repr .entative Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage , (1O
Applicant Information Detailed Scope and Location of Work:
Applicant Name: (-G1� rcC' PcMi-ViorklerAV
Applicant Phone: tu12-t% -(moo
Applicant E-Mail: \-\of) tv.- k \N 5t-
Project Information a • ? e� ` !4, r >t . C , ' ALA - C •
Owner Name:2 4JC1y
Parcel#: , (53" l 2-1"t .-0
j 2 0 `Iy``
(For Parcel#,contact Eagle County Assessors Office at(970-32 4640 or visit
www.eag lecou nty.uslpatie)
(use additional sheet if necessary)
For Office Use Only:
Date Received:
Fee Paid:
Received From:
Cash Check #
CC: Visa/ MC Last 4 CC# exp date:
Auth #
12-Mar-2012