HomeMy WebLinkAboutB14-0211 Application.pdfDepartment of Community Development
75 South Frontage Road
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: ..-r
2f/ ~./,,d// .r /
(Number) (Street) (Suite#)
Building/Complex Name: C /.? ~.#'/ S /f V/4':;2
Contractor Information
City ~/./'./~ State: C' C:
Contact Name/??' /C,,f/P?V'I ~
Contact Phone: 2/ /-J ?V-· 6?4:?=
....---------......---------------~
Project#: ---'-/?\'--'---"""',)<-...:-I Lf-'--·-"'o:;J'"""'""5~Cf _____ _
ORB#: __ j)--=-_(l{;-=--1'-P_/_..:.Cj_( ____ _
ti L/·u;J f I
Block# __ Subdivision: _______ _
Work Class: Addition (0) Alteration (0)
Type of Building:
Single-Family ( Q) Duplex ( Q Multi-Family (Q)
Commercial (0 Other (Q) _________ _
Contact E-Mail:~.r.£°17 ..r/~~#/?f e [.::?/'C .;::;>/L;;;work Type: Interior (Q) Exterior (Q Both (Q
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 information 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 ap-
proved, International Building and Residential Codes and other
ordinances of the Town applicable thereto.
X j:_ /(41 ft CJtmA.tk= . Tve&Joa f-~owner's Representative Signatur/{Required)
Applicant Information
Applicant Name: -----------------
Applicant Phone:-----------------
Applicant E-Mail:-----------------
Project Information
Owner Name: ________________ _
Parcel #: ::----,--:-::,--,-=----:----,...,,--------(For Parcel#, contact Eagle County Assessors Office at (970-328-8640 or visit
www.eaglecounty.us/patie)
For Office Use Only:
Fee Paid: ________________ _
Received From: ______________ _
Cash Check # ____ _
CC: Visa / MC Last 4 CC # ___ _ exp date: __ _
Auth # ___ _
r
Electrical
Mechanical
Plumbing
Work Included Plans Included
(Qfes QNo (QYes (QNo
Oves QNo QYes (QNo
Oves QNo QYes QNo
Valuation of
Work
Building QYes QNo QYes QNo I Value of all work being performed: ----; /Kvt7~·'7a
{value based on IBC Section 109.3 & IRC Section 108.3) 7
Electrical Square Footage
Detailed Scope and Location of Work: --------&. /(4//,c:l"-/,1!7f
_;z:-~~L ~ /;?L#-f ,,,,,:?A/C/ 'j&f1S l)Qfi_...
~,,,?./// ,J/.#<
(use additional sheet if necessary)
Date Received:
20 13-Feb 0 1