HomeMy WebLinkAboutB14-0249.pdf Department of Community Development
75 South Frontage Road
TOWN OFIIL ' 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 11:
1 6700Crex - (J3
DRB#:
(Number) (Street) (Suite#)
1 Building Permit#:
Building/Complex Name: L/O TPS /46:4'
Contractor Information 1t Lot#: Block# Subdivision:
Business Name: 51, •1 1 tL-
�J Work Class: New 0 Addition 0 Alteration iC$.
Business Address:
City State: Zip: Type of Building:
�� Single-Family 0 Duplex lul Multi-Family 0,
Contact Name: (wG Commercial 0 Other 0
Contact Phone:_ D J
pj j Work Type: Interior Exterior 0 Both 0
Contact E-Mail: T Gini -�
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 ()No ()Yes ()No
comply with the information and plot plan, to comply with all Town
ordinances and slate laws, and to build this structure according to Mechanical es (No ,eYes ()No /Q/)&0
the town's zoning and subdivision codes,design review ap-
proved,International Building and Residential Codes and other Plumbing ()Yes ONo °Yes ONo
ordinances of the Town applicable thereto_
Building 1Yes ()No [ 'Yes ()N
o
X Value of all work being performed:^ $ r7r9f Oa)
0
Owner/Owner s Repr s tative Signature(Required) (value based on IBC Section 11119.3&IRC Seclion 108.3)
Electrical Square Footage 77/r r1te.
Applicant Information, Detailed Scope and Location of Work:
Applicant Name: (U L C�y— 6e-1-A3 a n 001
1 ,%a'Akt
Applicant Phone: _ 1��CUAe.A0 i 10
f 17 'Cj;, f(� �{ c
Applicant E-Mail: 6. �.JI, r112 IT UQ -h-‘Cod
Project Information /� !!-`�� � ''++ p + ' u �' 1 ' �.Q, \f �
Owner Name: { V '1 1J. �e`ri n`` l.i��i �~
Parcel#:
IFor Parcel contact Eagle County Assessors Office at IVO -3540 or visit
www,eaglecounty.uslpatie)
(use additional sheet it necessary)
For Office Ilse Only: Date Received:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp date:
Auth #
12-Mar-2012