HomeMy WebLinkAboutB14-0250.pdf Department of Community Development
75 South Frontage Road
TOWN aF VAGI. ► 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#:
1 q ItTC42.- ace-E- -0e— 7,5
DRB#:
(Number) (Street) (Suite#)
I
0 RP-t-
P t C Building Permit#:
Building/Complex Name: f
Contractor information 11 Lot#: Block# Subdivision:
Business Name: )-- ItU 1 R 4, ,,,���777...
-] Work Class: New 0 Addition 0 Alteration
Business Address:
City State: Zip: Type of Building: r
Single-Family 0 Duplex 0 Multi-Family �l1
Contact Name: f Commercial C) Other 0
Contact Phone: 9.�7"n 1O 5 1 1 L 2
Work Type: Inferior Exterior Both
Contact E-Mail: C �1 ("' _VI ]-S,,Q p1
I hereby acknowledge that I have read this application,tilled 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. 1 agree to Electrical °Yes I()No °Yes QNo
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 ONo CO-Yes ONo fil 060
the town's zoning and subdivision codes, design review ap-
proved,International Building and Residential Codes and other Plumbing jYes OjNo cYes ONo
ordinances of the Town applicable thereto_ p�,
Building 9Yes ONO Yes ONO "9240.
X � Ct Value of all work being performed: $ .62,6Owner/Owners Rep ntative Signature(Required) (value based on IBC:Section 109.3&IRC Section 108.3)
Electrical Square Footage a 1
Ft-
Applicant Information DetailedyScope and Location of Work:
Applicant Name: 1_. efeir �p1L;fl ' OL5 0 U t' .' ` . I 11 -0.M
J'
Applicant Phone: rl-etNgi ]ili Y}(0 1 y\ (I(t_
Applicant E-Mail: f y CI, VQA LlhA
Project Information VQl
�PP P��"`
Owner Name: Ye[c ]n[ { L !TLC iL
LJ
Parcel it: i?Irr `"U 2
(For Parcel*,contact Eagle County Assessors Office at 1i or via
wwwr.eaglecounty.w&patiel
(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