HomeMy WebLinkAboutB14-0289 Application.pdfTOWN OF~ Department 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)
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• ~~reet Add~ss: Project#: ~ l L\: · 0 L{~ ~ N. ~\flt£ 1'D w ORB#: ~/7A: ~./brG
(Number) (Street) (Suite#)
. Building/Complex Name;iirft,"RJSut£ Building Permit#: 614. c:blSC{
Contractor Information
Business Name: ~<..'-/ ~2..ATIO"-\
Business Address: no { ~ NO"bX h ~ (\)2 .
city 6 ·~"vx m state: Co zip: f!(vZ:rr
Contact Name: JOHN (CR'OH·4
Contact Phone: q1) :):') l-(o"'J-') "8"
Contact E-Mail: ~~~NC:, Bol>Ub\4( .((h}t\_,
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, ernational Building and Residential Codes and other
ordina ce ft o icable thereto.
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Ow Signature (Required)
• Applicant Information
·Applicant Name: ~ t:-1 Ll:Ro N
. Applicant Phone: 9-x.>-"J)l{o?f)/{
Appiloant E-Mail: ~ Ne,(,.O {:u,[)\l·y .(al(_,
Project Information Owner Name: _______________ _
Parcel#: 02lc:l3' t.5(J.c,9'3·0C)l
(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# ___ _
Lot#: Block# __ Subdivision:--------
Work Class: New (0) Addition (Q) Alteration ("1<
Type of Building:
. Single-Family ( Q) Duplex ( Q Multi-Family~)
Commercial (Q Other (Q) _________ _
Work Type: Interior (Q) Exterior (m Both (Q --------~-·~---··-----·-~----------·-----·-----~--~-~"---·---------~
------• ~ h
Valuation of
Work Included Plans Included Work
Electrical (O'es QNo (()Yes (()No
Mechanical Oves QNo QYes (QNo
Plumbing QYes QNo QYes QNo
Buil~in_~--· _l&'lv~~-Q~o .Q~e~ _QN~. ~B_,~§;L_
Value of all work being performed: $ "5''0 , q£i LJ 0
(value based on IBC Section 109.3 & IRC Section 108.3)
Electrical Square Footage
... -------···-····----··------·--···--··--····-----·--···--~-·~--·---------·· -:
Detailed Scope and Location of Work: ~ f\ lr ~
ft1>lACt:1YltNT OF L1m1TCD
?e ~s~\l\H ~OC61.J~u: slH:12ciht«t7L
·--o;e~113:j· Ves\-l£NYNh.
~ ,'J,(Y\O, I ,LIN.
(use additional sheet if necessary)
Date Received:
2013-Feb 01