HomeMy WebLinkAboutB14-0301 Application.pdf Department of Community Development
75 South Frontage Road
TOWNVAIL Vail, CO 81657
Tel: 970-479-2128
www.vailgov,com
Gr 1,,,,t& Development Review Coordinator
PERMIT APPLICATION
(Separate applications are required for alarm &sprinkler)
Project Street Address: Project#:
Z1-ZZ. CptZT-u" I� l tom3E--
DRB#:
.(Number) (Street) (Suite#) •
Building Permit#:
Building/Complex Name: � t�-Rr---- �oT_L-\--- `'
Contractor Information Lot#: RAJ Block#.13 Subdivision: V MI L A(00""\\c
Business Name: ftL CAA-70M 7- utt-1) S
Business Address: CM2-el E .rL Lev,v, ED k 1� Work Class: New .141 Addition ) Alteration 0
City EbwiebS State: et) .Zip: .3tb 3 2 Type of Buildin
Single-Family! ) Duplex 0) Multi-Family 0)
Contact Name: 1'c� 1.M S Rt S,e Commercial 0 Other )
X970 - 33 ( �- (P190
Contact Phone:
Contact E-Mail: rL.vAo�U PCl[._C�.1& bYt-t • GO'VL1 Work Type: Interior ) Exterior Both
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 O)Yes })No O)Yes No
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according toMechanical )Yes )No i )Yes ONo 0
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Plumbing ()Yes tzNo °Yes OQNo 0
ordinances of the Town applicable thereto.
Building Q}Yes }No °)Yes °}Na n
X Value of all work beingJ51) ' O i
performed: $��I
Owner/Owner's Representative Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage
Applicant Information Detailed Scope and Location of Work: {�
Applicant Name: Ul\O SC-,6et ,
.� - Gr �e stl- A.,2,--t. A.,A.,2,--t_ \otpre- e,(
Applicant Phone: 970 " 331 -6213 0 �' aL.. buA&t.k/- . Nipfrox, Z21-- GubI L
Applicant E-Mail: &L 0Vol d ; o AA' C p v\ r.4-4-S t,-- t rLlikko Q
Project information jZ
Owner Name: Ytlili Sit ct...vr
Parcel#: 2-t 0 3 —Al— tD 3 V j 2-
(For Parcel 4,contact Eagle County Assessors Office at(970-328-8640 or visit
www.eaglecounty.us/patie}
(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:
Ruth #
15-Mar-2012