HomeMy WebLinkAboutB14-0305.pdf Department of Community Development
75 South Frontage Road
TOWN OF Y►4IL 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#:
66 zv 7.1.(kFrcv 1a_ 2
(Number) (Street) (Suite#) DRB#: f0►+J�
(JY-etr 4��Cj _ J t l Building Permit#:
Building/Complex Name: o
Contractor Information �,. Lot#: Black# Subdivision:
�Business Name: v\ t G i ��r p,Uz
Work Class: New 0 Addition Alteration
Business Address:
City_ State: Zip: Type of Building:
��f A Single-Family 0Duplex{ } Multi-Family 0Contact Name: [/1
Commercial 0 Other
Contact Phone: 91 o 7 /O 3 —1 -7
Contact E-Mail: 1(aj/tt 6121 i idS' y" Work Type: interior Q Exterior 0 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 f]Yes ONO epes ONo /2'CUD
comply with the information and plot plan,to comply with all Town fa
Yes
and state laws,and to build this structure according to Mechanical Yes O)No Oes JNo ti4GYTI]
the town's zoning and subdivision codes, design review ap-
proved,International Building and Residential Codes and other Plumbing jaYes ONo C40 Yes ONo
ordinances of the Town applicable thereto. ,r
Building ,Yes JNo ��Yes ONo ! Or
X APt . Value of all work being performed: $ /53;erero
Owner/Owner's R prentative Signature(Required) (value based an IBC Section 709 3 S IRC Section 108.3) /
Electrical Square Footage 11
Applicant Information Detailed Scope and Location of Work:
Applicant Name: f( �+ -� /h1 -2 e rc e k 0-C
Applicant Phone: 1 5, Li lj e } (SAL4 N142--
Applicant E-Mail,
QApplicantE-Mail. a,1( Si► YC4 ' (O[ IVt
'
Project Information ,� I e 6 C CEJ 11\1 �1� ice• c
Owner Name: � Lt rJ ��� `�a� v^ Y 1 0,66 i le .
Parcel#: DI - IL 30 - °°o 7—
(For
(For Parcel#,contact Eagle County Assessors Office at(970.328-8840 or visit
www.eag leco unty.uslpatie)
(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