HomeMy WebLinkAboutB14-0319 Application.pdf Department of Community Development
(1111
75 South Frontage Road
TOWN OF U�jJ}.' 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#
0 (: (XD P kc-- O 7-.)4-
(Number) (Street) (Suite#) ORB#
Building/Complex Name: ,A./\) 1 _ Building Permit#:
/
Contractor Information Lot# Block#_ Subdivision:
Business Name. 6
Work Class: New 0 Addition 0 Alteratiory4
Business Address:
City State: Zip: Type of Building: .2
'5�rpt Single-Family 0 Duplex 0 Multi-Family 0
Contact Name
�
y 5 Commercial(0 Other 0
'I
Contact Phone: '. 0 7 7 (.4
� rte[ By}fl_ (Work Type: Interior Exterior Both
Contact E-Mail S
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 ElectricalYes cJ}No Yes (No D
comply with the information and plot plan,to comply with all Town ���fff���fff���'''""''''' w
ordinances and state laws, and to build this structure according to Mechanical ()Yes 0)No ()Yes Okto
the town's zoning and subdivision codes, design review ap-
proved,International Building and Residential Codes and other Plumbing pYes )No pies °No -€ 0ordinances of the Town applicable thereto.f Building 95es ONo 1-Yes ONv -73 WO
X ! �j Value of all work being performed:"" $ 8�d0 '-
Owner/Owner's Re r sentative Signature(Required) (value based on IBC Section 109 3&IRC Section 108 3) i,t
Electrical Square Footage
Applicant Information L Detailed Scope and Location of Work:
Applicant Name 0-Nara�' �Y— r. ff 14 ,"-A.1-7E..1
f ,� $1
pp1i�tL 4-,'rl.,rz,. I�.�.r~n�[�r.! F•�G lV�f � fr.�-p'"i,
Applicant Phone: CaLLe+ �l S 4-115t/11~A A-f I'VI ►•4
Applicant E-Mail.
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Project Information I r i
Owner Name: 10 1 -- U I i
— ,�U l 06 .]
13�7o
Parcel#: C2�JrP. C r le
(For Parcel Al,contact Eagle County Assessors office t t 7 0 or visit
viA•roa.eagicicounty.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:
Auth#
12-Mar-2012