HomeMy WebLinkAboutB14-0339 Application.pdf TOWN OF VAIN 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#:
Li " lebtt5_) enbe f-AttA. Cr 6 " '
Number DRB#:
(Number) (Street) (Suite#)
Building/Complex Name: 111.1 'i'd- j"/'r)L ` Building Permit#:
Contractor Information F Lot#: Block# Subdivision:
Business Name: Pi / U t t C t (S
G, ` Work Class: New(Oj Addition(Oj Alteration
Business Address: CIA A ci r j Cti�
g
City —ID L�/it 1,C t' State: er'0 Zip: 61 zz z Type of Building:
Single-Family C) Duplex(:) Multi-Family �1.�'I
Contact Name: i-.tAb4 rr�err!cc{e( j (1
J ) Commercial``-J' Other
Contact Phone: 3t 3 ti*1 le-
Contact E-Mail: 1°-3 " 6.?
' t�7- �t t t?fey
` Work Type: Interior O Exterior O Both ','4
C T°»
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 IQYes P4)No QYes ONo
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 4111N)No °Yes ONo
the town's zoning and subdivision codes,design review ap-
proved,International Building and Residential Codes and other Plumbing Yes 0No °Yes °No
ordinances of the Town applicable thereto. ..
Building -Yes ONo 'tgYes ONo
X �4 Value of all work being performed: $ `CCL e —B
Owner/Of ner s =.resentative Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage
Applicant Information ,j Detailed Scope and Location of Work: (A/
ApplicantCITE) r(Name: ,P>( - +r.l((14 t Alstcrco
Applicant Phone: LI fid_?6, /- `) `r-if c t T t. )R!; S 04 -gei
Applicant E-Mail: S e vC-C-tt/ r Cid (, 6 /L'Cdr 1 )V -4. To ( sakLA, (e %( C'2c f`a i4cc
Project Informationf loot c Loi Oc ze,t.-04 `Y D U t" c'tz
Owner Name: 71 j.:.,j}'(4 is it 1,0ef 14 I r,
Parcel#: 1 o`( ' ;01005—
(For Parcel#,contact Eagle County Assessors Office at(970.328-8640 or visit 'Pq.Q t1(Z.
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:
Auth #
12-Mar-2012