HomeMy WebLinkAboutB14-0360 Application.pdf Department of Community Development
75 South Frontage Road
ITII
TOWN 4F VRl2 ; Vail, CO 81657
Tel:970-479-2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
Prole t Street Address: Project#
Irla
(Number) (Street) .(Suite#) DRB#:
f r Ir- Building Permit#:VSt.Building/Complex Name;Contractor Information Lot#; Block# Subdivision:
Business Name. spc
Work Class: New(0 Addition 0 Alteration Business Address
City State: Zip: Type of Building:
Single-Family i0j Duplex{�} Multi-Family(0
Contact Name: Gay-01/41,-----,
Commercial(0 Other 0
q -jY
Contact Phone: 1 0 ]—{ L 0
Contact E-Mail: (Oil\(45:), _E,'i} 1 i -ri Y ") Work Type: Interior Exterior 0 Both 0
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 '(es J No Yes JNo 50 U�
comply with the information and plot plan,to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical ,►j Yes fat No 'Yes -e1Vo �j 0
the town's zoning and subdivision codes, design review ap-
proved,
+�
International Building and Residential Codes and other Plumbing ()Yes Q)No ()Yes (JNo /0 00C)
ordinances of the Town applicable thereto f 1
Building °Yes DNo ()Yes DNo 4/5 00❑
x `
Value of all work being performed: $ 624 °Q r]ar,
Owner/Owner's Repr sentative Signature(Required) (value based on IRC Section iO i 3 8 IRC Section 108 3) /
Electrical Square Footage —10-1 lizi,
Applicant Information Detailed Scope and Location of Work
(�
Applicant Name' ONC f i\ rt ot� 1. IV -, 0f-A0
Applicant Phone. U t_r Ve7 4 L' AaNn.c' L`5) _` n
Applicant E-Mail: 7 Y �.�N-e�S .ProL•{.1
Owner
Informationj Vl r1
Owner Name: `` i
Parcel#: X1-4❑ I ��� 1 l ^ r)-2-c)
(For Parcel X.contact Eagle CarfntyRssessors office at(970-328-8840 or visit
www.eaglecounty.us/patle)
(use additional sheet if necessary)
For Office fisc Only.
Date Received:
Fee Paid:
Received From:
Cash Check#
CC: Visa/ MC Last 4 CC# exp date:
Auth #
12-Mar-2012