HomeMy WebLinkAboutB14-0387 Application.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAI1 �'' 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#:
f5— WeSi- Liov‘CineaJ
(Number) (Street) DRB#: /4101-14-0(Suite#)
Building Permit#:
Building/Complex Name: Uct_i Mart- o4
Contractor Information Lot#: Block# Subdivision:
Business Name: —1-1,..Q.„1,2,00 �,,��,,1
�t 0 cu, /a$e /ale \r Work Class: New(�jj Addition(Qjj Alteration
Business Address: ! J
City Crraa. State: CO Zip: S'Oyy(6 Type of Building:
Single-Family 0 Duplex 0 Multi-Family 0
Contact Name: -Roue t Commercial(�j Other 0
Contact Phone: I-3-0-53(-g 8y
Contact E-Mail: 6bolL i akg-1100 .1�Ctt,COwh
Work Type: Interior i) Exterior�oth 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 ()Yes ao ®Yes elo
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 G)No ()Yes No
the town's zoning and subdivision codes, design review ap-
proved,International Building and Residential Codes and other Plumbing )Yes No ()Yes e No
ordinances of the Town applicable thereto.
Building 0Yes ))No °Yes ONo
X ✓1 e u p�732 Value of all work being performed: $ ( ,/3p.Oct 0
Owner/Owner's Representative Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage �1
Applicant Information Detailed Scope and Location of Work: froom Ro0P 0),..47-
Applicant Name: (Zp..A•ZA lit (Zoom 2iS44vtQ ro0c'aisteut.. 'ba
Applicant Phone: 910-53(-5'}ge( -a /
(,1pl,,1;5� As 'ova LZ/i ,�2Y'c��'dIYutS,
M i
Applicant E-Mail: �l olei @-14,.42,(-o0�f✓�c,Co.Cow. l�Q0Ort ft.- Lo .�t cd, SO n-i I L rsiuo �(ibr),)
Project Inform tion IJ I� �4 5. i0.1S LAD 'rL 314 'PIP it rOC. L,ct_,(!LLS-f-.
Owner Name: �o wvov '1206, (-(n,4�ita� �?d Jail Mtirrio} �O'y 1� o n.tte rC 3S'
Parcel#: a IOiO"?- i?-OOi
(For Parcel#,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:
Auth #
12-Mar-2012