HomeMy WebLinkAboutB14-0393.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAL Vail, CO 81557
Tel: 970479-2128
www,vailgov,com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinklr)
Project Street Address: Project#;
f`:746 'rcycLso—
DRB#:
(Number} (Street) (Suite#) -... .
(a. BuildingPerini## -- -----
Building/Complex Name: F , ; - ---
Contractor Information Lot#: Block# Subdivision:
Business Name: .c..6cm.- i +cif 4Q y L . . . .
Business Address - — Work Class: New ) Addition { Alteration
City a State _ Zig &i%3 .? Type of Buildfn
. Single-Family U) Duplex 0 Multi-Family 0
Contact Name: tC. kotatt
Commercial Other )
Contact Phone: 970-3'1G-0+
Contact E-Maii:- o�O er k4 'circ aid .• h Work Type; Interior eiExterior Ci Both CI
•
•
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 }f46 Yes � Nar511.
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 ONE} 1.1 Yes ()No te• �.
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other plumbing Owes QNo 0Yes allo •
ordinances of the Town applicable thereto.
Building ()Yes ONo °Yes ONo X ••
-- ---__---- `Value of all work being performed: J.L10,339 ,07,0
OwnerfOwner's Representative Signature (Required) ( iud basad on IBC Section 109-3&ERC Section 908.3
!Electrical Square Footage
Applicant Information DetailedScope and Location of Work: __----
Applicant Name: L- xrynD.A UAL, P � ,3( c# > I l a -ere { �Cac�s (AraiI £
Applicant Phone; _9/0- o 2 - . Ir%Likk EFrYt-
Applicant E-Mail: E PA.06r 4r145•
Project Information +�
Owner Name: - zx�. „;_ LJ 'EE . J(J..i arch, i s'Iris �
Parcel#k:_,2 l 01,,a L eoff -------
(For Parcal#,contact Eag to County Assossoi^$Orrice at[979-28-81340 or visit
varmaag lacoutrty.usipatlal
(use additional sheet Ff necessary}
Fur Oflice Use.Only;
Date Receiy+xd:
Fee Paid:
Received From:
Cash Check #
. CC: Visa JMC Last4CC # expcfate:
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