HomeMy WebLinkAboutB14-0398.pdf Department of Community Development
75 South Frontage Road
TOW OFVl1. ■ 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#:
(S'L o VN . Lt fA \eu_c f L L\ '1J DRB#
(Number) (Street) (Suite)
�� Building Permit#:
1
BuildinglCompiex Name: LJli 1 �,w ]V[c__
Contractor InformationLot#: Block# Subdivision:
a�
Business Name: Tr� oft,is_ ACo t -
Work Class: New 0 Addition 0 Alteration{0
Business Address:
City State: Zip. Type of Building:
Single-Family 0 Duplex 0 Multi-Family 9
Contact Name: leTt i. 1 � Commercial 0 Other j
I0Contact Phone: `5r1
���i�Q /�,,,,,,, Work Type: Interior p Exterior 0 Both 0
Contact E-Mail:= !C,i llCI Z _tux__cs
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 14000 Work
and state that all the information as required is correct. I agree to Electrical tYes ONo Oyes ()No r 7 O 00
comply with the information and plot plan,to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical icbYes ONo OYes rNo 3 tOt
the town's zoning and subdivision codes,design review ap-
proved.International Building and Residential Codes and other Plumbing f0Yes ONo Yes JNo
ordinances of the Town applicable thereto.
Building )Yes ONo pYes ONo 51.o7_71)
XValue of all work being performed: $V A C
Owner/Owner's Re sentative Signature(Required) (value based on IBC Section 109.3 8 IRC Section 108.3)
Electrical Square Footage 5 I J
Applicant Informatioemtrathyz____
Detailed Scope and Location of Work: "prApplicant Name: -�l�D 7 c�l'C'1 Q...Y't1T1 O�xx- I, L(TLk.tuf�
,
Applicant Phone: ► + ■_ •
a 1. i1 a t A '► y
Applicant E-Mail: 17-14 ak_t_rmLid Ob
Project lnformatinn �J - cY`� C C.Q aw a n(�. t '
Owner Name: Lien_` c' b • Grp
r' ev +n C'_l 4-
Parcel#: 21 6 + - p--7 — 0 1(f)(For Parcel#,contact Eagle Cnty sesso ice at(970-328-8640 or visit
www,eagiecounty.uslpatie)
(use additional sheet if necessary)
For Office Ilse Only: Date Received:
Fee Paid:
Received From:
Cash Check#
CC: Visa/ MC Last 4 CC# exp date: _
Ruth #
12-Mar-2012