HomeMy WebLinkAboutB14-0400.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIN' Vail,CO 81657
Tel: 970-079-2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm&sprinkler)
Project Street Address: Project#:
I dei b w rho P n D r�
DRB#:
(Number) (Street) (Suite#)
lip Building Permit#:
Building/Complex Name:-eat:,f G14r s
Contractor Information
{Lot#: Block# Subdivision:
Business Name: 5� -- U 4
Work Class: New 0 Addition LI a Alteration
Business Address:
City State- Zip: Type of Building:
Single-Family . 1, Duplex 0 Multi-Family 0
Contact Name: r a�7� Commercial * Other 0[�
Contact Phone: `io O t---n
1J
i Work Type: Interior Q Exterior 0 Both
Contact E-Mail: SM-0,h
"� 1 �1
I hereby acknowledge that 1 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. 1 agree to Electrical inYes (3No ( Yes ONo /5–(,-i Q
comply with the information and plot plan,to comply with all Town 5r
es
and state laws, and to build this structure according to Mechanical pYes ONo ekes ONo 4 di7
the town's zoning and subdivision codes, design review ap-
proved,International Building and Residential Codes and other Plumbing )Yes ONo0Yes i°No 30/000
ordinances of the Town applicable thereto.
Building Yes ()No 9Yes ONo 'gam po-p
X Value of all work being performed: $.3301 CL
Owner/0 er's R sentative Signature(Required) (value based on IBC Section 109 3&IRC Section 108 3)
Electrical Square Footage 2-Le
Applicant Information Detailed Scope and Location of Work:
Applicant Name: L O a +p, +t.y- 3 - k„p2. O.c .r-!1!ry? +ri LAIL` Si l:LP
Applicant Phone: Of kc &i l Rep I f.C(.P_ IJ .-Dc crn e
Applicant E-Mail: W s 4-1/1 If?X 1,/OA1Lr'.` 1 t _-+ Or?
Project Information . I .e `)d r + �flf ono
Owner Name:7 C -t CCL1 k L..I .1 i nr
44)
yf
Parcel#: `\ 3 ~ I�— MoD
(For Parcel C,contact Eagle County Assessors Office at(979.328-8640 or Wan
www.eaglecounty.usipatio)
(use additional sheet if necessary)
For Office I:se Only: Dale Received:
Fee Paid:
Received From:
Cash Check#
CC: Visa/ MC Last 4 CC# exp date:
Auth#
12-Mar-21112