HomeMy WebLinkAboutB14-0452 Application.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIL , 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#:
4229 B Nugget Lane
(Number) (Street) (Suite#) DRB#:
I Building/Complex Name: Building Permit#:
Contractor Information Lot#: Block# Subdivision:
Business Name: Jerry Sibley Plumbing, Inc
Business Address:
I i
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PO Box 340 Work Class: New t1 Addition Alteration(€
i
City Mintum State: CO Zip: 81645 Type of Building:
Kristena Wyatt ,Single-Family j Duplex Q Multi-Family 0 I
Contact Name: y i
Commercial Other 0 i
Contact Phone: 970-827-5736
Contact E-Mail: ispinc@vail.net Work Type: Interior Exterior Both
Pinc
J
I hereby acknowledge that I have read this application,filled out I Valuation of I
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 ONo 0Yes ONo
comply with the information and plot plan,to comply with all Town
' ordinances and state laws, and to build this structure according to 1 Mechanical °Yes Q)No ()Yes ONo 18,000.00
the town's zoning and subdivision codes, design review ap-
I proved,International Building and Residential Codes and other Plumbing ()Yes Q)No 0Yes ()No
1 ordinances of the Town applicable thereto.
, 1Building Yes ONo Yes ONo
,� '�G I NaN
I X '°'` '"" i Value of all work being pertormed: $
r Owner/Owner's Representative Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage
E Applicant Information
I Detailed Scope and Location of Work:
Applicant Name: Jerry Sibley Plumbing, Inc Replace boiler&water heater
Applicant Phone: 970-827-5736
s
I Applicant E-Mail: jspinc@vail.net
Project Information l
Owner Name: STEPHEN C. HELBING JR HERITAG
Parcel#: 2101-123-07-034
(For Parcel#,contact Eagle County Assessors Office at(8704284640 or visit
1 www.eaglecounty.us/patie)
"- , -- R. .. .,- (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