Loading...
HomeMy WebLinkAboutB14-0472 Application.pdfTOWIOF~ Department of Community Development 75 South Frontage Road Vail, CO 81657 Tel: 970-479-2128 www.vallgov.com Development Review Coordinator BUILDING PERMIT APPLICATION (Separate applications are required for alarm & sprinkler) Project Street Address: (!zor O Jee)+~ ~o. tis. l?cl (Number) (Street) (Suite #) Building/Complex Name: -V1"'"'1 ~--· ...... /-"'-'tl'--J_f,'--1._~"""· _h __ .. c""'o ........ /_· _ Contractor Information Business Name: Jj, ;, I( i.J-f c~j bn Gr;:o{1hy Business Address: fl: ,1 · d'o X I & / City Ku/Ci,/? state: tc Zip: cf/I,.• Y 9 Contact Name: To.Jcrn So.. /l'i.£t&-· Contact Phone: ?7 a -3 }l; -Pt I/ q I hereby acknowledge that I have read this application, filled out in full the information required, completed an accurate plot plan, and state that all the information as required is correct. I agree to comply with the information and plot plan, to comply with all Town ordinances and state laws, and to build this structure according to the town's zoning and subdivision codes, design review ap- proved, International Building and Residential Codes and other ordinances of the Town applicable thereto. x~!Yr/~~ Owner/Owner's Representative Signature (Required) Applicant lnfonnatlon Br 1 A,;-\J &, U'l SR /1-nUf ApplicantName: Vcu.) !J100;1~ ~hco/ Applicant Phone: 9 7 0 1-/ 7 2 · 7 I (., r' Applicant E-Mail: 6 C. <) Un .5-€ / f"N'-VI ~ti tn S, .J)jJ u Project lnfonnatlon / . J 1 1 -< . 1 ,.'V\ J Owner Name: V CA-! f1 Ou 11 ~ ..;Jc h._,._, _ Parcel#: .2,) 0 I 0 .2. 30 IPoo I (For Parcel If, concact &gle County Aa..sora Office at (970-321""40 or visit www."9fecounty.Ullpdet For Off'1ee Use Only: Fee Paid: ~ · .:3 I RecewedFrom:_V.........=.·~fY\"--'-·~S~~-~~~~~~ cash Check#~~~-cc: @MC Last 4 CC# CZ5Cf'\ exp date: __ _ Auth # \;)OCi iS~ --~~~~~~~~~~~~~~~~-- Project#: f>fr> IY · D lo\ o] Building Permit#: __ ... 6 .... l_y..__· oY ___ .._1 ........ a..__ ___ _ Lot#:_ Block#_ Subdivision:------- Work Class: New 0 Addition 0 Alteration /fl(. Type of Bull~I : Single-Family Duplex 0 Multi-Family 0 Commercial · Other Q ________ _ .,/ Interior I> Exterior Q Both 0 Valuation of Wor1< Included Plans Included Wor1< Electrical Qves QNo QYes QNo Mechanical Qves Q>No Qves QNo Plumbing Qves QNo Qves 0No Building (l!Jves QNo ~Yes QNo 5r:x.x.) ~ Value of all wor1< being performed: $ 5 00 O~ aL (value based on IBC Section 109.3 & IRC Section 108.3) ' Electrical Square Footage Detailed Scope and Location of Wor1<: (e 010 k' e. otY: f&-r-h ·ti~ 1 W cd I g..n cl CMQ dwr ; ;, or-:f.,-u 6-133 (use additional sheet if necessary) DateRece ~©~fl\Vl~ ~ DEC o 9 2014 LJ µ_ ~;q() TOWN OF VAIL 12-Mar-2012