HomeMy WebLinkAboutB14-0477 Application.pdf Department of Community Development
75 South Frontage Road
TOWN CFO 1 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#:
108 South Frontage Road,Vail, CO 81657
(Number) (Street) (Suite#) DRB#:
Medical Professional Bldg. Budding Permit#:
Building/Complex Name: g
Contractor Information Lot#: Block# Subdivision
Business Name: Vf4l{ L \1A `i h c ]it CIS. ____
Work Class: New a Addition 0 Alteration(p
Business Address:` C10t CL. —_ _ _ _ __ _ _ __
City V N__. State: Zip: 1(-..C-TA Type of Bulldin
Single-Family U) Duplex t0 Multi-Family 0
Contact Name: .i-)Avalt, (k-.,_—
-
Commercial figOther 0
Contact Phone: 9 10 - (0'1- a LI Z
4
Contact E-Mail HO ,/
4 MC., c 0 ifyi Work Type: Interior 0 Exterior 0 Both
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 stale that all the information as required Is correct. I agree to Electrical YesNO Yes No 4
•• ply with the information and plot plan,to comply with all Town 0 O t
ord ances and state laws,and to build this structure according to Mechanical ()Yes ONo eYes ONo I t i OCO
the I• 's zoning and subdiv •• codes, •_ •n r view ap-
prov ',International Build' g end Res'd a • . other Plumbing Oyes OND ®Yes ONo Di C{7O
ordin. _ of the Town plicable reto
Building ()Yes ONO (gYes ONo 4a U�t
X :z'__ /_ r Value of aN work being performed: $X'-11C )O
Owner/Owner's •-•resentat 7 (value based on IBC Section 100.3 a IRC Section ice 3)
Electrical Square Footage 1C.'Q
0
Applicant Information Detailed Scope and Location of Work:
Applicant Name: l_) P L iEwoo o 7r.1S-ri.43c F 1C1 ,
Applicant Phone: CI C'i- -Fria �'vS70 SPCC ICS 04 -\� I—+& 1 tI
t ; .I, l .., 1 , cw,
ApplicantE-Mae:. ) '�'nA .c,tr Gig -114v S.
Project Information •AlL I L)4
Owner Name:
Parcel#: 0 i Cl 1 ri, 4 O )
(For Parcel fr,contact EV*County Assessors Office at 157542€4540 or visit
www.esyNcowtwustpstle)
(use additional sheet d necessary)
For Office Use Only Date Received:
Fee Paid:
Received From:
Cash Chedc#
CC: Visa/MC Last 4 CC# exp date:
Auth#
124tat-2012