HomeMy WebLinkAboutB15-0028.pdfTOWN OF~ Department of Community Development
75 South Frontage Road
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:
:;i.13 ) >& ('.,....:. t. "''~ c.-\:. ~ •
(Number) (Street) ~~ C.. (Suite#)
Building/Complex Name: ~~ :> CX'"'P e k
Contractor Information
Business Name:
Project# __ ij)_~_S\ _ __)_-_i _=_; _-_-Q_a_· ==<,~S<'~·-~-----
ORB#: _________________ ~
B 'Id' p ·-:::7 ; , i:_; ·-0 () r) "K_. u1 1ng ermit #: __ 1""-;._t_ ~ ____ Cl-______ _
Lot#: Block# __ Subdivision: _______ _
;~ 1?\,\AQ'-'>.a\~
Business Address: :2 . ."3 &:£\.~ ~ .u'-{ .)..."\ Work Class: NewO Addition 0J' Alteration (Q
" City h ~"" State (o Zip: ~\(e'-\..S:-
Contact Name: ___.~""'-'"'"""""""~------------
Contact Phone: __ q_,.;:i__._7_,,__,-""'CO=-..h:=-0\.-=--''6'":__ ______ _
Contact E-Mai I: _____ ,s;.....,~""'~""' .... ""'"-'""'e"""=__,,,,, ~t.._.o ... ':..._..\..,,__.,. __._c-...-3'ek:---==->--
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.
Applicant Information
Type of Building:
Single-Family Q Duplex 0 Multi-Family {i)J
Commercial 0 Other Q __________ _
Work Type: Interior Q-' Exterior 0 Both 0
Work Included
Electrical QYes QlNo
Mechanical QYes QlNo
Plumbing Q'Yes QNo
Building QYes 0No
Plans Included
QYes QNo
QYes QNo
Qres 0No
QYes 0No
Valuation of
Work
\Sf>().00
Value of all work being performed: $ \'50<0 . o 0
(value based on IBC Section 109.3 & IRC Section 108.3)
Electrical Square Footage
Detailed Scope and Location of Work: --------
Applicant Name: _ _,,).j..-c=....,e:-,,,,,...,_.o&-,.,_N""""<-'1e'"-""~""::a-.-e...,~"".......,~=.__...·.,_, -\,'f" ~ k),.)... ~~ V '-~
Applicant Phone: ___ C\_,_7__,._7_._~-~0~':::>...-9\.~~'S>~------~ t, --\ ~ ~""""""" '("C"\~ _..,,.
Applicant E-Mail: Ji.~ <!! Va .... ~ , '('"..,e.~--~_..__.,..._.,_..1._¥<,--.-________ _
Project Information I ~ \
Owner Name: _j<S.;; ~a =\,-\f,.Q i'-~ct\ 'f'f">t? {~
Parcel #: :±..lo ~ \Y, ~ \":t 0 \':=\,
(For Parcel#, contact Eagle County Assessors Office at (970-328-8640 or visit
www.eaglecounty.us/patie)
For Office Use Only: A}-tf' < S-O
Fee Paid: ,~ _,}-
Received From: ______________ _
Cash Check # ____ _
CC: Visa / MC Last 4 CC # exp date: __ _
Auth# ___ _
=:c~>--~~~ \p~
·'S"otoe>O
(use additional sheet if necessary)
Date Received:
TOWN OF~ Received
By Carolyn Godfrey at 2:36 pm, Feb 18, 2015
I 2-Mar-2012