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HomeMy WebLinkAboutB15-0281.pdfDepartment 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 r~uired for alarm & sprinkler) P•r~ street Addross' {iJa(Z(I-/ Af2M'> ...... P-ro-ie-ct_#_: ___,,p,__g;_::::s-_1_lf' ___ o_OL6_c-_5 __ . --------. '£ o fA:-51 n-i £A Dew 0 f?. f 0 I DRB#: ~ i40) <b] (Number) (Street) (Suite#) \)IL ,.._ c Pt A . ...., /1 Building Permit#: b{ 5 -(J cly:; / Building/Complex Name: Cf'lO IJ(., INN '-11 t.... /1 Contractor Information Business Name: i.\-flt tO Cu 'l1cm DOI<.. Q0fls.. Business Address: {) O''f lf 10 'f City fl,Q~ k~Q) State: ro Zip: &' (~ °52 Contact Name: f\ I (S H ~ t 0 . Contact Phone: q 10 31 () 2 bl t Lot#: Block# __ Subdivision: _______ _ Work Class: New ( Type of Building: Single-Family ( Commercial ( Duplex ( Other ( Addition ( Alteration ~ ) Multi-Family (.~ Contact E-Mail: (ti(<.. @ H £.-11> CJ 5 !619\ 6Ut<... Qtf;,ZS (tl'tr' Work Type: Interior ( ) Exterior ("{soth ( ) 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 ~cd;nanv•h• ij;,jcable theceto. Owner/Owner's Representative Signature (Required) Applicant Information Applicant Name: ..... S~Afi--'--'-'-_f.__=-------------­ Applicant Phone:---------------- Applicant E-Mail:---------------- Project Information (; (!!\ AG 4 5 11 OwnerName: ___ ~U!5.--~u--______ 1"f ____ _ Parcel#: :l( 0 { 0 81-5 lf D "?] (For Parcel#, contact Eagle County Assessors Office at (970-328-8640 or visit www.eaglecounty.us/patie) Work Included Efoctrfcal ( )Yes (~)No Mechanical )Yes ()'-)No Plumbing )Yes ( )"')No Building ( 't)Yes ( )No Valuation of Plans Included Work )Yes ( )No )Yes )Yes lt )Yes )No )No )No I !J 1 00() Value of all work being performed: $_l_S"'__,.~· ()_• u_· o __ {value based on IBC Section 109.3 & IRC Section 108.3) ' Electrical Square Footage Detailed Scope and Location of Work: _______ _ IJJ\f<-rf(l. fnoj,f1AJ(,, 't / •t ·os@&~.J6. (use additional sheet if ne.-c~es .. s-.a~-~~--:--.~~-=-i ..-F-o-r 0-f-fic_e_U-se_O_n_ly-: ------------~ ~ © ~ ~ '¥' ~ :l J 63 , S I Date Received: Fee Paid:------~~~--------- Received From: _____________ _ AUG 0 ti 2015 Cash Check # ___ _ CC: Visa I MC Last 4 CC # ___ _ Auth# ___ _ exp date: __ _ TOWN OF VAIL 2013-Feb 01