HomeMy WebLinkAboutB15-0354 Application.pdfProject #:
DRB #:
Building Permit #:
Lot #: Block # Subdivision:
Work Class: New 0 Addition 0 Alteration
Type of Building:
Single-Family Duplex 0 Multi-Family 0
Commercial Other 0
Valuation of
Work Included Plans Included Work
Electrical
Mechanical
Plumbing
Building
(yes 0)N°
OYes No
DYes ONo °Yes ONo
Yes ONo Oyes ONo E771 3 2â
0Yes ONo OYes ONo
Value of all work being performed:
(value based on IBC Section 109.3 & IRC Section 108.3)
Electrical Square Footage r ,
Detailed Scope and Location of Wo 7 7 I 32_
011
e Oreq3t T rci P
- 1 6- r re I Y J roaQ_
Tr°,
$5777 ,52. 0
TOWN OFVAII.'
F AQ I('
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:
Kee S. Pron-1-049-g_
(Number) (Street) (Suite #)
Building/Complex Name: DOA 0 VV P V1 Iles,
Contractor Information
Business Name: Gorle,V1 rp'G) to id' Poo jet-
Business Address: Rd . 6e .k⢠2.9 I
City ib(â e c K4At:d f State: 6.0 Zip: %LI
Contact Name: VI I I : MAt TA -1-r gl-
pl LI 16 1 0 Contact Phone:
Contact E-Mail: I a ts) s) (d4Work Type: Interior Exterior 0 Both
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, Internation I Building and Resid ntial Codes and other
of th own ap he
Owner/Owner's Representative Signature (Required)
Applicant Information
Applicant Name:
IV: I I:4 in
Applicant Phone: 0140 ) LWS
Applicant E-Mail: ,3, Hg GAD C), 0,411
Owner Name:
Project Information To a F 1/4
Parcel #:
(For Parcel #, contact Eagle County Assessors Office at (970-328-8640 or visit
www.eaglecounty.us/patie)
(use additional sheet if necessary)
For Office Use Only:
Fee Paid:
Received From:
Cash Check #
CC: Visa / MC Last 4 CC # exp date:
Auth #
Date Received:
12-Mar-2012