HomeMy WebLinkAboutB17-0087.pdf +F, Department of Community Development
75 South Frontage Road West
Vail, CO 81657
TOWN OF VAIL
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm,Sprinkler& Public Way)
Project Street Address: Project#:
14e)-1. sU'Pre—I4- Gri. Z (2-a
(Number) (Street) (Suite#) DRB#:
Building/Complex Name: 1'f`r) } Building Permit#:
Project Information: Lot#: Block# Subdivision:
Owner Name: Stew 4- h+tW�.—r
Parcel# 21( 122 - 11 - c a 3
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New(c--) Addition (CT'I) Alteration({ )
www.eaglecounty.us/patie)
Contractor Information Type of Building:
504. ' 5-Tuq.r 01Pc ,Pyo. Single-Family(( ) Duplex(CT) Multi-Family(I')
Business Name: Al"'"trte' - 6a7`1s 44*, Lt Z Commercial(n) Other(f')
Business Address: Gp•p t i OL. ST' Su r-r - 2.M
City GL State: C-D Zip: $( 3 1 Work Type: Interior(C') Exterior(r) Both (l)
Contact Name: is.1-44.4 Do- (S �ts+-
Contact Phone: Q.o. 'L c ct. re3 e4- Valuation of
Work Included Plans Included Work
Contact E-Mail: Qd1.C44 . 55*a.i . .
I hereby acknowledge that I have read this application,filled out in full the Mechanical (0)Yes ( No (C)Yes ( No
information required,completed an accurate plot plan,and state that all �c
the information as required is correct. l agree to comply with the infor- Plumbing :)Yes (0)No (k)Yes ((_)NO 7j CI SSD,oQ
matlon 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 approved,International Building and Residential Building ')Yes ( )No (0)Noa0 O 006 fl
Codes and other ordinances of the Town applicable thereto. 551 Opo,(!)o
Total Value of all work being performed: $ ' -$ '51 (3'tro
(value based on IBC Section 109.3&IRC Section 108.3)
Owner/Owner's Representative Signature(Required) Detailed Scope and Location of Work: /lei'/4.2e SeTri62
Applicant Information
Applicant Name:
Applicant Phone: deCr' a 4- 4Y Af 4q: Uz
Applicant E-Mail: " ,/
Additional Authorized ProjectDox Users : U!/' day , 1 J,OGtcsZ7' Peekta7
Full Name: GL�JYu.//b(�d.[.T�.�!
E-Mail: Q G K_47 C1ikaf7? .
Full Name: (use additional sheet If necessary)
E-Mail:
(use additional sheet if necessary)
Date Received:
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa I MC Last 4 CC# exp date:
Auth #
Rev.2015-Dec