HomeMy WebLinkAboutE17-0067.pdf Department of Community Development
75 South Frontage Road West
Vail, CO 81657
TOWN OF VA M14 Tel: 970-479-2139
www.vailgov.com
ELECTRICAL PERMIT
Electrical Permit Submittal Requirements Including Heat Tape Installation
_Floor plan 1 Site plan showing proposed work _Occupancy Group listed on plans
_Load Calculations and one-line diagram when loads or circuits are being added _Building Type
NOTE:For Multi-Family and Commercial buildings—plans and calculations must be prepared by a Colorado Licensed Electrical Engineer
Project Street Address:
CI SP CCS c r:L(4- Project#:
(Number) (Street) (Suite#) Building Permit#: I I+c
Building/Complex Name: 0 0
Electrical Permit#: l _ 1)1
Project Information:
Owner Name: lh r; 4
t'\r S cr e ` S C. L Lot#: Block# Subdivision:
Parcel# 0 \ o'2-G 3 e)
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Define Scope and Location of Work:
www.eaglecounty.us/patie)
G l �1n-I C 1� tL Alta()Q-A
Contractor Information
Business Name: 1- (�-IL �' �t�L �`�
Business Address: Fe, (5.0 7 5 a
City vw,. State: C.e Zip: t`mac‘5-
Contact Name: 3;L1 ryes.
Contact Phone: i 1 et 33` 7(4,t,;.. '
Contact E-Mail: to► cJ J nn (moi JAI t . Az+ (use additional sheet if necessary)
L i
I hereby acknowledge that I have read this application,filled out in full the Includes Temporary Service: (C)Yes A)No
information required,completed an accurate plot plan,and state that all
the information as required is correct. I agree to comply with the infor-
mation and plot plan,to comply with all Town ordinances and state laws, Work Class:
and to build this structure according to the town's zoning and subdivision New(C) Addition (C) Remodel r j Repair(r)
codes,design review approved,International Building and Residential
Code and er ordinances of the Town applicable thereto. Other(C)
X � Type of Building: Single-Family(R_ Duplex(C
pr
Owner/Owner's Re\\gs`entative Signature(Required)
Applicant Information Multi-Family(C) Commercial (() Restaurant(( )
Other )
Applicant Name: , .t t J c r
Provide BOTH square footage of area of work
Applicant Phone: °I-1 0 - W-6 t. - ZEE(.0' AND Valuation(Labor&Materials)
Applicant E-Mail: bi l+o J fin ' /4--‘
L fl�e f Amount of SQ Ft.: lei S •Ct -
Additional Authorized ProjectDox Users Electrical$: 3 5-.7
Full Name:
E-Mail:
Date Received:
Full Name:
E-Mail:
For Office Use OW
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC # Auth #
Rev.2015-Dec