HomeMy WebLinkAboutE16-0160 Application.pdf Department of Community Development
n e Road
75 South Frontage West
. .. . . Vail, CO 81657
TOWN OF VAIL
Tel: 9Z0-479-2139
www.vailgov.com
ELECTRICAL PERMIT
Electrical Permit Submittal Requirements Including Heat Tape Installation
Floor plan/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:
Vos-I (Zoog go Project#:
(Number) (Street) (Suite# 12))U) Building Permit#: � .031�
Building/Complex Name: N:1✓e :(/ox,1 I R 10i
Electrical Permit#:
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.Project Information:
Owner Name:; ki r . 1n UC.S�'lMeh'l-S
Lot#: Block# Subdivision:
Parcel#.. Zi C.t— o-7 l -o6-azo(
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Define Scope and Location of Work: Re_- A/14-Q' (illy\ ``-
www.eaglecounty.us/patie) ..
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Contractor Information
_ 91\0\01Q. Seriit ce -(-o IZ�"G Vl,'b.� W� .
Business Name: l Q : a v
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Business Address: �� ;ct YK f S-11nS [�(!: :fie t.✓
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City State:: Zip:
Contact Name:
Contact Phone:
Contact E-Mail: (use additional sheet if necessary)
I hereby acknowledge that I have read this application,filled out in full the Includes Temporary Service: O Yes 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-
mationand 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 ^
codes, design review approved,International Building and Residential New M Addition (Q Remodel ( Repair(O
Codes and other oIdinan••es of the Town applicable thereto. Other 0
J
X C , '�c�o�-- --
Type of Building: Single Family.CI Duplex 0
Owner/Owner's Represent6itj9 Signature (Required)
Applicant Information: Multi-Family 0 Commercial O Restaurant O
Other O
Applicant Name: Ca.'-I .g 4`Nc-cC w-c V\
Provide BOTH square footage of area of work
Applicant Phone: 1° — (ICJ S-7k7 6 AND Valuation(Labor&Materials) `
Applicant E-Mail: COur((t LA l•S bIA.,(}, • CO►vN .:
Amount of SQ Ft.: ��00
Additional Authorized ProjectDox Users .
$: S loz5a
Full Name: Sha.r& MeiI t/;i, .
E-Mail: SkO\.1y\e- ®. (4,1c.Lys;I4,-COW\
Full ull Name: ( '
E-Mail: 4 /,
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC:.Visa/MC Last 4 CC.# • Auth #
Rev.2015-Dec