HomeMy WebLinkAboutB16-0114.pdfTOWN OF~7?J Department of Community Development
75 South Frontage Road West
Vail, CO 81657
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical, Alarm, Sprinkler & Public Way)
--·-·------------·----·--..------------------------,
Project#: _________________ _ Project Street Address:
I 7 tel> ///' , Ff(C'?V IJJG.f Rb }~ll'JG. t\
{Number) {Street) {Suite#) ORB#: ------------------
I Building/Complex Name: T/H?i!.ff N re, D6C Af>Ts . Building Permit#:---------------
: Project Information: .
Owner Name: To w /l/ t_,'> tP-I/ A / L
·Parcel# ;;zo/'5 -1;;./-29-00/
. (For Parcel #, contact Eagle County Assessors Office at (970)328-8640 or visit
www.eaglecounty.us/patie)
Contractor Information
Lot#: Block# __ Subdivision: _______ _
Work Class: New ( Addition ( Alteration ()()
'·Type of Building:
Single-Family (
. Business Name: ')';1 Mf/I VAUE'f Cc"4'S//clt)CTr~;t/ xf\;1if:t0mmercial (
Duplex ( ) Multi-Family <X)
Other (
i Business Address: _f?J<. __ l_'-/~t_l/ ___________ _
! City J};:J t-7 /) cA-/ State: LC> Zip: f? I b S '/ Work Type: Interior (>() Exterior ( ) Both ( )
i Contact Name: Jo/l,v s. r. P/ctef2E
: Contact Phone: '"l 70 ·-F <16 -7? SS
Contact E-Mail: )'vc. SeRv/c e,,.{? VJ ,,t/oo, Co,4:1
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 infor-
mation 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 esign review approved, International Building and Residential
Codes a d other ordinances of the Town applicable thereto.
OwneflOwner's Representative Signature (Required) I Applicant Information
. I '
Applicant Name: .Jfi',//A,/ Sr ?/ C:,12 I._) c
! Applicant Phone: 9 '70 :? Yb ? 7 3 s
Valuation of
Work Included Plans Included Work
I Mechanical ( )Yes (X)No )Yes )No
Plumbing (,X)Yes )No )Yes /3,t>O U
j Building ()('.)Yes )No )Yes
i Total Value of all work being performed: $ __ ~~--
1, (value based on IBC Section 109.3 & IRC Section 108.3)
'l Detailed Scope and Location of Work: _______ _
i
Applicant E-Mail: )! Uc.· Se/? V1C.C5. f:.~· ~/fooc.o/u[
t//9#1T<--/ To;c.c7:>//V/# UAJ/Ts
It:vcLu 0c~ "l>R-'llvAu ~E/J?k'e,Ate/t/I
I
' Additional Authorized ProjectDox Users
! Full Name: _________________ _
i E-Mail: --------------------
Fu 11 Name: _________________ _
E-Mail: ___________________ _
(use additional sheet if necessary)
For Office Use Only: JI. ..-, G0 0b
~e~~: ~~ I
Received From: ______________ _
Cash Check# ____ _
CC: Visa I MC Last 4 CC # __ _ exp date: __ _
Auth# ___ _
Rev. 2015-Dec
I
£,t/ 2.d7.d.RcNJ,,#.:S r GP/ f<ec?fJT,c~c!'
Date Received:
APR 18 2DlB
TOWN OF VAIL