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HomeMy WebLinkAboutB16-0302.pdfTOWN OF~~~ 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) -·------·------·-·--··---··--·-----··-·-··-----~----------------------. · Prfect Stree~Address: ~ , <:2~ J '± vt Rose\ D\ \ \J~ (Number) {Street) {Suite#) Building/Complex Name:-------------- Project lnformatio~ ' C \ ' Owner Name: -l>~f') ~IS 2)CA1 $. i Parcel# ~ ) D 3 I ~ Z.0 Lj{) d.6 (For Parcel#, contact Eagle County Assessors Office at (970)328-8640 or visit www.eaglecounty.us/patie) Contractor Information Business Name: t\.e: Me.() W t-..J ~V Bus;oef A<ld,., f'.o -&.. :i.-::i_ <; l( l City v <A\ j S~:Eo Zip:8 r 6~8 Contact Name: 1)c_ t0 ~; S ~C (" l 1 S, ~ Contact Phone:------------------ Contact E-Mail: ------------------ 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, design review approved, International Building and Residential Codes and other ordinances of the Town applicable thereto. x'--~~~-'--~'--'~==.__4------ 0wner1 owner· s Representative Signature (R uired) Applicant Information C . I ' Applicant Name: JJ f.. rv 1-J, 1) \rv · ;;;:£3.~ \, $ f_ 1 Applicant Phone: 9 f () -S 3 L-5 'J...22 Applicant E-Mail: tOsi a 0 ~ <. Q o.rosc; z~: Gds. ,. lo rv-, Additional Authorized ProjectDox Users Full Name: ------------------- E-Mail: ____________________ _ Full Name: ------------------- E-Mail: ____________________ _ · (use additional sheet if necessary) Project#:------------------ ORB#: _________________ ~ Building Permit#:--------------- Lot#: Block# __ Subdivision:-------- · Work Class: New ( Addition ( Alteration ~ Type of Building: Single-Family ( ) Duplex (°)Q Multi-Family ( Commercial ( ) Other ( ) __________ _ Work Type: lnterior'M Exterior ( ) Both ( ) Valuation of Work Included Plans Included Work 2 0 cJ )No Do, )NoJOoo,~ Mechanical ( v)Yes )No ()()Yes Plumbing [)?)Yes ( )No <X)Yes ( Building <X)Yes ( )No cV)Yes ( )No 50:?0 i <!9 · Total Value of all w~;: be:~~erformed-: --~~DO c;@ I (value based on IBC Section 109.3 & IRC Section 108.3) Detailed Scope and Location of Work: _______ _ l..Q.(,ou.-b' q IA rQ Noiv LoQ.c~ ~t,v"',1 tv1 L0G.. l\s ''".rt~v=1or 0"11y ~ G J c~ be;-\-\,, vo o tl\,1 ~ \ w<l ~c.,V'' (use additional sheet if necessary) Date Received: -------~~:-:::-::::~-;::::-i ;.._.Fo-r-Of-fic-eU-se-0-nly_: _________ ___, ~ © ~ Q W ~ u Fee Paid:------------------ Received From: ------------AUG O 4 2016 Cash Check# ____ _ CC: Visa / MC Last 4 CC # ___ _ exp date: ___ _ Auth# ___ _ Rev. 2015-Dec TOWN OF VAIL