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HomeMy WebLinkAboutB16-0484 (2).pdfBlJILD·l~G PERMIT APPLICATION (Separate applications are required for alarm & sprinkler} (Suite#) Project#=-----------~-~ ORB#: Bui~i~~-P-erm-it-#:~~~~-P-1-~-\~b~-~-{j=--, _-_tl\~'6~-q--..,..1~--~--~--~ Project Street Address: 4q57 . luniaa:LN -=-I (Number) (Street) Building/Complex Name: __________ _ Lot#: Block#_ Subdivision: _____ _ Contractor Information BusinessName:h/fs-tf'w fin:place ~l~ WorkClass: _Ne~_< ) Addition( Alteratio~0 Business Address: qlD IJOtf;~VvlJn £4 Type of Building: . __ City Avon Sta~~Zip: 8 / ~ 0.Q Single-Family 9<l-Duplex ( .. ) Multi-Family ( ) Contact Name: Nidaola5 !1 Jehbct:.« · Commercial ( l Other{ ) Contact Phone: CJ7D1>J1-4J. LJ / Work Type: contact E-u: ni ct w@~ie.tnhre.plaa. COYYl Interior~ Exterior ( ) Both ( ... ~ ... Contractor ' · r-iaren Vucich. Parcel#-: ()101-./.3/-0/-0/2> (For Parcel#, contact Eagle County Assessors Office at (97o-328-8640 or Visit www.eaglecounty.uslpatle) (use additional sheet if necessary) For Office Use Only: , 4 ') /-, Fee Paid: ___________ -iV __ ,~--- Received From: ___________________ _ cash Check#---- CC: Visa I MC Last 4 CC# ---exp date: __ _ Auth # __ __ Work Included Electrical ( )Yes ().<lNo Mechanical ~Yes ( )No Plumbing (·)Yes .MNo Building ( )Yes ~o Plans Included ( . )Yes )No { )Yes )No )Yes }No )Yes )No Valuation of Work Value of all work being performed: . $ 3.5 00 (value based on IBC Section 109.3 & IRC Section 108.3) Electrical Square Footage Date Received: RECEIVED NOV 11 2016 Town of Vail 01-Jan-ll