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HomeMy WebLinkAboutB16-0435 Application.pdf i _......-----5 Department of Community Development 75 South Frontage Road West TOWN OF VAILveil, CO 81657 Tel: 970-479-2139 www.vailgov.com BUILDING PERMIT APPLICATION (Separate applications are required for Electrical,Alarm, Sprinkler&Public Way) Project Street Address: o _,F Project#: I al�i� ChC rCYI 1 (ly ft(Number) (Street) (Suite#) DRB �J'"� ��'0�1LA C�P) 11 i Building/Complex Name: Rawl(�CC�J I ca_iik O Building Permit#: &U. 0 435 Project Information: ��Gl� J a QQQQQQG/C 6J _ Lot#: Block# Subdivision: }Owner Name: Parcel# a /O3 / / L/ 01-loo. (For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New(Q) Addition(Q) Alteration(6) www.eaglecounty.us/patie) Contractor Information Type of Building: S--) ----1-1- 1 (��S ' „^i ,,, ,� Single-Family(0) Duplex(0) Multi-Family( ) Business Name: -1- �f`� 1 W £Commercial(0) Other(Q) Business Address:// 0017 7 C R c 3 7 __... I City S/ f7 OD�" State: � Zip: g!k SpA Work Type: Interior(0) Exterior(0) Both(®) ti._ 1 Contact Name: Jam--(f� AnC � 970 37�'- s.6(Pi 1 Contact Phone: Valuation of �, � � Work Included Plans Included Work i Contact E-Mail: (A)/ CPSOp rI Si 0( I hereby acknowledge that I have read this application,filled out in full the 1 Mechanical (0)Yes (e)No (9)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- Plumbing (I )Yes ( `.)No (C)Yes ((})No 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 � fl DQ i codes,design review approved,International Building and Residential Building `% Yes o (t_,r)Yes ( )No i . i Codes and other ordinances of the Town applicable thereto. ' Total Value of all work being performed: $ /// 0 Cu I I / (value based on IBC Section 109.3&1RC Section 108.3) I i Ow r/Owner's epresentative Signature(Required) Detailed Scope and Location of Work: • — _ 1 Applicant Information _ / _PVA Sr Applicant Name: J- its j/1�1)'1 iQ(/J OL&1 q-7O S 7c - L16 pl i ,wv�-e29v✓� d, 4 , Applicant Phone: 4 / _ i int//(. cit, w / 7 Applicant E-Mail: J- -C-P5'f�J'Ylec 60 50pris- ? Additional Authorized ProjectDox Users / /1. -- L(4 Full Name: F E-Mail: Full Name: (use additional sheet if necessary) E-Mail: I(use additional sheet if necessary) Date Received: For Office Use Only: Fee Paid: E ©j wfn E -, Received From: D Cash Check# CC: Visa/MC Last 4 CC# exp date: OCT 12 2016 Auth # Rev.2015-Dec TOWN OF VAIL