HomeMy WebLinkAboutB16-0072.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)
Project Street Addre~s: , =J!rri/ (118 Project#:
5.5..5-Vcu/ "'er/k-v Or. tUN --------------
(Number) (Street) 7 (Suite #)
Building/Complex Name: /7Q ho r 16 1 '/ L c:x/b<? ....
Project Information:
Owner Name: ;f. /{. ck ~er J,-
Parcel# 2 1 tJ 7C>8 -; o .. ;:;--o I I
(For Parcel #, contact Eagle County Assessors Office at (970)328-8640 or visit
www.eaglecounty.us/patie)
Contractor Information
Business NameG. Grez·~ /.l-.:;s(,,~.n rc.ib.Pe~,.q.
BusinessAddress: /?O 8ox -79.9"1
City /1 // e> t-t State: CO Zip: 816? C5
Contact Name: Geg-re;,.<? G-1E'9~
Contact Phone: 970~ '172 -"{jl'jj{j
DRB#: ____ ~--------------~
Building Permit#: _.-3:::.....i...\ .r;:.~----{5--=o....-~Q'°"'J__._ .... ~'°-------
Lot#: Block# __ Subdivision:--------
Work Class: New((' ) Addition ((') Alteration (!X'')
Type of Building:
Single-Family ( ) Duplex ((. ) Multi-Famil~
Commercial((.) Other((~), __________ _
Work Type: Interior(})<) Exterior((') Both ((')
Contact E-Mail:9c?Or?'c?., c;'(~q?-f'y·~~0:2s/~/k..+ :...:r ...,.._ v ...-=-->'-
Work Included Plans Included
Valuation of
Work
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~~~~1Jti:rdi an / of the Town a:pli .. bl~ thereto.
X . ~-(. ~ ,.~ ,,...
Owner/Owner's Representativ · ure Required)
Applicant Information
Applicant Name: c~;; k-0-4 P~seTU...4'.-?pt-t
Applicant Phone: S 7() -£'ZcP ·---/" 8 (()LJ
Applicant E-Mail: C/fns6°a-. 012<0 C~ ~/e.,<.
Additional Authorized ProjectDox Users /Je'r/
Full Name: ------------------
E-Mail:. ___________________ _
Full Name: ------------------
E-Mail:. ___________________ _
(use additional sheet if necessary)
For O~ce Use Only: e-f+, / 7 '(;. 6 /
Fee Paid: ____ J ____________ _
Received From: ______________ _
Cash Check # ____ _
CC: Visa I MC Last 4 CC # ___ _ exp date: __ _
Auth # ___ _
Rev. 2015-Dec
Mechanical (')Yes {l)No (l)Yes (l)No
Plumbing lfl,)Yes (l)No (l)Yes (l)No
Building
Total Value of all work being performed: $ ~ C'tt'r:!~ -·
{value based on IBC Section 109.3 & IRC Section 108.3)
Detailed Scope and Location of Work: ;[..j~h4 oc;,-%· :$,:::.bd roc;•"?J
~~,.t~// /-;7.V.:<:.> Yd!z-"",..-rX, Ca'£u€;{,, ~·,va/&n~-"5 1
/&,4/,-c~/,~t't?/S · /J~//L<~.5/o.:.-c-, .s-Aotu+:I
/?E-''4:.? ,4;(:. ~ a// ,ba,~c.H.•......_,.
' ?a,;_,,/ ,,oa~ ~ cQ_,£,:_e,.
(use additional sheet if necessary)
Date Received:
0 ~~~ow~ n
MAR 2 J Z016 LJ
TOWN OF VAIL