HomeMy WebLinkAboutB16-0103.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 Address: 1eclif> Project#: ~t;1/} If.I /VIV I Ck IN /IJ JLk t-C:,
(Number) (Street) (Suite#) ORB#:
Building/Complex Name: M/3fltJ~W (/(Gl7j\ {'(J/Vllt> Building Permit #: 'B!b--0103
Project Information: /3Xt J-Lot#: Block# __ Subdivision:
Owner Name: 'JU t if:::. --
Parcel# 2t.O. 3' /._ t./-:3 L'f /JI 2
(For Parcel#, contact Eagle County Assessors Office at (970)328-8640 or visit Work Class: New ( ) Addition ( ) Alteration <)<2.
www.eaglecounty.us/patie)
Contractor Information !/Type of Building:
/f?F'bli/ Gt.OtJE (~llJ~(l\fJC/11)111 Single-Family ( ) Duplex ( ) Multi-Family ( )<.)
Business Name: I
·• Commercial ( ) Other( )
Business Address: /;OX-{j/ 7
City MltllT(LK.AI State: t IJ Zip: Bt6CfS-Work Type: Interior ()Q Exterior ( ) Both ( ) I
Contact Name: 70tfN c~v~e '
Contact Phone: ll_7&-q7t._-?fPS7 Valuation of ·
,PJA.r -, Work Included Plans Included Work
Contact E-Mail: rtOlf/l/~11/ (IUJUe l'thfl5liC(}C{lp!tJ 1 tt! E ;--------------------;
I hereby acknowledge that I have read this application, filled out in full the :.II Mechanical ( )Yes ~)No )Yes )No -0 -
information required, completed an accurate plot plan, and state that all /t
the information as required is correct. I agree to comply with the infor-.! Plumbing ~)Yes ( )No )Yes )No . 7 (2cro
mation a~d plot plan, to comply with all Town ordinances and state laws, 1: k. '
and to build this structure according to the town's zoning and subdivision · c!"f""n. ffO A
codes, design review approved, International Building and Residential ii ~uilding . ··. <9',)Yes ( )No )Yes )No =Jj<l,/"-'-r,,__v_
:odeo '"~~ th•o;o IT!:~;~~!;l~=~~~;;;~~=~);-.~~~-~---
er/Owner's Representative Signature (Required) ·1· 0 t .1 d S d L t· f w k ' e a1 e cope an oca ion o or : 1
Applicant Information . ..
Applicant Name: "JOf!N CttJCl/f--T/f:E: . JI 1)£;() f{fT?ltbrli Cef~IAHif? ay,/ t'f IJAl//31ff'UF
ApplicantPhone: ccz12--tf7/-?flf57 ' ifc/ltf(L:-Tl?.£, t"klJiUIJ/lil'D /-1Xl/Ji."fa,,..f:
Applicant E-Mail: j()l{f-Nt!-1/-5/7£/IJ(t,•o(J}:-((JJJ5flr'f/Cn@U .M 7 J Clf-B iAlb/3 JV 8.(J rtf ~ &b/?/~ Ji l /ffi.l'MU f=-11'£1'/-d/£ 1Ali&e0
Full Name: ------------------fbi412 #i?4&f ·. & fl~ f
Additional Authorized ProjectDox Users
E-Mail: __________________ _
Full Name: ------------------(use additional sheet if necessary)
E-Mail: __________________ _
(use additional sheet if necessary)
Date Received:
For Office Use Only:
Fee Paid:
Received From:--------------
Cash Check# ___ _ APR 1 0 2016
CC: Visa I MC Last 4 CC # ___ _ exp date: __ _
Rev. 2015-Dec
Auth# __ _ TOWN OF VAIL