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HomeMy WebLinkAboutB16-0161.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· \ } { 5-2-1 G't\ft L,'0•1.;, h{e.. t c:fr e, __ _ Project Information: \~ W 'S Owner Name: , 2~ _ OocJ\. _ Parcel# '2\ D \ o~ 0300 \ -0 Y3 (For Parcel #, contact Eagle County Assessors Office at (970)328-8640 or visit www.eaglecounty.us/patie) Contractor Information Business Name: e /vf L (_ l \ ( • Business Address: \'O ~ fJ X c...l 6 5S city ~ayle state: Co Zip: 9 l"5 J contact Name: -Se Sf lA0oJ5 contact Phooe Cj"W-Y 11 -~ 1"11 Contact E-Mail: 3-f'.1£~ e ti/[ oC C ( 1 { 0 (V'\ 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, de · n review approved, International Building and Residential ~,. .... "· , "'W=~ Owner/ ner' Representative Signature (Required) Project#:------------------ DRB#:-----------,------- Building Permit#: --·~_J-=--p-~_6_/_· _b_..;._( ____ _ Lot#: Block# __ Subdivision:-------- Work Class: New ( Addition ( Alteration~ Type of Building: Single-Family ( ) Duplex ( ) Multi-Family ( Commercial (~Other ( ). __________ _ Work Type: Interior(~ Exterior ( ) Both ( ) Work Included Mechanical ~Yes ( )No Plumbing ( )Yes (~No Valuation of Plans Included Work )Yes )Yes "'0_ )No\11. '3, 500 )No () / ooL-Building ~Yes ( )No ( )Yes )NoX ((JI O 0 Total Value of all work being performed: $f'1,.Jm£__ (value based on IBC Section 109.3 & IRC Section 108.3) ( b . I Detailed Scope and Location of Work: Wodl. f( "-r"C{ {o a" Gle~&+o\ Modtr tlc("Z.t:.fc'ovJ Applicant Name: -=a..:::::._"-JL--;:-,--,.;..--=-....,,,.,r7"'1'",--------1' \ J ~ L I \' , -~...>~ ~ k~ (( fe-.WO{ (_·.e~ cAQ l t) (use additional sheet if necessary) E-Mail: ___________________ _ (use additional sheet if necessary) Date Received: For Office Use Only: dJ / ,37. <6 Fee Paid: ________ -.J>..,:__ __ -______ _ Received From: --------------- Cash Check # ___ _ CC: Visa / MC Last 4 CC # __ _ "-"I ~©[g~W7~ ~ 0 D. MAY l 2 2016 exp date: Auth# ___ _ Ro." 'Jn1 i::;._no,... TOWN OF VAIL