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HomeMy WebLinkAboutE16-0094_1.pdfTOWN OF~' Department of Community Development 75 South Frontage Road West Vail, CO 81657 Tel: 970-479-2139 www.vailgov.com ELECTRICAL PERMIT Electrical Permit Submittal Requirements Including Heat Tape Installation _Floor plan I Site plan showing proposed work _Load Calculations and one-line diagram when loads or circuits are being added _Occupancy Group listed on plans _Building Type NOTE: For Multi-Family and Commercial buildings-plans and calculations must be prepared by a Colorado Licensed Electrical Engineer I Project Street Addresy i 5~) I £::' L:_,' c>iA..s· (-..eJr-2 _.(1 ,'1c:/e-Project#: _____________ _ (Number) (Street) (Suite#) I I Building/Complex Name: _L~c~' '~( -~~-( _______ _ 1 1 Project Information: ...-;---tr J Owner Name: ~"'C-"i'f Wood~ ---------~-~------ Building Permit#:--------------- Electrical Permit#:-------------- Block# Subdivision: _______ _ Lot#: ' Parcel # ,2fo J Qt.//{) :? tJn I ... 0 4(5' / (For Parcel#, contactEagle CountyJ\SsesscirS Office at (970)328-8640 or visit I www.eaglecounty.us/patie) Ii Define Scope and Location of Work: Elec+t:"r.c... I j ~ y.Jf'.2 -\-Q 61Ne.+,r t1c.c Jiq Contractor Information Business Name: £/~· l;:-<' ... >t~; ~· /i"' .c Business Address: )\c: t'.So{ f J j t/ctyi City // Ut? / 1 State: c;; Zip: c )) /6. <JD Contact Name: -:-\.' ) {\ I" Contact Phone: S7h P. /65- Contact E-Mail: ,;Ci kc:/effri/ 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 and other rdin nces of the T wn applicable thereto. x ' (-oc:>M I •· (use additional sheet if necessary) I I j 1ncludes Temporary Service: ( ) Yes ·.:() No I Work Class: i, New ( ) Addition ( ) Remodel ( ) Repair ( ) I / 'i oth~J: vpq tr:~'~ e u--,/?r·fa r I Type of Build;ng, s;ngle-Fam;ly ( ) D"plex ( ) I I Ownef!Ow er's Representative Signature (Required) ! Applicant Information l'C vJ j I Applicant Name: -::se n 00 _5 Applicant Phone: cr10 ·-~l 7 I-(pr q l Applicant E-Mail: >e1f@ eModrC , (0 /Y7 Additional Authorized ProjectDox Users : Multi-Family ( ) Commerciaf'K Restaurant ( ) _rn_he_r <_>==::::::::::::::::::::::::::::::.::::::.::::::.::::: _____ .1_ 1 , i Provide BOTH square footage of area of work : AND Valuation (Labor & Materials) Full Name: ------------------- E-Mail: ____________________ _ Full Name: ------------------- E-Mail: ____________________ _ For Office Use Only: Fee Paid:---------++--+-'"~+-------­ Received From: -----~----------- Cash Check# ____ _ CC: Visa / MC Last 4 CC # ___ _ Auth# ___ _ Rev. 2015-Dec Amount of SQ Ft.: ~ Electrical$: 1/j{:JU~/ ~~-- Date Received: 0 ig©i~DWigfn! MAY !. 2 2016 M TOWN OF VAIL I