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HomeMy WebLinkAboutB16-0217.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) Contractor Information Bus;oe" Name Syt J,R6-e ,S;;,,.,,,fJ::f t· Business Address: _'D 0 13 3 0 3 -~·de_ City e Aj /e.. State: Co Zip: 'il{AJ/ Contact Name: \/AN<!.e C-AMo// Contact Phone: 970 390.S:J.8'9 -970 3igsl/Ztf Contact E-Mail: :5 yNf:hetc,s;J>jtv!}5 €!JJM8tl eo/lf 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 er nances of the applicable thereto. Type of Building: Single-Family (0) Duplex (0) Multi-Family (0) Commercial (0) Other (0) __________ _ Work Type: Interior (C) Exterior (Cl Both (Cl Valuation of Work Included Plans Included Work Mechanical (::.)Yes <C)No (0)Yes (0)No Plumbing ("')Yes (0)No (UYes (Q)No Building ~Yes (C~No (~Yes (0lNo Total Value of all work being performed: $ t $()()"0 , (value based on IBC Section 109.3 & IRC Section 108.3) Detailed Scope and Location of Work: £elfol[e AND Applicant Information .I I'""' r"S Re,m11ce t.Jgfea 'J)flM/.){Jcg1J c. r r. Applicant Name: 'iJ ~ nlllu)oon suasa?At"e 4 ~ xt.o sruns. Applicant Phone: I 'J (J " W Applicant E-Mail: Replsce 5AMe j1Xl. .5,AMe_oa.J( Additional Authorized ProjectDox Users /oCA{eD @t)e.& Dec.l{ ~T Sou!he.Ast Full Name: --------------t.dllNe«. c£ UP1t ~(O -fo iµc/uoe. 111et.J E-Mail: ~M~e~e_b~na~~~e __________ _ Full Name: (use additional sheet if necessary) -See A TTAC.h. t!.D E-Mail: ___________________ _ (use additional sheet if necessary) Date Received: For Office Use Only: ,J.. Cf 4' < ( Fee Paid:------~='------------ Received From: --------------- Cash Check # ____ _ ~©~OW~ n JUN 0 ~ 2016 LJ CC: Visa / MC Last 4 CC # ___ _ exp date: __ _ Auth# ___ _ Rev. 2015-Dec TOWN OF VAIL