HomeMy WebLinkAboutB16-0465_1.pdf Department of Community Development
di) 75 South Frontage Road
TOWN OF Y, EL Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
Project Street Address: , Project#
9)2Z) . V '/ v 0R . 1°/A
DRB#:
(Number) (Street) (Suite#) l /�
Building/Complex Name: 13 r-Oo/-fre Building Permit#. 1 �/ �,
Contractor Information �` Lot#: Block# Subdivision:
£Business Name: /O. £/1 4 1 br` / /?O
�S V/ N��71--- 5. -
Work Class: New(�j Addition (�j Alteration (®
Business Address: pn� /�
City, Tc--.-AI✓e-r` State:(.._:e Zip: 2 2 3 Type of Building:
Contact Name: I.._,i�N c'a PL. �1DCc(X / Single Family 0 Duplex 0 Multi Family
Commercial (J Other 0
Contact Phone. 3D3 - 2 77----302-3V
Contact E-Mail: -i NAL / C C P, CO M Work Type: Interior Exterior 0 Both 0
I hereby acknowledge that I have read this application, filled out Valuation of
in full the information required,completed an accurate plot plan, Work Included Plans Included Work
and state that all the information as required is correct. I agree to Electrical °Yes ®)No ()Yes ONo
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical Wes O)No °Yes ONo 5' t e,
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Plumbing ()Yes 0)No ()Yes ONo
ordinances of the Town applicable thereto.
// Building °Yes ONo ()Yes ONo
X Own C/ )rk,i s Representative Value of all work being performed: $ 5� 0oC) 0
Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage
Applicant Information Detailed Scope and Location of Work:
J cd
Applicant Name: /1)/J m //• Ma (f So/V ke y-Ja e yj 1-0c/f a--
Applicant Phone: - �&i_AJ 1---ii--<1_0-2± �/-C�g �,
Applicant E-Mail: n1 G I ISe,fUJC�-Cl/U/L1e ,/4.irzo ,CDy►'� �y j l 022-—0j V-�'�SW 3(/ �yoo1iI77c.
Project Informatio.n�- /f / GIU,S i' —2/•g,,'i,--auc'3/ c sec °2. 33 I --'z`'c-`3
Owner Name: .Je&Nl�f �• fF (a ��
Parcel#: 2 16 3 6 I`f 66 00 1
(For Parcel#,contact Eagle County Assessors Office at(970-328-8640 or visit
www.eaglecounty.us/patie)
(use additional sheet if necessary)
For Office Use Only:
Date Received: D E (� IE (I M I
Fee Paid:
Received From:
Cash Check # "' bL f 3 1 2016
CC: Visa/ MC Last 4 CC# exp date:
Auth # TOWN OF VAIL
12-Mar-2012