HomeMy WebLinkAboutB16-0475_1.pdf e"---) Department of Community Development
75 South Frontage Road
TOWN VA, C.,
1 ` 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:
W4 ?a /Mead° Y Project#:
1,0
DRB#:
(Number) (Street) ,f (Suite#) ) '`J
Building/Complex Name:010)44Zln /widow To tol ilding Permit# ( 7 `.O 4 l 5.
Contractor Informationn �_ n Lot#: Block# Subdivision:
Business Name: Cd le ,&1D £ flj4 'J T C"✓Dd(J �t�_, ..
Business Address:.2(5 14.15,a-�✓1GCC�T 5 t Work Class: New( j Addition 0 Alteration (I�l
City .e l(/e4 ' State:ex/ zip: v02)- 3 Type of Building:
�' / Single-Family 0 Duplex 0 Multi-Family 0
Contact Name: �"'�
Commercial (EJB Other 0
Contact Phone: 8 - ? 77 •as 3 V _
Contact E-Mail: he-c / G G/9• GO"Yie1 Work Type: Interior a 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 toElectrical Yes 0)No 0Yes
No .
comply with the information and plot plan,to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical ®Yes Q)No OYes ONo
the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Plumbing ()Yes Q)No ((JYes ONo
ordinances of the Town applicable thereto.
Building QYes DNo ()Yes QNo
x ba,“4-94(--iiteve-C- Value of all work being performed: $ "!f ao 0
Owner/Owner's Representative Signature (Required) (value based on IBC Section 109.3&IRC Section 108.3) ,
Electrical Square Footage
Applicant Information //�� Detailed Scope and Location of Work:
Applicant Name:vf}1//A IC!^!1'L?B` II- III y a a //71`U le hrs.?lack_
Applicant Phone: 1- 'ay?. Li!?.. !.2 A 7 . 6A,i/ /rlerdaig XV 33 t lnsvt f
Applicant E-Mail:C/AVll3. krr6bQrdallelovery. CO,✓t 1:4/.."4.4,74 71D e6f1/I9 4/ ANSI sitodekk
`,IdO �T vProject Information J to C.4.1sGy /
Owner Name:
Parcel#: -10 -r4 II
6PD-
(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: E C V
Date Received:
Fee Paid:
Received From: 206
0
Cash Check# Nov
CC: Visa/ MC Last 4 CC # exp date:
Auth #
TOWN OF 'VAIL ____,
12-Mar-2012