HomeMy WebLinkAboutB16-0081.pdf • Department of Community Development
75 South Frontage Road
TOWN OF VAIL E Vail, CO 81657
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
l Project Street Address: Project#:
q°\ 1,ONVVVic- -P/ t c ✓off C3
Number DRB#:
( ) (Street) (Suite#)
Building Permit#: eg 16` 0 I
-y.,___&._.
1 Building/Complex Name:
Lot#: Block# Subdivision:
Contractor Information
Business Name: GfOV YLV-j i.-07e14/ Ot•` ,1z
Business Address: I 1-- I Vo-ACVDW rie_Av., c7,0\-e,,pli Work Class: New( ) Addition ( ) Alteration (X!
City VA-)1. State:00 U
Zip: 8 oSI Type of Building: \\
iL.� ,N C-4-1-4Single Family ) Duplex( ) Multi Family /
G7
Contact Name: T� K f"°
Commercial ( ) Other( )
Contact Phone: /210'37 ' �7 r7 Ci
Contact E-Mail: G7 'Or-4 N @ C-70N4cP-1yv 1 t, (A-1 Work Type: Interior( ) Exterior( ) Both ( )
I hereby acknowledge that I have read this application,filled out
in full the information required,completed an accurate plot plan, Valuation of
and state that all the information as required is correct. I agree to Work Included Plans Included Work
comply with the information and plot plan, to comply with all Town Electrical ( )Yes ( )No Please submit
ordinances and state laws, and to build this structure according to electrical permit
the town's zoning and subdivision codes, design review ap- application.
proved, International Building and Residential Codes and other
ordinances of the Town applicable ereto. , Mechanical ( )Yes ( )No ( )Yes ( )No
X -..—T Plumbing ( )Yes ( )No ( )Yes ( )No
0r, -r Owner's Representative Signature (Required) =ul di ( es ( )No ( )Yes ( )No
Value of all work being performed: $ /99.00 o0
Applicant Information (value based on IBC Section 109.3&IRC Section 108.3)
Applicant Name: r)q�V e Vi"Tv►ic7' 1-- Detailed Scope and Location of Work:
Applicant Phone: I (D 44c--)3g/ 1 \\ i-k- ar-1 �- 17v1-/ 1\ b,00M�--�/ rApplicant E-Mail:pia STA cts S J1�L • co r`-- 4 vvi i t�ovf, ,,✓ t l�7 , (/- J,/,, -0,
/3`f
Project Information v/ L Ivv��
Owner Name: v \ r
Parcel#: Z l o 17 VVi7(7° -'-f
(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 �`� I �=!? (�( Date Received: D
Fee Paid:
Received From: APR 0 1 2016
Cash Check#
-
Ls—
J 7 cp J
CC: Visa I MC Last 4 CC# exp date: TOWN OF VAIL
Auth #
Rev.2015-Oct