HomeMy WebLinkAboutB16-0179.pdf Department of Community Development
75 South Frontage Road
Vail, CO 81657
TOWN OF VAIL ' 0;d,- `--) Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
i Project Street Address: Project#:
770 V'crk -4o Pa+cL_ 443
(Number) (Street) (Suite#) DRB#: �L'- O
Building Permit#: ,T tI b 0 1 -7 9
Building/Complex Name: •
Lot#: Block# Subdivision:
Contractor Information
Business Name: s1,.i4-1,.,e21-i c. S tcLL43 S u.r_ -------__._-__------____----------------------_..----------.
. L33ot3'a if L. Work Class: New( ) Addition ( ) Alteration ( )
Business Address: Pp Q[
City E%tx__ State: Ce, Zip: Ss(6 31 Type of Building:
Single-Family( ) Duplex( ) Multi-Family( )
Contact Name: Ualt_C Ae -Com`
Commercial( ) Other V) Y p
Contact Phone: 170 3`t o G189 -----------____--
Contact E-Mail:..S14_-)tmac.-:=IGS t c.IL..tS (G Ma,l.Cou1 Work Type: Interior( ) Exterior(>4 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 e Town applicable thereto. Mechanical ( )Yes ( )No ( )Yes ( )No
X li A i
Plumbing ( )Yes ( )No ( )Yes ( )No
Owner ' Repress Si��to (Required)
Building (X,)Yes ( )No ( )Yes (?QNo
fild1> emptiort
Value of all work being performed: $ (00 O
Applicant Information "7-31) (value based on IBC Section 109.3&IRC Section 108.3) / 11
Applicant Name: Detailed Scope and Location of Work:
Applicant Phone: Iia-w^e1...A.42_ y- VY-f k e.e_ LAJ•w J.-t - 440l►^�. -
Applicant E-Mail: l III watyd. ecu -)S-1- 0 a„ "" S i t cL
L. a -1-0 S bj l t. L.)c- a vLL
Project Information II � - -"'"_ `�� rep t-'�S but LE
Y Soli .
Owner Name: C� Sa Nom- „ c„r, .0!!,1,44-12-_-
Parcel#: g` I 0 I C(31 1 uo3
(For Parcel#,contact Eagle County Assessors Office at(970-328-8640 or visit
www.eaglecounty.us(patle)
(use additional sheet if necessary)
For Office Use Only: Gq)
Fee Paid: b q it 6, ps. ( Date Received: D E C U M
Received From:
Cash Check# '",. MAY 2 3 2016
J
CC: Visa/ MC Last 4 CC# exp date:
Auth # Rev.2015-Oct L,., TOWN OF VA I L_