HomeMy WebLinkAboutB17-0050 Application.pdf ,
=R Department of Community Development
75 South Frontage Road West
Vail,CO 81657
TOWN OF VAIL
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm, Sprinkler&Public Way)
Project Street Address:
n
Cll)1 iVry
.F Jm# KrI . i Project*:
(Number) (Street) C (Suite#) DRB#: f�, e
Building/Complex Name: L i'�+ 11(11(!/ iYV i. Building Permit*: 'J1 1-00 5 t
Project InformatirJ `U f 7 , p s ��J`V
Q .Lot#: Block# Subdivision:
Owner Name: rpe rLet
Parcel Cat (19 f 1 f F'ic
(For Parcel It,contact Eagle County Assessors Office at(970)328-8640 or visit i Work Class: New(0) Addition(0) Alteration
, G
www.eaglecounty.us/patie)
•
•
Contractor Information Type of Building: •
i1 (� I Single-Family(0) Duplex(0) Multi-Family(0)
Business Name: ; c, �1[fit ,)bl'As,5 Hej"114/' SIC' E Commercial(0) Other(0)
Business Address: Z.5 Clic ots4. J^_e N
I City �lp State: Cb Zip: a`6v Work Type: Interior(0) Exterior(0) Both(0)
Contact Name: qr�� rpr4-.& sr�
I Contact Phone: CII0 ^90`/— 0c 9 Valuation of
Work Included Plans Included Work
I Contact E-Mail: Pr e J e P.f J f:11 i'c'e CO Ill
I hereby acknowledge that I have read this application,filled out in full the 'Mechanical (C))Yes to (C)Yes (ONo
information required,completed an accurate plot plan,and state that all r� :••z.
the information as required is correct. I agree to comply with the infor- :Plumbing (( Yes (Q)No ((DYes (Qj No /i)1 _'r,'J J- ; 3sc
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 .
YesNo ^Yes No
codes,design review approved,International Building and Residential Building �) ( (�J (
Codes and other ordinances of the Town applicable thereto. "- "" - "" f - 1
Total Value of all work being performed: $ i
I L±Lk ?(value based on IBC Section 109.3&IRC Section 108.3)
Owner/Owner's Representati Sig ature(Required)
Detailed Scope and Location of Work:
Applicant Information
, 0c /y _ R`2.\tc... V1ls,vw�'�nq_ as pe-'
Applicant Name: q G`, lU �)_� �( r
l /r rr
'Applicant Phone: 1 6 -` G Z 3n--T ( :f (AM u`'c1 to is E.671r; c...1M 1_g .
Applicant E-Mail: '6-0 Ef-i T B vc V/ M,4 Z L o c 1'1 �/
Additional Authorized ProjectDox Users
Full Name:
i
E-Mail:
Full Name: (use additional sheet if necessary)
I
j E-Mail:
(use additional sheet if necessary)
i Date Received:
For Office Use Only:
s,RecFee Paid: 15--
Received
eived From:
Cash Check#
CC: Visa/MC Last 4 CC# exp date:
Auth #
Rev.2015-Dec