HomeMy WebLinkAboutB16-0020 �
� � � � Department of Community Development
75 South Frontage Road West
TOWN QF VAlL � va�i, CO 81657
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm, Sprinkler&Public Way)
' Project Street Address: � ^' ��T ,P�(�p-��53
�� � Project#:
S�l 8 Sa.:�rr� 7!�n�rnC�-u �+� 3cis'
(Number) (Street) (Suite#) DRB#:
l Building/Complex Name: ��S i �s^-� /1�' V�C_ Building Permit#: �'�`���
Project Informatiorr. j/ Lot#: Block# Subdivision: f (K� )
Owner Name:___ 1��V�,n/ .xr�}� �����-
_.....
____ __._ .. _ ..._._... _.___
Parcel# Zlvi� 31Zp�,�- � �
f(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit 'WO�k C18SS: N2W( ) Addition( ) Alteration (h)
www.eaglecou nty.uslpatie)
.�.,..�,,....._...�...,��..�„nn�....
!Contractor Information Type of Building:
' �� � Single-Family( ) Duplex( ) Multi-Family( X)
; Business Name: • .1,ivT&lzrx�al SNG ,
'"�'�a� Commercial( ) Other( ) ;
i Business Address: f�. � ' �o� �9'� ,,_::__ ----- -:
'.City �aLC,o��Stat�Zip: �1(aSS I Work Type � Interior(}�) Exterior O Both O
-- --�- -_�� -- --._ _,
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� Contact Name: /�Arc..� °--�-A_2rr.s,2�
Contact Phone:_`�''���— �'�lo `� �('o1c..f Valuation of
, � Work Included Plans Included Work
, Contact E-Mail: 1 nl�e-i l��-�!`��AS'�.R��- Cp�.N
I I hereby acknowledge that I have read this application,filled out in full the `Mechanical OYes ONo OYes ONo ` �~ ,'
� information required,completed an accurate plot plan,and state that all �
; the information as required is correct. I agree to comply with the infor- 'Plumbing OYes (X)No OYes (�,)No �1�,
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 -�;
codes, design review approved,International Building and Residential Building ( �Yes ONo (�Yes ONo ftJ�� 000 ;
._. .. __ .:,..!
Codes and ot � nces of n pplicable thereto.
i . Total Value of all work being performed: $ ��. �(�
�;X jl(value based on IBC Section 109.3&IRC Section 108.3�
� Owner/Owner's epresentative Signature(Required) � Detailed Scope and Location of Work:
�Applicant Informatio� ' .�
' C,�..�t�r2r (J�-rA � ���. �S'�
Applicant Name: -�,4-RI7�'Z,Cr .�.JT&R.��,I .�nK,
ca.�4�-r� 1 K�z,.tc�, i � ��r�s
��;Applicant Phone: °{`l�` .�Z(�— �!o'�L� I ��
!Applicant E-Mail: �,n��.�,�j,►"r�J�lc�r� qvl�� j �."r.t�`�F /V�uV `�'sr�SSe,�BS' ' �
Additional Authorized ProjectDox Users I Nf�'u-� l�►.,�n wuc�A �o`} j��,�- 12,.� ,
�, Full Name: � L �rt,�
' E-Mail: �
� Full Name: i(use additional sheet if necessary) i
� E-Mail: � !
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(use additional sheet if necessary) --•--
� � �
� Date Received: ;� � � 1�,�' � �i � -� ��2 �
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For Office Use Only: !� I� '��
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Fee Paid: n. )� � � �
R �� !r°��; ��� z . 2�1� �.
Received From: !; '�:;
, ;� .P�
Cash Check# �
CC: Visa/ MC Last 4 CC# exp date:
_... .
Auth #
Rev.2015-Dec