HomeMy WebLinkAboutB14-0459_B14-0459_1415913900 Department of Community Development
75 South Frontage Road
TOWN OF VAIL' 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: Project#:
DRB#:
(Number) (Street) (Suite#)
Building/Complex Name: Building Permit#:
Contractor Information Lot#: Block# Subdivision:
Business Name: C C. t'((��Itt,cv�`n,,1 * W i
(�
Work Class: New l0 Addition(0 Alteration (0
Business Address: P.o. ,0y,2011
City t lVl State: e.0 Zip: F51(e.),3`1 Type of Building:
S Single-Family 0 Duplex 0Multi-Family(0)
Contact Name: . C1�i
ii � � Commercial(®j Other 0
Contact Phone: l cru\\),3 -q�T�
Contact E-Mail: tvtitc- 0-6s00kA.t.C t✓t1,( Work Type: Interior O Exterior Both
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 to Electrical ( Yes Q)No °Yes °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 IQYes Q)No °Yes ONo
the town's zoning and subdivision codes,design review ap-
proved,International Building and Residential Codes and other Plumbing Gres Q}No (*Yes °No v9 , et'
ordinances of the Town applicable thereto. Building °Yes °No ()Yes °No
X 1�{� ,y�t �. _ Value of all work being performed: $ 4 00
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: AtehA
Applicant Phone: Lc 4;01-r i: 6/ffdtL rq Ll s/L 7
Applicant E-Mail:
Project Information ;1 • J
Owner Name: Vai I b fp•
Parcel#: /D/ O"72 —2_0 60/
(For Parcel#,contact Eagle County Assessors Office at(970-328-8640 or visit
www.eag le co u nty.0 s 1p ati e)
(use additional sheet if necessary)
For Office Use Only: Date Received:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp date:
Auth #
12-Mar-2012