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HomeMy WebLinkAboutB16-0093.pdfTOWN OF~ Department of Community Development 75 South Frontage Road West Vail, 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: A 1 la 7) {/onshe.c{d Pt . IJP41 L __ _ (Number) (Street) (Suite #) Building/Complex Name: Ar r~bc(I.. e <? V0.'1L s Q,.., Project Information: Owner Name: ________________ ~ ontact E-Mail: I hereby acknowledge that I have read this application, filled out in full the information required, completed an accurate plot plan, and state that all the information as required is correct. I agree to comply with the infor- 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 a ove a 10nal 8 "!ding and Residential Codes and other of the Town ap · able thereto. 0 ner/Owner's Rep Applicant Information pplicant Phone:------------------- Ap icant E-Mail: ___ ....,... ____________ _ E-Mail: ____ __,.--..-------------- Full Name: ------------------ E-Mail: ___________________ _ (use additional sheet if necessary) For Office Use Only: or; , ;2__ c.; Fee Paid:----------------- Received From: --------------- Cash Check # ____ _ CC: Visa I MC Last 4 CC # ___ _ exp date: __ _ Auth# ___ _ Rev. 2015-Dec Project#:----------------- ORB#:----------------~ Building Permit#: _J;~('-"b"-·-_Q"-=(5_°f-'-=>--S..._ __ _ Lot#: Block# __ Subdivision:-------- Interior ({.) Exterior ( (') Both ((') Work Included Plans Included Mechanical {')Yes (')No ( ... )Yes (C)No Valuation of Work 1.AA '"-" Plumbing (/)Yes {(')No ((/JYes (C)No 'b-,....Vd - Building {')Yes {")No ({f.JYes (C)No Total Value of all work being performed: $ (value based on IBC Section 109.3 & IRC Section 108.3) Detailed Scope and Location of Work: 81) l) 0 I)(' 7b, ·Jc T~ To L tJ""' er' f:.l ourv"\ (use additional sheet if necessary) Date Received: D ~©~~w~~ n At'K ui 2016 ~ TOWN OF VAIL