HomeMy WebLinkAboutE16-0161.pdf r�1
Department of Community Development
_, 411)
- 75 South Frontage Road West
ail, GO 31657
TOWN OF WAIL' ' - -• Tel:970-479 2139
• www,vailgov.com
ELECTRICAL PERMIT
EIectrical Permit Submittal Requirements lncludinq Heat Tape Installation
_Floor plan I Site plan showing proposed work _Occupancy Group listed on plans
_Load Calculations and one-line diagram when loads or circuits are being added _Building Type
NOTE:For Multi-Family and Commercial buildings—plans and calculations must be prepared by a Colorado Licensed Electrical Engineer
Project Street Address: )
'856- n -- • , Project#:
(Number) (Street) (Suite#) ` Building Permit#: /
Building/Complex Name: c,J(J\-e- Electrical Permit#: 6�6 '-0 ( tU
Project Information: \ . Lot#: Block# Subdivision:
Owner Name: �),\ilk,v� a A--(11--
Parcel
--(1r
Parcel# �( Cl o: 16 30 "7--i'-
(For
�
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Define Scope and Location of Work: '
www.eaglecounty.us/patie)
-- -,.1 \—r� C r SSS
Contractor Information ,
Business Name: f� ELIC-I�I C_ L L� (4- _)01,0,,,? SCti j C! i A
Business Address: Pb t r ___ 4- 'City �'�0�� State Zip: ��0 5Contact Name: 5J Contact Phone: C170 - 7(,,Contact E-Mail: RD >I E--- C C-�i,�1at L ; CrY\ heet if necessary)
i hereby acknowledge that i have read this application,filled out in full the includes Temporary Service: ( )Yes No
information required,completed an accurate plot plan,and state that all
the information as required is correct I agree to comply with the infor- 1 IDri
mation and plot plan,to comply with all Town ordinances and state laws, Work Class: 1V ,�
and to build this structure according to the town's zoning and subdivision New( ) Addition( ) Remodel Repair.A��ud�
codes;design review approved,InternationalBuil ing and ResidentialC
Cod- and other ordinances of Town applicabl thereto. Other( )
X :. „
Owner/Owner's Representative Signature(Required) Type of Building: Single-Family( ) Duplex -
Applicant Information i Multi-Family( ) Commercial( ) Restaurant( )
1 Other( )
- Applicant Name:
Provide BOTH square footage of area of work •
Applicant Phone: i AND Valuation (Labor&Materials
Applicant E-Mail: (Amount of SQ Ft: ...;-17-__-:- ._:'�'; .%' SO 0
Additional Authorized ProjectDox Users I Electrical$: 5)( , �-
Full Name:
E-Mail:
'Date Received:
Full Name:
E-Mail: E ro, r5it 1t� I
For Office Use Only: D
Fee Paid: $ ( I AUG 1 2 2016 I
From:
ReceivedI
Cash Check#
CC: Visa/MC Last 4 CC# Auth# L JOWWN ' '
Rev.2015-Dec