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HomeMy WebLinkAboutE16-0152 application.pdf Department of Community Development ' - 75 South Frontage Road West TOWN OF VAIL 1 Tel: 970-479-2139 www.vailgov.com - ELECTRICAL PERMIT Electrical Permit Submittal Requirements Including Heat Tape Installation _Floor plan/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 • Pro ect Street Addr s: 1 ag2i (r.z✓i-c-1 V co Un ' Project#: (Number) (Street) (Suite#) ' Building Permit#: Building/Complex Name: Electrical Permit#: ProjectwrInformation: amematio 7`U1Q,2I i5 n,l ti.6-l'7 Lot# Block# Subdivision: Owner Name: '(lT�j 770( Parcel# 2 t O 3 12 ZO`K 031- 1� ' (For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Define Scope and Location of Work: NOT /1-0(1)/4 0 / ` I-0 0 www.eaglecountyus/paiie) Contractor Information • (�in i, , G� v�1-c f c 1Z�&# Business Name: J► ►1" c i 6`fie � G -�� G Business Address: �� 12� !NI N!�+.t40 0 � l� SwLr . City 6���64ci (2-t /d'n State: CO zip: O4 2� 400 vx49 j DPIK s �/° C.69 ContactName: 0 AV/ U •110 _ /f kODU 2 (7 t Z{ ' J 5,nAtiv0 CK Contact Phone: n/7 0 3?'✓-- 1/73 3 1 L 0 �0 3 �-rIr" ' L I� 1t� Contact E-Mail: 6 N S Pitaky 63 ii G-.M 4-12,,Ct?Jfl (use additional sheet if necessary) I hereby acknowledge that I have read this application,filled out in full the Includes Temporary Service: ( )Yes (1 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- j mation and plot plan,to comply with all Town ordinances and state laws, Work Class: and to build this structure according to the town's zoning and subdivision e codes,-design review approved,International Building and Residential New( ) Addition Remodel( ) Repair ( ) Codes .n• ether ordinances of the Town ••p ,•e thereto. Other( ) X AIN—SII ,A • Type of Building: Single-Family Duplex ( )Owner/Owner's Representative Signature(Require. Applicant information Multi-Family( ) Commercial( ) Restaurant( ) R/(11 "/A 0 NO (/‘. Other( ) Applicant Name: / I �J q7i,) _ 90 —1173 1 1 7?) _ i Provide BOTH square footage of area of work Applicant Phone: ( I1 AND Valuation(Labor&Materials) Applicant E-Mail: r n l 0 y 63 6-9 (---M 9 Amount of sq Ft-: / 00 S( Fr Additional Authorized ProjectDox Users Electrical$: CI O0 Full Name: E-Mail: Date Received: Full Name: E-Mail: © E n For Office Use Only: D V L� Fee Paid: Received From: 1 AUG 0 1 2016 ij Cash Check# CC: Visa/MC Last 4 CC# Auth# TOWN OF VAIL Rev.2015-Dec