HomeMy WebLinkAboutE16-0133 Application.pdf Department of Community Development
' 75 South Frontage Road West
Vail, CO 81657
TOWN OF VAIL' Tel: 970-479-2139
www.vailgov.com
ELECTRICAL PERMIT
Electrical Permit Submittal Requirements Including Heat Tape Installation
_Floor plan I Site plan showing proposed work _Occupancy Group fisted 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:
.a il 2 as- /nett dow /Jr. Project#: p f
(Number) (Street) // 1/ (Suite#) Building Permit#: u� 4—0 c9 -1S
BuildinglComplex Name: /9vSTrta (7ays C i t`i` (/o'er i c 2
Electrical Permit#: L� '�I�J_J
Project Information:
Owner Name: Lot#: Block# Subdivision:
Parcel# ( -10GO8' a- 7700, 7rArx'9A /5-
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Define Scope and Location of Work: Pa A-4—"I
www.eaglecounty.us/patie)
.. br4 0 de./ moo hnSame SGvr Jetta(
Contractor Information < •
,// add Some C("e-C f/ r670'o1P SO•AC / 41(-f
Business Name: ' vitt--1p 0E/1 OneXd ASSG- /�
Business Address: �� , ,w /�r 4,% LD Ca��0A (,L,t/( ie /n I'em4,y
City Ila c'i !te: Co Zip: q'/(5- 7 H1 en.•
Contact Name: .C42 tm2 GUt(Iiii �
Contact Phone: C 7o • 7-5 (17d 33 - ' x'01 d
Contact E-Mail: Z!/,►, : (I s 1 ci-U,.‘ C ILA . ,,,, (use additional sheet if necessary)
I hereby acknowledge that I have read this application,filled out in full the includes Temporary Service: ( )Yes (g)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-
mation and plot plan,to comply with all Town ordinances and state laws, I Work Class:
and to build this structure according to the town's zoning and subdivision New( ) Addition ( ) Remodel X) Repair( )
codes,design review approved,International Building and Residential
Codes and of - or•inanc-s of the Town applicable thereto. 'Other
( )
do 7 or (i7-7,-7,-,-f I Type Single-FamilyDuplex
Owner/Owner's Representative Signature(Required) yp of Building: ( ) ( )
Applicant Information Multi-Family( ) Commercial y) Restaurant( )
UQ ale(/YP1' I Other( )
Applicant Name: ,_<-;4e ._. --------- ____---- _------- --------------- - ----
Provide BOTH square footage of area of work
Applicant Phone: q?0 t/77 5-61a 6770 33l-q5r ' O • AND Valuation(Labor&Materials)
Applicant E-Mail: Z.(/f a r rept a` c fiits u 5 Aaus•dal CO ' Amount of SQ Ft.: ti O q i,7C4
Additional Authorized ProjectDox Userso'DU
Electrical$: .e/
Full Name:
E-Mail:
Full Name: I Date Received:
E-Mail:
For Office Use Only: I 1 - CIEHE
Fee Paid: JUN 2 u 2016
Received From:
Cash Check#
CC: Visa/ MC Last 4 CC# Auth # TOWN OF JAIL
Rev.2015-Dec