HomeMy WebLinkAboutB16-0248 Application.pdf Department of Community Development
75 South Frontage Road West
Vail, CO 81657
TOWN OF VA I L Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm,Sprinkler&Public Way)
Project Street Address: Project#:
)-41 egdav Pr.
(Number) (Street) ,/ (Suite#)J DRB#: 16 n- I0 07 I7
Building/Complex Name: %/(1511-t a /10 it C6'114 fid ( Building Permit#: #)l
Project Information: Lot#: Block# Subdivision:
Owner Name:
Parcel# al0/0 8 eL 7 7 00 / (/iruvih 0/5
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New(C) Addition(C?) Alteration(A;)
www.eaglecounty.us/patie)
Type of Building:
Contractor Information
,!!
Single-Family(C) Duplex(C) Multi-Family(C)
Business Name: jv51'r!a oS Co'ldo. /15:5*C_ Commercial( C.) Other(C')
Business Address: a. �, /neatloa. 114 Vail Cul rF/6f
City Vat'1 State: CO Zip: 141‘.5-7 Work Type: Interior(C) Exterior(0) Both(tg)
Contact Name: S'/ Ue. tile,reer,
Contact Phone: 70 11(77 ��8'7 a- q70 2.71-9 fie Valuation of
Work Included Plans Included Work
Contact E-Mail: S'CU a(-ref/ , CVf Jf(a Maus
I hereby acknowledge that I have read this application,filled out in full the Mechanical (X)Yes (C)No (CYes (C)No � roc'
information required,completed an accurate plot plan,and state that all �d D
the information as required is correct. I agree to comply with the infor- Plumbing t)<?)Yes (C)No (( )Yes (C)No 6 f
motion 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
/'� Q O®u
codes,design review approved,International Building and Residential °Building ( )Yes (C)No (C)Yes (C)No V.i,
Codes and other ordinances of the Town applicable thereto.
044111 / ''Total Value of all work being performed: $ /04-6'6a
X ti fr vrr (value based on IBC Section 109.3&IRC Section 108.3)
Owner/Owner's Representative Signature(Required) Detailed Scope and Location of Work: AO UI✓1/ p WQ 11
Applicant Information 1 1
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Gt7°/` it) .reeL 4 mr)re 5'Pice In CV,- far7Try �-(- ke
Applicant Name: '
Applicant Phone: It 70 e/77—5-3 7 9- q 70 ??i-
,Adel t/Ui�c forCoo hi., reyhei 5), Re/neve sold
Applicant E-Mail: 5'L(p a r Pen ®" at/stela' Am/sac/4 c�N, bti r + co Ll!/1t11 /ep7"ce 6ar Owe
Additional Authorized ProjectDox Users (.,Uakr '�i/ era/if' ,}"yiie er, , n 54//pc irk.
Full Name: d00r , replace Q. nee" -r01/eA,
E-Mail: -- ---
Full Name:
(use additional sheet if necessary)
E-Mail:
(use additional sheet if necessary)
Date Received:
For Office Use Only:
Fee Paid:
^ ,,
Received From: D c(,J� /7'
Cash Check# /
CC: Visa/MC Last 4 CC# exp date: JUN 2016
Auth #
Rev.2015-Dec —
TOWN OF VAIL