HomeMy WebLinkAboutB16-0210.pdf + CC —3 ) Department of Community Development
75 South Frontage Road West
Vail, CO 81657
TOWN OF VARA 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm,Sprinkler&Public Way)
Project Street Address: Project#:
(d) +{�-,► r� ?to vi..) elk Z 1/y34 /
(Number) (Street) (SuitDRB#: 16, -019z —�}
Building/Complex Name: Sc..)-(1 •�,yi \ GancLrnirr I'll I'V Building Permit#: 3I( `G a (0
Project Information: Lot#: 9 Block#. Subdivision:
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Owner Name: 1 p1Gilue 7,--504-01,,e,, -Pci1 Q1 N.
Parcel# ZIA-2lot a6,il6c,r)8 /ai' - 2 ic 1063 6012.
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New( ) Addition-f/ ) Alteration ( )
www.eaglecounty.us/patie)
Contractor Information Type of Building:
Single-Family( ) Duplex( ) Multi-Family(*)
Business Name: C.('_. Cerit:Ar`cam cvl /LC Commercial ( ) Other( )
Business Address:-P.0, . - .o`f\ 38
City N y` State: CO Zip: 6/G Zc Work Type: Interior( ) Exterior( ) Both (ter-)
Contact Name:'—t'ofri Vii /Pother l CC, Act„ r Ci
Contact Phone(Vc,-S3 -e?1B f 9-1o)3 j--'5`1 c1 5 Valuation of
Work Included Plans Included Work
Contact E-Mail. . ?., . , -go. - r1
+Gal• Y-a 6 pY� Co-C'ce Mechanical__ 1144 - . b. .
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- Plumbing (r) Yes ( )No (,.--)Yes ( )No c,�D 00
mation and plot plan,to comply with all Town ordinances and state laws, il-e
and to build this structure according to the town's zoning and subdivision
codes, design review approved,International Building and Residential Building ( )Yes ( )No ( )Yes ( )No c1:5(1-'')D, GC)
Codes and other ordinances of the Town applicable thereto. CI S.r000 . e)°Total Value of all work being performed: 1oco• 0 C) 1
X a ivieyi‘ro C`il/„(..) ,. , (value based on IBC Section 109.3&IRC Section 108.3)
Owner/Owner's Representative Signature(Required) Detailed Scope and Location of Work:
Applicant Information _ ,,��� ��p ,1�
Applicant Name: �--nc'r C V On(' nT W
Applicant Phone: �I t.rir Ovti7 S�CO Y�r11�l r1e Uri i A ?IA
Applicant E-Mail:
3 ! A ,t• ti� 'IA rcc u s ,,c
Additional Authorized ProjectDox Users CGvlr' GV-t_'c V\, fV-eW <<,-c. 2-56
Full Name: t11 r r1 Cti( co,v e r5 f()rt.
E-Mail:
Full Name: (use additional sheet if necessary)
E-Mail:
(use additional sheet if necessary)
Date Received:
For Office Use Only: //// 36 \V1 I.
Fee Paid: `t �' � D
Received From:
Cash Check# ji
JUN u6 ZU1b
CC: Visa/ MC Last 4 CC# exp date: ., 1
Auth # I (7g
6/
Rev.2015-Dec T®VV!°J O„`�~I L