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HomeMy WebLinkAboutB16-0105.pdf VO 7;1302A Department o Community Development 75 South Frontage Road West TOWN OF VAIL ' Vail, CO 81657 Tel: 970-479-2139 www.vailgov.com BUILDING PERMIT APPLICATION (Separate applications are required for Electrical,Alarm, Sprinkler&Public Way) Project Street Address II 12-V) SV) ro,a0(C C 4 ce.k Project#: (Number) (St eet) (Suite#) DRB#: Building/Complex Name: Building Permit#: Project Information: Lot#: Block# Subdivision: Owner Name: Qj c v- in bor cisev` Parcel# 21 01 ^ 05.3 - 01 - 010 (For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New(C) Addition ((--) Alteration(C-) www.eaglecounty.us/patie) Contractor Information Type of Building: Business Name: J P C I Single-Family( . Duplex(C) Multi-Family(C') Commercial(C) Other(C) Business Address: ap>t 3$1-9 City AVON" State: CO Zip: 1 L lo Work Type: Interior 65 Exterior(C) Both(C) Contact Name: —rov+\ 5c ' Sc)" .i Contact Phone: GI 1 6 ca(p 0 S Ub Valuation of Contact E-Mail: �-6Yvk V p S + Vck+\ c COW. I Work Included Plans Included Work ^7 I hereby acknowledge that I have read this application,filled out in full the Mechanical ( )Yes (r)No ( jYes (C)No \\C1/L(lo 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 C)Yes (C)No (C)Yes (C)No mation 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 codes, design review approved,International Building and Residential Building ()Yes (C)No (C)Yes (C)No Codes and other ordinances of the Town applicable thereto. '_ X ' Os-� Total Value of all work being performed: $ 11 .,L.l2 0 (value based on IBC Section 109.3&IRC Section 108.3) Owner/Owner's Represe tive Signature(Required) Detailed Scope and Location of Work: Applicant Information Cvv.okit a., (iNl,r 9 rutvtgLe� Applicant Name: P 1 O.M II')h Sy ctrv� -Tv)c. s \ Applicant Phone: 9-7(� - Greco - d S I�Q V) �1� 12 u�1Rf� / 3 G��' �t�v.ale✓� Applicant E-Mail: '1t-Ov-. S + a i 1 c COw. I �({���Jc.'T a c(lUJ r]�v�� `y o Additional Authorized ProjectDox Users ` `t`^1^ovt Gha ()NIL Lt/ 2 4 u$ 1.40-Cr Full Name: 1\tk't'(,'CS 41 C'�� 2_ \\,, ,Ie c'I J WIA.7Lr 64.05 E-Mail: \ tAnt Q1:-1‘'R vx . S;()ewe 11 Vn ;\•, , Full Name: (use additional sheet if necessary) S � � E-Mail: -..L,A.j`t )) N C,ron�rv%t y.e )/ (use additional sheet if necessary) Date Received: For Office Use Only: EIiEi) © U 1��7l Fee Paid: Received From: APR 13 Cash Check# 2016 CC: Visa/ MC Last 4 CC# exp date: C / 1 Auth # TOWN OF VAIL Rev.2015-Dec