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Home My WebLink AboutB16-0116.pdfTOWN OF~ Department of Community Development 75 South Frontage Road West Vail, CO 81657 Tel: 970-479-2139 www.vailgov.com BUILDING PERMIT APPLICATION (Separate applications are required for Electrical, Alarm, Sprinkler & Public Way) --·-------·--·-----·-····--·----------------·--··-----....-----------------------. Pgect Street Mdress: &rE. Ltr , o t.f 2 ZJMOUJ · · -NE. •(Number) (Street) (Suite#) Building/Complex Name:-------------- Project Information: 1 , Owner Name .. · __ --'S=+':.~~';_:~~""-""=-"-~~'-""'--;........:....:.-="'----'lft"--_,_· Parcel#_--=---=_,__,_ _ _._......,,. _ _.._-"'"'----''-----'------- (For Parcel#, contact Eagle County Assessors Office at (970)328-8640 or visit • www.eaglecounty.us/patie) Project#:----------------....-- ORB#: :Dk&\ \D©@ q tvt-P ' Building Permit#: '\3 lb-0 / f b Lot#: Block# __ Subdivision: _______ _ Work Class: New ( Addition ( Alteration <)c'.'.J Type of Building: Single-Family <(.) Duplex ( ) Multi-Family ( Commercial ( ) Other ( ) __________ _ Work Type: Mechanical Plumbing Building Interior ( ) Exterior )k'j Both ( Valuation of Work Included Plans Included Work )Yes (~o )Yes )Yes ()(}No )Yes )Yes ( )No <)<JYes )No )No )No Total Value of all work being performed: $-~--- ' X_---'......,.-=--~.....,,_,,.,.__.;...<_¥---:;NC-----------~ {value based on \BC Section 109.3 & \RC Section 108.3) I ature (Required) _,,.,.. tl__../' • Detailed Seo e and Location of Work: _,_,.~~~~~-- ! Applicant Information . J ~ · '!f-T '/!.. rTD , Applicant Name: /(;1111ttu :If-_b;::lf!ZI} N A/; :). .v .; /l/. . Applicant Phone ~ 'f -:f / 0 582 · ,,-r-_:. : ,:= S .' 'tJ , Applicant E-Mail: '_.c:_Kn?e ME {Jk.J,es~ J Atlfr/ (Q!J:-k~!'l-1~7!~1-~---r----------- : Additional Authorized ProjectDox User~ Full Name: ------------------- .E-Mail: ____________________ _ ' Full Name: -------------------i (use additional sheet if necessary) : E-Mail: ____________________ _ ' (use additional sheet if necessary) Date Received: For Office Use Only: Fee Paid: 8$ .<1 U Received From: ______________ _ Cash ___ _ Check# ____ _ D ~~~0'¥7~ !IPR p ZU16 ~ CC: Visa/ MC Auth# __ _ Last 4 CC # ___ _ exp date: ___ _ Rev. 2015-Dec TOWN OFVA\l