HomeMy WebLinkAboutB16-0175.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)
~----------------·---····---···-··---··-·-------·-·-···-··-·-.-----------------------.
Parcel#_-=----=---==-==---'=--"'""'"-'-"'=-+-----
(For Parcel#, contact Eagle County Assessors Office at (970)328-8640 or visit
www.eaglecounty.us/patie)
Project#:-----------------
ORB#: _________________ _
Building Permit#: -·~n~~h_~_{)_/ _],__---_S_· ___ _
Lot#: Block# __ Subdivision: _______ _
Work Class: New ( Addition ( Alteration R<J..
Type of Building: Contractor Information J.. V (' Single-Family ( Duplex ( Multi-Family(""-
•Business Name: t==\6!-J..:C~=<o ~5'\"i?-"'-L.-"'J l t> J Commercial ( ) Other ( -----------
.Business Address: '"T'Cl b ~ 1L/ \
•City f2 4 <qt...-E: State: C. 0 Zip: fl,\ <RS \ ·Work Type: Interior S)l) Exterior ( ) Both ( )
Contact Name: "1\..~ ~ \f .,..>':Cuc
Contact Phone: '11-D --:?~-2-~Z.. 5
Contact E-Mail:\~~ tt\.cle cL:<lc1 u:h~ :~ es~et: l ~ l<J./VL .
Work Included
I hereby acknowledge that I have read this application, filled out in full the Mechanical ( )Yes
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 <)4.¥es
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, desig review approved, lnternation uilding and Residential Building Nf es
Codes nd o r ordi ances of the Towo appl able thereto.
)No
)No
)No
Plans Included
)Yes ( )No
)Yes ~o
Valuation of
Work
/, tJ 0 0 ,-
)Yes ~o '] fJ 0 0 .·-
l ... ··.-+
Total Value of all work being performed: $ (0 1'0{)0, ··
(value based on IBC Section 109.3 & IRC Section 108.3)
0
Applicant Information
Applicant Name: ~So:~ '\(_U'\'S~'C"'S N
' Applicant Phone: $ () ~ -~ \ 4 -l:, C/ '-' 1
'Applicant E-Mail:~ r BO \ L3 Q. ct Mc<". l 1 ~
Additional Authorized ProjectDox Users
·Full Name: ------------------
'E-Mail: ___________________ _
Detailed Scope and Location of Work: ~ W--.-0 ~ A..i'> ~LO.(£ ~lt<= P'-O.UO
/}.," " '£ .~~< u>.= ~ ~g."'4~'1:>
· Full Name: ------------------i (use additional sheet if necessary)
E-Mail: ___________________ _
' (use additional sheet if necessary)
Date Received:
For Office Use Only:
Fee Paid: ________________ _
Received From: ______________ _
Cash Check # ____ _
CC: Visa I MC Last 4 CC # ___ _ exp date: __ _
Auth# ___ _
Rev. 2015-Dec