Loading...
HomeMy WebLinkAboutB16-0186.pdfDepartment 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) Project Street Address: YiB f.~wt)t\~u (Number) (Street) (Suite#) Building/Complex Name\!\\~ lnt'1 Plt.c..2.cv Project lnfor~on: n Owner Name: Y(ji\ryo RCA.ml rt:t ~ !\kAcu~cA.J' o\v.n1V\, Parcel# '.), \ 0 \ -0 32_-5l\---0 I b (For Parcel #, contact Eagle County Assessors Office at (970)328-8640 or visit www.eaglecounty.us/patie) Contractor Information Business Name: t\-fl o\ ~llr\Q ~Caci: 1 lD 0. Business Address: £0 \OCT'A U!D"J City \-J\\o-\u.rn state: L.o Zip: 2.lwlf-5 Contact Name: 61e,,rtt.ril t\c I 4 Project#:----------------- DRB#:-----------....,..---=------ Building Permit#: _~_"""'b""':>-l_b_-_Q __ f-=S_(; ___ _ Lot#: Block# __ Subdivision: _______ _ Work Class: New((' ) Addition ((~ ) Alteration (<)(}_ Type of Building: Single-Family (l) Duplex((') Multi-Family(~) Commercial((') Other((') _________ _ Work Type: Interior~ Exterior (C) Both ((') Valuation of contact Phone: ErY?) ~0-21R 13 Contact E-Mail: ~o\ 0 ft-1cht,ma:kl1 Q)1 · lorY) . I hereby acknowledge that I have read this application, filled out in full the Mechanical information required, completed an accurate plot plan, and state that all Work Included (")Yes (r)No Plans Included Work (rJYes ((')No the information as required is correct. I agree to comply with the infor-Plumbing mation and plot plan, to comply with all Town ordinances and state laws, (')Yes ((')No ((')Yes ((')No and to build this structure according to the town's zoning and subdivision codes, design review approved, International Building and Residential Building (")Yes (r)No ((')Yes (r)No '(pl <too Codes !Jd, other ordinanceLs of;;._~ ow ., applica/,i;_., thereto. x _2)0c.-<.&t_ c /< cY oWner/Owner's Representative Signature (Required) Applicant Information Applicant Name: E7\e,,1~t\.. ~\J Applicant Phone:(r\Q) 3'JD-Z&/3 Applicant E-Mail: ~en:vo\@\:'f.tdrcroodd140· C'efr? Additional Authorized Projectoox Users Full Name: ------------------ E-Mail: ___________________ _ Full Name: ------------------ E-Mail: ___________________ _ (use additional sheet if necessary) For Office Use Only: ~-. f/ '"") ~~ ' ( ); - Fee Paid: _____ 1_.r ____ / ________ _ Received From: --------------- Cash Check # ____ _ CC: Visa/ MC Last 4 CC # __ _ exp date: __ _ Auth# ___ _ Rev. 2015-Dec Total Value of all work being performed: $ _____ _ (value based on IBC Section 109.3 & IRC Section 108.3) Detailed Scope and Location of Work: _______ _ 'Fe<f)JQ\l(., ~wal\ 1 Cbi:vnoeJ for J;-y-e,, ~rin l\u<::.. ~&\,~ \ \)Clkh°\ V\~ I ..\cy~ ~ plU1 Wl-- C~\\ ntr (use additional sheet if necessary) Date Received: ~--------------. D ~©~D\W~~ MAY 2 4 2016 1UJ L. r TOWN OF VAIL !1 --~----~-------'