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HomeMy WebLinkAboutB16-0453.pdf Department of Community Development 75 South Frontage Road West TOWN OF VAIL♦ Vail, CO 81657 � __' Tel: 970-479-2139 www.vailgov.com B G PERMIT APPLICATION (Separ applications are required for Electrical,Alarm, Sprinkler& Public Way) Project Street Address: Project#: 1360 Westhaven Dr. Unit 6A (Number) (Street) (Suite#) DRB#: Building/Complex Name: Millrace Building Permit#: (0 - 0 L� Project Information: Lot#: Block# Subdivision: Owner Name: Jase+°l-Rtrseell—6611-0 U 1M Lc , r /C(r-P2'1s Parcel# 210312111009 �.. (For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New(0) Addition (0) Alteration 0) www.eaglecounty.us/patie) Contractor Information Type of Building: Cairn Construction Group Single-Family(0) Duplex(Q) Multi-Family(U) Business Name: Commercial (0 Other(0) Business Address: PO Box 1273 City Edwards State: CO 81632 Zip: Work Type: Interior M Exterior(O Both (Oj Contact Name: Jason Russell Contact Phone: 970.306.9093 Valuation of Contact E-Mail: jason@cairnconstructiongroup.com Work Included Plans Included Work I hereby acknowledge that I have read this application,filled out in full the Mechanical OYes ONo Oyes (0No 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 °Yes ONo (OYes ONo 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 OYes No l�Yes 00No Codes and other ordinances of the Town applicable thereto. Total Value of all work being performed: $5000.00 X (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 fireplace with similar model, add tile to wall behind Applicant Name: Jason Russell Applicant Phone: 970.306.9093 fireplace, replace flooring in living room Applicant E-Mail: jason@cairnconstructiongroup.com J' o. Additional Authorized ProjectDox Users Full Name: E-Mail: Full Name: (use additional sheet if necessary) E-Mail: (use additional sheet if necessary) Date Received: 22 For Office Use Only: 2 E © ___ Fee Paid: . - 7 ( D Received From: OCT 2 0 2016 Cash Check# 1175. CC: Visa/ MC Last 4 CC # exp date: J Auth # TOWN OF VAIL Rev.2015-Dec