HomeMy WebLinkAboutapplication_15.pdf 41111° Department
of Community Development
75 South Frontage Road West
TOWN OF VAIL ` TelVail, CO 81657
: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm, Sprinkler& Public Way)
Project Street Address: Project#:
(Number) (Street) (Suite#) DRB#:
Building/Complex Name: I ,r-- 8 g,� Building Permit#: --0° )-tC
Project Information ,.. . Lot#: Block# Subdivision:
Owner Name: ': `..' d ,q,4,.,2:1.--c,«r,..,_ -rd'(
Parcel# 0/ d 1 ( D . 0004
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New( ) Addition ( ) Alteration ( )
www.eaglecounty.us/patie)
Type of Building:
Contractor Information
Business Name: t ,�1 !„e.t.a.,4� '' r ,,
Single-Family( ) Duplex( ) Multi-Family(5Y)
''�.0
Commercial ( ) Other( )
Business Address CJ�J /(off Q
City State: = Zip: tLi I Work Type: Interior O Exterior( ) Both ( )
Contact Na '''"4.1/1 ,
Contact Phone: Valuation of
Work Included Plans Included Work
Contact E-Mail: �+:,4.1 tcI :,, d C arm
I hereby acknowledge that I have read this application,filled out in full the Mechanical Yes ( )No (/)Yes ( )No 15
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 ('y()Yes ( )No ( /)Yes ( )No 11,0 C)a
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 subdivision3`x.
codes, design review approved, International Building and Residential Building ( )Yes ( )No ( )Yes ( )No .JO3O
Codes and other ordinances of the Town applicable thereto.
Total Value of all work being performed: $ 33 5 bo
X ''' Lit.'
t (value based on IBC Section 109.3&IRC Section 108.3)
Ow i er's Representative Signature(Required)
Detailed Scope and Location of Work:
Applicant Information �. � �A3
:::::
: 76 , e� -2 ��A >. :� , �.y�C�t'c .�t
_ `" (t•t � ° yi r. «atm l�a. � u:V2, Ct «L i. < ,fid.? s
.
Applicant E-Mail: J I t 44" ,,; €�° h.3 M , ;) f
Additional Authorized ProjectDox Users C�c�ri_ 64.4? _ '4=P ' .,.,.. f : )A.4,!4 ss
Full Name: :a.,. 1/r..„. ,. /,°
E-Mail:
Full Name: (use additional sheet if necessary)
E-Mail:
RECEIVED
(use additional sheet if necessary)
Date Received: 62018
For Office Use Only:
Fee Paid: Town of Vail
Received From:
Cash Check#
CC: Visa/ MC Last 4 CC# exp date:
Auth #
Rev.2015-Dec