HomeMy WebLinkAboutB16-0156 transmittal.pdf f
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Department75 oSouth Community
Frontage Development
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TOWN OF in i t ! Vail, CO 81657
r Tel: 970-479-2139
6+05M; 1 • 1 i5 ) Un www.vailgov.com
B�TNG PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm,Sprinkler&Public Way)
Project Street Address: '
11 10 St3 NN gt.)IZS T DR• 0 S Project#:
(Number) (Street) (Suite#) DRB#:
Building/Complex Name.}►)1. Ga t.. COUR S E' Building Permit#: 6,5 'o a3 I/614.01510
To w n1 N6 fh b SProject Informat�
Lot#: Block# Subdivision:
Owner Name: gSEU_
M E
Parcel# 71 O 1 -- 091 -01 f - (o B
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New( ) Addition<) Alteration( )
www.eaglecounty.us/patie)
Contractor Information Type of Building:
M(�
Single-Family( ) Duplex( ) Multi-Family
Business Name: LOWbgQCmft.K->m ►TChtt;t.t. illec4 IcAbommercial( ) Other( )
Business Address: (134 CHS£€,S C T. # ALI
City Z,A(., State: CQ Zip:101431 -Work Type: Interior(x} Exterior( ) Both( )
Contact Name: 5pAiNg. m/7ai-ie LL-
Contact Phone: 9-70 7(p 774,' Valuation of
Work Included Plans Included Work
Contact E-Mail:94p4 4 F@...51.1 Atiktep'1/JuIE=L1..COM
I hereby acknowledge that I have read this application,filled out in full the Mechanical Yes ( )No (>0'1'es ( )No 2,` (n0, OO
information required,completed an accurate plot plan,and state that all
• the i •rrnation as required is correct. I agree to comply with the infor- Plumbing ( )Yes ( )No ( )Yes ( )No
mati• and plot plan,to comply with all Town ordinances and state laws,
and t. •uild this structu iii
'•• :ccording to the town's zoning and subdivision Building )Yes )No )Yes )No
code , •-sign i• : i• �ved,International Building and Residential ( ( ( (
' Code. a dot - • •• . -. of the Town applicable thereto.
Total Value of all work being performed: $ZZ,gt00.00
X & . d (value based on IBC Section 109.3&IRC Section 108.3)
Owne zir er's Repre entative Signature(Required)
Detailed Scope and Location of Work:
Applic- t Information O
of CM /B Ave Hea4rlrl& Zot
Applicant Name: , I11 �gbigsr �
Applicant Phone: ✓Prn f. S >� -fqll'> h t P
Applicant E-Mail: -i-". M 1 if _ ' 1111: ... 0 6a. .e.-
Additional Authorized ProjectDox Users 'U L1 1t R ge Di r1 13'r 4th A i la yl_.
Full Name: E ASErAA Agb aSArEgS•
E-Mail:
Full Name: (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/MC Last 4 CC# exp date:
Auth #
Rev.2015-Dec