HomeMy WebLinkAboutE17-0048_1.pdf Department of Community Development
75 South Frontage Road West
TOWN OF VA11Vail,CO 81657
Tel:970-4792139
www.vailgov.com
ELECTRICAL PERMIT
Electrical Permit Submittal Requirements Includine Heat Tawe Installation
_Floor plan/Site plan showing proposed work y bpd on plans
,Load Calculations and one-line diagram when loads or circuits are being added Building Type
NOTE:For M lti-Famiy and Commercial buil-plans and calculations must be prepared by a Colorado Licensed Electrical Engineer
Project Street Address:
Sy /ARK5-fu R C r Project#:
(Number) (Street) (Suite#) Building Permit#: J ) ` 6 Ga
BuildinglComplex Name: Electrical Permit#: I l C o q
Project Information:
per Name: / is e N Z /Gf7 p 122 I Lot#: Block# subdivision:
Parcel* c /a ! V 3
(For Pereel 1,contact Copy Assessors Office at(970)328-8640 or visit Define Scope and Location of Work:
1
\
Contractor Information
Business Name:�Jo c,c Scrin�i r / C Crg)
T c 1a �� 3 6A, r ����,>^
Business Address: K 5/4 v‘:gi-11EL (e iz Box7Iy
City F ier,c p}/ State: C'C') Zip: S d qy
Contact Name: 4-34/1/9/ 7J6 /Z6-,
Contact Phone: %O T i — d
Contact E-Mail:`C�/W/ !/ A G/ ✓e/rn mi T C 6 nAir, use additional sheet if necessary)
I hereby acknowledge that I have read this application,filed out in full the Includes Temporary Service: (C)Yes 0 No
information required,completed an accurate plot plan,and state that all
the information as required is correct. I agree to comply with the infor-
z mation and plot plan.to comply with all Town ordinances and state laws, Work Class:
and to bund this structure according to the town's zoning and subdivision
codes,design review approved,International Building and Residential New(C ) Addition(( Remodel Repair(C')
Codes and of the3own applicable thereto. Other(C'.)
Owner/Owner's R (Required) Type of Building: Single-Family(16 Duplex(0
Multi-Family(") Commercial f Restaurant(n
Applicant Information
Other(T)
Applicant Name: /1/q/0 io 7 r�/1 J iv Ci h
::Applicant Phone: 70 C/ / I .- / �; y 'AND Valuationde BOTH square �area of work
A )
pplicant E-Mail: pN&yL/ 6/E.c47,, /rc06AA,2,66 iSV 0
nt of SQ Ft:
Additional Authorized ProjectDox Users
Electrical$: di 0 O d
Full Name:
E-Mail:
Full Name: Date Received:
E-Mail: RECEIVED
'For OIRCe Dee Oily:...._ _.. .. __..._.. APR 13 2017
Fee Paid:
Received From: Town of Vail
Cash Chedc#
CC: visa/MC Last 4 CC# Auth#
Rev.2015-Dec