HomeMy WebLinkAboutB17-0016.pdf '• Y?� Department of Community Development
75 South Frontage Road
TOWN OF VAIL _ Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
WATER HEATER PERMIT APPLICATION
(REPLACEMENT ONLY)
(This permit is applicable to one and two family dwelling units only)
Project Project#: _
Street Address: 4
/770 n9 �Ir-�orn a , - I_ Building Permit#:
(Number) (Street) (Suite#) Lot#: Block# - Subdivision:
Contractor Information Work Class: Alteration( ) Work Type: Interior( )
Business Name: eblorQ O 1)46 rhoe.hotteliem
Type of Building Slagle Family{ - ) Duplex( )
Business Address: 6056 E baseline Ad 411.55
1
�yy /� Joint Property Owner Approval ( )Yes ( ) No
City 1�tC.64 State: R2 Zip: gs G� I �� �., Y �. _,
Water Heater Type yp ( )Gas Y(� ) Electric ,
Contact Name: L6li 1 Number of Appliances
Contact Phone: l][ICI-c't 2- J GT S - . - _ - _— .._.�_...._.- . : :_ _ _-1
L f Celt Sheets Included ( )Yes ( )No
Contact E-Mail: "liver il5Qd�l4-arnteic►n lrr�• h"------7----------- - . ... _. ) No,._...j.
Vent Location Photograph
( )
,.. ____,H
h Included Yes (
(when apptcatle)
Owner/ ni A
er's Representative Vgnature(Required) Submittal Checklist Complete/Attached ( ) Yes ( ) No
_ _—_
Applicant Information Plans Included ( )Yes ( ) No
Ir „
Applicant Name: 0( ` t71ace��
"`'' h I� Detailed Scope and Location of W rk: ne
Applicant Phone: iSV(.0" 6,2, 4273 a1`4n ele ci e tliuo e+r 1
Applicant E-Mail: eo /1111�f 5 a ale 14c rnlchar�tc!J1114;4v- "'" 5 {
cowl :1 ;teovirkee4 / Afeoroeek
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Project Information (use additional sheet if necessary)
Owner Name: : 1
l
Parcel#: :
(For Parcel#,contact Eagle County Assessors Office at(970-328-8640 or visit ;P �]lumbing value of work being performed: $ ! 0 !
www.eagiocounty.us/patiel
For Office Use Only: Date Received:
Fee Paid:
Received From:
Cash Check #
CC: Visa / MC Last 4 CC # exp date:
Auth #
06-Jun-11