HomeMy WebLinkAboutB14-0240_B14-0240 Application_1404935940.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAI! Vail, co 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATION
(Separate applications are required for alarm & sprinkler)
Project Street Address: Project#:
181 West Meadow Drive
DRB#:
(Number) (Street) (Suite#)
Building/Complex Name: Vail Valley Medical Center Building Permit#:
Contractor Information Lot#: Block# Subdivision:
Business Name: Vail Clinic, Inc
Business Address:
181 West Meadow Drive Work Class: New 0 Addition(0 Alteration (®
City Vail State: CO Zip: 81657 Type of Building:
Dan Feeney
Single-Family 0 Duplex Multi-Family 0
Contact Name:
Commercial(0 Other 0
Contact Phone: (970)390-6493
Contact E-Mail: daniel.feeney@vvmc.com Work Type: Interior Q Exterior i® Both (®
I hereby acknowledge that I have read this application,filled out Valuation of
in full the information required,completed an accurate plot plan, Work Included Plans Included Work
and state that all the information as required is correct. I agree to Electrical ®Yes ONo ®Yes ONo 100,000.00
comply with the information and plot plan,to comply with all Town
ordinances and state laws, and to build this structure according to Mechanical ()Yes Yes Q)No °Yes ONo 75,000.00
the town's zoning and subdivision codes, design review ap-
p.. -•, ernational Building and Residential Codes and other Plumbing IEYes ONo °Yes ONo 25,000.00
o dinance• oft e n applicable thereto.
Building ®Yes ONo °Yes ONo 1,100,000.00
X , `4 //i . Value of all work being performed: $ NaN
Owner/Ow - Signature(Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage 6100
Applicant Information Detailed Scope and Location of Work: Improvements to
Applicant Name: Dan Feeney certain patient sleeping rooms and construction of a
Applicant Phone: (970)390-6493 cardiac catherization lab
Applicant E-Mail: daniel.feeney@vvmc.com
Project Information Dan Feeney
Owner Name:
Parcel#: 210107101013
(For Parcel#,contact Eagle County Assessors Office at(970-328.8640 or visit
www.eaglecounty.us/patie)
(use additional sheet if necessary)
For Office Use Only: Date Received:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp date:
Auth #
12-Mar-2012