HomeMy WebLinkAboutB16-0153.pdf Department of Community Development
75 South Frontage Road West
Vail, CO 81657
TOWN OFV 1I 2 Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm, Sprinkler&Public Way)
Protect Street Address:
Project#:
-7(62 Fo1 A
(Number) (Street) (Suite#) DRB#:
Building/Complex Name: V Ai L- v11-G1 ' _ Building Permit#: _
Project Information: Lot#: Block# Subdivision:
Owner Name: /- Xhrvt5C1Z 1m t E►°
Parcel# 7Lbt -Oil - 1\ ` 015
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New( ) Addition (•) Alteration( )
www.oag recounty.uslpatle)
Contractor Information Type of Building:
Single-Family( ) Duplex(0) Multi-Family(' )
Business Name: S✓PiNS CH4FPE6,. ConvsTecloa'.1 Commercial ( ) Other( )
Business Address: 77 lrvt E r At.- 1-tC7AD
City AA-wA-1 State: CD Zip: 2316,Z.v Work Type: Interior( ) Exterior( ) Both(0)
Contact Name: r?LC-/vr" fHoC?�rtdy
Contact Phone: (917o) 37' - 75c15 Valuation of
Work included Plans Included Work
Contact E-Mail: Erti6N1—Gon+Ef1-,j£ Ev-An+sc mff COW'
I hereby acknowledge that I have read this application,filled oul In full the Mechanical (10)Yes ( )No ( )Yes (4111)No 311`110
information required,completed an accurate plot plan,and state that ail
the information as required is correct. I agree to comply with the infor- Plumbing (0)Yes (1 )No ( )Yes (f)Na 32 l a-O _
oration and plot plan,to comply with all Town ordinances and state laws,
and to build this structure according to the town's zoning and subdivision
�tgU
codes,design review approved,International Building and Residential Building (1111)Yes (1 )No (I)Yes ( )No
Codes and other ordinances of the Town applicable thereto.
Total Value of all work being performed: $ 9141S.5°
X ���� /'L n�, - (value based on IBC Section 109.3&RC Section 108.3)
Owner/Owner's Representat'' Signa (Required) Detailed Scope and Location of Work:&Jeri -- 51cfino}'Xu.�
Applicant Information ,J 1
hOd�i�Ot t1vr<v��1 �o hOt SCa�r� DaIiO,
Applicant Name: �.vrarT �D�(,�i<-te/2y l /
Applicant Phone: ?-70)37(y-754fS .41-(c,„,:,)f Qf{^�43( p/J[u:a /cue- - 2p(•�ce/I`mc'nr
Applicant E-Mail:��+ta/vT6,ohtG/ZYa7Er/ s Chfit, -C dm Wr466"!/ 71/'l cfryu,1// it i S.ufJe� /aG/l—
Additional Authorized ProjectDox Users Pod fr?)/hoc/4 rho,. -6;e17,cc ,t A (74.6;acrl/Spar.-tr
J
Full Name: ,11t/A`( /IA4..44/A/5l<( 5Ia/(5 Ii h iij, 4-4 014-5 r/ /44^o(i7
E-Mail: A-1-tr r4 Litt l A/.3g1/
1 �gi+rSC�clq��.Cr'rt�t g'y�i4nctSl/1r�. AAA.hr fxo(ruO>" d-MrsK� 1'414.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