HomeMy WebLinkAboutB17-0003.pdf rte,.
Department of Community Development
--- 75 South Frontage Road
Vail, Colorado 81657
1 ...Tel: 97.0-4.M4128.,
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BUILDING PERMIT APPLICATION
(Separate applications are required for alarm&sprinkler)
Project Street Address: - Project#:
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(Nurfll, (Street) (Suite#) DRB#: �,/
Building/Complex Name: S us- V\ v () 1 Building Permit#: GC
Lot#: Block# Subdivision:
Contractor information
Business Name: 10'Sjc n t !f t/r-r (t S 01 Work Class: New( ) Addition( ) Alteration ( vr
Business Address: q 10 Y\04.j-1 Vt.c�V\eI p Type of Building: ___City A U✓\ State: C ,0 ZZp: ' f C0 2(3 Single-Family( ) Duplex( ) Multi-Family(t(
Contact Name: )C k1,J e 1,-5),) (Al" Commercial( ) Other( )
hContact Phone: Li 7 0 62_7-` ( C Z75 Work Type: Interior(L7)--Exterior( ) Both( )
ContactE-Mail: h',(t(t.J L ialc`i -Cvl\. F;V-r lur r ,.( V 1 . Valuation of
Work Included Plans Included Work
Contractor Registration Number.
Electrical ( )Yes ( )No ( - )Yes ( )No
X ¢ ) Mechanical ( 4Yes ( )No { )Yes ( )No �j/l) X1.2 i
O er/Owner's Representative Signature(Required) Plumbing ( .)Yes ( )No ( )Yes ( )No
Project Information Building ( )Yes ( )No ( )Yes ( )No
Owner Name: -
/ -"Z / ( 2) Value of all work being performed:(val $ 3/ 0 ( '7 . -2.__I
Parcel#: ( l� J v s(7_1( Value
l orIBC being
pert 8 IRC SecOon 108.3)
(Por Parcel#,Co Assessors Office at( x-6640 or visit
www.eaglecounty.us/patie) Electrical Square Footage
Detailed Scope and Location of Work: .1 Vt --�- ‘k :, c)vt (') F o v c p t c (A- J (Ln. -)-
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(use additional sheet if necessary)
, RECEIVED
For Office Use Only: Date Received: •
Fee Paid: AN 0 3 2017 .
Received From:
Cash Check # Town of Vail
CC: Visa I MC Last 4 CC# exp date:
Auth #
o17an-11