HomeMy WebLinkAboutB17-0340_VVMC_EE_PERMIT - Bldg_1503521591.pdf Department of Community Development
75 South Frontage Road West
TOWN OF VAIL Vail,CO 81657
Tel: 970-479-2139
www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm,Sprinkler&Public Way)
Project Street Address: Project#:
180 FRONTAGE ROAD
(Number) (Street) (Suite#) DRB#
Building/Complex Name: VAIL VALLEY MEDICAL CENTER Building Permit#:
Project Information: Lot#: Block# Subdivision:
Owner Name: VAIL VALLEY MEDICAL CENTER
Parcel#210107101013
(For Parcel#,contact Eagle County Assessors Office at(970)328-8640 or visit Work Class: New(0) Addition(Q) Alteration(®)
www.eaglecounty.us/patie)
Type of Building:
Contractor Information
GE Johnson Construction CompanySingle-Family(C) Duplex(0) Multi-Family( )
Business Name: Commercial(0) Other(f)HOSPITAL
Business Address: 25 N Cascade Avenue, Suite 400
City Colorado Springs State: CO Zip: 80903 Work Type: Interior(0) Exterior( ) Both(•)
Contact Name: Travis Clem
Contact Phone: 970.331.6328 Valuation of
Contact E-Mail: clemt@gejohnson.com Work Included Plans Included Work
I hereby acknowledge that I have read this application,filled out in full the Mechanical ( )Yes (C)No (®)Yes (C)No 476300
information required,completed an accurate plot plan,and state that all
the information as required is correct. I agree to comply with the infor- Plumbing (CD)Yes (0)No (®)Yes (C)No 300000
mation 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
codes,design review approved,International Building and Residential Building ®)Yes (C)No (®)Yes (C)No 915024
Codes and other ordinanyown applicable thereto.
X ' Total Value of all work being performed: $1,691,324
(value based on IBC Section 109.3&IRC Section 106.3)
Owner/Owner's Representative Signature(Required) Detailed Scope and Location of Work:
Applicant Information SMALL MISC. INTERIOR MODIFICATIONS.
Applicant Name:
Applicant Phone: 1 CHRIS K I
o3 a17 7sto? NEW OXYGEN ENCLOSURE
CHRISK NEW ACCESSIBLE RAMP AND TRANSFORMER
PROJECT-1.COM
Applicant E-Mail: °�
ENCLOSURE.
Additional Authorized ProjectDox Users
Full Name: NEW UNDERGROUND TANK.
E-Mail: TEMPORARY EXTERIOR FACILITIES.
Full Name: DEBORAH WILLIER
(use additional sheet if necessary)
E-Mail:DEBORAH.WILLIER@DAVISPARTNERSHIP.COM
(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