HomeMy WebLinkAboutB17-0021_B17-0021_1486741200.pdf P
1-'- ti: Department of Community Development
75 South Frontage Road West
TOWN OF PAIL} T
Vail,0 7s 1657
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www.vailgov.com
BUILDING PERMIT APPLICATION
(Separate applications are required for Electrical,Alarm,Sprinkler&Public Way)
'Project Street Address:��// Project#
Ott wi/rdPigi { &IG yy.����jj- 1.0 f
I(Number) (Street) �} �,�// , (Suite 4) DRB#:
BuildinglComplex Name:/at l� a B, 41 / Building Permit#:
Project Information: rKitiAS-
3Zit
i'1�r/ Lot it: Block# Subdivision:
I Owner Name: l FJ W(
'Parcel# 2t010gZ O27I I
1(Por Parcel#.contact Eagle County Assessors Office at(970)326.8640 or visit I Work Class: New(Q) Addition(Q) Alteration( 71.
www.saglecouaty usipatle) _____I
ContractorIn#orntatian IType of Building:_ — T^ -- 07 i
!/ j/� Single-Family(Q) Duplex(Q) Multi-Family(r!J)
i Business Name: ilii exit FGdae,g��,rr Commercial(0) Other(0)
Business Address:O 1zf�4,f Wf-- i .;,._ —r== -___. ,�a•. _.a, Y-7.. —
City ' State: k/v Zip: 8U32-
{ Work Type: Interior(0) Exterior(Qy 8krtii
Contact Name: 603 41141 # -•- �......,._._.. _ R T��.. ....v.._._ .� _..�
'Contact Phone: rZ �t— 77771 Valuation of F
Contact E-Mail: ei feirk� fk it ri,-.Gd�t.. 't' tided Plans Luded Work
I hereby acknowledge that f have read this application,filled out In full the IMechaniC61 LJ)Y (ONo lYe No 2.....4____5-0°79
Information required,completed an accurate plot plan,and state that all i f�� p¢0 j
the information as required is correct. I agree to comply with the Infix- i plumbing )Y (ONo (C Ye (C)No F
oration and plot plan,to comply with,all Town ordinances and state laws, t
and to build this structure according to the town's zoning and subdivision
codes,design review approved,international Building and Residential Building )Yes (()No ( Yes (OjNo Ls�2,__
Codes a other ordinances of e Town applicable thereto. y—______=:":7 ...._--.....
Total Value of all work being performed: $ 0610 1
�1Sl�J�-.-- I(value based on ISO Secion 109.3&IRC Sec Ion'106.3)
OwnerlOwner's Representative Signature(Required)
i ; Detailed Scope and Location of Work:
{Applicant Information /� /! �7 �e /igl y� A(113.-
� ��Y.
I Applicant Name: gout�/€ALL ( f[ [,Cd(
iA IlcantPhone: 6�ir--33. rOUZO i ��G c44. /,�
;Applicant E-Mail: I 0eit , rh/tat• — ;
Additional Authorized ProjectDox Users £ ' / 1'kJ rte. + f
:Full Name: ! A perrn� t ? ows
.E-Mail: i YVIP,,447 • Cowl,
r
1
iFull Name: I(use additional sheet if necessary)
i E-Mail: •
f(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