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HomeMy WebLinkAboutE16-0163 signed app.pdfDepartment of Community Development 75 South Frontage Road West Vail, GO 81657 Te!: 97iJ-479-:2139 www.vailgov.com --"~----- ELECTRJICAl PERMJT Electrical Permit Submiif:al Reourrements Including Heat Tape Installai:ion _floor plan I Site plan showing proposed work __ Occupancy Group listed on plans _Load Calculations and one-line diagram when loads or circuits are being added _Buikfrng Type NOTE: For Mufil..Family and Commercial buildings-plans and ca!culafions must be prepared by a Colorado Licensed 8ectrical Engineer Project Sfreet Address: Q +1 G ,3()_3 ~ce Cre<'°J _.__{'1 v<:: rr 0_ Pmject#: ---~-...---.,,.--------..------ ; Building Permit #;I3 i 6 -wa I (Number) (Street) (Suite #") Building/Complex Name:_[~() VV H Ot .!16~'$ ,,.-. : Electrical Permit#: J;:} b -0 I L~---j Project Jnformali?'* l <::::::b l Owner Name: RD> c k2:C2D . '>-) ,' !' ~ f'j( Parcel# d/()J -0£-~:-31 -CC);), (For Parcel#, contact Eagie County Assessors Office af {970)328-8640 or Visit 1 ww1v.eagJei;o:mtY.uslpafie) Contractor Information . Lot#: Block# Subdivision:-------- Business Name: E/I( /(,'~ £"/r(;{l;c-h". l BusinessAddress: 21C) £j}J/~J/ ~/l"J' (}/i1J t1·20~/.,.L.,r.LK-4--s.::..J.$....<.LU:~~nr...4--1:x:;~'-I--!-~~ City £""""a.rJs State: lt) Zip: '(16)2. 1------------- Corrtact Name: /'I. Kr He,· 1'1~ r f 1 1 Contact Phone: q 70 -Lt 71 -QI 01 ·------------------- //./ . / J ~ Lf) (use additional sheet if necessary) Contact E-Mail: e ~r.~ut.e<.l.!"•c..~11t111t, 'o"" 1----------------------' I hereby acknowledge that I have read this appiicafion, filled out in full the Includes Temporary Service: ( ) Yes OQ No infunnation required, complcti.ed an accuraie plot plan, and sr..Ie f!ral: all the illfomrai:ion as required is correct. J agree to comply with the infor- mation and plot plan, to comply with@! Town ordinances and stare laws, and to build this struciure according to the fawn's zoning and subdivision codes. design review appr , International Building and Residential c~ and oi:her ordin of ' applicable tl:Jereto. Work Class: New { ) Adcfrtion ft<) Remodel 0Q Repair { ) Other( )--------'--------~ X,__ __ ~~-Qt~~-t!:__-----:--:-----Type of Building: Single-Family { ) Duplex ( ) OwnerJOwn s R resenta!:ive ·gnature (Required) l l -Multi-Family ( ) Coilercial ( ) Resiaurant ( ) Applic· ~ ~ ( --\ ; r l Other K) ~I,/\ ex J;SC::... . Applicant Name: ·s-]tv J/, VA</ ,'o 1 :) · i 1 /J.J -/ I Provide BOTH square footage of area of work ApplicantPhone: -t-f 7( -t::rr,r)-8 jANDValuafion (Labor&Materials) . Applicant E-Ma!l: -~J~C~<CtC~ r-t'.JAJ,fru.ct 16.--, (o:,rmount of SQ Ft: f3Xf-3§Qc!X..; {-f. Additional AuthoAfjd Pro1ec:i:Dpx ~sers ~Electrical $#....S;;) J Q(X) -· FunName: ,[Jj,/[1e, Aijr1c.{---, LI ____________ _____. E-Mail:..m,lke; puredP.·"1jn-,.JuclD, CL)fJ\ 1·DateReceived: Fw!Name: ------------------~ E-Mail: ___ j For Office Use 0!/ ·2 .'l ;:-_ 0 fee Pald: _ tf.-1 _d., a ~ Received from: -------- Cash -Check# _____ _ cc: Visa/ MC Last 4 CC#_____ Auth # ___ _ Rev. 2015-DeG -----------·--·-·· ··-----------------'