HomeMy WebLinkAboutB12-0075 - REV1 - 042312TRANSMITTAL FORM
Project Street Address:
__________ ______________________________ ___________
(Number) (Street) (Suite #)
Building/Complex Name: ________________________________
Revised ADDITIONAL Valuations (Labor & Materials)
(DO NOT include original valuation)
Building: $_____________________
Plumbing: $_____________________
Electrical: $_____________________
Mechanical: $_____________________
Total: $_____________________
Description / List of Changes:
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
(use additional sheet if necessary)
Permit #(s) information applies to: Attention: ( ) Revisions
( ) Response to Correction Letter
____________________________________ __________________________ ___attached copy of correction letter
( ) Deferred Submittal
____________________________________ __________________________ ( ) Other
Revision Submittals:
1. “Field Set” of approved plans MUST accompany revisions.
2. No further inspections will be performed until the revisions are approved & the permit is re-issued.
3. Fees for reviewing revisions are $55.00 per hour (2 hour minimum), and are due upon issuance.
Date Received:
01-Oct-11
Department of Community Development
75 South Frontage Road
Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
For Office Use Only:
Fee Paid: _________________________________________
Received From: ____________________________________
Cash _________ Check # ___________
CC: Visa / MC Last 4 CC # _________ exp. date: ________
Auth # _________
Contractor Information
Business Name: ________________________________________
Business Address: ______________________________________
City _____________________ State: _______ Zip: ____________
Contact Name: _________________________________________
Contact Phone: _________________________________________
Contact E-Mail: _________________________________________
I hereby acknowledge that I have read this application, filled out
in full the information required, completed an accurate plot plan,
and state that all the information as required is correct. I agree to
comply with the information 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 ap-
proved, International Building and Residential Codes and other
ordinances of the Town applicable thereto.
X___________________________________________________
Owner/Owner’s Representative Signature (Required)
Applicant Information
Applicant Name: _______________________________________
Applicant Phone: _______________________________________
Applicant E-Mail: _______________________________________
B12-0075
660LionsheadPlace 576
LionSquareLodgeSouth
SREBuildingAssociates
POBox6376
VailCo81658
Sarah
970-390-5776
sarah@srebuilds.com
Contractor
Additionofstructuralplanstosupportexisting
chimney.
0
0Sarah Wyscarver Digitally signed by Sarah Wyscarver
DN: cn=Sarah Wyscarver, o=SRE Building Associates LLC, ou,
email=sarah@srebuilds.com, c=US
Date: 2012.04.23 14:37:30 -06'00'
RECEIV
VED
04/23/2012 @ 2:44PM
April 23, 2012
April 23, 2012