HomeMy WebLinkAboutB12-0210 - REV1 - 090412 TRANSMITTAL �,; Department of Community Development
75 South Frontage Road
�'��� �� ��jl =• Vail, CO 81657
Tel: 970.479.2128
www.vailgov.com
Development Review Coordinator
TRANSMITTAL FORM
Use this form when submitting additional information for planning applications or building permits.
This form is also used for requesting a revision to building permits. A two hour minimum building review
fee of$110 will be charged upon reissuance of the permit.
Application/Permit#(s)information applies
to: Attention: Revisions
�� ^_ �� � Response to Correction Letter
ol l �attached copy of correction letter
0 Deferred Submittal
�Other
�Project Street Address:
1y'7� (.�es�NAVC,.I i76Z x*�
(Number) (Street) (Suite#)
BuildinglComplex Name: �L(�ST(ZC—A M IDrJD0.5 Description of TransmittaU List of Changes, Items Attached:
� � /�G W ��}TN 5 �
�Applicant Information �I
i(architect,contractor,ownerlowner's rep) 'U�=� �1 TC N E N
iContact Name: I�I J�II C�! �O,vSrQUCTI f)iJ �•E1� Y �"_"QS � I�11SC. T2�m
i Address fl �Y ����
�City V/�!L State: l�� Zip: g��OS
�ContaCt Name: ��}l�t� /!11 1�1 C�.(�. (use additional sheet if necessary)
Contact Phone: -1�� ��y— c��(D� Building Permits:
ca Kmi n i ck C�? �_h0�.�.'Dl�7 Revised ADDITIONAL Valuations(Labor 8�Materials)
',Contact E-Mail: (DO NOT include original valuation)
i
', I hereby acknowledge that I have read this application,filled out Building: $ ?�,S�Q
' in full the information required,completed an accurate plot plan,
; and state that all the information as required is correct. I agree to Plumbing: $�i .�.C�D
' comply with the information and plot plan,to comply with all Town /
ordinances and state laws, and to build this structure according Electrical: $ (p� 1 d�
to the town's zoning and subdivision codes, design review ap- �
; proved,International Building and Residential Codes and other Mechanical: $
; ordinances of the Town applicable thereto.
�X �F, �TACI-kE� Total: $a 50,g��
Owner/Owner's Representative Signature(Required) -- -------------------- -----�--- ------_--
Date Received:
p C� � I� I1M1�
For Oftice[]se Only: ��� � � ���
Fee Paid: �
Received From:
c�sn Check# TO W N OF VA I L
CC: Visa/MC Last 4 CC# exp.date:
Authorization#
�
Department of Community Development
75 South Frontage Road
TQWN OF VAIL '` vai�, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
BUILDING PERMIT APPLICATlON
(Separate applications are required for alarm & sprinkler)
Project Street Address: Project#:
i--���. u� Pa1Ft�'���)2 '�-- DRB#:
i(Number) (Street) (Suite#)
' / Building Permit#:
4 BuildinglComplex Name:�c_-�/S�� eGivi%G�
'Contractor Information Lot#: Block# Subdivision:
sBusiness Name: M.(n�Cf`C ���kt.�L.��LG- -----__.________--- ------- -----
�Work Class: New( ) Addition ( ) Alteration( )
Business Address: �L2 /�U)( L��/� 6
#.,�__._.__�._��.. ___��� �._.w_�..w.�,..�__ _�.�.H�,�,.�.a���.��.�__..�_ I
;City �/�¢-(� State:�_Zip: (S� Type of Building: � �
�T �Single-Family( ) Duplex( ) Multi-Famil ) ;
"Contact Name: ��-Uj[Z�/!�<<f� �Commercial( ) Other( )
-- -- -_- --- _._ ---�
�Contact Phone: Q�_ � L! ��� � _..__ _ __ _ . _,__ — _ ._
_.__ __. --------
/ _ ;Work Type: Interior ) Extenor( ) Both( ) ;
;Contact E-Mail: d /� (1�]In�Iti(C� i�/1�60 �LOYN � � 1
' — -- �_ �� -- _
� 7 � ____ __. --- __- ---- - ___—_ --- -- ---
I hereby acknowledge that I have read this application,filled out Valuation of�
` in full the information required,completed an accurate plot plan, � Work Included Plans Included Work �
i and state that all the information as required is correct. I agree to �Electncal OYes ONo OYes ONo �
comply with the information and plot plan,to comply with all Town
! ordinances and state laws, and to build this structure according to �Mechanical OYes ONo OYes ONo ;
� the town's zoning and subdivision codes, design review ap- p
:. proved, Intemational Building and Residential Codes and other �Plumbing (,�Yes ( )No ( )Yes ( )No �1'�`
i ordinances of the Town applicable thereto.
f Building ( )Yes ( )No ( )Yes ( )No �
x ____.� ���
'X �Value of all work being performed: $ J� �
�Owner ner's Repres tative Signature(Required) �(value based on IBC Section 109.3&IRC Section 108.3� �
; Electrical Square Footage
Applicant Information
---_ ____ _
Detailed Scope and Location of Work:
;Applicant Name: .d=�-l��Zl�/N l f l� ���o�in2_ �-L�C��b�.-—
i Applicant Phone: � - 1 � �/�� �,�7-��
, �
`Applicant E-MaiL• � /���C�C �_�(��-� j Jl/(��j/ �C � �-C ���y
i J
'Project Information _ � [: �P� �/C��i2 S l� �//S� I 2!�'1 '/,ivT�j�
(Owner Name: 611��2/ /�f�13�Cs _
�
;Parcel#: Z�I,���� (1 (9C3 �' ����t
',(For Parcel#,contact Eagle County Assessors O�ce at(970-328-8640 or visit
:www.eaglecounty.uslpatie)
___ .._.___._. .._._ __..__..___. ..__._�.__ . _._ _. ..__�.____ ...._ _ ... _ ' (use additional sheet if necessary)
_ _ _ __ _ _ _ _
For Office Use Only:
Fee Paid: Date Received: � � � � � �
Received From: D
Cash Check# S�D � 4 �012
CC: Visa/ MC Last 4 CC # exp date: �
Auth # �DiODRM
TQWN �F VAIL
15-Marv2012