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Home My WebLink AboutB12-0365 CR1 TransmittalTransmittal Form 061912 TRANSMITTAL FORM Project Street Address: __________ ______________________________ ___________ (Number) (Street) (Suite #) Building/Complex Name: ________________________________ Building Permits: Revised ADDITIONAL Valuations (Labor & Materials) (DO NOT include original valuation) Building: $_____________________ Plumbing: $_____________________ Electrical: $_____________________ Mechanical: $_____________________ Total: $_____________________ Description of Transmittal/List of Changes, Items Attached: __________________________________________________ _______________________ ___________________________ __________________________________________________ __________________________________________________ __________________________________________________ __________________ ________________________________ (use additional sheet if necessary) Application/Permit #(s) information applies to: Attention: ( ) Revisions ( ) Response to Correction Letter _______________________ _____________ __________________________ ___attached copy of correction letter ( ) Deferred Submittal ____________________________________ __________________________ ( ) Other 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. Date Received: 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: Authorization # Applicant Information (architect, contractor, owner/owners rep) Contact Name: ________________________________________ 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 approved, International Building and Residential Codes and other ordinances of the Town applicable thereto. X___________________________________________________ Owner/Owners Representative Signature (Required) B12-365 David Rhoades 660 W. Lions Head Pl. Lions Square Lodge David Woycio 4060 S. Clay St. Englewood CO 80110 Metro Solar Inc 303-782-9099 dave@metro-solar.com David G. Woyciuo See attached revised dwgs. and narrative 0 RECEIVED 09/04/12 9:40AM