HomeMy WebLinkAboutB12-0486 REV3 MECHANICAL TRANSMITTALrnWs of VAIL
Department of Community Development
75 South Frontage Road
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.
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Application /Permit #(s) information applies
to: Attention: Revisions
Response to Correction Letter
El _attached copy of correction letter
Deferred ubmittal r
()Other �EC�1 uC=cZ
Project Street Adddr ss:
�/L1�1 /Xll�- Q/l2 C,GL
(Number) (Street) ite #) -
Building /Complex Name: ti' -z'd a Description f Transmittal/ List of Changes, Item Attached:
Applicant Information
(architect, contractor, owner /owner's rep)
Contact Name: /��l
Address:: J 2 -7, 4v
City L �/ State: ) Zip:
Contact Name: ��C`�l° G (use addition,
sheet if necessary)
Contact Phone: d Building Permits:
Revised ADDITIONAL Valuations (Labor & Materials)
Contact E -Mail: t .(DO NOT include original valuation) __4
I hereby acknowledge that I h e read this application, filled out Building:
in full the information required, completed an accurate plot plan,
and state that all the information as required is correct. I agree to Plumbing:
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according Electrical:
to the town's zoning and subdivision codes, design review ap-
proved, Inte national Building and Residential Codes and other Mechanical:
ordinances f the,T n ap-able thereto.
Tota I:
Owner /Ownbr's Represen ?tive Signature (Required)
For Office Use Only:
Fee Paid:
Received From:
Cash
CC: Visa/ MC Last 4 CC #
Authorization #
Check #
exp. date:
Date Received:
$0
D
OCT 2 2 2012
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TOWN OF VAIL