HomeMy WebLinkAboutB12-0484 REV4 TRANSMITTALTO�IN OF UAI[�����
DeparEmeni of Community Development
75 South Frontage Road
Vail, CO 81657
Tei : 970-479-2128
- .-__..' ' --- www.vailgov_com
:��`�` vDevelopment Review Coordinator
TRANS�f!lTT�L ��R�/I
Revision Submittals:
1. "Field SeY' 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.
Permit #(s) information applies to: Attention: ( evisions
� ( ) Response to Correction Letter
��'`� - �Z - d�-{ $ L� attached copy of correction letter
( ) Deferred Submittal
( ) Other
Project Street Address:
�li� S �fi'/L� �i��s� �
(Number) (Street) (Suite #)
Building/Complex Name: ��,�,q� w�✓ �
�u�G�•!� i Description / List of Changes:
Contractor Information
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Business Name: �I� Cpnlj��w••�i•.J I��2br_d� � �.[��/1.�.,r r..� ,���! r�r�e�
BusinessAddress: �0 . �O� Z�D 2 � �T—��������G ���/��
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City ���� f State: �_ Zip: -��%(�J � �
Contact Name: �/1�,�.,G� 0 £ _ �
Contact Phone: Z� � oZ 3� ��yy 1� �(use additional sheet if necessary)
Contact E-MaiL ���(,�,�j��0 L. Cd M Revised ADDITIONAL Valuations (Labor & Materials)
i(DO NOT include original valuation)
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 informafion 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, Intemational Building and Residential Codes and other
ordinances of the Town applicable thereto.
x� � ,��_4�___
Owner/Owner's Representati�Signature (Required)
Applicant Information
Building:
Plumbing:
Electrical:
$
$
$
�-
l—
GD
Mechanical: $ ��� /� �
�
Total: $ L1000 �
Applicant Name: S�Q , L,������ (u �G.,� Date Received:
Applicant Phone: f %O - � IrD - /,�(i (7
Applicant E-Mail: s/LC,f'�,�, �, (� �plriG�s-/T n/ C�/i
For Office Use Only:
Fee Paid:
Received From:
Cash Check #
CC: Visa / MC Last 4 CC # exp. date:
Auth #
�l� �� '�' I'_I,'� `�i
JAN 1; 2013