HomeMy WebLinkAboutB13-0239 REV1 TRANSMITTAL Department of Community Development
0 75 South Frontage Road
TOWN OF VAIL 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
3 . O cQ 3 e v,:;� Be—JD4 _attached copy of correction letter
pn z O 2 ^ D � Deferred Submittal
/� J / (O O Other
Project Street Address:
5/VS RCLC
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached:
Applicant.Information
, 95% gFFIGC—ir LAuK 8I y
(architect, contractor, owner/owner's rep) ' �GE FU2t)ACE 025r,4I K S I�ND D�t1
Contact Name: �f}KE tye)n l�s PLum,81,uq LAC Two Taq 4R)ai; _ SP n 1 o c&g
Address: I R�� jd�, �7]7d /ZIJE uflcr- Lnum Tw1R5„ 'RENnOK I o Exasrmjq
City 1A)gEg r I d 4 E State:—C zip: SDD33
Contact Name: _Kim BASy f}RR (use additional sheet if necessary)
Contact Phone: 30 " a 33 — 00 Building Permits:
I1 Revised ADDITIONAL Valuations (Labor& Materials)
Contact E-Mail: i m� QK2�( /�641 hinq. 1'01" (DO NOT include original valuation)
I hereby acknowledge that I have 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, International Building and Residential Codes and other Mechanical: $
ordinances of the Town applicable thereto.
X � 6=gCNE,f1) Aqq� Total: $
Owner/Owner's Representative Signature (Required)
Date Received:
For Office Use Only: 0
Fee Paid: JUL 2 5 2013
Received From:
Cash Check#
CC: Visa/VIC Last 4 CC# exp.date: TOWN OF VAIL
Authorization #
Department of Community Development
0 75 South Frontage Road
TOWN OF VAIL Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
(Separate applications are required for alarm & sprinkler)
Project Street Address:
r [Building,oject#:
(Number) (Street) ,�( (Suite#) RB#:
Building/Complex Name: y Permit#:
Contractor Information Lot#: Block# Subdivision:
Business Name: 6V_,0IJVWW
/' 11
a
Business Address: 10-0 r y 1 Work Class: New o, Additi9n Alterat°n (0
r P
City State:� Zip: )0�.!� TYPe of Building:
Contact Name:
4 6 Q. Single-Family Qj Duplex M Multi-Family
-? � Commercial G Other
Contact Phone: ���-�p��5
Contact E-Mail: (~ l r Work Type: Interior O Exterior Q Both Q
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
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 Electrical Yes t(DNo QYes ONo
ordinances and state laws, and to build this structure according to Mechanical Yes O)No QYes QNo
the town's zonin an ision codes, design review ap-
pr na Iona Building an des and other Plumbing Yes OjNo QYes ONo
dinar ces f the Town applicable thereto.
Building QYes ONo QYes QNo
X /I I _ r
Value of all work being performed: $ } --
Owner/ wner s e-presentative Signature (Required) (value based on IBC Section 109.3&IRC Section 108.3)
Electrical Square Footage
Applicant Information
�! Detailed Scope and Location of Work:Sao T
Applicant Name:
f
Kzle
16
Applicant Phone: 6�_ _� G
Applicant E-Mail:
Project Information el'
Owner Name: (,t f r
Parcel #:
(For Parcel#,contact Eagle County As essors office at(970-328-8640 or visi
www.eaglecounty.us/patie)
(use additional sheet if necessary)
For Office Use Only
Fee Paid: Date Received:
Received From:
Cash Check # RECEIVED
CC: Visa / MC Last 4 CC # exp date:
Auth # By Shelley Bellm at 4:45 pm, Jul 25, 2013
12-Mar-2012