HomeMy WebLinkAboutB13-0485 transmittal ` Department of Cam�nunity Qeaelopment
75 South Frontage Road
TOW'� OF �'AIL � � ����, co$�s�7
Tel: 9��.479.2128
www.vai Igou.com
Development Re�iew Goordinatar
TRA�JSMITTAL F�RM
lJse Ehis form when submitting addition�l information far pfanning apPlications or building perrnits.
7his fprr�t is also used for requesting a re�ision ta building permEts. A twa hour minimum building reuiew
fee of$110 will be charged�pon reiss�ance of the permit.
ApplicationlPermit#(s�information ap�lies
tp; Artention: �Revisions
$'E 3-04$5 Q Response ta Carrection Letter
�attached copy of correction le#ter
Q Deferred Submiftal
�Other
Project Street Address:
1330 Sandstone Drive 5
(Number} (5treet} (Suite#}
BuildinglComplex Name: Q��fI00k �Val! Descrip#ion of Transmittaif List of Changes, Items Attached:
toad calcs for ekectrical wark
Applicant Information
Addition�i �aivatiions f�r mecha�ical
{architect,contraator,awnerlowner's repJ
Contact Name: �� LLC
Bath f�n valuations are included in the electrical
Address: P•�.BOx 8812
City Avon Siate: C� Zip: $�62f}
Carr#act Name: �-affy Bi'ii#
(use additiona3 sheet if necessary)
Contact Phone: ��0-376-4301
Buiiding Rermits:
la� traraswestconstructi�an.cc�m Revised A�DITIONAL Valuations(�.abor 8�Materials)
Cantact E-Nlail: rY� (DO N�T include orig9nal valuatio�)
I hereby acknowledge that I ha��read this appiication,fi�fed out Builciing: $
in f�ll#he information required,completed an accurate plot plarr,
ar�d s#ate tF�at all the infarmation as requir�d is correct. I agree to Plumtaing: $
comply with the informakion and�fot plan,to corr�ply widh all Town
ordinances and s#ate laws, an�l to build this structure according ���ctrical: $
to the town's zor�ing and subdivision codes, cfesign review ap-
proved, Intemational Builcfing and ResidentiaE CodES and cather ��chanicaL �520b_OQ
orcfinanc�s of tf�e Town ap�licable thereto.
� � �� - _ -rotai; $�ZOO.00
� ..:. _
��' � ° � __
C}wnerl�wner's Representati�e Signature(Required}
Qate Received:
F'or Office Use Onlv:
Fee Paid:
Received From:
Cash Ch�ck#
CC: Visa/MC Last 4 CC# exp. date:
Authorizatiorr#