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HomeMy WebLinkAboutB12-0245 transmittal and special inspections report Department of Community Development 75 South Frontage Road TOWN OF VAII } va�i, co s�ss7 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. ApplicationlPermit#(s) information applies to: Attention: ( ) Revisions L ,� � ( ) Response to Correction Letter I� l�-- � Q �-'t �:� attached copy of correction letter � I; O � ( ) Deferred Submittal ��- �- - �� (�Other �i�L. I�SP�:�,T/O�f I�l�02T Project Street Address: 1 q >�i-r�-�. c�JL r��� (Number) (Street) (Suite#) Building/Complex Name: Description of Transmittal/List of Changes, Items Attached: Applicant_Information ` Nl�� ��,��0/Z-� Q� S��IA-� (architect,contractor,owner/owner's rep) iLGS��-C�T7 OU. � � Contact Name: (�r--/�1Z� l� l L_L_. Address: '1�Q QeO,�� � �`� City �,n(,�Jh�'�-��� State: C.Q Zip: � �� ��� Contact Name: G (use additional sheet if necessary) Contact Phone: �1� � ��� 3`� � � Building Permits: � ��� � G�,.���� evised ADDITIONAL Valuations (Labor&Materials) Contact E-Mail: �r-'f�1�,� � T�=(.-��r�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 the� cable thereto. X Total: $ � Owner/Owner's Representative Signature (Required) Date Received: 1 �� � � �3 For Office Use Only: � v � � " � Fee Paid: D Received From: ;_��;�' (�,�'j ��'�� Cash Check# CC: Visa/MC Last 4 CC# exp.date: Authorization# TOWN OF VAIL � . TOWN OF VAI�� ' FINAL REPORT OF SPECIAL INSPECTIONS Project: 1_�.�l�Q �� i�-�'�� (.�l�C� Permit Number: �� � ���� Project Location: �(o�� �GC k.(' (��'CG�� �U�.. �c�.�f �`c�/'G c�.� Owner/Address t7�CU, �F`�'t-�IkI� ('�����.'`.1�� City: ��k l r-- Zip: �j%(l s�i Design Professional In Charge:I��..t� (�� q �G� Address: IT� �c.°�TC,UI'� � �-�j D Z,D �r�u✓rf-�! � �� t� ��f� c�ty: G—i�v����ol 5,�r��, � State: � Zip: � Phone:R 7��1�`J 7��� Fax: �?� ��5���'�J�- E-mail: �C,calC � I,f�/'i Pt7�`�eG� � �9 m To the best of my information, knowledge, and belief, the special inspections and/or testing required for this project, have been completed in accordance with the contract documents. Interim reports submitted prior to this Final Report of Special Inspections form a basis for, and are to be considered an integral part of this final report. Any discrepancies that were noted in all interim reports have been corrected. �urc�I.��`v L�XGa (�Q �`c�✓1 �j,�,�2 ' �- r�-- �� �� � �. �` ���m-�' o ► ����� �..��M,-„;����,- Prepared by: � ,���. .�,6����,�f:�.���- .� �, .ti ,�;, .�� �. , �.�f..v � �� �`''� .,�=' �. Lt 1/� , �y`o .�,..� Type or P t Name ' e `- � � �s M �a :• .� ��a'��7 m� '° ���,� �2.�� �,�°���� ignature �'',p��k'��.'�;�,o ��'s�`� j�.- � - l ���,ar����g����,� Date Preparer's Seal and Signature Required D � � � 0 � � ��� ��� �o�� �owN �� v��� � � TOWN OF VAI� ' FINAL REPORT OF SPECIAL INSPECTIONS Project: l�c,t_Q.�1v�q P'� t�-�c"�'9� ��C..�... Permit Number: �1��=(���� Project Location: �(�1� �t1,� �1,(" ��'�G.�� �pR�, �c.,;� , �i'jlt9 r� �,� Owner/Address �7(�(�. I�:F-�-�Ik� ��P���1Z.1Z�, City: ��l �.- Zip: �%(��_ Design Professional In Charge: t A,.t t �Gr Address: _ �"� Gc°OTC�� f �D Z D ����,�,�—s./ �47Cc [y. ���� City: �IGvLt,�oc�ol.- S A�t� g State: � Zip: g1�� Phone:�7fl�/�`J 7��Y� Fax: g?� ��5���4J� E-mail: .tf C�v� . To the best of my information, knowledge, and belief, the special inspections and/or testing required for this project, have been completed in accordance with the contract documents. Interim reparts submitted prior to this Final Report of Speciat Inspections form a basis for, and are to be considered an integral part of this final report. Any discrepancies that were noted in all interim reports have been corrected. ��c.✓cos-��`v L XGa V'GJ �7`c�✓1 ��� , ��- I���c��-- �,( � , . �, � D y ��,� �:� �� � ��. � ���w:�s� �9•. Prepared by: � ,�t�• �, ,�,,,��"?�".��� . � �'`�:��. C�C,.�I l, t�t v� <�g �,: 4 n�}i . ' Type or P t Name � -r p ��' c �,s . � �.� �bt���� m� ., � ���� ignature r�,�ti� 2�� ,..��rw``'�. ������������,�� 1�— � ' � "�°¢�s�oo���a��� Date Preparer's Seal and Signature Required p � � � o � � ��C' 0 5 �013 TOWN OF VAIL