HomeMy WebLinkAboutB14-0215 Rev1 TransmittalTRANSMITTAL FORM
Project Street Address:
__________ ______________________________ ___________
(Number) (Street) (Suite #)
Building/Complex Name: ________________________________
Building Permits:
Revised ADDITIONAL Valuations (Labor & Materials)
(DO NOT include original valuation)
Building: $_____________________
Plumbing: $_____________________
Electrical: $_____________________
Mechanical: $_____________________
Total: $_____________________
Description of Transmittal/ List of Changes, Items Attached:
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
(use additional sheet if necessary)
Application/Permit #(s) information applies
to: Attention: ( ) Revisions
( ) Response to Correction Letter
____________________________________ __________________________ ___attached copy of correction letter
( ) Deferred Submittal
____________________________________ __________________________ ( ) Other
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.
Date Received:
Department of Community Development
75 South Frontage Road
Vail, CO 81657
Tel: 970.479.2128
www.vailgov.com
Development Review Coordinator
For Office Use Only:
Fee Paid:
Received From:
Cash _____ ____ Check # __ _ _______
CC: Visa / MC Last 4 CC # exp. date:
Authorization #
Applicant Information
(architect, contractor, owner/owner’s rep)
Contact Name: ________________________________________
Address:
City _____________________ State: _______ Zip: ____________
Contact Name: _________________________________________
Contact Phone: _________________________________________
Contact E-Mail: _________________________________________
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 information 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, International Building and Residential Codes and other
ordinances of the Town applicable thereto.
X___________________________________________________
Owner/Owner’s Representative Signature (Required)
B14-0215
1034 Homestake Circle
Wayne Haskins Construction-Debbie Gowie
PO Box 1913
Eagle Co 81631
Debbie Gowie
970-390-7532
debbie@waynehaskinsconstruction.com
Debbie Gowie
Move electrical switches for garage entry.
Install new fixture at above cabinet lighting
300.00
300