HomeMy WebLinkAboutB16-0199_Tr_770 PPD_1478897907.pdfTRANSMITTAL 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
( ) Revisions
( ) Response to Correction Letter
______________________________________________________________ ___attached copy of correction letter
____________________________________ __________________________ ( ) 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:
Cash _____ ____ Check # __ _ _______
CC: Visa / MC Last 4 CC # exp. date:
Applicant Information
(architect, contractor, owner/owners rep)
Contact Name: ________________________________________
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/Owners Representative Signature (Required)
B16-0199
770 Potato Patch Dr. uNIT 13
Ed Venerable
6464 S. Quebec St #400
Centennial CO 80111
Ed Venerable
303-525-7775
ed@paragonhomesdenver.com
Revised drawings per Building official comments
DRAWING LIST:
A1.1, A2.1, A3.1. M0.0, M1.0, M2.1H, M2.1P
0
06/28/16