HomeMy WebLinkAboutB17-0024.002 Approval.pdf 1
1317 - 002 , 002
Department of CommunityDevelopment
75 South Frontage Road
TOWN OF VA1L$ pVail, CO 81657
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Tel:970.4779.2139
www.vailgov.com
TRANSMITTAL FORM
Use this form when submitting additional information, changes&inspection reports for 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.
Submit this form only to:cdev_submittal@vailgov.com. Deliver paper plans to Community Develop-
ment or upload your revised/corrected plans to the appropriate project in ProjectDox,when requested.
Application/Permit#(s)information applies to: 1?-/7. O
DS qW
( ) Revisions ( ) Response to Correction Letter attached copy of correction letter
O Deferred Submittal (74)-Other j7 i. CD✓Z"YGQ ��. ,,rOy•-
Project Street Address:
2C ) ^! Pr . Description of Transmittal/List of Changes, Items Attached,
�J f"I' _ Indicate changed plan pages:
(Number) (Street) (Suite#) / // /
Building/Complex Name: �.-r51_ Ft�l;/( Q-cp1 tc.G 4.44,,-, ?reK_ iST
/ 1 / ie.,: . l u / -1
Applicant Information -- p j( a1-' f /C.17 gr. /ro,„
(architect, contractor, owner/owner's rep) -�
Contact Name: ?-7)4,1 K/.A.. :5- ^/ / O CI
Address: 75 .5-0,1-1-, .0.,,,,‘,75c.._ ?p W .1--
City ()G0State:
c-v Zip: .j65. ' (use additional sheet if necessary)
Contact Name: ;4.-1 iir
si-
Building Permits:
Contact Phone: '.20 3 7' - oc7 y9' Revised ADDITIONAL Valuations(Labor&Materials)
� / (DO NOT include original valuation)
Contact E-Mail: �,/`' k vot / o✓ - Co '✓\ c47
Building: $ s 0 00
I hereby acknowledge that I have read this application,filled out
in full the information required,completed an accurate plot plan, Plumbing: $
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: $
ordinances and state laws,�,%d to buil. r: structure according
to the town's zoning and,/.divisio. o• -s, design review ap- Mechanical: $
proved, International B ' sing and,.- - la .des and other
ordinances of theT.,," applicable ereto. Total: $
Owner/Owner's R:.* - . rye Signature(Required)
;6<<jl1 1 Of p g+ �1� .t ®DE RECEIVED
1_:E.0\imIEp!�'� �� MAY 25 2017
Date..__._ __
Town of Vail
By: __--- •-- - .
a 6 :mace: _s-._m--__--
'33 � ,()'8 21-Apr-2017