HomeMy WebLinkAboutB15-0032 Welding Special Inspection transmittal.pdfDepartment of Community Development
75 South Frontage Road
Vail, CO 81657
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 $110 will be charged upon re issuance of the permit.
Application/Permit #(s) information applies
to: * BIS -oca2
·······-······· ····---------····----------·······-··-----------------------·----······· ....
•Project Street Address:
• 5c::f3 E.L1c>rYSbeqd CR-
•(Number) (Street)
Attention:
(Suite#) _
O Revisions O Response to Correction Letter
fiattached copy of correction letter
() Deferred Submittal O qther __________ _
•Building/Complex Name: 10vtl i Description of Transmittal/ List of Changes, Items Attached: • ,.
c.q?CC,cJ \Vefc:f111~ )IJ5pEt:JrVf1 i Applicant Information
; (architect, contractor, owner/owner's reij.) L -
•• A)leM~n Cm$Jl'Uc:n~ ; Contact Name: Lt::e-ALLE:""/YJAN
'Address: P 0, l3?£· =\OB 5
City GyfSc.tfV( state: CO Zip: Bf03 ~
l.E.C-ALL...Efi'JAAI ·.Contact Name: ------------------f (use additional sheet if necessary)
:: f
Contact Phone: 37@ --OB9D . Build;~~r;;;;;;: u um umm ••• mu mu umuuu -•
. . f 1·81..-1/\f""h/1 ) eD_ Jlf1"J ~/ f C"~evised ADDITIONAL Valuations (Labor & Materials)
Contact E-Ma1IQ __ __,_! ' 1~ _ '= ~ 'fJQI!!..!i_ ; ~((DO NOT include original valuation)
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, Int n tional Buildin and Residential Codes and other
ordinan t e To · able thereto.
Owner/
For Office Use Only:
Fee Paid:-------------------
Received From:-----------------
Cash---------Check# _______ _
CC: Visa / MC Last 4 CC # exp. date: ____ _
Authorization#-----------------
••Building:
•• Plumbing:
•• Electrical:
•• Mechanical:
;!
.·Total:
Date Received:
$ ________ _
$ ________ ~
$ ________ _
$ ________ _
$0
~([;~DWI~ n
JUL 2 1 2015 U
TOWN OF VAIL