HomeMy WebLinkAboutB15-0057 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: Attention: O Revisions •
O Response to Correction Letter . M t\iXlN • il_attached copy of correction letter • 0 Deferred Submittal ·
,;QOther s 12.D fA.iP:f INSfKnoN
. . . . .. ............. ... .. ............. . . . ........... ru..£0.Q.n . mCL Yol.vt· .. .
Project Street Address:
\'3.>35 WGssnW&~ Ci(LCLG-__ _
(Number) (Street) (Suite#)
Building/Complex Name: _l"'--~-'--_\J_G.;;_-_'1-'----------
Applicant Information
(archite~wner/owner's rep)
Contact Name: t:Nv\ON ~ KOON~:~·\
Address:------------------
City _________ State: ___ Zip:-----
Contact Name: -----------------
Contact Phone: q 3--o 3 "":\--~ L\-'3 ~ S
Contact E-Mail: 6A-Ko...W <? ~Gti<.. f?:.U. ( <J)S. C.Civ-1
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 sub tvis n codes, design review ap-
proved, In rnational Buildin and !Residential Codes and other
ordinanc s of the Town appli ble thereto.
X.~--4-~~-------.--~~~~
(Required)
For Office Use Only:
Fee Paid:------------------
Received From:----------------
Cash _________ Check# _______ _
CC: Visa / MC Last 4 CC # exp. date: ____ _
Authorization # ----------------
Vl-G-c () R__ ') jl
Description of Transmittal/ List of Changes, Items Attached:
\<..C-f o r'L~ ~'{(__ \ 1'l S.f 0-LIIDN S
(use additional sheet if necesspry)
Building Permits:
Revised ADDITIONAL Valuations (Labor & Materials)
(DO NOT include original valuation)
Building: $
Plumbing: $
Electrical: $
Mechanical: $
Total: $0
~CG~~W~ n
JUL 2 7 2015 LJ
TOWN OF VAIL