HomeMy WebLinkAboutB17-0193.001 REV1 TransmittalTOWN Of® Department of Community Development
75 South Frontage Road
Vail, CO 81657
Tel: 970.479.2139
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: 611 · 11 ~ • 00 I
~evisions f) Response to Correction Letter _attached copy of correction letter
fl Deferred Submittal f) Other __________ _
Project Street Address: ·3cr1--b L v e·, c" SJ .... ·, ve
(Number) (Street) (Suite#)
Building/Complex Name:-------------
Applicant Information
(architect, contractor, owner/owner's rep)
Contact Name: l ~ p 0 £ 01'\ k. ( c,
Address: $"(2 }-C:, S \i t(l lo (,\-
City c(.,/\\e,f"'l'\C\I State: \0 Zip: Koo\)
Contact Name: -----------------
Contact Phone: q '\-o -~ GI ·-t> o :t<>
Contact E-Mail: C.\SC Q 9\1"'.J <8\°f'C!i\. to'""'
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, I ernational Building and Residential Codes and other
ordinan s of the Town applicable thereto.
X.~~,1--...,,,..-~~~~~~~~~~
epresentative Signature (Required)
Description of Transmittal/ List of Changes, Items Attached,
Indicate changed plan pages:
f o 1/ f'.?. ~ c\ 0... h6 <se , b "' Q \ vw-\frr'-j f-11,..
·-: -. ' ,. 0. vr,..,"' ....._ "'J. f-Q,.,. nev \ e-..,..
( se additional sheet if necessary)
Building Permits:
Revised ADDITIONAL Valuations (Labor & Materials)
(DO NOT include original valuation)
Building:
Plumbing:
Electrical:
Mechanical:
Total:
Date Received:
$
$ -JtStrr .. ,n~~
$
$ lb, 'g(J(J
$ It; ~f1.a. '
RECEIVED
SEP 21 2017
Town of Vail
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21-Apr-2017