HomeMy WebLinkAboutB17-0087.002 transmittal.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIt Vail, CO 81657
r�--11,,,,,�w� ! / Tel: 970.479.2139
laitm L ro : „Lev_S�lO w�.l f-f 1Je Pa( V �,p ywww.vailgov.com
TRANSMITTAL FORM , , Z0
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: f2j - 11" S
054 Revisions (5 Response to Correction Letter attached copy of correction letter
(17 Deferred Submittal ':Other
Project Street Address:
1YS�, �.✓F� tt- �� _`��, Description of Transmittal/List of Changes, Items Attached,
!1 Indicate changed plan pages:
(Number) (Street) (Suite#)
Building/Complex Name: WA A Aci' /isosioeJ # CCTV s
Applicant Information
(architect,contractor,owner/owner's rep)
Contact Name: 74(,(,44 Ar DAvis P{44..
Address: F. U. a $c ?j'9
City �s LE" State: GO Zip: $ (.3 / (use additional sheet if necessary)
Contact Name: $(Air S. TNM-MPSt —Th /C/'•
Building Permits: ;l
Contact Phone: q 1-0. Z G . Go'3 n f Revised ADDITIONAL Valuations(Labor&Materials)
(DO NOT include original valuation)
Contact E-Mail: e:t
Building: $
I hereby acknowledge that I have read this application,filled out
in full the information required,completed an accurate plot plan, Plumbing: $ C
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: $ 0
ordinances and state laws, and to build this structure according
to the town's zoning and subdivision codes, design review ap- Mechanical: $ G
proved,International Building and Residential Codes and other
ordinances of the Town applicable thereto. Total: $
X
Owner Owner's Representative Signature (Required)
Date Received:
21-Apr-2017