HomeMy WebLinkAboutB16-0491.006_transmittal.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIL 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: 70\ b LAC\
CiRevisions (7 Response to Correction Letter _attached copy of correction letter
Deferred Submittal ('Other
Ppject Street Address:
Jb 2) &U'( - C' - Dg__ 4 t 1 Description of Transmittal/List of Changes, Items Attached,
Indicate changed plan pages:
(Number) (Street) A_ ' (Suite#)
v"
Building/Complex Name: ` v LSW�-� 1 `e4\SQ \
Applicant Information 9(a �S Q `' -}- 2— 0
(architect,contractor,owner/owner's rep) `�
Contact Name: D� •
Address:
City State: Zip: (use additional sheet if necessary)
Contact Name: r �_
Building Permits:
Contact Phone: Revised ADDITIONAL Valuations(Labor&Materials)
(DO NOT include original valuation)
I Contact E-Mail:
Building: $
j 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, and to build this structure according
to the town's zoning and subdivision codes, design review ap- Mechanical: $
'roved,International Building and Residential Codes and other
�'•.n� o the Town applicable thereto. Total: $ _
X
Own- /• er's epresentative Signature(Required)
Date Received:
21-Apr-2017