HomeMy WebLinkAboutE16-0242.001 transmittal.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAl1 A " Vail, CO 81657
•6 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 s to Community De.: ..-
Sent or upload your revised/corrected plans to the appropriate project i rojectDox,when requeste.
Application/Permit#(s)information applies to: . OAgoi / 6 --) (l(
( Revisions ( ) Response to Correc' Letter atta •-• copy of correction letter
O Deferred Submittal ( )Other
Project Street Address.
�s'if P � �r _ ,� Description geed plan
List of Changes, Items Attached,
�46� ' Indicate changed plan •ages:
(Number) (Street (Suite#) ,r ,4 ��% ,O _/,�pe,,r ,e 4� ,W
Building/Complex Name: "pa, l ./���4t.(�,e�t�'1`� / )1 !/ �. �. �. � .. . 2"
s ,
-eel.1 Oce,, A(J AY ,�>�C 140-61 ,u� �%
Applicant Information /1/) 1 ��j (4CA/ACa . `
/, ' til. l
,.., A ' I. .. . ..al Ill— A '..,....'.-:.. ///de //
(architect, contractor,owner/oner's rep) % '
!, -c. f�-. _ / . .. ' 4., . ..#. . ii 1.4.nI'.
Contact Name: c3D ; h �frj 117`'4
Address: r' gc 757145-
4 ice% ,,�
City ..� State: (", Zip: ��� 0 (use adds ional�heet if necessary) / 0
Contact Name:
Building Permits:
Contact Phone: 77/C))Y --45-g/ . 5. Revised ADDITIONAL Valuations (Labor&Materials)
(DO NOT include original valuation)
Contact E-Mail:
Building: z\
I hereby acknowledge that I have read this application,filled out V
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:----41r-r'
ordinances and state laws, and to build this structure according
to the town's zoning and subdivision codes, design review ap- Mechanical: ', •r !/
proved, International Building and Residential Codes and other
ordinances of the Town applicable thereto. Total: $ '_ -
X I
Owner/Owner's Representative Signature(Required) l
Date Received: iJO � �� ffL
21-Apr-2017