HomeMy WebLinkAboutWallace_transmittal_3 6 18.pdf 144 Department of Community Development
75 South Frontage Road
TOWN OF VAIL Vail, CO 81657
Tel: 970.479.2139
www.vailgov.com
TRANSMITTAL FORM S . Co. p.o/s
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$110 will be charged upon reissuance of the permit.
Submit this form only to: cdev_submittal@vailgov.com. Deliver paper plans to Community Develop-
ment or upload your revised/corrected plans to the appropriate project in ProjectDox,when requested.
Application/Permit#(s) information applies to: l I - 00 81. 141-g tj JeFt-ii )-J 1 -, t2o,
FT Revisions (r l Response to Correction Letter _attached copy of correction letter
Deferred Submittal C1'Other CANe4 aL 4 Oa.TIM 55TTLt�egti
Project Street Address:
148* ��f FPi�F^l/L � _,� O p Description of Transmittal/List of Changes, Items Attached,
Indicate changed plan pages:
(Number) (Street) (Suite#)
Building/Complex Name: Wa,VLp c. (2eCt o GC.3h4$d Ll ISA-rrIED
; 2`i ). 3 t. SRYLu c v-t.✓i.a.LS
Applicant Information
(architect,contractor,owner/owner's rep)
Contact Name: AL44.- A- ')Q.1/:S la`t A
Address: ( ldr3 GA.P t rt,t.. Sr $T• 'Lt
(use additional sheet if necessary)
City 1E-A t State: W Zip: g (to"i I
Contact Name:
Building Permits:
Contact Phone: C; , 20't . 6?s a +. Revised ADDITIONAL Valuations (Labor&Materials)
(DO NOT include original valuation)
Contact E-Mail: (,L t t Ci 4 S STA I A. . C-.41Nenek
Building: $
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: $
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