HomeMy WebLinkAboutB17-0432.001_transmittal.pdf i
((6;):
Department of Community Development
75 South Frontage Road
Vail, CO 81657
TOWN OF VAIL 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: I - t1 3.
V"Revisions (H )Response to Correction Letter _attached copy of correction letter
Deferred Submittal (, 1 Other
Project Street Address:
ri 2S Cv,r 1,/ e CL ip5 Description of Transmittal/List of Changes, Items Attached,
Indicate changed plan pages:
(Number) (Street) ` I �r (Suite#)
V
Building/Complex Name: 4'i1t`Gdt,r(AAKrjc 16Jc400 42e4344 (qj(L ottf.,
Applicant Information
(architec contractor wner/owner's rep)
JContact Name: Q 4-1.4.4 A Vit.
Address: F.10'i--10.7 0o�+
City C-JWFRIIC i CQ State: L' Zip: (phi z (use additional sheet if necessary)
Contact Name: JOH-A/ (..4 e-4
6r70 -/ii ( `17,O Building Permits:
Contact Phone: `1 Revised ADDITIONAL Valuations(Labor&Materials)
r_ ], (DO NOT include original valuation)
Contact E-Mail: J 4C.r/k( Y4 ifefe*wear f i 11"."-
.1 Building: $ 2 Dc)11„ 6,0
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 th,e Town applicable thereto. Total: $ '?• + ''a
x _ `".
Owner/Owns.s --presentative Signature(Required)
; •
Date Received:
21-Apr-2017