HomeMy WebLinkAboutNew Contractor transmittal.pdf Department of Community Development
75 South Frontage Road
���WN � �°��� 2L)'JMTel: 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: ij f g -o2q
IVRevisions ( ) Response to Correction Letter attached copy of correction letter
( ) Deferred Submittal ( ) Other
Project Street Address:
so
$
CL:101ASIN__Er21__CLCAtig aac Description of Transmittal/List of Changes, Items Attached,
Indicate changed plan pages:
(Number) (Street) p�J(Suite#)
Building/Complex Name:
\10" iD C \ (� ��S h bak\A Y00 4 S
Se_e g i-fQC h /nC i •
Applicant Information
foes — 3
(architect,contractor,owner/owner's rep)
I Contact Name: 1 �hc�\--kJIU rpt b. 2Lever v-tt,1 Y1.5 12--(i 1 lite, 2
Address: P.)_ 8d cq 3 I .'..L{4ih
City lam) QS J v1/4A. State: Zip: et6,-7- (use additional sheet if necessary)
Contact Name: ►L, Tap sti`t'
Building Permits:
Contact Phone: 99-0 39-e- -9--(1 - Revised ADDITIONAL Valuations(Labor&Materials)
(DO NOT include original valuation)
Contact E-Mail: -{�r\? P
Building:Ph.�® t � 'w�J1-yowl g� $ �G(?�
I hereby acknowledge that I ave read this 4115lication,filled out
in full the information required,completed an accurate plot plan, Plumbing: $ 5 ono)
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 T wn applicable thereto. Total: $ t
Owner/Owner's Representative Signature(Required)
Date Received- '? f+ a} ,_;
•is
21-Apr-2017