HomeMy WebLinkAboutB16-0490 REV5 Transmittal.pdf Department of Community Development
75 South Frontage Road
TOWN OF w 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: ) Lo 0419 D
4 Revisions di:Response to Correction Letter _attached copy of correction letter
(17 Deferred Submittal a/Other -Drat-A spirch4 r L.. e!a.V'
4
Project Street Address:
30-3 (N'-c__ C r c i-7) rc, ! Z Description of Transmittal/List of Changes, Items Attached,
Indicate changed plan pages:
(Number) (Street) _ (Suite#)
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Building/Complex Name: tiW im- S P r1'(yv2kr— dra rl �' foo
dr& 11S -1>tSala ry_ f- (c,✓t
Applicant Information
(architect,contractor,owner/owner's rep)
Contact Name: 1:3U$1141,Itt A SSa
Address:
Ci State: Zip: (use additional sheet if necessary)
ty
Contact Name: Set -G
Building Permits:
Contact Phone: /70 /4,35 rj' Revised ADDITIONAL Valuations(Labor&Materials)
(DO NOT include original valuation)
Contact E-Mail:
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
or.Hance e th- Town applicable thereto. Total: $
X
Owner/�� , •- -pr::entative Signature(Required)
Date Received:
21-Apr-2017