HomeMy WebLinkAboutB16-0490.010 transmittal.pdf Department of Community Development
Vi 75 South Frontage Road
TOWN OF VAIL a 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
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fee of$110 will be charged upon
on 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: ?-))(S 0 1-+R D
K)Revisions ( )Response to Correction Letter attached copy of correction letter
( 1 Deferred Submittal (:!)Other
Project Street Address:
3 Q-c CDC/-- \ 2� Description of Transmittal/List of Changes, Items Attached,
Indicate changed plan pages:
(Number) (Street) (Suite#)
Building/Complex Name: 9..c..0.0 \cc -S -S Pfac1.1-h()(\ co. ) 'PQ,-\-;o 40 ' )
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Applicant Information C` - C,01A ib l cK-K-
(architect,contractor,owner/owner's rep) �� "
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�2\1\SIGYIS --\-t SCR)-1-VN t( �
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e-Name: �,JP)()M iCcl.) � se-V\CAOS5t)"C:-Q_
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Address: (_,0/ Y0 �.Q�-1 a
City V AAL State: ( U Zip: T(LQ SSS (use additional sheet if necessary)
Contact Name:
1()_ 5- LO Building Permits:
Contact Phone: I () Revised ADDITIONAL Valuations(Labor&Materials)
(DO NOT include original valuation)
Contact E-Mail: *A (;)y 1/i1().S
Building: $_ '2_Z- ,,67-0
I hereby acknowledge that I have read this application,filled out
in full the information required,completed an accurate plot plan, Plumbing: $ 5, (J '7)
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: $ g0,6-(37)
ordinances and state laws, and to build this structure according
to the town's zoning and subdivision codes, design review ap- Mechanical: $
proved 1 ternational Building and Residential Codes and other
ordi .nc:s of the Town applicable thereto. Total: $ 5 0/ Zr-0 -
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Owner/Ow,-r'O/RepFesentative Signature(Required)
Date Received:
21-Apr-2017