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HomeMy WebLinkAboutApplication.pdfzed' cra►7.4 72ty 108 8r" Street, Suite 401, Glenwood Springs, CO 81601 Ph :970 -945 -8212 Ex :970 -384 -3440 inspection Line :888 -868 -5306 www.garfield-county.com BUILDING PERMIT APPLICATION RECEIVED FEB 2'9013 GARFIELD COUNTY )MMUNITY DEVELOPMENT I Parcel No: (this information is available as the assessors office 970.9- 15- 9i3-d) Lot No: Block No: Subd./ Exemption: 2 Job Address: (i an address has nor been assigner,, please provide CR, HWY or Street Warne it City) or and legal description S f l0 ICJ) 3 Owner: (property owner) Mailing Address: , (,r0,�4 te9`7[ F. / - 0\14,/,e. co goct` Ph: All Ph: 4 Contractor: 'ED 51- ` r-.0.--)17 Mailing Address � & 9 r...<4- 4ytk Z.CIr C© �6z Ph: q70- 9/B3-2e©( Alt Pb: ,6,25:615/05-- �� ,o. 5 Manufactured home install r: Mating Address: Ph: Lie #: 6 Architect: Mailing Address: Ph: Alt Ph: 7 Engineer: Mailing Address: Ph: Alt Ph: 8 Sq. Ft. of Building: Sq. Ft. or Acres of Lot: Height: No. ol` Floors: / 9 Use of Building Residential ❑Commercial DOther Class of Work: . ❑New Alteration ❑Addition DRepair ❑Demo DMove 10 Describe Work: j r f �^ r '�' rcid0CI -LC tI �O76r j1t /n !e raj- Wi`t �— (- (,Q& P{?? - 'Fall ,� I l Garage: 1 [Attached ❑Detached Septic: DISDS DCommunity Type of Heat:. ❑Nat. Gas ❑Propane ❑Electric DOther 12 Driveway Permit :} 14 Owners valuation of Work: �� r NOTICE Authority. This application for a Building Permit most be signed by the Owner of the property, described above, or an authorized agent. If the signature below is not that of the Owner, a separate letter of authority, signed by the Owner, must be provided with this Application_ Leeal Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for purposes of inspections by the Building Department. Other Permits. Multiple separate permits may be required: ( I) State Electrical Permit, (2) County ISDS Permit, (3) another permit required for use on the property identified above, e.g. State or County Highway/ Road Access or a State Wastewater Discharge Permit. Void Permit A Building Permit becomes null and void if the work authorized is not commenced within 180 days of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement. CERTIFICATION I hereby certify that i have read this Application and that the information contained above is true and correct. I understand that the Building Department accepts the Application, along with the plans and specifications and other data submitted by me or on my behalf(submittals), based upon my certification as to accuracy. Assuming completeness of the submittals and approval of this Application, a Building Perrot will be issued granting permission to me. as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by the Building Department. In consideration of the issuance of the Building Permit,, agree that I and my agents will comply with provisions of any federal, state or local law regulating the work and the Garfield County Building Code, ISDS regulations and applicable land use regulations (County Regulation(s)). I acknowledge that the Building Permit may be suspended or revoked, upon notice from the County, if the location, construction or use of the structure(s) and facility(ies), described above, are not in compliance with County Regulation(s) or any other applicable law. 1 hereby grant permission to the Building Department to enter the property, described above, to inspect the work. I further acknowledge that the issuance of the Building Permit does not prevent the Building Official from: (1) requiring the correction of errors in the submittals, if any, discovered alter issuance; or (2) stopping construction or use of the stnicttre(s) or facility(ies) if such is in violation of County Regulation(s), or any other applicable law. Review of this Application, including submittals, and inspections of the work by the Building Department do not constitute an acceptance of responsibility or liability by the County of errors, omissions or discrepancies. As the Owner, I acknowledge that responsibility for compliance with federal, state and local laws and County Regulations rest with me and my authorized agents, including without limitation my architect designer, engineer and! or builder. i HEREBY ACKNOWLEDGE.. THAT I HAVE READ AND UNDERSTAND THE NOTICE & CERTIFICATION ABOVE: mai RS SiG • TRE I ATE STAFF USE ONLY Special Conditions: Adjusted Valuation: 73-5 ,Y Plan Check Fee: Permit Fee: tom' Manu home Fee: Misr Fees: __ Total Fees: 5107 Fees Paid: t100 Balance Due: BP No & Issue Date: ISDS No & Issued Date: ROOF- — P5 � Setbacks: OCC Group. Const Type: Zoning: 1 BLDG DEPT: PLNG DEPT: APPROVAL DATE APPROVAL DATE