HomeMy WebLinkAboutApplication- Permit.pdfGarfield County Building & Planning Department 108 8th street Suite 401 Glenwood Springs, CO 81601-Phone: (970}945-8212 Fax: (970)384-3470 Project Address Parcel No. Subdivision Section
Township Range 004614 CR 233 SILT, CO 217906200634 6 6 92 Owner Information Address Phone Cell Sara Marie DUnn 4614 CR 233 970-379-5116 Contractorls I Mullenax Construction & Roofing
Proposed Construction I Details Re-roof residence FEES DUE Fee Re-Roofing Permit Fee Total: Monday, November 16, 2009 Rifle CO 81650 Phone Primary Contractor (970)625·5154 Yes Valuation:
$ 7,600.00 Total Sq Feet: 2400 FEES PAID Amount InvTotal. PaYf:ype . AmtPaidAmt Que $100.00 $100.00 Inv # ROOF·11·09·19887 $100.00 Check # 12511 $100.00 $ 0.00 Required Inspections:
Fo"",p"lIon, ,,", 1 (970)384-5003 Inspection IVR See Permit Record Building Department Copy 2
2 3 4 5 6 7 8 9 10 11 12 GARFIELD COUNTY BUILDING PERMIT APPLICATION !O8 8th Street, Suite 401, Glenwood Springs, Co 81601 Phone: 970-945-82121 Fax: 970-384-34701 Inspection Line: 970-384-5003
www.garfield-countv.com Parcel No: (this infonnation is availabie at the assessors office 970-945-9134) '2-J 79. w Z . ro. (Po+ Sq. Ft. or Acres;!..l:f!!5 Height: o New o Addition Garage:
Septic: o Attached o Detached o ISDS Driveway Permit: Owners valuation of Work: NOTICE No. of Floors: Authority. This application for a Building Permit must 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. Legal Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for purposes of inspections by tlle Building Department. Other
Permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County ISDS Pennit, (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 dale of issuance and if work is suspended or abandoned for a period of 180 days after cormnencement. 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. Assumlng completeness of the submittals and approval of this Application, a Building Permit wiJl 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, I agree that I and my agents will comply with provisions of any federa~ state or locallaw regulating the work and the Garfield County Building Code, ISDS regulations
and applicable land use regulations (COUnty Regulation(s»). I acknowledge that the Building Pennit 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 Regulatlon(s) or any other applicable Jaw. I 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 after issuance; or (2) stopping construction or use of the structure(s) or. facilitY{ies) if such is in violation
of County Regulatlon(s) or any other applicable law. Review of this Application, iw.;, d' g 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 r, knowledge that responsibility for compliance with federal, state and local laws and County
Regulations rest with me and my authorized agents, including without limitation my archite9 g, engineer and! or builder. I HEREBY ACKNGl GETHAT7VEREADANDUN~~T NOTICE & CERTIFICATION
ABOVE: DATE STAFF USE ONLY Special Conditions: Adjusted Valuation: Plan Check Fee: Permit Fee: Manu home Fee: Mise Fees: ICD,OD ISDS Fee: Total Fees: Fees Paid: BP No & Issue Date: ISDS
No & Issued Dale: IDO_c)~ /DO, DO -)3 0 Setbacks: OCCGroup: ConstType: Zoning: