HomeMy WebLinkAboutApplication.pdfGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-countv.com
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
❑ Commercial/Multi-Family
❑ Manufactured Home (SF or Duplex)
;d Residential (SF, Duplex, or Townhome)
O Demolition
O Reroof
INVOLVED PARTIES
Property Owner: G-/er),,, J--�;3r\ Cit f1 dan-. J Phone: (07.0 ) 436 - i
Mailing Address: 4/1 C Z C //,2!L7 69 SS/hSZ
Phone:
Contractor: 30 n ra cid
( )
Mailing Address:
Architect:
Phone:
( )
Mailing Address:
1�, ,,
Engineer: S'i� �,- r\ lezac5 4 ,—/��r �*�'�-
Phone:
(cj 7-0) 6 re- J?)- -
Mailing Address: et -f- ! r Co
Manufactured Home
Mailing Address:
Installer:
Phone:
( )
PROJECT NAME AND LOCATION
Describe Work: Add,' r(,d it, e Xt S I , i) o r -..t
c
f
Job Address: 41 I c2 Z b/ 5-( I -/ (0 / 4 i 2
Assessor's Parcel Number:
Owner's Valuation
Sq.Ft of Building:
/
Sub. Lot Block
of Work: $ .74( €.(047 Property
Size (Sq.Ft or Acres):
It of Floors: /
ac a- s
ct) a
Height:
Class of Work:
■ New • Alteration
(Addition
•
Repair
• Move/Relocation
Garage:
'Attached
•
Detached
Septic:
• ISDS
•
Community
Type of Heat:
aNatural Gas
• Propane
• Electric
• Other
Driveway Permit:
• Exempt
1 •
Permit #:
NOTICE
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 the Building Division.
Other Permits. Multiple separate permits may be required: (1) 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 Division 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 Permit will be issued granting
permission to me, as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by the
Building Division. In consideration of the issuance of the Building Permit, I 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.
I hereby grant permission to the Building Division 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 Regulation(s) or any other applicable law.
Review of this Application, including submittals, and inspections of the work by the Building Division 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 and Certification above as well as
have provi• ed the req ired information which is correct and accurate to the best of my knowledge.
Property Owner Print and Sign
Date
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation:
7,69(93'.&c.
Plan Check Fee:
61-1L)-1
Permit Fee:
85z.,75-
Manu ho e Fee:
N c\
Misc Fees:
01 k
Total Fees:
137*. b 4
Fees Paid:
�jl �. ?�
Balance Due:
8;z. 75
BP No:
ISDS No:
-'32(toq
/
Setbacks:
r , P25, 510
OCC Group:
s'gc___
Const Type:
SRC
Zoning:
g...
BUILDING / PLANNING
DIVISION : /lam �` d`--1-24-4,- 7/0.
Signed Approval Date
ra 4
gd_rm (>c,
The Building Division will collect a Plan Review fee at time of application submittal. The permit fee, as
well as any Septic or Road Impact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by person having written authority from the owner
to act as their representative.
Building cannot be occupied until a Certificate of Occupancy (CO) is issued. Using the building without a
CO will be considered an illegal occupancy and may be grounds for vacating the premises. (Final/CO
inspection requirements will be attached to your approved field set of plans.)
hereby acknowledge I hgve read, understand, and will abide by the requirements of this
checklist, -
01.7/ /1c/fc—
rope
hecklist-
rope y'Owner Print and Sign Date
Building Plan Review
Description of Work: addition to existing structure
Bin #:
Location Address: 411 261 COUNTY RD
SILT, CO
General Information
Case Manager: David Bartholomew
Plan Case Number: BLDG -6-14-7976
Parcel: 212736400048
Application Date: 06/20/2014
Contacts
Owner: Glenn & Sandra Adams
Applicant: Glenn & Sandra Adams
Applicant Phone: (970)456-3099 Email:
Building
Planning/Zoning
Engineered Foundation / Property Pro e Line Setbacks
p
NIS Driveway Permit / 30ft Stream Setbacks
Surveyed Site Plan / Flood Plain
Nr A Septic Permit and Setbacks / Building height
Grade/Topography 30% Toning Sign -off
Attach Residential Plan Review List N/4 Road Impact Fees
/%
Minimum Application Questionnare Nl HOA/DRC Approval
N` Subdivision Plat Notes / Grade/Topography 40%
N/A
` Fire Department Review Planning Issues
Valuation Determination/Fees Subdivision Plat
Red Line Plans/Stamps/Sticker General Comments:
/ Attach Conditions V//ad /e14
Application Signed
/ Plan Reviewer To Sign Application
Parcel/Schedule No.
40# Snowload Letter - Manu. Homes
Nl /1 Soils Report
1/9. 7.6P
C� 512 = 9 A, 1.00 8 Z 8o . oo
/t _ 176,983-1 6 d
Wednesday, July 2, 2014
1