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Home My WebLink AboutApplication.pdfRECEI,T Garfield County Community Development Department JUL 2 1 7014 108 8th Street, Suite 401 GARFIELD COUNTY Glenwood Springs, CO 81601 IMMUNITY DEVELOPMENT (970) 945-8212 www.garfield-countv.com TYPE OF CONSTRUCTION ❑ Commercial/Multi-Family ❑ Manufactured Home (SF or Duplex) ❑ Residential (SF, Duplex, or Townhome) BUILDING PERMIT APPLICATION $ Demolition 71 0 Reroof ,INVOLVED PARTIES L� Property Owner: c_)c ' \cv � � f �f n Phone: (17C ) 7 i ` ga a I Mailing Address: S S C�� e A- e Int F , Co I (y5 (') Contractor: ba.hQ S i C Phone: (!'7V ) -7 (a -.2 S8 1 Mailing Address: 1` 0 Cin off- -4 S, 1* t CO TI(p5a Architect: Phone: ( Mailing Address: ) Engineer: Phone: (- Mailing Address: Manufactured Home Installer: Phone: ( Mailing Address: PROJECT NAME AND LOCATION Describe Work: t-C'_m O\ I yix ()c Job Address: (aT3 C-R c�c( (= ce , CCS I (e7 S U Assessor's Parcel Number: Sub. Lot Block Owner's Valuation of Work: $ Property Size (Sq.Ft or Acres): ..2 YY CtC, • fto-,5e -7 13 Sq.Ft of Building:S heck 3bo Height: # of Floors: Class of Work: 0 New ❑ Alteration ❑ Addition Garage: 0 Attached Septic: ❑ ISDS Type of Heat: 0 Natural Gas 0 Propane Driveway Permit: 0 Exempt O Repair 0 Move/Relocation O Detached ❑ Community 0 Electric 1 0 Other O 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 provided the required 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: Plan Check Fee: Permit Fee: Manu hom Fee: Misc Fees: , Total Fees: 7c. bo Fees Paid: 2, i Balance e: BP No: ISDS No: 0\40-- 330 x Setbacks: OCC Group: Const Type: Zoning: /PLANNING DIVISION : )BUILDING � U V v — �` � — 14 Signed Ap val Date Pd. 4 W. Doi v 4 111-61) -.�,( Colorado Department of Public Health and Environment Air Pollution Control Division — Indoor Environment Program — Asbestos/IAQ Air Unit 4300 Cherry Creek Drive South, APCD-IE-B1 Denver, Colorado 80246-1530 Phone: 303-692-3100 — Fax: 303-782-0278 E-mail: asbestos@state.co.us DEMOLITION APPROVAL NOTICE This approval notice is granted subject to Colorado Air Quality Control Commission Regulation No. 8, Part It, adopted December 21, 2007, and effective January 30, 2008 and the Colorado Air Pollution Prevention and Control Act C.R.S. (25-7-101 and 25-7-501 et seq). This notice signifies that the structure was inspected for asbestos, luminous exit signs (containing radioactive material), and Ozone -Depleting Refrigerants and the demolition contractor has properly notified the Colorado Department of Public Health and Environment pursuant to Regulation No. 8, Part B. As a contractor, you may be subject to other demolition licenses and permits, depending on the requirements of the county and municipality in which the work is being performed. The Colorado Department of Public Health and Environment, Air Pollution Control Division, strongly suggests that you check with county and municipal authorities in order to determine any other Local building/permitting requirements that must be met. Please note that certain asbestos -containing materials (ACM) may remain in the structure during demolition. Therefore, any demolition debris left behind after the completion of post - demolition site cleanup may constitute a "reason to know of asbestos -contaminated soil" at the site, subject to the requirements of Section 5.5 of the Solid Waste Regulations (6 CCR 1007-2, Part 1). THE ORIGINAL APPROVAL NOTICE MUST BE POSTED ON SITE AT ALL TIMES. Immediately notes the Asbestos/IAQ Unit of project modifications by fax (number above) or e-mail (address above) and the appropriate county health department by fax Project modifications include changes in the scope of work or the scheduled work dates, etc. This demolition approval notice is valid beginning 7/3/2014. The actual scheduled work dates are from 7/3/2014 through 8/27/2014. Approval issued on: 7/10/2014 Record number: 100330 Fee Paid: $55.00 Notice Number 14GA3687D Check number: 892 For the location specified below: House Structure 634 CR 296 Rifle Garfield County This notice has been issued to: Dane Shaffer PO Box 274 Silt, CO 81652 Asbestos Building Inspector: Douglas A. Close Cerification No.: 2930 Inspection Date: 06/05/2014 Issued RWJ Colorado Department of Public Health and Environment Air Pollution Control Division — Indoor Environment Program —Asbestos/IAQ Air Unit 4300 Cherry Creek Drive South, APCD-IE-B1 Denver, Colorado 80246-1530 Phone: 303-692-3100 — Fax: 303-782-0278 E-mail: asbestos@state.co.us DEMOLITION APPROVAL NOTICE This approval notice is granted subject to Colorado Air Quality Control Commission Regulation No. 8, Part B, adopted December 21, 2007, and effective January 30, 2008 and the Colorado Air Pollution Prevention and Control Act C.R.S. (25-7-101 and 25-7-501 et seq). This notice signifies that the structure was inspected for asbestos, luminous exit signs (containing radioactive material), and Ozone -Depleting Refrigerants and the demolition contractor has properly notified the Colorado Department of Public Health and Environment pursuant to Regulation No. 8, Part B. As a contractor, you may be subject to other demolition licenses ,and permits, depending on the requirements of the county and municipality in which the work is being performed. The Colorado Department of Public Health and Environment, Air Pollution Control Division, strongly suggests that you check with county and municipal authorities in order to determine any other local building/permitting requirements that must be met. Please note that certain asbestos -containing materials (ACM) may remain. in the structure during demolition. Therefore, any demolition debris left behind after the completion of post - demolition site cleanup may constitute a "reason to know of asbestos -contaminated soil" at the site, subject to the requirements of Section 5.5 of the Solid Waste Regulations (6 CCR 1007-2, Part 1). THE ORIGINAL APPROVAL NOTICE MUST BE POSTED ON SITE AT ALL TIMES. Immediately notes the Asbestos/IAQ Unit of project modifications by fax (number above) or e-mail (address above) and the appropriate county health department by fax. Project modifications include changes in the scope of work or the scheduled work dates, etc. This demolition approval notice is valid beginning 7/3/2014. The actual scheduled work dates are from 7/3/2014 through 8/27/2014. Approval issued on: 7/10/2014 Record number: 100329 Fee Paid: $55.00 Notice Number: 14GA3686D Check number: 892 For the location specified below: Shed Structure 634 CR 296 Rifle Garfield County This notice has been issued to: Dane Shaffer PO Box 274 Silt, CO 81652 Asbestos Building Inspector: Douglas A. Close Cerification No.: 2930 Inspection Date: 06/05/2014 Issued by: RWJ