HomeMy WebLinkAboutApplication.pdfGarfield County
Community Development Depa rtment
108 81h Street, Suite 401
fl "if r ijl irv If l\ Glenwood Springs, CO 81601 .~\\ ~,) l _, r...1 l !Fi _; (910) 945-8212
sc:r 1 , zo14 www.garfield-county.com
r1i\RFlt]ll C~iy,:~F CONSTRUCTION
i · 'UNI.,, :'rw:wp~M; 11
•· • ' • ;.1 • L:.J Co mercial/Multi-Family
Q Manufactured Home (SF or Dupl ex )
~ Re si dential (SF, Duple x, or To w nhome)
INVOLVED PARTIES
0 Demo lition
0 Re roof
Property Owner: ~;Cl VI Ct f hvt~~ Phone:(_)
Mailing Address : ' ·1 ~=~ =~':): =&\Q .,C CJ> ~ \ (::>~'""' °'.\)\(a
· Cf7o-Zl!?/-.$'7B/
Contractor: (Y'i.g v e ~ Co11si\oL;bQV\. IA yLLe. Phone :(~) is~ ·96 4 2
Mailing Address : 560 S l~ MrYH1C1 ~ .t-( b fq .,iJ ~)At.:tw1,,1 (O XJQS
Architect: _________________ Phone: ( __ ) _____ _
Mailing Address :--------------------------
Engineer: fvk-fl1 , '1\1\'\ V' Phone: (j_]Q_) Gaz?; -5 1( 3
Mailing Address: S? ·O . §toy (961-, £1 ~\!:?rWO\(i() q J /d s j
Manufactured Home Installer:-----------Phone : ( __ ) _____ _
Mailing Address :--------------------------
..
PROJECT NAME AND LOCATION
' Describe Work: ' ~ 2-' c c\ o..... -:2.> \ ./ ") ., )'' '\ \( oo:ev--, ~ \.1. e-n ,"'(>\. ...,.._ r . ;-' r,
' ') I ,
Cu f3 1b sv ·-9o u, Job Address: \ C, O ~ +J ~4 1"L~">t 2 2 £ ]?i'f (e, 1 '°J rr /)JO
Assessor's Parcel Number: d 17..J ·S fc ·lD Sub . -~,("'"'J_A__,__ ____ Lot __ Block
Owner's Valuation of Work:$ J <>o, '-\AA . 2§.. Property Size (Sq .Ft or Acres): _S"""""-D~--
Sq.Ft of Building:, \ 10(). 0 Height:------#of Floors: _____ _
Class of Work: 0 New 0 Alteration ~dd i t ion 0 Repa ir 0 Move/Relocation
Garage : D Attached 0 Detached
Septic : OOWTS 0 Commun ity
Type of Heat: 0 Natural Gas D Pro pane D Electric D Other .
Driveway Permit: · D Exempt D Permit#: ______ _
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, descr ibed above, or
an authorized agent. If the signa ture 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 lega l and adequate access to th e property for
purposes of inspections by the Building Division .
Other Permits. Multiple separa te permits may be required: (1) State Electrical Pe rm it, (2) Coun t y OW TS Perm it,
(3) another permit required for use on the property identified above, e.g . State or County Highway/ Road Access or
a State Wastewater Dis charge Permit.
Void Permit. A Building Permit becomes null and void if the work authorized is not commenced within 180 days of
the d ate of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION --
1 hereby certify that I ha ve read this Application and that the information contained above is true and correct. I
u nde rstand that the Building Division accept s the Application, along with the plans and specifica tions and ot her
d ata sub mitted by me or on my beha lf (submittals), based upon my ce rtification as to accuracy. Assum ing
completeness of the submittals and approval of this Application, a Bui l ding Permit will be issued granting
permission to me, as Owner, to construct the structure(s) and faci lities detailed on the submittals reviewed by the
Building Divi sion. In co n si deration of the issuance of the Building Perm it, I agree that I and my agents will comp ly
w ith provisions of any fed era l, state or loca l law regulating the work and the Garfield County Building Code, OWTS
regulations and applicable land use regulations (County Regulation(s)). I acknowledge that the Bui lding Permit
may be sus pended or revoked , upon notice from the County, if t h e location, construction or u se of the structure(s)
and facility(ies), d escr ibed above, are not in compliance with County Regula t ion(s) or any other a pp licab l e law.
I hereby grant permission to the Building Divis ion to enter the property, des cribed above, to inspect the work. I
further acknowledge that the issuance of the Building Permit does not p revent the Building Official from: (1)
requiring the correction of errors in the submittal s, if any, discove red after iss uance; or (2) stopping construction
or use of the structure(s) or facility(ies) if such is in viola tion of County Regu lation(s) or any other app licab le law.
Review of this App lica tion, including submitta ls, and inspections of t he work by the Bui lding Divis ion do not
co nstitute an acce ptance of res ponsibility or lia bility 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 Reg ulatio ns
re st with me and my au tho rized agents, including w ithout limitation my architect designer, engineer and/ or
bu i lder.
I hereby acknowledge that I have read and understand the Notice and Certification above as well as
have provided the required information which is corr t and accurate to the best of my knowledge.
Property Owner Print and Sign
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation: Plan Check Fee : Permit Fee : Manu home Fee :
Total Fees: Balance Due:
167.0I
Setbacks: , OCC Group:
Pz5"uf' 51tJ' L~
Const Type: .r.e-c.,.
BUILDING/PLANNING DIVISION ' ;IP~
Signed Approval
Date
Misc Fees :
VALUATION FEE DETERMINATION
Applicant
Address
Date
_N_a_n ..... cy_J_o_h_ns_o_n __ , A_d_d_it_io_n ______ Subdivision
_1_70_H_wy_.__3_2_,5,"""R_i_fl_e _______ Lot/Block
10/9/2014 Co ntractor
Finished (Livable Area):
Main
Upper
Lower
Other
Total
Total
Basement:
Unfini shed
Square Feet
Valuation
Conversion of Unfinished to Finished
Other
Total Valuation
Garage/Storage (wood framed)
Co nvers io n of garage to finished livin g
Carport
Other
Total
Craw l Space
Total
Valu ation
Valuation
Decks!Pa tios/Porc hes
Cove red
Open
Other
Total Valuation
Type of Construction:
Occupancy :
Total Valuation
Total Valuation
-
768 sq.ft
sq .ft
sq.ft
sq.ft X $74.68
768 sq.ft
768 sq.ft X $41.00
sq.ft X $33.68
sq.ftX
sq.ft X $18.00
sq.ft X $56.68
sq.ft X $12.00
sq.ftX
sq .ft X $9.00
378 sq.ft X $24.00
sq.ft X $12.00
sq.ft X
Commercial
sf X
sf X
sf X
sf X
sf X
sf X
NI A
NIA
Maves Con struction, Kyle
57,354.24
31,488.00
0.00
0.00
9,072.00
0.00
97,914.24
Building Plan Review
Description of Work: adding a 31' x 24' living room & basement onto existing hom e
Bin#:
Location Address: 17 0 Hwy 325
RI FLE, CO
Ca se Manager: David Bartholomew
Plan C ase Number: BLD G-9-14-80 78
P a rcel: 212 73 12000 I 0
Application Date: 09/17/20 14
Building
__ _;/ ___ Engineered Foundation
,_I/ It Driveway Permit
/ Surveyed Site Plan
~(~ Septic Permit and Setbacks
/ Grade/Topography 30%
/ Attach Residential Plan Review List
/ Minimum Application Questionnare
r--1/A Subdivision Plat Notes
1'-1/ A Fire Department Review
/ Valuation Determination/Fees
/ Red Line Plans/Stamps/Sticker
/ Attach Conditions
/ Application Signed
/ Plan Reviewer To Sign Application
/ Parcel/Schedule No.
tJ/A 40# Snowload Letter -Manu. Homes
JJ)A Soils Report
Thursday, October 9, 2014
Contacts
Owner: Nancy Joh nson
Applicant: Nancy John son
Applicant Phone: Email:
Planning/Zoning
I Property Line Setbacks
I 30ft Stream Setbacks
/ Flood Plain
I Building height
/ Zoning Sign-off
ff/A Road Impact Fees
IV/If HOA/DRC Approval
/ Grade/Topography 40%
11 Planning Issues I
Subdivision Plat
General Comments:
cG Garfield County
Community Development Department
108 81
h Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
SINGLE FAMILY OR DUPLEX BUILDING PERMIT APPLICATION CHECKLIST
In order to understand the scope of work intended and to expedite the issuance of a permit, it is
important that complete information be provided. Please review this document to determine if you have
adequate information to design your project and to facilitate a plan review.
APPLICATION FORM: Please make sure the following information is provided on the application.
• Parcel number obtained from the County Assessor's Office. -C'v,\\,, (
• Job address (assigned physical address)
• Legal Description: lot, block, filing, subdivision or tract, section , township and range.
• Owners name, mailing address, phone, fax, or cell.
• Contactors name, mailing address, phone, fax, or cell. ~
• ArchitecUEngineer's name, mailing address, phone, fax or cell.
• Building size, height, number of stories, lot size .
• Use of building (residential)
• Class of Work (new, addition, alteration, repair, demo, move, other)
• Description of work .
• Type of heating (natural gas, propane, electric, other).
• Sewer system (Community or OWTS), also see other items below.
• Garage (attached or detached).
• Driveway permit (please see other items below)
• Valuation (labor and materials) see attached worksheet.
OTHER ITEMS:
--If you anticipate obtaining a water-tap from the City of Rifle, please provide a letter indicating that
the City will provide water service. (Required to submit building permit application).
ISDS requires a septic permit application to be submitted with the building permit application.
• A separate electrical permit must be obtained from the State of Colorado Electrical Board .
..-. At the time of building permit submittal, you are required to show proof of legal and adequate
access to the site. This may include proof of right to use a private easement, County Road &
Bridge permit, or Colorado Department of Highway permit, including a Notice to Proceed. The
~ _ County Road & Bridge Department can be reached at 970-625-8601.
r.) If you anticipate excavating or grading prior to issuance of a building permit, you will be required
to obtain a seRarate gradil]g per_mit. -
_-•,,..-If you belong to a Homeowners Association (HOA), it is your responsibility to obtain written
approval , if required .
..--Provide copies of any Resolutions and/or Land Use Permits associated with this property .
..... ~ Additional Dwelling Units may require Administrative Review.
• Minimum dwelling dimension is 20 ft wide x 20 feet long .
• A Colorado State Licensed Electrician and Plumber must perform installation and hook-ups,
unless the homeowner is performing the work.