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Home My WebLink AboutApplication.pdfGarfield County Co mmun ity Development Depa rtment 108 8th Street, Suite 401 Gle nwood Spr i ngs, CO 81601 (970) 945-82 12 www.garfield-county.com TYPE OF CONSTRUCTION D Comme rcial/M ul ti-Fam i ly I D Demo lition D Manufactured Home (SF or Duplex) • Resident ial (SF, Duplex, orTownhome) I D Re roof INVOLVED PARTIES Property Owner : W, \l t bM J. ~ Mt'\Rr~~ E:. Hi;i!,AlTDti' Phon e: 193-o ) &'~<o-~&'~ M ailing Add r es s: P.o. Bo)l. 2>S N t::. w CA<;r\£ l Co. ~ l Co~3: Contractor: Co vfJ w. MollLlorJ Phone : ( ~1-o ) ~ tf '2 -&" SSS Mailing Add res s: P. O. \3o't. fl 'Z. S1L-r ~ Ca. ~((o~ Architect: Af/A Phone :( __ ) M ailing Address: En g ineer: IJ/A Phon e:( __ ) j M ailing Address: M anufactured Home Installer : NIA Phon e: ( ) Mailing Addres s: PROJ ECT NAME AND LOCATION Des cri b e Work: ~okJS"rll.UCTI 0 .S tJ £ 1 'x 10 1 B%E:.7f.WfrC( (J.) I AT\A-CHE:~ I .;i_g • 'I--::i. 4-. <; atlll.~ ~ Job Address : J':/--J_";f-o ~ll.OtJTAGrF K(JA-O Me.""1 (1t ~ra. . Co g I " '-4-';f . Assesso r's Par cel Number:c::2( g WCo '-looo <o4 Sub . Lot --Block -- Owner's Valu at i on of Work:$ ~'3. ;s~o . Pr o pert y Siz e (Sq . Ft or Acres): I q,. 9 I <.I r Sq .Ft of Build i ng: '142 (.I Height: /'./'-2. .. #of Floors: ::J_ Cl ass of Work: • New I D Al teration I D Addi t ion D Repair I D Move/Re location Gara ge: •At tached D Detached Se ptic: •ow Ts D Co mmu nity Type of Heat: D Natu r al Gas I •Propane I D Electri c I D Ot her Driveway Pe rmit: D Exempt D Perm it#: NOTICE Authority. Thi s 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. Lega l Access . A Building Permit cannot be issued without proof of l ega l and adequate access to the property for purposes of in spections by the Building Divi sion. Other Permits. Multiple se parate permits may be required : (1) State Electrical Permit, (2) County OWTS Permit, (3) anoth er permit required for use on the property id entified above, e.g. State or County Highway/ Road Access or a State W astewater Discharge Permit. Void Perm it. 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 sus pend ed 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 un derstand that the Building Division accepts the Application, along with the plans and sp ecification s and other data submitted by me or on my beha lf (su bmittals), based upon my certification as to accuracy. Assum ing comp leteness of the submittals and approva l of this Application, a Building Permit will be issued granting permi ssion to me, as Owner, to construct the structure(s) and facilities detailed on the submitta ls reviewed by the Building Divi sion. In conside ration of t he issua nce 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, OWTS regulation s and applicable land u se regulations (County Regu lation(s)). I acknowledge that the Building Permit may be suspended or revoked, upon notice from the County, if the location, con st ruction or u se of the structure(s ) and faci lity(ies), described above, are not in compliance with County Regulation(s) or any other applicab le law . I hereby grant permission to the Bu ilding Divi sio n to enter the property, described above, to in spect the work. I further acknowledge that the issu ance of the Building Permit does not prevent the Building Officia l from: (1) requiring the correction of errors in the submittals, if any, discovered after is suance; or (2) stopping construction or use of the st ructure(s) or facility(ie s) if such is in violation of County Regulation(s) or any other applicable law. Review of this Application, including submittals, and in spections of the work by the Building Divis ion do not constit ute an accepta nce of respon sibility or li ability by the Co unty of errors, omission s or discrepancies. As the Owner, I acknow ledge that responsib il ity for co mpl ia nce with federa l, state and local laws and County Regulation s rest with me and my authorized agents, including without limitation my architect designe r, engineer and/ or builder. I hereby acknowledge that I have read and understand the Notice and Certification above as well as have provide d the required in;r1!.ation which is Cf.f:_ect and accurate to the best of my knowledge. Cc l£ w. Mo u.1.To #.f l,J.Jd., ().). fl{~ ! / -----------~-4-=-=-==----o 2 Le 9 LZOI '/ Property Owner Print and Sign Date OFFICIAL USE ONLY Special Conditions: Adjusted Valuation: Plan Check Fee: Permit Fee: Manu home Fee: Misc Fees: 1-z,oqb I 4-S. I 1 22'3.Z.f --- Total Fees: Fees Paid: Balan?" BP No : OWTS No: ~6B.16 ~.3(o ~LIZ£ -3 3Ci1 Setbacks: I OCCGroup: Const Type: Zoning: , ...z:f!-c ~/ZC rz ;:-~ J2Z.f SI() BUILDING/ PLANNING DIVISIO N: ~/~ ;f}ff Date .~ . I. , , ~ ; ~ Buildin g Plan Review Description of Wor k : construction of 7' x 10' breezeway w/ attached 28' x 24' garage Bin#: db Loca tion Address: Sec06, T 0 6S , R9 1W NEW CASTLE, CO 8 1647 Case Ma nage r : David Barth olomew Plan Case Numb er: BLDG-9 -1 4-8066 Parcel : 2 18106400064 Applica tion Date: 09/09/201 4 Building rJ/11 Engineered Foundation '/ Driveway Permit / Surveyed Site Plan r-> //t I Septic Permit and Setbacks / Grade/Topography 30% / Attach Residential Plan Review List / Mini mum Application Questionnare tJ)A Subdivision Plat Notes µ/A Fire Department Review / Valuation Determination/Fees / Red Line Plans/Stamps/Sticker I Attach Conditions / Application Signed / Plan Reviewer To Sign Application / Parcel/Schedule No. tJ/11 40# Snowload Letter -Manu. Homes fl/A Soils Report Friday, September 19, 2014 Contacts Own er: Willi am & Mart ha Moulton Applica nt: Will iam & Mart ha Moulton Applicant Phone: (970)876-2288 Email : Planning/Zoning I Property Line Setbacks I 30ft Stream Setbacks I Flood Plain I Building height ,/ Zoning Sign-off tf4 Road Impact Fees /J/tf HOA/DRC Approval I Grade/Topography 40% / Planning Issues J ____ _.,Subdivision Plat General Comments: ;/tJt;tj;P1 tb 72. ~K /~.tJ~; ll;2._,CJ96 . tJ-o