HomeMy WebLinkAboutApplication.pdfa
E P 0 2014
SCANNE0
Garfield County
hity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
GARFIELD COUN1Y (970) 945-8212
www.garfield-county.com
)ta�Iv1U(JITY ()E:UrI_Q4�Nff:i,i
TYPE OF CONSTRUCTION
O Commercial/Multi-Family
❑. Manufactured Home (SF or Duplex)
BUILDING PERMIT
APPLICATION
0 Demolition
Residential (SF, Duplex, or Townhome
0 Reroof
INVOLVED PARTIES
M
Property Owner: ''� 1 Q NU 9' 1 � Phone: (o2o3) C67 3S -
Mailing
SMailing Address: P lrra4bond0.62 CO V
Contractor: Phone:
Mailing Address:
Architect: Phone: (
Mailing Address:
Engineer: Phone:
)
Mailing Address:
Manufactured Home Installer: Phone:
Mailing Address:
[PROJECT NAME AND LOCATION
Describe Work: I %) s / /a,1 -c o)"1 ai? We -/t k 6(..‘f -b Lcr
Job Address: 1,C76 1I ILGP)Ara '
Assessor's Parcel Number:
Owner's Valuation of Work: $
Sq.Ft of Building:
a i! i iio a cY) g //2
Sub. Lot Block
Class of Work:
Garage:��f, ,
Septic: U`"
Type of Heat:
❑ New
Property Size (Sq.Ft or Acres):
Height: # of Floors:
Alteration "4415eklifien 0 Repair 0 Move/Relocation
0 Attached
O OWTS
O Natural Gas
Driveway Permit:
O Exempt
O Detached
O Community
0 Propane
0 Electric 0 Other
O Permit #:
23
3
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 OWTS 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
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, OWTS
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.
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 provide o required informon which is correct and accurate to the best of my knowledge.
Property 0 ner Print and Sign
Dg/off
Date
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation:
1; a
Plan Check Fee:
?o.,57
Permit Fee:
i 59. if
Manu home Fee:
---
Misc Fees:
._.-
Total Fees:
z z. 9 76
Paid:
Felo.si
Balance Due:
i 57. Z<
BP No:
OWTS No:
Bu &- 33t.P3
Setbacks:`
OCC Group:
Const Type:
Zoning:
BUILDING / PLANNING
DIVISION : /
- ey Iv" " 7 /-
—0-----
Signed Approval Date
• c a ccs W/ 1
3
Building Plan Review
Description of Work: converting kitchen into wet bar
Bin #:
Location Address: 12694 HWY 82
CARBONDALE, CO 81623
General Information
Contacts
Case Manager: David Bartholomew
Plan Case Number: BLDG -9-14-8062
Parcel: 239327400007
Application Date: 09/03/2014
Owner: Nana Karumidze
Applicant: Nana Karumidze
Applicant Phone: (203)667-3570 Email:
Building
i.)( Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/Topography 30%
Attach Residential Plan Review List
Minimum Application Questionnare
A)1 Subdivision Plat Notes
Nl Fire Department Review
Valuation Determination/Fees
Red Line Plans/Stamps/Sticker
Attach Conditions
Application Signed
/ Plan Reviewer To Sign Application
Parcel/Schedule No.
/• 'A 40# Snowload Letter - Manu. Homes
P/71
Soils Report
13 A
Planning/Zoning
roperty Line Setbacks
30ft Stream Setbacks
Flood Plain
Building height
oning Sign -off
Road Impact Fees
OA/DRC Approval
Grade/Topography 40%
lanning Issues
Subdivision Plat
General Comments:
V/fite/rAd
71?/f
66v• sa /,/e/
Wednesday, September 17, 2014
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.)
I hereby acknowledge I have read, understand, and will abide by the requirements of this
checklist.
Property Owner Print and Sign
09/03 //Y
Date