HomeMy WebLinkAboutApplicationGA.— &LD COUNTY BUILDING PERMIT APPLICA..JN
108 8a' Street, Suite 401, Glenwood Springs, Co 81601
Phone: 970-945-82121 Fax: 970-384-3470 Inspection Line: 970-384-5003
www.PLufteld-county.com
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Parcel No:
2445-101-00-951
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Job Address:
Plan Check Fee:
Logan's Wash Federal 1-6 Pad Site: Section 6 Township 8 South Range 97 West
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Lot No: Block No: Subd.l Exemption:
I Z57125
n/a n/a n/a.
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Owner. ureau at n girt
Address
Ph: (970)319-8898
Wk Ph;
Rep: EnCana Oil & Gas (USA) Inc.
2717 CR 215/Parachute, CO 81635
Renata Busch -cell
970 285-2825
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Contmclor:
ouadna
Address q W ve.
�o� en, Lou ����
Ph:
303 430-0521
Alt Ph:
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Archilect 1 Engineer:
Address
Ph:
Alt Ph:
V- f5
Brad Schmolesky
same as contractor
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Sq. Ft. of Building:
f303'430-0521
Sq. Ft. of Lot:
height:
No. of Floors:
APP O AL
476
63,000
0,
1
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Use of Building:
To house a gurno and associated equipment
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Describe Work:
Install a re -fab building on COGCC approved pad site location
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Class of Work:
® New ❑ Alteration ❑ Addition
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Garage:
n/aSeptic_
❑ Attached ❑ Detached
n/a ❑ ISDS ❑ Community
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Drivgway. Permit:
Owners valuation of Work: S
ExistingLocation
60,000
NOTICE
Authority. This application for a Building Permit must be signed by the Owner ofthe property, described above, or an authorized agent. Ifthe signature below is not that orthe owner. a separate
letter of authority, signed by the Owner, must be provided with this Application.
Legal Access. A Building Permit cannot be issued wuheut proof of legal and adequate access to the property for purposes of inspections by the Building Department,
Other_Permim Multiple separate permits maybe 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.
Vold Permit, A Building Permit becomes null and void if the work authorized is not commenced within 190 days of the date of issuance and if work is suspended or abandoned for a period of I Bo
days after commencement.
CERTIFICATION
I hereby certify that 1 have read this Application and that the information contained above is true and correct I understand that the Building Department 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 tome, as Owner. to construct the struchue(s) and facilities detailed on
Me submittals reviewed by the Building Department.
in consideration of the issuance of the Building Pemtil, I agree that 1 and my agents will comply with provisions orany 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 structures) and facility(ics), described above, are not in compliance with County Regulation(s) or any other applicable law
I hereby grant permission to the Building Department to enter the property, described above, to inspect the work. 1 further acknowledge that the issuance of the Building Permit does not prevent the
Building Official ftotrt: (1) requiring the correction efcr ors in the submittals, if any, discovered after issuance, or (2) stopping construction or use of the structurc(s) or facdity(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 Department do not constitute an acceptance of responsibility or liability by the County of error, omissions
or discrepancies. As the Owner, I acknowledge that responsibility for compliance with federal, state and local laws and County Regulations rest wish me and my authorized agents, including without
limitation my architect designer, engineer and/ or builder.
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ AND UNDERSTAND THE NOTICE & CERTIFICATION ABOVE
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OWNERS SIGNATURE enata use DATE
STAFF USE ONLY
Special Conditions:
470x 429,q
cs
�'
ol
Adjusted Valuation:
Plan Check Fee:
Permit Fee: Il« nu home Fee: Mise Fees:
(4V15',:7-4
10 -1� 6
I Z57125
ISDS Fee:
Total Fees:
Fees Paid:
Balance Due:
C �►�
BP No & Issue Dale:
ISDS No & Issued Date:
.41A. �
'�
70- f
�" ����.
Setbacks:
OCC Group:
Const Type:
Zoning:
U
V- f5
B G DEPT:
PLNG DE
APP O AL
DATE
APPROVAL DATE