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Home My WebLink AboutApplication - PermitGarfield County Building & Planning Department 1 oa Bth Street Suite -401 Glenwood Spri ngs , CO 816 1>1 - Phone : (970)945-8212 Fax : (970)384 ·34 70 ProJect Address 7815 CR 309 RIFLE, CO Owner Information George & Ella Hedricks Contractor(s) Woodsmlth Construction Proposed Construction I Details Detached garage FEES DUE Parcel No. 217533200162 Address co Phone (970)876-2822 FEES PAID Subdivision Permit NO. BLRE-9-1 0-1770 Permit Type: Resid~ntial Building Worlc plassification: New Permit Status: Active Issue Date: 1 01512010 Expires: 04/03/2011 Section Township Range Phone Cell Primary Contractor Required Inspections: Yes Valuation: Total Sq Feet: $ 21,600.00 1200 Far lnapecllarw call: 1 (888}868-5306 Inspection lVR See Permit Record Fee Amount lnv Total Paytype Amt Paid Amt Due Plan Check Fee Residential Building Fee Total: $227.01 $349 .25 $576.26 lnv # BLRE-9-10-20543 s 576 .26 Check# 9954 Check# 9962 $227.01 5349 .25 $0.00 Building Department Copy I I Tuesday, October 5, 2010 2 I 2 ; 3 4 5 GARFIELD COUNTY BUILDING PERMIT APPLICATION 108 8111 Street, Suite 401 , Glenwood Springs, Co 81601 Phone: 970-945·8212/ Fax: 970·384·3470 I Inspection Line: 888-868·5306 www, 2arfi ld I~ •9;!!.!1! V.CQm Parcel No: (this infonnalion is a•-ailablc 81\hc assessors office 970-94S-9134} ~ lt5 _ "'5Cila -00 -~ ~ Job Address: (if an Dddress has not been assigned , please provide Cr, Hwy or Street Name & City) or lllld legal description '1 B 15 (_,{.?.., 3oCf R.tFLe (.O. 6/~':io Lot No: Block No: Subd./ Exemption: Owner: (propcny owner) £i...L.A HECJR.t(K Mailing Address: '16/!S c.e. 3o9 /(JFL~ CD'D/b Ph: ~0 cO Z.5 -1'Y1 5 Contractor: Ph: e ~ Alt Ph; . VI ao J)~fv'IITI/ co N~Tt?.UuJo fl. Mailing Address: SJI..:r. C.o. 353/fli~I/E f CA P~cl. B t ~ sz. 'c3?fa-28L"'L, Alt Ph: J•\1~ 3'7<1-3tfb 6 Architect I Engineer: Mailing Address: Ph: Alt Ph: vvoov~ITH I I II I I 7 Sq. Ft. of Building: (2..oo c!J 1iqo r. • ~.crcs of ~: Hc:ig~t: ,, I "' -"1 f'EA No. of Floors: I . 5. + Ac /0-~ l.t'tiLL!:I I I 8 Usc: of Building: 4/fRAG£. 9 Describe Work: Fourv.l)Anc,J I ~ I PF< fV-1 e tlf-\Rt14 L £i..T. /viE: TAL I"'' U,li~t,vt ~t( e!) 10 Class of Work: I JC>lew o Alteration o Addition 11 Garage: Septic: tJ lA 2$1SDS o Attached ~Detached o Community . 12 Driveway Permit: £.1V~TIN 4 O"ners valuation of Work: s ffi(')QJ .- NOTICE Autbori'Y. This application far a Buildins Pcnnit must be sisncd by the o .. ncr of \he propeny. descnbed ab cwc, or an authariud ascnt If the sisnaturc below is not thai of the Owner, a scpanuc letm of authority, sisncd by the Owner, must be pro\idcd with this Appl ication Laal t\ctF5L A Building Permit cannot be issued without proof oflegal and adequate access 10 the property for purpo ses of inspections by the Buildina Ocpanment. O!her Permiu. Multiple scp1111te pcnnits may be rcquiml: (l ) State Electrical Pcrnut, (2} County ISDS Permit, (3) another permit required for usc on the property identified above, e.g. State or County Highwa)·/Road Access or a State \\'IS!ewa~ Disclw-se Permit Vgjd PermiL A Building Permit becomes null and void if the work authoriud is not commenced within 180 days of the date of iuuance and if work is suspended or abandoned for a period of ISO days alltr cammcncenu:nL CERTIFICATION I hereby cenif)• thatl ba\'1! read thas Application and that the information contained above is cr.... and cam:ct I understand that the Building Dcpattmcnt IC:q)IS the Application, along wilh the pllUIS and spcei6cations and alhcr data submiacd by me or on my bebalf(submillals), based upon my cenification as 10 accuracy. Assuming camplet..neu of the submit1als and appro,-.J of this Application, a Building Permit will be issued gnmting permission to me, as Owner, to construct the structurc{s) and facilities detailed on the submillals rc\i~cd by \he Building Depanmtnt ' In consideration afthe issuance of the Building Permit, I agree that I and my agents will comply with pro\-isions of any federal. swc or lacallaw regulating the worlc and the Garfield County Building Code, ISDS fC1!U]atioos and applicable land usc regulatio ns {County Re!JUiatian(s)). I adcnowlcdgc that \he Building Permit may be suspended or rc\vl<cd. upon notice Cram the County, if the location, consuuction or usc ofthestruetuR(s) and faWil)'(ics), described abo,·c, ate not in compliance ,.;th County Rcgulation(s) or any other applicable low I hen:by gram permission to \he Building DcpattnXtUIO enter the property, dcscn"bcd above , 10 inspect the work. I further aeb>owlcdgc thai the issuance of the Build in g Permit docs not prc•-mtlhc Building Official from: (I) requiring the c:orm:tion of errors in the submittals, if any, disc:a,·crcd alia-iJSUIIICC; or (2) stopping c:onstniCiion or usc of the stniCIUrC{s) or facilil)'(ies) if sw:h is in \iolation of County Regulation(&) or any olhcr applicable law. Re\i cw of this Application, including submi1tals, and inspections of the work by \he Building Dcpanmont do not constitute an acceptance of responsibility or liability by the County af crron, omissions ar discrepancies . As the 0"'1'1cr, I acknowledge that responsibility for compliance with fedora~ statcllld local laws and County Regulations rest with me 111d my autboriud ascnts, including without i limitation my an:hitoct desif!Dcr, engineer and/ or builder. I HEREBY ACKNOWLEDGE TiiA T I HAVE READ A. ... 'D UNDERSTAND THE NOTICE & CERTIFICATION ABOVE . ~t ~ 6id_u_LL u z~ 20/0 ,,-.:::::_ owrf"Rs SIGNATURE .. DATE Pill n f c+·dl~~o ~~ \0.-.. IU STAFF USE ONLY ! Spedal Conditions: Adjusted Valuation: Plan Check Fee: Permit Fee: Manu home Fee: Mise Fees: 21,6oo .-2Z 7. 0/ 3lf 9. z.f' JSDS Fee: Total Fees: Fea:s Paid: Balance Due: lU:&t & Issue Dale: lSDS No & Issued Date: 51b.Zb l crJ ~t·O \ ??l/9. z5' -1110 Stttbacks: OCCGroup: Coast Type: ! Zoning: ;J..S/ zs-1 10 JZ-7 .Jr5 'R BL ~ 4. . ~-i /r 0 APPROVAL DATE ~~/~~ AP~-DATE-- I The following items are required by Garfield County for a final Inspection: 1) A final Electrical Inspection from the Colorado State Electrical Inspector. 2) Permanent address assigned by Garfield County Building Department and posted at the structure and where readily visible from access road. 3) A finished roof; a lockable building; completed exterior siding; exterior doors and windows installed; a complete kitchen with cabinets, sink with hot & cold running water, non-absorbent kitchen floor covering, counter tops and finished walls, ready for stove and refrigerator; all necessary plumbing. 4) All bathrooms must be complete, with washbowl, tub or shower, toilet, hot and cold running water, non-absorbent floors, walls finished, and privacy door. 5) Steps over three (3) risers, outside or inside must be must have handrails. Balconies and decks over 30" high must be constructed to all me and IRC requirements including 'guardrails. 6) Outside grading completed so that water slopes away from the building; 7) Exceptions to the outside steps, decks, grading may be made upon the demonstration of extenuating circumstances., i.e. weather. Under such circumstances A Certificate of Occupancy may be issued conditionally. 8) A final inspection sign off by the Garfield County Road & Bridge Department for driveway installation, where applicable; as well as any final sign off by the Fire District, and/or State Agencies where applicable. A CERTIFICATE OF OCCUPANCY (C.O.) WILL NOT BE ISSUED UNTIL ALL THE ABOVE ITEMS HAVE BEEN COMPLETED. A C.O. MAY TAKE UP TO 5 BUSINESS DAYS TO BE PROCESSED AND ISSUED. OWNER CANNOT OCCUPY OR USE DWELLING UNTIL A C.O. IS ISSUED. OCCUPANCY OR USE OF DWELLING WITHOUT A C.O. WILL BE CONSIDERED AN ILLEGAL OCCUPANCY AND MAY BE GROUNDS FOR VACATING PREMISES UNTIL ABOVE CONDITIONS ARE MET. I understand and agree to abide by the above conditions for occupancy, use and the issuance of a C.O. for the building identified in the Building Permit. } ZZ-20/Q OWNERS SIGNATURE .. DATE Bapplicationdecember2007 Building Plan Review Description of Work: Detached garage Bin#: Location Address: 7815 CR 309 RIFLE, CO Case Manager: David Bartholomew Plan Case Number: BLDG·9--I0-6602 Parcel: 217533200162 Application Date: 0912412010 Building rJ(;.; I Engineered Foundation tv(!) Driveway Pennit / Surveyed Site Plan IJ/11 Septic Pennit and Setbacks J 7 Grade/Topography 30% Attach Residential Plan Review List / Minimum Application Questionnare / Subdivision Plat Notes ~/r4 Fire Department Review / Valuation Detennlnation/Fees / Red Lrne Plans/Stamps/Sticker / Attach Conditions / Application Signed 7 Plan Reviewer To Sign Application 7 < ParceUSchedule No. N/A 40# Snowload Letter-ManLL Homes 1'1/,1 Soils Report Contacts Owner: George & Ella Hcdricks Applicant: George & Ella Hcdricks Applicant Phone: Emalt Planning/Zoning / Property Line Setbacks / 30ft Stream Setbacks / Flood Plain / Building height / Zoning Sign-off N(,t I Road Impact Fees N/~ HOAIDRC Approval / Grade/Topography 40% / Planning Issues 7 -----ssubdivision Plat General Comments: VA ftA.,thl/11 Z./1 boo.- ,Pi'n"'" / ;:-~ e 3 " 9. z, 5"" /2WI~ ,ce(/., z..z..1 .. o I 70r,rt..-576. zt:, ~.f-ffi;tl -ZZ7 .. 0/ - _ptte:::-3'11. z> Applicant: Job Address: Subd-Lot/block: FEE ESTIMATE FOR S/F STICK BUILT HOMES (AU FEES ARE ESTIMATES UNTIL FINAL PLANS ARE REVIEWED) (_o. 8tt.:,so FINISHED LIVING SPACE: sf X 74.68= ---------------------------- UNFINISHED BASEMENT: sf X 41.00= ---------------------------- CRAWLSPACE: sf X 9.00= GARAGE: no sf X 18.00= 2 I (· co -r z. a 0 -------------------------- UNCOVERED PATIO/DECK: sf X 12.00= ---------------------------- COVERED PATIO/DECK: sf X 24.00= ---------------------------- MISC: ------------------------------ MISC: ------------------------------ TOTAL VALUATION: Q:, t, {p Q0 THIS SECTION WILL BE DETERMEND BY GARFIELD COUNTY BUILDING & PLANNING PLAN REVIEW FEE: &d.l .O I PERMIT FEE: TOTAL: PERMIT: SEPTIC= PERC: GARFIELD COUNTY BUILDING AND PLANNING 970-945-8212 MINIMUM APPLICATION REQUIREMENTS · For SINGLE FAMILY DWELLING CONSTRUCTION Including NEW CONSTRUCTION ADDITIONS ALTERATIONS And MOVED BUILDINGS In order to understand the scope of the work intended under a permit application and expedite the issuance of a permit it is important that complete information be provided. When reviewing a plan and it's discovered that required information has not been provided by the applicant, this will result in the delay of the permit issuance and in proceeding with building construction. The owner or contractor shall be required to provide this information before the plan review can proceed. Other plans that are in line for review may be given attention before the new information may be reviewed after it has been provided to the Building Department. TWO (2) SETS OF CONSTRUCTION DRAWINGS & TWO {2) SITE PLANS MUST BE SUBMITTEDFOR ALL APPLICATIONS. Please review this document to determine if you have enough information to design your project and provide adequate information to facilitate a plan review. Also, please consider using a design professional for assistance in your design and a construction professional for construction of your project. Any project with more than ten (10) occupants requires the plans to be sealed by a Colorado Registered Design Professional. To provide for a more understandable plan in order to determine compliance with the building, plumbing and mechanical codes, applicants are requested to review the following checklist prior to and during design. Applicants are required to indicate appropriately and to submit the completed checklist at time of application for a permit. Plans to be included for a Building Permit, must be on drafting paper at least 18"x24" and drawn to scale. Plans must include a floor plan, a concrete footing and foundation plan, elevations all sides with decks, balcony, steps, hand rails and guard rails, windows and doors, including the finish grade line and original grade. A section showing in detail, from the bottom of the footing to the top of the roof, including re-bar, anchor bolts, pressure treated plates, floor joists, wall studs and spacing, insulation, sheeting, house-rap, (which is required), siding or any approved building material. Engineered foundations may be required. A window schedule. A door schedule. A floor framing plan, a roof framing plan, roof must be designed to withstand a 40 pound per square foot up to 7,000 feet in elevation, a 90 M.P.H. wind speed, wind exposure B or C, and a 36 inch frost depth. All sheets to be identified by number and indexed. All of the above requirements must be met or your plans will be returned. All plans submitted must be in compliance with the 2009 IRC, and 2009 IECC. 1. Is a site plan included that identifies the location of the proposed structure or addition and distances to the property lines from each corner of the proposed structure(s) prepared by a licensed surveyor and has the surveyors signature and professional stamp on the drawing? Properties with slopes of 30% or greater must be shown on the site plan. (NOTE Section: 106.2) Any site plan for the placement of any portion of a structure within 50 ft. of a property line and not within a previously surveyed building envelope on a subdivision final plat shall be prepared by a licensed surveyor and have the surveyor's signature and professional stamp on the drawing . Any structure to be built within a building envelope of a lot shown on a recorded subdivision plat shall include a copy of the building envelope as it is shown on the final plat with the proposed structure located within the envelope. Yes ' 2. Does the site plan also include any other buildings on the property, setback easements and utility easements? Please refer to Section 3-301 in the Garfield County Zoning Resolution if the property you are applying for a building permit on is located on a corner lot. Special setbacks do apply. Yes f 3 . Does the site plan include when applicable the location of the I.S.D.S. (Individual Sewage Disposal System) and the distances to the property lines, wells (on subject property and adjacent properties), streams or water courses? Yes ' 4 . Does the site plan indicate the location and direction of the County or private road accessing the property? Yes { 5. Have you provided any RESOLUTIONS and/ or LAND USE PERMIT(S) associated with this property? Yes if Yes please provide a COPY. No __ ,..:....._ __ 2 6 . Are you aware that prior to submittal of a building permit application you are required to show proof of a legal and adequate access to the site? This may include (but is not limited to) proof of your right to use a private easement/right of way; A County Road and Bridge permit; a Colorado Dept. of Highway Permit, including a Notice to Proceed; a permit from the federal government or any combination. You can contact the Road & Bridge Department at 625-8601. See phone book for other agencies Yes X 7. Do the plans include a foundation plan indicating the size, location and spacing of all reinforcing steel in accordance with the IRC or per stamped engineered design? Yes 'I 8. Do the plans indicate the location and size of ventilation openings for under floor crawl spaces and the clearances required between wood and earth? Yes N•A· No ____ _ 9. Do the plans indicate the size and location of ventilation openings for the attic, roof joist spaces and soffits? Yes ,V.A, ----'-----No ____ _ 1 0. Do the plans indude design loads as required by Garfield County for roof snow loads, (a minimum of 40 pounds per square foot up to & including 7,000 feet above sea level), floor loads and wind loads? Yes Y 11. Does the plan include a building section drawing indicating foundation, wall, floor, and roof construction? Yes \. 12. Does the building section drawing include size and spacing of floor joists, wall studs, ceiling joists, roof rafters or joists or trusses? Yes X 13. Does the building section drawing or other detail include the method of positive connection of all columns an q beams? Yes Y ----'------ 14. Does the elevation plan indicate the height of the building or proposed addition from the undisturbed grade to the midpoint between the ridge and eave of a gable or shed roof or the top of a flat roof? (Building height measurement usually not to exceed 25 feet) Yes \ 15. Does the plan include any stove or zero dearance fireplace planned for installation including make and model and Colorado Phase II certifications or phase II EPA certification? Yes rJ, A. No ------- 3 16. Does the plan include a masonry fireplace including a fireplace section indicating design to comply with the IRC? Yes (\} A . No _____ _ 17. Does the plan include a window schedule or other verification that egress/rescue windows from sleeping rooms and/or basements comply with the requirements of the IRC? Yes N A 18. Does the plan include a window schedule or other verification that windows provide natural light and ventilation for all habitable rooms? Yes N A. 19. Do the plans indicate the location of glazing subject to human impact such as glass doors, glazing immediately adjacent to such doors; glazing adjacent to any surface normally used as a walking surface; sliding glass doors; fixed glass panels; shower doors and tub enclosures and specify safety glazing for these areas? Yes y No ____________ __ 20. Is the location of all natural and liquid petroleum gas furnaces, boilers and water heaters indicated on the plan? Yes !J.ft · 21. Do you understand that if you are building on a parcel of land created by the exemption process or the subdivision process, are building plans in compliance with all plat notes and/or covenants? Yes ·l 22. Do you understand that if you belong to a Homeowners Association (HOA), it is your responsibility to obtain written permission from the association, if required by that association, prior to submitting an application for a building permit? The building permit application will be accepted without it, but you run the risk of the HOA bringing action to enforce the covenants, which can result in revocation of permit issued. Additionally, your Plan Review fee is not refundable if the plans have been reviewed by the Building Department prior to any action by the HOA that requires either revocation or substantial modification of the plans. Yes '{ 23. Will this be the only residential structure on the parcel? Yes fV,rf No lfno-Explain: ______ _ 24. Have two (2) complete sets of construction drawings been submitted with the application? Yes X. 25. Do you understand that the minimum dimension a home can be on a lot is 20ft. wide and 20ft. long? Yes /). tl. 4 26. Have you designed or had this plan designed while considering building and other construction code requirements? Yes \. 27. Do your plans comply with all zoning rules and regulations in the County related to your properties zone district? Yes X 28. Does the plan accurately indicate what you intend to construct and what will receive a final inspection by the Garfield County Building Department? Yes -x 29. Do you understand that approval for design and/or construction changes are required prior to the application of these changes? Yes \( 30. Do you understand that the Building Department will collect a "Plan Review" fee from you at the time of application submittal and that you will be required to pay the "Penn it Fee" as well as any "Road Impact11 or "Septic System" fees required, at the time you pick up your building permit? Yes ~ 31. Are you aware that you must call in for an inspection by 3:30 the business day before the requested inspection in order to receive it the following business day? Inspections will be made from 7:30a.m. to 3:30p.m. Monday through Friday. Inspections are to be called in to 888-868-5306. Yes ____ x:......:· __ No _____ _ 32. Are you aware that requesting inspections on work that is not ready or not accessible will result in a $50.00 re-inspection fee? Yes ;( 33. Are you aware that you are required to call for all inspections required under the IRC including approval on a final inspection prior to receiving a Certificate of Occupancy and occupancy ofthe building? Yes V 34. Are you aware that the Pennit Application must be signed by the Owner or a written authority being given for an Agent and that the party responsible for the project must comply with the IRC? Yes X 5 35. Do you understand that you will be required to hire a State of Colorado Licensed Electrician and Plumber to perform installations and hookups, unless you as the homeowner are performing the work? The license number of the person performing the work will be required at time of applicable inspection. Yes , ... 36. Are you aware, that on the front of the Building Permit Application you will need to fill in the Parcel/Schedule Number for the Jot you are applying for this permit on prior to submittal of a bui1ding permit application? Your attention in this is appreciated. Yes V 37. Do you know that the local fire district may require you to submit plans for their review of fire safety issues? Yes ' {please check with the building department about this requirement) 38. Do you understand that if you are planning on doing any excavating or grading to the property prior to issuance of a building permit that you will be required to obtain a grading permit? Yes v 39. Are you aware that if you will be connecting to a public water and/or sewer system, that the tap fees have to be paid and the connections inspected by the service provider prior to the issuance of a Certificate of Occupancy? Yes 1\}.ll 40. If you anticipate obtaining a water tap from the City of Rifle, please provide a letter indicating that the City will provide water service. No building permit application will be accepted without such a letter. 1 Yes fl/. t-t . I hereby acknowledge that I have read, understand and answered these questions to the best of my ability. Signature of Owner fltu_;_;~l (~:~ tt~ k 0 Phone: __ ~_2_5-_1_1..:....rJ_~~ __ (days); Date IlL£~ q-zz__ /u __________ (evenings) Pr~ectName:. ____ ~-~-~-~-~ ____ r_i~ __ D_R_,_~_~_-___ G __ A_e~A~~~E~------------------------- Project Address: ___ '7_8_t_5 ___ c_· ._,_~_. __ 3_o_"l __ ..:..t2_J_P_t-_E_,___c_v_. _8_1_&_s_o __ 6 Notes: If any required infonnation is missing delays in issuing the pennit are to be expected. Work may not proceed without the issuance of a pennit. If it is detennined by the Building Official that additional infonnation is necessary to review the application and plans to detennine minimum compliance with the adopted codes, the application may be placed behind more recent applications for building penn its in the review process and not reviewed until required infonnation has been provided and the application rotates again to first position for review, delay in issuance of the pennit or delay in proceeding with construction. bpminreqsfJun20 10 7 GARFIELD COUNTY BUILDING REQUIREMENTS Codes: 2009 me, IBC, IFGC, IMC, IPC, 2009 IECC. Setbacks: Check subdivisions and zone district for setback requirements. Snow load (measured at the roofl Not ground): 40PSF up to 7000ft. elevation. 50PSF 700 I ft to 8000ft. 75PSF 8001 ft to 9000ft. IOOPSF 9001 to 10000ft. Seismic design category: B Weathering probability for concrete: Severe. Termite infestation probability: None to slight. Wind speed: 90mph. Decay probability: None Wind Exposure: B or C (see section R30 1.2.1.4) Frost Depth: 36in. to 8000ft. elevation. 42in. 8001 and above. Winter Design Temperature: Minus 2 to 7000ft.; minus 16over 7000ft. elevation. Air Freezing Index: 2500deg F-days to 7000ft.; over 7000ft. to be determined by Building official Ice shield under-layment required. Mean Annual temp: Variable Insulation: Windows/doors U=.35, Skylights U2::.6, TBL 402.1.1, 2009 JECC . Minimum R-Values: • Ceilings/roofs R values are R-38 stick built structures. R38 log construction and steel rafter construction. • Walls R values are R-20 wood frame . See Table 402.2.5 2009 JECC for steel framing • Floors R-values are R-30 or enough to fill cavity. • Basement wall R-values are R-10 /13. • Slab perimeter R-values and depth is R-1 0/24in . • Crawl space wall R-value are R1 0/13. If floors over crawl space are not insulated, the crawl space walls must be insulated. Basement wall must be insulated to frost depth . Common walls garage to house must have R-20 insulation . Common ceiling/floor garage to house must have R-20. Take precautions to protect plumbing in these areas. 8 BOARD OF COUNTY COMMISSIONERS OF GARFIELD COUNTY CERTIFICATION AND AFFIDAVIT REGARDING ILLEGAL ALIENS The Contractor, 1·1hose name and signature appears belot·t, certifies and agrees as follOI~S: 1. The Contractor shall comply with the prov~s~ons of C.R.S. 8-17.5-101 et seq. The Contractor shall not kno1·1ingly employ or contract Nith an illegal alien to perform ~fork for the Board of County Commissioners of Garfield County, Colorado ("BOCC") or enter into a contract t·lith a subcontractor that kno1·1ingly employs or contracts 1·li th an illegal alien. 2. The Contractor represents, 1-1arrants, and agrees that it has verified that it does not employ any illegal aliens; that it has participated or attempted to participate in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security; and othen~ise shall comply Nith the requirements of C.R.S. 8-17.5-102(2)(b). 3. The Contractor shall comply 1'11 th all reasonable requests made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and Employment. If the Contractor fails to comply l'lith any requirement of this provision or C.R.S. 8-17.5-101 et seq., the BOCC may terminate Nork for breach and the Contractor shall be liable for actual and consequential damages to the State. 4. If the Contractor is a sole proprietor, the undersigned hereby swears or affirms under penalty of perjury under the laws of the State of Colorado that (check one): ~ I am a United States citizen, or I am a Permanent Resident of the United States, or I am lal·tfully present in the United States pursuant to Federal law. I understand that this sworn statement is required by la1·1 because I am a sole proprietor entering into a contract to perform work for the BOCC. I understand that state law requires me to provide proof that I am la1·1fully present in the United States prior to starting l·tork for the BOCC. I further ackno~o1ledge that I l'lill comply with the requirements of C.R.S. 24-76.5-101 et seq, and 1·1ill produce the required form of identification prior to starting work. I ackn01-tledge that making a false, fictitious, or fraudulent statement or representation in this .s1·1orn affidavit is punishable under the criminal laNs of Colorado as perjury in the second degree under c.R.S. 18-8-503. CERTIFIED and AGREED to this 22 day of CONTRACTOR: (Contractor Full Legal Name) By: Signature of Authorized Rep I~~iqration Atfidavit IOB/06) Final EXHIBIT FEIN or Social Security Number Title Permit Card POST ON SITE PermitND. BLRE-9-1 0-1770 AGREEMENT In consideration of the issuance of the permit, the applicant hereby agrees to comply with all laws and regulations related to the zoning, location; construction and erection of the proposed structured for which this permit is granted, and further agrees that If the above said regulations are not fully complied with in the zoning, location, erection and construction of the above described structure, the permit may then be revoked by notice from the County Building department and IMMEDIATELY BECOME NULL AND VOID. Residential Building Owner's Name: George & Ella Hedricks Job Address: 7815 CR 309 ~R~IF~L=E.~C~O~--------------------------- Parcel#:217533200162 Owner's Phone: -------1 Total Square Feet: 1200 Contractor(s} Phone Primary Contractor Work Description: Detached garage Woodsmlth Construction (970)876-2822 Yes Inspection Scheduling Code Footers Foundation Walls Framing Final Mise Insulation Grout Mechanical UG Plumbing Rough Plumbing Gas ADDITIONAL INSPECTIONS MAY BE REQUIRED POST THIS IN CONSPICUOUS PLACE WHEN CONSTRUCTION IS STARTED For Inspections Call : 1-888-868-5306