HomeMy WebLinkAboutApplication• - — - - •
•CI -Tc", Z -Z 17 t
ills Sth Silva Suite 401, Gielnrotx1 Springs. CO 81601
Ph:970-945-8212 Fx:970-384-3440 Inspection Line:368-SAY-5306
www.garlield-eminiv.com
BUILDING PERMIT APPLICATION
1
Parcel No: (this information ix nraidalde et the assessors offile 970-945-9)34)
'-'81-41-1-1—reln4-6€i7c-r-wi 2/ 7 7 / yVao.,-y7
Lot No: Block No: Solid/ Exemption:
5E.moo 11 . ircy,th.51.., 0 C? , ZAN r, t. ",c1 3 Sw
2
Tr3D
Job Address: I if IM address has not hese ssigned. please provide CR, 1 INT or Sireel I'Vritar LC (ity) or a r d ieeSt description
Ill -414V6-- ',. e.... 3C -D Rk P•l_._. C 0 B 1 tz '0
3
Owner: (j7reperti. owner)
UW IS
Mailing Address: . ').MX, 6563
ir,VI:
?Cks -a 31 - a0E,
Alt Ph:
1VA- (0-11 - k 807
-
4
Contractor:
C;t51.P.i.ist Vj Lt.:A- A-.C.wE,5
Manufactured home installer
Otil t -1,f cLard(
Mailing Address: bii. so
07394. ).1-kLif 6 So (37, to f,i,.55-
Mailing Address:
)1 66. vil-u.Ey ?L toimos-,2 to 8D5Fo
Ph:
ecto -..)66-8E,Dt
Ph:
(PO- 4-10- i.--N3ci
All Ph:
Lie /1:
loo Zaipo
5
6
Architect:
,
Mailing Address:
Ph:
Alt Ph:
7
En neer.
%IAD i..46/HCR-Ir-16
Mailing Address:
PrO. 0(.1.‹ li•C-. IhleADitt Or N(51$
Ph:
`435.- 769 —S
Alt Ph:
8
Sq. Ft. orBuildin g..j.a1/4-kb
Sq. FI. or Acres of Lot:
Height
Height, 'i
No. of Flgrs:
9
Use of Building:
XResidential 0Commereial DOther
Class of Work:
DAlteration DAddition DRepair DDemo °Move
13
.1t4lew
Describe Work:
i RC_ R 3-(-012,y CA -Pi_ Coro
11
Garage:
0Allached ElDetached
Septic:
XISDS DCommunity
Type of Heat:
CIN at. Gas g.,'rapane DElectric DOther
,--)
12
Driveway -
Pcmit:Cie—E1 2— - n •
Owners valuation ol-Work:
c•:)?,.90 ono
i
This application Mr o Building Permit must be signed by the Caviler of the propeny, described above. of an authorized anent. lithe signature below is not that of the Mama separate
letter of authority. sipcd by the Owner, must be provided with this Applicalion.
LetAl• AM -I5. A Building Pemtit cannot be issued without proof of legal and adequate access ta the property for purposes *f inspections by the Building Department.
Other Permits. Multiple separate permits may be menthol. (1) Slate Elccineol Pamir, (2) County !SOS Permit, (3) another permit requited for use art the prupeny identified above, e.g. State or
Conroy Ilighwayriload Access or a State WaSt[W3WT Dtrcbecgc Permit.
Mold Permit, A Building Penult becomes null and void lithe work authorized is not commenced within 180 days of the Mart of issuance end if work is suspended or abandoned far a pcdod of 180
days after commencement.
CERTIFICATION
1 hereby certify dna 1 have mud this Application and that the information cartinined above is MR and correct. I understand shut the Building Demur -lent mews the Application, along with the plans
and specifications and ni liar data submittal by urs or on my behrlf (submittals), basal upon my certification as to accuracy
Assuming completeness of the submittals and approval !Antis Application, o Building Permit will he issued granting permission to me, as Owner, to construct the structurc(s) oral faciliiies dmailed on
the submittals reviewed by the Building Department.
In consideration era. issuance of the Building Pen-nii. I agree that I and ing agents will comply with provisions or any federal. stale or local law regulating the work nod the Garfield County Building
Code, ISDS regulmions and applicable laud use regulations (County Regulation(s)). I aelmowledge that the Building Permit may be suspentled or revoked, upon nolice from the County, inane location,
construction or use of the structurc(s) and focitityriesl, described above, art not in compliance with County Regulatian(s) or any other applicable law.
1 hereby grant permission to the Building ficpanittens to cuter the property, described ribose, to inspect the work. 1 further acknowledge that the issuance of the Building Permit does nal prevent the
Building Official from ( 11 requiring the correction of errors in the submittals, if tiny, discovered oflcr Issuance; or (2) slopping construction or use of the sustaine() or faritity(hm) ifsuch 15 in violation
of Counly Regalotion(s) or any ether apoiisetae law.
Review of this Application. including submittals. and inspections of the work by the Building Depanment do not constitute an acceptance of responsibility or liability by the County of emus, omissions
or discrepancies. As the Owner. I acknowledge that responsibility for compliance With federal, state and local laws and County Regulations rest with toe and my authorized agents, including without
limitation my architect designer. engineer nod/ ar btlitder.
111 11Y ACKNOWLEDGE THAT I BALE READ AND UNDF: STAND THE NOTICE & curriFICATLON ABOVE.:
f
/ I r ", ....T. .------
0 cibck-}
p .1 R1 ATU E ...
DATE —
Kin( z.a.rel
CY2z
STAFF USE ONLY
24
Special Conditions:
Adjusted Valuntion:
// .6 0.- tV()
Plan Cheek Fee:
I 3 6 . 0 )
Permit Fee:
20 9: z
Munn home Fee:
0_< 60 00
Prlisc Fees:
„..--
.1
Total Foes:
g41,5: '6'
Fees Paid:
1O e .---.
Balance Due:
8 i*C. 6
BP Nu& Issue Dam
et,Mf-a [9.5.)
ISDS No & Issued Dale:
2Pt-Dib53
Setbacks: i
r zs- ei,c 5/0
OCC Group
E0C-
Conti fype: Zoning:
22c ?••••
//1//,40----
A PPRO% AL DATE
APPROVAL DATE
Applicant
Address
Date
VALUATION FEE DETERMINATION
Lewis Residence
TBD CR 320
1/29/2013
Subdivision
Lot/Block
Contractor
Finished (Livable Area):
Main sq.ft
Upper sq.ft
Lower sq.ft
Other sq.ft X $74.68
Total Square Feet 0 sq.ft
Total Valuation
Basement:
Unfinished
Conversion of Unfinished to Finished
Other
Total Valuation
Garage/Storage (wood framed)
Conversion of garage to finished living
Carport
Other
Total Valuation
Crawl Space
Total
Valuation
Decks/ Patios/Porches
Covered
Open
Other
Total Valuation
Type of Construction:
Occupancy:
Total Valuation
Total Valuation
830
sq.ft X $41.00
sq.ft X $33.68
sq.ft X
sq.ft X $18.00
sq.ft X $56.68
sq.ft X $12.00
sq.ft X
sq.ft X $9.00
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
N/A
N/A
Goldenvilla Horses
0.00
(2nd floor -site finish)
27,954.40
0.00
0.00
0.00
0.00
27,954.40
e—
Building Plan Review
Description of Work: Amending BLMF-10-12-2657
Bin #:
Location Address: 8877 CR 320
RIFLE, CO
General Information
Contacts
Case Manager: David Bartholomew
Plan ('ase Number: BLDG -I-13-7468
Parcel: 217719400547
Application Date: 01125/2013
Owner: Grayson & Kate Lewis
Applicant: Grayson & Kate Lewis
Applicant Phone: (806)231-2089 Email:
Building
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/Topography 30%
Attach Residential Plan Review List
r
Minimum Application Questionnare
Subdivision Plat Notes
Fire Department Review
Valuation Determination/Fees
Red Line Plans/Stamps/Sticker
Attach Conditions
Application Signed
Plan Reviewer To Sign Application
Parcel/Schedule No.
40# Snowload Letter - Manu. Homes
Soils Report
i
Planning/Zoninq
Property Line Setbacks
30ft Stream Setbacks
Flood Plain
Building height
Toning Sign -off
Road Impact Fees
/AY/ HOA/DRC Approval
Grade/Topography 40%
Planning Issues
Subdivision Plat
General Comments:
1/414(44.0( ? 9'5Y. 90 s,4' shudt!)
,,4,4 e 10e).
,� VL/. 5 �
7° 7-71-1- CZ",
Tuesday, January 29, 2013
NOTE: If any required information is missing, delays in issuing the permit are to be expected. If
determined by the Building Official that additional information is necessary to review the application
and/or plans for compliance, the application may be placed on hold until the required information is
provided. Work may not proceed without the issuance of a permit.
The building department 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
checldlst.
Signattfre f Owner
Oc/730 12_
Date
Garfield County Building & Planning
108 81h Street, Suite 401
Glenwood Springs, CO 81601
Phone: 970-945-8212 Fax: 970-384-3470
www.oarfield-county.com