HomeMy WebLinkAboutApplicationPermit No:
GARFIELD COUNTY BUILDING PERMIT APPLICATION
108 81° Street, Suite 201, Glenwood Springs, CO 81601
Phone: 970-945-8212 / Fax: 970-384-3470 / Inspection Line: 970-384-5003
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Parcel/Schedule No:
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AGREEMENT
PERMISSION IS HEREBY GRANTED TO THE APPLICANT AS OWNER, CONTRACTOR AND/OR THE AGENT OF THE CONTRACTOR OR OWNER TO CONSTRUCT
THE STRUCTURE AS DETAILED ON PLANS AND SPECIFICATIONS SUBMITTED TO AND REVIEWED BY THE BUILDING DEPARTMENT.
IN CONSIDERATION OF THE ISSSUANCE OF THIS PERMIT, THE SIGNER. HEREBY AGREES TO COMPLY WITH ALL BUILDING CODES AND LAND USE
REGULATIONS ADOPTED BY GARFIELD COUNTY PURSUANT TO AUTHORITY GIVEN IN 30.28.201 CRS AS AMENDED. THE SIGNER FURTHER AGREES THAT
IF THE ABOVE SAID ORDINANCES ARE NOT FULLY COMPILED WITH IN THE LCOATION, ERECTION, CONSTRUCTION, AND USE OF THE ABOVE DESCRIBED
STRUCTURE, THE PERMIT MAY BE REVOKED BY NOTICE FROM THE COUNTY AND THAT THEN AND THERE IT SHALL BECOME NULL AND VOID.
THE ISSUANCE OF A PERMT BASED UPON PLANS, SPECIFICATIONS AND OTHER DATA SHALL NOT PREVENT THE BUILDING OFFICIAL I
REQUIRING THE CORRECTION OF ERRORS IN SAID PLANS, SPECIFICATIONS AND OTHER DATA OR FROM PREVENTING BUILDING
CARRIED ON THEREUNDER WHEN IN VIOLATION OF THS CODE OR ANY OTHER ORDINANCE OR REGULATION OF THIS JURISDICTION.
ROM THEREAFTER
OPERATION BEING
THE REVIEW OF SUBMITTED PLANS AND SPECIFICATIONS AND INSPECTIONS CONDUCTED THEREAFTER DOES NOT CONSTITUTE AN ACCEPTANCE OF
ANY RESPONSIBILITIES OR LIABLITIES BY GARFIEID COUNTY FOR ERRORS, OMISSIONS OR DISCREPENCIES. THE RESPONSIBILITY FOR THESE ITEMS
AND IMPLEMENTATION DURING CONSTRUCTION RESTS SPECIFICIALLY WITH THE ARTICTECT, DESIGNER, BUILDER, AND OWNER. COMMENTS ARE
INTENDED TO BE CONSERVATIVE AND IN SUPPORT OF THE OWNERS INTEREST.
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I HEREB ACKN01 EDG 3`I CI HAVE READ AND UNDERSTAND THE AGREEMENT ABOVE (INITIAL):
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Job Address:
Cid › D"Vd�tC0--
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1 Lot No: Block No:Subd. / Exemption: `
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2
Owner: r' `Ol.
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Address
to ,•---3..Sv.// se.: %& _
Ph:
97 `92o-'%/ et)
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Contractor:
e(..,41,,,-/o'it—
Address:
Ph:
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Lic. No.
es
4
Architefgj't�fEngineer:
ALS 7" j�
Address•
1 v 1.10A 55/
Ph: .
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ie. No.
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5
Sq. Ft. of Building:
let- e(difi6n� /0 NA- /az .
Sq. Ft. of Lot: , f
�t
Height: ..,,,s,/
No. off Floors:
6
Use of Building: /y
.5 / A/T4 icAv✓e-tom #46 A
7
Describe Work:
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8
Class of Work: ❑ New o Alteration ❑ Remove
e ---Addition ❑ Move
9
10}(n
Garage: o jingle
Double
Carport: o Single
o Double
Driveway Permit o On -Site Sewage Disposal ❑ Site Plan
►"lA -1 1D .•S'_Lf. - (Septic)
11
Valuation of Work: $ zo /Fa, c
(•,
Adjusted Valuations:
$ l
1 /,
/41g140-
/ �
12
Special Conditions:
NOTICE
A SEPARATE ELECTRICAL PERMIT IS REQUIRED AND MUST BE
ISSUED BY THE STATE OF COLORADO..1441-171
CONSRUCTION
THIS PERMIT BECOMES NULL AND VOID IF WORK 011 T
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR, IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL
PROVISIONS OF LAWS GOVERNING THIS TYPE OF WORK WILL BE
COMPLETED WITHIN WHETHER SPECIFIED HEREIN OR NOT. THE
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY
TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
LOCAL LA REG . ATING ' 1 NSTRUCTION OR THE PERFORMANCE
OF CO S. UCTI .
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Plan Check Fee:
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Permit Fee:
4
2409,25 ,25
Total Fee: Dated Permit Issued:
345, AP
OCC Gr up' Const. Type:
Zoning:
Setbacks:
Manu. Home: ISDS No. & Fee:
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` APP ROVA /DATE APPROVALIDATE J
AGREEMENT
PERMISSION IS HEREBY GRANTED TO THE APPLICANT AS OWNER, CONTRACTOR AND/OR THE AGENT OF THE CONTRACTOR OR OWNER TO CONSTRUCT
THE STRUCTURE AS DETAILED ON PLANS AND SPECIFICATIONS SUBMITTED TO AND REVIEWED BY THE BUILDING DEPARTMENT.
IN CONSIDERATION OF THE ISSSUANCE OF THIS PERMIT, THE SIGNER. HEREBY AGREES TO COMPLY WITH ALL BUILDING CODES AND LAND USE
REGULATIONS ADOPTED BY GARFIELD COUNTY PURSUANT TO AUTHORITY GIVEN IN 30.28.201 CRS AS AMENDED. THE SIGNER FURTHER AGREES THAT
IF THE ABOVE SAID ORDINANCES ARE NOT FULLY COMPILED WITH IN THE LCOATION, ERECTION, CONSTRUCTION, AND USE OF THE ABOVE DESCRIBED
STRUCTURE, THE PERMIT MAY BE REVOKED BY NOTICE FROM THE COUNTY AND THAT THEN AND THERE IT SHALL BECOME NULL AND VOID.
THE ISSUANCE OF A PERMT BASED UPON PLANS, SPECIFICATIONS AND OTHER DATA SHALL NOT PREVENT THE BUILDING OFFICIAL I
REQUIRING THE CORRECTION OF ERRORS IN SAID PLANS, SPECIFICATIONS AND OTHER DATA OR FROM PREVENTING BUILDING
CARRIED ON THEREUNDER WHEN IN VIOLATION OF THS CODE OR ANY OTHER ORDINANCE OR REGULATION OF THIS JURISDICTION.
ROM THEREAFTER
OPERATION BEING
THE REVIEW OF SUBMITTED PLANS AND SPECIFICATIONS AND INSPECTIONS CONDUCTED THEREAFTER DOES NOT CONSTITUTE AN ACCEPTANCE OF
ANY RESPONSIBILITIES OR LIABLITIES BY GARFIEID COUNTY FOR ERRORS, OMISSIONS OR DISCREPENCIES. THE RESPONSIBILITY FOR THESE ITEMS
AND IMPLEMENTATION DURING CONSTRUCTION RESTS SPECIFICIALLY WITH THE ARTICTECT, DESIGNER, BUILDER, AND OWNER. COMMENTS ARE
INTENDED TO BE CONSERVATIVE AND IN SUPPORT OF THE OWNERS INTEREST.
Garfom.003
I HEREB ACKN01 EDG 3`I CI HAVE READ AND UNDERSTAND THE AGREEMENT ABOVE (INITIAL):
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Applicant
PLAN REVIEW CHECKLIS
Building
/14Engineered Foundation
/44 -Driveway Permit
`✓ Surveyed Site Plan
Septic Permit and Setbacks
Grade/Topography 30%
�-' Attach Residential Plan Review List
Minimum Application Questionnaire
Subdivision Plat Notes 6•,e
va Fire Department Review
Valuation Determination/Fees
'Lied Line Plans/Stamps/Sticker
i(i(A(- Attach Conditions
Application Signed
Date
1z� �
✓Plan Reviewer To Sign Application
reel/Schedule No.
4/440# 40# Snowload Letter- Manf. Hms.
GENERAL NOTES:
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3-
Planning/Zoning
Loperty Line Setbacks
30ft Stream Setbacks
x//g.F1ood Plain
Building Height
'oning Sign -off
N Road Impact Fees
Orr HOA/DRC Approval
grade/Topography 40%
Planning Issues
Subdivision Plat Notes