HomeMy WebLinkAboutApplicationi:6 Garfield County
Community Development Department
108 gth Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
r -
TYPE OF CONSTRUCTION ------D Commercial/Multi-Family
D Manufactured Home (SF or Duplex)
D Demolition
~---.. ---!
-------Ji'1 Residential (SF, Duplex, or Townhome) =~ Reroof -------
INVOLVED PARTIES
Property Owner: 0,4£! '\ 1i A \J !hll MfJ Phone : (Tu) 6Ij-c£~
MailingAddress: \D<.oS ~6 8f],1 aft.&, [lo? .. -SS\(o5D
Contractor: G,~ WM~ !hone: fDo) 5}9--cQC.p
Mailing Address: \DtoS E:AQ:;£, 21, ~·q; ch). 8\tr&L\ \ i.e
Manufactured Home Installer:-----------Phone: ( __ ------
Mailing Address: ------------------------------
PROJECT NAME AND LOCATION
Describe Work: C~l>I Cn,H111.e,;,1-W .\n ~ '-uJ...1 1«£i 1Jt,li!!>i=. ~j
JobAddress: \O(oS:: W:~& ebt ~.~.b
1
llo. B\(aQJ
Assessor's Parcel Number: di}?r · ?:63 -(l)~-rub. c.'!VAbSi~tM \)hW lof~~ Block
Owner's Valuation of Work: $ llSit: 'fO Property Size {Sq.Ft or Acres): lo • S l~
Sq.Ft of Building: -.i.~i...::.:~~=-=-~ _ _.\._l=.._
1
___ #of Floors:._l ...... Y ..... u.._ __
Class of Work: GJ New ~Alteration D Addition D Repair D Move/Relocation
Garage: D Attached
Septic: ~OWTS
Type of Heat: D Natural Gas
Driveway Permit: ~Exempt
D Propane
l
C!l Detached
D Community
i( Electric T D Other
D Permit#:-------
' I
NOTia -
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.
Vold 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.
CERTIFICATIQN -=i
I 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 Regulatlon(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. I
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 provided the required information which is correct and accurate to the best of my knowledge.
cg~""'/ w'tA.lla.ce ~°'JvJ-\>J~
Property bwner Print and Sign \
Ja.-7-H
Date
OfFICl~L USE ONLY
Special Conditions:
Adjusted Valuation : Plan Check Fee : Permit Fee: Manu home Fee: Misc Fees:
15~511.3b B4z.so 1zqb.15'
Total Fees : Fees Paid: Balance Due: BP No:
Zl:!B,bS' .Lt-°l r519./fo &£>€ .. ?A-1'{
Setbacks: OCCGroup: Const Type: Zoning:
f i.~ rzis, $1?J :C'/2.L ~C-
BUILDING /PLANNING DIVISION :_,~d~....;'~~111'-o=. . ...;... ___ z._/;....,?.r--~------
Signed Approval Date
~·
cG'" Garfield Co11nty I
Community Development Department
108 8th Street, Suite 401
Glenwood Springs; CO 81601
(970) 945-8212
www.garfield-countv.com
Applicant:
Job location:
Sub-Lot/Block:
Gary & Patricia Wallace
1~65 ~age Rd. Rifle
Craig Exemption Lot # 3
BUILDING PERMI~
FEE ES"FIMATE
WORKSHEEl'
I I
'I
..
Fill ONLY in the yellow areas
Type of Space
Finished Living Space: Main level & Loft
(NIA for Mamifocl/lred llomcJ I
Unfinished Basement
Crawl Space
Garage
Covered Patio/Deck
Uncovered Patio/Deck
Misc: Sunroom
Misc:
Misc:
Total Valuation
Manufactured Home Set-Up
Single level ($400.00)
Multi-Level ($600.00)
Total Set-Up Fee
Septic
Permit ($123.00)
--
Percolation ($150.00)
Total Sep tic Fee
Square Feet
-1902 sQft X
SQ ft X
Ill ,_-sq ft X
sqft X
305 SQ ft X
~Q ft x
174 sqft l -sq.It X
sq ft X
Value
per sq. ft.
$74.68
$41.00
$9.00
$18.00
$24.00
$12.00
$24.00
$0.00
$0.00
This section will be determined by Garfield County.
rrotal fees
Plan Review Fee
Building Permit Fee
Pt1 )" separately ll'ith Ca .rh o r Clied 011/y (Road impact fees)-Other
Due at time of Application Submittal
Due at time of Permit Pick-Up
•
Valuation
$142,041.36
$0.00
$0.00
$0.00
$7,320.00 1
$0.00 :
$4,176.00
$0.00
Valuation
$0.00
Valuation
$0.00
------· $0.00
$0.00
$0.00
Gar:ficld Co11111):.J
B uildin g/ Zoning P lan R eview Checklist
Permit Number:
Building Planning[ Zoning
/ Engineered Foundation / Property Line Setbacks
/ Driveway Permit / 30 ft . Stream Setbacks
/ Surveyed Site Plan I Flood Plain
/ Septic Permit and Setbacks / Building Height
/ . Grade/ Topography 30% / Zoning Sign·Off
> / Attach Residential Plan Review List }/II Road Impact Fees
/ Subdivision Plat Notes / Grade/ Topography 40%
JV/Ir Fire Department Review Planning Issues
/ Valuation Determination/ Fees L Subdivision Plat
/
Red Line Plans/ Stamps/ Sticker
/ Attach Conditions
I Application Signed General CQmments:
/ Plan Reviewer to Sign Application
/ Parcel/ Schedule No.
/J/11 40# Snowload Letter -Manu. Homes
tf t? Soils Report