HomeMy WebLinkAboutApplicationR·ECEIVED
JUL 1 Z015
GARFIELD couN ·
)MMUN ffY DEVELOPMENT
Garfield County
Community Development Department
108 8 1h Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
TYPE OF CONSTRUCTION d
D Commercial/Multi-Family 1 D Demolition
D Manufactured Home (Single or Multi·Le_v __ e_I_)==_._...,._...... _________ ·----~-=--__ _ D Resident~ (SF, Duplex or Townhome) D Reroof
I INVOLVED PARTIES ~e...~C_r.,lk (' l'Jf,l'fiJ
rropertv 0wner: L~ ,~5 ~Jr rhone: 1' 7•
Mailing Address: =2t~~~So a.".;::;; ":5€ T Cu
l
)~t;1 sz s
Contractor: _________________ Phone:( __ . ______ _
Mailing Address:----------------------------
Architect: __________________ Phone:( __ . ______ _
Mailing Address:----------------------------
Engineer: __________________ Phone:( ________ _
Malling Address: ___________________________ _
Manufactured Home Installer: ___________ Phone:( __ -------
Mailing Address: ___________________________ _
-
PROJECT NAME AND LOCATION
Describe Work: U / .. ·f1...:?d: // (:='c
Job Address: 2-J 9 ).. S /(t..Jf ~ f_ f},£& Co SC<4. S:O
I Assessor's Parcel Number: _______ Sub.--------Lot __ Block __ i.
I Owner's Valuation of Work:$ 2.0CrJ ~ Property Size (Sq. ft. or Acres):
I
Sq. Ft. of Building:-------Height:------#of Floors:. _____ _
1 Septic:
I Type of Heat:
Class of Work: D New D Alteration 1 b Addition l HRepair D Move/Relocation
D Attached I D Detached
I D OWTS E ommunity
~ D Natural Gas -0-P-ro-p-an_e___ 0 Electric
Garage:
I -Driveway Permit: D Exempt d Permit#: -------
--·--r I D Other
'
NOTICE - -
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 Divi sion.
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. --------I CERTIFICATION
I hereby certify that I have read this Application and that the information contained above is true and correct. 1
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 Regutation(s)). I acknowledge that the Building Perm it
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
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 submlttals, 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.
I 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 o r 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, eng ineer and/ or
builder.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as,
hav rovlded the required Information which is correct and accurate to the best of my knowledge.
Dat e
OFFICIAL USE ONLY
Special Conditions:
: Adjusted Valuation: Plan Check Fee: Permit Fee: Manu home Fee:
Zooo,--4).01 f::,9.ZS' -
Total Fees: Fees Paid: BP No:
11 4-.u ~ Of Ba~n 9 ~u~~ ~G, ?i oJ
Setbacks: OCCGroup: Const Type:
; I I u.. ~e f~O , J!.1.$ {,/o
I
/ HJ I BUILDING /PIANNING DIVISION ,JP.~~
Signed Approval
Misc Fees:
-
OWTSNo: --Zoning: CG
~
I Pate
L Gar:ficld Cou11t)'
Building/ Zoning Plan Review Checklist
Permit Number: rENC--7-15-~ea/
Building
JV/ I} Engineered Foundation
tJ/ A Driveway Permit
/ Surveyed Site Plan
rJ//I Septic Permit and Setbacks --l-Grade/ Topography 30% -t---Attach Residential Plan Review List
____ Subdivision Plat Notes
__ / __ Fire Department Revi ew
__ / __ Valuation Determination/ Fees
__ / __ Red Line Plans/ Stamps/ Sticker
__ / __ Attach Conditions
/
----Application Signed
/
----Plan Reviewer to Sign Application
/
----Parcel/ Schedule No.
t-1/A
40# Snowload Letter -Manu. Homes
f'J/ II Soils Report
Planning/ Zoning
/ Property line Setbacks
/ 30 ft . Stream Setbacks
/ Flood Plain
/ Building Height
/ Zoning Sign-Off
/VIA Road Impact Fees
/ Grade/ Topography 40%
/ Planning Issues
/ Subdivision Plat
General Comments: