HomeMy WebLinkAboutApplicationGarfield County 1
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-countv.com
1al
GOkti.D
V41101\M 0E:41
TYPE OF CONSTRUCTION
❑ Commercial/Multi-Family I 0 Demolition
❑ Manufactured Home (Single or Multi -Level)
■ Residential (SF, Duplex or Townhome) f 0 Reroof
BUILDING PERMIT
APPLICATION
INVOLVED PARTIES
Property Owner: Steven G Haines
Phone: ( 970 ) 903-3892
Mailing Address: 0126 Linden Circle Carbondale, CO 81623
Contractor: Homeowner Phone: ( )
Mailing Address:
Architect Dryas Design Studio Phone: ( 203 ) 610-7633
Mailing Address: 596 Jacobs Place Carbondale, CO 81623
Engineer: Odisea Engineering
Mailing Address: PO Box 1809 Paonia, CO 81428
Manufactured Home Installer: N/A
Phone: ( 970 ) 270-7353
Phone: (
)
Mailing Address:
PROJECT NAME AND LOCATION
Describe Work: New Residence Construction
Job Address:
Assessor's Parcel Number: 2393-284-09-012 Sub. Cooperton Townsite Lot 17, C Block 9
Owner's Valuation of Work: $__78,221 Property Size (Sq. Ft. or Acres): 9450 sq. ft
Sq. Ft. of Building: 996 sq. ft
Height:L _ # of Floors: 1.5
Class of Work: T i• New 0 Alteration 0 Addition 0 Repair 0 Move/Relocation
Garage: lip. 1 ❑ Attached 0 Detached
Septic: ® OWTS 0 Community
t
Type of Heat: 0 Natural Gas 0 Propane ■Electric 0 Other
Driveway Permit: 0 Exempt U Permit #:
1
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 Division 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.)
hereby acknowledge I have read, understand and will abide by the requirements of this
checklist. / p
S#l? i (J - sAe,Ct n45
Property Owner Print and Sign
615
Date
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 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.
Void 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.
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 Regulation(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.
53'e
I
Property Owner Print and Sign
Date
6/-4 )
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation:
84/57`:56
Plan Check Fee:
.57769
Permit Fee:
5g -7,›
Manu home Fee:
Misc Fees:
Total Fees:
/466.44
Fees Paid:
SSD .31
Balance Due:
9/ 6, O�
BPNoo
OWTS No:
1g1-4-3(01-1
S 3k
Setbacks:
Fz5 125, 31 rJ
OCC Group:
-E•C
Const Type:
.Z'gG
Zoning:
P
BUILDING / PLANNING
DIVISION :
Signed Approval Date
pd. # 210, (471I0)1S
Garfield County
Community Development Department
108 Bth Street, Suite 401
Glenwood Springs, CO 81601
(970)945-8212
www.garfield-countj.com
BUILDING PERMIT
FEE ESTIMATE
WORKSHEET
Applicant: Steven G Haines Phone: 970 903-3892
Project Address; No address yet : Parcel # 2393-284-09-012
Subdivision: Cooperton Townsite Lot: 17, C
Block: 9
Type of Spacer_ —.
Suare.Feet -- —
Valuation _—.._.... __.
Finished Living Space (N/A for Manufactured Homes)
996
-
$74, 381
Unfinished Basement
0
$0.00
Crawl Space
0
$0.00
Garage
0
$0.00
Covered Patio/Deck
0
$0.00
Uncovered Patio/Deck
320
$3840.00
Misc:
0
$0.00
Misc:
0
$0.00
To alk alums i
78' 221:00`
Mattufaatured Herne Set -Up.._ _
Fee M>
Single Level ($400)
—
$0.00
Multi -Level ($600)$0.00
i _
$0.00
Tota; > µ _ . _ -
0.00
eptic{overs
. .
New Installation ($123)
$123.00
Alteration and/or Repair ($75)
$0.00
Perculation ($150)
$150.00
Ses ticFt
273:00
This Section Determined by Garfield County
Plan Review Fee
$0.00
Building Permit Fee
$0.00
Manufactured Home Set -Up Fee
$0.00
•
Septic Fee (OWTS)
$0.00
Other (Ex: Road Impact Fee)
Total Fees Due
**Ali fees are estimates until final pian review is completed"*
$0.00
$0.00
Garfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.earfietd-county.com
Applicant:
Job location:
Sub-Lot/Block:
BUILDING PERMIT
FEE ESTIMATE
WORKSHEET
Haines Residence
TBD
Cooperton Townsite, Lot 17
Fill ONLY in the yellow areas
Type of Space
Finished Living Space: Main Level & Loft
(N/A for tltasuf(Iezured Homes)
Unfinished Basement
Crawl Space
Garage
Covered Patio/Deck
Uncovered Patio/Deck
Misc:
Misc:
Misc:
Total Valuation
Square Feet Value
per sq. ft.
1067
105
198
Manufactured Home Set -Up
Single level ($400.00)
Multi -Level ($600.00)
Total Set -Up Fee
eptic
Permit ($123.00)
[Percolation ($150.00)
Total Septic Fee
Valuation
sq ft X 574.68
sq ft X 541.00
sq ft X 59.00
sq ft X 518.00
sq ft X 524.00
sgftX 512.00
sq f1 X 50.00
sq.ft X $0.00
sq ft X 50.00
$79,683.56
$0.00
$0.00
$0.00
$2,520.00
$2,376.00
$0.00
$0.00
50.00
$84,579.56
Valuation
$0.00'
Valuation
$0.00
This section will be determined by Garfield County.
Plan Review Fee
Building Permit Fee
Pay separately with Cash or Check onl v (Rood rmpact fees )- Other
Due at time of Application Submittal
Due at time of Permit Pick -Up
Total fees
$577.69
$888.75
$577.69
$888.75
$1,466.44
£,°«:ty _I
Biaildinv Checklist
Permit Number: &:,e6 b./5_3.4 5.E1,7: /s-?
Building
Engineered Foundation
Driveway Permit
S- urveyed Site Plan
S- eptic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
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.
N1/
40# Snowload Letter — Manu. Homes
Soils Report
Planning/ Zoning
Property Line Setbacks
f 30 ft. Stream Setbacks
Flood Plain
Building Height
` Zoning Sign -Off
NRoad Impact Fees
▪ Grade/ Topography 40°
Planning Issues
Subdivision Plat
General Comments: