HomeMy WebLinkAboutApplicationGarfield County
APR 082416
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.Rarfield-countv.com
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
❑ Commercial/Multi-Family
E
Residential (SF, Duplex, or Townhome)
0 Manufactured Home (SF or Duplex)
❑ Demolition
❑ Reroof
O Grading (locate all utilities prior to grading)
INVOLVED PARTIES
Property Owner: e)P,tA. v. - S �%��� �� d
Mailing Address: PC) • 80,e )172.
Contractor:
Phone: ( `Z7v ) 6( 7
,-Ca 6z5'
Mailing Address:
Phone:(
} t
Architect: r v! CA.k-) GA.. S. CI Ei i ci
G= tr oo CI 11) � k 5 01)
Engineer:Lic. t-kv,'�z�e
Mailing Address: G J�
Manufactured Home Installer: I} �-
Phone: (17t)) g6 7 - 2 6 /
Mailing Address:
T NC Phone: ( 72 )
f2 -
Phone: (
Mailing Address:
PROJECT NAME AND LOCATION
Describe Work: Rt- rP cia-t ett
Job Address: (- D , 5tc Jyr v t71&6,..)-60,„-4))(7)
Assessor's Parcel Number: Sub. Lot
Owner's Valuation of Work: $ l52
Property Size (Sq.Ft or Acres):
Block
3,6t/
Sq.Ft of Building: 30 `t d Height: 2•1 r it A " # of Floors: g.
Class of Work: INew 0 Alteration 0 Addition
[Garage:
Septic:
Type of Heat:
Driveway Permit:
Grading
131/Attached
II ISDS
0 Natural Gas IR Propane
Exempt
Square Feet of Earthwork E A-
❑ Repair 0 Move/Relocation
❑ Detached
❑ Community
Electric ❑ Other
❑ Permit #:
Cubic Yards of Earthwork
13B
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 ISDS 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. 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, ISDS
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.
hereby acknowledge that l 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.
Property Owner Print and5ign G
G'-Gs"--of-
l
Date
OFFICIAL USE ONLY
Speaal Conditions:
Adjusted Valuation:
/5,,53/ Ere)
Plan Check Fee:
Sitz.sn
Permit Fee:
/zge.if
Manu home Fee:
Misc Fees:
Total Fees:�//
Z II /e.b5
Fees�FPaid:
V��.d14
Balance Due: )
1 3, 0. 1 L
BP No:
IISSD'S No:
{r
15u2E- yigD
e i rqI LH
Setbacks:
OCC Group:ja .r.c..„
Const Type:� �
Zaning:12-..
BUILDING / PLANNING
DIVISION : eg
4/0-4 //4
Signed Approval Date
Garfield County
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:
Lf ti/01c-
) osfp,
BUILDING PERMIT
FEE ESTIMATE
WORKSHEET
Fill ONLY in the yellow areas
Square Feet Value
per s;. ft.
Type of Space
Finished Living Space
(,1 A for ,t a:Wiaciured !lamest
Unfinished Basement
Crawl Space
Garage
Covered Patio/Deck
Uncovered Patio/Deck
Misc:
Misc:
Total Valuation
Manufactured Home Set -Up
(Single level ($400.00)
Multi -Level ($600.00)
Notal Set -Up Fee
Septic
Permit ($123.00)
Percolation ($150.00)
Total Se . tic Fee
Valuation
HJZ n[) sgltX'
sq.fi X
Itl ix sq.lt X
i?6'0 sq.ft X
snit X
sgftX
sq.ft X
1. ft X
$74.68
$41.00
$9.00
$18.00
$24.00
$12.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
This section will be determined by Garfield County.
Plan Review Fee
Building Permit Fee
Pay separately with Cash or Check only (Road impact fees)- Other
Due at time of Application Submittal
n
+ti
Valuation
$0.001
Valuation
$0.00
$0.U0
CIA nn
Garfield ConirtyJ
ev ew Check!!st
Permit Number: /2 -tee - ¢-l6 - ¢/¢O
SEPT ¢-/6 - / 1 /
Building
Engineered g Foundation
Driveway Permit
Surveyed Site Pian
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
N/A
IjA
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
1
Planning/ Zonin&
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign -Off
NM -
Road Impact Fees
Grade/ Topography 40%
Planning Issues
Subdivision Plat
General Comments:
Garfield County
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:
BUILDING PERMIT
FEE ESTIMATE
WORKSHEET
Lindsay Residence
1270 CR 112 Carbondale
N/A
Type of Space
Fill ONLY in the yellow areas
Square Fee
Finished Living Space: ML=640, UL w/Balc=745
(N/At for Manufactured Nacres)
Unfinished Basement
Crawl Space
Garage
Covered Patio/Deck
Uncovered Patio/Deck/514;15
Misr:
Misc:
Misc:
Total Valuation
1385
1760
528
464
sq ft X
sq ft X
sq ft X
sq ft X`
sq ft X
sq ft X
sq ft X
sq ft X
sq ft X
Value
per sq. ft.
Valuation
$74.68 $103,431.80
$41.00 $0.00
$9.00 $0.00
$18.00 $31,680.00
$24.00 $12,672.00
$12.00. $5,568.00
$0.001$0.00
$0.00 $0.00
$0.0Q $0.00
4 $153,351.80
Manufactured Home Set -Up
Single level ($400.00)
Multi -Level ($600.00)
Total Set -Up Fee
rSeptic
Permit ($123.00)
Percolation ($150.00)
Total Septic Fee
Valuation
$0.00
Valuation
$o.00
This section will be determined by Garfield County.
Plan Review Fee
Building Permit Fee
Pay .separately with Cash or Check_ only (Road anpaci fees)- Other
Due at time of Application Submittal
Due at time of Permit Pick -Up
$o.00
$0.00
Total fees $0.00