HomeMy WebLinkAboutApplicationJ
n n ('""': ·~1 •r" 1 ,Community Development Department ~' ~· ~. 111 . · \\.ll'J ../ ~ R V i · 108 gth Street, Suite 401
JUN 2 2 2016
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-countv.com
GARrlf:L;) COUNTY
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D Comm ercial/Multi-Family
D Manufactured Home (SF or Duplex)
0 Res id ential (SF, Du lex, or Town home)
INVOLVED PARTIES
PropertyOwner: E{g[ f;LE;/V" Phone: (7/~ )57tJ -6:;~v
M ailing Address: ,3?7Z> ?&~zed 46'r Seu~ C&_ s.G;Z~ .. Co8'/o
.....__._.._-=--~=--............ -"""""""""'---=-:...L....:.:::....-::::.......;.....=c..;__;__ Phone: ( V 9 ) 5-zv -!:, CJ~ 0
. _"'5'/7}r 6u-/,..;r""Q#/,.6"'...Vii ~# / J."'~~ ~iteett tJM<:,JL .&€urA/2,b Phone: (7Zl> L37/_,6-.;?G<2
Cp,,v/,4C:. Mailing Address: ~ J1 /?eJ.. ~,6'~,7 ~, e'o g'/~ocZ,
r-----------------------------------------------1
Engineer: /km~ d'55ct:_ ~t/ft Phone: ( 77.(i'J) 9~-7? ?S--
Mailing Address:/d?-/S-6MN .f) /i1v~ 6tuS, ee .9/~~/
Manufactured Home Installer: _____ -=-_........-:: ____ Phone:( __ ) ~
Mailing Address: //" /
PROJECT NAME AND LOCATION
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JobAddress:...£..iSZ!ii.L--.::..:.::~:?::!.~~~=+-~..::..tC..~:...L:.~~~'..k!~~~-------l
Assessor's Parcel Number:~378?20f'&'f"""3 Sub. C!/E.PG/£ ~ 1l1ot 1{3 Block
Owner's Valuation of Work:$ ef&e, &ff'Z:? ~ Property Size (Sq.Ft or Acres):
; --------~
Sq.Ft of Building: Height:------#of Floors: ________ __
Class of Work: D New D Alteration D Addition pair D Move/Relocation
Garage: D Attached D Detached
Septic: Cl ISDS D Community
Type of Heat: Cl Natural Gas D Propane D Electric D Other
Driveway Permit: Cl Exempt D Permit#: -----------------
NOTICE
Authoritv. 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.
Leeal Access. A Building Permlt 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 Electrica l 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
Vold Per mit. 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 hereby certify that I have read this Application and that the Information contained above ls true and correct. I
understand that the Building Dlvlslon aOO!pts the Application, along with the plans and speci fications and other
data submitted by me or on my behalf (submlttals), based upon my certification as to accuracy. Assuming
completeness of the submittals and approval of this Application, a Building Permi t will be issued granting
permission to me, as Owner, to construct the structure(s} and facilities detailed on the submlttals reviewed by the
Building Division . In consideration of the issuance of the Bull ding 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 Regulatlon(s)). I acknowledge thatthe Building Permit
may be suspended or revoked, upon notice from the County, if the location, construction or use of the structure(s)
and faclllty(les), described above, are not in compliance with County Regulatlon(s) or any other applicable law.
I hereby grant permission to the Bull ding Division to enter the property, described above, to inspect the work. I
further acknowledge that the issuance of the Building Permit does not pr event the Building Official from: (1)
requiring the correction of errors In the submltta ls, if any, discovered after Issuance; or (2) stopping construction
or use of the structure(s) or facility(ies) if such is in violation or County Regulallon(sl or any other app licable law.
Review of this Appllcatfon, Including submlttals, and Inspections of the work by the Building Division do not
constitute an acceptance of responsibility or Uablllty 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 Regulat ions
rest with me and my authorized agents, Including without llmltatlon my architect designer, engineer and/ or
bu"lder.
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.
A-~ll I-i-c. ~ca..g.....,: iff~r l -p./-JG..
Property Owner Print and Sign Date
OFF.ICtAl JfSE C!IM:Y
.•
Special Conditions:
Adjusted Valuation: Plan Check Fee: Permit Fee: Manu home Fee:
;z~o tt?o. f.!!? /00~ /SS~. 75 ~
Total fees: Fees Paid: 9'-1 Balance Due: ~:
1653. 7.) ~(X:A . 643. BI
Setbacks: DCC Group: Const Type :
25 /?Zti)IO .z~ :CJZ.G
BUILDING/PLANNING DIVISION :_d __ ·.u.~..,-~..:=i.:;:-=;.a,,::;:;...>i<:'--;:~~-~----
Slgned Approval
Misc Fees: -
Zoning:
R.
~te I
------·-·-
Permit Number:
Building 7'
----Engineered Foundation
_f\y'._11 __ Driveway Permit
I Subdivision Plat Notes
f'YA Fire Department Review
/ Valuation Determination/ Fees
/ Red Line Plans/ Stamps/ Sticker
I Attach Conditions ..
/ Application Signed
/ Plan Reviewer to Sign Application
/ Parcel/ Schedule No.
/J/lf 40# Snowload Letter-Manu. Homes
tv/IJ Soils Report
Planning/ Zoning
r.J./ A Property U~e Setbacks
30 ft. Stream Setbacks
flood Plain
Building Height
Zoning Sign-Off
Road Impact Fees
Grade/ T9pography 40%
Planning Issues
l Subdivision Plat
\
General Comments:
' .
~ --;J 200 oc:.c:; ,
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