HomeMy WebLinkAboutApplicationAdmit -
Garfield County
V'Carnmunity Development Department
-�, 108 8 Street, Suite 401
0% Glenwood Springs, CO 81601
ail ? (970) 945-8212
-(-0131 ,, '4ww.garfield-county.com
TYPE OF CONSTRUCTION
❑ Commercial/Multi-Family
❑ Manufactured Home (Single or Multi -Level)
Residential (SF, Duplex or Townhome)
INVOLVED PARTIES
Property Owner: f!,.21tL
Mailing Address: 5 10
13
Contractor:
Mailing Address:
❑ Demolition
❑ Reroof
TICA � 1 2 z.tl
Phone: (q 16 ) 9 11' 1
r rN Si us*z
Phone: 10
Architect: a-rGA Phone: (moi Zo)
Mailing Address: 1 fir' 4 mrd 4 146b
Engineer: GI 11' ( SuG LA -Ir -4 Phone: [976
Mailing Address: LIA 'W % h Z
Manufactured Home Installer:
Mailing Address:
PROJECT NAME AND LOCATION
Describe Work:
Phone:( )
Job Address: -1 . 3�L - z.
Assessor's Parcel Number:
Sub.
Lot Block
Owner's Valuation of Work: $ 0. 000 Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building: tU Height: # of Floors:
Class of Work:
I ❑ New 13 Alteration
O Addition
[3 Repair
Garage:
i'
l ❑ Detached
1 ❑ Attached
❑ Move/Relocation
Septic: OWTS ❑ Community
Type of Heat: ❑ Natural Gas M Propane I [3Electric
Driveway Permit: 0 Exempt ❑ Permit #:
❑ 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 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. 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 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.
Property Owner Print and Sign
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation: Plan Check Fee: Permit Fee:
77 B.SI. go .S45. 84 B 3 9 7S
Total Fees: Fees Paid: Balance Due:
17'e5-59 C`3f.. 4q 1, 03Z, 80
Setbacks: OCC Group: Const
X25 ,eZ✓r 5/0
Date
Manu home Fee:
Misc Fees:
r
BP No:
OWTS No:
-
GiiS)�l
ype:
Zoning:
_r_ PC,
12,
BUILDING/ PLANNING DIVISION: — 0AZ/
6
Signed Approval mate
v~* )41 Ce 'b 3sa.
10-4 Garfrld Co�inn�
Builder HU rin Review Chi
Permit Number:
Application Signed
. Plan Reviewer to Sign Application
Parcel/Schedule Flo.
4O##5nowload Letter- Manu- Homes
/ Soils Report
Planning/ Zoning
Building
7-
Engineered Foundation
Driveway Permit
/
Surveyed Site Pian
Grade/ Topography 40%
/
Septic Permit and Setbacks
l
Grade/ Topography 3030
Building Height
Attach Residential Pian Review List
d
Nf 1T
Subdivision Plat Notes
N(R
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed
. Plan Reviewer to Sign Application
Parcel/Schedule Flo.
4O##5nowload Letter- Manu- Homes
/ Soils Report
Planning/ Zoning
`
MIA
Property Line Setbacks
Road Impact Fees
30 ft. Stream Setbacks
Grade/ Topography 40%
/
Floold Plain
l
Subdivision Plat
Building Height
General Comments:
ell, 51e" 940� 1g.60do azo
A+X 7¢.66 = 697P. Z0
,A 7
Zoning Sign -Off
MIA
Road Impact Fees
Grade/ Topography 40%
/
7
Planning Issues
Subdivision Plat
General Comments:
ell, 51e" 940� 1g.60do azo
A+X 7¢.66 = 697P. Z0
,A 7
Garfield County
Community Development Department
108 8`h Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.aarfield-county.com
SINGLE FAMILY OR DUPLEX BUILDING PERMIT APPLICATION CHECKLIST
In order to understand the scope of work intended and to expedite the issuance of a permit, it is
important that complete information be provided. Please review this document to determine if you have
adequate information to design your project and to facilitate a plan review.
APPLICATION FORM: Please make sure the following information is provided on the application.
• Parcel number obtained from the County Assessor's Office.
• Job address (assigned physical address)
• Legal Description: lot, block, filing, subdivision or tract, section, township and range.
• Owners name, mailing address, phone, fax or cell.
• Contactors name, mailing address, phone, fax, or cell.
• Architect/Engineer's name, mailing address, phone, fax or cell.
• Building size, height, number of stories and lot size.
• Use of building (Residential).
• Class of Work (New, Addition, Alteration, Repair, Demo, Move/ Relocation).
• Detailed description of work.
• Type of heating (natural gas, propane, electric, other).
• Sewer system (Community or OWTS), also see other items below.
• Garage (Attached or Detached).
• Driveway permit (please see other items below).
• Valuation (labor and materials), see attached worksheet.
OTHER ITEMS:
• If you anticipate obtaining a water -tap from the City of Rifle, please provide a letter indicating that
the City will provide water service. Required to summit building permit application.
• OWTS requires a septic permit application to be submitted with the building permit application.
• A separate electrical permit must be obtained from the State of Colorado Electrical Board.
• At the time of building permit submittal, you are required to show proof of legal and adequate
access to the site. This may include proof of right to use a private easement, County Road &
Bridge permit, or Colorado Department of Highway permit, including a Notice to Proceed. The
County Road & Bridge Department can be reached at 970-625-8601.
• If you anticipate excavating or grading prior to issuance of a building permit, you will be required
to obtain a separate grading permit.
• If you belong to a Homeowners Association (HOA), it is your responsibility to obtain written
approval, if required.
• Provide copies of any Resolutions and/or Land Use Permits associated with this property.
• Additional Dwelling Units may regyire Administrative Review.
• Minimum dwelling dimension is 20 ft wide x 20 feet long.
• A Colorado State Licensed Electrician and Plumber must perform installation and hook-ups,
unless the homeowner is performing the work.