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HomeMy WebLinkAboutApplicationGarfield County Community Development Department 108 Vh are OCA 2 8 Za16 Glenwood Ej ings, CO81641 (970) 945-8212 www.Qaffield-munty.com BUILDINGPERMI. IT APRJGNTO TYPE OF OONS'TFZIicn ON Com ercial/Multi-Family Demolition Manufactured Home (5ngle or Multi -Level) Pasidential (g, Duplex or Townhome) Fbroof I WOLVED PARTIES Property Owner: J�9 ok rA-\�X. Phone: M ail i ng Address: C -7M W l NCkff'iS S 0 f l (bntrador:D.��1.1,r-rS-G Phone: Mauling Address: Architect. r Phone: ) 1 bQ9 9 't Mailing Address: i S S+ t 2 Lr�l %]1 Z Engineer: 1 Phone: c )6�6 Mailing Address. U3• We C QAmy-\ Manufactured Home Installer: Q /R Phone: ( � Mailing Address: PROJKT NAM EAND LOCATION Describe Work: VNLUD SQj2A Q�aAcm e.omJ+lQA-4lLt Jab Address: As'sessor's Parcel Number: Y�S�3)Z)@b. Lot Block Owner's Valuation of Workm 11R C Z- Property Sze (5q. R. or Ames): 5a. R. of Building: ' � Height: #of Floors Oassof Work: 4UNew bLAteration I UL lAddition WFbpair I W Move/Wocation Garage: tached WDetached S?ptic Community Type of Heat: W Natural Gas ffJRopaneI ' Sectric t1JOther Driveway Pbrmit: Exempt I WPL-rmit #: ac,V\f*6�en, ee ncO C,Sa ; n a � . L6kA 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 maybe required: (1) Sate Sectrical Permit, (2) County OJUTSPermit, (3) another permit required for use on the property identified above, e.g. Sate or County Hghway/ Fbad Access or a Elate 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. r" 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 agentswill comply with provisions of any federal, state or local law regulating the work and the Garfield County Building Gbde, ONTS regulations and applicable land use regulations (County Fegulation(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 Obunty Regulation(s) or any other applicable law. I hereby grant permission to the Building Division to enter the property, described above, to inspect thework. I further acknowledge that the issuaneeof the Building Permit doesnot 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 fadlity(ies) if such is in violation of Qunty Fegulation(s) or any other applicable law. Feview 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 PeWlations 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 GBrtification above, aswell as, have provided the required information which isoorrect and accurateto the best of my knowledge. �c Property Owner Print and Sign OM(IAL UM OILY — - ,93edal (bnditions: Adjusted Valuation: 415 Plan Check Fee: Permit Fee: Manu home Fee: Misc Fees: 000.00 1 251.25 --- .� TO al Fees: Fees Paid. Balance Due: BPNo OhIVT5N 4414.x& 3, 3 �51.'�� ,4 --- Setbacla OOCGroup: const Type- Zoreing- FX,-',fe25 Slp V Fvb BUILDING/ BANNING DIVISONJ : P�a*(t 'n 1 & Sgnedpr al Date r -10 -¢ Ili 3.NO eco, 10lu11(o Garftrlcl Cattttrr BufldinvJ Zoning ]Plan Review Checklist Permit Number: VLliO - 10 - j{v-4414 o Building / Engineered Foundation N Driveway Permit J Surveyed Site Plan N/A Septic Permit and Setbacks f Grade/ Topography 30% / Attach Residential Plan Review List N� Subdivision Plat litotes P�A Fire Department Review Valuation Determination/ Fees / Red Line Plans/ Stamps/ Sticker Attach Conditions / Application Signed / Plan Reviewer to pA Sign Application Parcel/ Schedule No. 40#Snowtoad Letter—Manu. Homes Soils Report Planning/ Zonin Property trine Setbacks 30 ft. Stream Setbacks Flood Plain Building Height / Zoning Sign -Off Road impact Fees Grade/ Topography 40% Planning Issues N/ASubdivision Plat General Comments: Sra-�e op DAek- 1-20 -+ r oe VOLI"'(*00 : 0/51000. PAN- A19iol' .