HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-Lou nty. Com
TYPE OF CONSTRUCTION
O Commercial/Multi-Family 0 Demolition
BUILDING PERMIT
APPLICATION
O Manufactured Home (SF or Duplex)
O Residential (SF, Duplex, or Townhome) O Reroof
INVOLVED PARTIES
Property owner: Jeff Kirkpatrick Phone: 303 )775-7956
Mailing Address: 228 Mesa dr Rifle, Co 81650
Contractor: High Profile Roofing LLC Phone: ( 970 1485-4367
Mailing Address: Po Box 2313 Glenwood Springs,Co 81602
Arch: Phone: ( )
Mailing Address:
Engineer: Phone: ( )
Mailing Address:
Manufactured Home Installer: Phone: (_)
Mailing Address:
PROJECT NAME AND LOCATION
Describe Work: Tear -of existing roofing materials, to install 2 rows ice and water shield at eaves
and finish up dry -in with synthetic underlayment, new flashing and 30 year asphalt shingle
Job Address: 228 Mesa dr Rifle, Co 81650
Assessor's Parcel Number: Sub. Lot Block
Owner's Valuation of Work: 5 22'365.00
Property Size (Sq.Ft or Acres):
Sq.Ft of Building: Height: # of Floors:
Class of Work: 0 New 0 Alteration 0 Addition 0 Repair 0 Move/Relocation
Garage: 0 Attached 0 Detached
Septic: 0 ISDS 0 Community
Type of Heat: 0 Natural Gas 0 Propane 0 Electric 0 Other
Driveway Permit: 0 Exempt 0 Permit tf:
NOTICE
Authority. ority. 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.
Leal 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 1 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, 1 agree that 1 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)). [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.
1 hereby grant permission to the Building Division to enter the property, described above, to inspect the work. 1
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.
l hereby ac
have
at 1 have read and understand the Notice and Certification above as well as
ulred information wh h Is correct and accurate to the best of my knowledge.
Owner Print and Sign
74 17
Date
'OFFICIAL USE ONLY
Spedal Conditions:
Adjusted Valuation:
Plan Check Fee:
Permit Fee:
100
Manu home Fee:
Mlsc Fees:
Total Fees:
1 01)J
Fees Paid:
(t V
Balance Due:lie
Koo1=-14CTQ
j5 d o:
Setbacks:
OCC Group:
Const Type:
Zonktg: K
BUILDING / PLANNING
DIVISION :
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