HomeMy WebLinkAboutApplicationW 1 ; 3 Wll
Garfield · County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-countv.com
TYPE OF CONSTRUCTION
D Commercial/Multi-Family
D Manufactured Home (S ingle or Multi-Level)
af"R~sidential (SF, Duplex or Townhome)
-INVOLVED PARTIES
J __ g _ Demolition
I D Reroof
Property Owner: ~~~.ex,.._ ~Jy Jt ;it,,/ Phone: (~7 ) lf oiS 20 Li -z_
Mailing Address : /910 .G/uf}./ t'ft-c.~ /.Jlttvt-~~I l'O ~ t> 21<
Email Address: f~~l:.Yil @> 1::.?rtL-n-tt./# ~ · .Al£./
Contractor: __ 0_"'4_1/b'Z-___ ;t$ __ ~ __ w __ z..--_____ Phone:( __ ) _____ _
Mailing Address:-------------------------
Email Address: _________________________ _
Architect: /);'9-ff 0 ,,/ F7fr.. C Cl,,//./ £,tt-
Mailing Address : 'f 1'Zl-tr~,._,. ~.e.
EmailAddress: ~I\) €SC.e> G
Phone: ( f'~{) ")"t> 7' 7 8 f, ~
4.J• ~ i/l'-t L--t}J 3 711?
~~. 01~
Engineer: S~M I'rJL-' Phone: ( tfJ~ )qt{< /C04-
Mailing Address : I/ tr W · t I-?12S£r 4. rJ5 {P 'iflbOI
Email Address: /Ji::P!Z @ 5&i;t~ pc. ~d~
' PROJECT DETAILS
Describe Work: /l(i:ri.J ~,.J~Tfl.vcfi1,.J to9 1£>/Yl. C-t;./l ,t,_
PAtZ-rJ -b \...P ~\Oex\OL
Job Address: r: ~.P · ~/L d? Gw' :> t'"o
Assessor's Parcel Number: Z-S ~~/*)° ¥000 I~
Sub. rR l1l!l-.:5.ecv# Lot Block wrr rt/: 6 ------
Owner's Valuation of Work: $ ,,7.f?Z., e:>t::>e> -Property Size (Sq. Ft . or Acres): ?. / t/
Sq. Ft. of Building: / e 6' Z-Height: Z?f / #of Floors: z_ t-~p-">'f.V\£-t'"
I ~ New D Alteration I D Addition
D Attached
D Repa ir I D Move/Relocation
ft De t ached
Class of Work:
Garage:
PROJECT DETAILS CONTINUED
Septic:
Type of Heat:
Driveway Permit:
NOTICE
5t OWTS
lif'Natu ral Gas
D Exempt
I D Propane
D Community
~Electric j D Other
D Permit#:--------
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 ifthe 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.
understand that the Building Div ision 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 cons ideration of the issuance of the Building Permit, I agree that I and my agents will
comply with prov isions 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 i nspect 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 facil ity(ies) if such is in violation of County Regulation(s) or any other
applicable law. Review of this Application , includ ing 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 ~ndf o r 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 .
.reff1<~"'~-rz-:/cs~z
Property Owner Print and Sign Date
OFFICIAL USE ONLY
Special Conditions:
Total Fees:
S~.J3>
Setbacks:
Date
I e Gu1:.fie/d Cmmty I
Building/ Zoning Plan Review Checklist
Permit Number:
Bujlding
___ /_ Engineered Foundation
f V!Yltf?Driveway Permit
__ __,/~ Surveyed Site Plan
___ /_ Se tic Permit and Setbacks
----Grade/ Topography 30%
----~ach Residential Plan Review List
/V ~Subdivision Plat Notes
!{, /, Fire Department Review
/
__ _,./:::;....._ Valuation Determination/ Fees
__ __.:::= · ed Line Plans/ Stamps/ Sticker
___ _.......-:_ A;plication Signed -----------Plan Reviewer to Sign Application
--___:;_~-Parcel~ Schedule No.
----40# Snowload Letter-Manu. Homes
F
c.P
Planning/ Zoning
D ,f.. Property Line Setbacks
Q 1 K · 30 ft. Stream Setbacks
/Flood Plain S;;;. J./, 7fi
----~ding Height
____ Grade/ Topography 40%
-----..-/......--Planning Issues
/\I i A-. Subdivision Plat
General Comments:
JNJJ~
;sr
bsacr
<trio y; 27
2} ~by 71 ft:::
/5'1,29L
211~0
I fl:>, ~sz.
and/or plans for compliance, the application may be placed on hold until the required information is
provided. Work may not proceed without the issuance of a permit.
The Building Division will collect a Plan Review fee at time of application submittal. The permit fee, as
well as any Road Impact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by person having written authority from the owner
to act as their representative.
Building cannot be occupied until a Certificate of Occupancy (CO) is issued. Using the building without a
CO will be considered an illegal occupancy and may be grounds for vacating the premises. (Final/CO
inspection requirements will be attached to your approved field set of plans .)
I hereby acknowledge I have read, understand and will abide by the requirements of this
checklist.