HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8"' Street, Suite 401
'Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-countv.com
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
0 Commercial/Multi-Family
I❑
Demolition
0 Manufactured Home (Single or Multi -Level)
Residential (SF, Duplex or Townhome)
Reroof
INVOLVED PARTIES
�nWl� T� (f r70 ) � 9 2.(6502.(650Property Owner: � �(�1r( 14.iV � � Phone:
yb672.
jp 2.53 , i.�4t, Cdt
Email Address: .SYI(,� l . t-r�i
Mailing Address:
Contractor: Phone: (
Mailing Address:
Email Address:
Architect: Phone: (_)
Mailing Address:
Email Address:
Engineer: on 0�4.J} Phh]one: (1 1.)5 ) ) `9-2-2—E,5
(,5 l.0 Ehitt 6W Or 1 b n
Mailing Address:
Email Address:
Manufactured Home Installer: Phone: ( )
Mailing Address:
Email Address:
PROJECT DETAILS
Describe Work: Ji iRe), dDy l e
Job Address: -1 P cit 2 -5 i ei "t i ( n
Assessor's Parcel Number: 212 / 3 )-40 0 Pi 5- '90
Sub. Lot Block ( —�--
Owner's Valuation of Work: $ libr�i I) Property Size (Sq. Ft. or Acres): J(,1i(.#'("5
Sq. Ft. of Building: 1501) + Height: i+-41 # of Floors: 1
Class of Work: 0 New
Garage:
0 Attached
0 Alteration
0 Addition
0 Repair
11( Detached
0 Move/Relocation
PROJECT DETAILS CONTINUED
Septic: ❑ OWTS
Type of Heat: 0 Natural Gas
Driveway Permit: 1 - 0 Exempt
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. 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
I designer, engineer and/ or builder.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provicj d the re = u€re in rmat€on which is correct and accurate to the best of my knowledge.
0 Propane
❑ Community
❑ Electric
❑ Permit #:
❑ Other
Prop#rty Owner Pr t and Sign
OFFICIAL USE ONLY
Special Conditions:
Date
Adjusted Valuation:
Total Fees:
Setbacks:
R)
Plan Check Fee: Permit Fee: Manu home Fee:
3 2 ,53 502.3 M) fl
Nes Paid:99 Bal nce Due: BP No:
OCC Grou
}C Cons e:
BUILDING / PLANNING DIVISION :
Sig
r'3 f��1-1/(Irk"
val
113c l eAs:
OWTS No:
Zoning:
Date
1 (i ut:field [runty
Building/ Zoning Plan Review Checklist
Permit Number: t8,Lp—o4— /7- 4 -
Building
v.f/ Engineered Foundation
Planning/ Zoning
g-roivs, Property Line Setbacks
riveway Permit ! 2 5 30 ft. Stream Setbacks
S6Veyed•Plan its -
Site /V "- Flood Plain
Septic Permit and Setbacks
pry_ Building Height
Grade/ Topography 30% Zoning Sign -Off
Attach Residential Plan Review List d Road Impact Fees G/y-a-cc
J11Subdivision Plat Notes L"'7 --Grade/ Topography 40%
Fire Department Review. Planning Issues
Valuation Determination/ Fees X11, 4 Subdivision Plat
--Red Line Plans/ Stamps/ Sticker
L ------Attach Conditions
Application Signed General Comments.
/60" s',F. )94 eb-O
L —ran Reviewer to Sign Application
Parcel/ Schedule No.
1/r r( 40# Snowload Letter– Manu. Homes
Soils Report