HomeMy WebLinkAboutApplicationAPR i 4 ?TU
GurJield County
BUILDING FEFM IT
AFF'IICATONOmmunity Development Depart ment
108 8th Sreet, $ite401
Genwood Srings, æ81601
(s7o)st5-8212
www.qarfield-county.oom
TYFE OF æt lSIH.rC'tl Oñ¡
[Tll Õmmercial/
Manufadured Fbme (Sngle or Multi-Level)
E ryq@lal (EQple¡ or royv¡lo¡e) Þaã,¡
fiwolvÐPARnES
[Ð Demolition
FÞroof
Roperty Oryner:
MailingAddress:
EimailAddress;
-TTavls Ç
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Omtrador:
MailingAddress:
EinailAddress:
Arctrited: Ç,rrrÉ l4.9 O$üht*êa
Fhone: (4|'lo ) ZôA lsls
Cútlt
rbaT
Fhone: latla) 211.4?;11
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Fhone: ( )
MailingAddress:
EinailAddress:
trçineer:êlL gcc-\+ -IãrY\ lr.nl<Fhone: (q1o) AV.S-oS11
q 9oçMailingAddress:
Ei¡ailAddress:NA
Manufadured l-lome lndaller:Nfr Fhone: ( )
MailingAddress:
EinailAddress:
FFûETDËTAß
Describe Work:
ùc'tMåøl t -{4ñø¿n
Jcb Address:
Assessor's Parcel Number z 7-303- lq-oo4
$b.Lot &t Bock-
On¡ner'sValuation of froperty Sæ (8. R. or Acres):1.84 +t.
Q. R. of ELrilding:3.ç19 Fleight:z?l- lr r #of Hoors l-llz-
Oassof Work:
Garaç:
Ë**lflrupa¡r
E OetacrreO@Rtta*reo
[TF]Ateration [E]Roo¡t¡on [E Move/rulocation
Saptic
ripeofteàt:
FFNET;I.DETA¡lsæNNNUED
ño¡rs ll[]o¡mmuníty
fìâs H Ropane im CIher
Driveway Þrmit:EIBerrrpi
NOÏCE
Authority. This application for a B.¡ilding Frmit mud be dgned by the Orvner of the property, deuibed abovo,
or an authorized æBnt. lf the dgnature below is not that of the Ouner, a separate letter of authority, dged by
the Oruner, mu$ be provided with thisApplication.
Leoal Aæss. A B.rilding Þrmit cannot be is$ed without proof of legal and adequate accessto the property for
purpoæs of inçedions by the B:ilding Dvidon.
Qherturmitg Multipleseparatepermitsmayberequired:(1)SateBedricalfurmit,(2)ÕuntyClrlliSturmit,
(3) another permit rquired for use on the property identified abovre, e.g. Sate or ôunty Hghway/ Fbad Affiss
or a SateWadewater Dsdnrge furmit.
Voidturmit. A&.rildingÞrmitbeæmesnullandwidiftheworkauthoriædisnotæmmenædwithin180drys
of the date of isslanceand íf work issuçended or óandoned for a period of lS0daysafter æmmenæment.
:CRflRAAïoN
I haeby certify that I have read thisApplication and that the information æntained above istrue and ærred. I
under$and that the &:ilding Dvisjon acceptsthe Application, along with the plans and çecifications and other
data submitted by me or on my behdf (zubmittals), bd upon my ærtification asto accuracy. Assrming
completenæof the slbmittalsand appror,d of thisApplication, a B:ilding furmit will be issred granting
permisdon to me, asOrvner, to æn$rud theSrudure(s) and facilitiesdetailed on thes.rbmittdsreviarued by
the fuilding Dvision. ln oondderation of the iss;ance of the fuilding Èrmit, I agree that I and my agentswill
comply with provisions of any federal, date or local lau¡ regulating the work and the G*field Ocunty fuilding
Oode, O¡VlSregrlations and applicable land uæ regulations (Orunty Fb$rlation(s)). I acknowledge that the
ELilding Fermit may be srçended or revoked, upon notiæfrom the Ocunty, if the location, æn$rudion or uæ
of the drudure(s) and fæility(ies), deecribed above, are not in æmplianæ with ùunty Fbgulation(s) or any
other applicable lary.
I hereby gnant permisdon to the fuilding Elividon to enter the property, described above, to in+ed the work. I
further ad<nowledç that the issranæ of the å.¡ilding Fsrmit does not prevent the fuílding Officid from: (1)
requiring the ærredion of errors in the s.¡bmittdg if any, disævered after iss.¡anæ; or (2) dopping
condrudion or use of the Srudure(s) or facility(ies) if st¡ú is in violation of ôunty Fbguldion(s) or any other
applicablelal. FÞviorof thisApplication, indudings:bmittalq and inspedionsof theworkbythefuilding
flvisjon do not conÉitute an acceptance of reçondbility or liability by the ôunty of errorg omissjons or
disøepancies. Asthe C)¡vner, I acknowledge that reçonsibilityfor complianæ with federal, date and local la¡ris
and Øunty FÞgulations red with me and my authorized æpnte induding without limitation my archited
and/ or builder
I hereby acknowledge that I have read and underdand the Notiæ and Grtificáion above, as well as, har¡e
provided the required ion whidl is corred and aæ.¡rate to the be$ of my knovledge.
ql¡cltt
Roperty On¡ner fr int and Sgn -Tl'aVif J.çtr.¡{+Date
7
oFon¡_usEo¡,¡LY
S:ecial Ornditions' 1¿ NtÀ'þa& lîqt of c-otúih'oug.
AdiuSed Valuation9|42,ll4. on
Hans4 fheck FÊe:02.4b
turmit tue:bltV31.55 Manu homefue:Ù,4 Miscfues:t¿/e
Total4g ftþs:
057.01 5ffi'.¿ot Balance Due:41,'1t*.t7 (ÀmE- l{&i}trBPNo:CIffïSNo:
Yvi:.{ì MI
Stbacks:
BLÀ¿.Øntt'lw
oæGoup: lR¿ÕnsType: IRC Qe¡iço:
É-
>leþo,tBUI I-DI NG / HANNI NG DIVIS ON
v
DateSøed
ilb7 .t 7Ø 8q
I G e;;;¿¡;a;,;¡l
Buildins,l Zonins Plan Review Checklist
Permit Number:ÞL<e-l4-tt- 4bt7
Building Planni Zonins
'/ Engineered Foundation
{Driveway Permit t4/^
N/A
'/ Buitding Height
Grade/ Topography 30%Zoning Sign-Off
/ Attach ResidentialPlan Review List
'/ Subdivision Plat Notes
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain,/ surveyed site Plan
/ Septic Permit and Setbacks
Fire Department Review
'/ Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed
'/ Plan Reviewer to Sign Application
/Parcel/Schedule No.
Road lmpact Fees
/ Grade/Topography40%
/ Planning lssues
Subdivision Plat
N/A
General Comments:
%nt!rq/r^f '
Ma,tn lr&Ll
l4pptu l*vrlX 4o# Snowload Letter- Manu. Homes
'r' soils Report
Valw,fron -
4,5t5 x 9'zî'44= I lfr l?'o4.
2-73xít6.Ø^* 1flt4.
anl
rp54
gubto*al 4t575
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