HomeMy WebLinkAboutApplicationCorfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, 0081601
(970) 945-8212
www. garfi el d -co u nt v. co m
BUI LDI NG FERN] IT
APPLI CAII ON
TYPE OF CONSTRUCTION
Commerdal/Multi-Family a��vta.v".4 rc�
Manufactured Home(Sngle or Multi-level) r�
it Residential (W,, Duplex or Townhome)
!
Demolition
BU %roof
INVOLVE
ffioperty
Mailingl
Email Add
Cont recto
Mailing A
Ernail Add
Architect:
Mailing A
Email Add
Engineer:
Mailing A
Email Add
Manufact
MailingA
Ernail Add
} PARTIES
IT
Gruner: i L.4
) N
�./o a 1 u- s
Phone: (9 y0) S ?
9 - / 33 `i
VG t-
idress: / 90
P./ o-zt. [. iv
g 04-54 -4_7
ress: ij 5- (
G' ‘...)147 k -P6 --it)
i
C -o tit
r:
Phone: (
)
idress:
ress
Phone: (
)
idress:
ress:
Phone: (_
)
idress:
ress
_red Home Installer:
idress
Phone: (
)
ress
PR OECT❑EMLS
l
Describe Work: Ai -_e_ p 4 61-4-- f f p loo o4 4.
v o. Z s c - A4 . 54-r ..l
Job Address: tp Ut2_ l 7)
Assessor's Parcel Number:
Slab. Lot Block
Owner's Valuation of Work `$ 1 21000 -') Property Sze (Sq. Ft. or Acres):
Sq. R. of Building: /o 5-O O Height: #of Roors: (
Class of Work: M New ®Alteration L JAddition UU %pair
Garage: LlAttached
I Al Detached
PROJECT DEfAILSODN11NU®
ptir_
!ovvrs
Type of Heat: 71 Natural Cas
11
Propane
F9
RB
FO
A�
Community
Driveway Permit: Ftl Exempt
Electric Il J Other
Iermit
NO110E
Authority. Misapplication 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 thisApplication.
Legal Access. A Building Permit cannot be issued without proof of legal and adequate accessto the property for
purposes of inspections by the Building Division.
Other Permits. Multiple separate permits may be required: (1) gate Electrical Permit, (2) County OWTS%rmit,
(3) another permit required for use on the property identified above, e.g. gate or County Highway/ Road Access
or a Sate Wastewater Discharge Permit.
Void Permit. A Building Permit becomes null and void if the work authorized isnot 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 asto accuracy. Assuming
completeness of the submittals and approval of thisApplication, 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, CWTSregulationsand 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.
hereby grant permission to the Building Division to enter the property, described above, to inspect 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 facility(ies) if such is in violation of County Regulation(s) or any other
applicable law. Ieview of thisApplication, induding 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 Fegulations rest with me and my authorized agents, induding without limitation my architect
designer, engineer and/ or builder.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required informatio .ch is correct and accurate to the best of my knowledge.
Rope
ner Rint and Sg
Date
omaAL uffi ONLY
Special Conditions:
otiitx,c16k5L Lii-. of (iItdi'iown.9
AIjusted Valuation:
V2)000. o0
Plan Check Fee:
Pi . 01
mit Fee:
2c� • 25
Manu home Fee:
Mi Fees:
Total Fees
416 345.2G
Fees Paid:
( '0 (
OX Group:
Balance Due:
43 204.25
Const
BP No:
CWTSNo:
3LCO - 4'
Type: —,
K)10-'
Zoning: c„, E...,
5et�s:
N
BUILDING/ PLANNINGDIVISOV
: 4'jr0017
1 _ Garfield Cosmo
Building/ Zoning Plan Review Checklist
Permit Number: 13LG4- 05-17- 4725
Building
N/A
NVQ,
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30%
Attach �ie1 Plan Review List
Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign Application
Parcel/ Schedule No.
40# Snowload Letter — Manu. Homes
NSA Soils Report
Planning/ Zoning
N/A Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
FF -
1 Zoning Sign -Off
NSARoad Impact Fees
Grade/ Topography 40%
Planning Issues
Subdivision Plat
General Comments:
T.6u M Fi(M91/1 09 BCc 9'41 • i
avvi Vk[.0 e e -i (i.);•(-11
tt<+ jII + Qvi of 9pr6.4 &9041/)
r7��C
of f c.- f b *c6t/ j -( i •:
362
va( Aiow : 12i Com. pm, elopi444
met, rAc•t otic.. tyA
(oI4JJJ