HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
2 �I1% 108 8th Street, Suite 401
MAY Glenwood Springs, CO 81601
(970) 945-8212
www.ifarfield-county.com
TYPE OFCONSTRUCTION -
BUILDING PERMIT
APPLICATION
❑ Commercial/Multi-Family
❑ Manufactured Home (Single or Multi -Level)
2esidentiai (SF, Duplex or Townhome)
11111L-1.1170 Demolition
0 Reroof
INVOLVED PARTIES
Property Owner:c� v S r
y Li `' Phone: ( )
Mailing Address: i7? C. ?2 03v 4+ � e r (' d 716 6-0
Email Address: eh.ty 5��- 1 Q & �`) S Q �[n ►tip . co
Contractor: OWi1 itt-
Phone:
Mailing Address:
Email Address:
Architect: Phone: ( )
Mailing Address:
Email Address:
Engineer: �.
Phone: ()
Mailing Address: i 0 - ?K.1 I7 ? b y iR-I 1,641.k '#'d7
Email Address: OLSI2 (ego-3CD C.(iC_dQ_Kj=+1 r3 ..0 s`w^--
Manufactured Home Installer: Phone: ( )
Mailing Address:
Email Address:
PROJECT DETAILS
Describe Work:
Job Address: ) / p ! �� 0 5(9 7?+'t Ce
Assessor's Parcel Number: 9 /off '7 97301 00 /
Sub. 'S / 71- &-Ict k/-5 Lot Block
Owner's Valuation of Work: $ / i, 2C1d Property Size (Sq. Ft. or Acres): -. ( a cres
Sq. Ft. of Building: va 0 Height: 1-2i # of Floors: /
Class of Work:
Garage:
❑ New
Attached
0 Alteration
0 Addition
O Repair
O Move/Relocation
O Detached
'r
PROJECT DETAILS CONTINUED
Septic:
Type of Heat
Driveway Permit:
0 OWTS
O Natural Gas
0 Propane
O Exempt
O Community
O Electric
0 Other
O Permit #:
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. 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. 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.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
providedhe required information which is correct and accurate to the best of my knowledge.
Pro rty Opr Print and Sign
Date
fZ1/7
OFFICIAL USE ONLY
Special Conditions:
12.31 111,26—
A justed Valuation:
Adjusted
441 --g6-..
an Check Fee:
Flan
4IO 1
Permit Fee:
Manu home Fee:
—'
Misc Fees:
____'
Total Fees: $ 3, 5ip
Fees Paid: 1
Balance D :2'56P
No;
OWTS No:
r.
XSe backs:5S=io
12=2)
OCC Group:
IRG
Const Type:
II?�
Zoning:
ROA%(
BUILDING / PLANNING
DIVISION : 14 colqii/a17
Signed Approval Date
tiP
2-05 , � (}. I�QS) [12 f 1 1-
Garfield County
Building/ Zoning Plan Review Checklist
Permit Number: 13 -g6 -o -17- 4733
Building
N/A
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
Subdivision Plat Notes
N�A Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
/ Attach Conditions
Application Signed
Plan Reviewer to Sign Application
Parcel/ Schedule No.
X 40# Snowload Letter— Manu. Homes
Soils Report
Planning/ Zoning
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
N/A
N/A
Zoning Sign -Off
N/A
Road Impact Fees
Grade/ Topography 40%
Planning Issues
Subdivision Plat
General Comments:
N
AltetoW Getwe c, = .CC 9F
VrAiILMI'IrI00
606 02.4 91q1-200.
R& 4 (A4410 1- fag :
1/A 640 vtkw (i‘01214 9f.)
/9, 2Oo IIII
Garfield County 1
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970J 945-8212
www.earfield-countv.com
Applicant:
Job location:
Sub-Lot/Biock:
Type of Space
Finished Living Space
(N/A for Manufactured Homes)
Unfinished Basement
Crawl Space
Garage: Foundation Only
Covered Patio/Deck
Uncovered Patio/Deck
Misc:
Misc:
Misc:
Total Valuation
BUILDING PERMIT
FEE ESTIMATE
WORKSHEET
Shaw Residence
TBD CR 2S9 Rifle
Silt Heights Lot # 1
Fi!! ONL Y in the yellow areas
Square Feet
sq Ft X
sq ft X
1759 sgfi X
800 sq ft X
sq.ft X
sq ft X
sq ft X
sq ft X
sq ft X
Value
per sq. ft.
874.68
841.00
$18.00
$18.00
$24.00
$12.00
$0.00
$0.00
$0.00
Valuation
1
$0.00
$0.00
$31,662.00
$14,400.00
$0.00
$0.00
$0.00
$0.00
$0.00
$46,062.40
Manufactured Home Set -Up
Single level ($40000)
Multi -Level ($600.00)
Total Set -Up Fee
Valuation
$ 400.00
$400.00
Septic
Permit ($123.00)
Percolation ($150,00)
Total Septic Fee
N/A
Valuation
$123.00
$123.00
otal fees
CR 7-» 7-6 lt i
This section will be determined by Garfield County.
Plan Review Fee
Building Permit Fee
( Road impact fees )- Other
Pay separately with Cash or Check Only
Due at time of Application Submittal
Due at time of Permit Pick -Up
Z -R - 973
$398.74
$613.45
$1,088.05
$521.74
$1,013.45
$2,623,24