HomeMy WebLinkAboutApplicationGarfield County
WWAJA VQY&9 nity Development Department
q q1088 th Street, Suite 401
SEP 14 2017 Glenwood Springs, CO 81601
(970) 945-8212
12 ww.earfield-countv.com
TYPE OF CONSTRUCTION _
Commercial/Multi-Family T I Q Demolition
❑ Manufactured Home (Single or Multi -Level) _
❑ Residential (SF, Duplex orTownhome) ❑ Reroof
INVOLVED PARTIES
Property Owner: Dave Hatch Phone: ((970) 309-1051
Mailing Address: 1885 County Road 319, Rifle, CO
Email Address:
Contractor: FBC Phone: ((970) 987-4601
Mailing Address:
Email Address: fbcjonisham@gmail.com
Architect:
Phone: { )
Mailing Address:
Email Address:
Engineer:
Phone: { )
Mailing Address: .
Email Address:
Manufactured Home Installer: _
Phone: { )
Mailing Address:
Email Address:
PROJECT DETAILS
Describe work: Removal of existing 50' communication tower and reclaim location.
Job Address: 1885 CR 319, Rifle, CO
Assessor's Parcel Number: 2177-233-00-253
Sub. Lot Block
Owner's Valuation of Work: $ 7,000.00 Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building: ._ Height:.,
# of Floors:
Class of Work: ❑ New Alteration ❑ Addition
Repair Move/Relocation
Garage: Attached
❑ Detached
PROJECT DETAILS CONTINUED
Septic: DOWTS Community
Type of Heat: Natural Gas L Propane F] Electric ElOther
Driveway Permit: Exempt LIPermit #:
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.
Lesal 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 irrd void if the wurk authorized is riot curnrnerrced 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 structures) 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.
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.
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.
Property Owner Print and Sign
OFFICIAL USE ONLY
Special Conditions:
9/11/17
Date
Adjusted Valuation:
Plan Check Fee:
Permit e (3c
Manu home Fee:
Misc Fe s:
lata€ Fce
Fees Pard
Balance Due:
BP No:
OWTS No:
Set
OCC OCC�G\ro p:
Const Typ
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BUILDING / PLANNING DIVISION :
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Signed Approval
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40TEss 1) KNOCK—DOPART NUVBER 5.94,0300,050.
2) PRE—ASSE BLED PART NUMBER; 6.96,0300.0%
3) ANTENNA LOADS ARE CENTRALLY LOCATED AND
4) *NO LOADING ASSUMES (1) 1124 TRANSMISSION
UK
000001,620.0163
DATESBY CNti #PPS
05 FEB 07
TinE$
6OFT S300 SUPERTITAN PROFILE