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GARFIELD COUlllTY DEPARTMElllT OF DEVELOPMElllT
BUILDllllG DIVISIOlll
3rd Floor1 Courthouse
100 sth st,...t
Glenwood Sprlngej Color•do 81601
(303) 945-8212'
Job Address --"-/-~....!.f_!:;___Co::::' :..:•c_Rd=·'--':'.:21'.:::4~,___:S~il=t-----------------
Nature of Work l3!1i Jdjrn Permit
Use of Building __ _,S"'/F-=---=Re=s=i::d:.:en=c=e=-------------------------------
Owner S'tephen & SUsanne Self
Contractor ------=Ho=bert=·=::....:Go=rdot=~1,_,,Cor=1,,,s~t,,. __________ ------------------
Amount of Permit: $ ....:6:.:3:.:2:..:•:.;6:.:5,_ ______ _
White -Treas.
Canary -Office
Pink -Applicant
Gold-Duplica1e
Date: -----'Ap"'. ""r""i,,.l..__.,_29~,'--"l"'-9"-87,__ _________ _
Jnis J. fl\;!_t.,z.,en.,,__ ___ _
Clerk
....
•
GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT
PERM! T NUMBER __j' .3' (.-, ~
DATE .f/d tj.f 7 please print or type
~ NAME
"' MAILING AD ~ CITY -NAME
i'l ~ ADDRESS ~ "' ---
" NAME
!:: DDRESS " ;:; CITY ~ PHONE
" LICENSE # -------
CLASS OF WORK
NEW ~ ALTERATION ____ ADDITION ___ _
DEMOLISH REPAIR MOVE
MOBILE HOME (make/f'IOdel)
S.F. OF BUILDING S.F. OF LOT~----
# OF FWORS 2. HEIGHT _.-::.:Z::c~"'--'----
# OF FAMILY UNITS I # OF BEDROOMS J
INTENDED USE OF BUILDING £¥/: 11tA1//..,x~t'-E---s-. -
GARAGE: SINGL .,.--DBL CARPOR°f: SINGLE_ DBL __
FIREPLACE
WATER SUPPLY ___ _.zte°""''flL __________ ~
DRIVEWAY PERMIT ---------------~
SITE PLAN ------------------~
BUILDING FLANS-------~~-------
SANITARY SEWER CLEARANCE S~ L ,
ON SITE SEWAGE DISPOSAL PERMIT A--&;d/;(
OTHER DOCUMENTS (specify)
VALUATION 7 ~.,, i3
PERMIT FEE ~ (~!l4 lll'¢LAN EE $ ;lff; 8 ..,_
TOTAL FEE $ "'""" ilo SCHOOL IUPACT FEE $ 2 10• I' 0
DATE PERMIT ISSUED -~-~---------~
ZONING DISTRICT _..L:7.J'L5.~:5..1':::.. ________ _
TYPE OF OCCUPANCY __ .,,.,,...~~--------
TYPE OF CONSTRUCTION _..__,_-"------~~~~
S. F. OF BUILDING._ 3 3 <>"'
MAX. HEIGHT k 2.--3 I
S. F . OF LOT ~~~~~c_,,,
ROAD CLASS.
SETBACKS FROM PROPERTY LINE: FRONT Ve f'Y,.
REAR RIGHT -----LEFT -----
OFF STREET PARKING SPACES REQUIRED ------
PLOT PLAN
NOTE: Show easements, property line dimensions,
al .l other. structures; specify north 1 and street
name. 'F'or odd shaped lots,, or iL. space is
too sznal.l, provide separate p.1ot pla:n.
# OF BUILDINGS NOW ON PARCEL No .-i~
USE OF BUILDINGS NOW ON PARCEL
FRONT PROPERTY LINE
STREET NAME/ROAD NUMBER c;. t<J Z/4:
CHECK IF CORNER LOT
DESCRIPTION OF WORK PLANNED ---------
I hereby acknowledge that I have read this
application and the above is oorrect and I
agree to comply with all county ordinances
and stat aws r g lating building construction.
FLOOD HAZARD ---------------~
CERTIFIED BLDG ELEVATION ---------~
SPECIAL CONDIT.TONS -------------
PROBLEMS WITH PERMIT -----------~
ADDITIONAL INFORMATION NEEDED --------
CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
OR ENGINEER -----------------
• •
------#' ~ __ Z__ S, £eJ±_~_ ----------. ----p-_!_ ________ _
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J
1311 CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
GARFIELD COUNTY, COLORADO
Issued Without Foo
Permission is hereby granted to ;·;;-~):\···:. • -v 12i 15;.i:• ine <£!1 f
Building Permit No.----';,'-·· :i'"· ""'".,"',;-------------..,---Zone District __ "l\"/"H'l/'-"'RDCL--------
situated at lG.~8 0."!11' lt..;J. 214, ~~iJ t Lot __ Blk.--Addition ------
for the following purpose----"'S,_,_i?~~-;1,. . .,·e"··.J"''"·-'"·:.;:;,_,·""''-----cc---..,c---....,.,,..-.,......----------------
IS~ Nature of Use)
Contractor -~i~"-'~;='""~ei:~t~C~C£J~l~~ .. ~:\oi~l~'::O~•~'f~,,~·a~·'~1·~·~1·~'i.r1~·---------------------------
TAKE NOTICE
No chang& shall bt made In
the use of this buOdil\9 with·
out prior notiu •lid c.rtifi·
IOlte from th• Building Official.
''
White: Owner
Grffn; L.•ridil"lg Agency
Gold: Contractor GARFIELD COUNTY BUILDING DEPARTMENT
Yellow: Bulldlng Departm•n-t
Pink; ANl91tiQr