HomeMy WebLinkAboutApplicationGurfield County
BUILDING PERMIT
APPLICATIONÞT\rEI)
AUG Z 4 2O1T
"",.þ-.M.
RE Development Department
1oB 8th Street, Suite 401
enwood Springs, CO 81601
lpTole4s-82L2
Ò
INVOTVED PARTIES
TYPE OF CONSTRUCTION
n Commercial/Multi-Family Demolition
n Manufactured Home (Single or Multi-Level)
EÉ Residential (SF, D1¡plex o¡ Townhome)Reroof
Property Owner:
Mailing Address:
Email Address:
Phone:
qÇ C
Contractor:*ú.L Phone:Qlo zs+- oqL,o
Mailing Address:
Email Address:3ctl.¿@ L
Architect Phone:
Mailing Address
Email Address:
Engineer: Phone:
Mailing Address
Email Address:
Manufactured Home lnstallen Phone: (_)
Mailing Address
Email Address:
PROJECT DETAILS
Describe Work:+L%Þ "lt ôr\
Job Address:
Assessor's Parcel Number:a L1
Sub. Lot Block
Ft.orAcres)r
-'91
dr/llOwne/s Valuation
Sq. Ft. of Building:
of Work:Z5,DÔÒ Propertysize (sq.
Height:IL¡#of
Class of Work:El{"*! Alteration ll Rddition ! nepair Move/Relocation
Garage:[þtachedAttached
FsSeptic:
Other! Propane þ4f rt..t'i'| | Natural GasType of Heat:
I lPermit #:Driveway Permit:Exempt
PROJECT DETAII.S CONTINUED
Community
NOTICE
Author¡W. This application for a Building Perm¡t must be signed by the Owner of the prope
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterof
rty, described above,
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.
1 CERTIFICATION
I hereby certify that I have read this Application and that the information contained above is true an d 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. ln 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 regulationsand applicable land use regulations (County Regulation(s)). lacknowledgethatthe
Building Permit may be suspended or revoked, upon notice from the CounÇ, 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
designe e ineer and/ or builder
I 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
and Sign
best of my knowledge.
\løo [,-,
Date
3
OFFICIAT USE ONtY
Special Conditions:
q11, p{¡ar,M ligt of oovúitionq.
Misc Fees:Permit Fee:4441.1Þ Manu home Fee:Adiusted Valuation:424'TIry.M
Plan Check Fee:62ø7.t4
BP No:,ßrl7tr-\Qoq-
OWTS No:
fn istì vrO
Balance Due:+el+.rrØTotal Fees:4"tzø.ø 3þ2t1r
Fees Paid:
ConstType:
I ß C .oþu' 0OCC Group:ltl ¿Setbacks:
FIR=2á'â=lo
BUTLDTNG / PIANNING DIVISION
Signed Approval
1þ4@!J
Date
Buil Z,onin Review Ch
Permít Number:ø.w-06- t1- 4407
Buildine Plann Zoni
x Engineered Foundation
t
N/A
¡Vt
NA
Septic Permit and Setbacks
Gradel Topography 3O%
Attach Residential Ptan Review List
,/ Subdivision Plat Notes
N/A
M-
N/A
"/ Grade/ Topography 40%
'r' Planníng lssues
/ subdívision Plat
General Comments:
qtæ;
l4x2ô o 342 q.?.
Jøhøho^ t
312x4t4.AØ=O24t27>.
@ tupct Fn -ÑA
15oo 2þ. trr,u' [16b¡UW,
^'tf¿a\
Driveway Permit
Surveyed Site Plan
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees
Fire Department Revíew
'/ Valuation Determinatíon/ Fees
,/ Red Line Plans/ Stamps/ Sticker
Attach Condítions
r' ApplicatÍon Signed
'/ Plan Revíewer to Sign Applícation
'/ Parcel/ Schedute No.
40# Snowload Letter- Manu. HomesxSoils Report