HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
NOV 0 7 701'? Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
TYPE OF CONSTRUCTION
D Commercial/Multi-Fam i ly
_D Manufactured Home (Single or Multi-Level)
121' Residential (SF, Duplex or Townhome)
/
INVOLVED PARTIES
Property Owner: Ut1 ~~ \ ~ s ~ l ~ "'-{., ~ ~
Mailing Address: l/ 11 t" .... o. J o u.> L~ c;. w s
I 0 Demolition
I D Reroof
Phone: (1zL) 9 ~ ~-15" '2 "2-.
(D tf1'b I
Email Address : Jo u.~b~ ~ :f @ Ja.f-'-\:: • c. 0 'l'Y"
Contractor: Phone: ( )
Mailing Address :
Email Address:
--
Architect: Phone:( __ )
Mailing Add ress:
Email Address:
Engineer: <:::;. C:i: /V\ Tak b 1 Clk'.:1--c..~ Phone: (s.BLl Cf 4S-looY
Mailing Address: 1l s= vJ 6 'ft. s~. C1 tJ S Co £1 bet
Email Address:
Manufactured Home Installer: Phone:( __ )
Mailing Address:
Email Address:
PROJECT DETAILS
AJJ;'""~ Co v tr'"eJ ?9. ~;a h ' ~ ' b llt•J\f • Describe Work: <::!')(1,{ '~
M Q. 'i-r~; v-.o ~ 'K ;-.s +.; "''°' vb o+ll ~l -t-0 0 IA.t'° ~ ~c.t r11 ""'t"rtt't ;:,~·k 'll
I tY1 t lA .v.> Lt1.
I \ I
Job Address: t./ If Cr w S re:> tf 1 l>o I
Assessor's Parcel Number:
Sub. Lot Block
Owner's Valuation of Work: $ crtio Property Size (Sq. Ft. or Acres):
Sq . Ft. of Building: 5tto Height: #of Floors:
Class of Work: 0 New I LJ Alteration IJLI Addition 0Repair I LJ Move/Relocation
Garage: 0Attached LJ Detached
-
PROJECT DETAILS CONTINUED
Septic: OWTS 0 Community
Type of Heat: Natural Gas Propane Electric Other
Driveway Permit: Exempt 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.
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 facil ities 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 .
fu r ther acknowledge that the issuance of the Building Permit does not prevent the Building Official from: (1)
requiring the correction of errors in the subm ittals, 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 re ith me and my authorized agents, including without limitation my architect
des ign _, _ ineer and/ r bui der.
I here y ackn wledge I ave read and understand the Notice and Certification above, as well as, have
provl d he r. • h is correct and accurate to the best of my knowledge.
11 /1 I r=t
Date / /
OFFICIAL USE ONLY
Special Conditions:
-~Ian Check Fee:
"l'l(l.€il
Manu home Fee: Misc Fees:
Fees Paid:
1· '<?l
Total Fees:
~Z,t:fC(. Ofo
BP No : OWTS No:
BL. 12" ~~oo~
OCC Group: I RC.. ConstType: I f'<.G Zoning:
11 /~/-io11
Signed Approval Date
B ilding/ Z oning eview Checklist
Permit Number: 6l.-~€-11-11-?~
Fiti-rl1£ COJM/4 ~afi o
Building
/ Engineered Foundation
/ Driveway Permit
/ Surveyed Site Plan
N/A Septic Permit and Setbacks
./ Grade/ Topography 30%
/ Attach Residential Plan Review List
./ Subdivision Plat Notes
WA Fire Department Review
/ Valuation Determination/ Fees
/ Red Line Plans/ Stamps/ Sticker
/ Attach Conditions
./
Application Signed
/ Plan Reviewer to Sign Application
../ Parcel/ Schedule No.
N/A 40# Snowload Letter-Manu. Homes
N/A Soils Report
Planning/ Zanin~
__ / __ Property Line Setbacks
N/A 30 ft. Stream Setbacks •
N/A Flood Plain
/ Building Height
/ Zoning Sign-Off
N)A Road Impact Fees
/ Grade/ Topography 40%
/ Planning Issues
./ Subdivision Plat
General Comments :
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