HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
RECEIVED
Springs, CO 81601
(970) 945-8212
FEB o 1 2 w.garfield-countv.com
BUILDING PERMIT
APPLICATION
GARFFIEWiRithillitfoni
jfghti_Famil y
D Manufactured Home (Single or Multi -Level)
Residential (SF, Duplex or Townhome)
❑ Demolition
[] Reroof
INVOLVED PARTIES.
Property Owner: k.z3 hone: I) 94-r-16 S3
Mailing Address: PC 61— ()[`^,, � •
Email Address: i L -%1- A `�TA� •. i CA.Z0AT -�
l r �` t�Z� �'3Z4 -G'3I�
Contractor: \ v� ' i7.t l 1 t �.. �" t]R.i-11C - Phone:j r 3 7 ]'� ���
Mailing Address:
Email Address:
Architect: Ca ra i(— �} CTU 1\0-41 I Phone: (C\71) )
a[(,0 fit„ 5,4, 4 3l
Mailing Address:
Email Address:
Engineer: \ 61.E. O t O Phone:/,j(g ) C +c"-1
)
Mailing Address: j S 4 Z (j am. Ca \ 600
Email Address:
Manufactured Home Installer: Phone: (
Mailing Address:
Email Address:
PROJECT DETAILS
Describe Work: J�l.�� I '➢
Job Address: / ,,
Asses or's Parcel Number: �SN
g1Ly3
Sub. kjI +.� a-.� �bl.l S,, L Lot to3
Owner's Valuation of Work::, o f 84/ Property Size (Sq. Ft. or Acres): /6/6
6
Block 3 -
Sq. Ft. of Building:
Class of Work:
Garage:
Z7i3iHeight: # of Floors: 2—
KNew ❑ Alteration 0 Addition Repair
psAttached • Detached
Move/Relocation
PROJECT DETAILS CONTINUED
LSeptic:
Type of Heat:
OWTS
Natural Gas ❑ Propane
Driveway Permit: • Exempt
NOTICE
❑ Community
El Electric
LJ Permit #:
Other
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 ackn ledge that I have read and understand the Notice and Certification above, as well as, have
provided the r aired information which is correct and accurate to the best of my knowledge.
Property Owe Print and Sign
Date
OFFICIAL
USE O LY
Special diti ns: irmktof Feet
19/I 461/14L Wsi Of CokotifioLi9. i 91A)
Adjusted Valuation:
?moi 9R30o
Plan Check Fee:
41 19ei.f
P rmit Fee:
` I 641.'?5
Manu home Fee:
L p
Misc Fe
eve33.o-
0
Total Fees:
61)o.44.1 -7,1;e4
Fees Paid:
Balance Due:
/ I1WWOG.Q3
BP No:
OWTS No:
� E---,Y)9y
eom >n�
Setbacks:
814. ivclopc.
OCC Group:
,5 VC,
ConstT e:
_ r
Zoning:
P1S---)
BUILDING /PLANNING
126f/tilt
DIVISION : 2� /108
Signed Approval Date
e. Garfieid Carrrgo i
Bulldiin g Zonin
Permit Number:
Building
Engineered Foundation
6v-444114 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.
. 40# Snowload Letter — Manu. Homes
Soils Report
Plan Review Checklist
01.-16- 50414
MP't - L0+ (03
z
t\l/A
Loin 1-tudd
jtevio l ,c (
T7fetI letgeekmcc.
e6w L JL
Couiwa Oxidelrafio
I,4&iWVW'th 6diO
Planning/ Zoning
;31640 Vei PK.
Property Line
N/A
NVA
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning 5ign-Di €
Road Impact Fees
Grade/ Topography 40%
Planning Issues
Subdivision Plat
General Comments:
g„d Iw1p 4- F& =' 733.(2
p(4/ 91A)
214(,p x 4 74j4 _ 2'2. I) 65-3.
(off 00 = 201 edCb .
2b5 k = 3 .4) on.
.410 x 12.00= 5151'0.
T-otAI alaImo.h'Ovt s.. 2�1)4f 3.