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Home My WebLink AboutApplicationGarfield County �p Community Development Department G�� 108 8t Street, Suite 401 ISI: Glenwood Springs, CO 81601 MAR �� ou�a-t (974) 945-8212 PRF ��\0391041 0391 �� www.garfield-county_com �DMM�I�� TYPE OF CONSTRUCTION 0 Commercial/Multi-Family yanutactured Home (Single or Multi -Level) sidential (SF, Duplex or Townhome) BUILDING PERMIT APPLICATION ❑ Demolition I❑ Reroof INVOLVED PARTIES Property Owner Mailing Address Email Address: Contractor: Mailing Address Email Address: ,4, 4rvt ' k �cf�-- Phone: (1Z0) 1 1 et- 4-00--- : 0- : t) o (30><- 1105-F 5 p e o Q.o St 64.2.. (V\ t' (L @ -01' /1 1----;(11, / I/' J C OL Cf. K : /1/z.)0 4) (52 N6 6,1/lDncfrAre CO Mme) ;+A.01e- G4wi Architect: AI L< IILJPfCJL/J jJ Phone: (3 412) Ng2-1Z0( Mailing Address: 3 Z Z'.3 /'zw -Pipe, 4-ve e,)/ an o Z°3 Email Address: "lel ct4( f avrg AMLA'& ,,Het) Engineer: IM ark UJAir Phone: ( 3 J1) 1/9p. ----lad a / Mailing Address: 3 .5 4/91h0. ve� �c03 + Email Address: fA/.1 (Aktrci GsS .rte 6U`I M . �D Manufactured Home Installer: Phone: ( Mailing Address: Email Address: ) PROJECT DETAILS Describe Work: -t y� ire w 1- 4 / 00 /f/A/ ee4<60/2/3/6,/e Job Address: 2 q Assessor's Parcel Number: Assessor's- 3 1` �� /31 z/ T Z o e b Sub. /45/0g4 r lie d �1, II Lot Block Cil[, )V ') 31 Owner's Valuation ofork: $- -94:-TT' G O(7l obb Property Size (Sq. Ft. or Acres): 1(1; -3 a 5t. E Sq. Ft. of Building: Z 1 LID Height: LA i9 )` # of Floors: - Class of Work: aNew 1 fl Alteration 1 ElAdditionAddition ❑ Repair I D Move/Relocation Garage: `Attached 1 ❑ Detached PROJECT DETAILS CONTINUED Septic: Type of Heat: OWTS Natural Gas —0 Propane Driveway Permit: xempt .4;0tilor+ extiil"- a rar.eli. _ Community D Electric El Other n Permit N: 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. 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 i designer, engineer 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 best of my knowledge. 714,, Property Owner Print and Sign i�✓ ze/i3 Date OFFICIAL USE ONLY Special Conditions: ROGtd I4 Fee (eilt9fPisivic-fr) Adjusted Valuation: 4/21017'2406`/P NaCheck Fee: I)Q4 .R� permit Fee: 1I roi'S.35 Manu home Fee: Misc Fees: �'dyg5.C� ---.. Total Fees: ��,�� 3 Fes Paid: 11 I • Balance Due: 4ij i7 . BP No: OWTS No: $ E-51'1- 1Mm�11 Setbacks: F=251 8245! . .1 OCC Group: I R G Const Type: 1 G I� Zoning: pat. BUILDING / PLANNING i DIVISION : 1 .1 1.I Sined Approval Date • Garfield County Community Development Department 108 8th Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 www.garfield-countv.com BUILDING PERMIT FEE ESTIMATE WORKSHEET Applicant: l'<v't $in "4J Phone: -4eZj r 7-6 . Project Address: IDO 1✓ic Ue i / -ir, 044 ,o subdivsion: 3 prig) 'r n $F�o' vP.i r�,r1 t;9-ks Lot: a 6 BI : S eC 3 1 Finished Living Space (N/A for Manufactured Homes) Unfinished Basement Crawl Space Garage (Conditioned) (i.e. insulation, sheetrock) Garage (Unconditioned) Covered Patio/Deck Uncovered Patio/Deck Misc: •Misc: Manufactured Home Set -Up Single Level ($400) Multi -Level ($600) Septic (WITS) New Installation ($123) Alteration and/or Repair ($75) Perculation ($150) Square Feet 4100 MO 7 Valuation 12- $74.68 $41.00 $18.00 $32.00 Fee Fee $24.00 $18.00 $12.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 This Section Determined by Garfield County Plan Review Fee Building Permit Fee Manufactured Home Set -Up Fee Septic Fee (OWTS) Other (Ex: Road Impact Fee) Total Fees Due $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ***All fees are estimates until final plan review is completed*** and/or plans for compliance, the application may be placed on hold until the required information is provided. Work may not proceed without the issuance of a permit. The Building Division will collect a Plan Review fee at time of application submittal. The permit fee, as well as any Road Impact fees will be collected when the permit is issued. The permit application must be signed by the owner or by person having written authority from the owner to act as their representative. Building cannot be occupied until a Certificate of Occupancy (CO) is issued. Using the building without a CO will be considered an illegal occupancy and may be grounds for vacating the premises. (Final/CO inspection requirements will be attached to your approved field set of plans.) 1 hereby acknowledge I have read, understand and will abide by the requirements of this checklist. Property Owner Print and Sign Date Garfield Cau�xty uildi� 1 onh Pi n Review Chtelf.st Permit Number: Mge"0'3-1Q7 - 5117 M dL yG 9r KG9i kee Building 1,,... Engineered Foundation VW -4413 Driveway Permit Surveyed Site Plan Septic Permit and Setbacks Grade/ Topography 30% Attach Residential Nan Review List Subdivision Plat Notes Fire Department Review Valuation Determination/ Fees Red Line Plans/ Stamps/ Sticker Attach Conditions Application Signed Plan Reviewer to Sign Application 7 NJA 7 7 N/A Parcel/ Schedule No. 40# Snowload Letter— Manu. Homes Soils Report t\A I fr' LWA- { (it ,w LU i. 1j340 6(405 -iVtAlrZG9i6Lt4 u ea V64 CvowL gpAu CovA/4L ("Alio tAi, cov . PMi a $ Planning/ Zoning 7 Property Line Setbacks 30 ft. Stream Setbacks Flood Plain Building Height / Zoning Sign -Off / Road Impact Fees Grade/ Topography 40% / Planning Issues Subdivision Plat General Comments: 1Da61 IwlpGf F& 43.2136 (East picAvi64-) yallj,'011 _ ' 210 72a. 212D5 `H0 110 -T0 0 x 11.E _ 1640.41 (o(,q. x 4 3l.00 = 1.41060. x 16.00 = 2.1) 120. x S 16.00 = I12(400. x S. 12.00 lo14901).