HomeMy WebLinkAboutApplicationEeGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970)945-8212
www.garfield-county.com
TYPE OF CONSTRUCTION
❑ Commercial/Multi-Family
❑ Manufactured Home (Single or Multi -Level)
Residential (SF, Duplex or Townhome)
❑ Demolition
Reroof
INVOLVED PARTIES
Property Owner: Phone:::(�)
Mailing Address: gL4oLA raN 7��1�.� pleyn
Email
Contractor: _M I R Phone: ( )
Mailing Address:
Email Address:
Architect:
Mailing Address:
Email Address:
Engineer:
Mailing Address:
Email Address: _
Manufactured Home Installer:
Mailing Address:
Email Address:
PROJECT DETAILS
Phone: ( )
Phone:
-Phone:(-)
Describe Work: RLjOf/ll(A Awb d N oy f loot- 4fv'cA.dw4 �'o0f ANA
r.uva,c( duxlflivo Unit wi4h wm,6Ki9j44,A k�,gt4m emt 6e(ow. .
Job Address:
Assessor's Pa
Sub.
Owner's Valuation of Work: $
Sq. Ft. of Building:
Class of Work: n New
Garage: I I lAttached
Lot Block
_ Height:
Alteration
Property Size (Sq. Ft. or Acres): 'A- C57 L
I
# of Floors:
Addition ❑ Repair jo move Relocation
n Detached
I PROJECT DETAILS CONTINUED
Septic: �OWTS [-] Community
Type of Heat: FINatural Gas Propane `l Electric —]-0Other
i
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. 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. uilder.
I hereby acknoMiledge thaAII have read and understand the Notice and Certification above, as well as, have
provided th r uire f ativn which is correct and accurate to the bes of;knowledge.
.)
S
Property OW/Aier Print and Sign 6ate
OFFICIAL USE ONLY
Special Conditions:
A dusted Valuation:
Plan Check Fee:
`8227.01
P rmit Fee:
`34q.25
Manu home Fee:
Misc Fees:
21 57.o0
G
Total Fees:
Fees Paid:
Balance Due:
BP No:
OWTS No:
� 57/0.2
`� 23.5b
552 75114
1S R4 k2s2 gA I O
OCC Group: I1�G
Const Type: 1 R G
Zoning: R
BUILDING / PLANNING DIVISION:
Signed Approva
Date
�- Car�elci G'ottrrty*
B uild.!P. / Zoning Pian Review Checklist
PermitNumber:
13461WVEv, 4 bipi
Building
Engineered Foundation
Driveway Permit
/ Surveyed Site Plan
/ Septic Permit and Setbacks
/
Grade/ Topography 30%
Attach Residential Plan Review List
0�id+ - Subdivision Plat Notes
NIA Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign Application
Parcel/ Schedule No.
NA. 40# Snowload Letter— Manu. Homes
Soils Report
Planning/ Zoning
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Goner I Comments:
Arm- of N&V Mrd
1,4 X 20. 07 a 240 43r-,
VGA W 0h .
-24 0 x 474. l08 = `2 1) 6.57.00
Ieoad lv>7 jac+ RIX = N/A
C 500 0,,P
Building Height
Zoning Sign -Off
Road Impact Fees
Grade/ Topography 40%
/
Planning Issues
N �►
Subdivision Plat
Goner I Comments:
Arm- of N&V Mrd
1,4 X 20. 07 a 240 43r-,
VGA W 0h .
-24 0 x 474. l08 = `2 1) 6.57.00
Ieoad lv>7 jac+ RIX = N/A
C 500 0,,P