HomeMy WebLinkAboutApplicationGarfield County
R EC E Ia61C* tunity Development Department
108 8th Street, Suite 401
APR 1 9 2011lenwood Springs, CO 81601
U (970) 945-8212
GARFIELD CO
COMMUNITY DEVELOP�'garfletd-county.com
TYPE OF CONSTRUCTION
❑ Commercial/Multi-Family
❑ Manufactured Home (Single or Multi -Level)
Residential (SF, Duplex orTownhome)
BUILDING PERMI
AP.PLI.CATION
El Demolition
n Reroof
INVOLVE] PARTIES
Property Owner: 11.AATI4AE E. • Mo ttabl.1,r Phone:
1`•
Mailing Address: o// • 3c9( J EW ( i [f ) CoCa .6 1(0 7
Email Address: A
Contractor: L��'W.C71.{ N 6170
Phone: () g/'¢%" es 55
�'}
Mailing Address: I'�d� 1p_ 2 5 (CT) CD P It) 52_
Email Address: U9 - rY] 01,41±00@ YV .5 r . Cc r -
Architect: lqQ Z N �i 9r1 D)D2k5 Phone:U� S4, 5G5
Mailing Address: I30()a S t L -L. i co 516'2 j 2_
Email Address:
C'-0 C iMoL 5 V wish, c rn
Engineer: Phone: (
Mailing Address:
Email Address:
Manufactured Home Installer:
Mailing Address:
Email Address:
PROJECT DETAILS r ]� j
Describe Work: S l k CE11m, 6 k$ U r•G• 5 f E [1(C,
Phone:(
)
Job Address: C +�PAJ] I Of i 0 Fl0-
Assessor) Parcel Nu er: (6 to G '�J - 6+
Z))(.. CM IW
n 81
Lot Block p
Owner's Valuation of Work: $ �y J J�1 MO Property Size (Sq. Ft. or Acres): /" 9 i44e.�.5
�}
Sq. Ft. of Building: i'3 (� Height: /'• • o # # of Floors: I
Class of Work: , New El Alteration ❑ Addition El Repair f D Move/Relocation
Garage: p Attached 0 Detached
3D -
FM/JCL I Lit 1 AIL) l.U1111 IIYUtU
Septic:
Type of Heat: Ei Natural Gas u Propane
Driveway Permit: ® Exempt
IOWTS
I
Community
® Electric U Other
❑ Permit #:
NOTICE
Authority. This application fora 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 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) orfacility(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 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.
7/11d7cieRIAEi 746.6' i ' ad's C1269/211 4,1. /' y/z '
Property Owner Print and Sign Date
OFFICIAL USE ONLYc
Special Conditions:
Comlioly (AKA WA.3.c, x,(rs + &APA -053-'6-46,20
Adjusted Valuation:
40174'2. A5
Total Fees:
Setbacks:
F%,fK2SI4l0
Pan Check Fee:
opot r. 54
Fees Paid:
P2446-,
OCC Group:
C
rmit Fee:
�bQ75
Blance Due:
Manu home Fee:
1.11 R
BP No:
1611, Pet
1JOV4LI 4i gtrid+)
Misc Fees:4 M
OWTS No:
Const Type:
zoning:
BUILDING / PLANNING DIVISION :
Signed Approval
bh /Zie2
Date
Crarfr�ld Co����y,
<" -rllc ,f ZoningIlan Review Checklist
Permit Number:
EPT- C"-
Ivlou(-too AbV
Building
X Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Pian Review List
NIA Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Pians/ Stamps/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign Application
Parcel/ Schedule No.
40# Snowload Letter— Manu. Homes
X Soils Report
N/A
K.L9i44,v,
Ci WI 9Wb Z
amtva teck-5
Planning/ Zoning
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign -Off
/ Road Impact Fees
Grade/ Topography 40%
Planning Issues
NIA Subdivision Plat
General Comments:
Ind I114100 -O -f 1=.ct `43'446% 00
(.3v+c'i tti € �i9t►'I
ggr� x . doe,
IG.00
o x Ie,. 00
TOTAL = `' 4S-7) -76.