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.