HomeMy WebLinkAboutApplicationGurfield County
BUILDING PERMIT
APPLICATIONCommunity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(9701 94s'8212
www.ga rfield-cou ntv.com
DemolitionEX Commercial/Multi-Family
E Manufactured Home (Single or Multi-Level)
ReroofE Residential (SF, Duplex orTownhome)
,. 7lottcØ?eat ltU LLC
Email Address¡
/tal 4
I ro
Property Owne
Mailing Address ,3
Phone:2.19 çoç îÇt z
,l;
ß3*
Phone: ,Q70 t 87¿l to66I
^)
Contractor:
Mailing Address;
Email Address:
Mailing Address:
Email Address:
Phone: I ìArchitect:
ìPhone:(Engineer:
Mailing Address:
Email Address:
Phone: (-)
Height:
ô 3
Lot
6
Describe Work:
suþ.
4&."x ¿/ô'X ll'gt' Po/e barn
ló'
Manufactured Home Installer:
Property Size (Sq. Ft. or Acres):
fofSq. Ft. of Building:/68Õ
Job Address:
Owner's Valuation of Work:
Assessol's
Mailing Address:
Email Address:
Block
Number: 2
ll ¡ddit¡on I nepair fl Move/RelocationClass of Work:[l ruew llAlteration
! oetachedGarage:Iattached
PROJECT DETAITS CONTINUED
Septicl ffi owrs ! Community
Type of Heatr I | ruatural cas fl eropane UJ Flectric Iotner
Driveway Perm¡t:l-l Exempt I lPermit *
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. lf the signature below is not that of the Owner, a separate letter of authority, signed by
the Owner, must be provided with this Application.
Lesal 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 orCounty 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. ln 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, construct¡on 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, elescribed 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 acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required information wh is correct and to the best of my knowledge.
K"
Property Owner Print and Sign
Qacal-
Cl^dt?
U*l
OFFICIAT USE ONLY
Køà, lmpacl ?¿c
(gr+tn à;+t"icÍ)
Soecial Conditions:
9¿o ¿,fta¿4à ltçI of øuÅrhonq.
Manu home Fee:Misc Fees:6 bat.1zPlan Check Fee:*422.14 Permit Fee:l bwjþAdiusted Valuation:
+'tÐt%.Ø
BP
'Ôb'I
@-N-s'w1Fees Paid:
E\82 . t4 e54(.boBalance Due:
*h07v.74Total Éees:
ConstType: V_B Zoning: ?U D B^r+tSetbacks: -
Í= l7 o Rls, b OCC GrouR:
U
BUTLD|NG / PLANNING DIVISION :
Signed Approval
JþlØ!þ
Date
Aea
NOTE: lf any required information is missing, delays in issuing the permit are to be expected. lf
determined by the Building Official that additlonal information is necessäry to review the application
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 lmpact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by a person having written authority from the
owner to act as their representative.
I hereby acknowledge I have read, understand, and will abide with the requirements of this
checklist.
óÅ//á
Print sig Date/ /
¡$¡o r¡eia ci;-1a;tx; .l
Buíldins.l Zonims Plan Revi ew Checklist
?LA- 0b-t6-52ø1
Wntvtnnù Ft/
Perrnit umber:
Buildine
'/ Engineered Foundation
€xc,vtqt Driveway Permit
x Surveyed Site Plan
Planning/ Zoning
--:-
N/A
N/^
Property Line Setbacks
30 ft. Stream Setbacks
Septic Permit and Setbacks
Grade/ Topograp
'/ Attach lan Review List
,/ subdívision Plat Notes
'/ Fire Department Revíew
'/ Valuation Determination/ Fees
'/ Red Line Plans/ Stamps/ sticker
Attach Conditions
'/ Application Signed
Plan Reviewer to Sign APPIícation
Parcel/Schedule No.
Flood Plain
Building Height
Zoning Sign-Off
'/ Road lmpact Fees
- "/ Grade/ Topography 40%
Planníng lssues
Subdivision PIat
NA
X soils Report
General Comments:
Wld¡A Ah¿&:
J10"Y 42 = ttbØo 9F
t) airwltôvt :
I,bø\ x 924.44= sÞ0t767-Ø
Roa¿l Inpct F,r¿t +try¿.72
l.b6o x e774.00
InÅ¡+ç*rt'ul / *u+¡ H gt", ct
Øvtqirvrcfi'U tyW.l-Þ
\car¡oattq 1wwp, U (W;tiy\
/