HomeMy WebLinkAboutApplicationREGÉNË.
IDommunity Development Department
108 8th Street, Suite 401
)ut j \ ?-Û\$'Glenwood Springs, CO 81501
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TYPE OF CONSTRIJCTION
EI Commercia ulti-Fam
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Garfield Couruty
Demolition
Manufactured Home Ie or Multi-Level
or TownhomResidentialDu Reroof
INVOTVED PARTIES
Property Owner:
Mailing Address:
Email Address:
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Phone:
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Contractor:
Mailing Address
EmailAddress
Architect: t,It tù*-\b¿r I ilr: j vJ¿srbe¡-L
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Mailing Address: T
Phone:(17>)qSG qtf!/
Email Address:
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Email Address:
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Phone: (
Describe Work:
I /'\LoaLu*lJob Address:
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Property Size (Sq. Ft. or
Manufactured Home lnstaller:
Sq. Ft. of Building:lÇ&)
Assessor's Parcel Number: tt
Sub"
luation of Work:
Height: \t S++-l-ut'/ #orFtoors
Acres):
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Block
Mailing Address
Email Address:
| | Move/RelocationClass of Work:I lrew l_lAlteration E na¿it¡on flRepair
Garage:!nttached
PROJECT DETAITS
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Detached
PROJECT DETAILS
Septic:Community
Electric Other
Exempt Permit #:
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
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 1"80 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 Appl¡cation, 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, 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 submiLLals, 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
design an or builder
I hereby I have read and understand and Certification above, as well as, have
provided th n which to the best of my knowledge.
a- t,q- /{
Print and Sign Date
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Natural Gas PropaneType of Heat:
Driveway Permit:
OFFICIAT USE ONLY
Special Conditions:Iwp
Adiusted Valuation:a'll^27Ð.0ó Plan Check Fee:+ b4h10 Wib\i.tç Manu home Fee:
NIA '"t"ör 4æ.b
Total Fees:atfl bq.ob Fees Paid:EûÊl4 Balance Due:4l'Zm.ul BP No:
K-t tç 53f3
OWTS No:
Setbacks:FlR.2ö,* lO
oCC Group: lR¿ConstType: Io-C Zoning:
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é{zrføøBUILDING / PLANNING DIVISION
Signed Approval Date
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Buildins.l T,onins Plan Review Checklist
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Permit Number: qryT-ô1- 16 -æ6+
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Buildine Planni ToningxEngineered Foundation
Driveway Permit
X Surveyed Site Plan
Septic Permit and Setbacks
Grade/Topography 3O%
,/ Attach ResidentíalPlan Review List
/ Subdivísion Plat Notes
tV¡
Propefi Line Setbacks
30 ft. Stream Setbacks
Flood Plaìn
Building Height
'/ Zoningsign-off
Road lmpact Fees
Grade/ Topography 40%
Planníng lssues
I subdivision plat
General Comments:
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Fire Department Revíew
Valuation Determination/ Fees
'/ Red Líne Plans/ Stampsl Sticker
Attach Condítions
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'/ Appticatíon Signed
/ Plan Reviewer to Sign Applicatíon
Parcel/schedule No.
N,A 40# Snowload Letter - Manu. Homes
X Soils Report ¡,b00 x 4l<.Ø' slt
' ,oo x qn.oo'ç'7p70.
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