HomeMy WebLinkAboutApplicationS? c+ 3
Garfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfieid-countv.com
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
❑ Commercial/Multi-Family
1 ❑ Demolition
D Manufactured Home (Single or Multi -Level
Igj Residential (SF, Duplex orTownhome)
El Reroof
INVOLVED PARTIES
Property Owner: /0-/-17 JGJ' � f /as Phone: ( 770 )) 375' — "5-2(.2_
Mailing Address: 19e. / )( //k2F C‘"&"7/7/1 , Ylef.
Email Address: 74,+4-) O 64c/ s+.74J'c- Le%41;4.4 sj Cr -'14-1
Contractor: 54r17- X15 8701/1— Phone: (
Mailing Address:
Email Address:
Architect: r34 ,-* 7 c25 4' So✓L Phone: (
Mailing Address:
Email Address:
Engineer: /4/1/61-72 4 /Alio c f"c-5 Phone: (s %/ )
Mailing Address: % er.0 /�eC Jilt- e(4, 1- /3¢,5 4 /� r/6 ,2
Email Address: ra'/ir+. 4.5N e5 , C'0►r7
Manufactured Home Installer: nV79 Phone: {
Mailing Address:
Email Address:
PROJECT DETAILS A�//
Describe Work: A141 f4+-1-1* 4413
Job Address: S''76, %acA f�6/4 / /0i^, _ + a�^!��►� /� �o ��i
Assessor's Parcel Number: -235 /162.0
Sub. ?170x'4+1-14 />►�G4 Lot 6-3/3 Block
Owner's Valuation of Work: $ oma, L' a Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building: /11.2 a
7 Height: %S -"G # of Floors:
Class of Work:
Garage:
75 J
ErNew
Attached
❑ Alteration
❑ Addition
❑ Repair
Move/Relocation
❑ Detached
PROJECT DETAILS CONTINUED
Septic: 2OWTS
Community
Type of Heat:
Natural Gas
Propane
U Electric
Other
Driveway Permit:
J 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 bui
I hereby acknowledge t
provided the requir
ead and understand th t€ce and Certification above, as well as, have
n which .eo ect and accurate to the best of my knowledge.
Property Ownet and Sign
6,- -20/r
Date
OFFICIAL USE ONLY
Special Conditions:
Road I Pkirit6f Pet
(5Adlglvrct
Misc Fees
$21385.00
Adjusted Valuation:
4235 685.
Plan Check Fee:
4 1140.'6
Permit Fee:
c3 (75,.35
Manu homeFee:
_
Total Fees:
Fes Paid:
alance Due:
P No:
OWTS No:
SEPT o6-16-5214
42) get(: 33
6j-jtl. q z
4IIerSI. RI
t26,4 -/k 5 43
Se backs:
rg=25)9=10
OCC Group:
If�G
Const Type:
(RG
Zoning:
e
BUILDING / PLANNING DIVISION :
•
7/12/ZM
Signed App oval Date
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 Impact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by person having written authority from the owner
to act as their representative.
Building cannot be occupied until a Certificate of Occupancy (CO) is issued. Using the building without a
CO will be considered an illegal occupancy and may be grounds for vacating the premises. (Final/CO
inspection requirements will be attached to your approved field set of plans.)
I hereby acknowledge I have read, understar`_and will abide by the requirements of this
checklist.
1 /cab J
Property Owner Print an
6 -Cc. -yr'
Date
re Garfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
BUILDING PERMIT
FEE ESTIMATE
WORKSHEET
Applicant:
Project Address:
Su bdivsion:
Phone:
Lot:
Block:
Finished Living Space (N/A for Manufactured Homes)
/ 27
$74.68
Unfinished Basement
'V/
$41.00
Crawl Space
$18.00
y / _
Garage (Conditioned) (i.e. insulation, sheetrock)
0-
$32.00
Garage (Unconditioned)
$24.00
Covered Patio/Deck
fk
$18.00
Uncovered Patio/Deck
2 3o
$12.00
Misc:
$0.00
Misc:
Total Valuation
$0.00
$0.00
Sin:le Level ($400)
Multi -Level ($600)
Total Set -Up Fee
$0.00
$0.00
$0.00
New Installation ($123)
Alteration and/or Repair ($75)
Perculation ($150)
Total Septic Fee
$0.00
$0.00
$0.00
$0.00
This Section Determined by Garfield County
Plan Review Fee
Building Permit Fee
Manufactured Home Set -Up Fee
Septic Fee (OWTS)
Other (Ex: Road Impact Fee)
Total Fees Due
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
***AII fees are estimates until final plan review is completed***