The URL can be used to link to this page

Home My WebLink AboutApplicationGarfield County •,I -y pmmunity Development Department �08 Stn Street,. Suite 401 IELD CO wood Springs, CO 81601 U k"DEVELur (970)945-8212 tO*161111" wwwearffeid-county.com BUILDING PERMIT APPLICATION Commercial/Mufti-Family D Demolition El Manufactured Home (Single or Multi -Level) Residential (SF, Duplex orTownhome) INVOL1pPAR7(Sy s i.-' .. .. Reroof Property Owner: -bav;., Phone: (2-03 ) 11.1•Il `-L Mailing Address: 'Vic) CL-rL0074_ fV C. 21i.2 -d9 Email Address: A\eAsi Ga M - Contractor: L)cinicS' 0-4- 4 Phone: (S`to) c12-1- t -1G0(4 Mailing Address: V# \. c-1.) S (-4,.•^.&.. 3:..sM.1V Cc, 53'1102.1 Email Address: Sk,e.rri 4- 1...)001 S'r 4e. Stier . /te.Ac Architect: c..c'Ce y-.. t�aair r Phone: (9 .0 ) Mailing Address: 2 -CSF\yd ��.� ��a..�� c o 9I LZ\ nr Email Address: VD -A .� ek-C" a- yr�� - C-0 lids. Engineer: rv« . \&r \\ Phone: ('ria) �iL - 321.3 Mailing Address: 32° I`^�+%. , 'ct.a-_ \0 Co S\(,2-3 Email Address: ec r -Li t- Va r e• Manufactured Home Installer: Phone: ( J Mailing Address: Email Address: • e Describe Work: s \4, +�^ •-k4 r+ s�S•.ti.� Job Address: C.�tee8 Assessor's Parcell Number: 2'19s-- 134- o`t- Off] g Sub. ASS (riw+ ''t`:\: Lot S Block Property Size (Sq. Ft. or Acres): .2' �+ Sq. Ft. of Building: 3'-7 La. Height; �- + # of Floors: -. Owner's Valuation of Work: $ 1. g 'to , 04.10 Class of Work: 0 New Alteration Garage: Attached D Addition Repair Detached Move/Relocation Septic: Type of Heat: Driveway Permit: OWTS Community TZNatural Gas jPropnE Exempt 1 I Electric J [ Permitt Other 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 Other Permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS (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. Vold Permit. A Building Permit becomes null and void if the work authorized is not commenced within 180 clays of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement. • „ :.• ' ' ' ' ' • !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 Lo 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 BLAing Permit, I agree that 1 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, constructiorror 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 •ner, I acknowledge that responsibility for compliance with federal, state and. focal laws and County Reguiati rest with me and my authorized agents, including without limitation my architect d gne engineer di or builder. ereby acknow •ge that 1 hav and understand the Notice and Ceatonfahove. as well as, have provide the'req for on which is correct and accurate to the b, st fnq4recjg) e. arty Owner Print and Sign Date _OFPICIALAISE ONP6' :' -.»-. : Special Conditions: ROA).. I ittips.64 Fzt , 9.te- 406/44- C4,0.46011 9 Oe phi" i444± . (geofr 010'i ct) Adjusted Valuation: AT 31_14 -4. Oo Pan Check Fee: 3 1)117 ei2. Fees Paid: I '31- 94 Permit Fee: S2j 140, /5 Balance Due: 52 22.1403 Manu home Fee: BP No: Misc Feu: 1 952p 03. 60 OWTS No: T tal Fees: 'r 5/4T45.-1 nrk utitth Setbacks • wl.elivt itteic OCC Group: IR6 Const Type: 1 R6 Zoning: ?IA) BUILDING / PLANNING DIVISION: 11 - 3/15/10for Signed A. • roy, Date gg, sip() iltolig and/Or plans fc r eompliar ce, the: application bray be placed on hold until the required information is provided:` Work May -hot proceed without the issuance of a permit. ThZe;Building Division Wilt Collect a Plan -Review -fee at time of application submittal. The permit fee, as Well- as;any Rpa -Impact fees will be collected when the permit is issued. The permit applicatian.mustbe-Sighed by the oinrner or by person having written authority from the owner to act as tfreir 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 here acknowledge 1 hay a •, understand and will abide by the requirements of this P7.1)-v(i ecklist. wner Pnnt and Sign Date Gexrfreld Cnunij , B u 4i.i 1 n snail Review Checklist Permit Number: %RS -01- (G1— BuildingPlanning/ Zoning Engineered Foundation 7 Property Line Setbacks 604Jt Driveway Permit WA 30 ft. Stream Setbacks Surveyed Site Plan ' A Flood Plain N/A Septic Permit and Setbacks Building Height Grade/ Topography 30% Zoning Sign -Off Attach Residential Plan Review List Road Impact Fees Subdivision Plat Notes Grade/ Topography 40% WA Fire Department Review Planning Issues Valuation Determination/ Fees Subdivision Plat 7 Red Line Plans/ Stamps/ Sticker ROGol 4t►n*:L0 ` et, 2 "B21"7O3. 06 Attach Conditions7 (t4 bl9i C� ) Application Signed General Comments: Plan Reviewer to Sign Application�� 150 ill �� l,25 Parcel/ Schedule No. NIA Lit 10124Ar 1, 525 40# Snowload Letter— Manu. Homes ,, fi61 PL -9; a., 3I 3 00 Soils Report Risi dam C.e_�3bd u 11'1448 = $24&y 444. e 4 &so k 3 32.00 = -20 60. 0/00 510A6t, trZet 3e 550 x f 4.66 =11 4'ic. av 'Psfib F (Alit CovAAPt62-• PA. 0 g213 k 5 11. 60 11l1e'b. g 51 I)