HomeMy WebLinkAboutApplication9706252554
LGarfield County
RECEIVED Community Development Department
0 '019 108 8°k Street, Suite 401
MAYGlenwood Springs, CO 81601
GARFIELD COUNTY (970) 945-8212
COMMUNITY DEVELOPMENT www.garfield-county.cam
12:36:13 p.m. 05-20-2019 1/2
L
BUILDING PERMIT
APPLICATION
Commercial/Multi-Family
} Manufactured Home (Single or multi -Leven
L_.J Residential (SF, Duplex or Townhome)
n Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
NVOLVED PARTIES
Property Owner:
L. Demolition
�w Reroof
Phone: (Th_p
Mailing Address: a
Email Address:
Contractor: Phone: (
Mailing Address:
Email Address:
Architect: Phone: ( )
Mailing Address:
Email Address:
Engineer: Phone: (__1
Mailing Address:
Email Address:
Manufactured Home Installer: Phone: ( )
Mailing Address:
Email Address:
' PJ:Mi DET • t .
Describe Work:
S ,i Pr" -.�• Y ��
Job Address: b --54:-. 0n krk 7c Q ( 1,0S(-)
Assessor's Parcel Number:
Sub. Lot Block
Owner's Valuation of Work: $ (e 0 ply Property Size (Sq. Ft. or Acres): / a.44e4
Sq. Ft. of Building. Height: # of Floors:
Class of Work:
Garage: 4)
New
rilE odel/Alteration
Addition
Attached
Detached
9706252554
12:36:24 p.m. 05-20-2019 2/2
:PROJECT D ,AfLS
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^ Septic:
CONT1NU D : "
. ..:. ' '_ .. .. - ..' -
OWTS
11 Natural Gas 1❑ Propane
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,'� »•r. j I
1 •._-.
y za�I$i'...1._ .-.•
■ Community
ri Electric
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Type of Heat:
( j Other
J j
Driveway
Permit:
nExempt
I I
Permit #:
No:
oaf 5 �
OWTS No:
NOTICE
.
Setbacks: _ _
Authority. This application
for a Building Permit must be signed by the Owner of the property, described above,
If the signature below is not that of the Owner, a separate letter of authority, signed by
provided with this Application.
Permit cannot be issued without proof of legal and adequate access to the property for
by the Building Division.
separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
required for use on the property identified above, e.g. State or County Highway/ Road Access
Discharge Permit.
Permit becomes null and void if the work authorized is not commenced within 180 days
and if work is suspended or abandoned for a period of 180 days after commencement.
or an authorized agent.
the Owner, must be
Legal Access. A Building
purposes of inspections
Other Permits. Multiple
(3) another permit
or a State Wastewater
Void Permit. A Building
of the date of issuance
.. -..----------. _.is-..__..�. .. ... _ c'��^..e�S_'�'r,.cif_.�?_i_..•...:�'��i:3i'1�:�..:�:C: Cv�'.A:t:3�'u^-�G`r�'.z�..
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 builder.
1 hereby acknowledge that 1 have read and understand the Notice and Certification above, as well as, have
pfovided the required informat 6-w is orregt and accurate to the best of my knowledge.
Orli' tt te. N
Prope Owner int and Sign
Date
Zo
0 F CIAL USE 0 t . .�� `.:.1 .` t,• . _ ,rf 1.i ..1.i.4 -q...., k.,' .': -.c'.4....;:.,-c•�:. '`,..; . ;ls_.F'..n•v*,.. ._ r ,a
Special Conditions:
Adjusted Valuation:
Plan Check Fee:
Perri* Fee:
DO
Manu. Home Fee:
Misc. Fees:
Total Fees:
�ao.ti�
Fees Paid:
aa®,
Balanc
No:
oaf 5 �
OWTS No:
r\la.,
Setbacks: _ _
OCC Group:
Const Type: p
Zoning:
BUILDING / PLANNING
DIVISION : :I :•. ! 5I2V 111
Signed Approval Date
t-4 Ibr . � 1 CC / 5111" oq