HomeMy WebLinkAboutApplicationSCt
cJleld County
RECENEp Community Development Department
108 St" Street, Suite 401
y�� Glenwood Springs, CO 81601
LL��. (970) 945-8212
GARFISLDG ° H www.garfield-county.com
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BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercial/Multi-Family
❑ Demolition
❑ Manufactured Home (Single or Multi -Level)
❑ Residential (SF, Duplex or Townhome) [❑ Reroof
INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
1\6i, Mac D Qx\ Phonl1e: () Bl
V
`prOjeth co+ntn.L ' Ind 64 ` 1SiCn ire
Contractor: 6ISirl ig- t.1-e-n2c$Ar11itili ' hone: U
Mailing Address:
Email Address:
Architect: 0-01C)0,2c Le eLC_l IP(0 1"�- CQ Phone: ?D )932_9 9-y
Mailing Address: �� 5 �• 'tic-- . -1-t0 •U lot co 9701-7.-P)
Email Address:
Engineer:
Mailing Address:
Email Address:
Phone:
Manufactured Home Installer: KVA Phone: ( )
Mailing Address:
Email Address:
PROJECT DETAILS -. -- r
Describe Work: t• -)e -A-0 `�E w1 Lac( Y- �]�G� rvt M d' S�c:LI- r
St'4 ( c�r�d
Job Address:
yr _0_301 -,to -v
I.
w�
tl. �'�
Assessor's Parcel Number: 2-15L5 0C') 000
2-0
Sub. Lot Block
Owner's Valuation of Work: $ IS 1000 Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building: Height: # of Floors:
Class of Work: ❑ New u Alteration 0 Addition 1 ID Repair n Move/Relocation
Garage: D Attached ❑ Detached
PROJECT DETAILS CONTINUED
Septic:
Type of Heat:
Driveway Permit:
WIOTICE
OWTS
Natural Gas
Exempt
Propane
AIL
Community
Electric ❑ Other
Permit #:
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
desi: ner, en_ineer and/ or hiiilder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required information which is correct and accurate to the best of my knowledge.
C / t 5 57,--k L
Prop rty Owner Print and Sign
Date
OFFICIAL USE ONLY
_ Special Conditions:
dt' c>i - MtA
of -tows-
rusted Valuation:
�Vd
T tal ees:
4T-• ti-.ce
Pan
�Checa3k Fee:
I.3I
Permit Fee:
151.7,5
Manu home Fee:
Misc Fees:
Setbacks:
90ilt N25 9'16
9
Fees Paid:
$1(3.31
B'ail;
1:11.:(5 u -
OCC Group:
BUILDING / PLANNING DIVISION :
BP No:
DI.0 - 904
Const Type: ` e,
OWTS No: aC
Zoning:
Signed Approval
put)
6 '2014
Date
Garfield County
BUILDING DEPARTMENT
108 Eighth Street, Suite 401, Glenwood Springs, CO 81601
Tel: (970) 945-8212
PLAN REVIEW CHECKLIST
Permit No: 131,6 -
Building Issues
i
N/A
Engineered Foundation
Driveway Permit
Surveyed Site Plan
N/A
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
N/A
N/a
Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign Application
N/A
N/,A
Parcel/ Schedule No.
40# Snowload Letter— Manu. Homes
Soils Report
Planning/Zoning Issues
N/A
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign -Off
Road Impact Fees
Grade/ Topography 40%
Planning Issues
N/A Subdivision Plat
General Comments:
VIAGOV 4 r.)4k %t = 40 c
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goeo Fe4 = NAS.
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