HomeMy WebLinkAboutApplicationGarficld County
BUILDING PERMIT
APPLICATIONReC gtúgpmunity Development Department
108 8th Street, Su¡te 401
t.Ï{:i !i I i'[i1:slenwood Springs, co 81601
8,ii5JF|3,r*y'ffi
WPE OF CONSTRUCTION
E Commercial/Multi-FamilY fl Demolit¡on
E Manufactured Home (Single or Multi-Level)
E] Residential (SF, DuPlex orT I Reroof
INVOTVED PARTIES
DARIN DICKINSON pt on",1303 )
520-0175
Property Owner:
Mailing Address:99 WESTBANK ROAD
Email Address:darindickinson@gmail.com
CMG ptrone, {970 948 1657
Contractor:
Mailing Address:PO Box 152 Rifle Co 81650
Email Address:john@cmgus.com
Arch¡tect:
Mailing Address:
Email Address:
Engineer:
Mailing Address:
Email Address:
Manufactured Home Installer:Phone:
Mailing Address:
Email Address:
PROJECT DETAIIS
Describe Work:Remove existing roof, install new shingle roof
Job Address:99 westbank rd
Assessol's Parcel Number
Sub. Lot
-
Block
-
Owne/s Valuation of Work:s24145.00 Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building: Height: # of Floors:-
Class of Work:! ruew flRlteration E Rod¡tion ! nepair Move/Relocation
Garage:Attached Detached
PROJECT DETAITS CONTINUED
Septic:OWTS I Community
Type of Heat:I I tttatural Gas Propane llElectric Io*rer
Driveway Permit:Exempt l-l Permit #:
NOTICE
of the property, described above,
rate 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 PermiÇ
(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.
Author¡tv. This application for a Building Permit must be signed by the Owner
or an authorized agent. lf the signature below is not that of the Owner, a sepa
CERTIF¡CATION
contained above is true and correct. I
the plans and specifications and other
I hereby certify that I have read this Application and that the information
understand that the Building Division accepts the Appl¡cation, along with
data submitted by me or on my behalf (submittals), based upon my certification as to accuracy' Assuming
completeness of the subm¡ttals 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 Bu¡lding 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 faciliry(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
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.
t,4sô 10t0712019
Property Owner Pr¡nt and S¡gn Date
OFFICIAL USE ONtY
Special Cond¡t¡ons:
Manu.home Fee:
h1/ R.
MiscPlan Check Fee:N)iR Permit Feel -sl an oaAdjusted Valuation:rùlll
BP Nö:
*nP-SQ4+
owis No:utr\Fees iaid:alôn.oo Balance Due:í6. ooTotel Fees:
$ tnn. oo
Const Type:w(,Zonin'g:
Ê.
OCC Groun:Y?þ-Setbacks:N,N
BUILDING / PLANNING DIVISION :
Signed Approval
t!þ/tg
Date