HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.Rarfield-county.com
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION _At
=Commercial/Multi-Family
Manufactured Home (Single or Multi -Level)
Residential (SF, Duplex orTownhome)
J 1 Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
Demolition
I U Reroof
INVOLVED PARTIES _
Property Owner:
Mailing Address:
Email Address:
JI-Jn ES V, v Li,- K/
9 607 Cr,L)UTY 4.04-n
� d 5 Z. thi i H94 4 6,a 3�,
Contractor: 4 m E S Li 'L v' g.,/
Phone: ( 1 /C 3 9 7 l97
61i1'/4, CCL) S-r',m, c,"� CL
►n
Mailing Address:
Email Address:
Phone: ( 9 7C) 4 , G' ..r j1 7
Z TY g,) l." 4 1.-E1L in) Cep i►g14 s Cc tee'( l
Architect: Phone: ( )
Mailing Address:
Email Address:
Engineer: I r{ 7N u 1� V i C 01 1Vc Eli 41 ►ii 1114 Pone: ( )
Mailing Address: 2- U/ a/ZI Roy LEX/ �� �,� Zy'P73
Email Address: �"' llca S.) f f 2 r � G`f' R UiC. O UJ( 5 }' S7" ►n �, , �' d In
Manufactured Home Installer: Phone: (
Mailing Address:
Email Address:
PROJECT DETAILS
Describe Work: .5 ft t /) /3 d ILO I )1
Job Address: q46.-2. Cr 6'A iArAV 1611 CI -FA,
Assessor's Parcel Number: 2. i F ' ‘ 3 6.C'` GR / L
sub./4 /' /1 Lt C kIRR: ' It i AP) a+.i) Lot til r7,CiL Block -36. - C' 14- ..' S e/
Owner's Valuation of Work: $ .300 @P ■ DV Property Size (Sq. Ft. or Acres):ir Z /`1
Sq. Ft. of Building 1 / £ 6)E, Height: Z` Fr # of Floors: .1
Class of Work:
Garage:
®New
Attached
Remodel/Alteration
Addition
Detached
PROJECT DETAILS CONTINUED
Septic: OWTS
Community
Type of Heat:
Natural Gas
Propane
[1 Electric
Other
Driveway
Permit:
Cxen•m pt
❑ 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 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 crect and accurate the b st of my knowledge.
Date
Property Owner Print and Sign
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valu tion:
9.4; 7/� XD
Plan Check Fee:
245. 2-i377
Permit Fee
26
Manu. Home Fee:
Misc. Fees:
Total Fees:Fees
Z2 , 0)
Paid:
2)61-. Pi
Balance Due:
3357,3Z
BP No:
KWE-4,253
OWTS No:
Ia.1
h
Setbacks:
OCC Group:
Const Type:
Zoning: 12.5
BUILDING / PLANNING DIVISION : s""-' Villialltt..
Signe ro' .illiliP-
S�
Date
fD.+ -0.14,1 Lzir, 511 17.01,0
Garfield County
BUILDING DEPARTMENT
108 Eighth Street, Suite 401, Glenwood Springs, CO 81601
Tel: (970) 945-8212
PLAN REVIEW CHECKLIST
Permit No:
■J413�6'�i3
Building Issues
Planning/Zoning Issues
Engineered Foundation
]riveway Permit
v Surveyed Site Plan
Se tic Permit and Setbacks
Grade/ Topography
30%
Attach Residential Plan Review List
/IAubdivision Plat Notes
N• Fire Department Review
� Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign Application
Parcel/ Schedule No.
%f 4 40# Snowload Letter — Manu. Homes
4s 4 Soils Report
`--- Property Line Setbacks
Ai', 30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign -Off
Alf Road Impact Fees
Grade/ Topography 40%
//A Planning Issues
f%tril Subdivision Plat
Descrjption & Summary:
ceels,1- » 2-9 z `),ao%3