HomeMy WebLinkAboutApplication_14
c
)Fr
s
LCGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www garfield-county.com
BUILDING PERMIT
APPLICATION
FPE OF CONSTRUCTION
�10— Commercial/Multi-Family
L 1 Manufactured Home (Single or Multi -Level)
Q Residential (SF, Duplex or Townhome)
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
iUDemolition
Reroof
INVOLVED PARTIES
Property Owner: ko A e.. droo t Phone: (5 Ho) 9 7 R - yQ / (o
Mailing Address. 7 $ th_3oc Cs -Jr s-Jr 1‘o04 L I Q.0 • Sia t(Q 'j
Email Address. PWo•Vek KaA;e_&jE ty,,,, i.tom
Contractor: \.4.- • flat \t\t
s,S - Crs �oo�� LPhone: ( 70 \) 9 A' 7— 6a.4'
M cZ
Mailing Address: ? 0\ S ‘J bu i n 1 ' - Art &6� j tmc-kkon , ri . 8lCo g
Email Address: Mr • r'\ Stl&w'Xe $S q t4"�icS en Al tL care\
Architect: Phone: (
Mailing Address:
Email Address:
Engineer: Phone:
Mailing Address:
Email Address:
Manufactured Home Installer: Phone: ( )
Mailing Address:
Email Address:
PROJECT DETAILS
Describe Work:
Job Address:
Assessor's Parcel Number:
Sub.
Owner's Valuation of Work: $
Sq. Ft. of Building
Gass of Work: . New -
Garage: Attached
t- Op
Lot Block
Property Size (Sq. Ft. or Acres):
Height:
Remodel/Alteration
# of Floors:
Addition
Detached
■
pRo3KT MAILS. CONTINUED
'Septic: r}W1S Community
DToe of Heat; �Natraral has PropaneElecxrrc ElD.. ., 1PerrIC �#:
Qriuewaxernpt
Permit._
;NOTICE __
Authority. This application fur a Building Permit mast be signed by t c Dwner of the property, described above,
or an authorized agent_ if the signature below Is not that of the O w ner, a separate letter of authority, signed by
1 the Owner, must be provided with this AR pl icatien, 1Jegal Access. A Building Permit cannot be issued without proof of legal and a dego ate access to the property for
purposes of inspections by the gu I I dire$. Division.
Other Perms. Multiple separate permits may be required: (111 State Electrical Permit, RI County ovitTS Permit,
(3) Brother permit required for use can the property identified above, e.g. State or County HIghwayI Road Access
i or a State Wastewater Discharge Permit.
void permit, A aciiiding permit becomes null and void if the work authorized is not commenced within 18.0 days
of the date of issuance and if work is suspended or abandoned for a iod Of (80 days after commencement_
CERTIFICATION
1 hereby certify that I .have read this Application and that the information contained above as true and correct. I
understand that the Building Drvisiarr accepts the Application, along with the plans and specifications and other
data submitted by me or on my beliaif is bmittals), based upon my certification as to accuracy_ Assuming
completene-ss of the submittals and approval of this Application, a Building Permit will be issued granting
permission to me, as der, to construct the structure(s) and facilities detailed on the submittals reviewed by
the 'Building Division. 1 n consideration of the issuance of the Bui4di rig Permit, I agree that I and my agents WI
comply with provisions of any federal r state or local law regulating the work and the Garfield County Building
Code, lovas regulaliorrs and applicable land use regulu #inns County R.egulation(s)). I acknowledge that the
Budding Permit may be suspended or revoked. upon notice from the County, if the location, construction or use
of the structure(s) and facility kes), described above, are not in compliance with County Regulatiert(s) of any
other applicable law.
I hereby grant described above to inspect the work, 1
permission to the Building Division to enter the property,
furt ie r acknowledge that the issuance of the Building Permit does not prevent the Building Official f rri (111
requiring the correction of errors in the sribrnittals, if any. disCOVered after issuance; or (4 stopping
construction or use of the structure(s) or facilit\r(res) if such is In violation of County Regulationts) or any other
applicable law, Review of this Application, including submittals, and inspections of the work by the Building
Orvi s ion do not constitute an acceptance of responsibility or lla bi Li ty by the County of errors, omissions or
discrepancies, As the Diner, I acknowledge that responsibility liter for compliance with fede rag, state and local Laws
sand County Regulations rest with me rid my authorized agents, i n dl'ud ing without Limitation my architect
designer, engineer and/.or builder_
t hereby acknowledge that l 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 Imowledge_
[OFICJALUSE ONLY
Special Conditions:
Date
Adjusted Valuation
Total Feel!
$100.00
Setbacks:
Plan Check Fee!
F arm it Fee,
$100.00
Fe es Paid
$100.00
OCCGroup:
Balance rue'
$0.00
IRC
Lrn�l�a y ko(
Nio!ti *Royal
Manu, Horne Fee:
Misc. Fees'
RP No: OWT F�IO'
ROOF-11-20-6591
Cori st _ Type:IRC
onirrr: PUD
11 / 17/2020
j _A _