HomeMy WebLinkAboutApplicationGørfield CountyÈã
Ê SãE
ü : 3äH ãHä'2, uã<=oE
Community Development Depa rtment
L08 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-82L2
www.garf¡eld-cou nw.com
@
WPE OF CONSTRUCTION
INVOLVED PARTIES
Com mercial/Mu lti- Fami ly Demolition
Manufactured Home (Single or Multi-Level)
ReroofResidential (SF, Duplex or Townhome)
Accessorv Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
Address: Inêtot Snig-t\¿ Lr)n€ u)a< 3i l-t. ( 0 Kl LogL
9k'ì'rnr^,nt.¡ lâ ti\.n"or i\' Conl-EmailAddress:J
Mailing
Sarnr¡¿l 5t n^^ttProperty Owner:Phone: t 11O I ¿ì8l- Ôtq 6
Contractor: Phone:
Mailing Address:
EmailAddress:
(
K "t"l \vrn r", \ Phone: t 6t-lo I at R I - 3Þ'1f
Engineer:É,r.n"s{ k,rll^n
'12-î\ rrf\¿¡i ñ S+. Srr il'e 2nz
Phone:
Architect:
$10 t crLoS* e223
l'.¿irl..,n, ',irolrr (D tlbz3Maillng Address:
EmailAddress:
Mailing Address:
EmailAddress:
Phone: {_}
PROJECT DETAITS
EmailAddress:
Manufactured Home lnstaller:
Mailing Address:
Job Address: T'ß Þ, Sc,¡'rrec. utl. Tår ecÊ , co I I c t O -
$ 4Ô0, OOO Propertysize (sq. Ft. orAcres): 35" 5Z gcre
Describe Work:
# of Floors
\\r
Sq. Ft, of Building : ") "11-L Height:I{al
(
Lot _ Block _
Owne/s Valuation of Work:
Sub,
Assesso/s Parcel Number:
XClass of Work:New Remodel/Alteration
XGarage:Attached
Addition
Detached
PROJECT DETAIIS CONTINUED
I hereby acknowledge that I have read and understand the Not¡ce and Certification above, as well as, have
provid lon which is correct and accurate to the best of my knowledge,
l,'lIt 7t
Owner and Sign o"{"
{CWTSSeptic:Community
Type of Heat:Natural Gas Propane Electric Other
Driveway
Permit:
Exempt Permit #:
NOTICE
AuthoriW. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. lf the signature below is not that of the Owner, a separate letter of authority, signed by
the Owner, must be provided with this Application.
Lesal Access, ABuildingPermitcannotbeissuedw¡thoutproofoflegal andadequateaccesstothepropertyfor
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 Applicat¡on, 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, 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 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 ín 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 Bu¡lding
Division do not constitute an acceptance of responsibility or liability by the County of errors, omissions or
disoepancies. 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.
ırHclALusEoNrv ?d. I ,, t o t, za e.c. tlprfzèzléãñ,>
Special Conditions:
Adiusted Valuation:-- I Plan Check Fee:
øzz¿- b62.?bv /, /oø. zz Permit Fee: - ¿
â/- vÒ4. r"Manu. Home Fee:
ñlA RIFilÞÞMisc. Fees:ét*tt
Due:îgI
Paid:
I oJ,22-fz.g/9.t7
Total Fefs:BP No:
OLRE.IZúL
OWTS No:5€t- 12117
s"tbã"þ"(OCC Group:
t, t2,C,
Const. Type:
l, 2, c,
Zoning:
Ru cr+ L
24-.AZc%,t*BUILDING / PLANNING DIVISION :
Signed Approval Date
Framing plans for each floor level and roof. All beams, columns, joists, rafters and trusses
specified. Pre-manufactured structures require the engineers stamp, signature and date,
Framing /connection details, braced wall lines, shear wall schedule, location and hold downs.
NOTE: lf any required information is missing, delays in issuing the permit are to be expected. lf
determined by the Building Official that additional information is necessary to review the application
and/or plans for compliance, the application may be placed on hold untilthe required information is
provided. Work may not proceed without the issuance of a permit.
The Building Division will collect a Plan Review fee at time of application submittal. The permit fee, as
well as any Road lmpact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by person having written authority from the owner
to act as their representative.
Building cannot be occupied until a Certificate of Occupancy (CO) is issued. Using the building without a
CO will be considered an illegal occupancy and may be grounds for vacating the premises. (Final/CO
inspection requirements will be attached to your approved field set of plans.)
I hereby acknowledge I have read, understand and will abide by the requirements of this
checklist.
úÈL \.)lt lt
Property Owner Print and
a
a
Gørfteld County
BUILDING DEPARTMENT
708 Eighth Street, Su¡te 407, Glenwood Spring, CO 87607
Tel: (970) 945-8212
PLAN REVI E W CHECKLIST
Permit ¡,to: ßLÆ- //-2/-72/1.
Building lssues
t/
//
t/
t/Engineered Foundation tØnild t2-7-z/
Driveway Permit
Surveved Site Plan-" ;47:rr-4-724f
Septic Permit and Setbacks
Pl a n n i ng / Toning, lss ues
ta Property Line Setbacks
ilA 30 ft. Stream Setbacks
tv4 Flood Plain
Building Height
t/ Grade/ToPograPhY 3o%
/ Attach Residential Plan Review List
Y- Zoning sign-off
Vtrq Road lmpact Fees il F,Þ
Grade/ Topography 40%
Planning lssues
Subdivision Plat
reæfhinr ?SrrbZZ
/a gîl.oo
ad¡usled bu,//,h1
ua/aa,hbn !
Rt F-/v,B.b =g//, aô
Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ StamPs/ Sticker
Attach Conditions
Application Signed Descriptio n & Summarv:
Plan Reviewer to Sign APPlication F¿-6 zTzz x 74.bø= 20427ø,qL
Parcel/schedule No êgM loo x 3z =t7J gØ. Ø
NA-40# Snowload Letter- Manu. Homes cf/¿5#X lg =
/Soils Report #22ç/ lloLJ b
K*4 zþ7-g;4
q,z?-2-t zooaø{
ønotle/ Ernìe K
Pl'!¿rsF
.€.o. z slæ/g*drn1,//tæ€/iØ/heph /2-6-24
CONDITIO NS OF PERMIT
B LRE-1 1 -21 -7 246
Samuel Jurmu
New S/F Dwelling w/ attached garage
TBD Scutter Ln, Rifle
s.28, T.05 , R.92, 212728400389
1) ALL WORK SHALL COMply W|TH THE 2015 INTERNATIONAL RESIDENTIAL CODE
(r.R.c.)AND 2009 INTERNATIONAL ENERGY CONSERVATION CODE (I.E.C.C.)
2) PROPOSED TMPROVEMENTS ARE SUBJECT TO ALL APPLICABLE ITEMS CONTAINED
IN THE ATTACHED "GARFIELD COUNry BUILDING REOUIREMENTS", NUMBER
REFERENCES NOTED ON PLANS REFER TO SPECIFIC ITEMS ON THIS LIST,
3) ELECTRTCAL PERMtTTtNG AND TNSPECTIONS BY COLORADO STATE ELECTRIC
BOARD, ELECTRICAL ROUGH-IN APPROVAL IS REOUIRED AT FRAME INSPECTION.
ELECTRICAL FINAL APPROVAL IS REOUIRED FOR FINAL INSPECTION &
CERTI FICATE OF OCCUPANCY,
4) WILDFIRE MITIGATION REOUIREMENTS: COMPLY WITH WILDFIRE MITIGATION
AND DEFENSIBLE SPACE REOUIREMENTS PER COLORADO STATE FOREST SERVICE
AND LOCAL FIRE DISTRICT.
5) OPEN-HOLE SOILS AND COMPACTION REPORT REOUIRED AT FOOTING
INSPECTION TO VERIFY 2.OOO PSF SOIL BEARING CAPACIry. PROVIDE COPY OF
ENGINEER'S REPORT FOR BUILDING INSPECTOR REVIEW AT FOOTING
INSPECTION.
ó) PRE-ENGINEERED ROOF TRUSSES, HAVE ENGINEERING FOR INSPECTOR AT TIME
OF FRAME INSPECTION,
7) ENGINEERED SEPTIC SYSTEM: ON-SITE WASTEWATER TREATMENT SYSTEM
(OWTS) TO BE INSPECTED BY PROFESSIONAL ENGINEER LICENSED IN THE STATE
OF COLORADO. PROVIDE ENGINEER'S FINAL REPORT PRIOR TO FINAL BUILDING
INSPECTION & CERTIFICATE OF OCCUPANCY.
195 W. 14th Street
Rifle, CO 81650
(970) 62s-s200
Publíc Heakh
RECEIVED
NOv I 6 202r
GARFIELD GOUNTY
COi,IM U N ITY DEVE LOPM ENT
2014 Blake Avenue
Glenwood Springs, CO 8L601
(e7o) e45-66t4
OWTS PERMIT APPLICATION
GørrteM County
WPE OF SYSTEM CONSTRUCflON
E New lnstallation E Alteration tr Repair
BUILDING USAGE TYPE
E[ Dwelling E Transient Use E Comm./lndustrial tr Non-Domestic
E other Describe
INVOLVED PARTIES
Property
MailingAddress: (,¿cL4 R.is{\cr'oo-.,¿ \,r.Jal S\\tt' CO Rì[¿52-
EmailAddress:
I I
MailingAddressl
EmailAddress:
(q-ro | saq- szSn
MailingAddress I o Å ¿t\(0 I
EmailAddress:oet . co{\ô
PROJECT TOCATION AND DESCRIPTION
Job Address:
Assesso/s Parcel Nu mber' 21 2 -1 28 u oD 3 Bclsub,-Lot-Block
BuildingorServicerype:Res\À¿rsla,\ rBedrooms:-5-Garbageoisæsa@rud-
Distance to Nearest Community SewerSystem:Nlft
Was an effort made to connect to the Community Sewer System:N/ r\
Potable Water Source
& Type
tr Well tr Sprlng E Stream orCreek F. cbtern
E Community Wctêr Systêm Nam€
Garfield County Public Health Department - working to promote health and prevent disease
Applicant acknowledges that the completeness of the applicatfon is condítional upon such further
nidndatorv and additíonal tests and reports as may be required by the local heahh department to be
made andÎurníshed by the applícant or bythe local health department for purpose of the evaluation of
the appllcation; and tlie issuàice of the permit is su.biect to such terms and cond¡t¡ons as deemed
neceisãry to ín-sure complíance with rules and regulatíons made, ínformation and reports submitted
herewith'and required tò be submitted by the appliænt are or will be represented to be true and
correct to the beit of my knowledge and belief and are designed to be relied on bythe local
department of health in evaluating the same for purposes of issuing the permit applíed for herein. I
fu rther u nderstand that any falsíficat¡on or misrepresentation may result in the denial of the
applicatíon or revocation of any permit granted based upon said application and legal actíon for perjury
as provided by law.
CERTIFICATIOfI
I hereby acknowldge ütat I have read ¡nd understand the Notfce and Certificadon above as
well as have prouíded the required information urñich ls correct and accurate to the best of
l,ln)zt
Owner andSfgn -- -r;T
oFFrcrAr usE (xtrY Rt.t llr.êo cll€crt tz3 t| /." r.tz,åb>
Sþochl Condltlons:
Pormlt Fecr
{ l¿?.oo
Tül For¡:*l¿3.cc Fe¡c P¡ld¡t¡2,3. oe
Bulldlry Permlt
øLP.e-1LqA
OWTSPcrmh:sepr-zz*1 bcüc Drtr:
12t07t2021
l¡hmDuo:,g
,2:-,1 ¡' .,,f"r¿.
12t07t2021
Grrffcld County Pubfc HGrhù ¡þprrùîont¡
sltn.dÄDp¡otnl lna