HomeMy WebLinkAboutApplicationGørfield County
BUILDING PERMIT
APPL¡CATION
Community Development Department
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Commercial/M ulti-Family Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
¡NVOLVED PARTIES
Property owner: 897rl7¿E (r-fArl€ u/, &?¡tl&y'<Jfrong ( Ç7êl 61g'*SSnZ
Mailing Address:7.Q E,(.>ø K,A ÅtL'f êe *t ê{J
Email Address:
Contractor:Phone: t1"fÒ ¡Q-14- tØòê,
Mailing Address:,
Email Address:¿.
Arch¡tect:Phone:
Mailing Address:
Email Address:
Engineer:é¿PP Phone: (q'7øl g¡?4 -rcâ6
Mailing Address: 9t<au ¿:e>
Email Address:rAe rL
Manufactured Home lnstaller:Phone
Mailing Address:
Email Address:
PROJÊCT DETAILS
Describe Work:Ees G<f
'rMÉz^ã/) 7d2c,* goø gf
Job Address:/¿14"1 Le 3Ðt lar L
Assessor's Parcel Nu mae¡: 9l"l'1 t€ltQl oë,,
sub. lot l- Block
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Owner's Valuation of Work:e.b propertysize (sq. Ft. o, acres¡rfuL,1iikft
sq. Ft. of Buifding: SF lë,ët Height: P6î 6i" # ol¡loorsz I
Class of Work:X New Remodel/Alteration Addition
Garage:X Attached Detached
PROJECT DETAILS CONTINUED
Septic
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
or an authorized agent. lf the signature below is not that of the Owner, a separate letter of author¡ty, signed by
the Owner, must be provided with this Application.
Lesal Access. ABuildingPermitcannotbeissuedwithoutproofof legal 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.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinlS0days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
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.
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Property Owner Print and Sign Date
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Community
Propane Electric OtherType of Heat:I Gas
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Driveway
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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. 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 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 w¡th federal, state and local laws
and County Regulations rest with me and my authorized agents, including without limitation my architect
e neer and/ or builder
CERTIFICATION
OFFICIAT USE ONtY *ìÅ ,gv
speciar conditions: sea a fuê/?e/ AN Þ/77aN S
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BUILDING / PLANNING DIVISION :
Signed Approval Dete
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BUILDING DEPARTMENT
1O8 Eighth Street, Suite 407, G¡enwood Sprlngs, CA 81æ1
Tel: (970) 94.s-8212
PLAN REVIEW CHE CKLIST
Permit No: ôlRE-Ol-23+1b7
Gørfield County
Building lssues
-'/Engineered Foundation
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OONÞ Septic Permit and SetbackssãPr-0t-23-7ræ
luation
NA
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tlg b-21'2?-
Plan ning/Zoning lssues
Drívewav PermitêRE2l-D-7
Surveyed Site Plan lvA
vø
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Property Line Setbacks
g6ft. Stream Setbacks
Flood Plain
Building Heíght
Zoníng Sign-Off
Road lmpact Fees
Grade/ Topography 40%
Planning lssues
Subdivision Plat
Grade/ Topography 30%
Attach Residential Plan Review List
Subdivision Plat Notes
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Red Line Plansl Stamps/ Sticker
Attach Conditions
Applícation Sígned
Plan Reviewer to Sign Applicatíon
Parcel/schedule No.
40# Snowload Letter - Manu. Homes
Soíls Report
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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 Officialthat 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
checkllst.
roperty er Print and Sign
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