HomeMy WebLinkAboutApplicationGarfuId County
Community Development Department
RE gfEt$tsfiLeet, Suite 401
GA
B-1
BUILDING PERMIT
APPLICATION
DemolitionCommercial/Multi-Family
Manufactured Home or Tinv Home (Single or Multi-Level)
ReroofResidential (SF, Duplex or Townhome)
Dwell Unit - MAXTMUM SIZE OF 1,200 FEET
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Email Address:
Property Owner:
Mailing Address:
Contractor: Phone: (-)-
Mailing Address:
Email Address:
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Phone: (E?O t *rt q- q7%
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Architect:
Mailing Address:
Email Address:
Email Address:
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Phone:( 903 | 335= Aos v
Mailing Address:
Engineer:
Sub. Lot
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Block
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Owner's Vafuation of Work: S 2EW- Property Size (Sq. Ft. or Acres):
Describe Work:
41" {{ a,c
Phone:
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Height:Sq. Ft. of Building:57,1 I o
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Job Address:
Assessor's Parcel Number:
Manufactured Home Installer:
Mailing Address:
Email Address:
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(Remodel/Alteration AdditionClass of Work:New
DetachedAttachedGarage:
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Septic: N+f,WTS A//Community
Type of neatrlf,Natural Gas Propane Electric Other
Driveway
Permit:
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Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. lfthe signature below is not that ofthe 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 Dlscharge 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.
lherebycertifythatlhavereadthisApplicationandthattheinformationcontainedaboveistrueandcorrect. 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)). All County development requiring a permit, except for
residential uses, are subject to Article 7 of the Land Use and Development Code. 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 uired information which is correct and accurate to the best of my knowledge.
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Print and Sign Date
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Adiusted Valuatidn:
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Plan Check Fee:tb3.nt Manu. Hbme Fee:\II
TotafEees:4t+ob t
Fees Paid:tab,l Balance Due:agz b5 ffin-kffig OWTS No:.TZtLSetbacks:o OCC Group:\RO const.rvnf:p 1 _'"tt'
I11252
BUILDING / PLANNING DIVISION :Ut);,'+k
Signed Approval Date
Garfteld County
B'IILDING DEPARTMENT
108 Eighth Street Suite 4O!, Gtenwood Springs, CO 81601
Tel: (970) 945-8272
PI.AN REVIEW CHE CKLI
Permit No: BIAE-//-2//- 9$?3
Building lssues
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E*grneered Fou*dation
riveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
Sr.+Mivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line PIans/ Stamps/ Sticker
Attach Conditions
Application Signed
Compliance Path/Plan Received
Plan Reviewer to Sign APPlication
Parcell Schedule No.
40# Snowload Letter - Manuf. Homes
Soils Report
Property Line Setbacks
35 ft. Stream Setbacks
Flood Plain
Buitding Height
ZoningSign-Off
Road lmpact Fees
Grade/ Topography 40%
Planning lssues
Subdivision Plat
Descri ption & Su mmarv:
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