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Community Development Department
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108 8`h Street, Suite 401
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Glenwood Springs, CO 81601
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(970) 94S-8212
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www.garfieldcountygco.gov
® Commercial/Multi-Family 0 Demolition
0 Manufactured Home & Tiny Home (Single or Multi -Level) 0 Fence
0 Residential (SF, Duplex or Townhome) 0 Reroof
0 Accessory Dwelling Unit (ADU) -MAXIMUM SIZE OF 1,200 SQUARE FEET 0 Siding
INVOLVED PARTIES �a
Property Owner: Mark Bintliff
Mailing Address: PO Box 1996 Glenwood
CO 81601
Phone: (970 )945-5902
Email Address: pastormark@newcreationchurch.orq
Contractor: JR Maintenance Phone: (970 ) 379-2544
Mailing Address: 415 Midland Ave. New Castle, CO 81647
Email Address: juniorvenegasx2l @gmail.com
Architect:
Mailing Address:
Email Address:
Engineer:
Mailing Address:
Email Address:
Manufactured/ Tiny Home Installer:
Mailing Address:
Email Address:
PROJECT DETAILS
Phone:) )
Phone:
Phone: ( )
Describe Work: Remove old roof, install new 3/4 plvwood decking on engineered wood trusses
install Ice and heat WIP300 versa sheild-entire roof, add new metal roof
Job Address:
Assessor's Parcel Number: 212335200098
Sub. Williams Trust Lot Block _
Owner's Valuation of work: $ 120,000.00 Property Size (Sq. Ft. or Acres): 7.3 acres
Sq. Ft. of Building: 10,000 Height: 20ft # of Floors: 2
Class of Work: New 0 Remodel/Alteration 0 Addition 0 Repair 0 Move/Relocation
Garage: 13 Attached 0 Detached
PROJECT DETAILS CONTINUED
Septic: 113 OWTS p Community
Type of Heat: 0 Natural Gas p Propane 1 0 Electric [3 Other
Driveway—�xempt 0 Permit#:
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)).
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 required information whi 10 i correct and accurate to the best of my knowledge.
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Property Owner Pn and Sign Date
OFFICIAL USE ONLY
Special Conditions:
AMaluation:
Plan Ch � k Eee:
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BUILDING / PLANNING DIVISION
Signed Approval Date
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NOTE: If any required information is missing, delays in issuing the permit are to be expected. If
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 until the 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 Impact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by a person with written authority from the
owner to act as their representative.
I hereby acknowledge I have read, understand, and will abide with the requirements of this
checklist.
Property Owner Pri and Sign
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Date