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f ,•1_ . GARFIELD COUNTY
APPLICATION FOR BUILDING PERMIT �
PERMIT NUMBER `-'1 ry T
plcase print or type DATE y/ d 9/ 1 7
TO BE FILLED OUT BY APPLICANT /1 PLOT PLAN
ADDRESS COLA:5p,b.D6 t t t1 s rAk0 COLL,ra NOTE: Show easements, property line dimensions,
SUBDIVISION all other structures, specify north, and street
V FILING # LOT # BLOCK # name. For odd shaped lots, or if space is
w TAX SCHEDULE # too small, provide separate plot plan.
LEGAL (SEC /TW;V /RNG) # OF BUILDINGS NOW ON PARCEL
W NAME, GQ �i r6 tlau iariz 11J 4pl,.t e6 USE OF BUILDINGS NOW / QN PARCEL
x MAILING ADDRESS /VD 01.4-4.-.1
p CITY 6, S . PHONE L
-- l � " YI, - Ae f[OL-
,� NAME /
a w ADDRESS CITY le On cf / m
NAME C- tJtNa,I ,GAZJJ5$QU e X.0 ?< i 7`"
,, ADDRESS iIaZ, Vt.t �y \P \ ./ 'I ,�
fi CITY 6 icnz SIrc h fsant s , 6 C. tnv„t. T'°
$ PPHONE? cC.7?CS LICENSE # /
CLASS OF WORK .1e Stec/it S int 7 n ti / �7 1)
NEW `/ ALTERATION .f/ ADDITION /./
DEMOLISH ,/ REPAIR MOVE �
MOBILE IIOME (make/model)
S.F. OF BUILDING-9)Q S.F. OF LOT
# OF FLOORS ! HEIGHT
# OF FAMILY UNITS # OF BEDROOMS
INTENDED USE OF BUILDING am df$S'P.Z5i5Ms
GARAGE: SINGLE DEL CARPORT: SINGLE DBL FRONT PROPERTY LINE
FIREPLACE
DOCUMENTS , STREET NAME /ROAD NUMBER
WATER SUPPLY Cj� /'..C — CHECK IF CORNER LOT
DRIVEWAY PERMIT DESCRIPTION OF WORK PLANNED
SITE PLAN
BUILDING PLANS Ue
SANITARY SEWER CLEARANCE --^ _ I hereby acknowledge that I have read this
ON SITE SEWAGE DISPOSAL PERMIT ,r l f fr application and the above is correct and I
OTHER DOCUMENTS (specify) agree to comply with all county ordinances
and state laws regulating building construction
�,a tC_ #.V'$
1 � s G e ` ai¢ )= �� �S NATURE
n O F' / . $ : ;!e FOR OFFI lift ONLY
VALU TION 2 43 O / FLOOD HAZARD
PERMIT FEE $ to. PLAN CHECK FEE $ 7 C t,io CERTIFIED BLDG ELEVATION
TOTAL FEE 9/•70 SCHOOL IMPACT FEE $ 4/1¢- SPECIAL CONDITIONS
DATE PERMIT ISSUED
ZONING DISTRICT — PROBLEMS WITH PERMIT
TYPE OF OCCUPANCY ,e/ Ar 5.72,
TYPE OF CONSTRUCTION V^ A/ ADDITIONAL INFORMATION NEEDED
S.F. OF BUILDING •^-fJQ, S.F. OF LOT .
MAX. HEIGHT •— ROAD CLASS. - CERTIFIED BY COLORADO REGISTERED LAND SURVEYOR
SETBACKS FROM PROPERTY LINE: FRONT OR ENGINEER .
REAR RIGHT LEFT
OFF STREET PARKING SPACES REQUIRED
/� �
� r s t%YYln.l'c� el
APPROVED: sr; . / 4/ . /, [,G li/ ` f t3 �rso: ✓ �' ill-L 7 Mr /
i ILDING DEPARTMENT . :ATE PLANNING DEPARTMENT DATE
Pg. 2
Existing water heater to be replaced with ndnimum 80 gallon,
fast- recovery, gas fired, using modified existing gravity vent.
Lighting fixtures, lite-tite wall and door vents shall be the type an
and size indicated on plans, or per attached Lighting Spec Sheet.
Carpet shall be equal to Alladin Mills "Legion ", 24ox, jute
back, installed over I" slab rubber, "Forum 11 ", or equal. Color
to be selected by owner.
Project must be carpleted, cleaned, and ready for owner occupancy
by 5pm, August 21, 1987.