HomeMy WebLinkAbout5747 BUILDING PERMIT APPLICATION
GARFIELD COUNTY, COLORADO
Applicant to complete numbered spaces only. PERMIT NO. .� 7 17 PARCEUSCHED NO.
' 0.
JOR ADDRESS ODQ4e. 1/3, b AZ L
1 LEGAL LOT NO. BLOCK SUBDIVISION
DESCR. \ \\ p i._ /y / , / � �X
2
OWNER \ � �1hUC� (L ! ADDRESS W Vn�l+i r� (13 P H. HS-76S WK. PH 9t 5�7D
3 CONTRACTOR VAN n 1 u se ADDRESS / PH. LICENSE NO.
4 ARCHITECT OR DESIGNER toto / , ADDRESS PH. LICENSE NO.
5 ENGINEER ADDRESS PI-I. LICENSE NO
6 S.F OF BUILDING a SFOFLOT I1 aCte5 HEIGHT l 1 NO. OF FLOORS 1
7 USE OF BUILDING cL..CVE V `l C Y S 4 / A rr , G 1 Q
8 CLASS OF WORK': �NE1 ) W I1I °ADDITION oALTERATION oREPAIR oMOVE o REMOVE � 04,7 ( ..F / 1 L� Q
9 F���� 0EESC0.IBE WORK: A,�A .V A 4{���(� "�'C�J L� �.l f•II� c.4_ 'r nL `Z'(Q .'Jhi'0� ✓Gc" •
0. v e1'v�a c t UU W Y F t•-•Oc L.-GA u I
10 GARAGE SINGLE DOUBLE CARPORT SINGLE DOUBLE
DRIVEWAY PERMIT ON SITE SEWAGE DISPOSAL PERMIT SITE PLAN ,yw,� ;
11 VALUATION OF WORK: $ ADJUSTED VAL.5) S Q 0 0.0 0 PLAN CHECK FEE In / r PERMIT FEE "/S3 .0 a
SPECIAL CONDITIONS: SCHOOL IMPACT FEE NO. OF BUILDINGS ON USE OF BUILDINGS NOW ON
PARCEL PARCEL
TOTAL Fern c.,R 9 C r OCC. GR. CONST. TYPE
NOTICE WATER SUPPLY DATE PERMIT ISSUED M.-„, / -75
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
SPECIAL REQUIRED RECEIVED NOT REQUIRED
VENTILATING OR AIR CONDITIONING. /
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS ZONING ✓ (/
NOT COMMENCED WITHIN 180 DAYS, DR IF CONSTRUCTION OR WORK 15 SUSPENDED
OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS •
COMMENCED. HEALTH DEPT.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW
THE SAME TO BE TRUE AND CORRECT, ALL PROVISIONS OF LAWS AND ORDINANCES FIRE DEPT,
GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN DR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE SOIL REPORT
AUTHORITY , VIO : TE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
LOC t �. R' .A LATING CONSTRUCTION OR THE PERFORMANCE OF
CO G.� a . SETBACK 1
FLOOD HAZARD
C Signature of Owner, Contractor or authorized ^ agent ' g n... stood ;lace above.
D si ( OAAKDw 1 /2 � ed „ / / .v7r MANUF. HOME ..
Building Department Approve/date • ar m
ming Departen i .11ldate I
OTHER
AGREEMENT
PERMISSION IS HEREBY GRANTED TO THE APPLICANT AS OWNER, CONTRACTOR AND /OR THE AGENT OF THE CONTRACTOR OR OWNER TO
CONSTRUCT THE STRUCTURE AS DETAILED ON PLANS AND SPECIFICATIONS SUBMITTED TO AND REVIEWED BY THE BUILDING DEPARTMENT
IN CONSIDERATION OF THE ISSUANCE OF THIS PERMIT THE SIGNER HEREBY AGREES TO COMPLY WITH ALL BUILDING CODES AND LAND USE
REGULATIONS ADOPTED BY GARFIELD COUNTY PURSUANT TO AUTHORITY GIVEN IN 30.28.201 CRS AS AMENDED. THE SIGNER FURTHER
AGREES THAT IF THE ABOVE SAID ORDINANCES ARE NOT FULLY COMPLIED WITH IN THE LOCATION, ERECTION, CONSTRUCTION AND USE OF
THE ABOVE DESCRIBED STRUCTURE. THE PERMIT MAY THEN BE REVOKED BY NOTICE FROM THE COUNTY AND THAT THEN AND THERE IT
SHALL BECOME NULL AND VOID.
THE ISSUANCE OF A PERMIT BASED UPON PLANS, SPECIFICATIONS AND OTHER DATA SHALL NOT PREVENT THE BUILDING OFFICIAL FROM
THEREAFTER REQUIRING THE CORRECTION OF ERRORS IN SAID PLANS, SPECIFICATIONS AND OTHER DATA OR FROM PREVENTING BUILDING
OPERATION BEING CARRIED ON THEREUNDER WHEN IN VIOLATION OF THIS CODE OR ANY OTHER ORDINANCE OR REGULATION OF THIS
JURISDICTION.
THE REVIEW OF THE SUBMITTED PLANS AND SPECIFICATIONS AND INSPECTIONS CONDUCTED THEREAFTER DOES NOT CONSTITUTE AN
ACCEPTANCE OF ANY RESPONSIBILITIES OR LIABILITIES BY GARFIELD COUNTY FOR ERRORS, OMISSIONS OR DISCREPANCIES. THE
RESPONSIBILITY FOR THESE ITEMS AND IMPLEMENTATION DURING CONSTRUCTION RESTS SPECIFICALLY WITH THE ARCHITECT, DESIGNER,
BUILDER AND OWNER. COMMENTS ARE INTENDED TO BE CONSERVATIVE AND IN SUPPORT OF THE OWNERS INTEREST. �
Garform,003 1 HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE AGREEMENT ABOVE (INITIAL Uhl' dJ 1