HomeMy WebLinkAboutApplication-Permit.pdf2 10 II GARFIELD COUNTY BUILDING PERMIT APPLICATION 1088'" Street, Suite 401, Glenwood Springs, Co 81601 Phone: 970-945-82121 Fax: 970-384--34701 Inspection Line: 970-384-5003 www.garfield~county.com
Parcel No: (this information is available at the assessors office 970-945-9134) o o Addition ~ached o Detached Garage: Septic: Owners No. of Floors:S Authority. This application for
a Building Permit must be signed by the Owner of the property, described above, or an authoIizcd agent. If the signature below is not that of the Owner, 11 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 Department. Other Permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County ISDS Permit, (3) another permit required
for use on the property identified above, e.g. State or County HJghwayl Road Access or a State Wastewater Discharge Permit. Void Permit. A Building Permit becomes null and void If the
work authori7..ed 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 J hereby certify
that I have read this Application and that the information contained above is tnie and correct. I understand that the Building Department 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 accnracy. Assuming completeness oftbe submittals and approval of [his
Application, a Building Permit will be issued granting permission to me, as Owner, to cOnstruct the stnlcture(s) and facilities detailed on the submittals reviewed by the Building Department.
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, ISDS regulations and applicable land use regulations (County Regulatlon(s). I acknowledge that the Building Pennit 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 Department 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 Sttucture(s)
or facility(ies) if such is in violation ofCoumy Reguiation(s) or any other applicable law. Review of this Application, including submittals, and inspections of the work by the Building
Department 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 iocallaws and County Regulations rest with 1\1C and my authorized agents, including without Ii mltation my architect designer, andl or builder. I HEREBY ACKNOWLEDGE
RE"~foJ"0m[lEf:S'M<gn·HE N()T[CE ABOVE: STAFF USE ONLY Special Conditions: Adjusted Valuation: ,-{-O ( om:>. rSD Plan Check Fee: 1JG"1.:B Permit Fee: 1E Mise Fees: !l6 g -I~ :5ft Manu
home Fee: Fees Paid: :S<:::;y d.. .:=tg ISDS Fee: Total Fees: 64'G.54 Balance Due: 5'4~·7G BP No & Issue Date: ~-7-0<j-/1';'5 (')(:1.0/"'I ISDS No & Issued Date: OCCGroup: fr<V Setbacks:
Const Type: tflU Zoning: rz APPRO AL • DATE DATE .
The following items are required by Garfield County for a final Inspection: I) A final Electrical Inspection from the Colorado State Electrical Inspector. 2) Permanent address assigned
by Garfield County Building Department and posted at the structure and where readily visible from access road. 3) A finished roof; a lockable building; completed exterior siding; exterior
doors and windows installed; a complete kitchen with cabinets, sink with hot & cold running water, non-absorbent kitchen floor covering, counter tops and finished walls, ready for stove
and refrigerator; all necessary plumbing. 4) All bathrooms must be complete, with washbowl, tub or shower, toilet, hot and cold running water, non-absorbent floors, walls finished, and
privacy door. 5) Steps over three (3) risers, outside or inside must be must have handrails. Balconies and decks over 30" high must be constructed to all IBC and IRC requirements including
guardrails. 6) Outside grading completed so that water slopes away from the building; 7) Exceptions to the outside steps, decks, grading may be made upon.the demonstration of extenuating
circumstances., i.e. weather. Under such circumstances A Certificate of Occupancy may be issued conditionally. 8) A final inspection sign off by the Garfield County Road & Bridge Department
for driveway installation, where applicable; as well as any final sign off by the Fire District, and/or State Agencies where applicable. A CERTIFICATE OF OCCUPANCY (CO.) WILL NOT BE
ISSUED UNTIL ALL THE ABOVE ITEMS HAVE BEEN COMPLETED. A C.O. MAY TAKE UP TO 5 BUSINESS DAYS TO BE PROCESSED AND ISSUED. OWNER CANNOT OCCUpy OR USE DWELLING UNTIL A C.O. IS ISSUED. OCCUPANCY
OR USE OF DWELLING WITHOUT A C.O. WILL BE CONSIDERED AN ILLEGAL OCCUPANCY AND MAY BE GROUNDS FOR VACATING PREMISES UNTIL ABOVE CONDITIONS ARE MET. I understand and agree to abide by
the above conditions for occupancy, use and the issuance of a e.O. for the building identified in the Building Permit. \ DATE Bapplicationdecember2007
GARFIELD COUNTY BUILDING AND PLANNING 970-945-8212 MINIMUM APPLICATION REQUIREMENTS For SINGLE F AMIL Y DWELLING CONSTRUCTION Including NEW CONSTRUCTION ADDITIONS ALTERATIONS And MOVED
BUILDINGS In order to understand the scope of the work intended under a permit application and expedite the . issuance of a permit it is important that complete information be provided.
When reviewing a plan and it's discovered that required information has not been provided by the applicant, this will result in the delay of the permit issuance and in proceeding with
building construction. The owner or contractor shall be required to provide this information before the plan review can proceed .. Other plans that are in line for review may be given
attention before the new information may be reviewed after it has been provided to the Building Department. TWO (2) SETS OF CONSTRUCTION DRAWINGS & TWO (2) SITE PLANS MUST BE SUBMITTEDFOR
ALL APPLICATIONS. Please review this document to determine if you have enough information to design your project and provide adequate information to facilitate a plan review. Also, please
consider using a design professional for assistance in your design and a construction professional for construction of your project. Any project with more than ten (10) occupants requires
the plans to be sealed by a Colorado Registered Design Professional. To provide for a more understandable plan in order to determine compliance with the building, plumbing and mechanical
codes, applicants are requested to review the following checklist prior to and during design. Applicants are required to indicate appropriately and to submit the completed checklist
at time of application for a permit. Plans to be included for a Building Permit, must be on drafting paper at least 18"x24" and drawn to scale. I
(V r Have you provided any RESOLUTIONS and! or LAND USE PERMlT(S) associated with this property? Yes if Yes please provide a COPY. No ___ _ 6. Are you aware that prior to submittal of
a building permit application you are required to show proof of a legal and adequate access to the site? This may include (but is not limited to) proof of your right to use a private
easement/right of way; A County Road and Bridge permit; a Colorado Dept. of Highway Permit, including a Notice to Proceed; a permit from the federal government or any combination. You
can contact the Road & Bridge Department at 625-8601. See phone book for other agencies Yes 1 ~'7 7. Do the plans include a foundation plan indicating the size, location and spacing
of aU reinforcing steel in accordan.ll~ with the IRC or per stamped engineered design? Yes IiJ f1' 8. Do the plans indicate the location and size of ventilation openings for under floor
crawl spaces and the ~::randZfqUired betw~:n wood and earth? 9. Do the plans indicate the size and location of ventilation openings for the attic, roof joist spaces and soffits? ;1..
Yes ;/11 No ___ _ 10. Do the plans include design loads as required by Garfield County for roof snow loads, (a minimum of 40 pounds per square foot up to & including 7,000 feet above
sea leVel), floor loads and wind loads? ;tIfo-Yes , . 11. Does the plan include a building section drawing indicating foundation, wall, floor, and roof ~e~structi~ , 12. Does the bUild~'nse
ction drawing include size and spacing of floor joists, wall studs, ceiling joists, roof raft~:s r' ists or trusses? Yes._./-fll.-'---'. __ _ 13. Does the building section drawing or
other detail include the method of positive connection of all ~~~mns~? 14. Does the elevation plan indicate the height of the building or proposed addition from the undisturbed grade
to the midpoint between the ridge and eave of a gable or shed roof or the top ~e~ flat r7!l rilding height measurement usually not to exceed 25 feet) I 3
25. Do you understand that the minimum dimension a home can be on a lot is 20ft. wide and 20ft. long? Yes 'fe;z 26. Have you designed or had this plan designed while considering building
and other construction code requirementsr Yes ,J J 27. Do your plans comflY with all zoning rules and regulations in the County related to your properties zone distri:t] ~ Yes __ -<JV=-___
_ 28. Does the plan accurately indicate what you intend to construct and what will receive a final inspection by the Garfi?untYBuilding Department? Yes AI I 29. Do you understand that
approval for design and/or construction changes are required prior to the application of ese changes? Yes __ I17-",,"'-_ 30. Do you understand that the Building Department will collect
a "Plan Review" fee from you at the time of application submittal and that you will be required to pay the "Permit Fee" as well as any "Road rm? or "Septic System" fees required, at
the time you pick up your building permit? Yes tV I 31. Are you aware that you must call in for an inspection by 3:30 the business day before the requested inspection in order to rec.eive
it the following business day? Inspections will be made from 7:30 a.m. to 3:30 p.m. Monday through Friday. Inspections are to be called in to 384-5003. Yes y v7 No _____ _ 32. Are you
aware that requesting inspections on work that is not ready or not accessible will result in a $50.00 re-inspection fee? Yes 10 33. Are you aware that you are required to call for all
inspections required under the IRC including approval on a final inspection prior to receiving a Certificate of Occupancy and occupancy of the building? Yes "Ie;' 5
WGnt Project Name: ______________________ ---, ______ _ Project Address: __ 3_q~:;"___C_-_<L_d-_S_I_--,-~_i H---"_e=-j{'------~_=__ __ _ Notes: If any required information is missing
delays in issuing the permit are to be expected. Work may not proceed without the issuance of a permit. If it is determined by the Building Official that additional information is necessary
to review the application and plans to determine minimum compliance with the adopted codes, the application may be placed behind more recent applications for building permits in the
review process and not reviewed until required information has been provided and the application rotates again to first position for review, delay in issuance of the permit or delay
in proceeding with construction. bpminreqsfMar2009 7
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'f"'e ~ tns J 0 M 6>-)c tVa ~J ~~ Eaf1/c~ Word 0~ Zu'MAZ 4~{2 ~'t~ S-t LL{ tboe-h,llc 194/~ 'D DC, -'1 9;:;-~ 9' '13 ~ I I I I I I
Building Flan Review Description of Work: Fire damage, remodel and demo building, Bin #: PIF Location Address: 000395 CR 251 RIFLE, CO 81650 Case Manager: Ken Smith PIau Case Number:
BLDG-7-09-6006 Parcel: 212719100031 Application Date: 07/14/2009 Building _____ Engineered Foundation _____ Driveway Permit _____ Surveyed Site Plan _____ ,Septic Permit and Setbacks
_____ ,GradefTopography 30% _____ Attach Residential Plan Review List _____ Minimum Application Questionnare _____ Subdivision Plat Notes _____ Fire Department Review __ -,-__ V'aluation
Determination/Fees -____ IRed Line Plans/Stamps/Sticker _____ .Attach Conditions ____ --'Application Signed _____ ,plan Reviewer To Sign Application _____ 'ParceIlSchedule No. _____
,40# Snow load Letter -Manu. Homes _____ .Solls Report Thursday, July 16, 2009 Contacts Owner: Max & Eunice Word Applicant: Max & Eunice Word Applicant Phone: Emait PlanninQlZoning _____
IProperty Line Setbacks _____ ,30ft Stream Setbacks _____ ,Flood Plain _____ IBuilding height _____ .£.7,oning Sign-off _____ IRoad Impact Fees _____ ,HOAlDRC Approval ."'._•.;•;. -....'..;
0."• . '~ _G radefTopography 40% _____ ,Planning Issues -----:Subdivision Plat General Comments: •
UIL INGPE GARFIELD COUNTY, COLORADO INSPECTiON WILL NOT BE MADE UNLESS THIS CARD IS POSTED ON THE JOB MIT Date Issued_J--,-'-""Z=O",,--'" "",O'--~/_ ___Z _ Permit No. ARE. -1 ~ 09 ~
113 S"""',--_ AGREEMENT In consideration of the issuance of the permit, the applicant hereby agrees to comply with all laws and regulations related to the zoning, location; construction
and erection of the proposed structured for which this permit is granted, and further agrees that if the above said regulations are not fully complied with in the zoning, location, erection
and construction of the above described structure, the permit may then be revoked by notice from the County Building department and IMMEDIATELY BECOME NULL AND VOID. g€MD6E~L~. ______________________
___________ _ Use Address or Legal Descriptfon 39 s: cU'5" L._iilELE. _____ -'-_____ _ OWner ~j{ vJ()~----_---contractor ~u6. ANtI.J""?,S... O =N"--__ Building permitType~TIALL-----------------------
--This Card Must Be Posted So It Is Plainly Visible From The Street Until Final Inspection INSPECTION RECORD Footing {~l;-L' <1) Driveway JJIf Foundation I Grouting ~l1) Insulation fJw.--Nit
/()-IV-d{ Underground Plumbing Drywall tP-3 -Dq fJvL of I[}·JA-o~ ~ Rough Plumbing Bnt E'e~ft70·' (A~t~ Of) /p-3-c> 9 (Prior to Final) y.:.----Rough Mechanical Septic Final I/-(O-O,?
T/rn~ )0-'i)-DO; v&4 Gas Piping 10-g -DC( J\hYL FINAL ;;< _I? -/0 ~;??, ~ Electric Rough (by State Inspector) (You Must Call For Final Inspection) IP,;~t:;:,m;ng:ojg(O? ~ , Notes Framing
/0-'6-0'1 tj::,? '{ ~.1Jm (to include oof in place & Windows & Doors installed & Firestopping in place) fJf--" I \. t THIS PERMIT IS NOTTRANSFERABLE n _ -.Iv \ Cl,l(;-\> lfylJ For Inspection
Call 970-384-5003 Office 970-945-8212 ,j"'-Ci';::'§Q:Jr,,," 1 t11Jr 108 8th Street, Suite 401 Glenwood Springs, Colorado 81601 :)7 DO NOT DESTROY THIS CARD APPROVED ] 2..D q E: \ /Date
• • ()? PROTECT P:~MIT ,;;{()«,; W~;R DAMAGE (DO NOT LAMINATE)
COUNTY OF GARFIELD -BUILDING DEPARTMENT CORRECTION NOTICE 108 8th St., Suite 401 Glenwood Springs, Colorado Phone· (970) 945-8212 Job located at ;3 r 0" C~ -zs:-/Permit No. I I :5 S
----+I~~~------------------------I have this day inspected this structure and these premises and found the foliowing corrections needed: ~& Pm!fr&~.5 iN 7NI.s.efo?;6iV'T ~VtC~ .. o Call
for Re-Inspection q ~ <is -7 0 -:::::: 1-o $50.00 Re-Inspection Fee must be paid prior to Re-Inspection You are hereby notified that the above correction must be inspected before covering.
When correction(s) have been made, cal! for inspection at 970-384·5003. Date ~-7' 20 /C!J Building Inspecto, ~ ~ Phone (970) 945-8212
ij fic:.pcif aJ \ ~I. ~ D~VY\~ d-i\.re0oJ:-~ VLoVJ\6 ~) R€:-p~~ 1;r:(~ 5('cJL~ ,Fc2C':'a... 9-2>o~Yc+-j r ,~~ revn .3(.,-_A4~ , q, (lOS g i tit' /0) e.....v Erl LA; vv.v~ j-000 K' ~
APPROVED . . SUBJEct 1'0 NOTED i!tXanIONS,. INSPECi10NS . GARFIEIJ) COUNTY BUILDING DEPARTMENT ~ 1(r(;/(fi ~ t:(-is mLDOOPY NO INSPECTION WITHOUT '1'HJ£R fLANS ON strE pa~ of
Kristen L. Hodgden Agent 433 East Avenue Rifle, CO 81650 970-625-1496 office 1 970-945·9165 office 2 970-625-1501 fax 8BB-798-FARM (3276) Auto. Hom!!. Ufe HelpingYou is what we i/o best
WWW.cfbinsursnce,com I www.colorsdowayofliie.com Form a\l'~~u UI~ Il'Buranco Compnny"& C"j<>mda F"rm BlI,,, .. u MUluo{ In$lI,ane~ Ccmpall\' 1_C"-vr~Y-L t~-'t'l(/. &,,--,<-\0,,"1J'-\
~-,.')f1> Tony Worrell 51"« -f'P Claims Representative main 970-858-1003 fax 970-858-8956 cell 970-210-3873 adj385@cfbmic.com Colorado Farm Bureau Mutual Insurance Company 303W.Aspen
(Fruita, CO 81521 )vW\.v.cfbinsurance.com \ PT&C FORENSIC CONSULTING SERVICES, P.A. PrOject a Project Time & Cost, Inc. Company lime&Cost \ 4950 S, Yosemite Street, Unit F2, #101 Greenwood
Village, CO 80111 LAWRENCE CANARY, CFI Senior Fire & Explosion Consultant 888.PTC.F!RE 303.923.3104 Fax 866.914.7561 eel! 303.887.9540 larry .canary@ptcinc.com www.ptcinc.com . I PT&C
FORENSIC CONSULTING SERVICES, P.A. PrOject a Project Time & Cost, Inc. Compan: lime & Cost I '4090 Southwest Freeway Suite 220 FRANK D. POAG, PI SeniOr Forensic Consu !tan Sugar land,
TX 77478 800.486.5752 281.242.1551 Fax 281.242.1 5S~ Cell 281.638.15$1 frank.poag@ptcinc.con www.ptdnc.con .-----•....... -.• -J. Max Word, MD Eunice Word mword52@suddenlink.net Aspen
/Snowmass Village: Lubbock: 45129th Enclave # 304 360 Wood Rd Snowmass Village, CO 81615 970-922-3304(H) Lubbock, TX79416 806-795-9738 (H) 806-543-3300(C) 806-778-5991 (Onstal J. Max
Word, MD Eunice Word mword52@suddenlink.net Aspen /Snowmass Village: Enclave # 304 360 Wood Rd Snowmass Village, CO 81615 970-922-3304 (H) Lubbock: 45129th Lubbock, TX 79416 806-795-9738
(H) 806-543-3300 (C) 806-778-5991 (Onstal Tad Schoon FF I EMT (970) 625-1243 Emergency 911 FAX: (970) 625-2963 taschoon@rifiefiredept.org 1850 Railroad Avenue' Rifle, CO 81650 RIFLE
FIRE PROTECTION DISTRICT Kevin Alvey Battalion Chief (970) 625-1243 Emergency 911 FAX: (970) 625-2963 kealvey@riflefiredept.org 1850 Railroad Avenue' Rifle, CO 81650
INSURED LOCATION COMPANY : MAX WORD : 4512 9TH ST : LUBBOCK, CO 79416 : CFBMIC DATE OF REPORT DATE OF LOSS POLICY NUMBER CLAIM NUMBER OUR FILE NUMBER ADJUSTER NAME BASEMENT -----"-----.--------------
-.... ---------.... ---.':--.. ----··---------··---···---_·_---··--------··---+1 ,, ,, , , ;___ ______________? _~~ __ :_~~_:_r Garage 14*'23 I : 7/6/2009 : 6/26/2009 : CS216384 : 0106312
: CS216384 : WORRELL TONY Utility Room 10*8 ------------------------------------------------i----------------------------------------------------, Bedroom 13.6*23 Cellar unfinished 13.6*23
SIMSOL® Adjuster CADI3.0·SP4 c
INSURED LOCATION COMPANY : MAX WORD : 4512 9TH ST : LUBBOCK, CO 79416 : CFBMIC DATE OF REPORT DATE OF LOSS POLICY NUMBER CLAIM NUMBER OUR FILE NUMBER ADJUSTER NAME UPPER LEVEL : 7/6/2009
: 6/26/2009 : CS216384 : 0106312 : CS216384 : WORRELL TONY .-,----.... ---"--------_._-----... -----... -.. ---_.-------",.----_ .... ----., .... ---_ ..... ---_ ... ----_ .. -----------.".,,
, , ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, , , BEDROOM 11.$*13.5 15*13 BEDROOM ,r ···----····,, ,, ," '", '" """""" """", ""',"", .... '" 'j, 10.5* 10.5 BEDROOM:'" , , i : 1 ! , ' : : :
: BATHROOM , ' i HALL & STAIRS , ' ___ . _____ . ______________ .. ________ . ______ .. ________ L .. _____ .... ___ L ... _____ ..... ___ ... ______ . _____ .. _____ .. ____ l ,, ''
,, '' ,, '' :, :' ,, i' SIMSOL® Adjuster CAD/3.0-SP4 c
INSURED LOCATION COMPANY : MAX WORD : 4512 9TH ST : LUBBOCK, CO 79416 : CFBMIC DATE OF REPORT DATE OF LOSS POLICY NUMBER CLAIM NUMBER OUR FILE NUMBER ADJUSTER NAME MAIN LEVEL . ,'/STAIRS
13*3 . : 7/6/2009 : 6/26/2009 : CS216384 : 0106312 : CS216384 : WORRELL TONY ::::::::::::::::~~b~~~--~:-~---------'-------"-------'----------.. -------' HALL 13*3 · ... -----_ .... -----_
... _--_ ....... -----_ ..... " KITCHl=N 12*14.5 LIVING ROOM i 8'16 . ' DINING 111.5*11 •• _______ ". ________ • _________ ••• _________ • _________ •• __________ •• _________ ... ______
_ ._. _____ •••• ________ • ________ •• _______ J SIMSOL® Adjuster CADI3.0·SP4 c
INSURED LOCATION COMPANY : MAX WORD : 4512 9TH ST : LUBBOCK, CO 79416 : CFBMIC DATE OF REPORT DATE OF LOSS POLICY NUMBER CLAIM NUMBER OUR FILE NUMBER ADJUSTER NAME MAIN LEVEL STAIR.{
13*3 : 7/6/2009 : 6/26/2009 : CS216384 : 0106312 : CS216384 : WORRELL TONY "::.':"::.:··:~~b~~~"'~~'~ ........... c ••••••••••• " •••••••••••• •• ............................. , .....................
..............H.. ALL 13*3 Ii L IVI N G ROO M 1·8'*10-·············· .. ·······················-1 1 1 : : I DINING 111.5*11 ..................................................................!
.. ...................................................... ..J SIMSOL® Adjuster CAD/3.0.SP4 c
INSURED LOCATION COMPANY : MAX WORD : 4512 9TH ST : LUBBOCK, CO 79416 : CFBMIC DATE OF REPORT DATE OF LOSS POLICY NUMBER CLAIM NUMBER OUR FILE NUMBER ADJUSTER NAME UPPER LEVEL : 7/6/2009
: 6/26/2009 : CS216384 : 0106312 : CS216384 : WORRELL TONY , ... _._.-----._.--------_.-------_._-------.-----------------------------,,, -----------_.--------------------------_.-,,,
,,, ,,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, B~DROOM 11.f*13.S ! ............ , 15*13 BEDROOM ,, "" ,' , , · ............ · ...................... · .......... 1, 10.5* 10.5 BEDROOM,'" i i
BA~,::,HROOM I HALL & STAIRS -----... ------------.----.-----.. --------.--.---...... 1. ______ .... ____ L .. __ ... __ " _____ .. ___ ... ____________________ .j ) ; ,, '' ; : i l
1 : : t SIMSOL® Adjuster CAD/3.0-SP4 c
INSURED LOCATION COMPANY : MAX WORD : 4512 9TH ST : LUBBOCK, CO 79416 : CFBMIC DATE OF REPORT DATE OF LOSS POLICY NUMBER CLAIM NUMBER OUR FILE NUMBER ADJUSTER NAME BASEMENT __ • __ •
___________ • ___________________ • __ • _______ ~ •• -.-___ .w.w _________ ._. _________ • __________________ , ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,---------------..
-----~-~-~---~-~~-:} Garnge14~3 I : 7/6/2009 : 6/26/2009 : CS216384 : 0106312 : CS216384 : WORRELL TONY I Utility ~oom 10*8 ----------------... --------.. ---.--------------+-------------------------
------··--------··---------1 I~Ar i i ~. ' : ~F3eZ:o" i ~ ~,6*23 Cellar tnfiniShed 13,6*23 .. __________________ . ________ .. __________ . ______ ~ ____ . ________ ._w __ . ______________
. __________________ ~ SIMSOL® Adjuster CAD/3.0.sP4 c
INSURED LOCATION COMPANY : MAX WORD : 4512 9TH ST : LUBBOCK, CO 79416 : CFBMIC DATE OF REPORT DATE OF LOSS POLICY NUMBER CLAIM NUMBER OUR FILE NUMBER ADJUSTER NAME BUILDING ESTIMATE
Estimate Grand Totals: Total Depreciation: A.C.v. Estimate Totals: Policy Deductible: Final Totals: $28,219.92 $592.34 $27,627.58 $5,000.00 $22,627.58 : 7/6/2009 : 6/26/2009 : CS216384
: 0106312 : CS216384 : WORRELL TONY ... This is an estimate of recorded damages and is subject to review and final approval by the insurance carrier . ... I SIMSOL® Form EST ·113.0·SP4
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Parcel Detail Garfield County Assessor/T reasurer Parcel lletaillnfDrmatiDn AA_sesSar IT reasur~f PLQR.~r1Y_S~il[ch I AssessoLSu_b9~L[jILm I A_~Jlssor ~13kSjBjlJ:ch CL~rkJtReco[d~r.B~ceR.lliJ~Sean;h
PercelOetail I\,alue Oetllil I Sales Uel13ll I HesidentLa[!ComrnerciallfTlR[QY~rngnt!Letail bD~ Detail I P_h_QIog[Bghs I MiIlLe~yJle'Lenue$Jtlllail Tax Area II Account Number II Parcel
Number II 21lllB Mill levy 021 II R210475 II 212719100031 II 47.116 (]wner Name and Mailing Address IWORO. J. MAX fi EUNICE 14512 8TH ST ILUBBOCK. TX 78416-4708 Assessor's Parcel Description
(Not to be used as a legal description) ISECT.TWN.RNG:IS-5-82 OESC: SEC 18 ISWSE SEC IS WII2NE. SENE. NWSE fi 38 lAC. IN OESC: SWSE LYING N OF HARRIS ILATERAL DITCH BK:0377 PG:0123 IBK:0372
PG:034o SPEC ASMT: SILT IWATER PROJECT location I Physical Address: 11385 251 COUNTY RO RIFLE I Subdivision: I I land Acres: 11238 I land Sq Ft: 110 I Section II Township II I II II
Range II II I II I I I I I I I I I http://www.garcoact.com/assessor IParcel.asp? AccountNumber=R210475 Page I of 4 7/1412008
Parcel Detail Page 2 of 4 II 19 II 5 II 92 II 2DD!l Property Tax Valuation Information I II Actual Value II Assessed Value I I land: II 32.33011 9.3801 I Improvements: II 197.73011 16.5401
I Total: II 230.06011 25.82011 Most Recent Sale \1 Sale Date: I Sale Price: I Basic Building Characteristics Number 01 Residential Buildings: III Number 01 Comm/lnd Buildings: 110 I
I I Residential Building Occurrence I Characteristics I I I I UNFINISHED BSMT: 11336 I I FINISHED BSMT: 11336 I I I STORY WI BASEMENT: 11672 I I I STORY: 11672 I I TOTAL HEATED AREA:
111.680 I I ABSTRACT CODE: IIFARM/RANCH RESIDENCE-IMPS I I ARCHITECTURAL STYLE: III-STRY IBSM I 1 EXTERIOR WAll: IIWO SIDING I I RDDF COVER: IlcOMP SHNGL I I ROOF STRUCTURE: IIGABLE
I I INTERIOR WAll: IIDRYWALL I I FLOOR: IICARPET I I FLOOR: IlsHT VINYL I I HEATING FUEL: IIGAS I J II II http://www.garcoact.com/assessor IParcel.asp? AccountNumber=R21 0475 7/1412009
Parcel Detail Page 3 of 4 I HEATING TYPE: IIFORCED AIR I I STORIES: IISTORIES 1.0 I I BATHS: 111.7 I I ROOMS: 116 I I UNITS: III I I BEDROOMS: 113 I I YEAR BUILT: 111866 I Tax Information
I Tax Year II Transaction Type II Amount I I 2008 II Tax Payment: Whole II ($881.32)1 I 2008 II Tax Payment: Whole II ($546.00)1 I 2008 II T ax Amount II $546.001 I 2008 II Tax Amount
II $881.321 I 2007 II Tax Payment: Whole II ($546.00)1 I 2007 II Tax Payment: Whole II ($876.82)1 I 2007 II T ax Amount II $876.821 I 2007 II Tax Amount II $546.001 I 2006 II T ax Payment:
Whole II ($865.52)1 I 2006 II Tax Payment: Whole II ($545.88)1 I 2006 II Tax Amount II $546.001 I 2006 II T ax Amount II $865.521 I 2005 II T ax Payment: Whole II ($546.00)1 I 2005 II
T ax Payment: Whole II ($868.28)1 I 2005 II Tax Amount II $546.001 I 2005 II Tax Amount II $868.281 I 2004 II Tax Payment: Whole II ($546.00)1 I 2004 Tax Payment: Whole II ($877.62)1
I 2004 Tax Amount II $877.621 I 2004 Tax Amount II $546.001 I 2003 I Tax Payment: Whole " ($1,084.28)1 I 2003 II Tax Payment: Whole II ($546.00)1 I 2003 II T ax Amount II $546.001 I
2003 II Tax Amount II $1.084.281 I 2002 II T ax Payment: Whole II ($545.88)1 I II II I http://www.garcoact.com/assessor IParcel.asp? AccountNumber=R21 0475 7/1412008
Parcel Detail I I I I I I I I I I I I I I I 2002 II Tax Payment: Whole II ($1.056,72)1 2002 II T ax Amount II $1.056,721 2002 II Tax Amount II $546,001 2001 II T ax Payment: Whole II
($1.079.42)1 2001 II T ax Payment: Whole II ($427,00)1 2001 II T ax Amount II $427,001 2001 II Tax Amount II $1.079.421 2000 II T ax Payment: Whole II ($427,00)1 2000 II T ax Payment:
Whole II ($1.116,20)1 2000 II T ax Amount II $427,001 2000 II T ax Amount II $1.116,201 1999 II Tax Payment: Whole II ($382,00)1 1999 II T ax Payment: Whole II ($1.119,12)1 1999 II Tax
Amount II $1.119,1211 1999 II T ax Amount II $382,001 Tqp~glp"g~ 8:>'~]'~~LOiltaboBeSegr~ORtions I Tre~a.sur.eL.!lJlIgbase Se]fJ;hOpliQDs !;Jerk HJIe~0r.derOa.tobJtse1earclL0R1iQns Page
4 of 4 The Garfield County Assessor and Treasurer's Offices make every effort to collect and maintain accurate data, However, Good Turns Software and the Garfield County Assessor and
Treasurer's Offices are unable to warrant any of the information herein contained, Copyright @J 2005 ~ 2008 Good Turns Software, All Rights Reserved, Database H Web Design by GoQJlJums
Sgftwgrn, http://www.garcoact.com/assessor IParcel.asp? AccountNumber=R21 0475 7/14/2009