HomeMy WebLinkAboutApplicationGarfield Co1111ty
Community Development Department
108 8 1h Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
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TYPE OF CONSTRUCTION -------------------------r·--·--------------0 Commercial/Multi-Family D Demolition
D Manufactured Home (SF or Duple x)
D Residential (SF1 Duplex, orTownhome) ____ j.__l!l_•_R_e_ro_o_f ______________ ~
f1NVc>LvEc>l>ARTIE5 _____ .. ______ ·-----·----·-----------------------
, Property Owner: Barbara Henning Phone : ( 970 )_27_4_-_46_s_o ___ ---1
, Mailing Address : 17377 Highway 82 , Carbondale, Colorado 81623
, ________________________ ------------------------1
[ Contractor: American Maintenance, Inc . Phone: ( 970 )_2_79_-_12_1_1 ___ _
Matting Addf~: 4336 County Road 113 Carbondale, Colorado 81623
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Architect: _N_o_n_e _________________ Phone: ._( ---------
Malling Address:-----------------------------
Engineer: _N_o_ne _________________ Phone:( __ -------
. Mailing Address : ____________________________ _
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t I Manufactured Home Installer: None Phone: ( I ---
l Mailing Address : ____________________________ _
----------··-----------------------------·-------·--~--------·---------·-l !_RO~CT NAME AND !_<?CATION ---------------------------! Describe Work: Barbara Henning Re -Roofing, removal of old roofing and replace with new roofing .
l Roofing Type to be the same -asphalt shingle
Job Address: 17377 Highway 82, Carbondale, Colorado 81623 I
1 Assessor's Parcel Number: Sub. Lot Block __ ,
j Owner's Valuation of Work: $9985 Property Size (Sq .Ft or Acres): I
J Sq .Ft of Building: Height: #of Floors: I
I dass of W~-: __ ~ ~~w J D Alte~~'.o~ __ l D A ~-dition____ ~~ep~~~~-D M~::~~~l.ocation ~ 1
l:rage: D Attached D Detac hed
~~;--: ;::~.,--T :~ropan•=: D1~:,::~: Ctther ~-
C way Permit: D Exempt I D Pe rmit#: _________ ___,
r NOTia·---~----·~~-~-~------------~------·--·--·-··~----,--·------·-·-~···
L::: ·-------~ . --~------~ I Authority. This application for a Building Permit must be signed by the Owner of the property, described above, or
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an authorized agent. If the signature below is not that of the Owner, a separate letter of authority, signed by the
I owner, must be provided with this Application.
I Legal AW$$ A Building Permit cannot be issued without proof of legal and adequate access to the property for
J purposes of inspections by the Building Division.
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Other Permits. Multiple separate permits may be required: (1) State El ec trical Permit, (2) County ISDS Permit, {3)
another permit required for u se on the property identified above, e.g. State or County High way/ Road Access or a
State Wastewater Disc harge Permit. j Void Permit. A Building Permit become s null and void if the work authorized is not commenced within 180 days of
I the date of issuance and if work is suspended or abandoned for a perio d of 180 days after comme nce ment.
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CERTIFICATION
I hereby certify that I have read this Applica tion and that the information contained above is true and co rrect . I
understand that the Building Division accepts the Application, along with the plan s and specifica tions and other
data submitted by me or on my beh alf (submittals), based upon my certification as to accuracy. Assuming
completeness of the submittals and approval of this Application, a Building Permit will be issue d granting
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permis sion to me, as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by the
Building Division . In co nsideration of the issuance of the Building Perm it, I agree that I and my agents will comply I with provisions of any federal, state or local law regulating the work and the Garfie ld County Building Code, ISDS
regulation s and applicable land use regulations (County Regulation(s)). I acknowledge that the Building Permit
may be suspended o r revoked, upon notice from the County, if the loc ation, con struction o r use of the structure(s)
and facility(ies), desc ribed above, are not in compliance with County Regulatio n(s) or any other applicable law.
I hereby grant permiss ion to the Building Division to enter the property, descr ib ed above, t o inspect the work. I
further acknowledge that the iss uance of the Building Permit does not prevent the Bu ilding 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 Regula t ion(s) or any other applicable law.
Rev iew of this Applica tion, including submitta ls, 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 disc repancies. A s the
Own er, I acknowledge that responsibi lity for complian ce with fed e ral, state and local laws and County Regulation s I rest with me and my authorized agents, including without limitation my architect designer, engineer and/ or
! builde _r·----------------------------~·
I hereby acknowledge that I have read and understand the Notice and Certification above as well as
have provided the required information which is correct and accurate to the best of my knowledge.
Barbara Henning 5-21-2014
Date
_j'.Ji . (JD /
Special Conditions:
Adjusted Valuation : Plan Check Fee : P ~iit Fee:. ~ Manu home Fee:
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Misc Fees:
Total Fees: !jesPaid :~ Balance Due : ~:
~ @_ ~ ~
Setbacks: OCCGroup :
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BUILDING / PLANNING DIVISION : --""""""=-"...>-£,l...L....l)IC._a.~-=-~=-==-..:..._ ____ _
Date