HomeMy WebLinkAboutApplication.pdfGarfield County
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{)1J1J1� Community Development Department
2�1h 108 8th Street, Suite 401
JUL 14 Glenwood Springs, CO 81601
GAC lF.lD C�UN�( (970) 945-8212
MU�vI1Y���Lpp�IENT www.garfield-countv.com
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
0 Commercial/Multi-Family J 0 Demolition
❑)Aanufactured Home (SF or Duplex)
Residential (SF, Duplex, or Townhome)
0 Reroof
INVOLVED PARTIES .
_10 wt,/
JProrwne:J/ 5 .S oeA71Y (gee)
Mailing Address:
Phone: ( 719 ) R 2 - %i s5
Contractor: Joe, )105 74 CO ALS i -/“A i O/V JA'C. Phone: (7�% () )37q- is/7
Mailing Address:
Architect: of ros
Mailing Address:
Phone:(
Engineer: 6kAlto v d ,s�,l4V(L lq n4 /
Mailing Address:
Phone: (
Manufactured Home Installer: Phone:
Mailing Address:
PROJECT NAME AND LOCATION
Describe Work: 14/(( /z(/y Add I%)Al mei /fiehvo4 It) JQk e
Job Address: 3-.) C 7 /cI /0
`%
Assessor's Parcel Number: Sub. Lot Block
Owner's Valuation of Work: $ 451 y(70
o-0
Property Size (Sq.Ft or Acres):
Sq.Ft of Building: Height: # of Floors:
Class of Work:
Garage:
Septic:
Type of Heat:
❑ New
Driveway Permit:
0 Alteration
0 Attached
atircidition
❑ OWTS
0 Natural Gas
0 Propane
0 Exempt
O Repair
0 Move/Relocation
O Detached
0 Community
Electric
0 Other
O Permit #:
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)). 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 which is correct and accurate to the best of my knowledge.
52—.5k.k_
roperty wner Print and Sign
Date
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation:
Z 4t
Plan Check Fee:
260.$
Permit Fee:
401.3.6
Manu home Fee:
0\0
Misc Fees:
01k
Total Fees:
662.23
Fees Paid:
Z(oa.gg
Balance Due:
4.01.3S
BP No:
OWTS No:
EL(L°-33o2.
Setbacks:
F.05/ZZ$ 5/0 /
OCC Group:
igc,
Const Type:
Zoning:
(s
BUILDING / PLANNING
DIVISION : /0fi�
Signed Approval Date
2f00.g8, ✓ 11 Z, 1--I`i-'1-{
The Building Division will collect a Plan Review fee at time of application submittal. The permit fee, as
well as any Septic or Road Impact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by person having written authority from the owner
to act as their representative.
Building cannot be occupied until a Certificate of Occupancy (CO) is issued. Using the building without a
CO will be considered an illegal occupancy and may be grounds for vacating the premises. (Final/CO
inspection requirements will be attached to your approved field set of plans.)
I hereby acknowledge I have read, understand, and will abide by the requirements of this
checklist.
Prferty Ownftr Print and Sign
?// e/
Date
Building Plan Review
Description of Work: build 12x14 addition and repair roof on entire home
Bin #:
Location Address: 383 167 COUNTY RD
GLENWOOD SPRINGS, CO 81601
General Information
Contacts
Case Manager: David Bartholomew
Plan Case Number: BLDG -7-14-8005
Parcel: 239501400070
Application Date: 07/14/2014
Owner: Kristen Olsen
Applicant: Kristen Olsen
Applicant Phone: Email:
JO 4
Building
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/Topography 30%
Attach Residential Plan Review List
Minimum Application Questionnare
Subdivision Plat Notes
Fire Department Review
Valuation Determination/Fees
Red Line Plans/Stamps/Sticker
Attach Conditions
Application Signed
Plan Reviewer To Sign Application
/ Parcel/Schedule No.
Nl 40# Snowload Letter - Manu. Homes
Soils Report
Planning/Zoning
Property Line Setbacks
30ft Stream Setbacks
Flood Plain
Building height
/ 7oning Sign -off
NRoad Impact Fees
N/4 HOA/DRC Approval
Grade/Topography 40%
Planning Issues
Subdivision Plat
General Comments:
fr/iAA7
/ 406 .� )- ,H)e'd
Wednesday, July 23, 2014
Garfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
Applicant:
Job location:
Sub-Lot/Block:
BUILDING PERMIT
FEE ESTIMATE
WORKSHEET
Fill ONLY in the yellow areas
Type of Space
Square Feet
Value
per sq. ft.
Valuation
Finished Living Space
(N/A for Manufactured Homes)
sq.ft X
$74.68
,$0.00
Unfinished Basement
, I b g
sq.ft X
$41.00
6 $$rb. $0.00
Crawl Space
sq.ft X
$9.00
6a#79 $0.00
Garage
sq.ft X
$18.00
$0.00
Covered Patio/Deck
sq.ft X
$24.00
$0.00
Uncovered Patio/Deck
sq.ft X
$12.00
$0.00
Misc: toyt,V,Gvu /Yita istvLt(4 »'
/68
sq.ft X
30,b8'$0.00
B.l/9f,0 $0.00
Misc: 4gir (2.vrpir12
sq.ft X
$0.00
10,ed6 $0.00
total Valuation :.41
,2 � . i15. t4 $0.00
1
Manufactured Home Set -Up
Single level ($400.00)
Multi -Level ($600.00)
Total Set -Up Fee
111111111111111,111111
Septic
Permit ($123.00)
Percolation ($150.00)
Total MITE c Fee
Valuation
Valuation
$0.00
This section will be determined by Garfield County.
Plan Review Fee Z
Building Permit Fee 4 J
Pay separately with Cash or Check only (Road impact fees)- Other
Due at time of Application Submittal
Due at time of Permit Pick -Up
Total fees
$0.00
$0.00
$0.00
***All fees are estimates until plan review is completed ***