HomeMy WebLinkAboutApplication.pdfcG Garfield County
Community Development Department
108 gth Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield -county.com
TYPE OF CONSTRUCTION
D Demolition D Comm e rcia I [~ lt!.::£.a m~L-·-··---·--·---·-.. ----
0 Manufactured Home (SF or Duplex) ~Residential (SF, Duplex, ~rTownhom_e~) ____ -] [!) Rer~~f·-·-·------~===~=~~-=~~-
-----------·-------------------~·-------------·------
INVOLVED PARTIES
Property Owner: _G_in_g_e_r_c_u_rr_ie ____________ Phone: ( 303 )_6_6_9-_4_2_27 ___ ------1
Mailing Address: 156 Commanchero Newcastle Co 81647
-------·--·-·-----·------·----------------·-·----·------·---------·------·
Contractor: Colorado Maintenance Group
Mailing Address: PO Box 152 Rifle Co 81650
__ Phone: ( 970 )_6_25_-_40_5_o ___ _
-·--------------·---·------------·-·---·----------·--··--
Architect: Phone:( ___ --------
Mailing Address:-----------------------------, ____________________________________ _
Engineer:-------------------Phone:( ___ --------
Mailing Address:-----------------------------
Manufactured Home Installer:------------Phone:( __________ _
Mailing Address:-----------------------------
----·----------!
PROJECT NAME AND LOCATION ----------·-··---·-··---------·-·---···.,..,.----·-·-·--·-·-----··-·-··-··------·----
Describe Work: Remove 3 tab shingles, install new dry in and install new 30 year laminate shingles.
Job Address: 156 commanchero newcastle co
Assessor's Parcel Number: _______ Sub . ________ Lot __ Block
Owner's Valuation of Work : $_7_3_2o_._o_o _______ Property Size (Sq .Ft or Acres): ____ ____,
Sq.Ft of Building:--------Height: ______ #of Floors :_1 ____ _
-C-la_s_s -oi W~rk: ----D-N~-;-n:JAi-te-ra-t-io~-1-D-A-d-dit-io-~-·
~---·--·----______ J _________ ,, _____ -----------·--1---.. --·-----"--------·-·-.. -·-·-·-.. -·-·"'"""----·--.. ·--l
[!) Repair D Move/Relocation
Garage: D Attached l!I Detached
Septic: 0 ISDS D Community
_r _vp_e_o_f_H_e_a_t:____ D Nat~~~ Gas _____ I~-~~~~~~~-.. ---~--] __ J __ ~-~-lect~~ --.. -..... _J __ ~-~th-er _-__ _
Driveway Permit: D Exempt D Permit#: _______ _
·------·----
NOTICE ---·------------------------·--------------~-··-. -- -----------· ~
Authority. Th is ap pli cation for a Bui ld ing Permit must b e sign ed by the Owner of the property, d esc rib ed above, or
an authorized agent. If the signature below is not that of the Ow ner, a separate letter of authority, sign ed by the
Owner, must b e provided with this Appl ication.
Legal Access. A Building Perm it cannot be iss ued without proof of lega l and adequate access to the property for
purposes of in spections by the Bui ld ing Divi sion.
Other Permits. Multiple separate p ermits may be re qui red : (1) State El ec trical Permit, (2) County ISDS Permit, (3)
an oth er permit re qu ired for use on the property id entified above, e .g. State or County Hi ghway/ Road Access or a
Sta t e Wa stewater Di scharge Permit.
Void Permit. A Buildin g Permit becom es null and void if the work authorized is not comm enced w ithin 180 days of
th e d ate of issuance and if work is susp ende d or a bandoned for a per iod of 180 d ays after commencement.
CERTIFICATION
I hereby certify that I hav e read this App lication a nd that the information contained above is true an d correct. I
under stand that t he Building Divi sion accepts the Application, along with the plans and specifications and other
data submitted by me or on my behalf (submittals}, ba se d upon my certification as to accuracy . Assum ing
com pleteness of the submittals an d approva l of this Application, a Bu ild ing Pe rm it will b e issued gran ting
p ermission to me, as Owner, to const ru ct the stru ct ure (s) and facilities detailed on the submittals reviewed by t h e
Bu ilding Divi sion. In consideration of the issuance of the Building Perm it, I agree t hat I and my agents will comply
with provi sio ns of any federal, state or local law regu lating the work an d t h e Garfie ld Co unty Bui lding Code, ISDS
regulations and applica b le la nd use regulations (County Regu lation(s)). I acknowledge that t he Building Permit
may be su spe nded or revoked , upon notice from the County, if the loca tion, construction or use of the structure (s)
and facility(ies ), described above, are not in compliance with County Regulation(s) or any other appli cab le law.
I hereby gr ant permissio n to th e Building Division to e nter the property, described above, to in spect the work. I
furthe r acknowledge that the iss uance of the Building Permit does not preven t the Building Official from: (1)
requiring the co rrection of errors in the submittals, if any, d iscovered after issua nc e; or (2) stopping construction
or use of th e structure(s) or facil ity(ies) if su ch is in violation of County Regulation(s) or any other applicable law.
Revi ew of this Application, including submittals, and insp ection s of the wo rk by the Buildin g Divi sion do not
cons titute an acceptance of responsibility or liability by the County of errors, omissions or d isc r ep anci es. As the
Owner, I acknowledge that re sponsibility for compliance with federa l, state an d loca l laws and County Reg ulation s
rest with me an d my authorized agents, includ in g wi thout l imit ation my architect designer, engineer and/ or
b ui lde 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.
Ginger Currie 8/7/2014
Property Owner Print and Sign Date
OFFICIAL USE ONLY
Special Conditions :
Adjusted Valu ation : Plan Check Fee:
~ ~ ~
Per mit Fee:
.. 60_
Manu home Fee: Misc Fees :
Tot al Fees :
:t I
BP No:
(JO -
Setbacks : OCC Group:
BUILDING/ PLANNING DIVISION : -=f._j"""""'r1."""wi"-"""--"!l'--#'__._l ..._1J,"""i ........ ~ ..... ~"""=-'~ ........ ~._......_ ___ _ 8 · ~;./(/
Sig ned Approval Date