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HomeMy WebLinkAboutApplication0 4 Z 00 O od U 0 y 0. U A. c cel .4 O a -0 g• 0 0 451,0 d54 00 " M r go 4 z`• yua, 3 O °' U A v) • o5O • 4-1 [tzz, 00 040 a C7 Parcel No: (this information is available at the assessors office 970-945-9134) s,. 3 4-0 CO 315 Job Address: (if an address has not been Assigned, please provide Cr, Hwy or Street Name & Ci or and legal description Lot No: dock No: 'Subd./ Exef iption: Alt Ph; Alt Ph: Alt Ph: No. of Floors: Use of Building: err IicL Describe Work: R i2v &/ vcr 'ccL ,VDD' Class of Work: , J o New Alteration ❑ Addition Septic: ,ISDS ❑ Community Owners valuation of Work: $ NOTICE 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 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 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 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 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 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 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 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 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 Department do not constitute an acceptance of responsibility or liability by the County of errors, omissions or .' .: cies. 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 limit ./.n my architect designer, engineer and/ or builder. I Hy BY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND TH 'NOTICE & CERTIFICA OVE: Ilittfr '" /, (6//-) N OWNE' ' SIGNATURE DATE o'q tr A. h c a 0 Height: ,P2 -?r Mailin Address 4&7/7 7(/& , 6 1'''''� '<\¢c g1 NA Q H y Sq. Ft. or Acres of Lot:' 1 r ; G' Garage: ❑ Attached 6I3h/l Detached Driveway Permit: )0_3-//.7)a IL' O U) ARA( / En 'neer: / Sq. Ft. of Building: /620/0 — N en <r yr \0 l'-•• 00 0' O -• .-. N .-• USE ONLY Special Conditions: ( ice .7 7f' Misc Fees: ISDS No & Issued Date: P G DEPT: y APPROVAL DATE iw 'e Manu home Fee: Const Type: Balance Due: (61 7. (S' Permit Fee: Off1 OCC Group: BLDG D . PT: APP OV•L DATE Plan Check Fee: 6171* Total Fees: 1940 01 Setbacks: Adjusted Valuation: .i k A 0the r a final Ins Garfield Coun C A final Electrical Inspection from the Colorado State Electrical Inspector. • ti N (II 060 a ✓ 'O ° C 0b 5 0 2 2 3 C El -tiY N -10 -0 c °' ° 5 N C bA U O 7 y (� r" a., -0 U 017 O0. 0 Y r0. g fed Com. 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