HomeMy WebLinkAboutApplicationTic Garfield County
Community Development Department
108 89' Street, Suite 401
Glenwood Springs, CO 81601
(97(1) 945-8212
www.garfield-county.com
TYPE OF CONSTRUCTION
't Commercial/Multi-Family
L Residential (SF, Duplex, or Townhome)
LI Manufactured Home (SF or Duplex)
BUILDING PERMIT
PPLICATION
❑ Demolition
❑ Reroof
❑ Grading (locate ail utilities prior to grading)
INVOLVED PARTIES fn
Property Owner: �a l; 5T`,-- riy Phone: ?) )(07.-15-tfg5f
y
Mailing Address:/ $S P� I (� f
Contractor: Phone: (
Mailing Address:
Architect: Phone: (
Mailing Address:
Engineer: Phone: (
Mailing Address:
Manufactured Home Installer: Phone: (
Mailing Address:
PROJECT NAME AND LOCATION
Describe Work:
PAN, door \-{wain L6cS
Job Address: ` sr5 T kiU i ' -* 1f
I
Assessor's Parcel Number: p219 -x -\V. 0 8Sub. Lot Block
Owner's Valuation of Work: $ .606 Property Size (Sq.Ft or Acres):
Sq.Ft of Building:tpIJO0 Height: 34 / # of Floors: 3
Class of Work: 0 New %Alteration 0 Addition 0 Repair 0 Move/Relocation
Garage: 0 Attached 0 Detached
Septic: 0 ISDS lit Community
Type of Heat: 0 Natural Gas 0 Propane E[ Electric 0 Other
Driveway Permit: 0 Exempt 0 Permit #:
Grading Square Feet of Earthwork Cubic Yards of Earthwork 0
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 Division.
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
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, 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 Division to enter the property, described above, to inspect the work. 1
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.
Property Owner Print an
Cfl/;vd/i3
Date
OFFICIAL USE ONLY
Special Conditions: GAL r1 —_f/ . Airit., /"----//174._ —1- 0.
Adjusted Vallion:
n a
Pian Check Fee:
2.3
Permit Fee:
0
Manu home Fee:
Misc Fees:
Total Fees:
e'
Fees Paid:
cvR3, as
Balance Due:
®
BP No:
ISUS No:
Gtr 2sE8
Setbacks:
OCC Group:
Const Type:
Zoning:
C
BUILDING / PLANNING
1
DIVISION : - 7—/-Z ot-3
Signe, Approv.: Date
Building Plan Review
Description of Work: adding door between bays
Bin #: C-2
Location Address: 28485 6 & 24
RIFLE, CO
General Information
rCase Manager: David Bartholomew
Plan Case Number: BLDG -6-13-7605
Parcel: 217711103008
Application Date: 06/28/2013
Contacts
Owner: Travis Tiffany
Applicant: Travis Tiffany
Applicant Phone: 970-876-2002 Email:
Building
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
GradelTopography 30%
Attach Residential Plan Review List
Minimum Application Questionnare
_r;Iv Subdivision Plat Notes
kik,N k, Fire Department Review
YR
Valuation DeterminationlFees
eyYLine Plans!Stamps/Sticker
jh Conditions
plication Signed
Plan eviewer To Sign Application
Parcel/Schedule No.
pc 40# Snowload Letter - Manu. Homes
Solis Report
PlannnglZoning
kirk Property Line Setbacks
30ft Stream Setbacks
Flood Plain
Building height
oning Sign -off
Road Impact Fees
HOAIDRC Approval
Grade/Topography 40%
Planning Issues
Subdivision Plat
General Comments:
Monday, July 1, 2013
NOTE: If any required information is missing, delays in issuing the permit are to be expected
determined by the Building Official that additional information is necessary to review the apnlicatF_= -
and/or plans for compliance, the application may be Placed on hold until the required informatrc
provided. Work may not proceed without the issuance of a Dern --
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 a person having written authority from the
owner to act as their representative.
I hereby acknowledge I have read, understand, and will abide with the requirements of this
checklist,
Property Own - - Tint an
Date