HomeMy WebLinkAboutApplicationRECEiVU
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Garfield County
GARFU ELL !k* Y
)MMUNITY
Corr-qunity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
TYPE OF CONSTRUCTION
0 Commercial/Multi-Family
,g Residential (SF, Duplex, or Townhome)
Ll Manufactured Home (SF or Duplex)
❑ Demolition
❑ Reroof
❑ Grading ; ate ail utilities prior to grading)
INVOLVED PARTIES
Property Owner: ,/ AiY) .2)0 R 0 / Phone: (?7 ) (76 - 2 3aV
Mailing Address: 0 VOS _M/Z)-- 14//9/ e ,l,�gu) e437, C4.
Contractor: r'') 1i 00,e S PO] 4A/2 Phone: PO ) E30-0 Z 0 f
_s
Mailing Address: / •fids v��J
Architect:
Phone: (
)
Mailing Address:
Engineer: _ _ Phone: (
Mailing Address:
Manufactured Horne Installer: Phone: ( )
Mailing Address:
PROJECT NAME AND LOCATION
Describe Work: 41 01 b Ir j I 1/0
//7 E,X t St) +t) (a STIZ OC.,1-01C'
Job Address: - / f% 11 1/J 11 4
Assessor's Parcel Number lr, 1 2) 101 . ub. /1 - r f 4l UOcr2. Lot 7 - 8 Block
Owner's Valuation of Work: $ 'Fg (.)C.e Property Size (Sq.Ft or Acres):,4 ,
Sq.Ft of Building: 381.3?V . ,k1, T/Unl-leight: / ' 6'' 74y0flR,t ',# of Floors: /
Class of Work: 0 New ❑ Alteration II& Addition 0 Repair 0 Move/Relocation
Garage:
Septic:
Type of Heat: 1E1 Natural Gas ❑ Propane
Attached
❑ ISMS
Driveway Permit: '.: 0 Exempt
Grading Square Feet of Earthwork
0 Detached
0 Community
0 Electric 0 Other
0 Permit #:
sd 4/6/0RD.
Cubic Yards of Earthwork,
NOTICE
Authority. This application fora 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
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
completenE 1 of the submittals and approval of this Application, a Building Permit will he 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. 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 1 have read and understand the Notice and Certification above as well as
have provided the required informatin is corr tan a u d r,t• t of my knowledge.
Property rwner Print and Sign
41
/ P ."64‘tiOile'
7- n -
Date
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation:
44 4.21.1 l
Plan Check Fee:
365, 61
Permit Fee:
5q 3. Z5
Manu home Fee:
�`.'
Misc Fees:
Total Fees:
q7 8, 84
Fees Paid:
2,280.5Y-4'
Balance Due:
6 98.4.9
BP No:
ISDS No:
C---` Rai
Setbacks:
FZS, ,az-3", 5/o
OCC Group:
S
Const Type:
'RGfi
Zoning:
BUILDING / PLANNING
DIVISION : 1///"/;" "
Signed Approval Date
1 gyp, ° `1
R3q5/ 7 -as • is
Building Plan Review
Description of Work: addition to existing structure
Bin #:
Location Address: 405 MID VALLEY DR
SILT, CO
i
General Information
Contacts
Case Manager: David Bartholomew
Plan Case Number: BLDG -7-13-7637
Parcel: 218107302006
Application Date: 07/23/2013
NV
Owner: Ham Dubois
Applicant: Ham Dubois
Applicant Phone: Email:
Building
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
/ GradelTopography 30%
Attach Residential Plan Review List
Minimum Application Questionnare
Subdivision Plat Notes
Ny4
Fire Department Review
Valuation DeterminationlFees
f Red Line Plans/Stamps/Sticker
Attach Conditions
NSA
Application Signed
Plan Reviewer To Sign Application
Parcel/Schedule No.
40# Snowload Letter - Manu. Homes
Soils Report
Planning/Zoning
Property Line Setbacks
30ft Stream Setbacks
r Flood Plain
7
Building height
r
Zoning Sign -off
Road Impact Fees
HOA/DRC Approval
GradelTopography 40%
f Planning Issues
Subdivision Plat
General Comments:
1
0
Fret. Ltulliq SpAzC 384 x 74.6$ 2q 677.1z_
Uptrio, 3 P f/t4 394 x41.U° : 15,-744 bD
TO AZ- V4(' ovt _ ,4Z[, 1Z -
Wednesday, July 24, 2013
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
4e1P,,,,•011111r
A liefifT0e--- C3
Property Owner Print and Sign Date