HomeMy WebLinkAboutApplication108 8th Street, Suite 401, Glenwood Springs, CO 81601
Ph:970-945-8212 Fx:970-384-3440 Inspection Line:888-868-5306 `
www.garfield-county.com
BUILDING PERMIT APPLICATION
GARFIELD COUNTY
1
Parcel No: (this information is available al the assessors office 970945-9134)
217711100359
Lot No: Block No: Subdi Ex ttdj *id U cit F'LANNING
N/A
2
Job Address: (if an address has not been assigned, please provide CR, FHWY or Street Name & Cio.) or and legal description
28730 Highway 6 & 24 Rifle, CO 81650 Section: 11 Township: 6 Range: 93 A TR IN THE SENE SEC 11
3
Owner: (property owner)
Bayou Well Services LLC
Mailing Address:
same as above
Ph:
970-625-0552
_
Alt Ph:
4
Contractor:
PNCI Construction
Mailing Address:
553 25 1/2 Road, Grand Junction GO970-242-3548
Ph:
Alt Ph:
5
Manufactured home installer:
Mailing Address:
Ph:
J
Lic #:
6
Architect:
Johnson Carter Architects, PC
Engineer:
7J,INIEL I iC. iNNIS
Mailing Address:
136 E 3rd. St. Rifle, CO 81650
Mailing Address: s+, koulS
Hi WE5TMNRK:R,2. MD
Ph:
970-625-0580
Ph:
3iii -1335--122
Alt Ph:
Alt Ph:
7
8
Sq. Ft. of Building: COQ
t
Sq. H. or Acres of Lot:
13.26 Acres
Height:
o�3.. 75 -� .
No. of Floors:
one
9
Use of Building:
DResidential ®Commercial DOther
Class of Work:
jgi,New DAlteration ❑Addition ❑Repair DDemo DMove
10
Describe Work: ,r-EKpcRAR s-rogR6e 15UiILDiNCl- - (411/411T A
11
Garage: N/A
DAttached ❑Detached
Septic: N/A
❑iSDS ❑Community
Type of Heat: N/A
DNat. Gas ❑Propane ❑Electric DOther
12
Driveway Permit:
N/A
Owners valuation of Work:
LEA5E 1--,4T- rag -Taro% — t 817 5o
Authority. This application for a Building Permit must be signed
letter of authority, signed by the Owner, must be
Legal Access. A Building Permit cannot be issued without proof
NOTICE
by the Owner of the property, described above, or an authorized agent. If the signature below is not that of the Owner, a separate
provided with this Application.
of legal and adequate access to the property for purposes of inspections by the Building Department,
(1) State Electrical Permit, (2) County ISDS Permit, (3) another permit required for use on the property identified above, e.g. State or
Wastewater Discharge Permit.
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
CERTIFICATION
information contained above is true and correct. 1 understand that the Building Department accepts the Application, along with the plans
behalf (submittals), based upon my certification as to accuracy.
Application, a Building Permit will be issued granting permission to me, as Owner, to construct the structure(s) and facilities detailed on
that land my agents will comply with provisions of any federal, state or local law regulating the work and the Garfield County Building
Regulation(s)). I acknowledge that the Building Permit may be suspended or revoked, upon notice from the County, if the location,
above, are not in compliance with County Regulation(s) or any other applicable law.
the property, described above, to inspect the work. I further acknowledge that the issuance of the Building Permit does not prevent the
in the submittals, if any, discovered after issuance; DT (2) stopping construction nr use of the structure(s) or facility(ies) if such is in violation
of the work by the Building Department do not constitute an acceptance of responsibility or liability by the County of errors, omissions
for compliance with federal, state and local laws and County Regulations rest with me and my authorized agents, including without
UNDERSTAND THE NOTICE & CERTIFICATION ABOVE:
kii241 .
Other Permits. Multiple separate permits may be required:
County Highway/ Road Access or a State
Vold Permit. A Building Permit becomes null and void if the
days after commencement.
1 hereby certify that 1 have read this Application and that the
and specifications and other data submitted by me or on my
Assuming completeness of the submittals and approval of this
the submittals reviewed by the Building Department.
In consideration of the issuance of the Building Permit, I agree
Code, ISDS regulations and applicable land use regulations (County
construction or use of the structure(s) and facility(ies), described
1 hereby grant permission to the Building Department to enter
Building Official from: (1) requiring the correction of errors
of County Regulation(s) or any other applicable law.
Review of this Application, including submittals, and inspections
or discrepancies. As the Owner, I acknowledge that responsibility
Iimitatio cI designer, engineer and/ or builder.
1 HE BY ACKNO ' : D E HAT 1 HAVE READ AND
...._
OWN . ]GNATURE / i DATE -
p D. -D..5 STAFF USE ONLY
Specidl Conditions:
Adjusted Valuation:
I e7 25-0
Plan Check Fee:
)99.7 i
Permit Fee:
307. Z$
Manu home Fee:
Mise Fees: pep:4k(Fee_
307• z.
Total Fees:
Fees Paid: s
''
Balance Due:
-7/ 474 Li
BP No & Issue ate:
ISDS No & Issued Date:
W—C)".-
Setbacks:
r- so!P7,41/,S/0
OCC Group:
S I
Const Type:
5
Zoning:
C% 61
rDEI17�'
Py$1G D T:/jZ-,9
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APPROVAL DATE
APPROVAL DATE `