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GARFIELD COUNTY BUILDING PERMIT APPLICATION
108 81h Street, Suite 401 , Glenwood Springs, Co 81601
Phone : 970-945-8212 /Fax: 970-384-3470 I Inspection Linc : 970-384-5003
www.garfield-county .com
Parcel No : (this information is available at the assessors office 970-945-9134)
b1 ~01~
Ph: Mailing Address:
9-ro-Cf'l1 -'J'f1'?.
Alt Ph;
et "tv -a\~ -l-11-i..-
6 Architect I t.ngmeer: A.)/ t\
Mailing Aqdress :
; ~~ <.OiaOhJ~ L+J.
--t-
Mllllmg Aaarcss :
6\W~ &lc.o\ ~1io-
l'h:
Alt Ph: 'no-0 uf1 _,4"
Alt l'h:
s
7 Sq. Ft of Building: · Sq. Ft. or Acres of Lot: Height: No. of Floors:
8 Use ofBuilding:
9 Describe Work:
10 Class of Work:
oNew o Alteration Addition
\ttached o Detached cISDS
11 Garage: IJ/A Septic:
12 Driveway Pennit: Owners valuation of Work : s
NOTICE
Al!J!w:in:. This applicui011 for a Building Pcmii1 must be siSJlc:d by the Owner of the propcny, desmoed 1bove, or u autboriwl ascnt. Ir the signa111re below is 1101 that of the Owner, a scpante
letter of 1\llharity, lisned by the Owner, must be prnvided with this Application.
Lrul Asma. A Buildina Permit camiot be issued wilhoul proof ofleg&l ud adequate oa:csa IO the property for JllllPOICS ofhlspcaiom by the Bw1ding Dcponmmt.
Otbrr Pcrm!p, Multiple &cpmlC permits may be required. (I) Stale Elem cal Permit, (2) County ISDS Permit, (3) uother permit rcquin:d for use 011 the pnperty idcnli6cd above, e.g. 51&12 or
Cowny Hishw11Y/ Road Accc11 or a St.ate Wutewlltef Di&ebarsc PcnniL
Vpid Penn!L A Building Permit becomes null ud void if the work authorii.cd is not commenced within 180 day1 of the date ofinuance and if work is suspended or abandoned for a period of 180
days after commcnCCZDCllL
CERTIFJCA TJON
I hereby ccnify tbal J have rad this Applicalioa ud that the infOftDl!iOll coutained above i s INC and comet. I lllldcnwid tblt the Building 0cpl11Jnalt ~the Appli calioa, al one with the pl1n1
11J1d rpcci6caaom ud other data submiacd by me or Oii iD)' bc:half(sulnninals), based upon my ccni6carlon u 10 accuncy.
Assumins GOmplctC11cs1 ohhc submiaah and approval of this Application, a Buildins Permit will be iuucd sranlins pcrmi11ioa to me, u Owner, to comtn1ct the IU'llCtllrc{s) md !Kililics detailed on
the submiaal1 reviewed by the Buildins Dcp1111DmL
In comideralion of !he iaSll&Dce of the Buildins Permit, I lif"ee !hat J ud ID)' as eats will comply with provi1ioas of any fcdcnl, it.ate or local Jaw resullling the work 1nd lhe Oariicld C01111ty Buildms
Code, ISDS resuJaliom Ind applicablc lcd 111c resul&lioas (COlllll)I RcgulatiOll(s)) I acknowlcdsc that !he Building Permit m1y be suspended or revoked. upon notice &nm !he County, ifthc localiot1,
eomtruct:ioa or use of the 11n1c:mn:(1) ud W:ility(ic1), dcs.:n'bed above, arc no t in compliance with County RcsulaliOb(s) or any other applicable law ,
I hereby panl pcnnil1ion to the Bwldina Department to enter die property, described above, to inspect the work. I further Kknowledsc lha1 the issuance of the Builclina Pcnnit doet aO\ prncnt the
Buildin9 Oftic:ial limn; (I ) requiring the comclion of mun in lhe 1ubmittals, if any, di1covcrcd after issuance; or (l) stopping conS1Nclion or use of lhe structure(•) or facility(ic1) if sud! is in violati011
ofCowity Rcgulllli011(1) or any other applicable law.
Review of this Applicarlon, illcludillg 1ubmi!W1, and inrpcct!0111 of the work by the Buildina Dcpanmcnt do 110! conslillllc an 1ccept111cc of responsibility or liability by the County of mm1, omissions
Of" discrcp1Dcics. As the Owner, I aclcnowlcdgc that respo11S1lnlity for compliance with federal, 11110 ud local laws ud Cowity Rcgulotilllll rest with me lllld my ~uthorii.ccf asmts, including without
limiwion ID)' atebitcct dui511er, c:nsiPcer and/ or builder.
I HEREBY ACKNOWL£0GE THAT I HA VE READ AND UNDERSTAND 1liE NOTICE 8l. CERTIFJCATION ABOVE;
ID 1 ~
DATE
STAFF USE ONLY
Special Conditions:
Adjusted Valuation: Plan Check Fee: Pcnnit Fee: Manu home Fee : Misc Fees:
7;~,0(J Cf}l.~( ~~3.25' -
ISDS Fee: Total Fees: F ~:=IPI Balance Due: mtns~te: ISDS No & Issued Date: --'2.52,~ (6;.2~ ~
Setbacks: OCCGroup: Const Type: zpu fj I DEPT• 10111,LB~ ~DEPT• ~{}f~f/flj ~ I F°~~~ APP OVAL DAT E DATE
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Garfield County
Building & Planning Department
108 8th Stree~ Suite #401 Glenwood Springs, Co. 81601
Offlce:910·945-8212 Fax: 910-384-3410
Inspection Line: 910-384-5003
Building Permit No. 11163
Parcel No: 2395-014-29-073 )
Locality: lronbridge PUD Ph2, flg 1,2&3, Lot 73 ________ _. '---'-----'----------
Job Address: 1195 River Bend Way, GWS
Use of Building: add 10X32 roofed patio/deck
-------------'-~--------
Owner: Burt, Matthew
Contractor: Baltzer Construction ------------
Fees: Plan Check: s 99 .61 Septic:
Bldg Permit: s 153.25 Other Fees: -
Total Fees: $ 252.86
Clerk: 3\\i~~u\ Date: 10/31/D/8 I
1110~ Assessor's Parcel No. ,.,::io-v , .... ,
Date 1013112008
BUILDING PERMIT CARD
1 Address 1195 River Bend Way, GWS (lronbridge PUD Ph2, flg 1,2&3, Lot 73)
ner Burt, Matthew Address save as above Phone II 947 -9443
itractor Baltzer Construction Address 33 Cardinal Ln, GWS Phone # 948-9741
backs: Front Rear RH LH Zoning ___ _
covered patio/deck addition
Is Test ___________ _
>ting-------------mdation __________ _
1ut ____________ _
:lerground Plumbing-------
JQh Plumbing ---------ming, ____________ _
Jlation ----------->fing ____________ _
wall ------------;Piping __________ _
INSPECTIONS
Weatherproofing __________ _
Mechanical ___________ _
Electrical Rough (State) _______ _
Electrical Final (State) ________ _
Final /Checklist Completed? __ _
Certificate Occupancy # --------Date __________ _
Septic System # _________ _
Date-----------Final __________ _
Other--------------
NOTES
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