HomeMy WebLinkAboutApplicationQ
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'\,, cG Garfield County
,..4}' I Community Development Department
.9 ?d, °108 8th Street, Suite 401 ~ Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
~-OFCONSTRUCT_IO_N _______ ~=------~~~--------1
D Commercial/Multi-Family j D Demolition
D Manufactured Home (Single or Multi-Level)
1 DI. Residential (SF, Duplex or Townhome) J D Reroof
Contractor: Q \..)) Qe("' Phone:( __ ------
Mailing Address: __________________________ _
Architect: _N.....,"'"\ ... B..L.--____ ~---------Phone:(, __ ------
Malling Address: __________________________ _
Engineer: N \ A Phone: ( ---·-----------------------
Mailing Address: __________________________ _
Manufactured Home Installer: ..... N .......... t~A .......... ________ Phone:( __ ,------
Mailing Address: __________________________ _
PROJECT NAME AND LOCATION
Describe Work: B tqJ\oc: \olj C.t 2rre o.:\ c\ecb ~ha± ,s v:rrlted ou:\= ±
Do-+ to ~VYY-Wt co de ,
JobAddress: I '{', ~ w m 5 ,('
Assessor's Parcel Number: cl l ~3_3lo aa3ob l Sub. Cn.n,100 (feQK Es191fol lo I Block
Owner's Valuation of Work:$ 5 l 5 3 8' Property Size (Sq. Ft. or Acres): 0 1 3io 3
Sq. Ft. of Building: ... 9' JS~>: 'tto l 12 Height: # of Floors: 3 (\ t\C ~ b:\sc.
J
Class of Work: Alteration D Addition D Repair D Move/Relocation
Garage: D Detached
Septic: Community
Type of Heat: D Propane D Electric D Other
Driveway Permit: D Exempt D Permit#: -------
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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 OWTS 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
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, OWTS
regulations and applicable land use regulations (County Regulation(sl). 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 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.
COe \i sSA Be .blouJ m~ ~
Property Owner Print and Sign
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation: Plan Check Fee: Permit Fee: Manu home Fee:
5,5 :32. ft!' B t.4-r JZS.1-5
Total Fees: Fees Paid: Balance Due:
20ta. "'° ~Bl. 4 1 1zs.z.5
Setbacks: OCCGroup: Const Type:
f'Z-0 1<10, s 7. :I:fZ{:__
BUILDING/ PLANNING DIVISION :_""'a...;;..--'"'~==-----~--+, ---"~'-------
Signed Approval
Misc Fees:
Zoning:
'Pu
Date
\ .@: Garfield Coumy j
BuJlding/ Zoning lPBan Review Checklist
Permit Number: oL~E-t'.5-16 -'1239
Building Planning[ Zo_nin~
fV/11 Engineered Foundation / Property Llne Setbacks
tJL A Driveway Permit / 30 ft. Stream Setbacks
/ Surveyed Site Plan / Flood Plain
Nt_A Septic Permit and Setbacks / Building Height
/ Grade/ Topography 30% / Zoning Sign -Off
/ Attach Residential Plan Review list µ/! Road Impact Fees
/ Subdivision Plat Notes / Grade/ Topography 40%
/IJ)ll Fire Department Review / Planning Issues
I
(
/ Valuation Determination/ Fees Subdivision Plat
/ Red Line Plans/ Stamps/ Sticker
/ Attach Conditions
/ Application Signed General tomments:
/ Plan Reviewer to Sign Application
/ Parcel/ Schedule No . 0/u/r/,4/
,U/'1 . 40#Snowload letter-Manu. Homes fl J.J/A Solis Report 7'-61 xrZ .oo =-~5;5>z . ~
/
and/or plans for compliance, the application may be placed on hold until the required information is
provided. Work may not proceed without the issuance of a permit.
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.
me \ ls5?. Be h \Olt) --m.etOOn 1kM.rruJ
Property Owner Print and ~ign s /i crlt lo