HomeMy WebLinkAboutApplicationc::e: Garfield County
Community Development Department
108 a* Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-1212
www.garfleld-county.CQm
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BUILDING PERMIT
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APPLICATION I I I
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Phone: ( ;+ -,_,. ) .:n '1 -u_•;~..J. L.. Property Owner: ()LI \}I n IQ /}.1. ct 14
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MaUlng Address : s (7 i?~& : .. 9 :; I ~: u:.1v I !. • -.... '. ... •( ,.._ll ( c Q ~I c.. • ..: d . -I
I Contnctur. 9-~~u <,'j •> .. t.;µ-![...,.-, •·•.C. ,..2~ J "'1 Phoned Ct J::. I ry t:> • '" -~ ·I I , .
, , -.... . -t MalllngAddress: .;t.'1:-?'j tl'> rt.-.~, 'l.?t '>L t.· •. M;'\ 1u.k i'._.1.. Li.? \-·! l\"b;,
I j Architect: __________________ Phone:(__} ______ _
J MalllngAddress: __________________________ _
~~-~------~--------, I Engineer: __________________ Phone: L_) _____ _
Malling Address: __________________________ _
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1 Describe Wortc: ?~.., · '"e .,.:;>" 'i · ·-1 • ·• • '" r1, 1 • ; j :big .• ~ 11 ; (;}r;g;= , it 1 •1 ~~t 1
· H-A.;;+J .~tm ;;::, r.M.J c; !!..'/ I ~ <. m .. ~ ~'-''--'l 'l -s, t..r'"i t.: fo•n •f '-'
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JobAddress: .")<-=; ?t~n. Cw...:·<.!.T 1 "-.ic\.k1(...fu,.-Lc-(:, ~ lb~'i 1
2 I 1 r? 1-1c;1.• N • A l"v )</ ' r-' t
Assessor's Parcel Number: ~ .l ;:1 b '-t 0 ;t "''14 Sub. s 4 A <\ u ,.u ;. Lot --L:_ Block-~--t
I 0 r' V I ti f Work $ I 9 ~ Pr Si (S Ft A wne s aua ono : I w ~ .,.. operty ze q. or aes: I
Sq.Ft of Bulldlng: l'J :1P ~-( Height: }') I # ofAoors: ' I
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Class of Work: El' New I a Alteration l 0 Addition I a Repair I a Move/Relocation I
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Garage: D Attached I D Detached
Septic: CIOWTS I la"'Communlty
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Type of Heat: 8-Natural Gas 0 Propane I IJ Electric [D Other
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Driveway Permit: lJExempt 0 Permit#: I I
Authority. This application for a Bulldlns Permit mus t be sisned by the Owner of the property, described above, or
an authorized agent. If the signature below rs no t that of th e Ow ner, a separate letter of authority, signed by the
Owner, must be provided with thlS Applicat ion.
I L!llal Acqss. A Building Permit cannot be Issued with out proof of legal and adequate access to the property for I
' purposes of inspections by the Bulldlng Division.
Qther Permits. Multfple separate permits may be required : (1) State Electrical Permit, (2) County OWTS Permit, I
(3) another permit required for use on the property identified above, e.g. State or County Highway/ Road Accef.s or t
, a State Wastewater Discharge Permit.
, VOid Permit, A Building Permit becomes null and voi d if the work authorized Is not commenced within 180 davs of I
the date of Issuance and If work Is suspended or abandoned for a period of 180 days after commencement.
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I hereby ~that I have read this Application and that the Information contained above is true and correct. I
understand that the Building Division accepts the AppUcatfo n, along with the plans and specifications and other
data submitted by me or on my behalf (submitta ls), based upon my certification as to accuracy. Assuming
completeness of the submittals and approval of this Appllcatron, a Building Permit wlll be Issued granting
permission to me, as Owner, to construct the struc:ture{s) and facilities detailed on the submlttals reviewed by me
Building Division. In consideration of the Issuance of th e Building Perm it, I agree that I and my agents will comply
with provisions of any federal, state or local law regulating the wortc and the Garfield County Bulldlns Code, o~rrs
regulations and applicable land use regulations (County Regula tion(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 fadllty(les), described above, al'@ not In compliance with Cou nty Regulatlon(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 adcnowledge that the Issuance of the Building Permit does not prevent the Building Official from: (1)
requiring the correction of errors In the submlttB !s, If any, dlsCOlll!red after lssuanct!; or (2) stopping c:onStTuction
or use of the structure(s) or fadllty(les) if such Is In violation of County Regu latlon(s) or any other appllcable law.
Review of this Application, Including submlttals, and Inspections of the work by the Bu!ldlng Division do not
constitute an acceptance of responslbllfty or llablllty by the County of errors, omissions or discrepancies. As tht!
Owner, I acknowledge that responslbillty for compliance w ith federal, state and local laws and County Regulaticms
rest with me and my authorized agents, Including without l;mitatlon my architect designer, engineer and/ or
builder.
I hereby acknowledge that I have read and understand the Notke and Cettlflcatlon above as wen as
hive provided the required Information which is co~ and accurate to the best of my knowledge.
t;L:itr.. /If ,./5'~ ; >
[)ate Property Owner Print and Sign
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Ad~ ValNUon:
{7500.gg.
FeesPafd: ~
4-oo .
OCCGroup:
Manuhome ~
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BUILDfNG I PlANNING DMSION: _)JJ....__ ... ·~'-="-"'-----.,.<-t='-=-_$_'-_·wj ____ _
5ilped Approval
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Date
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Permit Number:
Building 7' ----Engin~ered Foundation
_rJ ..... /_R __ Driveway Permit
__ / __ Surveyed Site Plan
___ N ..... ~_'4--.-. Septic Perm it and Setba cks
__ / __ Grade/ Topography 30%
__ / __ Attach Residential Plan Review list
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____ Subdivision Plat Not es
_rli-1V_t1_ Fire Department Revi e""
__ / __ Valuation Determination/ Fees
__ / __ Red line Plans/ Stamps/ Sticker
_/ ___ Attach Conditions / ,,
----Application Signed
/ ____ Plan Reviewer to Sign Application
__ / __ Parcel/ Schedule No .
__ ,/ _ _, 40# Snowload letter-Manu. Homes
rJ/.A
I Seils Report
Planning/ Z~ning
__ / __ Property Line Setbacks
/ 30 ft . Stream Setbacks
/ Flood Plain
/ Building Height
I Zoning Sign-Off
/V/A Road Impact Fees
I Grade/ Topography 40%
/ Planning Issues
/ Subdivision Plat
G~neral Comrrye~ts:
NOTE: If any required information i s missing, delays in issuing the permit are to be expected. If
determined by the Building Official that additiona t infonnation is necessary to review the application
and/or plans for compliance, the appllca11on may be placed on hold until the required in1ormatJon 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 pennit fee, as
well as any Septic or Road Impact fees will be co'llected when the permit is issued.
The permit application must be signed by the owner or by person having wrttten 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. (F"maUCO
inspection requirements will be attached to your approved field set of plans.)
I hereby acknowledge I have read, undemblnd, and wlll abide by the requlrement.11 of this
checkllst.
ult v \A I-'\ ()...A 'l ( I A ~j;.µ /11
Property Owner Print and Sign Date