HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8 Street, Suite 401
Glenwood Springs, CO 81501
OCT I
2816 (970) 94S-8212
www.garfield-county.com
TYPE OF CONSTRUCTION
❑ Commercial/Multi-Family
❑ Manufactured Home (Single or Multi -Level)
Residential (SF, Duplex or Townhome)
❑ Demolition
❑ Reroof
INVOLVED PARTIES )
PropertyOwner: /1 `i �i� I/Y���J� Phone:
Mailing Address: _;Z 110D &PAA '97 &
Contractor: : � 45 A B'mE Phone: ( )
Mailing Address:
Architect:
Mailing Address:
Engineer:
Mailing Address:
Phone: (j
Phone: (�
Manufactured Home Installer: 41 /l� _ Phone:
Mailing Address:
PROJECT NAME AND LOCATION
Describe Work: &y/,Lit A- z1O"Xt60' .5)1 12,4b 3 U /LD/Aj4
Job Address: COvits`Y /2 LC en 2RC S 0
IZ'73�
'� j-/U� � GH
Assessor's Parcel Num��
er: A LF2 f Sub a Lot 3A Block
Owner's Valuation of Work: $ Property Size (sq. Ft. or Acres): ] Q *aze 5
Sq. Ft. of Building: 210'0 Height: # of Floors: 1
Class of Work: - New ❑ Alteration ❑ Addition
Garage: ❑ Attached
Septic: ❑ �T �.
Type of Heat: ❑ Natural Gas ❑ Propane
Driveway Permit: 0 Exempt
❑ Repair ❑ Move/Relocation
3K Detached
❑ Community
❑ Electric Other
❑ Permit #:
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(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.
1 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.
Property Owner Print and Sign
9 --Z 7-
Date
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation:
r,3'71 &00.
Total Fees:
Plan Check Fee:
A454. �
Permit Fee:
&1q-75
Manu home Fee:
---
Misc Fees:
--
Fees Paid:
qo
Balance Due:
BP No:
&—P —
OWTS No:
Setbacks:
L2 2 X'2 s ro
OCC Group:
Const Type:
Zoning:
R -
BUILDING /PLANNING DIVISION: + IL..3,0
Signed Appr al Date
I"a.`id 1 a• ►1J % 4
VALUATION WORKSHEET
Permit No: BLRE- 10- 16-4456
sq h X $18.00
Total Valuation
Applicant Troy Trevathan
Subdivision
Address 2900 County Road 233, Rifle
Lot/Block
Date 11/2/2016
Contractor
RESIDENTIAL PROJECTS:
Total Valuation
Finished (Livable Area):
Type of Construction:
Main
sq ft
Upper
sq ft
Lower
sqft
sf X
Other
sq It X
$74.68
Total Square Feet
0 sq.ft
sf X
Total Valuation
Total Valuation
Basement:
Unfinished Basement
sq.ft X
$41.00
Conversion of Unfinished to Finished
sq.ft X
$33.68
Other
sq.ft X
Total Valuation
Garages, Pole Barns & Storage Buildings
2,400 sq It X
$24.00
Conditioned Garages
sq.ft X
$32.00
Conversion of garage to Finished living
sq.ft X
$56.68
Carports
sq.ft X
$18.00
Other
sq.ft X
Total Valuation
Crawl Space
sq h X $18.00
Total Valuation
Covered Decks, Porches & Patios
sq It X $ I8.00
Open Air Decks, Porches & Patios
sq It X $12.00
Other
sq ft X
Total Valuation
COMMERCIAL PROJECTS:
Type of Construction:
Occupancy:
sf X
sf X
sf X
sf X
sf X
sf X
Total Valuation
Total Valuation
Antlers Orchard
Lot 34, Block 32
Homeowner
0.00
0.00
57,600.00
0.00
0.00
0.00
57,600.00