HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 81h Street, Suite 401
Glenwood Springs, CO 81601
OCT 2 1 2016 (970) 945-8212
www.earfield-countv.com
BUILDING PERMIT
APPLICATION
TY ° E OF CONSTRUCTION
Commercial/Multi-Family
FET Demolition
❑ Manufactured Home (SF or Duplex)
❑ Residential (SF, Duplex, orTownhome) i Reroof 0 o O C t 1 k5
INVOLVED PARTIES
Property Owner: `rnr✓r+ ,,� eat -h 0.A />'c (v-- Phone: ( 97C') 5/ v - ,..if if
Mailing Address: Si/ C,./6rrd ' 4 ve. earfi,i1"1,4,-e-e, Gd x/6.23
/et
—• �app,�ys '7
Contractor: I A l. -LY Ho .o r1S i 114 //y ha Goi 1 PlSone: ( D) ro
.2-5 O L8 9.
Mailing Address: !'15 CR j2.S.. R iced [a' o cit (.5c)
23UicO)&5 L"IG.WEEic- -
Bra et: SE.ry-r, ug.[. 0u1LAI,Jc. Sy 4 rewl.5
i
Phone:
6R 620
( goo ) 3 .i o -i
Mailing Address: Pc 3Au .41.6 i.3ror) NE'
,
cavn[ogv,S
Engineer: EN GIweaR.8TJc,-t rifeHNeS ICWt. SERV
Phone:
6-70
(bo55) 14 513 12giS
Mailing Address: a7 l 1i #L, 9 -Ph Rue gA -SD
6Li — a i 00
Manufactured Home installer:
Mailing Address:
/J/4
Phone:
( )
PROJECT NAME AND LOCATION
Describe Work: R#of ive.r i teRG1•-e.,,-• armn(fs f'trri eif /I I- 14-4-
u1i
i c aif r,'Gi4 A''‘c,_r}9 4,(1/..e,-• 4 r e../1 cte.
1;:i
Job Address: /15 J CeaA ty , -/ fav
Assessor's Parcel Number:
Owner's Valuation
Sq.Ft of Building:
o.
23 ry 3 -3541- Sub 3 Lot Block
of Work: $
j, 5 2-0
39 gee Property
Size (Sq.Ft or Acres):
# of Floors:
b. 76'cr �re.s
s. f.
Height:
2 3. 3 lc'
Class of Work:
❑ New
• Alteration
• Addition
•
Repair
0 Move/Relocation
Garage: f e,c
0 Attached
•
Detached
Septic: iiiipt•
ISDS
•
Community
Type of Heat/jf 0 Natural Gas
0 Propane
• Electric
• Other
Driveway Prmit:
4
• Exempt ri
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 ISDS 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, ISM
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.
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.
�d
Property Owner Print an i
/a -
Date
OFFICIAL USE ONLY
Spedal Conditions:
Adjusted Valuation:
°el) 000
Plan Check Fee:
45et.3i
Permit Fee:
10&.75
Manu home Fee:
1/7
Misc Fees:
—
Total Fees:
I
Fes Paid:
/OC1 °�
Balance Due:
I) Ofiri. 14
B:
ISM No:
1o. L1M 3-1
1 A
Setbacks:
F25/I2r,/0I0
OCC Group:
AS,,cw41911 C.1,049 AS
Const Type:
Typc2s
Zoning:
iZ.
BUILDING / PLANNING
4I
DIVISION : �ri r 11 it -7/14,
Signed A . . rov . 1 Date
fid -.2" 60
Garfield Camay I
11111dingi Zonijcig Plan Resew Checklist
Permit Number: Bj LC - 10- ((p- 71
Building
Engineered Foundation
Driveway Permit
-Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
Subdivision Plat Notes
Fire Department Review
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
Soils Report
' VA
PiA
1 YA
Planning/ Zoning
WA
WA
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign -Off
Road Impact Fees
Grade/ Topography 40%
Planning Issues
Subdivision Plat
N/A
General Comments:
O/tival t 91*.e
%x 4o = 1)520 9
J4.6,0; o t4
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