HomeMy WebLinkAboutApplicationGørfield County
BUILDING PERMIT
APPLICATION
APR O ? ?01,l
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
ltg7ol945-8212
www.ga rfi eld-countv.com
TYPE OF CONSTRUCÍION
tl Commercial/Multi-Family tr Demolition
tr Manufactured Home (Single or Multi-Level)
E Residential (SF, Duplex or Townhome)tr Reroof
INVOTVED PARTIES
Phone: (??0 | 327- ?89 Z
9t ¿saco
Property
Mailing Address
owner: (tJ.^..L.5 þfrrqyo*
Email Address:
tn i Pt^ f?,-o-' p n
O,.¿ n<r<-Phone:(Contractor:
Mailing Address:
Email Address:
Architect:
Email Address:
Phone: ( )
Mailing Address
EnEineer: Phone
Mailing Address:
Email Address:
owner'sValuationofWorkr S ç0Ô09 PropertySize(Sq'Ft.orAcres)
e1-alDescribe Work:
g. J Lnr,
Height:
cllo
3t
I
# of Floors ,l
;lf (o Ql (st
to¡ 7f I ebck
Job Address:
Sq. Ft. of Building:
Assessor's Parcel Number:
Sub.
J?7 f:o f3rr^ut fr n
E Repair tr Move/RelocationClass of Work:p rrrew E Alteration El Addition
I oetachedGarage:E Attached
Manufactured Home lnstaller:Phone: ( )
Mailing Address:
Email Address:
PROJECT DETAILS
PROJECT DETAITS CONTINUED
Authoritv. This application for a Building Perm¡t must be signed by the
or an authorized agent. lf the signature below is not that of the Owner,
Owner ofthe property, described above,
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 perm¡ts. 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 contain ed 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. ln 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 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.
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Property Owner Print and Sign Date
A,bt, cot
E CommunityEI OWTS
E otherE Propane E ElectricE Natural GasType of Heat:
Septic:
E Permit #:Driveway Permit:E Exempt
NOTICE
OFFICIAT USE ONLY
Special Conditions:
Manu home Fee:Misc Fees:Permit Fee:944t.1âAdiusted Valuation:Øh,lt'n.nO Planþ2 Check Fee:
ø-1"t4
OWTS No:
üffiø- 4toøtq.(.1Paid:Feesq Ba#lance Due:
bK.2ØTotal Fees:
$tzø.øq
Zoning: 6KConst Type
lr< cOCC Grou'p:IR¿Setbacks:
F'â0rR=25,9: l0
shlzottBUITDING / PLANNING DIVISION
DateSigned
PO a tT
Connty
Buildins,l Zoninq Plan Review Checklist
Permit Number øßE-04-tl -Aar.l
Build tns Planni Zonins
x Engineered Foundation "/ Property Line Setbacks
N/n
N/^
Driveway Permit
x Surveyed Site Plan NÁ
Septic Permit and Setbacks
Grade/ Topography 30%/ Zoning Sign-off
Attach Residential Plan Review List N/A Road lmpact Fees
,/ Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
30 ft. Stream Setbacks
Flood Plain
Building Height
"/ Grade/ Topography 4o%
,/ Planning lssues
Subdivision Plat
/ Red Line Plans/ Stamps/ Sticker
'/ Attach conditions
'/ Application Signed
Plan Reviewer to Sign APPlication
Parcel/Schedule No.
N/A 40# Snowload Letter- Manu. Homes
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