HomeMy WebLinkAboutApplicationGarfteld County
BUILD¡NG PERMIT
APPLICATIONent Department
1OB 8'h Street, Suite 401
JUN 2 1?0lËlenwood springs, co 81601
; ir:, : 19701945-8212l-,,, 1,.t t',:rl ,
.. ', '; ' I 'www.garfield-countv.com
TYPE OF E Demol¡tionl-l Commercial/Multi-Family
tr]Manufactured Home (Single or Mul ti-Level)
ReroofEor Townhome)Residential (SF, Duplex
INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
¿Rhone:
Mailing Address:
-
Email Address:
Phone: lnl7l Pto øø4 3:<€ IContractor:
Architect: Phone: (-)--
Mailing Address:
Email Address:
Engineer: Phone: (-)-
Mailing Address:
-
Email Address:
Mailing Address:
-
Email Address:
Phone: ( )Manufactured Home lnstaller:
lg,rinccJe \ br',Jhrocr'-'. .{.. I F rrc¡ltr.n*. iu" k¡,:eu'w,.4 ne.-u clþ
Sub. Lot
-
Block
owner's Valuation of Work: $ ,Sc)flto ,o,-
PROJECT DETAII.S
Describe Work:
Height:
l^CLO
¡l ï#of
t".,'l rr a 7( {2 '?.cû,
Assessorr's Parcel Number:
Job Address:*-7n .-l -1
Property Size (Sq. Ft. or Ac
Sq. Ft. of Building:
! nepair Move/RelocationI Alteration LlRdd¡t¡onClass of Work:! ruew
! oetachedGarage:Attached
Septic:Community
PROJECT DETAII-s CONTINUED
OWTS
f lo*rer[_l electricNatural Gas ffi eropaneType of Heat:
Permit #ExemptDriveway Permit:
NOTICE
Author¡W. This application for a Building Permit must be
or an authorized agent. lf the signature below is not that
signed by the Owner of the property, described above,
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,
(3þnother 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
understand that the
I have read this Application and that the information
Building Division accepts the Application, along with
contained above is true and correct. I
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 Garfleld 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), descrìbed 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
d 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'
b )-t *t1
Print and Sign Date
OFFICIAT USE ONtY
Special Conditions:
Misc Fees:e Fee:Manu
f\)
ch eck Fee7l Fee:.25I
sted Valuation:
Ba4 lance Due:ln.2bFees Paid:q tb",bt,Total Fees:
Conoccsetbacks: N/rq
BUTTDING / Pl¡NNING DIVISION :
Signed Approval
W,ilß
Date
tlqlø
;@wættqe¡rn:"1
Buildin pl Zonins Plan Review Checklist
Permit Number: f,9,8,'0b'11- 4-î4 I
Buildins Planni Zonine
N/n
N/¡
x/e
Valuation Determination/ Fees
Red Line Plans/stamps/ Sticker
Attach Conditions
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
Application Signed
Plan Reviewer to Sign APPlication
Parcel/Schedule No.
40# Snowload Letter - Manu. Homes
Soils Report
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees
Grade/ Topography 40%
Planning lssues
Subdivision Plat
N/A
N/e
General Comments:
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P.où twp,c( f,øet N/A
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