HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8'}' Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
11Vtanill :: ;�rfiplrl-rni mite rnm
JUL 1 1 2017
GARFIELD GOUN rY
`) iMUNITY DEVELOPMENT
C 4
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
❑ Commercial/Multi-Family
❑ Manufactured Home (Single or Multi -Level)
atr
Residential (SF, Duplex or Town h ome)
ri Demolition
❑ Reroof
p
INVOLVED PARTIES
Property Owner: el r^4 oS • B u1 i � -
Phone: (97°) 6 /O - `7'330
Mailing Address: 6Y+• - - : 5Q.5
Email Address:
Geaci. G11ronc, 6LA/ Via css • [Q,„
Contractor: eA rrO r70 -s BM i') i I 4.�c--- Phone. (9 7 6 9 0 -913o
437 is' RA, G e-ok ni Si, r,e,-I- +e,,), 6D 0/50.5--
Mailing Address: 7 +
Email Address: 69 e �,r +P•: ei I r p ji , 5 h 4 I /d Cf . e o h,
Architect:
Mailing Address:
Email Address:
D
21 11 7 Z ,,i <1-r'
Fou nA.A-►'0.1,
Engineer:
rotc4. '� e
ytl
W N ay e- Li' .r u7
Phone: ( 970) Z cDS — Z3 S$
(-73-:G0 8/50)
�rr,c,r'1 •ca..,
/qS-SbG
Phone:( )
Mailing Address: 574 Z5 Re) - L n ti T 2 �'J Ga 231.5o5
Email Address:
Manufactured Home Installer: Phone:
Mailing Address:
Email Address:
PROJECT DETAILS
Describe Work: (o'n+ Ie.
,l4 I ✓ t% r}S 1'.r4.4 L..4-110
Job Address: L c 1 Z 3 R' ,'a S o n }' h •c. Co �v r te/ a
Assessor's Parcel Number: 2-18 1 - 093 - 07 - a Z$
Sub. RApi'dS or, MAC. (014"rcc1v Lot 2.8 Block
Owner's Valuation of Work: $_ %_Apt.+0 q. to 6 Property S
)176 Height: 16)J) 4 ,r
Sq. Ft. of Building:
Class of Work:
Garage:
�1
New E Alteration ❑ Addition
Attached
ize (Sq. Ft. or Acres): Z • ' 1 ,! �-�
# of Floors:
0 Repair 0 Move/Relocation ;
i
Detached
PROJECT DETAILS CONTINUED
Septic:
OWTS
Type of Heat: Natural Gas
Driveway Permit: VExempt
Propane
❑ Community
❑ I`Iechic npllier
❑ 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.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided t - • uired 1��,�- ion which is correct and accurate to the best of my knowledge.
Property Owner Print and Sign
7-l1 -l7
Date
OFFICIAL USE ONLY
Special Conditions:
NOW.ti+WAllovt fo comply with in.(.cv) aFIO& plkiil7 t w' io4 &1--#1cVile° rc povt.
Adjusted Valuation:
I) I�T31g27.oa
Pan Check Fee:ermit
ett5.39
Fee:
�f)406.1
Manu horn Fee:
�� /
Misc F es:
I� �.(�b
Total Fees:Fes
11.2,323 45
Paid:
13.4CO
alance Due:
& I j�241.11
BP No:
OWTS No:
ye,► to
,§Epr= 4817
Setbacks:
O1'Y9-2
OCC Group
=J
I ConstTy e:
ZoningF
BUILDING / PLANNING
a
.
DIVISION : 4/4/1017
Signed • , ov.`I Date
�`d •ii•i-+ IYIc
and/or plans for compliance, the application may be placed on hold until the required information 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 permit fee, as
well as any Road Impact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by person having written authority from the owner
to act as their -epresentattve.
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. (Final/CO
inspection requirements will be attached to your approved field set of plans.)
I hereby acknowledge I have read, understand and will abide by the requirements of this
checklist.
Property Owner Print and Sign
7- 11- /2
Date
Gurf eId Comm, J
uilding/ Zonirt Ilan Review Checklist
Permit Number: -R6- T' 1-7- 44tSI (v
fir- Ori - (-7-4<317
Building
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
Subdivision Plat Notes
N/A 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
N/A
N/A
(+h
Planning/ Zoning
{ Property Line Setbacks
30 ft. Stream Setbacks
N/A Flood Plain
Building Height
Zoning Sign -Off
Road Impact Fees
Grade/ Topography 40%
Planning Issues
Subdivision Plat
General Comments:
RG3idt► 0i0
Cov4A Patio GO
(��► C.nv. . Poetic 1 1 0
valfiovl -
21010 x 474.64= 4 150) 107
(� x 432.E 2.0)/&°.
60x'I6.002 4 1)4W.
.
110 x S 11.00 Q 4 11320,
TOTAL- = I'73�e77.