HomeMy WebLinkAboutApplicationci:v
JUL 201017
3ARFiELL) OMNI
iI•VELON,: •
Garfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
TYPE OF CONSTRUCTION
❑ Commercial/Multi-Family
❑ Manufactured Home (Single or Multi -Level)
❑ Residential (SF, Duplex orTownhome)
INVOLVED PARTIES
Property Owner:
O Demolition
O Reroof
Phone: (Ill) 7+)%
Mailing Address:
Contractor: 4'V
Mailing Address: S a 6 1i1NE SA ktre-M k
Phone: ( J /d )37�! 4.-4-4)
Architect:' 1 Nit Phone: (,' ttj) J 22 0 J
Mailing Address: OM'7..)-(N1?-if 6-' _ ]`43,4eu fi �sn
Engineer: ,f\ir, CU -31kg Phone: (1 76) c/6 3
Mailing Address: Zo 3 4 '60- ) C�a
Manufactured Home Installer:
A
Mailing Address:
PROJECT NAME AND LOCATION
AAnn
lel .. l
1 1 G -1
Describe Work:
Job Address:
Phone:(
Assessor's Parcel Number: 0"f (03 t 2 OIC Sud
Owner's Valuation of Work: $ rpm, 00
Sq. Ft. of Building: 756 S F Height: k
1) \rcitiO
G9
4.11-qiicsja_disio t Block
Property Size (Sq. Ft. or Acres): r -Z- Z7 5
! 2� # of Floors: I
Class of Work: 0 New 0 Alteration 0 Addition
Garage: , � 0 Attached
Septic: *COWTS
Type of Heat: Natural Gas 0 Propane
Driveway Permit: 0 Exempt
❑ Repair 0 Move/Relocation
Detached
❑ Community
0 Electric 0 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.
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.
Property Owner Print and Sign
L
1
Date
OFFICIAL USE ONLY
Special Conditions:
VA/ i61 compI;e 0u with wilaL4c 61tet44 49112k aorracc v.4#9.4Io4tl Art d+
Adjusted Valuation:
4213'20. 3�o. Ob
Plan Check Fee:
4,2Go. 64
Permit Fee:
$ 4D I.35
Manu home Fee:
—
Misc Fees:
--'
Total Fees: syr
Fees Paid:
Balance Due: /�
BP+No:
OWTS No:
] fJ� JJ
L2
Setbacks:
51 044
OCC Group:
IRS
Const Type:
I tz c
Zoning:
BUILDING / PLANNING
DIVISION : i '/'b/20 17
W
Signed Approval Date
PD 14g
ic%
C
Builidhfri l Zoning Plan
eview Checlilt§t
Permit Number: 131,g t'j— I7— 4$1
Building Planning/ Zoning
Engineered Foundation Property Line Setbacks
/ Driveway Permit \IX_ 30 ft. Stream Setbacks
Surveyed Site Plan N/A Flood Plain
/ Septic Permit and Setbacks Building Height
Grade/ Topography 30% Zoning Sign -Off
Attach Residential Plan Review List N/A Road Impact Fees
Subdivision Plat Notes ". Grade/ Topography 40%
Fire Department Review Planning Issues
Valuation Determination/ Fees Subdivision Plat
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed General Comments:
Plan Reviewer to Sign Application eAv.oW, 7eo
Parcel/ Schedule No. (/It1GO V. PafiO
NIA 40# Snowload Letter — Manu. Homes
Vat ooVI —
Soils Report
700 x 41).2.00 24)Re,o.
Sox 4.12.00 m. o
Tad] ' 9 )32o
t o 4 I tiie f pec z i -VA
(Na taw Iia44 bk SF.