HomeMy WebLinkAboutApplicationcG Garfield County
Community Development Department
r.R;;;-:E;;;-:C;;;;-:E=-=l==v===~~ gth Street, Suite 401
--r::""'""'"'ood Springs, CO 81601
(970) 945-8212
• arfield-count .com
SEP 1 9 2017
BY: !t3/lli.J. ........ :.
TYPE OF CONSTRUCTION
-----~------~~----~-D Commercial/Multi-Fam i.!Y__ [D Demolition
D Manufactured Home (Si ngle or Multi-Level)
-----"-----------~~---------J 0 Residential (SF, Due lex orTown_h_o_m_e ~) ____ ___ [!] Reroof
INVOLVED PARTIES
Property owner: Robert and Clara Smith
Mailing Address : 2920 CR 233 Silt CO 81652
Email Address : applesofgold777@aol.com
Phone: ((970) )930-2333
Contractor: A 2 Z Roofing LLC Phone: ((9 70) ~76 -4129
Mailing Address : PO Box 364 Silt CO 81652
Email Address : a2zroofingllc@outlook .com
Architect: _N_l_A ________________ Phone: ( __ ). ______ _
Mailing Address : _N_f_A _________________________ _
Email Address : N/ A ----------------------------
Engineer: _N_l_A ________________ Phone:( __ ) ______ _
Mailing Address : _N_l_A _________________________ _
Email Address: N/ A ----------------------------
1--------------------
Manufactured Home Installer:-----------Phone:( __ ), ______ _
Mailing Address :---------------------------
Email Address: ___________________________ _
PROJECT DETAILS
Describe Work: To remove existing roof, to install ice and water shield 6' up from all ea ves and around all protrusion s
To insta4i synthetic underlayment on remaining roof, to install CLASS A fir e rated 30 yr arch it ecu t ral shingl es
Job Address : 2920 CR 233 Silt CO 81652
Assessor's Parcel Number:
Sub. Lot Block __ _
Owner's Valuation of Work: $12,803.00 Property Size (Sq. Ft. or Acres):-----
Sq. Ft. of Building: 2100 Height: #of Floo rs:. ____ _
Class of Work: -q New -JCT Alteration I 0 Additio ~~ D Repair
Garage: D Attached LJoetached
-----
LJ Move/Reloc0 foo I ----
PROJECT DETAILS CONTINUED
Septic: 0 OWTS
,__T_y_p_e_o_f_H_e_a_t_: ---.. 0 Natural Gas
Driveway Permit: Exempt
NOTICE
D Propane
0 Community
--D Electric Oother
·-o Permit#: _______ _
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.
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.
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 th f-have read and understand the Notice and Certification above, as well as, have
mation which is correct and accurate to the best of my knowledge.
9/;1/;7
iate I
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation: Plan Check Fee: Permit Fee:d6
1'1 '
Manu home Fee:
f.\
Misc Fees:
BUILDING I PLANNING DIVISION : -~-'--. -'""C><~=-<-............ IL'--"'-~_,,L .... JJ'--...... 1"-'A .... ·"-'~"--"""""" .... fJ""'.------
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