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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""'.------ n ..... "