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Home My WebLink AboutApplicationGørficld CountyRACKTV IlEt 1 2 201? Communitv Development Department GARFTELD ü0{iry ry.,, ","t"i:,i:"",ï'r:,':ï iårt IMMUNITY nËV[t.ûF[,4Ëhl ( sTol s4s-BzLz www.garf ield-countv.com ?\( þnÀ BUILDING PERMIT APPLICATION Commercia Demolition Manufactured Home le or Multi-Level) Reroofor TownhomResidential " I I { 'l 'l I r I r'' Property Owner: MailingAddress: Email Address: AoD su¡¡u¿*f oR C'.Nrrgo¡ry N,.r€ Co xl6 €tçvgr c'v<-ßôß6f phone: ÂlO ¡3o4 -'{7lO LøV t . þþWfQJ,Jv\ùrç. æ^ ?3 Phone: (17o) bq - olo q t Þ 2 %t¿tSttW ØvV lpT1lo¡JContractor: Mailing Address: Email Address: 1ED3¡ 4à9 - tlreò u1lq-5r-AÉ åfÊntå",Arch¡tect: 6o,rsvY 'Ít¡(SorJMailing Address: Email Address: Email Address: Phone: ( IEngineer: Mailing Address: Phone: (_) å ont¿a0'6É-$çV ss@'. vç- . lt xa.sw¡¡sfir|,€ Cà 15' Manufactured Home lnstaller: 6öÒ Height: Assesso/s Parcel Number: Job Address: Sub. Owne/s Valuation of Sq. Ft. of Building: Describe Work: vL^(lJ Lot Block Mailing Address: Email Address: Property Size (Sq. Ft. or Acres): fi of Floors: â* )æ € rrJl,r -<nJ,4_ l-l Rdd¡tion ,[ Repair ll Move/RelocationClass of Work:| ruew LlAlteration lJDetachedGarage:,Ãlnttt.t't"¿ l,,illi7r,rl' fl.ì,, i itl., Ì ilr i I tl,. e3 PROJECT DETAITS CONTINUED Septic:OWÏS Community Type of Heat Propane Other Exempt Permit # NOTICE Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above, oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby 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. VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80days of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement. CERTIFICAT¡ON 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. 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 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 Build¡ng 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 desi neer 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 and Sign Date ral Gas Driveway Permit: Electric OFFICIAI USE ONLY Special Conditions:'Ò¿¿ alta¿hd |iel * anàíhae Manu home Fee:Misc Fees:Adiusted Valuation:*22,oØ.oo Plan Check Fee:+221.01 Perm¡t Fee:944.zry Balance Due:Ø4q.2>BP No: bAu-QÇ4 OWTS No: 4>7tz.Zø Total Fees Fees Paid: L?-7.01 a'lO OCC Group: 'Rê ConstType: IRC Zoning:K rloløtøBUITDING / PLANNING DIVISION : Signed Approval Date 1r?'+.a\t CLt I BuíIdíns.l Z,oni Review Checklist Perrnit Number: Build ine / Engineered Foundation f Driveway PermitxSurveyed Site Plan øße-12-t-1- bo24 \ Wvú Otlvry-áab Frryuv Septic Permit and Setbacks Planning/ ZoninF '/ Property Line Setbacks N 30 fl. Stream Setbacks Flood Plain Building Height Zoning Sign-Off Road lmpact Fees Grade/ Topography 4A% Planníng lssues Subdívisíon PIat General Comments: N/A Ñ/A Grade/ropo sraphv3o% '/- Attach Residentíal PIan Review Líst Subdivísion Plat Notes N Fire Department ReYiew / Valuatíon Determinatíon/ Fees Red Line Plans/ Stamps/ Sticker '/ Attach condítions Apptication Signed '/ PIan Revíewer to Sign Applícatíon / Parcel/schedule No. VA,40#snowload Letter-Manu. Homes x Soils Report ulalwvtion = oØ1Øo- (a+ eu+btuì{tz&) FoM twpøet F¿z= ñ/a