HomeMy WebLinkAboutApplicationR141iC ''Community Development Department
DEC 2 7 2017 108 8th Street, Suite 401
Glenwood Springs, CO 81601
GARFIELD COUNTY (970) 945-8212
)MMUNITY DEVELOPM Www.garfield-county.com
Garfield County
BUILDING PERMIT
APPLICATION
❑ Commercial/Multi-Family
❑ Demolition
❑ Manufactured Home (Single or Multi -Level)
Residential (SF, Duplex orTownhome) 1❑ Reroof
JIMUrenfe Gre L, i . t+t "yri4.:1g T1
MED
Property Owner: GC-EPUobDce,✓ bU5hirfa hone: (97c) 9 q 5= k �7/
Mailing Address: Q. ( • C iYi -? -p liz -. G--eivi1 bO S .51261 CO 6t 6 0 (
- i
Email Address: ft-0tCxr e. c� 1 e Im d Z. r i7e f
Contractor: Q l G f- t 0 C9 n5 AG' , C co Phone: ( 970) c3 4 5-67 1 2
Mailing Address: I-14 E3 De - C- i ,u} 5 0111 Cd €660(
Email Address: r tb L C_1 6 C1 t c6 tm o 1 110-
P Leik44 Ti
Anchit+eet+ �Uoxc d i o nO Phone: (.970:1) r¢
Mailing Address: ii c %`]�$ 'tJC� � � � Gd �` CO24/4er" OCL g/66 /
Email Address:
Engineer: N61 -7Q.
Mailing Address:
Email Address:
Phone: )
Manufactured Home Installer: \I G
Phone: ( )
Mailing Address:
Email Address:
Describe Work: Celx'11 V14 r-eir7 Sp Ace TV , -n df e
i6e S F .
Job Address: Z 7' Ceti fe it D R - G (-6t4,.•: c ecf ` rl
(uu�r�cj
5tii10l��j� GN(Q
Assessor's Parcel Number:
Sub. Lot Block
LS
Ili A f rill Owner's Valuation of VOA: $
r(o_ Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building: 1 , 111
. Height: t\.) in, , # of Floors:_
New Alteration 0 Addition
Class of Work:
Garage: ]Attached
❑ Repair
❑ Move/Relocation
Detached
1 PROJECT DETAILS CONTINUED`
Septic: ❑ OWTS
Type of Heat: III Natural Gas
Driveway Permit: it 1 Exempt
Propane
fl Community
Electric I 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
phereby 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 requir=d infor ation is correct and accurate to the best of my knowledge.
Property Owner Print and Sign
y.0 Pt6n
C eve).
cr
/2 27, 26/7
Date
e G wood
y--fr2e & G)
Yj OFFICIAL USE ONLY 1,
PSpecial Conditions:
0 SP, 044{ D` G1I4(51- (i s f d F Gol 1 11, 0148 .
Adjusted Valuation:
47)430, oo
Plan Check Fee:P
�R1. G1
rmit Fee:
(53.25
Manu home Fee:
1) 1 IA
Misc Fees:
> Total Fees:
i. 4P 2. g�
Fes Paid (
(o3.
Balance Due:
I gq • b5
BP No:
OWTS No:
' -ro l—
Ey IMA
Setbac s:
F25 R7.5/9 lb
OCC Group: /Q��
Const Type:
- 5
Zoning:
CL.
'9 BUILDING / PLANNING
K
DIVISION : ,' . }� 1/16711.6*
Signed Approval ( Date
Garfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
Con j -i T d 1z.
BUILDING PECIVMIT
FEE ESTIMATE
WORKSHEET
I) re 01 C606 -(-,C0
2c/ CerzLey- blz— 81G'ol
Applicant: LE..NLS'000 (-ARMH,51-4-1 b Lithone: (976j 46-6,712-
Subdivsxan. APde.Ess 1 G 64 F&-61' iG]]Lot: � A -S O`t
Project Address: '2.74 C� er1 t� r 1Z CrL ri c9 cn c1 �'-° r s e Go 1 60
D ck: Go► �5T8 uc�-t-r
Type of Space
Square Feet
Valuation
Finished Living Space (N/A for Manufactured Homes)
0
$74.68
Unfinished Basement
0
$41.00
Crawl Space
0
$9.00
Garage
0
$18.00
Covered Patio/Deck
0
$24.00
Uncovered Patio/Deck
0
$12.00
Misc: Ca7nvt rT (.0 0-e ',muse Spi 7C1 of -66
e 168 0
$0.00
Misc:
0
$0.00
Manufactured Home Set -Up
b Garfield County. --- ',7.',, ' ..n, ::_: .
Fee
Single Level ($400)
Building Permit Fee
$0.00
Multi -Level ($600)
$0.00
$0.00
Perculation ($150)*
Other (Ex: Road Impact Fee)
$0.00
Septic (OWTS)
b Garfield County. --- ',7.',, ' ..n, ::_: .
Fee
New Installation ($123)
Building Permit Fee
$0.00
Alteration and/or Repair ($75)
$0.00
$0.00
Perculation ($150)*
Other (Ex: Road Impact Fee)
$0.00
' Fri;;!: • fK..
1.
...: .This Section Determined
b Garfield County. --- ',7.',, ' ..n, ::_: .
Plan Review Fee r- p/1-{ p & err me
. .-r6.6 y Jr 2( $0.00
Building Permit Fee
$0.00
Manufactured Home Set -Up Fee
$0.00
Septic Fee (OWTS)
$0.00
Other (Ex: Road Impact Fee)
$0.00
***AII fees are estimates until final plan review is completed***
Careld Carr�rsy�1
Building/ Zoning Plan Review Checklist
Permit Number:
13Lz-0 -12- 17 -- 5/277
GL'd44 woo PGUrfi Q 14 17 121)1404e
Building
NA Engineered Foundation
N/A
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30% ,
C014iWuktc- 4
Attach Reid iuF Plan Review List
Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign Application
Parcel/ Schedule No.
I`I/A
40# Snowload Letter — Manu. Homes
Soils Report
Planning/ Zoning
NJA
i
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign -Off
Road Impact Fees
Grade/ Topography 40%
Planning Issues
Subdivision Plat
General Comments:
t/nkt,4z 1 Ar -4t_ (wdcklk%c, — d Ce,)
1� x I r-11696 c=›r.
q//(luA4h0N:
toe' X . 23 , —Trei30 .
Typ, $ ()cc. em. &5
1350.42
Pgeiveki 4344.'23
tedI r,t1pAoff - E& N/A
P0 hLtu 9. t=. m4,1,4