HomeMy WebLinkAboutApplicationGarfiefd Coøtn
108 dh Street, Suite 401, Glemvood Springs, CO 8/601
P h: 970-945-82 I 2 Fx:970-384-3440 Inspection Line : 888-868-5 306
www. garfìelcl-county.com
BUILDING PERTVÍIT APPLICATION7tts5.7b1.ot."4"' fifi"#"r":"WÅo"oÈ, r, * & I1Parcel No: (thß information
2q ß129
is available at the assessors ofice 970-945-9134)
2 Job Address: (ifan address has not been assigypd^please provide CR'ltzz tt)oAtbtlLkL bøs 9lt nt
HIVY or Street Name & City) or andlegal description
q101q5,nq1Ph:Ph:aMailing Address:
LISZ iil!,s\ty¡.l¿3 Owner: brooertu-Ñner\ .e.D+fiJdÀ lla,øvnra¡
Ph:AItPh:Mailing Address:4 Contractor: fulç
Ph:Liç#:MailingAddress:5 Manufactured home installer:
Ph:AItPh:Mailing Address:6 Architect:
AItPh:Mailing Address:Ph:Engineer:7
No. of Floors:
,Sq. Ft. orAcresoflot: I .Ot¿l Height:ItsSq. Ft. of Building:tqoSI
uNew EAlteration Eaddition Ehepair EDemo ElMove
Class of Work:9 Buildins:
XResidential ECommercial Eother
Use of
l0 Reeta¡r lb€ - w Acpt"!) àt^st¿qDescribe Work:
É'¡at. cas EPropane EElectric Eother
Type ofHeat:ll Garage:
úoo*n"o DDetached 0ISDS DCommunity
Septic:
letter of authoriry, signed by the Owner, must be prcvided with this Application-
Leqål Acc€ss. A Building Plrmii cannot be issued without proof of legâl and ada¡uate access 1o theproperty for purposes of inspections by lhe Building Departmflt.
County Higùway/ Road Access or a Stâte Wasteìrater Discharge Permit.
days after commencement'
.ERTIú'ICATI'N
and specifications and other data submitted by me or on my behalf(submittals), based upon my certification as to accruacy.
tüe submitt¿ls reviewed by the Building Depafment.
construction or use ofthe sbuchrre(s) and facility(ies), described above, are not in compliance with County Regulation(s) or any other applicable law.
of County Regulation(s) or any oûer applicable law.
limitation my architect designer, engineer and/ or builder,
Owners valuation of Work:Driveway Permit:12
DA
IHEREBY T I HAVE READ AND I.JNDERSTAND TTIE NOTICE & CERTIFTCATION ABOVE:
STAFF USE ONLY
Special Conditions:
Adjusted Valuation:Plan Check Fee:Permit Fee:
lm,oo
Manu home Fee:Misc Fees:
Total Fees:
lcv>()()Í'ees Paid:
IOO.Or)Balance I)ue:e EP No & Issuc l)ate:-zltc ISDS No & ksued D¡te:
N/A
Setbacks:OCC Group:Const Type:Zoning:I
DATE
1.Lo.l -7'Lo.l I
DÄTE