HomeMy WebLinkAboutApplicationGarfteld County
n Manufactured Home (Single or Multi-Level)
ReroofXl Residential (SF, Duplex or Townhome)
BUILDING PERM¡T
APPLICATIONCommunity Development Department
108 8th street, Suite 401
Glenwood Springs, CO 81601
(s701945-8212
www.garf ield-cou ntv. com
WPE OF CONSTRUCTION
E Commercial/Multi-Famil Demolition
INVOLVED PARTIES
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PROJECT DETAIIS
vDescribe Work:
Job Address:
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Parcel Num
Sub 0 2s
Owner's Valuation of Work:
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A.ff+0ô Property Size (Sq. Ft. or Aggg)
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Contractor: Phone:
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Email Address:
Mailing Address:
Email Address:
Property Owner:
Mailing Address:
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Email Address:
Mailing Address
Arch¡tect:
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Engineer:
Mailing Address
Email Address:
Mailing Address:
Email Address:
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Nl+Phone:Manufactured Home lnstallerl
n Rodition ! Repair | | Move/Relocationffittew! AlterationClass of Work:
! oetachedffintta.t''eoGarage;
aÅ-a-
Sq. Ft. of Building:Height:å?,? s/4 # or F loorr; &
PROJECT DETAILS CONTINUED
Septic OWTS Community
Natural Gas Propane Electric Other
Exempt l_l 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.
Lesal Access. A Buildi ng 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. 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) stopp¡ng
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
r,e neer an or builder
I hereby that I have read and understand the Notice and Certification above, as well as, have
the which is correct and accurate to the best of knowledge.
7
Property Owner Print and Sign Date
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Type of Heat:
Driveway Permit:
OFFICIAL USE ONLY
Special Conditions:
Adiusted Valuation:+zØttbn.o Plan Check Fee:tþh2414 P¡rmit Fee:*1fl4b.1b ManuÑ%lee:'t"#\37.01
Total Fees':+?2t0A1 'iî#,q4 Balance Due:?tr+lz.qry
BP No:gt IF,-53?t)
OWTS No:
Setbacks:
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occ Group: lRc_constType: IRC 'uiT b
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qfio /zotøBUILDING / PLANNING DIVISION
Signed Approval Date
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Garfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(9701 94s-8212
www.garfield-co untv'com
BUILDING PERM¡T
FEE ESTIMATE
WORKSHEET
divsion
Applicant:
Project Add 6t¡S,
Block
1
Lot:
P one:
tn of, rn4-Sq. Þ+',7 o
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574.68Finished Livins Space (N/A for Manufactured H omes)
s41.00Unfinished Basement
S18.ooaceCrawl
s32.00Garaee (Cond itioned) (i.e. insulation, sheetrock)
s24.00UnconditionedGara
S18.oob.r(Covered Pati
s12.00Uncovered Patio/Deck
so.ooMisc
50.00Misc
TotalValuation $0.00
so.oosinsle Level (5400)
$o.ooMulti-Level (S600)
Total Set-Up Fee 5o.os
50.00New lnstallation (S123)
So.oo
so.oo
Alteration and/or Repair (S75)
Perculation (5150)
Total Septic Fee $o.oo
s0.ooPlan Review Fee
So.ooBuildPermit Fee
so.ooManufactured Home Set-UP Fee
5o.ooSeptic Fee {OWTS)
so.ooOther (Ex: Road lmpact Fee)
This Section Determined by Garfield County
so.ooTotal Fees Due
***All fees are estimates until final plan review is completed***
BuíldÍns,l Zl.ni Review Checklist
Perrnir Number: BI.FE'04'tØ- çAqo
Yot* How à^(àwç çfP
Buildine
Engineered Foundation
Driveway Permit
'/ Surveyed Site Plan
Planni 7on
'/ Property Line Setbacks
Nldw
Nl\
'/ soils Report
30 fl. Stream Setbacks
Flood Plain
Buílding Height
Zoning Sign-Off
Septic Permit and Setbacks
/ Grade/Topography3Q%
Attach Residentíal PIan Review List
'/ Subdivision Plat Notes
Nl,Fire Department Revíew
,/ Valuation Deterrninatíon/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed
40# Snowload Letter - Manu. Homes
/ Road lmpact Fees
Grade/ Topography 40%
/ Planníng lssues
Subdivision Plat
General Comments:
'/ Parcellschedule No.
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