HomeMy WebLinkAboutAPPLICATIONRÉGENÉD
JUN B 1 ?"t1&
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Community Development lJcpartment
108 8th Street, Suite 401
Glenwood Springs, CO 81601
lsTole4s-821,2
www.ga rf ield-cou ntv. com
OF
Commercial/Mu Demolition
Gurfield County
BUILDING PERMIT
APPLICATION
Manufactured Home le or Multi-Level
Reroofor TownhomResidential
PAßTIES
Property Owner:
Mailing Address:
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/ü,!/Phone: t47r:Iq"/P'-,O f ,
wa1
Email Address:AtúE Ls ø¡J 1q {E@ C3 *fn L"t c-o L,*
Manufactured Home Installer:
PROJECT DETAIIS
Describe Work:- -.tr *f , ,J f'
Mailing Address:
Email Address:
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Contractor:
Mailing Address:
Email Address:
Mailing Address:
Email Address:
Phone:c-Architect:
Email Address:
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ðc)Le ,*)ð PMailing Address:
Phone: Õ7ðt4,!S- UZA f
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Engineer:
Job Address:-7
Assesso¡'s Parcel Number:
)-6 Lert,::eJi .8l¿"¿
Sub.
Owne/s Valuation of Work:
Sq. Ft. of Building: Height:
Lot
-
Block
-
PropertySize (Sq. Ft. orAcres):û:L
Class of Work:New
Garage:Attached
Alteration Addition
of
Detached
Move/Relocation
CONTINUED
Septic:OWTS ¡Community
Type of Heat:tr Natural Gas Propane Electric Other
Driveway Permit:Exempt Permit #:
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. lf 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'
otlrer permits. Multiple separate permits may be required: (1) state Electrical Permit, (2) County owTS Permit,
(g) ,noti,", 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
understand that the Buildi
read this Application and that the information
ng Division accepts the Application, along with
contained above is true and correct. I
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 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
d f'ê and/ or builder
I hereby acknowledge that I have read and understand the Not¡ce and Certificat¡on ebove, as well as, have
provided the required i correct and accurate to the best of my knowledge.
^JE CL
Property Owner Print and Sign Date
vlt(
OIFICTAI USE ONIY
SpecialCo
Au liq+ of ¿a^Àihottg.
nditions:
Manu home Fee:Misc Fees;Permit Fee:923'7.26Fee:eckchî24aValuationtlW0t
OWTS No:v-6BPBalance Due:frzâ1.2çl5vFees Paid:
1b
Zoning:VConstType: kôOCC GrouR: a_ ,9taSetbacks:
R?.
BUITDING / PLANNING DIVISION :
Signed Approval Date
tø
töq u,t6îg) v
BuildÍn El 7"s s Flan R"eview Checklist
perrnir Number: Þl¿O' 0b- lê'>246
yþlton Awto F/+e;M WP
?otu,ùa:iion P¿pùv9
Buildine
'/ Engineered Foundation
x
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
G ra d e/ 1 o p o gr a OIW"CÞww p, àal
"f
Attach *es¡ge&¡af plan Review List
N/^
N/A subdivísion Plat Notes
N/A Fire Department Revíew
'/ Valuation Determination/ Fees
'r' Red Line Plans/ StamPs/ Sticker
Attach Conditions
'/ Application Signed
/
'/ Parcel/schedule No.
N/d 40# Snowload Letter - Manu. Homes
X soils Report
Plann Zon
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees
Grade/ Topography 4A%
Planning lssues
TJ/A
N/a
/
Subdivisíon PIat
General Comments:
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