HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
RECEIVED 108 8th Street, Suite 401
Glenwood Springs, CO 81601
JUN 2 2019 (970) 945-8212
GARFtELD COUN"w.garfield-caunty.com
COMMUNITY DEVELOPMENT
TYPE OF CONSTRUCTION
❑ CommerciallMulti-Family
❑ Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)
INVOLVED PARTIES
BUILDING PERMIT
APPLICATION
n Demolition
[] Reroof
Property Owner: _atiCert Phone: ( 70)a7 171-61_3
Mailing Address: /5-413 eeecj, r R i YL co s% &co
cc RowEAY GJ'1A/' . coin
Email Address:
Contractor: ir C2(j- (pn5 it-Pvc,b Dn Phone: (Q 70) 3/9 -(c`/ 24 1
Mailing Address: .,_11 10 -F l2 5i _--./q)--La. S4/6-? D
Email Address: Tose 0 Tfc<11MV /L T1' (7fl\
Architect: Te lief- 4-4 Lj-i i<J)f - Phone: (43 70 _)4 1O -U25�._.
Mailing Address:
Email Address: _ - rel
Kurz +a Patti, Otki
Engineer: tyrl S _F� nee erny Phone: (T7O )_,A70/-1, '/
Mailing Address: S o? ir7lJa rn S [- r� i.4.1.4-3 Car d`"' 6 R 3
Email Address: _ � _a_04-1� efe /pr IS' E'n ` CP71
Manufactured Home Installer:
Mailing Address.
Email Address:
PROJECT DETAILS
J"
Phone:
Describe Work: ,&et) Aorne hC�I,t ;.rl�
Pa ►nq t 7) i9LtrT5) p /vr _bir y) r 'rcr� :° c
Job Address: '9th C -P+ 'a �a + �'{'`� 656" (o
Assessor's Parcel Number: ___g1,J0.57.L.0l'� -- - --- ----
Sub. r t' !u,51Mr, -frcleife Lot s.-. Block !
Owner's Valuation of Work: $______ /
%
Sq. Ft. of Building: 0 "!Co Height: / t # of Floors:
Property Size (Sq. Ft. or Acres): 9.9 7 /acres
1
Class of Work: gNew Alteration ❑ Addition n Repair
Garage: MAttached E Detached
Move/Relocation
r4
PROJECT DETAILS CONTINUED
ZOWTS [] Community
,f Natural Gas ❑ Propane n Electric f nOther
Septic:
Type of Heat:
Driveway Permit:
❑ Exempt Permit #: 6RP
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
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. 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 required information whirtris torraccurate to the best of my knowledge.
/Ilan
Property Owner Print and Sign
Date
OFFICIAL USE ONLY
Special Conditions:
Rvel.1hier Fes..
644 g6;r4)
Adjusted Valuation:
4210,147.00
. ' Total Fees:
214,S7backs:
33
rtza2.
-
n
-14
Plan Check Fee:
Fees Paid:
105(9.38
Permit Fee:
1)t45.'
Balance Due:
S1)976.61
OCC Group: 'Re...,
BUILDING / PLANNING DIVISION
Manu h /// one Fee:
BP No:
BLKE- 5818
Const Type: I p 6
Misc Fees:
OWTS No:
CPT- 5819
Zoning: R
-7/12/0/4
Garfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.ga rf ield-co u nty.com
BUILDING PERMIT
FEE ESTIMATE
WORKSHEET
Applicant: gk/evn
Project Address: oiO9 C2 96 3
Subdivsion: CCP (s gw3iev)
Phone: q 7(. -9 7L/
Lot:
J Block:
Type of Space
Finished Living Space (N/A for Manufactured Homes)
Unfinished Basement
Crawl Space
Square Feet
130
ValuatJ f.
Garage (Conditioned) (i.e. insulation, sheetrock)
Garage (Unconditioned)
Covered Patio/Deck
Uncovered Patio/Deck
Misc:
Misc:
I 3o
-76,
159 o408-.10
.3'3v
13'I3
$74.68
$41.00
9001'('.' d -
$18.00
$32.00
$24.00
$18.00
$12.00
$0.00
$0.00
Manufactured Horne Set -tip
Single Level ($400)
Multi -Level ($600)
Fee
$0.00
$0.00
S.e.ptic (OW 'S)
New Installation ($123)
Alteration and/or Repair ($75)
Perculation ($150)
Plan Review Fee
Building Permit Fee
Manufactured Home Set -Up Fee
Septic Fee (OWTS)
Other (Ex: Road Impact Fee)
Total Fees Due
Fee
$0.00
$0.00
$0.00
$0.00
$0.00
***All fees are estimates until final plan review is completed*"
$0.00
$0.00
$0.00
and/or plans for compliance, the application may be placed on hold until the required information is
provided. Work may not proceed without the issuance of a permit.
The Building Division will collect a Plat' Review fee at time of application submittal. The permit fee, as
well as any Road Impact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by person having written authority from the owner
to act as their representative.
Building cannot be occupied until a Certificate of Occupancy (CO) is issued. Using the building without a
CO will be considered an illegal occupancy and may be grounds for vacating the premises. (Final/CO
inspection requirements will be attached to your approved field set of plans.)
I hereby acknowledge I have read, understand and will abide by the requirements of this
checklist.
g4;
Property Owner Print and Sign
Date
Garfield County
BUILDING DEPARTMENT
108 Eighth Street, Suite 401, Glenwood Springs, CO 81601
Tel: (970) 945-8212
PLAN REVIEW CHECKLIST
Permit No: x'66-Iq-5818
Building Issues
7
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
f Grade/ Topography 30%
Attach Residential Plan Review List
Subdivision Plat Notes
N/A Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign Application
Parcel/ Schedule No.
40# Snowload Letter — Manu. Homes
Soils Report
*mkt/oily
Fiffi 01,1A4 et,
PM109
arow 1 ()aka,
Planning/Zoning Issues
Property Line Setbacks
l& 30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign -Off
Road Impact Fees
Grade/ Topography 40%
f Planning Issues
` Subdivision Plat
General Comments:
(oma( (hi pad f4 = 41)V16.00
(North pi sfin' )
' 2(V (4 741-C
x ` 32.00
leo )44 Ie2)•00 -3
212(i0 x 11.00 s g
\Wl1 il, oh
21114-7•G0