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Garfield County RECEIVED Community Development Department 108 891 Street, Suite 401 rr Glenwood Springs, CO 81601 (970) 945-8212 GARFIELD COUNTY www. arfield-countv.com COMMUNITY 0E JEL0pRJ4E T BUILDING PERMIT APPLICATION TYPE OF CONSTRUCTION n Commercial/Multi-Family Manufactured Home (Single or Multi -Level) 111Demolition Residential (SF, Duplex or Townhome) 1 I Reroof Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET INVOLVED PARTIES ' 1• Property Owner: , - :''` '!�%/C� 1_G2 ,�//LZ n O Mailing Address: G e. p Gua-, Email Address: Q' Ve�//anh / 61,2,77 atats-, Phone: (3' ') P` . c sfle 6/64 Contractor: COjitfrL,cfl ,1 Phone:770 ) 3 77 ' / "J 7 Mailing Address: 'Z2- 0`%LC_,Z'I77,7171Vd ►.-) ( , C � /6 Email Address: Architect: 6 qr.- 477/ /fit' Phone: [� 761 ) 3 77. 9 °37 Mailing Address: 7I /(fr ev' 4veva e Email Address: ja.C. ).-7-7 ;no 527 60,1 a/ / 1 Co'7l Engineer: Mailing Address: Email Address: Phone: ( ). Manufactured Home Installer: Mailing Address: Email Address: Phone: ( PROJECT DETAILS Describe Work: 017e ----V-4/1/ -s/r Q ,C/OS- raddleYI . (07 eXJ Ji7 ffj 52)-y e 4LIV/ /7 "PJ•I L(P-14 L ei .t Job Address: Assessor's Parcel Number: 2/ 2- - Z — © Sub.Ce .. pp.„. r s1#J-s CcJ 000 d co" Lid_ Lot c? Block Owner's Valuation of Work: $ ZO.' - Property Size (Sq. Ft. or Acres): Sq. Ft. of Building: Height l� ��0» # of Floors: Class of Work: New Remodel/Alteration Garage: Attached /. c Addition 573 s Detached PROJECT DETAILS CONTINUED Septic: Type of Heat: Natural Gas !� Propane Community riElectric ❑ Other Driveway Permit: —Exempt ❑ 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 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 prove . the quire • 'nformation which is correct and accurate to the best of my knowledge. Property Owner Print and Sign /• OFFICIAL USE ONLY v / J 4 V ' ~+ - 0 Special Conditions: Adjusted Valuation: .431b.bo Plan Check Fee: `3'74.05 P rmit Fee: 443.I5 Manu. Home Fee: N%q Misc. Fees: N/A T tal Fees: 141(.2.26 Fees Paid: sz�-. a1.44 Balance Due: `b Lett .7(� BP No: OWTS No: - IQOcj I h let Setba ks: F25�R I0/915 I OCC Group: R4 -,I Const Type: RG Zoning: pup BUILDING / PLANNING DIVISION : ,, 4/ b HtaV Signed Approval T Date PD#u64•41V#U013, 1110110200 Garfield County BUILDING DEPARTMENT 108 Eighth Street, Suite 401, Glenwood Springs, CO 81601 Tel: (970) 945-8212 PLAN REVIEW CHECKLIST Permit No: aa6-01-10-004i Building Issues Engineered Foundation Driveway Permit Surveyed Site Plan Septic Permit and Setbacks / Grade/ Topography 30% Planning/Zoning Issues 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. N/A 40# Snowload Letter — Manu. Homes Soils Report '960$41444y : Property Line Setbacks 30 ft. Stream Setbacks N/A Flood Plain Building Height Zoning Sign -Off WA Road Impact Fees Grade/ Topography 40% Planning Issues Subdivision Plat Description & Summary: 12d4A iviaM. Fa = NA (ob 9.1= Now I-1A1A1 a^� J Av tt V4wth6i ' u ,do(i ion► covisfi►ctchAw ad�l6)41filiyi 4.F. K. 37� x --7446 r ?Qin bd. 440 x 43r7.06= 1914400. TO-