HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
wwwgarfield-county.com
TYPE OF CONSTRUCTION
Commercial/Multi-Family
=Manufactured Home (Single or Multi -Level)
[] Residential (SF, Duplex or Townhome)
BUILDING PERMIT
APPLICATION
QDemolition
Q Reroof
n Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOLVED PARTIES
Property Owner/71;0204/ 0e1.4/vr tf. /7-74,45,e? Phone: (i O )876
Mailing Address: t Q, am�
Email Address: /00 124/ c2/JA7 a/7)4, /.e0/4--)
Contractor: Phone: (
Mailing Address:
mail Address:
Architect: Phone:
' Mailing Address:
Email Address:
Engineer: Phone: (
Mailing Address:
Email Address:
Manufactured Home Installer: Phone: (
Mailing Address:
Email Address:
'PROJECT DETAILS
Describe Work: /1��fig (! ''LC
Job Address: 3/f� 2L
Assessor's Parcel Number:�rl� 7/2- 4)3 EP
Sub. / Z �-.� .¢L)r 7p7IO►? Lot B Block
Owner's Valuation of Work: $ aEj4f)(5 «�Property Size (Sq. Ft. or Acres): 475-
Sq.
`fi75
Sq. Ft. of Building.
Class of Work:
New
Height: 0
QRemodel/Alteratio
6f Floors: C
X Addition
Garage: Attached
Detached
PROJECT DETAILS CONTINUED
Septic:
OFFICIAL USE ONLY
OWTS
1. Community
Type of Heat:
ENatural Gas
❑ Propane
❑ Electric
MOther
Driveway
Adjusted Valuation:
3) &COLI oo
Permit #:
Permit:
'Exempt
_
❑
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:ria. sc.N.�._„_ . _
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 which is correct and accurate to the best of my knowledge.
/3'I4I24/
II :VAN/ e �Q � •¢•¢ ���a� 1
wner Print and Sign ” Date
Propert
OFFICIAL USE ONLY
el
Special Conditions:
Pan Check Fee:
"Pe3.�i
Permit Fee:
°M"7.76
Manu. Home Fee:
WA
Misc. Fees:
WA
Adjusted Valuation:
3) &COLI oo
Li
4r�51
O
AP
g
Total Fees:ees
4w.16
Paid:
I 14o. Wei-
Balance Due:
o-
BP No:
F lAr- b�{30
OWTS No:
Iv/T
Set acks: g I
,0
OCC Group: IRC
Const Type: IR
Zoning: Rug ,
1�,,'�
BUILDING / PLANNING
DIVISION :
/� (2. e)'
Signed Approval Date
NOTE: If any required information is missing, delays in issuing the permit are to be expected. If
determined by the Building Official that additional information is necessary to review the application
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 Plan 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.
Property Owner Print nd Sign Date
LfM7/9/1 Aaf 'I'C--
967yyte-&-- e
Garfield County 1
BUILDING DEPARTMENT
108 Eighth Street, Suite 401, Glenwood Springs, CO 81601
Tel: (970) 945-8212
PLAN REVIEW CHECKLIST
Building Issues
Permit No: 0.446' P8 "2O - 43o
XEngineered Foundation
Z Driveway Permit
Surveyed Site Plan
N/A
Septic Permit and Setbacks
Grade/ Topography 30%
7 Attach Residential Plan Review List
Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
NI/A
N/A
I Red Line Plans/ Stamps/ Sticker
l Attach Conditions
Application Signed
Plan Reviewer to Sign Application
/
Parcel/ Schedule No.
f'
N/A
40# Snowload Letter — Manu. Homes
SSoils Report
Planning/Zoning Issues
WA
Property Line Setbacks
30 ft. Stream Setbacks
WA Flood Plain
Z Building Height
/ Zoning Sign -Off
N/A
Road Impact Fees
/ Grade/ Topography 40%
Planning Issues
Subdivision Plat
N�A
Description & Summary:
2C a '6w Cbv ,4 Di -e-.'
ex25 -200 5-e
200 x c1Q,.00 a (000.00
plotel lwp+ F -cc N/A