HomeMy WebLinkAboutApplicatione. Garfield County
Community Development Department
108 8° Street, Sults 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garkelcl-county.com
BUILDING PERMIT
APPLICATION
TYPE.OF CONSTRUCTION
A(le/ral I-0*w' Phone_ 16/51 e 57-70
[] Commereial/Multi-Family
I ['l Demolition
Manufactured Home (single or Multr-t evel)
Contractor: I7 r1 �� 811 5091~ 5740
Residential (5f. Duplex or Townhome)
; F ]Reroof
Accessory Dwelling Unit (ADULLAAXIMUM SPIE OF 1,000 SQUARE FEET
Property 0 er:
Mailing Address:
Emaii Address:
A(le/ral I-0*w' Phone_ 16/51 e 57-70
'1772.°4-.7
1•611----1S\Cheek 1"-;"" f f� � ` V(I (e( I n] "77ZU J
air Iu to (9,3mai / r ruin
Contractor: I7 r1 �� 811 5091~ 5740
Mailing Address:
Email Address:
j
6/r/ £i /1.1f aCe i Gen u� Or CO
',Qicfo 6 (201, C I
Architect: 7,0 0 k ea)(( i Ph ne: J� .'79 –{ (®O
Mailing Addref3;_j
Email Address
Diamond/6( gond? go, Car ,' r
�f �� d
dQ Ufa 6 6s -talker r brO�r
r C
�y�jr
Engineer: W ` r 1 Lb i C I Phone: (ZC.� - .�(�TO (�
aailingAddrrss:7
Email Addle -1s: J
2 I•tan Wciy l�I-1 Cen-lerIniq] CO!o1(2,
d 0!ezc3.-d (Z)c t I -tho fr, -n i Corn
Manufactured Home
Mailing Address:
Email Address:
Installer: ;trine: 1 J
ECT DETAILS
A ,, ,f
1 CA 47 �f midi -Ilan + ..Zoe heWle r PIU
Describe Work:
parch �LK, 41t Ta'r e Gam.! c are below exis i CG�n�
jobAdldieea: 5k ",i-- c�'. loo Ciizt fn Gey{o 1) Carbcractie
Assessor's Parcel
Sob. 1
Number: 0 ° 547-2 ,
i i m I e Black
Owners valuation
Sq. Ft of Building:
awed. $ perty Site (Sq Ft or Auesk 9 k6---4504(---
`�' r �'Sq.
f (P47 Height: I 1 '-6l r 09 Rai Floors: C' Ef- oe
OassofWork:
[New 0 Rernode //Altera ttonkfAdditi0n
yj remodel
w remodel
II JJ Detached
Garage:
0 Attached
PROTECT DETAILS CONTINUED
Septic:
WTS elei, eraC
nCommunity
llIlElectric
■ Other
Type ofNeaC
NaturI Gas ropane
Intal Fees:
�a� t64.ei
DrivewaylI'
Permit:
NOTICE
exempt
�--+ T ull
Permit it
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hrriks.tiftLichrit
Authority. This application
or an authorized agent.
the Owner, must be
Legal Access. A Building
for a Building Permit must be signed by the Owner of the property, described above,
If the signature below is not that of the Owner, a separate fetter of authority, signed by
provided with this Application.
Permit cannot be issued without proof of legal and adequate access to the property for
by the Building Drvision.
separate permits may be required: (1[ State Electrical Permit, {2} County OWTS Permit,
required for use on the property identified above, e.g. State or County Highway/ Road Access
Discharge Perini/.
Permit becomes null and void if the work authorised is not commenced within 180 days
and if work is suspended or abandoned for a period of 180 days after commencement.
purposes of inspections
Other Permits. Multiple
[3) another permit
or a State Wastewater
Void Permit. A Building
of the date of issuance
CERTIRCATION
l hereby certify that
understand that the
data submitted by
completeness of the
permission to me,
the Building Division.
comply with provisions
Code, OWTS regulations
Building Permit may
of the structure(5}
otherapplicable law.
I hereby grant permission
further acknowledge
requiring the correction
construction or use
applicable law. Review
Division do not constitute
discrepancies. As
and County Regulations
designer, engineer
I have read this Application and that the information contained above is true and correct. I
Building Division accepts the Application, along with the plans and specifications and other
me or on my behalf (submittals), based upon my certification as to accuracy. Assuming
submittals and approval of this Application, a Building Permit will be issued granting
as Owner, to construct the structure's) and facilities detailed on the submittals reviewed by
In consideration of the Issuance of the Building Permit. I agree that land my agents will
of any federal, state or local law regulating the work and the Garfield County Building
and applicable land use regulations [County Regulation's)). I acknowledge that the
be suspended or revoked, upon notice from the County, if the location, construction or use
and facility(ies), described above, are not in compliance with County Regulation's) or any
to the Building Division to enter the property, described above, to inspect the work. t
that the issuance of the Building Permit does not prevent the Building Official from: {1}
of errors in the submittats, if any, discovered after issuance; or {2) stopping
of the structure's) or facillty(ies[ if such is in violation of County Regulations) or any other
of this Application, including submittals, and inspections of the work by the Building
an acceptance of responsibility or liability by the County of errors, omissions or
the Owner, 1 acknowledge that responsibility for compliance with federal, state and local laws
rest with me and my authorized agents, including without limitation my architect
and/ or builder.
I hereby arknowladap that 1 have read and understand the Notice and Certification above. as well as. have
prothe reqs" ec(' formation which is correct and accurate to the best of my knowledge.
'[� t� [(am' Cx vr�
Property Owner Print and Sign
Jo IS -2oZo
Date
OFFICIAL USE ONLY1111110
Special Conditions:
/lusted Valuation:
CO
a� C,hehck Fee:
O[I ?b
it Fee:
324 Iia
Manu. me Fee:
1 A
Misc. Fees:
.
Intal Fees:
�a� t64.ei
ees Paid:
146,2.42_
li ante Due;
`.1,� 2� 43
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OCC Group: (pw
f
Const Type:I�
Zoning: n�rA�
1}`
J
BUILD/NG / PLANNING DIVISION :
+•
�
, '
2
lb I + " "Z
Signed Approval
Date
7.4z, a H1512021)
Fwd: permit application Page 2 of 2
ovoid( it btl/it tOld rlittNre
Iry•dll.M Jwr. .1001
m Wooly
M1IOt
A711%IPIll1. ','• rVyl ulwn Ie1 n Iula l•re p.nml I, I,t lir Anvil 10411. x,vnel of the property, ;411-1T,;11 thane,
of an a'dth'ul1nI agent, 11.11e sknallll a below Ia nlll that of the I)Ivnl!r, a app„ rdle I011e1 01 nulhorly, oI,nue by
the Owner. Opal be: provided wilh DV, Apollr0IIOn,
Imo) 9C1 glTl A la viMlnr Pe: roll cannot he Issued waho.,1 wool 1(l aegal and adequalt 40[011 10 Inn proprly f 0,
pulpe>n,fan Iptyll 010 by th0 9411411 °Irmo0.
1114104l9•R1 114140lr(. p.044 pr0O1•11 may be required: 1.10,0010.0..19000104,h 11)(.e0Nl)W1010,1011,
I111anelM1 pwr.a:1..g:A..d 1.f nu On the property idonbned above, a R. Slate 90 g4unty 100.0141 41640 A11 etc
or. 7041. iwtttvrwkr Ihac✓~.rgw Mr rod.
Ytlld MMI•} A14.Hlr/Promo lcee0mes null and void 11 We Tema alltli.er./ Il001 MOTS. rm *1(010 ]WT days
.0.10.0.0.04.012.0.1.411.041 u„peneat al .0044444.0 M, 1 period el 100 days Aller 1 nmmen 01:1001
t111ff1(•J11g11 - . - — — . —
4,, 4. 41.1llha,*en6Wla lagpr.afraprN 4110 the hlernn4anlnntdfp) 11,.00 la Dv(a J0,lron.
efeler1t00d that the Bu:IJing Df visa on acce(la the Application, 110110 wNh Ire pions and specl'*aliuns and other
dela submittal by me or on my behalf Ilubmdleltl, based upon my cenill[a lion at c0 ae1 ere ty. A[IulrIng
omplebe,1eu of the au4m1011, and approval orthla ApplIcaban, o puhemg Derma WII ba issued gnnhng
plo01IS.,0 (0 Dae, aelaranw,H (..*bull Il.alfVf W,l41 1I.0latilllel 811..edenl he auemiUi r1H.w.d by
114 06110foot 1Nett:on I 1x 1.6)310 Dar OH0a0300110. tl0d'nf/1wmd,l ap00414100l lad el,r.t.nra waU
eorrdolv0•H 6 plevisloea of torl1rot(0ee0(0 kgillawr/g0.Ur46a.ei.lk and Ilia u"a.INfI% 00,43011..4'0
1140(IW101egulallry,a aatd 1yOralwbb IMd .*0 •l(oIahof•1 I<, ooyla•d'Aatm{1)I 1 aoarMl.,l�.Isl1 '1"
Ho'I:Img Vee0vi1 may Ito spspvnd.d or,gvu0011. upu, malice humthe 4uu0ly, 1112, 0111100, c0111lIu11,2Ilm u 10
01 the c1„4Iulvl;Ianal 4,,ibl4l"1), 0.,v'Ibed ah102(I.1 witm,mnlllia,leawilt. (01:114 xggulallenh) et any
Mame amtirtalrfiaare.
1.40p.ren1.:on to the nvh.n,lgnYhl.0 to er,ln Orr 9'14»114.lk*ll 111011 41'14:, Ili i..p0cl 110 *0114 1
0,.300. .1.0443010 Mal Ih.Ism/into al(F04011dIne.rrmm000, nor preyenl the 0*1111dg 111Rcul liwiti 1I
requiringIho Dor lee] ton 0l Stroh 1. thesahmIli I (1 any, c410eilerl alter 0,0.0,010112) slapping
onallucllan or use of the merino. eta) or Iaci:tyllec) i12204.14 ah esbl,on o100.01Y RclulalloMsl or any other
u Pp11[301e 1,10, (a0 view of Ihh nppkjI14*, including soomt1114, and IelpelV9+f .1 iliTecliinirc by the Bolding
Division do not ronsl0ule a0 accepla oro of re411oeYbh11y 4r Iiabllny by 11.0 L9n4 ($I.NN1, 41rauxfona or
6lscrtoaneles Al Ina Owner. laeanowlod;e 11140 resp000l,,hty for cafnp6an[0 with leder al, scare and local laws
and County Ragulalions real with me and my aol hoeeed agenle,+alpbq Te.1•9vl1. rnwllinn my arMN lee
•!.1/
(141014 .e.Naa,lryr 10411 kava hail 200 o relna.da H
provided lir 4.6p4.d 1010O.n0D.n whkb i, (Wlnl
lie
• 8(400.
!❑*H»,
0400,114 1414..1 nim uld Win
1. owl r or
114Wi ire a, weD .,, Ila.
n
tV sOa Mx Of If
kllOal
r91' 51.70.1°
Date
Plan 1he00 Sen!
I en YIN:
MC ra11H,p.
PoiOlt 1rr-
.1140(011101
041 HIM* id, I Misr lent:
A),', N.e
(.0110 14410:
RW IS PO
OOP rlMt f 1•IAkM0M. 11101(1110.'
Signed 11000.141
Dat,
Andrea,
Please print, sign, scan (or take a photo with cell phone and send to me) and email back to me. I am
preparing the permit application to submit on your behalf. Another way to do this would be to send me
a letter "to the Garfield County Building Departmentjl that 1 am authorized to apply for your permit on
your behalf.
Thanks,
David Brown
https-llwehnTal:dicksonrnthenmfowa/4ae—item A-1PM,Note&id—RgAAAA-A-GraR-b1410-1)... 1-4/1312020-
DCGarfield County
BUILDING DEPARTMENT
108 Eighth Street, Suite 401, Glenwood Springs, CO 81601
Tel: (970) 945-8212
PLAN REVIEW CHECKLIST
Permit No: e- IO- 7 -,Cor- 37
Building Issues
I/A
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
Subdivision Plat Notes
NIA Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
7,
Application Signed
Plan Reviewer to Sign Application
Parcel/ Schedule No.
IA 40# Snowload Letter — Manu. Homes
Soils Report
Ng) AddifOw Toter(
awl °pia.
int -f4 f4 rit
Planning/Zoning Issues
N/A
N/A
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
f Zoning Sign -Off
N/A Road Impact Fees
Grade/ Topography 40%
Planning Issues
Subdivision Plat
Description & Summary:
Mai' kww ( AdtOVI
1.044 ISI AolAifiovi
I) '2o
12�
N/w A6Idifioti (DfAl I, (a415
AYrf.
11 &45 x `b 75 00
li 52p x `�
1600
IGr� x� fe.Co
200 x 4 21.00