HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601--æl+Þ (ezol e4s-8212
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Residential D lex or Townhome
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Manufactured Home (Single or Multi-Level)
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Property Owner:
Mailing Address:
EmailAddress:
C-onse- Q^*"-r^ t\,o. ,A .Phone:
Phone: tî+ol %3 qarJÐ
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Mailing Address:
EmailAddress:
\pPhone:
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\ c¡.¡\f-Contractor:
Mailing Address;
EmailAddress:
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Engineer:
Mailing Address:\
EmailAddress:
Manufactured Home lnstaller:
Phone:
Phone: f
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Mailing Address
EmailAddress:
PROJECT DETAIIS
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Describe Work:
Job Address:
Assessor's Parcel Number:
Sub.Iot
\(¿.¡-
Block
Property Size (Sq. Ft. or Acres):çot Kzø\Owne/s Valuation of Work: $_
sq. Ft. of Buitding: g-qqO
Class of Work:
Height:x,lÀ
CW RemodeUAlteration
Attached DetachedGarage
#of rloors: Þ I [,b
1>ë åi*-
PROJECT DETAIIS CONTINUED
Septic:
Type of Heat:Natural Gas Propane
Community
Electric Other
mpt Permit #:
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 authoríty, signed by
the Owner, must be provided with this Application.
leeal 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 L80 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. 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 compfiance with federal, state and local laws
and County Regulations rest with me and my authorized agents, including without limitation my architect
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.
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Property Owner Pr¡nt and S¡Bn Ct4--^Date
oFFrcrAt UsE oNtY pA r D . f 27{. o r c. c. 04 hc /zozz
speciar conditions:
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Plan Fee:ol Manu. Home Fee:N/^
Misc. Fees:N/AAd¡usted Valuation: -+ 29,/ly)e
Fees Paid:lzzq.ot Balance BP No:
ßt-co-7,1sç
ourfs ruo:
x/a
Total Fels:,f bq5"5b
Setbacks:OCC Group:Const.fype: p Zoning:
AURA I-
BUITDING / PTANNING DIVISION :
Signed Approval Date
Gørficld Coun4t
BU'IT'ING DEPANWENT
lOB Elghth Street, Suite 407, Glenwd Springs, cO 81607
Tel: (970) 945-8212
PLAN RE VIEWC HEC KLIST
ßLco - 04-r^- +4 SWPermit No:
Building lssues Plan n ing/Zoning lssues
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Z¡tø"1**
/ eaut(_fu&, Drivewav Permit 0b çe' Øl*)%iíwíM
ngineered Foundation
Grade/ropography 3o% 6æ'\WÍ- øW
Attach Residential Plan Review List
Subdivision Plat Notes
Fire Department Review P"-þÐ
Valuation Determination/ Fees
Red Line Plans/ StamPs/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign APPlication
Parcell schedule No. 0K fu tßN
Soíls Report
/¿4 Froodprain ewe,Çf"¡l*f,ú
MErt Buitding Height
Property Line Setbacks
30 ft. Stream Setbacks
Zoning Sign-off ûZ çet Evt)
Road lmpact Fees Pe* Ø"¡
Grade/ Topography 4A% 0f (e,r þttl
Planning lssues g¿ (er$u"Ì
Subdivision Plat
Descri otion & Summa
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NOTE: lf any required information is missing, delays in issuing the permit are to be expected. lf
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 untilthe 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 lmpact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by a person having written authority from the
owner to act as their representative.
I hereby acknowledge I have read, understand, and will abide with the requirements of this
checklist.
Property Owner Print and Sign Date
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