HomeMy WebLinkAboutApplicationGørfield County
* * -Çennmunity Development DepartmentxeE:ElVE4baa* street, suite 401
,i{ij r¡ { ,$.[çnwood Springs, co 81601
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TYPE OF CONSTRUCTION
Commercial/Multi-Family
Manufactured Home e or Multi
Demolit¡on
lex or TownhResidential Reroof
Dwelli Unit . MAXIMUM SIZË OF FEET
INVOI.VED PARTIES
Property Owner:
Mailing Address:
Email Address;
Phone: (_)
â
Contractor:
Mailing Address:
EmailAddress
Phone: fl?fc) 3Vî-Q4ù
.fr.
Phone:3 o¿luArchitect:
Mailing Address:
Email Address:
Remodel/Alteration
Attached
Engineen Phone:
Mailing Address
Email Address:
Manufactured Home lnstaller:Phone: I )
Mailing Address
Email Address:
PROJECT DETAITS
Describe Work:
Job Address;
Assessor's Parcel Number:
erock ßatr?z- ð8 A PCL
rb51Property Size (5q. Ft. or Acres):
Sq. Ft. of Buildingr fi of Floors
Class of Work;Addition
€arage:
Height:È's'bn
ed
t
ER
PñOJECT DETAILS CONTINUED
Septic:
Type of Heat:
Driveway
Permit;
NOTICE
Authorily. This
Natural Gas
Ëxempt
iK'"0'
Tàr*ðÀr'no,- N:
ù
ilding Perrnit must be signetl
Pernlit llr
ln Other
Community
flectric
I*c- Ì
a¡:plication for a Bu by tlre Owner of the property, described above,
or an authorized agent. lf the signature below is nr:t that of the Owner, a separate letter of authority, signed by
the Qwner, must be provicled with this Application.
lee¡l Aççes¡. A BLrilcling Permit cãnnrt be issueci without prnof of legal arrd adequate access to the property for
pulposes of inspections by the Buílding Division.
fthg¡*ge¡¡lrtt$, Multipie separate permits may be required: {1) State Ëlectrieal Permit. {2) Cor¡nty OWIS Permit,
{3) another permit roquired for urse on the property iclentified aleove, e,g.State or CoLrnty Highway/ Roacl Access
or a State W.3stewater Discharge Permit,
ygid eg¡rniL A Builcling Perrrrit becorles nuli ¿nd voicJ if the work autbori¿ed is not conrmencecl within 1.8Û days
of the date of issuance ancl if work is suspencled or abandoned for a period of L8û clays after coÍnrìlencernent.
CEAiFICATION
I hereLry certify that I have read this Application ancl that the infc¡rnration c,rntained above is true and ccrrect. I
unclerstand that the Br-rilding Division accepts thÈ Appl¡catiorr, along urith the plans and specifications and other
rJata submitted by nre or on my behalf (subrnittals), basecl upÐn my certificaticilr as to ãccuracy. Assuming
cornpleteness of the subrnittals arrd approval af this Applicåtion, a Building Pernrìt will be issued granting
permission to me, äs Owner, to construct the structure(s) and facilities detailecl on tlie subnrittals reviewecl by
the Builcling Ðívision. ln consideration of the issuance of the Buìldirrg Perrnit, lagree that lancl nly irgents tl./ill
comply with provisions of any federal, state or lelcal law regulating the work and the Garfield County Buílcling
Cocle, OWTS regirlatiorrs and applicable l¿nd use regr.rlations (County Regulation(s)). I aclotowledge that the
Building Permit may be suspencled or revokecl, upon notice from the County, if the location, construction or use
of the structure{s) and facility{ies}, dr:scribed abov€, ãre not irr cornpliance with County Regulationis) or any
other a¡:plicable law.
I hereby grant pernrissìon tc¡ the Buileling Ðivision to enter the property, cJ¡:scribed above, to inspect the work. I
furthe r ackrrowledge thêt the ìssuance oT the Bu¡lding Permit does not prevent the Builcling Official front: (1)
requiring the correctlon of errors in the submittals, if any, discovered af-ter issu*nce; or (2) stopping
construction or use of the structure(s) or facility{ies) if such is in violation of County f{egulation{s) or any r:ther
applìcable law. Review of this Application, including sulrmittals, ancl ins¡:ectìons of the work by the Building
Division clo not conFt¡tute ðn acceptânce of responsibility or liability by The Ctunty of errr:rs, omissions or
clíscre¡rarrcies, As the Owner, I acknowleclge that responsibility for compliance w¡th federal, state ¿nd local laws
and County Regulations rest with me ancJ rrry authorized agents, inclrrcling without linritation nty architect
designer,e¡1g,,,,,,,,,,,,,,,,!neerålcqgf bt¡ilcler'
I hereby acknowledge that I have read and understand the Noti
orovided the reouired information which is correct and accurate toarynrnr¿L*ril4;å, *É,
ce and Certifícation above, as well â$, have
the best of rny knowledge,
z z"Þz
lJate
s-7-23
Property Õwner Print and Sign
0tÐ;r#t
æear+âo/aedØNÞ
\OFFIËIAL USE ONtY
Special Conditlons;
Manu. Home Fee:
HìiËbD#t,îBtAdiusted Valuation:
,f B4q6q, Vb
BP Nor
mç-ß\ß("
OWTS No: '
SeÞst8+'"'Il.l'é3,or
Plan -Check F..ee:-773,Vç
6cl0,so
Fees Paid:
75
.""*.tl?á zo,ff:occ Group: RcSetbãcks:/)k
BUITDING / PLANNING CIIVISION :
Signed Approval Dãte
oo
Franring plans for each floor level and roof. All beams, columns, joists, rafters and trusses
specified. Pre-manufactured structures require lhe engineeis stamp, signalure arrd date,
Framing /corrnection details, braced wall lines, shear wall schedule, location anci hold downs
NOTE: lf any required information is missing, delays in issuing the permít are to be expected. lf
determined by the Building Official that additional information is necessäry to review the applicalion
and/or plans for compliance, the application may be placed on hold until the reqr-rired information is
provided. Work may not proceed without the issuance of a permit.
The Buitding Division will collect a Plan Review fee at time of application submittal. The permit fee, as
well as any Road lmpact fees will be collectecl when the permit is issued.
The permit application must be signed by the owner or by person having written aulhority from the owner
to act as their representative.
Building cannot be occupied until a Certificate of Occupancy (CO) is issued. Using lhe buil<ling without a
CO will be considered an illegal occupancy and may be grounds for vacating the premises, {Final/CO
inspection requirenrents will be attached to your approved fielcl set of plans.)
I heroby acknowtedge ! have read, understand and will abide by the requirements of this
checklist.
o
t
Ju*?ffi
Property Owner Print and Date
Jätr\6+.t- Þh\ ÊÉt\fir ðF [€*trp
I
Gorfield Counly
BUILDING DEPARTMENT
708 Eighth Street, Suite 407, Glenwood Springs, CO 87607
Tel: (970) 945-8272
PLAN REVIEW CHECKLIST
Permit No: øLKtr'O7-A3-B/8ó
Building lssues Planning/Zoning lssues Ru
e8þ1ry
/.4---rlo'
:/
^/A
ptic Permit and Setbacks
Grade/ Topography 30%
ttach Residential Plan Review List
Subdivision Plat Notes
AIA Fire De partment Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
ttach Conditions
Application Signed
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Energy Compliance Path/Plan Recelved
Plan Reviewer to Sign Application
Parcellschedule No.
40# Snowload Letter - Manuf. Homes
Soils Report
Property Line Setbacks
35 ft. Stream Setbacks
Flood Plain
¿/
Grade/ Topography 40%1
./
Planning lssues
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Subdivision P
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Irr wholn it cttttt:t'rtìs,
A¡lott Þaler lras been letained by ll. Arvicl .urd.l.rnet Johnson as Owner Repre*ent.tlive f()r llrr ¿dditiru'r
to the existittg residence of a honte lercated in Garfielcl Courrty at 47t County Roarl I I /, (,orlrondalo ( o
which property is ownecl Lry H Arvid ancl .lanet.lohnson. ln his capacity as Owner's Represent.rtive, A.¡rorr
Daler is representing tlre interest crf the Ownem of 471 County Roacl I l2 when rlealing wilh loc¿|, st¿te,
¡ncl federal governmental agencies, as well as sr¡bcontractors, rnatel'ial su¡lplies, ancl colrst¡ltanls
involvecl with the addition to 471 County Road 112,
{,
H. Arvid J nson