HomeMy WebLinkAboutApplicationGarficld County
BUILDING PERMIT
APPLICATION
_ _ ^Qemmunity Development Department
REcElvEDtogS'n street, Suite 401
JUN I 7 Zflqn*ood springs, co 81601
l970l94s-82L2
G A r< t- r E L D C Otrtt$ifrYcarfield-cou ntv.com
Jourl,,: i,tt t'r Dt\rrl ffi F
DemolitionCommercial/Multi-Family
Manufactured Home or Tiny Home (Single or Multi-Level)
I ReroofResidential (SF, Duplex or Townhome)
Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
Property owner: Chris Harvey Phone:
Maillng Address: 0993 Miller Ln., Rifle, CO 81650
EmailAddress:ch risha rvey0993@gma i l. com
{970 )618-8783
456-7122970Phone:Contractor:JNB Renovations, LLC
Mailing Address:506 County Road 294, Rilfe, CO 81650
EmailAddress:i nfo@ n b renovations. com
Phone:()Architect:
Mailing Address:
EmailAddress:
Englneer:
EmailAddress:
Phone: ()
Mailing Address:
EmailAddress:
Covered deck additionDescribe Work:
Sq. Ft. of Building:Height:
Phone:(
Job Address:0993 Miller Ln., Rifle, CO 81650
( 36,575.00
i \',itii., r jJl tot
L
1? :'.:. . i
t 'rlr. ". \'' I.ri., .i I "'
Own e r's Va I u ati 9 ir;Jof Work:
Sub.
Manufactured Home lnstaller:
Mailing Address:
217906100631
fof
Block
Assessor's Parcel Number
Property Size (Sq. Ft. or Acres|:
I ,:" i r'ri,',
r'New RemodeUAlteration AdditionClass of Work:
DetachedGarage:Attached
Septic:OWTS Community
Type of Heat:atural Gas Propane Electric Other
Driveway
Permit:
Permit #:
Aulhqtlv. 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 authority, signed by
the Owner, must be provided with this Application.
Lesal 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.
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)). All County development requiring a permit, except for
residerrtial uses, are subject [o Arlir-le 7 ol"the Land Use and Developrr]ent Code. I ackrrowledge tlrat the Building
Permit may be suspended or revoked, upon notice from the County, ifthe location, construction or use ofthe
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 t2) 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
is correct and accurate to the best of my knowledge.
Owner Print and Sign Date
Special Condltions:
"Adiusted Valuation:
TQ sZe .A Plan Check Fee:tn.B \
Permit Fee:lBt.z>Manu. Home Fee:Misc. Fees:
Jotal Fees:
b 2q'1. .oL Paid:€oqr,ftalance Due:
V 2e1.Ee <4q)BP No:
WAL
OWTS No:
Setbacks:zoflc:
BUITDING / PLANNING DIVISION :
OCC Group:Const. Type:
Date