HomeMy WebLinkAboutApplicationGarficld County
Community Development Department
108 8th Sueet, Suite 401
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BUILDING PERMIT
APPLICATION
lTlFFttrcUr(I'*f n'u cn o r,r
tr Commercial/Multi-Family tr Demolition
El Manufactured Home or Tiny Home (Single or Multi-Level)
tr Residential (SF, Duplex or Townhome)tr Reroof
tr Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
IKPhone:(r
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Email Address:fi..,
Property Owner:
Mailing Address:
contractor: &t futo B*.\L-r Phone: flS th*- oLT*
Email Address:r ,. FoO nck?t,ab*-\l-q,x" r
Mailing Address:ltvL3
Phone:(Architect
Mailing Address
Email Address:
Engineer: Phone:
Email Address:
Mailing Address
Manufactured/ Tiny Home lnstaller:
Email Address:
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4Mailing Address 6oS r-r.Ctosf'0". S,lFa {'t
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PROJECT DETAILS
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Height:
Job Add ,"rr, f4 Iq 6-^h eJ
Sq. Ft. of Building:t\bo
Describe Work:
tg
+6
€
Assessor's Parcel Number:
t L +6 L^r'r tL
oor, L
Owner's Valuation of Work: S
Sub.
"1Ll fofFl
Lot Block
PropertySize (Sq. Ft. orAcres): T
E Addition E Repair tr Move/RelocationClass of Work:.E New E Remodel/Alteration
E DetachedGarage:E Attached
PROJECT DETAILS CONTINUED
Ul owrs
E Natural Gas
CERTIFICATION
E Community
E Propane
acknowledge that I have read and understand the Notice and Certification above, as well as, have
required information which is correct and accurate to the best of my knowledge.
b- ttt-L{
Property Owner Print and Sign Date
Septic
Type of Heat:Ef Electric E other
Driveway
Permit:
E Exempt E Permit #:
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
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.
I hereby certify that I have read this Application and that the information contained above is true and correct. I understand
thatthe Building Division accepts the Application, alongwith 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 residential uses, are subject to Article 7 of the Land Use and
Development Code. I acknowledge that the Building Permit may be suspended or revoked, upon notice from the County, if
the 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 Pertnit 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 otheniapplicable 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
bytheCountyoferrors,omissions,ordiscrepancies. AstheOwner, lacknowledgethatresponsibilityforcompliancewith
federal, state, and local laws and County Regulations rest with me and my authorized agents, including without limitation my
architect d en eer and/ or builder
OFFICIAT USE ONtY aG
't ,
see atbaSpecial Conditions:
Manu home Fee:
$ 6ce-a H7
Plan Check Fee
/4,E. U Permit Fee:aaz,a5Adiusted Valuationh,m.e
OWTS No:t*:ttr -R?+3
Balance Duer ,;ha.oh BP No:ffitr-ffi;.'$ufiI."oTotlal Fees:qb 8,eb
Zonine:zriConst Tvoe::890.Setbacks:OCC Group:IPC-
BUTLDTNG / PLANNTNG DIVISION :
Signed Approval Date
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BUILDING DEPARTMENT
lol Eighth Street Suite 401; Gtenwood Springs' co 87607
Te!: (970) 945-8272
PLA N REV EW CH ECK ril5Til
Building lssues
permit No: FLT2FA 7*24-8 772-
PI nninglTaning lssues R.9
nhl)a-vL-,
P rope-rlY Line Sethacks
35 ft. Stream Setbacks
Flood Plain
Buitding Height
ZoningSign-Off
Grade/ TogagraPhY 4O%
Planning lssues
Subdivision Plat
Deseri ion Sunn a
a 6rr/0-dunolr
Fcurnd+tbEo
DrivewaY Permit
S+r'bd,i'visb+ P !a€ Flote s
re Department Review
aluation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
ttach Conditions
T@Road rmpact Fees Rl F E, E'D
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