HomeMy WebLinkAboutApplicationGorJield Coanty
Comm unity Development Department
108 8th street, Suite 401
Glenwood Sprlngs, CO 81601
(970) e4s-8212
www.sarf iel d -co qllty. com
BUILDING PERMIT
APPLICATION
DemolitioncommerciaUMulti-FamilV
Manufactured Home or TinY Home (Sinsle or Multi-Level)
II ReroofResidential (SF, Duplex or Townhome)
Accessory Dwelling Unit (ADU)- MAXTMUM SIZE OF 1,200 SqUARE FEET
Property Owner:
Mailing Address:PO Box 908, Glenwood Springs, CO 81602
Emall Address:paul,tomashosky@integralsdmtn.com
{970 )945-7653Adan ganlana, Slndra Rles/Matlhew[litne, [iolly l'lorFn/Dakolr [lea*tu. nOO phon":
PO Box 436, New Castle CO 81647Malllng Address:
Contractor:Storm King Roofing Phone:
Email Addressr katie@stormking roof . com
{970 \876-4146
Ph one: { IArch ltect;
Mailing Address:
Emall Address:
Ingineen Phone: ( I
Malling Address
Email Addressr
Remove and dispose of existing asphalt shinlles, install flashing, high
temp ice and water shiold and Malarkey asphalt singles to manufacturer'sspecs,
Descrlbe Workr
Job Address:126 and 128 Dakota Meadows Dr (duplox),.
Sub,Dakota Meadows Row House - tlot 25A-25B rio.U
Phone: { }Manufactured Home lnstaller:
Sq, Ft, of Building:Helght:ll of Floors:
Assessor's Parcel Number 2391 33203045 I 239133203046
Owne;'s Valuatlon of Work: $
Mailing Address:
Emall Address:
29996 , i Property Size (6q. T. or Acres):
Rehrodel/Alterdtion ditionClass of WotrR:New
DetachedGatage:Attached
Septlc:CommunityOWTS
Type of Heat:Natural Gas Electric
Driveway Permlt #:
Pernrit:
Authorltv, This application for a Building Pcrmit must bo signed by the Ownor of the property, described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
Legal Access, A Building Permlt cannot be issued without proof of legal and adequate access to the property for
purposes of inspections by the Building Division,
Other Pernlits. Multiple separute pernrits nray be required: (1) State Electrical Permit, {2) Couttty 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,
Vgld.Pgf nllt A Bulldlng Permlt becomes null and vold lf the work authorlzed ls not commenced wlthln 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 a bove is true and correct, I
understand that the Building Divislon 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 Bullding Permit, I agree that I and my agents will comply with provislons of any
federal, state, or local law regulatlng 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
resldential uses, are subject to Article 7 of the Land Use and Development Code. I acknowledge that the Building
Pur rrril r ray Lru susper rded ul r evuked, upurr rru[iue fr urrr llre CuurrLy, il [lre luuatiur r, uutrsttue tiutr ur use ol the
structure(s) and facility(iesJ, described above, are not in compliance with County Regulation(s) or any other
applicable iaw.
i hereby grani permission io the Buiiciing Division io enter the properiy, ciescribeci above, to inspect the work, i
further acknowledge that the issuance of the Buildlng Permlt does not prevent the Building Official from: (t) requiring
the correction of errors in the submittals, if any, discovered after issuance; or (?) stopping construction or use of the
structure{s} or facility(iesi 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 agents, including wlthout llmltatlon my archltect designer, englneer and/ or builder
I hereby
Propeny Print and Slgn
have read and understand the Notlce and Certlfication above, as well as, have
rmation whlch ls correct and accurate to the best of my knowledge
Date
Speclal Conditions:I
Adjusted Valuationl Misc. Fees:Plan Check Fee:-r8-T'65":oo Manu, Home Fee:
'T2i5.*Fees Paid:cp\ oo,Balance Due:4-ffiY*r1A OWTS No:
Tanino'-Siif)Sotbacksr *TflDl-'Tr22-
Signed Atrproval Date
.,9<BUTLDINC /PLANNING DIVISION:4-t