HomeMy WebLinkAboutOriginal Building Permit ApplicationGarfuId Countyt?rc
MAV '[.1 ] Ggffiunity Development Department
'ir \r
108 8th Street, Suite 4Ol
i I I ii :.tliU;]{-n{".odSprings,co81601. . :. i:i, -i:, i,.'
19zo; g4s_a2lz
www.ga rf ield co u nUco.gov
,1-
$N
$$
BUILDING PERMIT
APPLICATION
tr Commercial/Multi-Family tr Demolition
tr Manufactured Home or Tiny Home (Single or Multi-Level)
tr Residential (SF, Duplex or Townhome)tr Reroof
Dwell Unit - MAXIMUM SIZE OF FEET
propertyowner: 4cm *' J,u9* 1n;Z|Zphone: {q7ol n4(
Email Address:Gtvvtlt ,Lottt,
JU
looi-T t LLstut-bou-o to
Mailing Address:JE
Mailing Address:
Email Address:
DQPgL Phone:Contractor:
(
Architect:AJBa^s,D-bJo
Email Address:a){vt
Phone:4lo 0t o o
r,Bn rS*Jau^JAa"rH tfrt-f fl. A
Mailing Address;lo
1to lAcbt
Po s
6r^)J
Engineer:
Mailing Address:
Email Address:
Assessor'sparcetNumber: L3 q 5 O? I O Ce o ll
Describe Work:
Job Address:
owner'svaluationof work $ |5q it*Lr7At
sq. Ft. of Buirding: futhfiUL1'bl Height:
Phone:
t)
9
[ot
Floors: 2-I
(L
,11 tc(Sq. Ft. orAcres):
" To(l
Manufacture dl TinV Home lnstaller:
Mailing Address:
Email Address:
I eloct b
Class of Work:p[ ruew El Remodel/Alteration El addition [J Repair tr Move/Relocation
Garage:AAttached E Detached
PROJ ECT DETAII.5 SOI{TINUE D
Septic Community
Type of Heat:EI Natural Gas Electric E other
: Driveway X Exempt El Permit f:
Permit
NORCE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
Legal Access. A Build ing 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 rnay 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 commencernent.
CERTIFICATION
lherebycertifothatlhavereadthisApplicationandthattheinformationcontainedaboveistrueandcorrect. lunderstand
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 rne, 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 perrnit, except for residential uses, are subject to Article 7 ofthe 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 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 ofthe 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 a or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the requ ired information which is and accurate to the best of my knowledge.
l,4A/ 4-,U?At -,
Property Owner Print and Sign Date
oFFlctAL usE otrltY
Special Conditionsl
Adjusted Valuation:Plan Check Fee:Permit Fee:Manu home Fee:Misc Fees:
Total Fees:EEA'U
Balance Due:BP No:
6T-0F,.q*4)OWTS No:
Setbacks:OCC Group:Const Type:toK'
EUtLDtNG / pUwwtrue DIVISION :
Signed Approval Date
Gurficld Counfit
Com munity Development Department
1O8 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l9rts-82t2
www.garfieldcou nwco.gov
rltr
lllr
BUILDING PERMIT
FEE ESTIMATE
WORKSHEET
beq/Licant:1
Lot:Block:
Project Ad orrl-tdress:5oe3
7 I \14t L,o S101.4sItjFinished Living Space (N/A for Manufactured Homes)
S32.ooUnfinished Basement
Crawl Space
I Lt o-gGaraee (Attached)
s40.00Garase (Detached)
Ia eCovered Patio/Deck
s18.ooUncovered Patio/Deck
5o.ooMisc:
50.00Misc:
5o.ooSinele Level (5400)
5o.ooMulti-Level (5500)
$o.ooTotalValuation
Total Set-Up Fee So.oo
New lnstallation {5600)
Seotic - Maior Reoair (New Svstem & 5TA) (5600)
Septic - Minor Repair (Tank Onlv) {52O0)
Alteration (5200)
So.ooVault & Haul ($75)
Total Septic Fee 5o.oo
Plan Review Fee
Building Permit Fee
Manufactured Home Set-Up Fee
Septic Fee (OWTS)
Other {Ex: Road lmpact Fee}
This Section Determined by Garfield County
Total Fees Due
***All fees are estimates until final plan review is completed***