HomeMy WebLinkAboutApplicationGarfield County
BUILDING PERMIT
APPLICATION
Development Department
; rl- f , I '.t ,frpf,,8'n Street, Suite 401
' i - (9701945-8212
'' I www.Farfi eld-countv.com
TYPE OF CONSTRUCTION
Commercial/Multi-Familv Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
,x Accessorv Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
Property Owner:
Mailing Address:
Email Address:
EP-Nr'l'cr> LLa Phone: t17r. I 3t1'U:,bL
broul a l[c, ut /
Contractor Phon e:{
Mailing Address:
Email Address:
Architect:Phone:{ ?ot l .4o4 -21'o
Mailing Address:
Email Address:
-5-62t1- +e4
Engineer ?,d.Phone: (
Mailing Address:
Email Address:
/?40C' U brdLt&tt't Ro #ni<Atn tq/A ?qn+
Manufactured Home lnstaller:Phone )
Mailing Address:
Email Address:
PROJECT DETAITS
Describe Work:lb
Job Address:
Assessor's Parcel Number:
Sub.Ntu'etz vl az^/ ,An*e*Lot 6 Block
Owner's Valuatio n of Work: S PropertySize (Sq. Ft. or Acres):
Sq. Ft. of Building:Height:# olFloorst /
Class of Work lXlrue*Remodel/Alteration Addition
Garage:hed Detached
Septic:
Type of Heat:Electric
Community
Other
Driveway
Permit:
PropaneNatural Gas
Exempt
PROJECT DETAI tS CONTINU ED
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
purposcs of inspcctions 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.
VoidPermit, ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
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 nry behalf (subrrrittals), based uporr rrry certification as to accuracy. Assurrrirrg corrrpleterress
of the submittals a nd 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
applicablc land usc rcgulations (County Rcgulation(s)). All County dcvclopmcnt rcquiring a pcrmit, cxccpt for
residential uses, are subject io Article 7 of the Land Use and Deveiopment Code. i acknowledge that 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.
lherebygrantpermissiontotheBuildingDivisiontoentertheproperty,describedabove,toinspectthework. 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 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
acceptanceof responsibilityorliabilitybytheCountyoferrors,omissions,ordiscrepancies. AstheOwner, 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
provided the required information which is correct and accurate to the best of my knowledge.
2
Property Owner Print and Sign Date
,z
OFFICIAI. USE ONIY
SpecialConditions: ,, I / Af, l tr\- t*t.a A l-ereffiUled( u-{//Ut)/ / /A/V>
Adiusted Valuation:
t2?^ 02q.7a
Plan Check Fee:
741- tF '*i.'\Elzg Manu. Home Fee:Hi'iH'*o-Plgt
Tota a4Ita
Fees Paid:nce D
occ G Const. Type:
.t4
ZoniSetSacks:
-cahlL 7t-%
Date
recer redcoardddalp defarH 6,ao.26)
6Utorrue / PLANNTNG Drvrsrdff:
Signed Approval
Garfield Coanty
BUILDING DEPARTMENT
108 Eighth Street, suite 401, Glenwood Springs' CO 81601
Tel: (97o) 94s-8212
PI.^AN REVI EWCH ECKLIST
Permit No, /l/e/ t\/arl
Grade/ Topography 30%
Attach Resident'id Plan Review List
Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
I,ferzlt flhe'
o
Building lssues
4 arevsAe// /R€-og-a4
Engi.neered :Foundatto.n
Planning/Zoning lssues
35 ft. Stream Setbacks
,
Flood Plain--7-
//
CbN>
A/k
'Bui'iciing fieight
Zoning Sign-Off
Grade/ Topography 40%
Planning lssues
Subdivision Plat
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7)ebo.e
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Soils Report o?q,70
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