HomeMy WebLinkAboutApplicationDocusign Envelope lD: 161CE836-A58A-45FC-A566-16539D6EF20C
Com m unity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
1970194s-8212
www.garfieldcountvco.gov
TYPE OF CONSTRUCTION
INVOTVED PARTIES
Garfield County
BUILDING PERMIT
APPLICATION
tr Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
tr Rerooftr Residential (SF, Duplex or Townhome)
tr Manufactured Home or Tiny Home (Single or Multi-Level)
tr Demolitiontr Commercial/Multi-Family
tr Move/RelocationE RepairEl AdditionE Remodel/AlterationE NewClass of Work:
JobAddress: Tbd County Rd 320, Rifle, CO 81650
15'
Describe 1111or1, New Modular (lRC) Home
2052Sq. Ft. of Building:
423.424Owner's Valuation of Work: $
f of Floors: 1Height:
2.233Property Size (Sq. Ft. or Acres)
Lot 2 Block
Assessor's Parcef Number: 217527401002
Sub. Dotson Minor
PROJECT DETAITS
Phone: (970-718-5504
789-5448Phone:435Civco EnqineerinqEngineer:
Home lnstaller: Jamie BUrChManufacturedl Tiny
Address: PO Box 1758, Vernal, UT 84078Mailing
vanceking@civcoengineering.comEmailAddress:
Emait Addresr. jamiebeyes@gmail.com
3027 Palterson Rd, Grand Junction, CO 81504Mailing Address
Phone: (_)N/AArchitect:
Mailing Address
EmailAddress:
Email Address: clavicl-mahovsky@elaytonhomes com
671 23 Rd. Grand Junction. CO 81505
Phone:( 970i249-9939--contractor: Clayton Homes
Mailing Address:
Address: 8495 Hwy 6 &24, Parachute, CO 81635
Property
Mailing
con radfa m i lv89(Oo ma i l. comEmail Address:
owner: Conrad, Kurtis & Nicole & Booker, Me lissa6on", t g70t216-0912
Garage:E Attached E Detached
Docusign Envelope lD: 161CEB36-458A-45FC-A566-16539D6EF20C
PROJECT DETAITS CONTINUED
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 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 of the 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 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
provided the required information which is correct and accurate to the best of my knowledge.
by:
wicole Conrad 6/2/202s
Property Owner Print and Sign Date
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 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.
CERTIFICATION
E Permit #:E Exempt
NOTICE
Driveway
Permit:
E PropaneE Natural GasType of Heat:E otherE Electric
E CommunityE oWTSSeptic:
Signed Approval
hl,'r*h
Date
Tz?tsPIANN;NG D1VtStOft2,424BUILDING /
RZoning:Setbacksi
OWTS No: '
E-Efif.q3ilj
Const
BalanceFees Paid:
I
a2 No:_
tz I ?e:
OCC Group:
'"'^)l"ilbz, ''
'"p)'i,'zsPlan Check Fee:
4/9. +F
Misc Fees:
R.tFes>+l.5qB't{s".8ft:lAdiusted Valuation:qt,249.u
seealtacheel ANb ffIONSSpecial Conditions:
\OFFICIAL USE ONLY
Docusign Envelope lD: 161CE836-A58445FC-A566-16539D6EF20C
MANUFACTURER'S AND/OR ENGINEER'S STRUCTURAL PLANS: Provide the following
information.. SOILS REPORT - lf the project is located in a subdivision with a final plat requiring site specific
soils investigation report or if Structural plans make a specific reference to a soils report, then a
copy of the soils report is required to submit a building permit application.. Design specifications to include roof and deck snow load, wind and seismic design and frost
depth.. Foundation plan showing complete footing and foundation dimensions.. Footing and foundation details specifying reinforcement and referenced on plans.. Framing plans for each floor level and roof. All beams, columns, joists, rafters and trusses
specified. Pre-manufactured structures require the engineers' stamp, signature and date.. Framing /connection details, braced wall lines, shear wall schedule, location and hold downs.
NOTE: lf any required information is missing, delays in issuing the permit are to be expected. lf
determined by the Building Official that additional information is necessary to review the application
and/or plans for compliance, the application may be placed on hold until the required information is
provided. Work may not proceed without the issuance of a permit.
The Building Division will collect a Plan Review fee at time of application submittal. The permit fee, as
well as any Road lmpact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by person having written authority from the owner
to act as their representative.
Building cannot be occupied until a Certificate of Occupancy (CO) is issued. Using the building without a
CO will be considered an illegal occupancy and may be grounds for vacating the premises. (Final/CO
inspection requirements will be attached to your approved field set of plans.)
I hereby acknowledge I have read, understand, and will abide by the requirements of this
checklist.
t
DocuSlgned by:
t',li col e Con rad 6/2/202s
Property Owner Print a 431...Date
24
Gurfrcld County
BUILDING DEPARTMENT
108 Eighth Street, Suite 401, Glenwood Springs, CO 81601.
Tel: (970) 94s-8212
PLAN REVIEW CHECKLIST
Permit No:6LnF-o6-35-Q3o?
Building lssues
NA
1 subdivision Ptat
y Permit
Surveved Site Planflffirobz,-?3lo
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
ttach Conditions
Engineered FoundationoR6zt-P-tz
Application Signed
*hru t RcJ
Energy Compliance Pa{h/P
Pla n ning lToning lssues t)
Grade/ Top6graphy 40%
Planning lssues
Property Line Setbacks
35 ft. Stream Setbacks
,,""rl@t;/g*rh
Building Height
Zoning Sign-Off
Road,rmpact Fees R.tF 6 '8,>/
qqd6b Raol zo244S@s ("eol
^z+^ilDescriotion & Summarv:m$lr
r_ (cD@H)
Plan Reviewer to{gn
-/Parcel/ Schedule No.
2,052 modular ,,
nhfVf lwne -f q6P, ao
lan Reqeived
Application
40# Snowload Letter - Manuf. Homes ZO52 crdtal x Z4 l/r2,/6.oo
5q8?")I{
Soils Report
(tf s.E.D. R