HomeMy WebLinkAboutApplication- Permit 1
BUILDING PERMIT APPLICATION
GARFIELD COUNTY, COLORADO
Applicant to complete ' n L umbe er re Q d / spaces only. PERMIT NO. 5 ?50 PAR,EUSCHED NO. •
JOB ADDRESS ! le ] f 7 .(/7 - L ( J? I fflet ��
1 LEGAL LOT NO. BLOCK SUBDIVISION
DEESCR. ,11 (�
2 OWNER M ,i4 eaw ADDRESS 60 Hy' 82 PH. WK. PH.g4 11
3 CONTRACTOR 4 • 0. 1 7t.'( 40N ADDRESS Q, 0� 1 •• 03/4-10 fll pH./451745 LICENSE NO. /
4 ARCHITECT OR DESIGNER 012,ge, jriA'V ADDRESS 715 417 P811440 LICENSENO.0 , I iO)
5 ENGINEER PAT rruo 700" ADDRESS 7190,4445, pl-e q# LICENSE NO. lco7g9-
6 S.F OF BUILDING 17, q?.Z S.F OF LOT 670 HEIGHT I NO. OF FLOORS 2
7 USE OF BUILDING9/0//
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8 CLASS OF WORK: o NEW )(ADDITION oALTERAATTION c REPAIR
/y o � MOVE oREMOVE
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9 DESCRISE 467o .9p e / / ?j mn G
VP 60 f a t yr
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10 GARAGE SINGLE DOUBLE CARPORT SINGLE DOUBLE
DRIVEWAY PERMIT ON SITE SEWAGE DISPOSAL PERMIT SITE PLAN
11 VALUATION OF WORK: $99 /!f, c23 .20 ADJUSTED VALS PLAN CHECK FEE 57o ,7/ PERMIT FEE / ;7, 1 � j
SPECIAL CONDITIONS: J ✓ SCHOOL IMPACT FEE / NO. OF BUILDINGS ON USE OF BUILDINGS NOW ON
5 / L b n ',/ /r, 79 _ q o 0 D 3 3° TOTAL FEE � � , f � /j OCC / J COtJSTLTYPE � / '
NOTICE WATER SUPPLY DATE PERMIT ISSUED 9 -4/ -,42
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL PLUMBING, HEATING,
VENTILATING OR AR CONDITIONING. SPECIAL APPROVALS REWIRED - RECEIVED NOT REQUIRED
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS ZONING
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED
OR ABANDONED FOR A PERIOD -OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. HEALTH DEPT.
I HERESY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW
THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES FIRE DEPT.
GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE SOIL REPORT
AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
LOCAL LAW REGULATING CON OR TH PERFORMA.NCE OF SETBACKS
OONSTRUC , _
roar. /Pi.:L�. 40 FLOOD HAZARD
Signature of Owner, on factor or authorized agent ifi od noti•- at.ve. —
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Building Department Approvaldate n P. Ling Department Apy ':8
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AGREEMENT
PERMISSION IS HEREBY GRANTED TO THE APPLICANT AS OWNER, CONTRACTOR AND /OR THE AGENT OF THE CONTRACTOR OR OWNER TO
CONSTRUCT THE STRUCTURE AS DETAILED ON PLANS AND SPECIFICATIONS SUBMITTED TO AND REVIEWED BY THE BUILDING DEPARTMENT
IN CONSIDERATION OF THE ISSUANCE OF THIS PERMIT THE SIGNER HEREBY AGREES TO COMPLY WITH ALL BUILDING CODES AND LAND USE
REGULATIONS ADOPTED BY GARFIELD COUNTY PURSUANT TO AUTHORITY GIVEN IN 30.28.201 CRS AS AMENDED. THE SIGNER FURTHER
AGREES THAT IF THE ABOVE SAID ORDINANCES ARE NOT FULLY COMPLIED WITH IN THE LOCATION, ERECTION, CONSTRUCTION AND USE OF
THE ABOVE DESCRIBED STRUCTURE. THE PERMIT MAY THEN BE REVOKED BY NOTICE FROM THE COUNTY AND THAT THEN AND THERE IT
SHALL BECOME NULL AND VOID.
THE ISSUANCE OF A PERMIT BASED UPON PLANS, SPECIFICATIONS AND OTHER DATA SHALL NOT PREVENT THE BUILDING OFFICIAL FROM
THEREAFTER REQUIRING THE CORRECTION OF ERRORS IN SAID PLANS, SPECIFICATIONS AND OTHER DATA OR FROM PREVENTING BUILDING
OPERATION BEING CARRIED ON THEREUNDER WHEN IN VIOLATION OF THIS CODE OR ANY OTHER ORDINANCE OR REGULATION OF THIS
JURISDICTION.
THE REVIEW OF THE SUBMITTED PLANS AND SPECIFICATIONS AND INSPECTIONS CONDUCTED THEREAFTER DOES NOT CONSTITUTE AN
ACCEPTANCE OF ANY RESPONSIBILITIES OR LIABILITIES BY GARFIELD COUNTY FOR ERRORS, OMISSIONS OR DISCREPANCIES. THE
RESPONSIBILITY FOR THESE ITEMS AND IMPLEMENTATION DURING CONSTRUCTION RESTS SPECIFICALLY WITH THE ARCHITECT, DESIGNER,
BUILDER AND OWNER. COMMENTS ARE INTENDED TO BE CONSERVATIVE AND IN SUPPORT OF THE OWNERS INTEREST. ��/
Gartorm.003 I HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERS AND THE AGREEMENT ABOVE IINITIAIILaw Z
6 : 1 r V '77,62-7,-) A.ofee