HomeMy WebLinkAbout5882 BUILDING PERMIT APPLICATION
L GARFIELD COUNTY, COLORADO •
Applicant to complete numbered spaces only. PERMIT NO. 'J P ARCEUSCHED NO.
J00 ADDRESS / .. - ) a SG.L7
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1 5
M S GR ,
LOT P J PR T OP r/ Ii) 4es1 "*S- � f/
sueDIVISION , vie 6,/,p � G�T /�C. / u
2 OWNER fk ddd 4- IIL/LIna. rely ADDRESS . 3 Oft W.3 D *54•u14g;Tit PH. G S'37- ry q WK PH. SLi— x('T
37,2
3 CONTRACTOR g f w j ADDRESS 54 PH. sh a. LICENSE NOS
-
4 ARCHITECT OR DESIGNER N(4- ADDRESS PH. LICENSE NO.
5 ENGINEER ,t1;/1- ADDRESS PH. LICENSE NO,
6 S,F OF BUILDING l 0 S.F OF LOT 'I IJ Qc `P p f1rcP., HEIGHT NO. OF FLOORS
7 USE OF BUILDING 4Urr 1
th �
8 CLASS OE WORK: KNEW o ADDITION oALTERATION aREPAIR rMOVE nREMOVVE
9 DESCRIBE WORK: � re .CI n r P '5 IcOrtintl,M Q+I$$ . 1% J DIN f •
A.,-,,,le - , ;4,_ (r $iIt In 0MP
10 GARAGE SINGLE DOUBLE 1 . 4 1 a CARPORT SINGLE DOUBLE iss z'
DRIVEWAY PERMIT ON SITE SEWAGE DISPOSAL PERMIT SITE PLAN lIJ6
`
11 VALUATION OF WORK: $ 51 ADJUSTED VAL$ PLAN CHECK FEE S9, ../ PERMIT FEE t' 1 7 r Z
SPECIAL CONDITIONS : /716 Q /,/ a 0 _ D tit IV SCHOOL Ii 6 O 6 PARCEL BUILDINGS ON U CEL UILDINGS NOW ON
��{{ �l 7 TOTAL FEE OCC. GR. CONST, TYPE
C//
NOTICE WATER SUPPLY DATEPERMITISSUED .., " Ifr�
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING, '
VENTILATING OR AIR CONDITIONING. SPECIAL APPROVALS REQUIRED RECEIVED Nor REWIRED
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 HEREBY 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 REGULATIN CONSTRUCTION OR THE PERFORMANCE OF SETBACKS
CONSTRyr,TION , p
hn 1 ID j — it
FLOOD HAZARD
Signature of Owner, Contractor or authorized
Y uthorized agent i g r : u y•.d notice ..ova. D .
%Tv r6 ."1!7 . 3 J Q / // � p lvi MANUF. HOME a�0
.7
Building Department Approve /date = arming Departmen Apr or: •
OTHER �$,n5 JSd, d d
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 30.28201 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,
Garform,003 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ AND UNDERSTAND THE AGREEMENT ABOVE (INITIAL /- < 1
•
I hereby acknowledge that 1 have read, understand and answered these
questions accurately to the best of my ability.
e �>
3-3 -9(,
signature date
Phone: Y c 7e2 (clays); 4,25 37 C9 (evenings)
Project Name: /, v clkj t 5 ro'( RSi°644 (
Project Addressor c'1 Y get th ,2 R
Notes:
(1) if you have answered No on any of these questions you may be required to provide this information at
the request of the Building Official prior to beginning the plan review process. Delays in issuing the
permit are to he expected. Work may not proceed without the issuance of the permit.
(2) If you have answered Not necessary for this project" on any of the questions and it is determined by the
Building Official that the information is necessary to review the application and plans lo determine
minimum compliance with the adopted codes, please expect the following:
• A. The application may be placed behind more recent applications for building permits in the review
process and not reviewed until required information has been provided and the application
rotates again to first position for review.
B. Delay in Issuance of the permit.
C. Delay in proceeding with construction.
(3) If you answered No to this question the circumstances described in the question could result in a "Stop
Work Order" being issued or a "Certificate of Occupancy" not being Issued -
PerApp02.95 Effective August 15, 1995
•
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