HomeMy WebLinkAboutApplicationGarfield County
REGENED
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-82L2
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BUILDING PERMIT
APPLICATION
TYPE OF
commercial/Multi-F Demolition
Manufactured Home (Single or Multi-Level)
x Residential (SF, Duplex or Townhome)Reroof
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF FEET
PropertyOwner: Jonqt^av^ ?,Jnt*@,a+O POuloS
Address: 15 81 Rioe. ße^d Naq , 6l*uood 9pß, La ât bot
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Mailing
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Contractor:
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Mailing Address
Email Address:
Phone:
Phone:
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AEngineer:
Mailing Address
Email Address:
Architect: È.ai L "le -
Mailing Address:
Email Address:
Phone: ( )
PROJECT DETAITS
Email Address:
Mailing Address
Manufactured Home lnstaller: N. A
F,'n is l^ Ò + u,,^ (i ni th ..) þa seaa u^+,Describe Work:
(À)6lq^
Assessor's Parcel Number:72_0 L
Sq. Ft. of Building:'?-t I 441'Ê.Height:
CÒ 9I
Property Size (Sq. Ft. or Acres):Owner's Valuation of Work:JÔO
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Job Address: l\Ø1 ItVer
Class of Work:ll! nemoOet/AlterationNew Inooition
tF AttachedGarage Detached
PROIECT DETAT t5 CONTIN U ED
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)). 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 Bu¡lding Official from: (1)
requiring the correct¡on of errors in the submittals, if any, discovered after issuance; or (2) stopping
construct¡on 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 Build¡ng
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
desi er neer or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the which is correct and accurate to the best of my knowledge,
Property Owner Print and Sign Date
Septic:)WTS Þ4Community
Type of Heat:Natural Gas Propane Electric Othe I
Author¡tv. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. lf the signature below is not that of the Owner, a separate letter of author¡ty, signed by
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.
Permit #:ExemptDriveway
Permit:
CERTIFICATION
OFFICTAL USE ONIY
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Special Conditions:
Misc. Fees:N/AAdiusted Valuation:qAb^o.oo Plan Check Fee:*q8Åô Perm¡t Fee:+.4ß2.1î"Manu. Home FeelN/A
Baq lance Due:
lÅF2.%
BP No:wq,:qtg UwnvnØ n tTV
OWTS No:Total Fees:*tqv.ryz Fees Paid:
4loo ,oo
oCC Group: IRO Const. Type: RO Zoning: PutoSetbacks:
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BUILDING / PLANNING DIV]SION :
Signed Approval
J
Date
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Garfield County
BUILDING DEPARTMENT
L08 E¡ghth Street, Su¡te 401, Glenwood Spr¡ngs, CO 81607
Tel: (970) 945-8212
PLAN REVIEW CHECKLIST
Permit ¡,to: ÞLff ' 04' l 4'Þ4 l 6
Building lssues Planning/Zoning lssues
N/A
N/a
NYA
ñ/e
x/a
ñ/e
N/A
Engineered Foundation
Driveway Permit
Surveyed Site Plan
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
Attach Conditions
Application Signed
Plan Reviewer to Sign APPlication
Parcel/schedule No.
40# Snowload Letter - Manu. Homes
Soils Report
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees
Grade/ Topography 40%
Planning lssues
Subdivision Plat
VA
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Descriotion & Summa
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