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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(s7ol e4s-82L2
www.ga rfield-cou ntv.com
Commercial/M u lti-Fami Demolition
Dwell Unit . MAXIMUM SIZE OF 1,OOO SQUARE FEET
Property o*n.rr,fl/i(o + llãssìra R ee Phone: tQl0 I 37q - /,,f5 O Í
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Mailing Address:
Email Address:
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Contractor:"/Y:ko P,, o Phone::? r?-dgsô
Mailing Address:
Email Address:
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Architect:Phone: €lO I l9q -SøS y
Mailing Address:
Email Address:
Engineer:Yte{tllï tw4-osno
Mailing Address:
EmailAddress:
Manufactured Home lnstaller:Phone: I
Mailing Address:
Email Address:
Describe workr 3 t kÇo twt ncsì+e4f ù 6,!- ho,-n e.-
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Job Address:.rl
Assessor's Parcel Number: I3I f /ô,ô9o 75
Sub.øt 75 Brock--
Owner's Valuation of Work: $Property Size (Sq. Ft. or Acres): Jz-ù/--oç¡es
Sq. Ft. of Building:Height:
Class of Work Addition
t
(
a
Residential or TownhomF, DU
nufactured Home eor
Reroof
rl
Garage:
0
a-
Remodel/Alteration
#of
Detached
DETAIIS CONTINUED
Community
Type of Heat:atural Gas Propane Electric Other
Driveway
Permit:
mpt
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
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
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 land 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 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
e neer a 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.
5-- /7 -2t
Property Owner Print and Sign Date
Permit #
OFFICIAL USE ON[Y
Special Conditions:
Adiusted Valuation:*iqry,aÐ og
Plan Check Fee:
6l"zqz,8b
Permit Fee:i t-QQO,6-6
Manu. Home Fee:
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Misc. Fees:.
Rltr= $1.399,70
Total Fóes:
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Fees Paid:
$ ¡er s.t¿
Balance Due:
+Lqqr)"56
BP No:
BLfae - oSt l
OWTS No:
Cor'tuv N lly
Const. Type:
tl¿3
Zoning:?uÞSetbacks:¡ . . .ü)ndtt0n OCC Group:
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BUILDING / PTANNING DIVISION
Signed Approval Date
{,-?-21
Garfield County
BUILDING DEPARTMENT
108 Eighth Street, su¡te 407, Glenwood Spríngs' CO 81607
Tel: (970) 945-8212
P N REVIE W CHE CKLIST
permit no: ßLRl- 0l- 2l - bøb I
Pl a n n i ng I Zoning lssues
aNr
ues
Engineered Foundation
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Ñ4.- se ptic Permit and Setbacks
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¡(-zoÐ)AIA Ftood Plain
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IIJft
Property Line Setbacks
30 ft. Stream Setbacks
Building Height
Zoning Sign-Off
Road lmpact Fe þel.,Vtrtv)
NA Grade/ropography 30% SW
L./Attach Residential Plan Review List^
360bs,1,
subdivision ptat Notes
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Fire Department Review fl0T,9,
Valuation Determination/ Fees
Red Line Plans/ StamPs/ Sticker
Attach Conditions
t/N k Grade/ Topography 40%
r/ Planning lssues
Subdivision Plat
746q?5
Description & Summarv:Application Signed
Plan Reviewer to Sign APPlication
Parcel/Schedule No.
40# Snowload Letter - Manu. Homes
l./Soils Report J
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