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Community Development Department
108 8th street, Suite 401
Glenwood Springs, CO 81601
19701945-8212
www. ga rfield-cou ntv.com
TYPE OF CONSTRUCflON
Commercial/Multi-Family Demolition
Manufactured Home (Single or Multi-Level)
Residential lSE) Ouplex or Townhome)Reroof
Accesso Dwelli Unit . MAXIMUM SIZE OF FEET
INVOTVED PARTIES
Property owner: ß.¡¡s-\\ * L. Cn-Lr.okt Phone:(qr. )ttzt{ q3-l+
J GMailing Address:
Email Address:
Contractor:Phone: (q1Þ ).{z{ 437+
Mailing Address:
Email Address:
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Architect:Au- D*oer Phone:4rs "L-?
Mailing Address: StQn € Koo Å Cr.^^.Á S¡sn 1¡ B¡:çor-l
EmaitAddress: Koç.. A, â-\\ A-a4I. . ¿on¿
Engineer:6t-.^ *ooc}" Ç^.^ hêr^rr\q. Phone:lo t-
Mailing Address
Email Address:
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Manufactured Home lnstaller:Phone: f )
Mailing Address:
Email Address:
Describe Work:
Job Address:C
Assessoy's ParcelNumber: þ4"1 11z \l r\ Ç-(,Ò
suu. tir<¡.}-Éa1ì.sP:,.,f lot 5b Block-
Owne/s Valuation of Work: 530Q,opo € Property Size (Sq. Ft. or Acres|:l4.si l
sq. Ft. of Building: \8 4o qL Height; Ðq /- le/+tt r of Floors: I
Class of Work:{ttew Remodel/Alteration Addition
DetachedGarage:Attached
PRO¡ECTDETAII.S
I PROIECT DËTAIts CONTINUED
Septic:Community
Type of Heat Natural Gas Propane Electric Other
I Driveway
-l"lrytliNOTICE
Authoritv. 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 authority, signed by
the Owner, must be provided with this Application.
Leqal 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.
CERTITICATION
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 ¡nspect 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 l2l 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
engineer 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.
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Property Owner Pr¡nt and S¡gn Lo.,Date
Permit #:
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Special Conditions:
Misc. Fees:
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Permit Fee: ^-þt. bzo.'rc
Manu. Home Fee:
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Adiusted Valuation:
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Plan Check Fee:
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Balance Duel -þtr,bzo,'te
BP No:,
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OWTS No:
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Total Fées:
òl-"t v4.57
Paid:oît "lL
Fees1t,
Const. Type:
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Zoning:
PUD
Setbacls:
OK
OCC Group:
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BUITDING / PTANNING DIVISION :
Signed Approval Date
22 00
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 untilthe 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 consídered an illegal occupancy and may be grounds for vacating the premises. (Final/CO
inspection requirements will be attached to your approved fíeld set of plans.)
I hereby aeknowledge I have read, understand and will abide by the requirements of this
checklist.
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Property Owner Print and Sign Date
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Gurfield County
BIJILDING DEPARTMENT
708 E¡ghth Street, Suite 401., Glenwood Spr¡ngs, CO 81601
Tel: (970) 945-8272
PLAN REVI EW CHECKL rsT
6KE-tØ4þ707fPermit No:
Building lssues Planning/Zoninglssues PAÞ
v/ Engineered Foundation
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Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
t/
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Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ TopographY 30% , Ii
?eh\e ;lP lo v leore*l
Attach Residential Plan Review List
Subdivision Plat Notes
UV¿ Fire Department Review
'-/ Road lmpact Fees
/./ A Grade/ Topography 40%
Planning lssues
Subdivision Plat
n ion & Summa
Nft
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Valuation Determination/ Fees
Red Line Plans/ StamPs/ Sticker
Attach Conditions
L/ Application signed
t/Plan Reviewer to Sign APPlication
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Parcel/schedule No'
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