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Community Development Department
108 8th street, suíte 401
Glenwood Springs, CO 81601
(e7ar94s-8212
www.garfield-counN.com
Gmfield Couttty
BUILDING PERMIT
APPLICATION
DemolitionCommerclal/Multi-Famllv
Manufactured Home (Sinele or Multi-Level)
ts Reroofflesidential (5F, Duplex or Townhome)
Accessorv Dwelline Unit (ADUI - MAXIMUM slzE oF 1,000 SqUARE FEET
properryowner JPt" (EþL ffiA;r1 UtrùlV lvL, p¡one: ( 1'?o ) 310 -t5 t+
3o. W* L+øæ Lv-Õ<. (1-Ð 7l t-2t-7-Mailing Address:
Email Addressl
Emall Addressr
Contractor:
Mailing Address: 60Z0 et¿
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Architect:
Mailing Address:
Email Address:
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Englneer:U*OAue?-Ø,rr.-t¡.|
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pnon", t4-70 tLql 'q00
Maillng Address:
Email Address:
Describe Work:
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Phone:
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Property s¡ze (5q. Ft. or Acres):
ttManufactured Home lnstallen
Sub.
Assessor's Parcel Number:
Job Address:
owner's Valuation of Work:
Sq. Ft. of Buílding:
Maillng Address:
Email Address:
n.tght: d-ït' #ofFloors: I
Class of Work:1ffi"*Remodel/Alteration Addition
DetachedGarage:
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PROJECT'DETAI$ CONTINUED
Septic:f,wTs Community
Type of Heat:ural Gas Propane Electric Other
Dríveway
Permit:l-lExempt
Permit #;
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
oranauthor¡zedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
Leßal Access, ABuildingPermitcannotbeissuedwithoutproof oflegal andadequateaccesstothepropertyfor
purposes of inspections by the Building Division.
Other Permits. Multiple separate permits may be required: (1) State Electr¡cal Permit, (2) County oWTS Penrit,
{3) another permit requíred for use on the property identified above, e.g. State or County Highwayf Road Access
or a State Wastewãter Discharge Permít.
Void Permít. 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
lherebycertifythatlhavereadthisApplicationandthattheinformationcontainedaboveistrueandcorrect. 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 consìderation 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, ifthe 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 permiss¡on 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 const¡tute 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 arch¡tect
designer, engineer andl or builder.
I hereby acl<nowledge
provided the wh
understand the Notice and Certification above, as well as, have
rate to the best of my knowledge
Date
æ
and Sign
a
Special Conditions:
Permit Fee: .-zàl-gn4.ts Manu. Home Fee:
¡t /r Misc. Fees:
Rttr-EBr>6z.zs
Adiusted Valuation:-.
þ244-nÐ.6ú
Plan Check Fee:'{1.173,74
Fee's Paid:
t r.rr I .1t
Due:79 BP No:
BLf¿€f o7l
OWTS No:
¿oraMuÀ¡ lry'"Ëiillq,+tr
Zoning:PUD'Æblurr:OCC Group:IrtL
Const. Typel
I ec-
M'-%rmtBUILDING / PTANNING DIVISION :
Slgned Àpproval
z
Dete
. 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.o 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 until the 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 Impact 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 considered an illegal occupancy and may be grounds for vacating the premises. (Final/CO
inspection requirements will be attached to your approved field set of plans.)
I hereby acknowledge I have readn understand and will abide by the requirements of this
checklist.
g/r^,/,
Date -,/Print
Gørfteld County
BI/ILDING DEPART7,,ENT
1.O8 E¡ghth Street, Su¡te 407, Glenwood Sprinqs, CO 87601
Tel: (970) 94s-8272
PLAN REVIE CHEC KLIST
Permit No:øtßtr-Ø-z1-70n
Building lssues Planning lZoning lssues VUÞ
Engineered Foundation
er,erTf-Driveway Permit (On liel)
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ ToPograPhY 30%
Attach Residential Plan Review List
Subdivision Plat Notes
Fire DePartmer¡t ReviewLb?Øú
Valuation Dètdrmination/ Fees
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t/
NA
ØND
t/
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t-
Descri
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees
Grade/ Topography 40%
Planning lssues
Subdivision Plat
n Summa
t"/ Red Line Plans/ stamps/ sticker SeoUb
| -lAttach conditions #,;,t
K+A pro) Iq4-78
t.t7'?þ7ê z6M
sb,,PrøslJep.f{a
Application Signed
Plan Reviewer to Sign APPlication
Parcel/schedule No'
40# Snowload Letter - Manu. Homes
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