HomeMy WebLinkAboutApplicationGørfield County
Com munity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
19701945-82L2
www.ga rfield-countv.com
BUILÐING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercia l/M ulti-Family Demolition
Manufactured Home (Single or Multi-Level)
h<¿'Residential (SF, Duplex or Townhome)Reroof
Accessorv Dwellins Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
rNvowED ES
t/t
S'
I (urn,
Phone:3t7 _QilV4Property Owner:
Mailing Address:
Email Address:
ê
7o
él
e
C
aPhone:
/¿ø
Contractor:
Mailing Address:
Email Address:
IL ¿4
S A
l¿Li )Çt
'>èÒ4t¿r -Arch¡tect:
Mailing Address:
Email Address:
OûPhone:løaEngineer:
Mailing Address:
Email Address:
Phone
Email Addressr
Manufactured Home lnstaller:
Mailing Address:
PROJECÍ DETAIIS
JobAddress: l-i3D. CAt urcc¡rTe iZA¡.lCË pR. c*eaoNp¡L€
Describe Work:
'Rorrh,
Lot
qA
#of
zvqS LT.7-o â trCr Í
Property Size (Sq. Ft. or Acres):q.234ð¡of Work:
Height:1t1z-
Assessor's Parcel Number:
sub. êa lL (o/lt I Block
-
Owner's Valuation
Sq. Ft. of Building:
Ì Remodel/Alteration AdditionClass of Work:New
Garage:Attached Detached
PROJECT DETAITS CONTINUED
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
ts and accurate to the best of my knowledge.
/¿ t^A/
Property Owner Date
CommunitySeptic:
Propane Electric OtherType of Heat:Natural Gas
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
Lesal 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. Mult¡ple 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.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
Permit #:
NOTICE
ptDriveway
Permit:
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 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 perm¡ssion 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 (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 Appl¡cation, 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
designer, engineer and/ or builder
OFFICIAI UsE ONLY -"¿, f r, ¿*(' .14 cc \ofoç/Zèrt ç$-.-
Special Conditions:
Manu. Home Fee:
r.¡ lrt r.i";il,oqø.07Plan Check Feelgl. L4b 7+
Permit Fee:óz-63s./5Adiusted Valuation:-.
'6e Y+.1/,Ð,î¿
'êi,'à"ä2,"n BP No:
råLR€"-'! I h¿.
OWTS No:
.s€TÞ1-- 1r("!Total Feesí
#4^t9n,6{
Feãs Paid
{ lr ¿'q ü .q-t
Zoning:
Ê*ufa.At*
Const. Type:
lR.(.k_
Setbacks:
ô
OCC Group:
tß(
&æ"*%,rffi-BUITDING / PLANNING DIVISION :
Signed Approval Date
Gørfield County
BUILDING DEPARTMENT
1,08 Eighth Streel suite 407, Glenwood Springs, CO 81601
Tel: (970) 94s-82L2
PLAN REVI EW CHECKLI ST
perm it ¡,to: € LRE-/2 - 4 ^ 7/êô
Building lssues
Engineered Foundation
Pla n n i ng lZoning lssues
Property Line Setbacks
Surveyed Site Plan
Septic Permit and Setbacks
Þ/' Grade/ToPograPhY3o%
Attach Residential Plan Review List
t/ subdivision Plat Notes
Y æ Fire DePartment Review
Valuation Determination/ Fees
Red Line Plans/ StamPs/ Sticker
Attach Conditions
*emÈ"riveway Permit
La
N fr
t/ subdivision Plat
8 3s32¿r723?2t)7gl7t3
Description & SummarV:
NA
NA
ØNÞ
Þ/
^^ L ıL-- -- a^rL^-1.JU îi. 5tream 5etþacKs
Flood Plain
Building Height
oning Sign-Off
Road lmpact Fees
Grade/ Topography 40%
Planning lssues
i
II
.t
I
Application Signed
Plan Reviewer to Sign APPlication
Parcel/ Schedule No.
40# Snowload Letter - Manu. Homes
Soils Report
K+Are Po r,
oW h,rle
RrrþlalyaruQ)=fzrneuz
FLS {tzz x U,68 = 9/t lb4, ¡¿
oraul/ 7b7y /g = /+g{2_cjar ?îr r 32 = aL ?aF
ê P/4 /1/ x /9 > 5/ l3g
+ uLp///s/ y /z = t4B/z
ëe215á0,?b
:
hæp*
ts rE
/-
t/
a!ÞsÞ/ but?'/rio7
ta/uaoÇ'a4-