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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(9701 94s-8212
www.gaff¡eld-counW.com
Garfrcld County
BUILDING PERMIT
APPLICATION
DemolitionCom mercial/Multi-Family
Manufactured Home (Single or Multi-Level)
Reroof'Residentíal (SF, Duplex or Townhome)
Accessorv Dwellíng Unít (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
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Phone: t\1ol Ct4C47À
EmailAddress:
Property Owner:
Mailing Address;
Email Address:
Phone: ( )
(l lt
3\..r,ìrJr^^ ù..rxø,< LLLContrector:
Mailing Address:
Phone: r1ìc 3GÇ,,- K^qa
Phone:
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Engineer:l'{\r, %o,o
Architect:
Maíling Address;
Email Address:
Mailing Address:
Email Address:
Manufactured Home lnstaller: Phone:
Owne/s Valuation of Work: Propefi Size
Describe Work:A)
Lot 6
Height:
or Acres):
g),7so
3o8 #of
(ì
)oq1æøl
Sq. Ft. of Building:
BlockSub.
Assessoy's Parcel
Job Address:
Mailing Address:
EmallAddress:
Y lnooitionGla¡sof Work:Nerv lnemodeilAlteration I
vGarage:Attached Detached
0wTs
Type of Heat:I Gas(lttatura Propane Electric Other
Driveway ü:
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 s¡gnature below is not that of the Owner, a separâte letter of authority, signed by
the Owner, must be provided with this Application.
LeEql Accgss, 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 perm¡ts 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.
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 fac¡lities 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
Buildíng 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 fromr (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
applícable law. Review of this Application, including submittals, and inspections of the work by the Building
Ðivision do not constitute an acceptance of responsibility or liability by the County of errorg omissions or
discrepancies. As the Owner, I acknowledge that responsibility for compliance w¡th federal, state and local laws
and County Regulations rest with me and my authorized agents, including without limitation my architect
or builder
Septlc:
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
information which is correct and accurate to the best of my knowledge.
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Property Owner Print and Sign Dated.,Àñ
Special Condltions:
Plan Check Fee:il-w.zb &2"åûi.,ca
Manu. Home Fee:
N/A HfÞ'ê::g.>!wt
'"ê'5'åzo.at Feés Paid:
tt,z?o,ú
Balánce Due:
ëz,DtlL,#
BP No:
6.*e-1La\
OWTS No:
Ca¡.r¡lr¡¡l tlY
IOCC Group:
I Èc-
Const, Type:
I fa(-
Zoning:
P. v. D.
Setbatks:OL
tødø,)BUIrD¡NG / PT.ANN|NG DTVIS|ON :
Signed Approval Date
nll-
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 Buílding Officialthat additional information is necessary to review the application
and/or plans for complíance, 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
wellas any Road lmpact fees willbe 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 read, understand and will abide by the requirements of this
checklist.
Owner Print and n Date
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Gørfteld County
BUILDING DEPARÍMENT
7Og E¡ghth StreeT Suite 40L, Glenwood \pr¡ngs, CO 81607
Tel: (970) 94s-8272
PLA NRE VIE W CHECKLIST
Perm it ¡ro: F:*RE- //-Z'/ - 723*
Building lssues Pla n n i ng lToning lssues YÚÞ
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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
Property Line Setbacks
30 ft. Stream Setbacks
NA Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees
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l,/ Grad e/ Topography a0%
/ Planning tssues
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Application Signed
Plan Reviewer to Sign APPlication
Parcel/schedule No.
40# Snowloa
Soils Report
d Letter - Manu
Subdivision Plat
Descript ion & Summarv:
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