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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
ls7ole45-82t2
www.qarfield-countv.com
Gaffield County
BUILÐING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
DemolitionCommercial/Multi-FamitxManufactured Home (Single or Multi-Level)
ReroofResidential (SF, Duplex or Townhome)
Accessory Dwell Unit - MAXTMUM SIZE OF 1,000 SqUARE FEET
INVOLVED PARTIES c\n <<-+
Address: Saul . Mort'an e+ t 4 ÐAYnoil" ÔÔhA
þ - (úirTJ- 4\ô70 ^L.
PhonelProperty
Mailing
o,nn"r,.Sau I Mor-rtn
EmailAddress
Phone:Contractor:
Mailing Address:
Email Address:
Phone:(q+ô )qâ+-ô3aôArchitect:
Mailing Address:
Email Address:
Phone:
I
Email Address:
Mailing Address:
Engineer:
x x AdditionClass of Work:New Remodel/Alterat¡on
Manufactured Home Installer:Phone tt
Mailing Address:
EmailAddress:
PROJECT DETAI[S
Describe Work:
Job Address:
Assessor's Parcel Number:
Sub.
zt"5- lt { ao ogt
Owner's Valuation
Sq. Ft. of Building:Height:
of Work:{LqD?. ¡q
5Ê3 + r9l
Lot Block
Pro perty Size (Sq. Ft. or Acres):
# of Floors 2
Garage:Attached N/¡
¡.t/*
Detached
<.R Ac
ECT DETAILS CONTINUED
Driveway
Permit:
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignatùrebelowisnotthatoftheOwner,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 Permít 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 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 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 Bu¡lding
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
desi er and/ or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
required informatíon
Permit #:
is correct and accurate to the beqt of my knowledge.
tlaa la t
rty Owner Print and Sign Date
Septíc:OWTS Community
Electric OtherType of Heat:Natural Gas Propane
OFFICIAL USE ONtY 0ct(Ç
T\A#"HìH ;o tþa /#, alpv¿ an exú*bg aUre sqs7l*7.1
Adiusted Valuation:
þ44.¿/¿B 8f Plan Check Fee:
-495.6t
Permit Fee:5q3.2e Manu. Home Fee:
N/¡'
Misc. Feesl
TotafFees:q-79.8b Fees Paid:
t3al.¿t ffi3
Due:?sBalance BP No:
gLR€ -?OO3 x/¡OWTS No:
Setbacks:
----
OCC Group:
lrzc
Const. Type:
tR<
Zoning:
RU ÊAL
lø¿elÐ %á-Z-27-22BUITDING / PLANNING DIVISION :
Signed Approval Date
Gørfield County
BUILDING DEPARTMENT
108 Eighth Street, Suite 407, Glenwood Springs, CO 81601
Tel: (970) 945'8272
PLAN REVIE WCH EC KLIST
Permit No: A tgg <7-21-7Ø3
k
Building lssues
l,/Engineered Foundation
N, A Driveway Permit
Surveyed Site Plan
ptic Permit and Setbacks
NI4
q$úffied 16Ø
o?e^.hale ryy ',íå
&¿d?d 0t/T5 candtþæu
Grade/ ToPograPhY 30%
Attach Residential Plan Review List
Subdivision Plat Notes
Fire DePartment Review
Valuation Determ¡nation/ Fees
Red Line Plans/ StamPs/ Sticker
Attach'Conditions
Application Signed
'/ Plan Reviewer to Sign Application
Parcel/schedule No
,r/40# Snowload Letter - Manu. Homes
ta Soils Report
Pl a n n i ng I Toning lssues
'/ Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees fVtinìmnS
Grade/ Topography 40%
Planning lssues
Subdivision Plat
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Descript ion & Summarv:
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Garfietd County
Community Development Department
-.
l0g grh Street, Suite 401ulenwood Springs, CO g160l
(9701 94s-8212
www.parfield-countv.com
SINGLE FAI.,TILYOR, DUPLEX BUI LDING. PERMIT APPLICATION CHECKLIST
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APPLICAT|ON FORM: ptease make s' Parcer nuTfg'"0r"'"åãï,."','=,i:'3:ii,l"^"rî3sritfffl:: is provided on the apprication.: l:3,iH:lÌJ:::"1,"J on"''ä' address)
: S#å1.J*1 þ ffi !,fil"'i: :HJfii ",:'l"J ri I i n s, o r secti o n, town s h ip a n d ra n s e
' Architeci;"il;,ii#Xi:13 ;:*ïs' phone, i"", -oï
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p h o n e rax o r ce r
: F:ffi "i [îi ffiî "iil,î;:#'Åtierat¡on,
Add*ion, Repa i r, M ove/ Rerocatio n).. ]vRe of heatins fn"t*iãåì, oroi s:ääïff,Liî ;åi:i'iå;îli[îl remsbe,ow. Drivewar o"T:,1!1";;ä #er tems betow).. Valuation (labor ano matenãı].="" attached worksheet.
OTHER FEMS:
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SINGTE FATII/IIIY oR DUPTEX
BUITDING PERM|T
APPTICATION CHECKLIST
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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 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.
nt and Sign Date
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