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Com munity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-82L2
www.garfi eld-countv.com
TYPE OF CONSTRUCTION
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Garfield County
BUILDING PERMIT
APPLICATION
Demolit¡onCom mercial/M ulti-Family
Manufactured Home (Single or Multi-Level)
ReroofResidential (SF, Duplex or Townhome)
Accessory Dwellins Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOTVED PARTIES
Property Owner:
Mailing Address:
n Phone:o a
uJo /
- (,otYlEmail Address:e
Contrector:Phone )
Mailing Address:
Email Address:
eArchitect:one:
Mailing Address:
Email Address:
o
Engineer C Phone 6s
Mailing Address:b
t4Email Address (ù
Manufactured Home lnstaller:Phone: ( )
Mailing Address:
Email Address:
PROJECT DETAITS
Describe Work:U&/ /tern e
Job Address:
Assessor's Parcel Number: Z oòzo 50
suu. ?ruVor4 n4 Lgq Fu.l Lot Block _
Owner's Valuation
Sq. Ft. of Building:
of Work: 5
722? "
or Acres)
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ll,o t3, s1l
Class of Work:X New Remodel/Alteration n
Garage ù<Attached Detached
]WTS
Electric OtherPropaneType of Heat:Natural Gas
Permit #:
EIE*"'ptDriveway
Permit:
PROJECT DETAITS CONTINUED
Septicr
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,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.
Voidpermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwith¡n180days
of the date of issuance and if work is suspended or abandoned for a period of L80 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 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
desi e neer and/ 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 Print and Sign Date
oFFrcrAr usE oNtY PAlÞ l¿ T¡o .5t58 lølz ê22'
6ee a*achteÅ, CrNÞ lTlOlr.l SSpecial Conditions:
Manu. Home Fee:
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Misc. Feesr gUt
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Permit É
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PlanVal
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BP No:OWTS No:
Cô¡4^{u^l rlY
nce Due:
{ to.?*7ÉztFeesPaidTotal F-eeslfi øÞØ.o'l
aonr..tr'l",R
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Zoning:
P. u.Þ.OCC Group:tRcSetbacfs:
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51o-ZUi;r+l,tBUTLDTNG / PLANNING DIVISION :
Signed Approval Date
Gurfield County
BUILDING DEPARTMENT
1.08 E¡ghth Street, Su¡te 407, Glenwood Spr¡ngs, CO 81601
Tel: (970) 945-8272
PLAN RE VIEWC HECKLIST
Permit No: fi¡18Ç,-e4'-Z-74¿lZ
Building lssues
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Plann ing/Zoning lssues
Ftg I
Engineered Foundation Property Line Setbacks
30 ft. Stream Setbacks*rhÈrriveway Permit
,..,4
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
Application Signed
Plan Reviewer to Sign APPlication
Parcel/schedule No.
40# Snowload Letter - Manu' Homes
Soils Report
,-.-
Flood Plain
-
Building Height
--"- Zoning Sign-Off
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Road lmpact Fees
¿'"' Grade/TopograPhY40%
Planning lssues
Subdivision Plat
7 347{el
Descri & Summa
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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 ior complianðe, 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 wilibe 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.
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Owner Print and Sign Date