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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-82L2
www.sarf¡eld-countv.com
Garficld County
BUILDING PERMIT
APPLICATION @
DemolitionCommercial/Multi-Fami ly
Manufactured Home (Sinele or Multi-Level)
ReroofResidential (SF, Duplex or Townhome)
Áccessory Dwelline Unit (ADU)- MAXIMUM SIZE OF 1,000 SQUARE FEET
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Email Address:
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Property Owner:
Mailing Address:
Mailing Address:
Email Address:
Phone: (_)Contractor:
)l{¿., sþon c. B-t,'. S, p e lv ,'LL(Phone: ( )Architect:
Mailing Address:
Email Address:
Engineer: Phone:
Mailing Address:
Email Address:
Mailing Address:
Email Address: ,.
Describe Work:
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Property Size (Sq. Ft. or Acres):It
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Manufactured Home lnstaller:
owner's Valuation of Work:
Sub.
Assessol's Parcel Number:
Job Address:
sq. Ft. of Buildlng: 'S ? f, S*1 Heisht:
Lot I cl Btock
X Remodel/Altérãtión AdditionClass of Work:New
(DetachedAttachedGarage
CommunitySeptic:k
OtherPropane Ä/A El ectricType of Heat:llNaturalGas
Driveway
Permit:
Permit #:
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. lf the signature below is not that of the Owner, a separate letter of authority, signed by
the Owner, must be provided with this Application.
Leqal 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 Perm¡ts. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
(3) another permit required for use on the property ident¡fied 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 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 (2l'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
er ran 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.
Property Owner Pri and
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Date
see a#â úed e2/1/b / ryAlLqSpecial Conditions:
*""ñ7ftPermit Fee: . -612,v5 Manu. Home Fee:u/eAdiusted Valuation:-
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Plan Check Fce:
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OWTS Ño:
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Balance Due: -6tZ,F BP No:
Bt Æ-71boTota'-;Vs:,rl Fees Paid:
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Zoning:R,un¡lConst. Type:
l. R.C .
Setbacks:oCC Group:
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5-A-22BUILDING / PLANNING DIVISION :
Signed Approval Date
,M
Gørfield CounQ
BUILDING DEPARTMENT
708 E¡ghth Street, Suíte 407, Glenwood Springs, CO 81607
Tel: (970) 945-8272
PLAN REV IEW c HECKLIST
Permit xot B LRF-O4-22-746O
Building lssues
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Pl a n n i ng / Toning lssues
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 Determ ination/ Fees
Red Line Plans/ StamPs/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign APPlication
Parcel/ Schedule No.
40# Snowload Letter - Manu' Homes
soirs Report O/41-úA/A
Property Line Setbacks
3û ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees N/4
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Grade/ Topography 40%
ning lssues
Subdivision Plat
Ðescri ntion & Su nìtnarv:
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