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Community Development Department
1OB 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-82t2
www.garfi eld-cou ntv.com
@
Gørfuld County
BUILDING PERMIT
APPLICATION
Commercial/M ulti-Fami I Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
Accessory Dwelli Unit U - MAXIMUM SIZE OF SQUARE FEET
INVOTVED PARÏIES
Property Owner:
Mailing Address:
Email Address:
+Phone:r17Ol 3 q-%qz
o
Contractor:Phone: 87(s t 37q-6642
Mailing Address
Email Address:
Odvt
I
>- s,lF I
phone: t@_t 1b¿(-çSSlArch¡tect:
Mailing Address
Email Address:
(r a
Engineer:Phone:n%-q o
Mailing Address
Email Address:
I t/t\-
Manufactured Home lnstaller:Phone: I ì
Mailing Address
Erfbil Address:
PROJECT DETAIIS
Describe Work:R"^r^
Job Address:rn
Assessor's ParcelNumber: 2lZ1 LILO 8tott
Sub.Lot
Owner's Valuation of Work:
sq. Ft. orBuitding: l?6
^øßl,
Height:
Class of Work:X ñew Remodel/Alteration Addition
Garage:Attached Detached
Community]WTSSeptic:
OtherPropaneE lectricNatural GasType of Heat:
Permit #:Driveway
Permit:
pt
PROJECT DETAITS CONTINUED
NOTICE
Authoritv, This application for a Building Permit must be signed by the Owner of the property,described above,
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 andvoidiftheworkauthorizedisnotcommencedwithinlS0days
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 contain ed 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
des ner, e neer an or builder
I hereby acknowledge that I have read and understand the Not¡ce and Certification above, as we ll as, have
provided the required information which is correct and accurate to the best of my knowledge
q{ru/ r.z-
Property Owner Print ¡"af" I
OFFICIAT USE ONLY lD.280 C.C. o{zz
Special Conditionsl €æ atèaúe{oa/uD/VAA(S
usted Plan Check Fee:2îD^67 Permit Fee:" -431,h9
Manu, Home Fee:Nlr
'"'lri, ?z Fees Paid:
* z8 o,5l
Balance Due:qaLb6 BP No:
ELP:e-744+
owt'f No:
-rl/tsetbackstôL-OCC Group IRL Const. Type:
t RC Zoning:
Êrrf?.4 L
BUTLDTNG/pLANNrNGDrvrsroN, ÙJiv*It l-2+2-
Signed Approval Date
Garfield County
BUILD'NG DEPARTMENT
708 Eiahth Street, Suite 407, Glenwood Spr¡ngs, CO 87601
Tel: (970) 945-8272
PLAN RE VIEW CHECK LIST
permit No: 8tÆ-O4-Z-7444
Building lssues
.L Engineered Foundation
N,h Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List NA
Pl a n n ing lToning lssues
/UA subdivision Plat Notes fA
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees
Grade/ Topography 40%
Planning lssues
Subdivision Plat
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
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