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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
ls7ol94s-82t2
www.Fa rfield-cou ntv.com
Gørfield County
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Com mercial/M ulti-Familv Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOTVED PART¡ES
Property Owner:
Mailing Addressr
tillZf dF " ¿ "' Phone: t¿f10t Ç48-/t20
Email Address:
Phone: tfft I -e'/a'44f8
Mailing Address:
Email Address:)¿aE /¿¿ó t FF¿ùtaø fl¿¿têU¿at{ 7Û cr oror t . fu tø
arcnxec:tfrrut+a/ 4¿/4t8tr7¿Æy'/ë, phone: êVt I ô/f -ûþ?A
Mailing Address:
Email Address:ë,êt1¡
Engineer: ¿Ey'f ' vëi 4"zz¿¿¿n¿ t î-<'i / Phone: (qr^ I f/?'AfVs
Mailing Address:
Email Address:/t,/tt/ 1/,/ " F l¡sztr'E_9ø*zr "
Manufactured Home Installer:Phone: ( )
Mailing Address:
Email Address:
PROJECÍ DETAII.S
Describe Work:
Job Address:(a
Assessor's Parcel Number:
rct Ð Block-
Owner's Valuation.of Work:Ura4¿¿
z, or ø.6¡Å-property size (sq. Ft. or Acres): 4ll/g ft¿ø,S
14' #ofFloors¡ /Sq. Ft. of Building:Height:
.f.fy
Class of Work:l/ñew Remodel/Alteration Addition
Garage:Attached Detached
vr CommunitySeptic:
Other
@erooane
Type of Heat:atural Gas
Permit #:mptDriveway
Perm¡t:
PROJECT DETAITS CONTINUED
NOTICE
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.
legal Access. ABuildingPermitcannotbeissuedwithoutproofof legal andadequateaccesstothepropertyfor
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 identif¡ed 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 contained above is true an d 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 er eer and/ or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the req uired information correct and to the best of my knowledge.
Owner Pri and
lrEl'l ,rl¿ cK.lll. IOFFICIAT USE ONtY 2{,Ð ë1 tt Þ7¿
6ee a'ttaùed'aNÞfl72NsSpecial Conditions:
Manu. Home Fee:
N/A
Misc. Fees:Plan Check Fee:Lrq+.w Ziïiil.c,ïüü'ïäit.b
BP No:
grR,E - l bto
OWTS No:
5g?1. 7 bâ I
Fdes Paid:
$ l,tq{.q6
Balance DueL¿
L,qM+,55
Total FeeS:
+.9û91
Zoning:p. u.D.
Const. Type:
l.¿.c.'*W)NÞ ttOCC Group:
l, ß.c.
BUTTDTNG / PTANNING DlVlSlON :
Signed Approval
g-lv--,
Date
)i,M,
Gørfuld County
BUILDING DEPARTMENT
708 E¡ghth Street, Suite 407, Glenwood Spr¡ngs, CO 87607
Tel: (970) 945-8272
PLAN REVIEW CH ECKLIST
Pernnit No: Bl-K E - O]-ZZ-7bCIy
tsuilding lssues Planni Zoning lssues PUD
¿at'?Engineered Foundation
en";-0 8't7-Z
D riveway P e r mit ¿ WrVt- / -rrþraClf
Surveyed Site Plan
Septic Permit and Setbacks
¿- Grade/ Topography 3o%
: Lolzz
IJilÐ rro pe rty Li ne setba cks
llTZ x 6Z=
658x 16=
¿+73K tL'=
aà¡'nøleÅ bnJi,ìry,r
v^Tr.q+r'crr.\
30 ft. Strèam Setbacks
Flood Plain
Building Height øA
C aa-l¿-ê an 44'lr1,9
Zoning Sign-Off
Road lmpact Fees
Grade/ Topography 40%
Planning lssues
Subdivision Plat
ch Residential Plan Review List
-/ Subdivision Plat Notes
NA Fire Deoartment Reviewnolhinq ín7nÞ
Valuation óetermination/ Fees
-/ Red Line Plans/ Stamps/ Sticker ?lù î818c1
Ø Attach conditions ?AiNT Kúo"êú nqþ
Descri CIn Surn¡'na
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37æ+o"
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Application Signed
Plan Reviewer to Sign APPlication
Parcel/ Schedule No.
40# Snowload Letter - Manu. Homes
Soils Report
trt€ qFîî x 7¿/. bs= a4%2'æ
cmúl ¿M5 t< t8 - 75) 5l2.oo
4++0{6,b0
Rtr qeÞ 6zr7os,oo
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 Officialthat 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, u d and will abide by the requirements of this
checklist.
Owner P tgn
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