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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
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www.qarfield-countv.com
TYPE OF CONSTRUCTION
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BUILDING PERMIT
APPLICATION
DemolitionCommerculti-Fam
Manufactured Home (Single or Multi-Level)
ReroofResidential (SF, Duplex or Townhome)
Dwelli Unit (ADU) - MAXIMUM SlzE OF 1,000 SQUARE FEET
INVOLVED PARTIES
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Phone:( 97Ô tZlq -2Ðl+Property Owner:
Mailing Address:
Email Address:Át Drf,rcÉr ol¿flm< , t()rr1
Contractor:Phone:t 3l-plp- 8l
Mailing Address:5t
Email Address:lder I .c0
Architect:Phone: ¡þ5¡ 7t Pta' Q t (-\-
Mailirrg Address.
Email Address:ryr.lc5@ rnu etltYtitt .ratm
Engineer:¡Phone;
Mailing Address;
Email Address:
Manufactured Home lnstaller:NIA Phone:(
Mailing Address
Email Address:
PROJECT DETAITS
Describe Work:
Job Address:
Assessor's parcet Numb *, Al Ð.'1At-o t O8 O>L
5ub.rot 4l Block-
Owner's Valuation
Sq. Ft. of Building:
of Work:Property size (sq. rt. or@:5,3y
qxÕD Height:Ital # of Floors: I
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Class of Work:v New Remodel/Alteration Addition
Garage:Attached lx Detached
PROJECT DETAITS CONTINUED
CommunitySeptic:
OtherPropaneKatural GasType of Heat:
Driveway
Permit:
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 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.
NOTICE
lÍlExemnt
Authoritv. This application for a Building Permit must be
or an authorized agent. lfthe signature below is not that
signed by the Owner ofthe property, described above,
of the Owner, a separate letter of authority, signed by
Electric
Permit #:
nd that the information contained above is true and correct. I
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
compiy 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, construct¡on 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
I hereby certify that I have read this Application a
understand that the Building Division accepts the
d r,e neer and/ or builder
CERTIFICATION
I hereby acknowledge that I have read and und erstand the Notice and Certification above, as well as, have
provided the required information which co and accurate to the best of my knowledge
Property Owner Print and Sign Date
OFFICIAT USE ONtY a
â€e atÈaúeal ¿7A/Þ/v¿/VsSpecial Conditions:
MPermit Fee:16 Manu. Home Fee:Plan Chusted Val2
OWTS No:Due:Fees Paid:Tota 1l
Const. TypeOCC Group:RCSetbacks:
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?-6-zzBUILDING / PLANN¡NG DIVISION :
Signed Approval Date
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BUILDING DEPARTMENT
708 Eighth Street, Su¡te 407, Glenwood
'pr¡ngs,
CA 87607
Tel: (970) 945-8212
PI.AN RE VIEWCHE c KLIST
Perrmãt F,!*;øLRE-09-22-776ô
BurãËding Essues
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t/ soils Report
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FIannE nglZonãng Ësss.¡es
Property Line SetbacksEngineered Foundation
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Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
ion Plat Notes
Fir:e Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach conditions Tnhb
Application Signed
Plan Reviewer to Sign APPlication
Parcel/ Schedule No.
40# Snowload Letter - Manu. Homes
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NK
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30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees
rade/ Topography 40%
Planning lssues
Subdivision Plat whilù
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Desani tE*n E*X Í*f! û11æ
32oo e,l. f' 72 4 tozrt/Ø:"
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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 until the 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 acknowtedge I have read, understand and will abide by the requirements of this
checklist.
Property Owner Print and Sign Date
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