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mun¡ty Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-8212
www. garf¡eld-countv.com
INVOLVED PARTIES
Garfield County
BUILDING PERMIT
APPLICATION
Evpr or coNsrRucroN
DemolitionCom mercial/M ulti-Family
Manufactured Home (Single or Multi-Level)
ReroofResidential (SF, Duplex or Townhome)
Accessory Dwelling Unit (ADU)- MAXIMUM SlzE OF 1,000 SqUARE FEET
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Email Address: fr
Property Owner:
Mailing Address:
Phone:
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Contractor:
Mailing Address:
Email Address:
Phone:Arch¡tect:
Mailing Address:
Email Address:
Mailing Address:
Email Address:
Engineer:
Pho ne: IManufactured Home lnstaller:
Mailing Address:
Email Address:
PROJECT DETAIIS
rf\Describe Work:
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Height:# of Floors: ?
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?t{Property Size (5q. Ft. or Acres):5.zEt344
Assessor's Parcel Number:
Job Address:
Owner's Valuation of Work:
Sq. Ft. of Building:
Lot 2- Block
{Class of Work:New RemodeUAlteration Add¡tion
x DetachedGarage:Attached
lEl'CommunitySeptic:
OtherPropaneElectric-lNaturalGasType of Heat:
Permit #:Driveway
Permit:IExempt
NOTICE
AuthoriW. This application for a Building Permit must be signed by the Owner of the pro
or an authorized agent. lf the signature below is not that of the Owner, a separate letter
the Owner, must be provided with this Application.
Lesal 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 Ìs not commenced withÌn 180 days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
perty, described above,
of authority, signed by
CERTIFICAT¡ON
I hereby certify that I have read this Application and that the information contained above is true an
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 th¡s 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 compl¡ance with federal, state and local laws
and County Regulations rest with me and my authorized agents, including without limitation my architect
d correct. I
desisner, engineer and/ or builder
PROJECT DETAITS CONT¡NUED
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 Pr¡nt and S¡8n Date
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6ed atûaúea/-/Ta/1/SSpecial Conditions:
Manu. Home Fee:*/r et
Misc. Fees:Plan Check Fee:{t.Ln 6z ïT'liae,qsVal
OWTS No:
sg?1- 71Sq
Balance Due:
f2,498,q5
tstR e - ?7S8
BP No:Fães Paid
$ r.¿t?.82-'å'älïå¿,r,
Zoning:
R,UßÀL
Const, Type:
l. R. (-OCC Group:
l. R.C.
Setbãcks: ,ûE_
BUILDING / PLANNING DIVISION :
Signed Approval
4-g-2-
Date
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Gadteld County
SUILDING DEPARTMENT
708 Eighth Street, Su¡te 4o7, Glenwood Springs, CO 81607
Tel: P7a) 5-8212
PLAN REVIEW CHECKLIST
permit No: 6 UpF -Ø -ZZa7,5B
Building lssues Planning/Zoning lssues RU|UIL
.ZZ-774
Permit and Setbacks
de/ Topography 30%
f Attach Residential Plan Review List
Engineered FoundationrcæìuQ?-ø-z
Driveway Permit /)qr_9. T.
Su Site Plan
Subdivísíon Plat Notes
Fire Department Review
Valuation Determ ination/ Fees
Red Line Plans/ Stampsl Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign Application
Parcellschedule No.
40# Snowload Letter - Manu. Homes
Soils Report
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
éa'-'- Grade/ Topography 40%
5272q7
øtradrmpact rees € PÞJ_
Description & Summarv:
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Planning lssues
Subdivision Plat
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