HomeMy WebLinkAboutApplicationGarfield County
ñs{äüffi munity Development Department
1oB 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-82t2
.com
Accesso Dwell Unit - MAXIMUM SIZE OF SQUARE FEET
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BUILDING PERMIT
APPLICATION
Demolition
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Commercia ulti-Fam
Manufactured Home (Single or Mu
Residential SF, DU or Townhome
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PARTIES
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Phone: (î)ë, ïf- hhl
Contractor:
Architect:
Property Owner:
Mailing Address:
Email Address:
Mailing Address
Email Address:
Mailing Address:
Email Address:
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Phone:
Phone: Û7" t lLt\-- ûþf
Manufactured Home lnstaller:
Engineer:
Mailing Address
EmailAddress:
Mailing Address:
Email Address:
t,/>Descríbe Work:
Job Address:1tu t,^ D¡ìx tQ. 6uA flrnøt
Assessor's Parcel Number:
Sub.
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Owne/s Valuation of Work:
Sq. Ft. of Building:
Class of Work:
Propefi
Addition
Garage:Attached
model/Alteratíon
Detached
S ¡rø
DETAITS CONTINUED
r Septic:munity
Type of Heat atural Gas Propane E lectric Other
Driveway
Permit:
pt Permit #:
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 Buílding 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,
YSid Jg¡¡1it 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 L80 days after commencement.
'GERTIFICATION
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 revíewed 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 facÍlity(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 liabilíty 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 acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the req information which is correct and accurate to the best of my knowledge.
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Property Owner Print and Sign Dete
sOFF¡CIAI USE ONIY
âee 'tt at¿y' ffiailsSpecíal Conditions:
Permlt Fee: -lg/,%Manu. Home Fee:ñlû Misc. Fees: // -¿
Rt Frwbt'rnus CAdiusted Valuation:q.55q,22 "i\ï:w"'
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Balance Due:ga BP No: I
ffi-:ÆarTotl Fees:
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Fees Paid: ^
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co"'t.#* B '"Ëtrr-,
OWTS No:
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Setbacks:o'þ:"h-z
lZ-?-ZZ-BUtLDtNG / pl-Rrrr¡rrrrua DrvrsroN :
Signed Approval
/
Date
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G,ørfi'eld Coa:ntY
BUILDING DEPARTMENT
708 Eighth Street, Su¡te 407, Glenwood Springs, CO 87607
Tel: (970) 945-8272
PLAN R EVI E WC HECKLIST
Per¡æÊ-e r:Ja: þ¿þ- l/-ZZ-'7?Z/tl
FÍa n; r I utglZerr t n: g IssueçBurldfrng iss=ues
^'ry
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ ToPograPhY 30%
Attach Residential Plan Review List
Subdivision Plat Notes
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//Lg6 ft . stream setbacks
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Flood Plain
Building Height
Zoning Sign-off ,%4
Road lmPact Fees rTunlm4=S
Grade/ Topography 40%
Planning lssues
Subdivision Plat
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Valuation Determination/ Fees
Red Line Plans/ StamPs/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign APPlication
rcel/ Schedule No.
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