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Community Development Department
108 8th street, Suite 401
Glenwood Springs, CO 81601
(970194s-8212
www.garfield-countv.com
INVOLVED PARTIES
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercia l/M u lti-Fa mily Demol¡tion
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhomel 4Áo'^ I ha*yl Reroof
Accessory Dwelling unit (ADU) - MAXIMUM SIZE bF 1,000 SQìJARE FEET
Property Owner:
Mailing Address:
Email Address:
Phone: ?tl) , bt"-(21þl
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Phone:(77o fizg -lò&bContractor:
Mailing Address:
Email Address:
hzt -)l¿Ze-Phone¡
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Arch¡tect:
Mailing Address:
Email Address:
JEmail Address:JouA,Of^.hùf e,ft4lr7e¿fû/Þt ,Co ¡v\
Phone: t,?ßlaffi'zt'"gl
Mailíng Address:
Engineer:
Email Address:
l\)*Phone: ( )
PROJECT DETAII.S
Manufactu red Home lnstaller:
Malling Address:
Desøibe Work¡
Sub.
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Owney's Valuation
Sq. Ft. of Building:
Job Address:
Assessor's Parcel
x Add¡tionClass of Work:New Remodel/Alteration
Detached Ehnnl hf^-(nGarage:Attached
Framing plans for each floor level and roof. All beams, columns, joists, rafiers 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 wíll be attached to your approved field set of plans.)
I hereby acknowledge I have read, underctand and will abide by the requirements of this
checklist.
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V",LDoC"¿C--: {/n*/rdz,
Proper$ Owner Print and Sign Date
I Sept¡c:
Type of Heat:Natural Gas Propane
Community
Electr¡c Other
r Perm¡t:t. -- *-Flr'"'nt
Driveway Permit #:
NOTICE
Author¡tv. This application for a Building Permit must be signed by the Owner of the property, described above,
oranauthorizedagent. lfthes¡gnaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
LegalAccess. ABuildingPermitcannotbeissuedwithoutproofoflegalandadequateaccesstothepropertyfor
purposes of inspections by the Building Division.
Other Permits. Multiple separate permits may be required: (1) State Electr¡cal Permit, (2) County OWTS Permit,
(3) another perm¡t 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.
I CERTIFICATION
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 Appl¡cation, 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 subm¡ttals and approval of th¡s Application, a Building Permit will be issued grant¡ng
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 Perm¡t, 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 Perm¡t may be suspended or revoked, upon notice from the County, if the location, construction or use
of the structure(s) and facil¡ty(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 Perm¡t does not prevent the Building Official from: (1)
requiringthe correct¡on of errors in the submittals, if any, discovered after issuance; or (2) stopping
construction or use of the structure(s) or fac¡l¡ty(¡es) 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 compliance with federal, state and local laws
and County Regulations rest with me and my authorized agents, including without limitation my architect
ra or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the information which is correct and accurate to the best of my knowledge.
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Propefi Owner Print and Date
OFFICIAT USE ONIY
6ee a *Þa úed CANÞ / ftA/I/SSpecial Conditions¡
Adiusted Valuation:-'ll-l^4n ao 'ETR:ga 'Y'ä7, zg Manu. Home Feei *,'".rñì7A
fltl>gt¿s OWTS Nı:
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t*oMN>OCC Group:tRb ,onn.rtf? b Zo+¡ing:t\
ttl,MBU|IDING / PT.ANNTNG DTVTSTON
Signed Approval
7-î:E
Date
Gørfield County
BU'LÐING DEPARTMENT
708 E¡ghth street, Suite 401, Glenwood Spr¡ngs, CO 81æ1
'rel: (970) 94s-8212
PLAN REVIEW CHEC KLIST
Permit No: fl¿Rg-0¿,-26- S/þZ
Building lssues Planning/Zoni'ng lss
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Engineered Foundatíon
Septíc Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
A/A
NA
NA
Property Line Setbacks
35 ft. Stream Setbacks
Flood Plaín
Buildíng Height
Zoning Sign-Off
Road lmpact Fees
-/
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/ Subdivision Plat Notes
Fíre Department Revíew
Valuation Determinationf Fees
Red Line Plansl Stampsl Sticker
Attach Conditions
Applícation Signed
Plan Reviewer to Sign Applicatíon
Parcel/schedule No.
40# Snowload Letter - Manu. Homes
Soils Report
¿/ Lra¿el Topography 4o%
Planning lssues
Subdivísion Plat
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Description & Summarv:
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