HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-82L2
www.ga rfi eld-countv.com
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BUILDING PERMIT
APPLICATION
tr Demolitiontr Commercial/Multi-Family
tr Manufactured Home or Tiny Home (Single or Multi-Level)
tr Reroof.d Residential (SF, Duplex or Townhome)
tr Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
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Phone:ftlalQKi-+rec?Qtfin'er)
Email Address:
Property Owner:
Mailing Address:
Mailing Address:
Email Address:
ovlz_ts narJ Phone:Contractor:''To
Architect:RE
R
Phone: ( )
Mailing Address:
Email Address:
Engineer: Phone:
Mailing Address:
Email Address3
)
Phone:
(
Manufactured/ Tiny Home lnstaller:
GJ',fi!:l
Mailing Address:
Email Address:
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Sub. Lot- Block-
Owner's Valuation of Work: S Nt Property Size (Sq. Ft. or Acres)
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Height:*86 sotrr
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Describe Work:
CkQ-b OM DK|EJob Address:e
Assessor's Parcel Number: A
- Aao udtM*ls' For- oWtFr Mrsl+ A*+sttFxJ.T
6. I 3/+
Sq. Ft. of Building x{+# of Floors:-
303
cL u.l
tr Move/RelocationE Remodel/Alteration E Addition E RepairClass of Work:I trtew
E DetachedE AttachedGarage:
PROJECT DETAIUi CONTINUED
Septic:E] OWTS [J Community
Type of Heat:pNatural Gas E Propane E Electric E other
Driveway
Permit:
E Exempt E Permit #:
NOTICE
Authoriw. 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. A Building Permit cannot be issued without proof of legal and adequate access to the property for
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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 Permlt.
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.
CERTIFICATION
lherebycertifythatlhavereadthisApplicationandthattheinformationcontainedaboveistrueandcorrect. lunderstand
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 thisApplication, a Building Permitwill be issued granting permission to me, as Owner, to constructthe
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)).
All County development requiring a permit, except for residential uses, are subject to Article 7 of the Land Use and
Development Code. I acknowledge that the Building Permit may be suspended or revoked, upon notice from the County, if
the location, construction or use ofthe 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 p!'event the Building Official from: (L) r'equiring the correction
of errors in the submittals, if any, discovered after issuance; or (2) stopping construction or use ofthe 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, statc, and local laws and County Regulations rest with me and my authorized agents, including without limitation my
architect neer a or builder
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 Print and Sign Date
OFFICIAL USE ONI.Y
speciar conditions;
s ee a tta al ea/ CaTy p I T/: aA/6
^o'ff"|:\yw'.Plan Check Fee:lnn mt vVt -
effiFfi",zC Manu home Fee:Misc Feesr,
Totafre;s:2537q,
Fees Paid:
loo, oo Balance Due:a7q.z5 BP No:
8/AE-gyqz
OWTS No:
et<Ehno
Setbacks:
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oCC Group: RC constrype: tRC ^P"""X
I l- tBUttDtNG / PLANNTNG DtVtStON :
Signed Approval Date
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Gurfield ConntY
BU/ILDING DEPARTMENT
7:08 Eighth Streq Suite 4OI, Glenwood Springs, CO 81601
Tel: (970) 945-8272
PI.^AN R EVIEW CHE c KLIST
bt RE-ol-24-g+?zPermit No:
Building lssues
NA
Engineered Fou*dation
Driveway Permit
Surveyed Site Plan
Pla n ni ng lZoning lssues
Line Setbacks
35 ft. Stream Setbacks
Flood Plain
Buitding Height
Zoningsign-Off
Planning lssues
Subdivision Plat
Des ion &ma
Approval
Permi{and Setbacksuy
Attach Residential Plan Review List
Subdivlsion Plat Notes
Fire Department Review
Valuation Determ ination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed
Complia nce Path/Plan Received
Plan Reviewer to Sign APPlication
ParceV Schedule No.
40# Snowload Letter - Manuf. Homes
Soils Report
Road rmpact Fees t 5m +
rn it/1 i rn vle
Grade/ Topography 40%
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