HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
i'.1 F",i., i.:!Gl€nwood Springs, CO 81601
(9701945-82L2lAlts2M
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BUILDING PERMIT
APPLICATION
I hiirp EroF€oft srfr u cno ru
Commercial/Multi-Fami Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
Accessorv Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOLVED PARTIES
Property owner: MoU^',o. bvr^-o,^l,it'.Phone o 6 1
Mailing Address:5Lt T',tr9 {Go (}. G9.r^uoa) L..i*<rr- I o P.Ieo
.J".
cl ta
Email Address:
Contractor:
Mailing Address:
Email Address:
Architect Phone: ( )
Mailing Address:
Email Address:
Engineer:Phone:
Mailing Address
Email Address:
Manufactured Home lnstaller:Phone: ( )
Mailing Address:
Email Address:
PROJECT DETAILS
Describe Work:
Job Address:
Assessor's Parcel Number:,.ttt 4t?q b o&w4 'i
suu. tJqhr,n r,^. t{i!,td .1," Lot Q Block
Owner's Valuation of Work 1_5, w Property Size (Sq. Ft. or Acres)3tr , Bqt
sq, Ft. of Building: 9A( Height:# of Floors:_
Class of Work:New V Remodel/Alteration Addition
Garage:Attached Detached
Septic:
Type of Heat:
Driveway
Permit:
PROJECT DETAILS CONTINUED
Community
Natural Gas Propane lectric Other
mpt Permit #:
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Applicatiorr.
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. Multi ple 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 Buildi ng 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
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 thisApplication, a Building Permitwill 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)). All Countydevelopment requiring a permit, exceptfor
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 of the
structure(s) and facility(ies), described above, are not in compliance with County Regulation(s) or any other
applicable law.
I herehv grant nermissinn tn the Ruildins Divicinn tn Fntpr thp nrnnertrr dpqrrihod ehnrro tn ihcna.i fho rarnrlz I
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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 (2lrstopping construction or use of the
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Application, including submittals, and inspections of the work by the Building Division do not constitute an
acceptance of responsibility or liability by the Cournty 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 designer, engineer and/ or builder.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required i on which is correct and accurate to the best of my knowledge
t :/1 /1 - O iLa'L'( / t- a
Property Owner Print and Sign Date
oFFtctAt usE oNtY 'I
Special Conditions:
\>ee affi&e4 (z/vD / / /o/v J
Adiusted Valuation:. r6tq.6ffi.ryt'Plan Check Feeltz ,41
Permit Fee:&6,29 Manu. Home Fee:
NI /A Misc, Fees:b,l/A
Total /ees:
13n bb Fees Paid:an.ql Balance Due:
a /q,2,aP No/
F;t.LE-gqffi
OWTS No:
Set uac!L-occGroup: IRO crnst.rype: tRfZ '"tu-
/l ,,1r t /(2Wt v'"fl\J 2- l-2BUTTDTNG / PLANNTNG D|V|SION :
Signed Approval Date
Gurfield Coan$:
BUILDING DEPARTMENT
708 Eighth Streel Suite 401, Glenwood Springs, cO 87607
rel: (970) 945-8212
PISN REVI EW CHE CKLI T
6LRE-o/-o?48/?/Permit No:
Building lssues Pla n n i ng | laning lssues
rlO As E*gineered Fou*dation
orlhl' U, Driveway Permit
-Zrurveved site Plan
ptic Permit and Setbacks
Gradel Topography 30%
Attach Residential Plan Review List
SuMivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ StamPs/ Sticker
ttach Conditions
Application Signed
Energy Compliance Path/Plan Received
Plan Reviewer to Sign APPlication
Parcel/ Schedule No.
40# Snowload Letter - Manuf. Homes
Soils Report
Property Line Setbacks
35 ft. Stream Setbacks
NA Flood Plain
Grade/ TopograPhY 40%
Planning lssues
Descri otio n & Summarv:
Building Helght
Zoning Sign-off <_rAA *
Road lmpact Fees mtbirzttts 0,4)
nell
Subdivision Ptat $2j78%-
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