HomeMy WebLinkAboutApplicationGarfteld County
CqgilUuXiW Development Depa rtment*EcfdVE rxtreet, suite 401
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BUILDING PERMIT
APPLICATION
DemolitionCommercial/M ulti-Fami
Manufactured Home or Ti Home (Si or Multi-Level
Residential or TownhD Reroof
Dwelli Unit DU - MAXIMUM SIZE OF SqUARE FEET
Property Owner:
Mailing Address:
Email Address:
Phone: (_)
Phone: (ol'LD I h25-f)ZDRContractor:
Mailing Address:
Email Address:
uh Phone:Architect:
Mailing Address
EmailAddress:
Address: 2?'l Sourtln Hth s,fi ft'LMnn . NE bgb?n
Phone:( 800 | 921 - 01qD
Email Address:
Engineer:
Mailing
Agl Sm{.rru,l
Nlnrr b0' x t,,l' x lg' Stg.ol Etuilunn Enra-aot. Lnl
Phone: (_)
rg'
N
JJ )
I
Height:
Describe Work:
2ttzgt"Ll 00022
Sq. Ft. of Building;Shoo
Job Address:5{
lot _ Block
Manufactured Home lnstaller:
Sub.
PropertySize (Sq. Ft. orAcres): 'l.Utl Se.toS
# of Floors: I
Owner's Valuation of Work:
Assessor's Parcel Number
Mailing Address
Email Address:
Class of Work:dlruew Remodel/Alteration Addition
XGarage:Attached Detached
]WTS CommunltySeptlc: N A
atural Gas Propane Electric OtherType of Heat:n/n
Drlveway pt
Extsh
Permit #:
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 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 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 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 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 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 l2l 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 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 authorlzed 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 information which is correct and accurate to the best of my knowledge.
Property Print and Sign Date
thcled QND/Ta/V€Special Conditions:9ee n
Manu. Home Fee:Misc. Fees:
Wi:l,W,'W Permit Fee:
Qoz.7o
BP No:
B-tflt -g'g<OWTS No:6fA rtgl
Totdf Fees:
ig
Fees Paid
-+(.1rj
-
Balance Due:
796, eb
Const."lPa Zg4ing:
\\
Setbacf: -occ Group:
t RC
BUITDING / PLANNING DIVISION :
Signed Approval Date
b.2Cd,?H
irlirlr,',] ri, 1' jllli.'
Gurfteld CountY
BUILDING DEPARTMENT
7oB Eighth Steet, Suite 4OI, Glenwood springs, co 81607
Tel: (970) 945-8272
PI.AN REV!EW CHE CKLI T
gt4*o6-2y'-8e68Permit No:
Building lssues
E*gineered Fou*dation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/Topography 30%
Attach Residential Plan Review List
SuMlvisio* Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ StamPs/ Sticker
Attach Conditions
Application Signed
Energy Compliance Path/Plan Received
Plan Reviewer to Sign APPlication
Parcellschedule No.
40# Snowload Letter - Manuf. Homes
Soils Report
Pla n ni ng lToning lssues
=t' ProPertY Line Setbacks
35 ft. Stream Setbacks
Flood Plain
Building Helght
-/ Zoning Sign-Off
Road Impact Fees 0O F/S
Grade/ TopographY 40%
Planning lssues
,- subdivision Plat
usqa 926/51
Descr ion&S mma
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