HomeMy WebLinkAboutApplicationRECFIVED
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li{,iY ilLf['tC0Mrr,Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-82L2
www. garfi eld-cou ntv.com
Garfield County
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
tr Demolitiontr Commercial/Multi-Family
tr Manufactured Home or Tiny Home (Single or Multi-Level)
E Residential (SF, Duplex or Townhome)tr Reroof
tr Accessorv Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOLVED PARTIES
Phone:d t"
o
$L
5z
Email Address:
Property Owner:
Mailing Address:
Phone: (_)
Email Address:
Mailing
Phone:
Mailing Address
Email Address:
Phone: (_)E r:
Email Address:
Mailing
Phone:ruanutlq[iny Home lnstaller:
Mailing Address
Email Address:
PROJECT DETAILS ^ -t-
r'f t
Property Size (Sq. Ft. or Acres):
# of Ftoors: 0P e {tca A
tlt tv
6.
Lot
Height:
Job dress
Block _lP'3r .Sub.
Owner's Valuation of Work: S
5q. Ft. of Building
Assessor's Parcel Number:
tr Move/RelocationClass of Work E New 6 Remodel/Alteration E Addition E Repair
E DetachedGarageE Attached
PROJECT DETAILS CONTINUED
E Community
E Electric E other
E Permit #:
NOTICE
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
ired information which is correct and my knowledge.
O /-
Prop€rty Owner Print and 5 Date
Septic:
Type of Heat:
.E(,owrs
E Natural Gas
Driveway
Permit:
E Exempt
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
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 bv 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.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinlB0days
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 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 regrrlations and applicahle land rise regrrlations (Corrnty Regrrlation(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.
lherebygrantpermissiontotheBuildingDivisiontoentertheproperty,describedabove,toinspectthework. lturther
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 liability
by the County of errors, omissions, or discrepancies. As the Owner, I acknowledge that responsibility for compliance with
federal, state, and local lawsand County Regulations restwith me and myauthorized agents, includingwithout limitation my
a rchitect e neer a or builder
OFFICIAL USE ONLY
nee athahel /VA/I/KSpecial Conditions:
Adiusted Valuation:'4000 "b'*5:v1',VHHE Manu home Fee Misc Fees:
Totalfees /{// /tl/ (2/./,G*l>t Balance 'paq7,WnEqu)OWTS No:
FI
Setbacks:
G-
OCC Group /Rc ,o"t rrOfrRC_,off,
7-5-zBUtLDtNG / PLANNTNG DTVTSTON :
Signed Approval Date
t'
Garfteld C*arctY'
BUILDINo DEPARTMENT
7:OB Eiqhth Steet, Saite 401, Glenwood Springs' CO 81607
Tel: (970) 945-8272
PtA NR EVI w CH EC KLIS
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T
Permit No:
PlanninglZoning lssuesBuilding lssues
, nAA)
rbrbr
Engi*eered Fo*ndation
DrivewaY Permit
rade/ TopograPhY 3O%
Attach Residential Plan Review List
SurMivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ StamPs/ Sticker
Attach Conditions
Application Signed
Energy Compliance Pathy'Plan Received
Plan Reviewer to Sign APPlication
Parcel/ Schedule No.
40# Snowload Letter - Manuf. Homes
Soils Report
Gza
no Ae PropertY
//a'4-
Linesetba/ *b4-
35 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmPact Fees
Grade/ ToPograPhY 40%
Planning lssues
Subdivision Plat
/o
Descri ption &Sum arv:
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