HomeMy WebLinkAboutApplicationGurfield County
BUILDING PERMIT
APPLICATION
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(e7ol94s-82L2
www.ga rfieldcou ntvco. gov
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TYPE OF CONSTRUCTION r- ,*.-,,-l ii
Commercial/M ulti-Family
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
7APhone:
Email Address:
Property Owner:
Mailing Address:
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Phone:
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Contractor:f ,l L[Tn ftD/ts{*.) t+,bt/]
Mailing Address:
Email Address:
Phone: &70,s1793aT
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Architect:
Mailing Address:
Email Address:
fz aPhone
Email Address:
Mailing Add
Engineer:
I
Phone: ( )Manufactured Home lnstaller:
Mailing Address:
Email Address:
PROJECT DETAITS
Assessor's Parcel Number:
Describe Work:
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Lot ,{V- Block _
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tloors: -/Sq. Ft. of Building:Height:aa-l}Yzla
Property Size (5q. Ft. or Acreslr
#of
Job Address:
Owner's Valuation of Work
Sub.
(New Remodel/Alteration AdditionClass of.Work:
DetachedGarage:Attached
Type of Heatl
Community
Electric
PROJECT DETAITS CONTINUED
Septic:
Other
Permit #:
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwncrofthcproperty,describedabove,
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 Permit.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinlS0days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
Natural Gas Propane
CERTIFICATION
NOTICE
mptDriveway
Permit:
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 a nd my agents wiii compiy with provisions of a ny
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 td 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, ifthe location, construction or use ofthe
structure(s) and facility(ies), described above, are not in compliance with County Regulation(s) or any other
applicahle 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 (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 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 information which is correct and accurate to the best of my knowledge.
Owner Print and Sign Date
OFFICIAT USE ONIY
Special Conditions: ' . - . . .Ar r tb- , . a ] t-2
1ec 4ttahed COND/-/ /2/VD
5:irr:#nt:b ww:tfb ,72'iIJ,#Manu. Home Fee:Misc. Fees: r
RFsrD iLs?g
"'t.ln.6(.o,Fees Paid:I u?9^qb
Balance
a) aa ]i]'#BP No:
R-t 0E4AC{A
OWTS No:
t*ffi'nlD 6cc Groupr
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Date
BUITDING / PLANNING DIVISION
Signed Approval
Gar$eld County
BUILDING DEPARTI{IENT
108 Eighth Street, Suite 407, Glenwood Springs, CO 8160L
Tel: (970) 94s-8212
PLAN REVI EW CHECK LIST
Permit No: 82-RE-05-A 5-/ a{a.
Building lssues Pfanning/Zoningtssues 7A>
Driveway Permit
Surveyed Site Plan
Septic Permit ancj Setbacks
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Grade/ TopograPhY 30%
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Attach Residential Plan Review list
Subdivision Plat Notes
Fire Department Review
Application Signed
perty Line Setbacks
35 ft. Stream Setbacks
Flood Plain
'Building Height
Zoning Sign-Off
Road lmpact Fees
Grade/ Topography 40%
Planning lssues
Subdivision Plat
Description & Summarv:
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Ft S 2r34x /o/,/6 zt47w.soEnergy Compliance Path/Plan Received
Plan Reviewer to Sign ApPlication
Parcel/ Schedule No
40#snowload Letter-Manuf. Homes 4 787x
Soils Report
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OPEI\-HOLH $OIL$ REPORT
IS REQUIRED AT FOCITING
INSPECTION ISOD PSF
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