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JUL 3 1 ?01?
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{emrnuniry Dev*lop:nsnt nËpårtmant
:08 tth str*et, Sulte 401
Glenwsod Springr, Cü *ISü1
{9701 9¡r5-S21¿
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üor*rllerciaïMulti-f arnily
Manufactured Horne {$ingle 0t
RË$idÊntiôl {$F, Duphx or Torunhome}
Demolition
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Prcp*rly Swner:
trlaillnS Address:
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f,cçailÂddrtssi
ts$trattér:& r *tzr: lJù{Y. F{:{.- lu}¡, "Fl¡sn*r rtlÔ I {*ð6 .* 3¿f ?
l$aillng åddre*:;llt3l &rÊ*ôü"r el. lä*'trLe t$ ñl|{6$
Êrnait åddress: {-ålr{*r-. e i ard rä) q i aráb$f:nc{ -c-&w\
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Art?ritnct:Fhons:#-I$ l?åS- g{ I I
ltl*iling 4ddresr:
try¡*ll Address:
Hnginrem Phune; fiio t f{q 4åq I
: lVlaill*g Addrers;
f¡fiaÊl åddress¡
s
hllan*f¡ctured Xome lnstallen Phons: { }
ç,
tutailång Addr*ss:
fnail Addre*sr
$ercrib* lÀ¡srk:
$ob Addrcsr:
Âssesgor's Ptrcel f{u¡nber:
S*¿b,
-&5"/-Ð f- @Òx
l"nt Slnck
Õllrn*fs v¡luatlon cf lâl*rh $, lr3 T #51*:,:- prrperty $tze {Sq" Fr" nr A**r};
5q. Fl, of Building:ärm ilelgh* ""-
Cla¡¡ af Wsrlt:
$arag*:
I nheration Ël a¿u¡t¡on
sof Flnorr:*-¿f,*-
flRepair fl luove,/Relocation
!SÐetached
sn;;
f!attached
Sept¡c:
Typ* cf Heat:
DrÍvenray Ferrnlt:
o\Al?s Community
n Nafural$as I ffi rronane
Exempt
flrt*irrrt
fleermit*;
ñotner
Aulhority, This applÌc*tion for a Buildíng Perm¡t must h* signtd by the Owne r $f the prüpËrty, dascribed shovs,
rr ãn authÕrired age nt, lf the sisnãturÉ h'elsw is not thüt óf the üwn*r, ü sepãrãt* l*tter sf åuthürity, signed by
the Owner, must be provided witlt this Application,
lesrU!$$å A Euilding Fermit can*oÌ be issued vaithsut proof of legal and adequate äcne55 ts the property for
pilrpo$es of inspections by the $uilding Divísion-
Sther f"sqfnit* Mult¡pl* såpårä1ë perm¡ts may be r*quired; {X} Sþt* Ëfectriæl Pfrñ}¡1, {?} {ounty OWTS pèrffiit.
{3} another F*rr,¡t reguirud for us* ün thê prÕpcrty id*ntifìed abave, e"g, State sr Csunty t"lighway/ fioad Access
rr å sTäte Wãstewåter Þischarge Perrnít.
V+ld ferrnit, A åuilding Perrnit become* null ¿nd v*id if the wsrk authori¡ed is nat comnrenced withirr LSS days
of tlle date of issuancc and if wark is susp*nded or abandnned for a period of 18S days aftsr comme ncËnìent.
I hereby ce*ily that I have read lhis Application ånd thåt th* infcrrnation cnntained ¡bove is true and cö'"rect. I
under$and thåt lhe Building Division accepts the,4pplícation, along with lhe plans and specificati*ns *nd cther
dâtå subm¡tted by me or ûn ¡ïy behalf {submittals}, based upen my certification âs ts äcçurðcy. Assuming
ccmpfet*n*ss qf ths *ubmitlals and approval oi this Apptic*tion, a Building Fermit will bs i*sued gruüting
perrnissic* to me, a5 Owner, lo cûnstruct the structureis) and facilities det¡iled ûn Thç submittlìt revì*wed by
th€ 8u¡ld¡ng ûivisiçn. tn considårution of the istuance of the Building përm¡t, I agree that I and my agerrts will
conrply with prnvísirns of any f*d*ral, stäte or lccaì law regulating tlre work and the Ga$ield County Btlildìng
tode, ûWT$ regulations and applicable land uss regulations {Cot¡nty Êegul¡tion{s}}. I ack*owledge that the
Br¡ilding Permit rnny be suspended' or revcked, upoü ñ*ti(ë fr*m th* tcunty, if thè lsmtíon, cönstrl¡ctíçn or urs
öf the struttüre{s} and farility{ies}, de,scrib*d âbove, are not ¡n ctrnpl¡ance wíth Caunty Êeåulatinn{s} cr any
other appticable law.
I hereby grant permissî*n to the Euilding Sivisìcn ts snte. the prcperty" dererlbed ¿bovc, to in$püct the work, I
furlher arknowl*dge that the is*ua:lce ûf thË, Suilding Pe¡mit dnrs nät prûvËnt the *uilding 0fficial framl {1}
requiring thË,rorrË{tiûn of errors i* thë s$bmittals, if any, discovered tfler íssuance; or {?i stopping
csTlstructìon or uæ of ths structure{s} sr facitity{l*s} if such is in violatian of Counìy *egulation{si *r any ather
apBlieable law. Êeview af thìs Àppliration, including submittals, and inspcctions af the work by the Building
Ðivisirn do not çsnstitute ðn åcceptånce of respon*ihilíþ or liability by lhe {outtty of erors, omissitns or
discrepancies. Ar the ûwner. I acknnwledge that responsìbilily for cnmplianc* with {ederal, $tåtË änd lnral law*
and {nunty ßeg*latî*ns rcst with me and my authorked äg€ntË, includíng wíthaut limitat¡{r¡ mT archiTect
and/ nr buílder.
I hereby acknowladg* that I har¡e read ard understand tfte Hotic* and Ce*iflcation äboysr as ruell as, have
gr*vid*d the requir*d information which is eorrect ãnd ãccurate to the bêst sf my knowledge.
.ÞLu. c Pt "[.,* Wc-. /hL
Fropnrty *wner Frint and Sign A
7-Q.17
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Þatê
Speti*l Çrnditfon*:t4tI
flanu home Fed: I lh'i*¡ ron<'' r\ lA,
Ådjust*d2//Plan Check Fee:
¡. 053,lpl 'iffiï,q5
8P Ho; I owts ltorffi;-r \E ,glffiç\BLì¡fii,'Íï.ç7 Fees Paid:
$frr. bþ åalanc* Oue:
ïlþL,qi
5et'backs:OCC Grtun:
8"18'¿ot7BUlLnlHG 1 PIÂÍ{NING ÞlVl$l$lrt ;
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Buildin Zanin Plan ew
b' 3r *D"7'l7- 4gllPermit Number:
uil
Engineered Foundation
/r? ,fl-
M,,A
D Permit
Su Site Plan
Permit and Setbacks
opograp hy 3A%
Attach Residential Plan Review List
Plannin Zon
ÐrU,Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
/,1 ,
N,il
C"( " BuitdingHeight
-/:
s
---¿Road lmpact Fees
--Zcradel
Topog raphy 4o%
nníng lssues
e M*rAl-
-[l-u,,"x",egg
Subdivísion Plat Notes
iV ,Å Fire Department Review
Valuatíon Determlnatíon/
Líne Plans/ Stamps/ Sticker
ch Conditions
Ap Signed
Reviewer to Sþn Applícation
Parcel/schedule No.
Ìr/ '4 40# snowload Letter- Manu. Homes
Soils Report
Subdivisíon Plat
General Comments:
f*ar&
*aw¡n'e
G*rfield C*wnty
Com munÍty Davrlcpnnonì ßÉpürtmênt
10fi 8th Street, $uite 4ûl
ülenwood Sprlngs, Ct 8t601
{e?r} e{5-82r,t
!Eww. gar$e*d-countv"cam
SINGLE FAA{ltY OR nUFLÊX FUILÞlhl$ FERñ¡llTAPPLICATIOI¡ ttlECKLl$T
ln *rder lo under*tand the sçrpê of wark intcndsd and to expedite the issuance of a permit, it is
important that complete information be provided. Ëlease r*view this document to dctorrnine if you have
adequ*te lnf*rmatian to de*ign your proj*ct and ta facilitate a plan rsview.
ÅPPLICATIÛH FüHM: Fl+ase make sure the following infarmation is provided on the application.r Par*el number abtained fram the Ëounty A$ses*or'$ Ofice.
' Jsb address {assigned phy*ical addres*)* L*gal üescription: block, lot, tract, subdivi¡ion, filing, or section, tawnship and range.. twner's nafne, rnailing address, phons, fax or cell.. tcntactûrs natnËr rnailir"rg addr*ss, phone, fax, cr ce*|.r Årclrit*cl and/nr Hngineer's name, mailing åddres*, phone, fax or cell.. Suilding siz*, height, numbâr of stories and fol síee,
" Uçe af building {Residential}.* class of work {New, Addition, Afteration, Repair, D*mo, Movel Relocationi.r üetailed description of work.
" Type of healing {natural gãs, propäne, elestric, ather).* $ew*r system (tommunity cr ûWT$), also see other itsms belcw.r Garage {Attached or Þetached),
" Oriveway pennil {please se* ather items below}.r Valuation ilabor and materials), see a{tached work*hact.
TTilËR ITË1I¡IS:. l! Vay anticipate obtaining a weter-tap from the City of Rifie, please provide a lefler indicallng that
the tity will províde water s*rvåce. Required ta submit building permit applicationr ÜWîS requlres a septin permit application ts be subrnitted Wjth th* building p*rmit application"* A saparate eleciric*l perrnit m*st be *btained from the State of Colorado Flectrical ffioard.. Åt the t*me of building permit submittal, you arç required to show prcof of legal and *dequate
äte€ss tc the site. This nay include proof of right tc u*e a privat* easemen{ tounty noàC A
$ridgc Permit, cr Oolorado Department of Highway permit, including a Notice to Froceed. The
Çounty Ro*d & Bridge Þ*padment can þe reached at 9?0-925€$01.. lf you anticipate excavating or grarting prior io issuance of a building pennit, you w*ll be r*quiredla oblain a separate grading permit.* ll yau b*lcng tc a Hcmeou¡n*r* Association {HOA} il is your responsibilis ta abtain written
approval, if roquired.r Ërovide *opies of any Resolutlonç and/or Land Use Perrnits associntçd with lhis praperty.¡ Additional Fwelling Units rnay require Admini*trative Review.r Minímum dwelling dirnsnsinn i* 2t ft. wide x l0 ft" long.I A tolarads Stat* Licen*ed Etectri*ian and Flumber must perforn installutior"r and hoak-ups,
unl*ss the horneowner is pe#orming the work.
ÊUltnlilü Pt*AlrlË¡ ? sçts of plans must be submitted. Plsns rnust þe 18'xâ4" minirnum size, oompletre,
identical,-loçiblç and,to scale. Åll pløns will be checked at the counterfcr nompleteness. lf any of thã
requir*d infcrmation is mi*sing, the building permit application cannot be accepted.
Silf FLAf'l: Please make sure the following infornation is provid*d nn lhe *it* plan.r Proper*yaddrus#legaldescription"r North Ånaw and Scal* on eacfi page.r $how *ll properly lines, br¡ilding envelopes, flood plain and ea*ements,r Prsvide setbaek distancs* frorn boundariçs, buildings, *eptic, well and waterways.r Lo*ation and directisn of the county *r private rsad and driveway nccessing the proper{ry.. Frspüçed and existing structurgç. ln*lude sheds, bårns, de*k*, patios, and any other nuiffiings"r Hxistins and proposed gmde, positivn drainage arcund structurs {to be containag on site}.r $trearns, rivërs, rrê6ks, spring*. ponde and ditche*.* Ëxisting and pnoposed wells, saptíc tanks, Ieach fieldr and othar s¡ntems {if applicable}.* Retaining walh {engineer stamped detail required fpr walls ov*r 4 ä., mnaàurçd from battorn ol
footlng to top of wall).
I'IüTH: Any sife plan d*picting the placement *T any portion of tho structr.rre within s0 fset *f a properg
line or not within an establiçhed building envelop* sir* Ue prepared, stamped and signod ny a ticen*en
lurvsyor" For struct*res to þ€ built within a huilding envelope, provide e cåpy of the recorded *ubdivlslanfinal plat with thç proposed structure localad in theluifding'envelope
AHtlllTHCTt¡R.ât PLAN$: Please provide the follawing Ínformation on Sre architectural ptans.r Minimum of fty (4) elevatians (N,$,ñ,W)" lndicate height of bullding rnea**res fronn existinçgrade tc the midpoint between the ridge and eave of a gable or sh*ð ruof or ts the top a¡ a flät
roof.* Ffoor plane for each level, includlng dimsn*ions and sc*le noled.r Çlearly laþel ench rÕsm ôr $päcr {bedroom, halh, kitchen, cloael, etc}.r $how th* lacatían sf the mechanical equipment.r Fuilding crcss sectiçnr wíth construction details.r Windsw sizês, typ*s and operati*n notsd on the flsor plans ar elevations.. Speciff roof slope/pitch, rsof cavering and *íding rnatsrials.r $fair and guard details spc*ifying riãeo run, treight and spacing.I Åttic, racf and crnwlspace vcntilation details. lndicatc sizç and location cf ventilation opening*.r Minlmum insulstl*n ehown for welh, Tloors, roofelceiling$, $låb$, bagements and crawl*pacå.* Frsvide stovo_and fireplace mðke, msdel, ãFA cr tolorado Phase ll tertification. il,tascnryfir*pfaces shall be designed t+ the lnlemationalRç*identialtods {lnC} red¡rements.
FTRUCTURåL PLAlttS¡ Fleasc provide the fslloï¡ring information on thc structural plans.r Design specifieatians to include roof and dêc* snow load, wind and *eisrnic design and frostd*pth.r Foundafian plan shcwing complete fnoting and foundati*n dimensions.r Fasting and foundati*n details epe*ifying ieinforcernent and refçrenced on plans.t Framin$ påans for cach flaor level and rool All beârns, cçlumns, joi*tn, retters and tru¡sestpecified. Fre'manufactured struc'tures requíre the engineers *tamp, signatur* and date.r Frarnin$ lconnection details, braced wall lines, shear ùail ecl"redu¡e, iorãmn and trold dçwns.
flrnl. tf any requlr*d information is rnisaing, delayg in i*suing itre pennit are tc ha expected. lfdeterminod by the ßuilding sfficial that sddiäüna¡ ¡ñrsrmâtiûn Ë necu**ary to review the applicati*n
andlor plans for compliance, the appli**tion may be placed on hold until the required information is
pr*vided. Work may not proceed withsut the i*suance of a permit.
The Euilding Divi*iun will collect a Plan Review fee at ti$rs of epplicotian submittal. The permit feÐ, as
¡¡¡oll as any Road lmpact fees will be ccllçcted whcn lh+ permit i* is*ued.
Tho ponnit application must þe signed by ths owler or hy porson having written autfrorÌty irorn the elrvnër
to aet ss Their reproeentative.
Suilding cannot he occupied untìl a tertíficat* of ûccupancy {Cû} is i*çued. Using the building without q
*û will bç coneidered an illegaÌ ûccupancy and may be ground* lcr vacating the $remi*es, {Final/Cüin*pection requirements will bo attached to your appr*vod field s*t of plans")
I her*by a*knowledge I have underetand ar¡d will abid* by ths r'*quir+ment* of this
chscklist.
and $ign Dats