HomeMy WebLinkAboutApplicationGarfield County
BUILDING PERMIT
APPLICATION
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munity Development Department
108 8th Street, Suite 401
Springs, CO 81601
945-8212
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Demolitionulti-FamCommerci
Manufactured Home (Single or Multi-Level)
TE ReroofResidential (SF, Duplex or Townhome)
Accesso Dwelli Unit D - MAXTMUM S|ZE OF 1,000 SqUARE FEET
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Property Owner:
Mailing Address:
Email Address:
Phone:/7 t-
Mailing Address:
Email Address:
3a-*, / -"
T I
Phone: I )Contractor:
Phone:Arch¡tect:
Mailing Address:
Email Address:
Phone: ( )Engineer:
Mailing Address:
Email Address:
Mailine Address:
Email Address:
Describe Work:
?/Height:
Phone:
¿L/BlockIot
fof
of Work:PropertySize (Sq. Ft. or
Manufactured Home Installer:
Job Address:
Assessor's Parcel Number:
Sub.
Owner's Valuation
Sq. Ft. of Building:
'(Remodel/Alteration AdditionClass of Work:J'¡"*
+fetachedGarageAttached
illli./.{lì \vr1r I rr l'11,.'li: ii J i..
Electric
Community
Other
PROJECT DETAITS CONTINUED
Septic:
Type of Heat:Gas Propane
Driveway
Permit:
Permit #
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
Legal Access, ABuildingPermitcannotbeissuedwithoutproofof legal andadequateaccesstothepropertyfor
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.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinlS0days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICAT¡ON
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)). 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 (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
desi er,neer 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 and to the best of my knowledge.
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Signed Ap
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Print and Sign
BUILDING / PLANNING DIVISION I
Date
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OFFICIAT USE ONtY
Soecial Conditions:'""ðï ;- tui{;¿t',* I ief of øu')ihonq .
Manu. Home Fee:
Ì.1/A
Misc, Fees:. .NÁPlan Check Fee:QâÔ4.ø P.ermit Fee:q-tulbAdiusted Valuation:+'/a4æ.Ø
Due:Balanceqet¿Ø
BP No:
Bij¿c- f(r't T
OWTS No:Total Fées:6l,zØl (A Fees Paid:
4sl 8,1
const. TvRe: ¡B¿Zoning:
RSetbacks:
FIR-2bt 4,lÒ OCC GrouC: ¡ç,
lât
Date
Gørfteld County
BUILDING DEPARTMENT
708 E¡ghth Street, Su¡te 407, Glenwood Spr¡ngs, CO 87607
Tel: (970) 945-8272
PLAN REVIEW C HECKLIST
Permit No: ?t#E Ø.n-rylfl
Building lssues Planning/Zoning lssues
Engineered Foundation
Driveway Permit
'/ Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
/ subdivision Plat Notes
NA
Fire Department Rev¡ew
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to S¡gn APPlication
Parcel/ Schedule No.
4O# Snowload Letter - Manu. Homes
Soils Report
Description & Summarv:
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Ttfal -ÇØ¡ø'
þ^¿ tvtpa,f F4. N/A
N/A
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees
Grade/ Topography 40%
Planning lssues
Subdivision Plat
N/n
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