HomeMy WebLinkAboutApplicationCommunity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
TYPE OF CONSTRUCTION
Commercial/Multi-Family
Manufactured Home (Single or Multi -Level)
Residential (SF, Duplex or Townhome)
] Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
BUILDING PERMIT
APPLICATION
(=Demolition
n Reroof
INVOLVED PARTIES
Property Owner: LI ea' 1 Phone: (1 1O) ,379 . �a j
Mailing Address: P. o. 3 o v 3
Email Address: `A .-(Ts W i 1-1=S .sop r
i� 1n
Contractor: Phone: ( )
Mailing Address:
Email Address:
Architect: _ _ Phone: (_
Mailing Address:
Email Address:
Engineer: ____... Phone: (
Mailing Address:
Email Address:
Manufactured Home Installer: Phone: 1
Mailing Address:
Email Address:
PROJECT DETAILS
Describe Work: Pr) I E' , [3 t L i- 1 )
Job Address: O a 4-1 c< i cJ 11� J
Assessor's Parcel Number: 1 a3 S 91jl {25
Sub. LOW L Lot 5 Block E.(
Owner's Valuation of Work: $ ) (. 0 Lica Property Size (Sq. Ft. or Acres): r
�It'
Height: I r ray IC' # of Floors: 1 ct
Sq. Ft. of Building:
Class of Work: New
Garage: Attached
Remodel/Alteration
Addition
Detached
PROJECT DETAILS CONTINUED
Septic: OW1 S O NF 11A- 11 Community
Type of Heat: Natural Gas Propane l Electric FrOther,0
Driveway Exempt ❑ Permit #:
Permit:
NOTICE
Authority. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. If 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
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.
CERTIFICATION
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. In 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. 1
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.
Property Owner Print and Sign
Date
'6'C)/'❑
OFFICIAL USE ONLY
Special Conditions:
Asljusted Valuation:
2111"A0•Db
Plan Check Fee:
12'21.0l
Permit Fee:
`tI
Manu. Home Fee:
N/a.
Misc. Fees:
A
Total Fees:
cP tj7(o, 2(4
Fees Paid:
$227.01
Balance Due:
34.01. 25
BP No:
OWTS No:
BLRE-04-20-6204
N/A
s
SSseebbacks: 9 10
OCC Group: ��
Const Type:1R6
Zoning: RURAL
/ PLANNING
lf,6
��2b�2D�BUILDING
DIVISION :
...Na(17
Signed Approval Date
PD. $227.01, CC, 4/01/2020
NOTE: If any required information is missing, delays in issuing the permit are to be expected. If
determined by the Building Official that additional information is necessary to review the application
and/or plans for compliance, the application may be placed on hold until the required information is
provided. Work may not proceed without the issuance of a permit.
The Building Division will collect a Plan Review fee at time of application submittal. The permit fee, as
well as any Road Impact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by person having written authority from the owner
to act as their representative.
Building cannot be occupied until a Certificate of Occupancy (CO) is issued. Using the building without a
CO will be considered an illegal occupancy and may be grounds for vacating the premises. (Final/CO
inspection requirements will be attached to your approved field set of plans.)
I hereby acknowledge I have read, understand and will abide by the requirements of this
checklist.
1/" 4Na
Property Owner Print and Sign
3/se h2e
Date
PC—, Garfield County
BUILDING DEPARTMENT
108 Eighth Street, Suite 401, Glenwood Springs, CO 81601
Tel: (970) 945-8212
PLAN REVIEW CHECKLIST
Permit No: LR5- - 2.0 ' 00'
Building Issues Planning/Zoning Issues
N/A Engineered Foundation / Property Line Setbacks
Driveway Permit 30 ft. Stream Setbacks
Surveyed Site Plan Flood Plain
NA Septic Permit and Setbacks ` Building Height
Grade/ Topography 30% / Zoning Sign -Off
Attach Residential Plan Review List lam`/�' Road Impact Fees
IF Subdivision Plat Notes Grade/ Topography 40%
WA Fire Department Review Planning Issues
.7 Valuation Determination/ Fees / Subdivision Plat
Red Line Plans/ Stamps/ Sticker
/ Attach Conditions
Application Signed Description & Summary:
Plan Reviewer to Sign Application PpiG V V1 AV'Gic-
Parcel/ Schedule No. 22 �dg�
40# Snowload Letter— Manu. Homes Vil (1 Dln
X Soils Report 0 x / 24• Sib 42 l)120 et