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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-82t2
www. ga rf i el d -cou ntv.com
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Phone:
Engineen è/> lÃLo €f-Aas-a , Tn¿,t^Phone:
Phone:
Mailing Address:
Email Address:
Manufactured Home lnstaller:
I
Mailing Address:
Email Address:
Describe Work:
Job Address:
Assessor's Parcel Number:
Sub.
aooS
Lot _ Block _
I
Owner's Valuation
Sq. Ft. of Building:Height:1g #ofF
Size (Sq. Ft. or Acres):
dition
Property
á'/
BUILСNG PTRM¡T
APPTICAT]ON
TY :oF:ßoitsrnuclt0
Commercial/M ulti-Family Demolition
Manufactured Home (Single or Multi-Level)
Residential lex or Town Reroof
Property
Mailing Address:
'Email Address:
Mailing Address:
Email Address:
tu\ç Phone:Contractor:
Phone:0
Þ CÔ I 0¿
Architect:
Mailing Address:
Email Address:
Class of Work:New
Garage:
Remodel/Alteration
Attached
of Work:
Detached
1"0a2 ft
Natural GasType of Heatr
Driveway
Permit:
PROJECT DETAII.S CONTINUED
Septic:Community
1
I
Propane Electric Other
it #:
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
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,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 a¿cepts 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
construct¡on 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
d neer a or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
ed uired i ts and accurate to the best of my knowledge.
Property Owner Print and Sign Date
QFfrclAt usE oNtY ?Å I t ? q.7, cc sg l*f*or_r
Special Conditions:
Adiusted Valuation:*tl^ glto Plan Check Fee:
S rqq.s
Permit Fee:
6tury. z6 Manu. Home Fee
x/a
Misc. Fees -N/n
Total Fées:
ûlob "îb
Fees Paid:
J I q 1.-t'
Balance Due:
êzoz z6 BP No:
gLr{€.' 614'l
OWTS Ño:
nl/¿
Setbacks:nl/-OCC Group:
lßc
Const. Type:
I AC
Zoning:
Êv r¿Â t-
!/-L2{BUITDING / PLANNING DIVISION :
Signed Approval Date
Gurfield County
BUILDING DEPARÍMENT
108 Eighth Strcet, Suite 407, Glenwood Sü¡ngs, CO 87607
Tel: (970) 945-8272
PLAN RE VI EW CHECKLIST
ßLR€-03-21-b74+Permit No:
Building lssues Planning/Zoning lssues
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/
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ StamPs/ Sticker
NT
./
t/
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees
Grade/ Topography 40%
Planning lssues
Subdivision Plat
nl*
t/ft
t/
t/
t/Attach Conditions
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Application Signed
Plan Reviewer to Sign APPlication
Parcel/ Schedule No.
40# Snowload Letter - Manu. Homes
Descriotion &Summarv:
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t/ soils Report
-t*A Jowetl S,rdìv exe{Yt\hon
sc,arthà in,Lapnrfi'Q4ø -' -l'lqg0 Exenr pli on(, rêæption 4q5L[b5
Framing plans for each floor level and roof. All beams, columns, joists, rafters and trusses
specified. Pre-manufactured structures require the engineers stamp, signature and date.
Framing /connection details, braced wall lines, shear wall schedule, location and hold downs
NOTE: lf any required information is missing, delays in issuing the permit are to be expected. lf
determined by the Building Official that additional information is necessary to review the application
and/or plans for complianqe, the application rnay be placed on hold until the required information is
provided. Work may not proceed without the issuance of a permit.
'lll
The Building Division will collect a Plan Review fee:at time of application submittal. The permit fee, as
well as any Road.lmpact fees will be collecfed 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 representativç.
Building cannet be gccupied until a Cçrtificate of Occupancy (CO) is issued. Using the building without a
CO will b9 considqred 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 thisIL,l b 5
er n Date
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