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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
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www.Farfi eld-cou ntv.com
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BUILD¡NG PERMIT
APPLICATION
TVPE OF CONSTRUCÍION
DemolitionCom mercial/M ulti-Family
Manufactured Home (Single or Multi-Level)
ReroofResidential (SF, Duplex or Townhome)
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOTVED PARTIES
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Email Address:
Property Owner:
Mailing Address:
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Mailing Address
Email Address:
Phone: ( )Architect:
Mailing Address
Email Address:
phone: (@ (u\ã5\1 Ïq 5.-lf:\
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Engineer:
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Mailing Address
Email Address:
Phone: (_)Manufactured Home lnstaller:
Mailing Address:
Email Address:
PROJECT DETAITS
Describe Work:
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2l1f - 767 -oo-als
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f of Floors: l.
Property Size (Sq. Ft. or Acres):
Block
Owner's Valuation of Work:
Sub.
Assessor's Parcel Number
Job Address:
Lot
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Sq. Ft. of Building: ltl 16- Height:
AdditionClass of Work:New Remodel/Alteration
Y DetachedGarage:Attached
PROJECT DETAILS CONTINUED
Community
CERTIFICATION
I hereby certify that I have read this Application and that the informatÌon 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 asto 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, engineer a 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
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I{Septic:
OtherNatural Gas propane N/A E lectricType of Heat:
Permit #:Driveway
Permit:
Exempt ¡t/a
Authoriw. 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.
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.
NOTICE
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iËnë¡ F d-a-Adiusted Valuationis ?,6^q0+
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Fee:
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Fee:
502
tfiaùl¡. Homefee:V¡
Balance Due:
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BP No:
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Total Fees:+ 82J,98 t{ot. ? t
Fees Paid:
OCC Group:
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Const. Type:
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Zonins:-?3Setbacks:
,r-n-z/'BUILDING / PLANNING DIVISION :
Signed Approval Date
Garfteld County
BUILDING DEPARTMENT
7o8 Eighth Street, Suite 407, Glenwood Springs, CO 87607
Tel: (970) 945-8212
PLAN RE VIEW CHEC K LIST
BuRg-o'J^Zl- bØtloPermit No:
Building lssues Pl a n n i ng I Zoning lssues
rUA
,/
N4
Nk Flood Plain
N4 Septic Permit and Setbacks t/Building Height
Zoning Sign-OffGrade/ TopograPhY 30%
Attach Residential Plan Review List N/A Road rmpact Fees no aldd,4' l, S ,t-
t / Subdivision Plat Notes
t/ Fire De partment Review
b' Valuation Determination/ Fees
L-
,/Attach Conditions
Property Line Setbacks
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t/ Grade/ Topography 40%
t/Planning lssues
Subdivision Plat
Descripti on & Surnmarv:
Red Line Plans/ StamPs/ Sticker
Application Signed
Plan Reviewer to Sign APPlication
Parcel/ Schedule No'
40# Snowload Letter - Manu. Homes
Soils Report
Engineered Foundation
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SurveyedTite Plan
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