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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
1970194s-82t2
www.garf¡eld-countv.com
Gørfield County
BUILDING PERMIT
APPLICATION
DemolitionCommercial/Multi-Family
Manufactured Home (Sinele or Multi-Level)
I ReroofResidential (SF, Duplex or Townhome) Garase
Dwell Unit DU - MAXIMUM SIZE OF FEET
104 Midland ave, suite 202, Basalt Colorado 81621
Steven DeClute p¡on".¡970 )379-5253
Email Address:steve@icgaspen.com
Property Owner:
Mailing Address:
104 Midland ave, suite 202, Basalt Colorado 81621
contractor: lndependence Construction Group p¡on".1 970 ) 379-5253
Email Addresr. steve@icgaspen.com
Mailing Address:
Phone: ( )Arch¡tect:
Mailing Address:
Email Address
p¡on".1970 t927-4363Engin""r. Albright and Associates
Mailing Address:402ParkAve, unit A, Basalt, Co 81621
Email Address¡Jack Albright jack@albright-associates.com
Construction of an attached 1850 square foot garage
Eagle's nest Subdivision [e¡ parcel D Btock
Phone:
Assessor's Parcel Number
1 1.20 acres92,500.00
Height:
Describe Work:
Job Add ress. 259 County road 119
Sub.
1
00 Ùbaat15 2.1.1
of Work:
Email Address:
Property Size (Sq. Ft. or Acres):
1 850
Man ufactured Home Installer:
Mailing Address:
Owne¡/s Valuation
Sq. Ft. of Building:16',-2"-314" # of
RemodeUAlteration AdditionClass of Work:New
/Garage:Attached Detached
no bathroom or water service in building
FRO¡ECT DETAILS CONTINUEÐ
Septic:
NOTICE
Author¡tv. This application fora Building Permit must besigned bythe Ownerof the property, described above,
or an authorized agent. lf 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 Perm¡t 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.
Vpidlefmjt. 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,
CERT¡FICATION
I hereby acknowledge that I have read and understand the Not¡ce and Certification above, as well as, have
provided the required information which is correct and accurate to the best of my knowledge.
Sfa-¿nD¿øtfu 3.7.2021
Community
Type of Heat -lNaturalGas Electric Other
Permit #:Driveway
Permit:
Exempt
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 Buílding Division. ln consideration of the issuance of the Building Permit, I agree that I and my agents will
comply wíth 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
Divisíon 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
eer and/ or builderer,
Property Owner Print and Sign Date
oFFrcrArusEoNry g. *{lá{ e êgfoià/tazl
Special Conditions
Adiusted Valuation:ûbq.7b5.5L Plan Check Fee:45n,44 Permit Fee:
ó793. v4
Manu, Home Feexls Misc. Fees:N/n
Total Fees:
4t,LQ1, l1
Fees Paid:
$ { ô3.q{
Balance Due:
6 g L?,26
BP No:
ßr¡.8 - 681I
OVWS No:tt/*
Setbacks:
o L OCC Group:
I ßß-
Const. Type:
tGc
Zoningr
R.V{LÀ L
/røk* h¿,k-7-b-21BUILDING / PLANNING DIVISION
Signed Approval Date
NOTE: lf any required information is missing, delays in issuing the permit are to be expected. lf
determined by the Building Officialthat additional information is necessary to review the application
and/or plans for compliance, the application may be placed on hold untilthe 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 lmpact 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.
Sþ*"t, Da&tfu 3.7.2021
Property Owner Print and Sign Date
Gurfield County
BUILDING DEPARTMENT
1,08 Eiqhth Street, Su¡te 407, Glenwood Spr¡ngs, CO 81601
Tel: (970) 945-8272
PLAN REV IEW CHECKLIST
Permit No: fi,gBÇ-\b-zt- bWI
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
Fire Department Review
Valuation Determínation/ Fees
Red Line Plans/ StamPs/ St¡cker
t-/ Grade/ Topography 4o%
(-/
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees
Planning lssues
Subdivision Plat
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Attach Conditions
t/Application Signed
Plan Reviewer to Sign APPlication
Nft
Parcel/schedule No.
40# Snowload Letter - Manu. Homes
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Sgits ReporT J
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Descriotion & Summ arv:
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