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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 94s-8212
www. ga rf i eld-countv.com
Gørfield County
BUILDING PERMIT
APPLICATION
DemolitionCom mercia l/Multi-Fa m ily
Manufactured Home (Sinele or Multi-Level)
ReroofResidential (SF, Duplex or Townhome)
t Dwel Unit - MAXIMUM S¡ZE OF I,OOO SQUARE FEET
o
t22lPhone: IQTO IProperty Owner:
Mailing Address:
Email Address:
Email Address:
Phone: 8W I g+Z1">-1
EmailAddress:
:,hone:r303)q3l-lOg+Architect:
MailingAddres' 3æ I Wgcü-lÞ-lèrst rt
EmailAddress:
Phone: iþ3 t
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Mailing Address:?. o, ßbx v 1
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Mailing Address:
Engineer:
Describe Work:
lnstaller:ManufacturedHome
2313 rqr oz or.Ì
sq. Ft. of Buildins: 4qgC Heisht:20'q"
o.5S2.
Phone: ( )
Ft. or Acres):
f of Floors: I
Owne/s Valuation of Work:
Sub.
Assessol's Parcel Number:
Job Address:
Mailing Address:
Email Address:
Addition€lass of Work:y'few Remode/Alteration
DetachedGarage:
l-PROJECT DETAIIS CONTINUED
i ' -- ---rSeptic:
rlpã of neat:
; Driveway
' Permit:
Inity
I Gas Propane Electric
Permit #:
Other
pt
NOICE _
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
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'
Lesal 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.
, CERT|F|CATION
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 ¡nspect 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 acce responsibility or liability by the County of errors, omissions or
discrepancies. As the Owner, I responsibility for compliance with federal, state and local laws
and County Regulations rest with me agents, including without limitation my architect
d r and/ or builder.
I hereby acknowledge that I have
provided the required information
the Notice and Certification above, as well as, have
accurate to the best of my knowledge.
{¿È&e 6-t*-zl
Property Owner Print and Sign Date
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oFFrqAL USE ONLY ?¿l,to3.+t cc ¿l cñ
Special Conditions:
/t7 ,, \\\
Manu. Home Fee:
NA
Misc. Fees: Lu l L" u,/(rF = ZVA7PIan Check Fee:
6/-79/, êz Permit
#2,
Fee:
7'/û.q6
Adiusted Valuation:{4¡t qqz,{o
BP No:
Ér8E. (9zg OWTS No:
cop*\uxttY
Fees Paid:
41803:+,
Balaríce Due:
6z,ylq. llTotal Éees:
$1.522,Etr
Zoning:PupConst. Type:
T GLC-
Setbacksc0Nn occ u'iH.-
-7-7-a
BUILDING / PLANNING DIVISION :
Signed Approval Date
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Garfteld County
Building lssues
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Engineered Foundation
DrivewaY Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ ToPograPhY 30%
BUILD/,NG DEPARTMENT
1,08 Eighth Street Suite 407, Glenwood Springs, CO 87647
Tel: (970) 945-8212
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Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees
Grade/ Topography 40%
Planning lssues
Subdivision Plat
LAN EV IEW CH KLIST
Permit No: aLKtr -^t-Z/- ¿/As
Pl a n n ing lZoning lssues
uN[,fuuhong'!)
a Attach Residential Plan Review List
Subdivision Plat Notes
Fire Departçnen.t fe.vie * ( b
MlestetdQ
Valuation Determiñation/ Fees
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Red Line Plans/ StamPs/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign APPlication
Parcel/Schedule No.
40# Snowload Letter - Manu' Homes
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