HomeMy WebLinkAboutApplicationGørfuld Counfii
Community Development Department
108 8th Street, Suite ¿101
Glenwood Springs, CO 81601
1970194s-82L2
www.ga rfiel d-counw.com
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BUILDING PERMIT
APPLICATION
Commercial/M ulti-Family Demolition
Manufactured Home (Single or Mu
Residential or
. MAXIMUM SIZE OF SQUARE FEETUnitDwelli
Phone: < t 74Ã- OIt4
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Email Address:
Property Owner:
Mailing Address:
,fràr" phone: rq7û ) q+ç., lz'al
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Contractor:
Mailing Address:
Email Address:
Architech Phone:
Maillng Address:
Email Address:
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f - V'tltila Phone: gfüq b7* qæ3Engineer:
Mailing Address:
Email Address:
EmailAddress:
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Job Address:
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Assessor's Parcet Numb "r, "?3g|7At3 ÔsOAq
Owner's Valuation of Work:lð oo
Phone: { I
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# of Floors: ?
Manufactured Home lnstaller:
Mailing Address;
5ub.
Describe Work:
r:l^nPq-
Sq. Ft. of Building: 5fåâ.f\ Height:
Property Size (Sq. Ft. or Acres):
New RemodeVAlteratlon Add¡t¡onClass of Work:
Attached DetachedGarage:
I Þnoiecr orrÁis corvr¡nuro
Septic:
ral Gas Propane
l
Community
Electric Other
Driveway
Permit:
,l?Exemnt Permit #
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
oranauthorízedagent. 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 perm¡t requíred 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. ln consideration of the issuance of the Build¡ng 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 cornpliance 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 Applícation, 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 a authorized agents, including without limitation my architect
des neer a or builder
I hereby acknowledge that I have Notice and Certificat¡on above, as well as, heve
provided the required information Which
G ¿rr¿¿-l fv\' 2 ealte-u¿ "(åna
to the best of my knowledge
DateProperty Owner Print and Sign
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OFFTCTALUSEONLy Pd. $ I ¡?,tl Ctícc.Fe ToZs tt lflf¿cz-t ¿r,Þ
speciar conditions:
æe dhclned ØND1TIAJS 0F WRn ff
Adjusted Valuation:
lo.ùy)
Plan Check Fee:&n.ôt Permit Fee: .
Çtgl.z5
Manu. Home Fee:
rt/a
Misc. Fees:Nj/ft
Total Fães
$Lqq,ob Fees Paid:
Cl¡?,9¡
Balance Due:þrg,F BP No:gw.€-7z47 OWTS No:
c o lt\^r\LrA l1/
setbacks¿OCC Group:
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Const. Type:
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Zoning:
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BUttDtNG / PtANNING DlVlSlON :CM,'r'l-/u
Signed Approval
I
Date
Garfield County
BUILDING DEPARTMENT
108 Eighth Street, Su¡te 407, Glenwood SPr¡ngs, CO 87607
Tel: (970) 945-82L2
PLA NRE VI E CHECKLI
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Permit No:
Planning lToning lssues ?üDBuilding 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
Valuat¡on Determination/ Fees
Red Line Plans/ StamPs/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign APPlication
Parcel/schedule No.
40# Snowload Letter - Manu' Homes
Soils RePort
Description & Summarv
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees n O
^Grade/ Topography 40%
Planning lssues
Subdivision Plat
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