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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(9701945-8212
www.garf ield-countv.com
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Gu.rrteld County
BUILDING PERMIT
APPLICATION
Iti-FamiCommercia Demolition
or MultiManufactured Home si
Residential SF,lex or Townhome Reroof
Dwell Unit (ADU)- MAXIMUM slZE OF FEET
Phone:
Email Address:
Property Owner:
Mailing Address:
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Contractor:
Mailing Address:
Email Address:
Arch¡tect:
Mailing Address:
Email Address:
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Phone: ( )Engineer:
Mailing Address:
Email Address:
Describe Work:
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rot r/l\ slock Ulft
Phone:
Height:
of Work:
Job Address:
Manufactured Home lnstaller:
Property Size (5q. Ft. or Acres): S,1 nf ru:
JO #of
Assessor's Parcel Number:
Sub. fvral
Owner's Valuation
Sq. Ft. of Building:
Mailing Address:
Email Address:
Garage:Attached Detached
CommuniryIXlwrssêBtlci
Electric Other
lfferoRaneType of Heat:Natural Gas
Permit #:
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
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.
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 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
d en neer a or builder
pt
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as,have
provided the requ ired information which is correct and accurate to the best of my knowledge
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Property Owner Print and Sign Date
Misc. Fees:
6æat*aúd2âNÞ/VA4VSSpecial Conditions:
Manu, Home Fee:xl¡.Permit Feet -¿,l"q 62,oe
Plan Check F¡e:
t.275.bb
BP No:
gLÈL'77E-¿,
OWTS No:
sePr-1?37
Fdes Paid:
Tl.,trq.tt
Balance Due:_-
2, llq,o (2lTotâl Fles:
4"R78,
Const. Type:
I'fl.€.
Zonlng:
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tOCC Group:l,lt.3.Setb-acks: ,OK
BUIIDING / PLANNING DIVISION
Signed Approval Date
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Garfield County
BUILDING DEPARTMENT
108 Eighth Street, Suite 407, Glenwood Spr¡ngs, CO 81601
Tel: (970) 945-8212
PL^AN REVIEW CHEC KLIST
Perm it No: SluQÇ-//-/ /-.ft //
Building lssues Planning/Zoning lssues
'/ EngineeredFoundation
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Yø septic Permit and setback tTTA?
Property Line Setbacks
30 ft- Stream Setbacksway Permit
Surveyed Site Plan
Grade/ Topography 30%
Attach Residential Plan Review List
Subdivision Plat Notes
Fire Department Review
Valuation 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
-- Flood Plain
Building Height
Zoning Sign-Off
tØ Road lmpact Fees
-/ Grade/Topography4o%
-/Planning lssues
Descripti &
un/afpennrf
Nh Subdivision ptat,!i@ StbPân-
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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 compliance, the application may be placed on hold until the 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.
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Property Print and Sign
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Date