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Garfteld County
BUILDING PERMIT
APPLICATION
DemolitionCommercial/Multi-Family
Manufactured Home (Single or Multi-Level)
ReroofResidential (SF, Duplex or Townhome)
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOLVED PARTIES
Phone: (170tUß- 1,37ç
Ca
bProperty Owner:
Mailing Address
Email Address:
Email Address:
Phone: (q7Õt t"(k' lt3 7.ç
Mailing Address
Contractor:
Phone: (tlO t3Z &t- bbft{
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Architect:
Mailing Address:
EmailAddress:
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Phone:,1zo I ç-tEngineer:
Mailing Address:
EmailAddress:
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Mailing Address:
Email Address:
ew Remodel/Alteration Addition
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Class of Work:
Garage;
PROJECT DETAIIS
Describe Work:
Job Address:
Assessor's Parcel Number:
Sub.
Owner's Valuation
Sq. Ft. of Building:
,
Block _
Q
Lot
of work: 5 17 ,
¿f 7,2 ¿\Ò- Propertysize (Sq. Ft. orAcres): 5, 3S a-C
Að ÒÒ S€. H eight:# of Floors: .?
gROJECT DETAITS CONTINUED
Septic:
Type of Heat:
Driveway
iPe rmit:
Natural Gas Propane
Community
Electric
Permit #:
Other
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NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
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 perm¡t 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.
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 Appl¡cation, 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 Bu¡ld¡ng 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)
requiringthe 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
eer and/ or builder
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.
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Property Owner Print and Sign Date
OFFICIAT USE ONLY t cß lol o t o?2
Special Conditions:Seea+hcl.edØND rNOI\IS
Adiusted Valuation:
û ßv"qr72 4
Plan Fee:75 Manu. Home Fee:
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Misc. Fees:N/A
totäl reeí:* tsoloq
Fees Paid:Balance Due:
5ql.3t '75 BP No:
BLR,E-?tO6
OWTS túo:
se?î -11o1
'"'thNb OCC Group:tßc Const. Type:
lR.C
Zoning:
R,UN-AL
Cøir+n u-28-zz
Date
BUttDTNG / PTANNTNG DIVISION :
Signed Approval
Garfield County
BIJILDING DEPARTMENÍ
708 Eighth Streel Suite 407, Glenwood Spr¡nqs, CO 81607
Tel: (970) 945-8272
PLAN RE VIEW CHECKL rsT
Permit No: ølR7-)a-z-74ûb
Building lssues
€JeprPþ
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Pla n n ing lTaning lssues
Engineered Foundation
Driveway eermit€Xghhþ
-
Surveyed Site Planætra7227/¿7
Septic Permit and Setbacki
Property Line Setbacks
30 ft. Stream Setbacks
AND.
/\14 Road
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/ Ptann ing lssues
Subdivision Plat
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Frood Prain l"enerø! edncahail
da*note'l r¿fu.tco\
Building Height -/
Zoning Sign-Off
tmpact Fees 1 ø?O,4
WttntfhLs
e/ Topography 4O%
Grade/ Topography 30%
Attach Residential Plan Review List
Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
40# Snowload Letter - Manu. Homes
Soils Report
¡rin*
Attach Conditionsî;i"Ë' öt',iË n þït + ^1+^cL)L.-
Application Signed Descripti on & Summarv:
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Plan Reviewer to Sign APPlication
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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 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.
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Property Owner Print tgn Date
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