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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(9701945-82t2
www.garfield-countv.com
Gurfteld County
BUILDING PERMIT
APPLICATION
WPE OF CONSTRUCÍION
Commercial/M u lti-Family Demolition
Manufactured Home (Single or Multi-Level)
Giãent¡aD(sF, Duplex or Townhome)I Reroof
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOTVED PARTIES
Property Owner:
Mailing Address:
t ü¿Phone:1l
(ba
Email Address
Contractor:Phone: f )
Mailing Address:
Email Address:
Architect:r\r Phone: ( )
Mailing Address:
Email Address:
Engineer:Phone: I )
Mailing Address:
Email Address
Manufactured Home Installer:Phone:
Mailing Address:
Email Address:
PROJECT DETAITS
Describe Work:\¿
LJÔ
Job Address:LtA'
Assessor's Parcel Number:
Sub.
å
[ot Block
Owner's vafuationofwork:S Gl, 6GO,È8 Property Size (Sq. Ft. or Acres):tl ,(t1at-
Sq. Ft. of Building:Height:r of rloors' Q
Class of Work:New Remodel/Alteration Addition
Garage:Attached Detached
i pRolrcr DETAITS CONTINUED
NOTICE
Author¡W. 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.
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.
CERTIFICATION
I hereby cert¡fy 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, construct¡on 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 tsuilding 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
e rneer an or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
ded the red information which is correct and accurate to the best of my knowledge.
Pro Owner Print and Sign Date
a
CommunitySeptic:
OtherPropaneElectricType of Heat:Natural Gas
Permit #:ptDriveway
Permit:
oFFlclAL UsE oNtY PAIÞ.S ,r23.6{ cß.* 58Ot ø.11,9/zozz afu
Special Conditions:
êi:i:ï;ü"eä'
Plan Check Fee:
473.oT
Permit Fee:a2275 Manu. Home Fee¡t/s ëlì"Ë"Ê'ø> #7ts,Eäfu.,q Fees Paid:
f .113, o'l Balance Due:
727.75
BP No:
tsr߀-1{59
OWTS No:- x7t
Setbacks:OCC Group:IRÞ Const. Type3
¡.F..c.
Zoning:
P,U RA L
614-22BUILDING / PLANNING DIVISION
Signed Approval Date
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 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.
Owner Print and Sign DateI TruLav¿-
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Garfield CounQt
BUILDING DEPARTMENT
L08 Eighth Street, Suite 407, Glenwood Spr¡ngs, CO 87601
Tel: (970) 94s'8272
PLA N REVI E W CHECKLIST
Permit No: BtRF-?¿f -2-ry61
Engineered Foundation
Driveway Permit
Surveyed Site Plan
na ohüne?
Seotic PermiCa nd Setbacks
3 exí alí nq / n ap bdt"dtnts
Grade/ Topoiraphy 30%
Attach Residential Plan Review List
Õ'/ Subdivision Plat Notes
N,rt
Plan n ing lZoning lssues
-/ Property Line setbacks
3û ft. Stream Setbacks
Flood Plain
Building Height
t/ Zoning sign-off
Building lssues
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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
Road lmpact Fees 7/5
Grade/ Topography 40%
Planning lssues
Subdivision Plat
Descript ion & Summarv:
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