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Garfield County
Commu nity Development Department
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945.82',2
BUILDING PERMlT
APPLICATION
TTPE OF CONSTRUCÍION
Demol¡t¡on-ommerçld¡/ lvl ul l¡-rdI I tll
ulti-Level)Manufactured Home (Single or M
Residential (SF, Duplex or Townhome)Reroof
Accessory Dwelling Unit (ADU)- MÆflMUM S|ZE OF 1,000 SqUARE FEET
INVOLVED PARTIES
Property Owner:bwtvtlJ "açq ûtçt+wtçJ Phone: ñ071 tub*nß
MallingAddress:llhl- ðotrt{'t\ Röh? \M ,rtitt\rr0DD ó?úþ.,0D.
Email Address:CWbyt¡,xß, ûgV4&âwt ktL,MvlA
Phone: ,Mo t %OÖ -0611
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Contractor:
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Email Address:J ¿lbcovr e .vl x\+oo, a$\\A
Dil tr,\o l"îcl RttsûKvMalling Address:-lpÞ
Email Address:
Lâil tlvîf Phone:
4 CþMaillng Address:
Arch¡tect:
Phone:Engineer:
Mailing Address:
Email Address:
Manufactured Home lnstaller:
MailingAddress:
Email Address:
Phone: ( I
ì PROJECT DETAILS
Describe Work:Øvl 0 v,l ONÉD NÚ3
þKÌúÚ
Ahf- .MArrH Row loq , áw*tww Ó?h+,Job Address:þtt"o\qbM?
Electric OtherPropaneGas
I PRO¡gCr DETAII-S COI{TINUED
Septic:Community
Type of Heat:
Driveway
Permit:
NOTICE
AuthqriW. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. lf the s¡gnature 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 perm¡ts. Multiple separate perm¡ts 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¡ñ/ that I have read this Application and that the ¡nformation 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 subm¡ttals 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 Bu¡ld¡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, ¡f the locat¡on, construct¡on or use
of the structure(s) and facility(ies), described above, are not in compliance with County Regulation(s) or any
other appl¡cable law.
I hereby grant permission to the Building Division to enter the property, desffibed 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 correct¡on 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 w¡th me and my authorized agents, including without limitation my architect
and/ or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
required which is correct and accurate to the best of my knowledge.
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Permit #:
,\z__
owner Print and S¡gn Date
OFFICIAL USE ONIY fts.tIlÞ.Je., os/o
ı?ß bþv^úed ØNDtTlôNgSpecial Condit¡ons:
Permit Fee:t'ttanurtileFee:Misc. Fces:
mirtímus N/APlan Check Feê:Adjusted valuatlon:
OWTS No:
s ËPr.1 9,7Balance Due:BP No:
rsunÉ -11t â
Total Fees:
* l4r. 'l
Fees Paid:
Zoningr
R,u RA L.
Const. Type:
l, R,Ê ,
occ Group:
t RC
Setbacks:
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tn)¡rn
Gørfield County
BUILDING DEPARTMENT
108 E¡ghth Street, Su¡te 407, Glenwood Springs, CO 81601
Tel: (970) 945-8212
PLAN REVIEW CHECKLIST
Permit No:B{RE*05*2b-75tb
Building lssues
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\ft
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Çç,ffi^la*r¿
Grade/ Topography 30%
Attach Residential Plan Review List
Subdivision Plat Notes
Fire Department Review
Va luation Determinatio
Red Line Plans/ Stamps/ Sticker
Attach Conditions
Application Signed
Plan Reviewer to Sign Application
Parcel/Schedule No.
40# Snowload Letter - Manu. Homes
NJ,4 Soils Report
Planning/Zoning lssues A
Property Line Setbacks
30 ft. Stream Setbacks
-- Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees ru,nlrn,¿S 4"5OO
Grade/ Topography 40%
Planning lssues
Subdivision Plat
Description & Summarv
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757 x 33,68 = #lz,c7e7b
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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
OTE: lf any required information is missing, delays in issuing the permit are to be expected. lf
etermined by the Building Officialthat additional information is necessary to review the application
nd/or plans for compliance, the application may be placed on hold untilthe required information is
rovided. Work may not proceed without the issuance of a permit'
he Building Division will collect a Plan Review fee at time of application submittal. The permit fee, as
'ell as any Road lmpactfees will be collected when the permit is issued.
he permit application must be signed by the owner or by person having written authority from the owner
I act as their representative.
uilding cannot be occupied until a Certificate of Occupancy (CO) is issued. Using the building without a
:O will be considered an illegal occupancy and may be grounds for vacating the premises. (Final/CO
rspection requirements will be attached to your approved field set of plans.)
hereby acknowledge I have read, understand and will abide by the rcquirements of this
hecklist.
Owner Date
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