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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(9701945-82t2
www. garfield-countv.com
Gørfield Coanty
BUILD¡NG PERMIT
APPLICATION
WPE OF CONSTRUCÍION
Com mercial/M u lti-Family Demolition
Manufactured Home (Single or Multi-Level)
Residential F lex or Town Reroof
Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOLVED
Property Owner:
Mailing Address:
Email Address:
Phone: ,97O¡o 2
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eI. /'tel
t/(tContractor:f xu¿-.1 Phone: P>o¡ ¿/oY c9o:Z
Mailing Address
Email Address:
Phone:7þ,36 ?ZV7
Email Address:
z_Arch¡tect:
Mailing Address:ioo I 6¡and "4v¿- 7Ut lu lo? 6¡.rtuaod 57 Cûå
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Phone:fie>7l
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Engin eer: ...
Mailing Address
Email Address:
Phone: ( )Manufactured Home Installer:
Mailing Address
Email Address:
PROJECT DETAITS
Describe Work:
674o Zoo22qo
Owner's Valuation of Work:
Height:# of Floors
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Sq. Ft. of Building:?zu .s.3
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Assessor's Parcel Number:
Job Address:
p ¡o pqrty s!¡e Þq.f t. o 1 Aç re s) ¡ | ".!r..t 2,.é: Sf ì.i t
K Addit¡onClass of Work:New Remodel/Alteration
x DetachedGarage:Attached
/
OtherPropane
pt
Natural Gas
Community
Permit #:
E lectric
Septic:
Type of Heat:
NOTICE
Driveway
Permitr
PROJECf DETAITS CONTINUEÐ
Authoritv. This application for a Building Permit must be signed by the Owncr of the property, described above,
or an authorized agent. lf the signature below is not that of the Owner, a separate letter of authority, signed by
the Owner, must be provided with this Application.
LeÊal Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for
pLrrposes 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 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 Perm¡t, 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, cotlstruction 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
construct¡on 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
neer and/ or builder
I hereby acknowledge that I have read and understand the Notice 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
oFFfcrArusE oNry p,AtÞ f ¡ otl. lo O(.{r f28¿l oc-/últoLzéþ,ü>
éæ a tur,{ ¡e¿,/ UA/b /T/ð N SSpecial Conditions:
Adiusted Valuation:
ie¿.rtoL.8o
Plan check Fee:
I " ll/u,lz Permit Feet ^ -h76A,7e
Home Fee:
/*,
Manu.,I H'iëfhp I Fre
BP No:
BLt¿g-?s1ù
OWTS No:
(0tq^{ü^r¡fy'"'^iîöoç,s7 FeesårYr¡
Paid:
ôt?. ?Þ
Balance Due:
1,308,L7
SetbaCf<s: .hND OCC Grouo:ipc Const. Type:l, R.c
Zoning:
P. t/. Þ.
BUILDING / PLANNING DIVISION :/lú,'rf -
Signed Approval
74ZZ
Date
Gørfreld Cowmff,
BUILDING DEPARTMENT
708 E¡ghth Street, Suite 407, Glenwood Springs, CO 87607
Tel: (970) 945-8272
PI.AN RE VIEW CHECK L rsT
Permit No: E tJ?É - 06-22-7174
Building lssues Pl a n n i n g/Zoning lss ues PUt>
LÞt<-Z-l
*'1+
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30%
/
Attach Residential Plan Review List
Line Setbacks
3û ft. Stream Setbasks
I Flood Plain
Building Height
¿' Zoning sign-off
yß Road lmpact Fees
Grade/ Topography 40%
Planning lssues
Subdivision Plat
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Desc ription & 5u mmarv:
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F¿g tlîlx
U9b/¡r7x
.Í* 5î3x
-P/¿ 5a8 x
Subdivision Flat Notesazl ?â7
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
32t 237
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