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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-8212
www.garf¡eld-countv.com
Garfield Coanty
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercia Iti-Fami Demolition
Manufactured Home (Single or Multi-Level)
2<Residential (SF, Duplex or Townhome)Reroof
Dwell Unit - MAXTMUM SIZE OF 1,000 SQUARE FEET
INVOLVED PART¡ES
Property Owner:úæ (p t8.scBQ
Mailing Address:2301 o\J r5
Emai lAddress: aoc*ìo u'l)'"2 ¡/ncÅ \' cc:
Contractor:ùr¡r.r ¿rz Phone: f )
Mailing Address:
Email Address:
Arch¡tect:rIz Phone:
Mailing ¡¿¿ress: 50l 2- Co.,
Email Address:r ,
Mo-q4-'s Dcsr4rr-TEngineer:phone: ¡ t'7O | 18 7' 218 I
Mailing Address:k n6rC'6 (o
Email Address:
Manufactured Home Installer:ñ Phone: (_)
Mailing Address:
Email Address:
PROJECÍ DETAITS
Describe wo'r, Ke3?dzvta*--, Siønh {ayu/tU
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Job Address:
Assessor's Parcel Numbe rt ?"I GB b 3 { o 0 at 2-
Sub.rot I1r,
-
Block
Q7t44.\ *(Owner's Valuation of Work:31Z,zo Property Size (Sq. Ft. or Acres)r
Sq. Ft. of Building:Height:# of Floors: À
q 5
Class of Work:K New Remodel/Alteration Addition
Garage:X Attached Detached
I
Electric OtherType of Heat:
ffiNaturalGas
Propane
Permit #:Driveway
Permit:
TBÞpt
Authoritv. This application for a Building Permit must be signed by the Owner 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.
Leeal 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.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinlS0days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
NOTICE
PROJECT DETAITS CONTINUED
Septic:Community
CERTIFICAT¡ON
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
e ineer 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.
,411,a 1on,
Property Owner Print Sign
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Date
i
oFFrcrALUsEoNry pAt Þ. t 1,351.3t eKfr8S0O otlzo/zozz-furt*
,sæatu¿hel ea/VÐ/nONSSpecial Conditions:
it:;;iß6 Manu. Home Fee:x/¡ÄlF¡iîe Þ é2,;Adiusted Valuation:2c8,9ry.4 a
Planbt Check Fee:t6q r?
Feés Paid:
* t,3g1,ar åt"åöi.'zç
BP No:
BrßE -7t 87
OWTS No:
sEPr'- 768Flf ii"üio,ts
Zonins:-eveA L
'setblcks:OCC Group:r.e.e.Const. Type:
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BUITDING / PLANNING DIVISION
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Signed Approval Date
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Gørfield County
BU'LDING DEPARTMENT
708 E¡ghth street, Su¡te 407, Glenwood Springs, ca 81æ7
Tel: (97o) %.s-8212
PLAN REVIEW CH ECKLIST
Permit No: êtRe -07-ZZ-7ô87
Building lssues
_/or-
Pla nning/Zoning lssues
Engineered Foundation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Gradel Topography 30%
Attach Residential Plan Review List
Subdívision Plat Notes
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Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Fire De partment Review
Valuation Determínation/ Fees
Red Line Plans/ Stamps/ Sticker
Attach Condítions
Application Signed
Plan Reviewer to Sign Application
" ParceU schedule No.
Altt 40f snowload Letter- Manu. Homes
Soils Report
Road lmpact Fees
Gradel Topography 40%
-Planning lssues
Subdivision Plat
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Description & Summarv:
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