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Community Development Department
1OB 8th Street, Suite 401
Glenwood Springs, CO 81601
(s7o1945-82t2
www.Fa rfi eld-countv.com
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BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCÍION
DemolitionCommercial/Mu
Manufactured Home e or Multi-S¡
Reroofex or TownhDuResidential
Dwelling Unit - MAXIMUM SIZE OF SqUARE FEETU
INVOTVED PARTIES
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Email Address:
Phone: û7Òl27'l ^2'Jt(
Property Owner:
Mailing Address:
Mailing Address:
Email Address:
Phone: e 7a | lLf Ll^ <3 Y 6¡\^t'cl:\MContractor:
Mailing Address:
Email Address:
Phone: (NÒArchitect:
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Engineer:
Mailing Address
Email Address:
Mailing Address:
Email Address:
Phonel
Describe Work:
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Height:
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)t7 9 0L30 / Oa?
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Job Address:
lot 4 Block
-Sq. Ft. of Building çKO
Manufactured Home lnstaller:
Assessor's Parcel Number:
Owner's Valuation of Work:
Sub.
Class of Work:ew
Property Size (Sq. Ft. or Acres): L' l" ACt c ¡
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Remodel/Alteration
Attached
PROJECT DETAILS
Rddition
Garage:Detached
PROJECT DETAII.S CONTINUED
tural Gas
Community
Electric
7 - lt * 22,
Propane
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required ¡nformat¡on which is correct and accurate to the best of my knowledge.
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Property Owner Print and Sign
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Date
Sept¡c:
Type of Heat:Other
-JDriveway
Permit:lFlExerrrut Permit #:
NOTICE
Authoritv. This application for a Building Perrnit must be signed by the owner of the property, clescribed above,
or an authorized agent. lf the signature below is not that of the owner, a separate letter of authority, signed by
the Owner, rnusL lre provided wlth thls Application.
Legal 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' Mult¡ple 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 andvoidiftheworkauthorizedisnotcommencedwithinlg0days
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 th is 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 facil¡ty(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 trorn: (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 thìs 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 comp
and County Regulations rest with me and my author¡zed agents, includin
and/ or builder,
liance with federal, state and local laws
g without limitation my architect
OFFICIAL USE ONIY 3tc.D êb
çea o/êa¿Áe/æ/VÞ/vaA/sSpecial Conditions:
luation:od Plan rË Manu. Home Fee:
LI *3t1.qsFees Paid Balance BP No:
ßrR€ .7 bîg N/¡
OCC Group:
l.R..c.Const. Type:
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Zoningr
RUf¿AL
BUtLDtNG / PLANNTNG DtVtStON :
Signed Approval Date
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Garfield County
BUILDING DEPARTMENT
708 E¡ghth Street, Su¡te 407, Glenwood Spr¡ngs, CO 87601
Tel: (970) 945-8212
PLAN REVIEW HE KLIST
Permit No: B2ßE-OVZZ-7¿6 I
Planning/Zoning lssuesBuilding lssuesta u/e
Engineered Foundation
Driveway Permit 0V-
- Surveyed Site Plan
-/ Septic Permit and Setbacks
Grade/ Topography 30%
-./Subdivision Plat Notes
3*ye o/,
NA
Property Line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Road lmpact Fees
Grade/ Topography 40%
Attach Residential Plan Review List
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ Stamps/ Sticker
ch Conditions
Application Signed
Plan Reviewer to Sign APP|ication
/ Parcel/ Schedule No.
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Planning lssues
Subdivision Plat
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Descrip tion & Summarv:
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40# Snowload Letter - Manu. Homes
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