HomeMy WebLinkAboutApplicationGørfuld County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
le7ol94s-82t2
www.Fa rfi eld-countv.com
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercia Iti-Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
hccessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
6?e;
öPhoneContractor:
Mailing Address:
Email Address:
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Phone:(91ût3.27 Z<:p3l,/pArch¡tect:
/.¿,l-Mailing Address:
Email Address:
phoner ffi-ø 1740 2?s t3Engineer, Òf) r,ç ft
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EoMailing Address:
Email Addressr
Mailine Address:
Email Address:
Phone: ( )
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Manufactured Home Installer:
PROJEST DETAITS
owner,sVa|uationofWork:s-PropertySize(Sq.Ft.orAcres):
Describe Work:
Height:
f/,
e
Lot
o3/
Sub.
Assessor's Parcel Number:
Job Address:
Sq. Ft. of Building:Zþ/ , { #or
Block
v Remodel/Alteration AdditionClass of Work:ñew
\/î-etachedGaragelAttached
PROJECT DETAITS CONTINUED
Sept¡c:)WTS Community
Type of Heat:Natural Gas Piopane tlectric Other
Driveway
Permit:
Exempt Permit #:
NOTICE
Authoriw, ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
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.
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 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 andvoidiftheworkauthorizedisnotcommencedwithinl80days
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 Permit, I agree that I and my agents will
conrply 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
fr.rrther 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
er, e 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.fær 2ê
Owner Print and Sign Date
OFFtctAtUsEoNty ?/\lD. * ç116.r"c.c oq /Lq /zozz
âø?- z+-h?ô/E/ Ø/V Þ / n2A/SSpecial Conditions:
Mlsc. Fees:N/AAdiusted V¿lu¿finn:
, /bg,7o/, t-A l5Fee:Plan Check Fee:70 Manu. Home Fee:
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'iilî\z,ru lance
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9,1 oFees Pa$L1 BP No:
BLT¿Ë.-? 932^
owls Noa
sÉPT -1A 73
Zonine:-- 'Ë'¿Ð-,QoBAtSetbacks:ît/,OCC Group:
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Const. Type:t,&.e
t}-u-zzBUILDTNG / PTANNING DIVISION :úrilb*A
Signed Approval Date
Gurficld County
BUILDING DEPARTMENT
708 Eighth Street, Suite 4O7, álenwood Springs, CO 87607
Tel: {97a) %s-8212
PLAN REVIEW C HECKLIST
Permit No: tt(A-g?-k ZAZZ_
Building lssues
Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
Subdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
-/ Red Line Plans/ Stamps/ Sticker
Conditions
Application Signed
Pla n ning/Zoning lssues
Property Line Setbacks
30 ft. Stream Setbacks
--/
l,VA
Flood Plain
Buildíng Height
Zoning Sign-Off
Road rmpact Fees llAAmùi'ZU S
Grade/ropography oox @o /Z/ C)
Planning lssues
Subdivision Plat
5V76î ?77/b5
geann€/
Descri & Summa
FL g 494 x 74 69-- 36r/tgí, tz-
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2?rqîó.oo
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t^1nÍ(,3,',:K€/"P/g
ot ol'9 Driveway permit
Surveyed Site Plan
QfuND,*,,,
-/
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Plan Reviewer to Sign Applicatíon
Parcel/ Schedule No.
40# Snowload Letter - Manu. Homes
Soils Report
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