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rl0Mf ,{Ullinc,qm-lylttJiliwÐpvelopmentDepartment
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970ls49-82t2
www.Rarfield-countv.com
TYPE OT CONSTRUCTION
3
Garfielú Counly
BUILDING PERMIT
APPLICATION
DemolitionCom mercial/M ulti-Fami ly
Manufactured Home (Single or Multi-Level)
ReroofResidential (SF, Duplex orTownhome)
Accessorv Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
owner: M xr-¿mt N , OrI?t Rl €N phone: (q1D I qæ - 4+31
Email Address:c
Property
Mailing Address: ?,o. E;oY- (.laz
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Phone: ( )Contractor:
Mailing Address
Email Address:
Email Address:Br*,xQ-ØvD ø rntNþ3f
Mailing Address: f,.o 3
LF:r\ey
C nYYlRrñ6S
Phone: 1 1lo I l+4 - ç'?fL4
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Architect: âLElt- rt-gZ-¡¿ +.ò
Þ'a1 lPe-¿ ¡
Phone:Engineer:
Mailing Address
Email Address:
(Manufactured Home lnstaller:
Mailing Address:
Email Address:
PROJECT DETAITS
owne/s Valuation of Work: 5 ß1oO Property Size (Sq. Ft. or Acres):k
Sq. Ft. of Building:,Ì8 4 Height:Lo7. 4
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Describework: Ckß-?De-l-
ap Klt,zz
Assessor's Parcel N umber:
Job Address:LF
Sub.Lot
f of Floors: /
Block
(New Remodel/Alteration AdditionClass of Work:
DetachedGarageAttached
PROJECT DETAILS CONTINUED
Septlc:
Type of Heat:
OWTS Communlty
Electric 0therNatural Gas Propane
Driveway
Perm¡tl
pt Permit #:
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must bc provided with this Applicatiorr.
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.
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 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)). All County developnrent requiring a permit, except tor
residential uses, are subject to Article 7 of the Land Use and Development Code. I acknowledge that the Building
Permit may be suspended or revoked, upon not¡ce from the County, if the location, construct¡on or use of the
ctrrr¡trrrolcl rnd f¡¡¡li+rrl¡acì ¡lac¡r¡ha¡l .h^.,- .'- nar in ¡amnlìrn¡a r¡¡i+h 1-a,¡n+r¡ Dôd¡,lrri^h/.ì a¡ rnr¡ a+hare!,ueru.!rJ, ,, vçJ!,¡vus ryrlrr les¡rry ¡¡L6srqUerr\r,
applicable law.
I hereby grant permission to the Building Division to enter the property, described 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 correction oferrors in the submittals, ifany, discovered after issuance; or (2) stopping construction or use ofthe
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
acceptanceof responsibilityorliabilitybytheCountyof errors,omissions,ordiscrepancies. AstheOwner, 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 designer, engineer andf or builder.
I hereby acknowledge that I have read and understand the Notlce and Certlflcatlon above, as well as, have
provided the required information which is correct and accurate to the best of my knowledge.
,,//* *,n q.lrì,,â0,2 v
Property Owner Print and Date
OFFICIAT USE ONLY
Special Conditions:
Adlusted Valuation:^ô'î.7/?,,æ Plan Check Fee:\ôR "?l
,ïU,T'A6 Manu, Home Fee:Misc. Fees:
'*27ç. ro to
Fees 'fri+t Balance Due: -iloZæ ËÏp-raâ.í OWTS No:
Setbacks:occGroup: tß-L ,o"t.rt'l,RL zoff:
to-/rëBUTTDTNG / PLANNTNG DTVTSTON
Signed Approval
I
Date
Gørfteld Coanty
BUILDINo DEPARTMENT
708 E¡ghth Strcet, Su¡te 407, Glenwood Spr¡ngs, co 87607
Tel: (970) 945-8272
PLA REVIE CHECK LIST
Permit No:SIRE-4-J3-832r
Building lssues Pla nning lZonlng lssueskEngineered Foundation
Driveway Permit
Surveyed Site Plan
Septic 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
Attach Conditions
Application Signed
Energy Compliance Path/Plan Received
Plan Reviewer to Sign APPIícation
Parcel/ Schedule No.
40# Snowload Letter - Manuf. Homes
Soils Report
Property Line Setbacks
35 ft. Stream Setbacks
Flood Plain
Building Height
ToningSign-Off
Road lmpact Fees
Gradel Topography 40%
Planning lssues
Subdivision Plat
Descri ot¡on & Sum merv
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