HomeMy WebLinkAboutApplicationGarfield County*:Ì r;
Community Development Department
¡:, ;'..1 , i ,', , , ¡ .,lQp ptf Street, Suite 401
Glenwood Springs, CO 81601
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www.Farfi eld-cou ntv.com
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BUILDING PERMIT
APPLICATION
TVPE OF CONSTRUCÍION
Commercial/M ulti-Family Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
Accessorv Dwellins Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
Property Owner:
Mailing Address:
Email Address:
Øean Lu a'/l¿z¿7a*r.L Phone: ( )n8¿øal
Contractor:Phone: (?7o ) 8"76 a5-78
I t6.¡--zMailing Address:
Email Address:
Bnv flK 3, /l ô,
b<-d.'t n ¿,.rt @* ro{' 4 e*
Architect:Phone: I ì
Mailing Address:
Email Address:
Engineer:Phone:
Mailing Address:
Email Address:
Manufactured Home Installer:Phone: ( )
Mailins Address:
Email Address
PROJECT DETAITS
Describe Work:ia¿¿
Job Address:
Assessor's Parcel Number:
Sub.Lot Block
Owner's Valuation of Work:PropertySize (Sq. Ft. or Acres):
Sq. Ft. of Building:Height:# of Floors:_
Class of Work:New N Remodel/Alteration Addirion
Garage:Attached Detached
PROJECT DETAITS CONTINUED
Septic:
Type of Heat:ral Gas
Community
Electric
Permit #:
Propane Other
Driveway
Permlt:
NOTICE
AuthoriW. This application for a Buildirrg Permit must be signed by the Owrrer of the property, described above,
or an authorized agent. lf the signature below is not that of the Owner, a separate letter of author¡ty, 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 andvoidiftheworkauthorizedisnotcommencedwithinlS0days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
lherebycertifythatlhavereadthisApplicat¡onandthattheinformationcontainedaboveistrueandcorrect. I
understand that the Building Division accepts the Application, along with the plans and specifications and other data
submitted by me or on my behalt (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 regulat¡ons (County Regulation(s)). All County development requiring a permit, except for
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 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 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 responsibil¡ty for compliance w¡th federal, state and local laws and County Regulations rest with
me and my authorized agents, including without limitation my architect designer, engineer and/ or builder.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the req nformat¡on which is correct and accurate to the best of my knowledge.
n1t r,/ Z3
Property Print and Dete
OFFICIAT USE ONLY
Soecial Conditions¡, . - t , I t**a*Wilil, aøk repab /rep /aæpzøL aa/y'
Adiusted Valuation:i?,çzz,oo iöä"trr"6 Manu. Home Fee:Misc. Fels
Totdf Fees: ^,275.'/ø [ö{j\'Balance Due: -//o7' Zþ sÏffr-ça â
OWTS No:
Setbacks:OCC Group:tRc ton*'tTþc t"qr
ii-3-2èBUTtDtNG / PLANNTNG D|V|SION :
Signed Approval Date
a,ü,
Garfield County
BUILD//NG DEPARTMENT
108 E¡ghth Strcet, Suite 407, Glenwood Springs, CO 87607
Tel: (970) 945-8272
Building lssues
PLAN REVI EW CHE.c KLIST
Permit No:BLBE-/o-23-82¿Z
Planning/Zoning lssues
gNù,:,m,fù"P,;w
Engineered Fjundatit
Driveway Permit
Surveyed Site Plan
110
Septic Permit and Setbacks
Gradel 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 Rece¡ved 4
Plan Reviewer to Sign Application
Parcel/ Schedule No.
40# Snowload Letter - Manuf. Homes
Soils Report
Line Setbacks
35 ft. Stream Setbacks
Flood Plain
Grade/ Topography 40%
Planning lssues
Subdivision Plat
Building Height
Zonine Sien-Off
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Description & Summarv:T#.
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