HomeMy WebLinkAboutApplicationG*rfielcl Coun4:
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hi AII iqg$ffSnity Development Department
iYlnrr e ' 108 8th Street, Suite 401
Glenwood Springs, CO 81601
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Dwell Unit - MAXIMUM SIZE OF SqUARE FEET
Phone:aProperty Owner:
Mailing Address:
Email Address:
I Demolition
or MuHomeManufactured Home or
ulti-Fam
ReroofResidentialor Town
t
tContractor:
Mailing Address:
Email Address:
Phone =(
Phone: 81trr 94.< " t 3AS
Architect:
Engineer:
Mailing Address:
Email Address:
Mailing Address:
Email Address:
Mailing Address:
Email Address:
Phone:Manufactured Home lnstaller:
Describe Work:
/l1-l,, r.r -
f of Floors: -l-
^r
I
tL
Height:Sq. Ft. of Building:ls'.lG
Property Size (Sq. Ft. or Acres):ia, L+ 5''1Owner's Valuation of Work:
Sub.
Assessol's Parcel Number:
Job Address:
rct I Block-
V v AdditionClass of Work:New Remodel/Alteration
Garage Detached
PROIECT DETAI 15 COt'lTtNU tD
Septic:Community
Type of Heat:Natural Gas Propane Electric Other
Driveway
Permit:
NONCE
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 be provided with this Application.
LegalAccess. ABuildingPermitcannotbeissuedwithoutproofoflegalandadequateaccesstothepropertyfor
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.
CERTIfICANON
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 cn 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 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, ifthe location, construction or use ofthe
structure(s) and facility(ies), described above, are not in compliance with County Regulation(s) or any other
applicable law.
I harohrr drlnf h6rmicci^n +^ tha Rrrildinc Frirricinn +^ aht6r +ha ^r^h6rh, nacariharl rhnrra tn ih.h6^t +ha r.rarl, I!,,sP,vPs,ltrv!Je,ivLv,,,JP!er
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 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 required information which is correct and accurate to the best of my knowledge.
Permit #:
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Print and Sign Date
USE ONIY t I
5 p e c i a * o "ot"" "b -t a fu,.;b./ 2n/b / z-7a48
Adjltsled Valuqtiop^
.>lq ;541. w Plqn Check Fee: ,d8r. /4 Perrqit feg: _ -4/4/.7s Fee:Manu.flprge/v+Misc. Fees,A/r+
Total4ees:- o.)_/Ztr, "'FeerPaid: I
tctq+t Balance Due; :,qzq, t5 EP No;. . ^1.5J&Err<rl
OWTS No:
setbacksuh--OCC Group /Rc const'rvJ fr?/ )Si''N
U?4BUILDING / PLANNING DIVISION :
Signed Approval
I
Date
Gurfield County,
BUILDING DEPARTMENT
7og Eighth Street Suite 4oI, Glenwood Sprlngs, CO 87607
Tel: (97Q 9a5-8212
PI.AN REVI EWCH EC KLIST
Permit No: P\RE-27 -Zt -8i59 7
Building lssues Pla n ning lZoning lssues
ry
UM^ttach conditions
-'/
Englneered Fo**dation
Driveway Permit
Surveyed Site Plan
Septic Permit and Setbacks
Grade/ Topography 30%
Attach Residential Plan Review List
Sub'divislon Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line PIans/ Stamps/ Sticker
Property Line Setbacks
35 ft. Stream Setbacks
Flood Plain
tding Height
Zoning Sign-Off
Road lmpact Fee
Lof t/
s mthtmtl9a&rlint1
Topography 40%
Application Signed n
Planning lssues
Subdivision Plat
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