HomeMy WebLinkAboutApplicationGarfield Cottru S
108 8'h Street, Suite 401, Glenwood Springs, CO 81601
Ph:970-945-82 I 2 Fx 970-384-3110 Inspection Line:888-868-5306
wllur. garfield-countv.conr
BUILDING PERMIT APPLICATION
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T"ry?'ryry'?ot the u::es.rogs offce 970-915-9 I 31)dDo<a Lot No: Block No: Subd./ Exemption:
2 (if anih ,'ff{:, o** Name & City)or and legal descnptionJob Address:provideaddress has not been
3 Owwr: lnrooertv ower\ ,lrt\ctt'A\U,[23 Mailins Address: r ,
3D i{r -k+cp V}Ph:ot4o.\61-ZLZc)AIt Ph:
4 Contractor: \'"ryd+#rlv(tk rl '18)tz AIt Ph
5 Manufactured home installer:Mailing Address:Lic #:
6 Architect:Mailing Address:Ph:AIt Ph:
7 Engineer:Mailing Address Ph:AIt Ph:
8 Sq. Ft. of Building:Sq. Ft. or Acres of Lot:Height:No. of Floors:
9 Use of Building:
ts*esidential ECommercial Eother ENew EAlteration EAddition )ElRepair EDemo EMove
Class of Work:
l0 Describe Work: n.Yr/+M\ULa1ai1t, q tLt *-'tL\04 r^-.ris &+h Yr/2<
ll Garage:
flAttached EDetached EISDS Ecommuniw
Septic:
[fNat. Gas EPropane EElectric Eother
Type ofHeat:
t2 Driveway Permit:Owners valuation of Work:
NOTICE
letter ofauthority, signed by the Owner, must be provided with this Application.lsal Acss. A Building Pemit cannot be issued without proof of legal md adequate access to the property for purposes of inspections by the Building Departrnmt.
Couty Highway/ Road Access or a State Wmtewater Discharge pemit.
Void Permit A Building Pemit becomes null md void if the work authorized is not commenced within 180 days of the date of issmce md if work is suspended or abmdoned for a poiod of 180
days after comencement.
CERTIFICATION
ad specifications md other data submitted by me or on my behalf(submittals). based upon my certification as to accwacy.
tle submittals reviewed by the Building Departrnent.
l(/l>-
DATE
v
I HEREBY THAT AND UNDERSTAND THE NOTICE & Cf,RTIFICATION ABOVE:
ek+ {1 d fi7,jk STAF'F'ONLY
Special Conditions:
Adjusted Valuation
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Plan Check Fee:
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Permit Fee:5'i,l Manu home Fee:Misc Fees:
Total Fees:
l)7,3u Fees Paid:
lv.7,7V
Balance Due:,€
BP No & Issue Date:ovg,?f ISDS No & Issued Date
Setbacks:OCC Group:Zoning:KuConst Type:
DATE
()I
APPROV
BLDG
DATEAPP
DEPT
NOTE: lf any required information is missing, delays in issuing the permit are to be expected. lf
determined by the Building Official that additional information is necessary to review the application
and/or plans for compliance, the application may be placed on hold until the required information is
provided. Work may not proceed without the issuance of a permit.
The building department will collect a Plan Review fee at time of application submittal. The permit fee, as
well as any Septic or Road lmpact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by person having written authority from the owner
to act as their representative.
Building cannot be occupied until a Certificate of Occupancy (CO) is issued. Using the building without a
CO will be considered an illegal occupancy and may be grounds for vacating the premises. (Final/CO
inspection requirements will be attached to your approved field set of plans.)
I hereby acknowledge I have read, understand, and will abide by the requirements of this
checklist.
Signature Date
Garfield County Building & Planning
lOB 8m Street, Suite 401
Glenwood Springs, CO 81601
Phone: 970-945-8212 Fax: 970-384-3470
www.qarfield-cou ntv.com