HomeMy WebLinkAboutApplicationJUL 'l 2. 1U\
Garfudd County
r "Rf\E.LD COU~n'~munlty Development Department MMU~\TI DE\JELOtiME 1oa atti Street. Sutte 401
) Glenwood Springs, CO 81601
(970) 945-8212
www·Qrflelckount,y.com
IJ Residential (SF, Duplex orTownhome) C Reroof
Contractor: Wf!\VZ= ~ b, qt Phone: t'1b > Soq .... ctifC
M1Hln1Address: (NC MLJ>CJSt n;: ~I Cls:J!&Ol\D6:ZE Gi> Siit&?Z.1>
Archltect: ____ .__N...,,J_(Jc __________ Phone: ( __ _. _____ _ ,
Malling Address: _______________________ _
Enalneer: ___ ___.N...._.,....-..Pr ___________ Phone: I._ _ __, ______ _
MallfnsAddress: _______________________ _
Manufactured Home lnstaller: __ _,,N ......... t.,_....Pr ______ Phone: I._ _ _, _____ _
Matlln1Address: _________ ,..._ _____________ _
Owner's Valuation of Work:$ Sbpp. rd) Property Size (Sq. Ft. or Acres): ----i
Sq. Ft. of Butldln1: Hefaht #of Floors:. ____ _
Garage:
Septic:
Type of Heat:
.. ,,,,,,. --..
Authorttv. This application for a Bu1kllna Permit must be slaned by the Owner of the property, described above, or ·
an authorized aaent. If the sllnature below ls.not that of the owner, a separate letter of authority, signed by the
Owner, must be provided with this Appllmiofi.
llgl Aq;eH. A Bulldln1 Permit cannot be Issued without proof of leeal and adequate access to the property for
purposes of lnspectlons by the Bulldlns Division.
QtMr Ptnnlts. Multiple separate permits may be requlrad: (1) State Electrical Permit, (2) County OWTS Permit,
(3) another pennlt required for use on the property Identified above, e.g . State or County Hlshwav/ Road Acceu or
a State Wastewater Oischal'le Permit.
Vgld Ptnnlt. A Bulldln1 Pennlt becomes null and void If the work authorized Is not commenced within 180 days of
the date of Issuance ind ff work Is suspendflf or 1bandoned for a period of 180 days after commencement.
I hereby certify that I have rnd this Application ind that the Information contained abow is true and correct. I
understand that the Bulldln1 Ofvtslon accepts the AppllcatJon, alon1 with the plans and specfficatlons and other
data submitted by me or on my behalf (submtttals), based upon my certification as to accuracy. Auumln1
completeness of the submlttals 11nd approval of this Appllcatlon, a Bulldln1 Permit will be Issued 1rantln1
permission to me, as Owner, to construct the structure(s) and facilities detailed on the submlttals reviewed by the
Buildtns Division. In consideration of the Issuance of the Bull ding Permit, I agree that I and my agents will comply
with provisions of any federal, state or local law rqulatlnt the work and the Garfield County Building Code, OWTS
regulations and applicable land use rl!l\Jlatlons (County Rqulatlon(s}). I acknowledge that the Buildlng Permit
may be suspended or revoked, upon notice from the County, If the location, constructlon or use of the structure(s)
and faclllty(les), described above, are not In compliance with County Regulatlon(s) or any other applicable law.
I hereby grant permission to the Bulldln1 Dtvlsion to enter the property, described above, to Inspect the work . I
further acknowledae that the ISSU1nce of the Buildln& Permit does not pl'1!\lent the Bulldln1 Official from: (1)
requiring the correction of errors In the submltt1ls, If any, discovered after Issuance; or (2) stopping construction
or use of the structure(s) or fadllty(les) If such Is In ~tlon of County ReculatlonCs) or any other applicable law.
Review of this Application, lndudlnt submtttals, ind Inspections of the work by the Bulldln1 Division do not
constitute an acceptance of responsibility or liability by the County of errors, omissions or discrepancies. As the
Owner, I acknowledge that responslblllty for complfance with mleral, state and loci I laws and County Resulatlom
rest with me and my authorized 1pnts, lndudlnt without limitation my architect deslaner, en1lneer and/ or
builder.
I hereby acknowleda• that I have read •nd understand the Notice and Certlflation above, as well as,
have provided the requl torm.tion which Is correct •nd accurate to the best of my knowledge.
Adjusted Valuation: Plan Ch9Ck FH: Manu home Fee:
S:ooo-;---72.31 -
TotalFees: fffshld:
IB~.5b ~8/. 41
~: , ~ occ Group:
(-P, f?,.1.S, $JO I
Const Type :
g ~e
IUILDING / P&.AHNING DIVISION :_.Ld~;:,,,-';..~:::.=..;...._,,_;"!_~_~_.-c!_:zf'-.;...-~----
Slpecl Approval
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Building / Zonin g P lan R eview C hecklist
Permit Number:
Planning/ Zoning
tJlA Property line Setbacks
30 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
' Road Impact Fees
Grade/ Topography 40%
Planning Issues
Subdivision Plat
General Comments:
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