HomeMy WebLinkAboutApplicationGurfteld County
BUILDING PERMIT
APPLICATION
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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-82L2
www.garfiel d-cou ntv.com
WPE OF CONSTRUCTION
fl comm ulti-Fa E Demolition
f] Manufactured Home ngle or Multi-Level
Residential (SF, DuPlex or Townhome)Reroof
PARÏIE5
Property Owner:
Mailing Address:
Phone:
Email Address:
Class of Work:
(Ð0) 371 - 7lú,¿
Phone:Contractor:
Mailing Address:
Email Address:
Architect:
Mailing Address:
Email Address:
Engineer: Phone:
Mailing Address:
Email Address:
Manufactured Home lnstaller: Phone:
Mailing Address:
Email Address:
t)
Describe Work:
Lot
Height:Sq. Ft, of Building:2,Wrø[
Owne/s Valuation of Work: 5
Assessor's Parcel Number:
Job Address:
Sub.
(5q. Ft. or Acres):
# of Floors:-
Move/RelocationNewAlteration
Detached
RepairAddition
AttachedGarage
PROJECT DETAILS CONTINUED
Septic:
of Heat:Natural
I Driveway Permit:Exempt
Propane
Community
Electric Otherü
Permit #
NOTICE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. lf the signature be low is not that of the Owner, a separate letter of authority, 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: (L) State Electrical Permit, (2) County OWTS Permit,
(3).¿nother 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 th at 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
per mission to me, as Owner, to construct the structure(s) and fa cilities detailed on the submittals reviewed by
the Building Division. ln consideration of the issuance of the Building Perm¡t, 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 Regu lation(s)). I acknowledge that the
Building Permit may be suspended or revoked, upon notice from the County,if the location, constructíon 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 aiknowledge 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
neer and/ or builder
I hereby acknowledge that I have read and un derstand the Notice and Certification above,as well as, have
provided the required information which is correct and accurate to the best of my knowledge'
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Property Owner Print and Sign Date
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OFFICIAT USE ONIY
Special Conditions:
MiscManu home Fee:Permit Fee:0ePlan Check Fee:Valuation:
60Pa
Iô0Total3t
Constocc G
BUILDING / PLANNING DIVISION
Signed Approval W,+