HomeMy WebLinkAboutApplicationGørfield County
BUILDING PERMIT
APPLICATIONCommunity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(e70) 94s-82L2
www.garf ield-cou ntv.com
f--'l DemolitionE Commercial/Multi-FamilytlManufactured Home (Single or Multi-Level)
T Reroofr[7 Residential (SF, Duplex orTownhome)
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Phone:(
Email Address:C inå
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Property Owner:
Mailing Address:
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Phone: (l7o I 7r{g ^ 2zo (Contractor:
Mailing Address:
Email Address:
Email
Mailing Address:
Architect:
Engineer: Phone: (-)-
Mailing Address:
Email
Phone: (_)
Describe Work:
v'la3o
,-0
Lot
Height:
(s
Block
Email
Owne/s Valuation of Work:
Sq. Ft. of Building:
Sub.
Property Size (Sq. Ft. or Acres):
fof
Manufactured Home lnstaller:
Mailing Address:
Assesso/s Parcel Number:
Job Address
Move/Relocationn R¿¿¡tion ! nepairNew!lf,f AlterationClass of Work:
! Detachedfr!nttachedGarage:
)
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PROJECf DETAII.s CONTI NU ED
Septic:Iowrs Community
Natural Gas Propane Electric Other
Driveway Permit:Exempt Permit #:
NOTICE
AuthoriW. This application for a Buildi ng Permit must be signed by the Owner of the property, described above,
or an authorized agent. lf the signature below 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 perm¡ts. 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 L80 days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement'
CERTIFICATION
Type of Heat:
I hereby certify that I have read this Application a
understand that the Building Division accepts the
nd that the information contained above is true and correct. I
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 constructthe 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 regulations (County Regulation(s))' I acknowledge that the
Building permit may be suspended or revoked, upon notice from the County, if the location, construct¡on 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 Build¡ng 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 compl¡ance with federal, state and local laws
and County Regulations rest with me and my authorized agents, including without limitation my architect
fr€neer or builder
I hereby acknowledge that I have read and understand the Notice
provided the required information which is correct and accurate to th
Owne nd Sign oatel (
and Certification above, as well as, have
e best of my knowledge.
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OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation:Plan Check Fee:Permit Fee:Manu home Fee:Misc Fees:
Total Fees:
I l(Ò Fees Paid:f/n Balance Due:
ø
BP No:
Rorf- 57vB
OWTS No:
Setbacks:OCC Group:Const Type:^W,:o
6 /2qBUITDING / PLANNING DIVISION
Signed Approval Date