HomeMy WebLinkAboutApplicationRECEIVED
JUL 3 0 2018
FIELD COUNTY
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-8212
www.ga rf ield-cou ntv.com
OF
SCANNED
BUILDING PERMIT
APPLICATION
Demolitionn Commercial/Multi-Family
-I Manufactured Home (Single or Multi-Level)
F Residential (SF, DuplexorTownhome)Reroof
INVOLVED PARTIES
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Email Address: ¿
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Phone: (') /Z)Property Owner:
Mailing Address:
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EmairAddress: . l*D4.,/dírt6) ¿5'/¡q.¡ ¿!
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Mailing Address:
Contractor:
Phone:
Email Address:
Mailing Address:
Arch¡tect:
Phone: (_)Engineer:
Mailing Address:
Email Address:
Phone: { )
Email Address
Manufactured Home lnstaller:
Mailing Address:
LlAlteration E Rddit¡on ! Repair | | rvlove/RelocationClass of Work:! wew
Inttached | | DetachedGarage:
PROJECT DETAILS
Describe Work:
Sq. Ft, of Building:
¡L
Height # of Floo
Job Address:N
Assessor's Parcel Number:
Sub.Lot
Owner's Valuation of Work: $
Block _
Property Size (Sq. Ft. or Acres):
f-
I PROJ ECT DETAIIS CONTINU ED
Septic:OWTS
Type of Heat:
NOTICE
Authoritv. This application for a Building Permit must
or an authorized agent. lf the signature below is not t
Community
Permit #
be signed by the Owner of the property, described above,
hat 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: (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.
CERTIFICAT¡ON
I hereby certify that I have read th
understand that the Building Divis
Sign
is Application and that the information contained above is true and correct. I
ion 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 thesubmittals and approval of thisApplication, a Building Permitwill be issued granting
permission to me, as Owner, to construct the 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, construction 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 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
desi er, engineer or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
the required which is correct and accurate to the best of my knowledge.
2' ),r ^/ rÂ
--wDate
\J
OtherElectricNatural Gas Propane
ExenrptDrlveway Permit:
OFTICIAT USE ONIY
Special Conditions:
Manu home Fee:Misc Fees:Permit Fee:Plan Check Fee:Adjusted Valuation:
OWTS No:BP No:
ç Á-2
Balance Due:4--Fees Paid
tnA nnltJll.|/Q
Total Fees
Zoning:
fl ttÞConst Type:OCC Group:Setbacks:
o+lpltî
Date
BUILDING / PLANNING DIVISION :
Signed Ap
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