HomeMy WebLinkAboutApplicationGarfield County
BUILDING PERMIT
APPLICATION
RECËIVED
AU6 2 7 2018
GARFIELD COUNTY
Commun¡ty Development Department
to8 8t street, Suite 401
Glenwood Springs, CO 81601
(9701 915-8212
www.qa rf iel d-countv.com
COMMUNIlY
El_ Co_m merc[¡ l1M u! ti- la m l!-Y_ff Manufactu¡qd H.ome {Sin_gle or Multi-l-evel}
=fl nesidg¡tþ! IlL Duplex or Townhome)
Demolition
@ Reroof
Property Owner:
Mailing Address:
Email Address¡
Contraclori
Mailing Address:
Emall Address:
Archltect:
Phone:,Q1o I qK1
Phonc: @t?lQ-4uqZ
-7
Phone:
Malllng Addressr
Emall Add¡ess:
Englneer:Phone:
Malllng Address:
Emall Address:
Manufastured Home lnstallen Phone¡
Malllng Address:
Emall Address¡
Job
Work:
Assessot's Numben
Sub.
Owne/s Valuatlon of
5q, Ft. of Bulldlng:
lot Block
Height:
Property Size (Sq. Ft. or Acres|:
f of Floors:_
t-'- __..
; Class
I
of Work:Repair
Garage:
I f-'l ruew i l-l eheration
¡,-r-r
IRuached
E e¿¿¡tion
floetached
l_l Move/Relocation
Permit#:
ill)"rfq:'
i:ì;irtld,.1 r't .:,r r1 ..., :,rJi¡¡1,\lrj{J
Scpdc:OWTS C¡mmunlty
Type of Heat:Natural Gas Propane Electric Other
Drlrcuny Permlt Exempt
Authorltv. This application for a Building Perm¡t must be signed by the Owner of the propefi, described above,
or an authorized agent. lf the signature below ls not that of the Owner, a separate letter of authority, signed by
the Owner, must be provided with this Applicatíon.
Lerel Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for i
purposes of inspections by the Building Division.
(Xher Permlts. 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 C,ounty Highway/ Road Access
or a State Wastewater Discharge Permit.
Vold Permit. A Building Permit becomes null and void il the work authorized is not commenced within 180 days
of the date of issuance and if work is suspended or abandoned for a períod of 180 days after commencement.
I hereby certify that I have read this Application and that the informat¡on contained above ¡s 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
permission to me, as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by
the Building Division. ln cons¡derat¡on 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 appl¡cable 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 Euilding Official from: (1)
requiring the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping
construct¡on 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 submittalg and inspections of the work by the Building
Divisìon do not constitute an âcceptance of responsibility or liability by the County of errors, omissions or
discrepancies, As the Owner, I acknowledge that responsib¡l¡ty for compliance with federal, state and local laws
and County Regulations rest with me and my authorized âgents, including without límitation my architect
designer, engineer and/ or builder.
I hereby acknowledge that I have read and undênstand the llotice and Certiflcation above, as well as, heve
provlded the requlred lnformation which is corråcî and accurate to the best of my knowledge.
eht /tg
oa/eProperty Owner Print and Sign
Speclal Condltlons:
Ad¡ut5r
|1{¡t¡on:
Plan Check Fee:
f-r I f\'%7'|4ìi'.*M"KJOIEIEE'Mlsc Fee¡: ^N)/t]
ä'ilii%'$iiT:*'#il.'öb BP No:
Þ-nnç -,qoe OWl'll ño:-wr/n
Setbacks: .ñlfi+"'ÍfrL Const TvDe:ÍPr rflvl P
BUttDtNG / PTANNTNG DtVtStON ;
Slgned Apprwal