HomeMy WebLinkAboutApplicationRECEIVED $OANNEO
AUG iJ g
GAR
c0M
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601, (970194s-82t2
www. ga rf i e I d -cou¡ly.çem
ld County
BUILDING PERMIT
APPLICATION
-TYPE OF CONSTRUCTION
n Commercial/Multi-FamilY Demolition
Manufactured Home le or Multi-Level
Residential or Townhome)Reroof
INVOLVEO 7r.ë 7r7 -e''ø'
Phone:Ûit I5tgl742-,
dt
Property Owner:J I tl 1 ¿¡ t'fc-/tz1/ateúE ¿1 ¿
Mailing Address: /
Email Address:t'11,ê t*t+iL. c erv-1
,L -a--(¡ ¿.R t
MailingAddress: t€2// e-ÍL t32. A/'eqo¿oo/sfr¡¿'ttS gtéo /
Phone:(7rol7ì7 a?a<.r*t,.¿lé€ C. I .
,L . êe tt?.,t/14 eEmail Address:t<
Contractor: lrr,2C C
Architect: Phone: (-)-
Mailing Address
Email Address:
e( ¡fvac- eê u,'Tê
alÂ
e ol
LtoJoto,
Phone: tI Tol et I l- têoéEngineer:t9a !> ,O"/y'o
5 sttalMailing Address
Email Address:
)Phone:Manufactured Home lnstaller:
Mailing Address
Email Address:
fl vlove/Relocation! Alteration ll Rdd¡tion p nepairClass of Work:! ruew
I DetachedGarage(Rttached
PROJECT DETAII.S
Describe Work:r?¿. L¿,'¿J € ).7 e l,'ô f ocnJ (LooF
Job Address: t <4t ¿&. t 2, Ç(o¿teooJ s?tra*S ?t 6 O I
Assessor's Parcel Number:
Sub.Lot Block
Owner's Valuation of Work: S / ç ot o e o Property size (sq. Ft. or Acres):EoÐ
Sq. Ft. of Building:/74c2 Height:v3 # of Floors: å .
RECEIVED
iifiiG il [l 2f]'{i-.,.: ii '. .1
GARFI
COMMUN
NTY
CONTINUED
Septic:OWTS
Type of Heat:Natural Gas
Driveway Permit:Exempt
Propane
Community
Permit #:
Other
NOTICE
Electric
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
, a separate letter of authority, signed byor an authorized agent. lf the signature below is not that of the Owner
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: (l-) State Electrical Permit, (2) County OWTS Permit,
(g) anotner 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 that I have read this Application and
unclerstand that the Building Division accepts the Ap
that the inlortnatiotr cotrtaitred above is true and correct. I
plication, 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 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 responsibillty for compliance with federal, state and local laws
and County Regulations restwith me and my authorized agents, including without limitation my architect
r,e and/ or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required information which is correct and accurate to the best of my knowledge.
el
Property Owner Print and Sign
t?ç 'l¿F7-7?/ aF a
æ Date
t¡r|l+ol:2q1.'o6 . ¿t'he'21? ¿'tt'ctcCC$ .
^,;í"1
L%u"
f
OFFICIAT USE ONLY
SpecialConditions: l:LîW-L\fl" W +r¿å rÙ+p t ær aNLyì
Misc Fees:Manu home Fee:Plan Check Fep:ßzt 14
Permit Fee:
/273,75Valuation:
¿rÐò
Adiusted
lsO.
BP No:
ßr-0é îTtcl
OWTS No:,'^'wiiwFees Paid:
ô15T,?f
Total Feesir{l Ol ' .P'l##E
¿t Zoning:k#wiSetbacks:
BUILDING / PLANNING DIVISION :
Approval
7"b'ælg
oE/oaûî
Date