HomeMy WebLinkAboutVoided ApplicationGurfield County
l-'l Demolitionfl Commercial/Multi-Family
fl Manufactured Home (single or Multi-Level)
l--l Rerooffi Residential (SF, Duplex or Townhome)
BUILDING PERMIT
APPLICATION
REG Communi$ Development Department
rut) r 1 Ìn1f! 108 8th street, Suite 401
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^ ¡^^t r¡1Çlenwood Springs, co 81601
GARFIE-uu.YoiJprirtt (e7ole4s-8212
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Phone:
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Email Address:
Property Owner:
MailingAddress:
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Phone:Contractor:
Mailing Address:
Email Address:
D'
{}Architect:
Mailing Addressr
Email Address:
<.Phone:fl
Mailing Address:
Email Address:
Engineer:
Mailing Address:
Email Address:
Phone: ( )Manufactured Home lnstaller:
Describe Work:
Job Address:
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Assesso¡'s Parcel Number:
Atlc Height:
¿)Propefi Size {Sq. Ft. orAcres}:
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Sq. Ft. of Building:
sua.ßû¡k t's l:.tå/¡g;si,)'" Lot Block
Owne¡'s Valuation of Work:
Alteration Addition Move/Relocation
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Class of Work:
Garage:
New
Attached
Repair
Detached
I Pßô¡ECT DETATTS COilNilUEO
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Septic:
Type of Heat:Natural Gas
Driveway Permit:Exempt
Propane
Commun¡ty
Electric Other
Permit ff;
AuthoriW. This application for a Building Permit must be signed by the Owner of the propefi, described above,
or an author¡eed 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.
Legat 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 Hlghway/ Road Access
or a State Wastewater Díscharge 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'
I hereby certify that I have read this Application and that the information conta¡ned 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 wÍll 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
compty 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 Perm¡t 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 th¡s Application, including submittals, and inspections of the work by the Building
Division do not constitute an acceptance of r.esponsibility or liability by the County of errors, omissions or
discrepancies. As the Owner, I acknowledge that responsibility for compliance w¡th federal, state and local laws
and County Regulations rest with me and my authorized agents, including without limitation my architect
andl or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, hav€
provided the required which is correct and accurate to the best of my knowledge.
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Property Owner Pr¡nt and Sign Date
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Special Conditions:
Misc Fees:Permit Fee:Manu home Fee:Adjusted Valuation:Plan Check Fee:
OWTS No:Balance Due:ffit-flq?Total Fees:Fees Paid:
40.ø¿l
Zoning:R.Const ïype:Setbacks:OCC Group:
BUILDING / PIANNING DIVISION :
DateSigned Approval
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