HomeMy WebLinkAboutApplicationGurfield County
BUILDING PERMIT
APPTICATIONfl- ,'**",
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108 8th Street, Suite 401
Community Development Department
Glenwood Springs, CO 81601
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E Comme Iti-Fami Demolition
Reroofor Townhome)
n or Multi-LevelManufactured Home
Residential
INVOTVEDPARTIES
Property owner:
Mailing Address:
þll.phone: ,970 , î30 -ô ? V 0
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Email Address:rt ¿oo, (0 ¡(\
Manufactured Home lnstaller:Phone: ( )
Mailing Address
Email Address:
PROJECÍ DETAIIS
Describe Work:r¿mpcJ e I ,t{ eri¿ r
Job Address:o CP- +93
Assessor's Parcel Number:
Sub.lot _ Block
-
Owne/s Valuation of Work:ooo Property Size (Sq. Ft. or Acres):(,
Sq. Ft. of Building: 3, 250 - Height:/5 t ?çs¡ç1ssß1 A-
Class of Work:ñer-I nepalr
rc&Å r¡(-
Mailing Address:
Email Address:
Phone:,1to, Pr [ -r3 ']]il"e["wl SContractor:
Architect:Phone: I ì
Mailing Address:
Email Address:
Engineer: Phone: (-)-
Email Address:
Mailing Address
Garage:Attached
Alteration Addition
Detached
, PROJECT DETAITS CONTINUED
Septic:OWTS
Type of Heat:Natural Gas
Driveway Permit:Exempt
Community
Propane Electric
Permit #:
Other
I
NOT¡CE
Author¡W. This aPPl ication for a Building Permit must be sign ed by the Owner of the property, described above,
or an authorized age nt. 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'
bther permits. Multiple r"p"r.t" permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
(3) .r""tl*r 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 APP|ication and that the information contained above is true and correct. I
understand that the Building Division accepts the App lication, 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
comp leteness of the submittals and approval of ihis Applicatio n, a Building Permit will be issued granting
permissi on 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 Build ing Permit, I agree that I and my agents will
comply with P rovisions of any federal, state or local law regulating the work and the Garfield County Building
Code, OWTS reg ulations 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) an d facility(ies), described above, are not in compl iance with County Regulation(s) or any
other applicable law.
I hereby grant permiss¡on 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
engineer lder
I hereby acknowl have read and understand the Notice a nd Certification above, as well as, have
which is correct and accurate to the best of my knowledge'
1-?1- tF
Property Owner and Sign Date
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Special Conditions:
Misc Fees:Manu home Fee:Adjusted Valuation:
OWTS No:BP No:Fees Paid:bl
Const Type:OCC Group:Setbacks:
lo-ryeÞlg
BUILDING / PI-ANNING DIVISION:
Date