HomeMy WebLinkAboutApplicationGarfield County
BUITDING PERMIT
APPLICATIONCommunity Development Department
RECEIVED ro8 8'h Street, Suite 401
Glenwood Springs, CO 81501
NUV 3l:l 2018 pTotsls-B2tz
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'i il¡TI ITIITY NEVELOPMENT
I TYPE OF CONSTRUCTION
n Commercial/Multi-Fa mt
INVOTVED PARTIES
Property Owner:
Mailing Address:
Email Address:
Contractor:
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Phone:
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Phone: (_)
Mailing Address:
Email Address:
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Describe Work:c {\ì.¡.V "{I
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í-Job Address:ês ¿l1v*.t o
Assessor's Parcel Number:
Sub.Block
Property Size (Sq. Ft. or Acres):
Lot
Owner's Valuation
Sq. Ft. of Building:
fl DemolitionnManufactured Home or Multi-
Residential Du or Townhome Reroof
ü
Phone: (_)Arch¡tect:
Mailing Address:
Email Address:
Phone:Engineer:
Mailing Address
Email Address:
Phone: (_)
.Email Address:
Manufactured Home lnstaller:
Mailing Address
ll Rdd¡t¡on ll nepair I I Move/RelocationClass of Work:! trtew ll Alteration
!Rttached fl DetachedGarage
of Work:
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Height:# of Floors:
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, PROJECT DETAITS CONTINUED
Septic:OWTS Community
Driveway Permit:Exempt Permit #:
NOTICE
Authoritv. Th is application for a Building Permit must be signed by the Owner of the property, described above,
rate letter of authority, signed bYor an authorized agent. lf the signature below is not that of the Owner, a sepa
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.
Voidpermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinL80days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
I CERTIFICATION
I
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.
lherebygrantpermissiontotheBuildingDivisiontoentertheproperty,describedabove,toinspectthework. 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 ner, engineer or builder
I hereby acknowl that I have read and understand the Notice and Certification above, as well as, have
provided the h is correct and accurate to the best of my knowledge'
I hereby certify that I have read this Application and that
understand that the Building Division accepts the Applica
Print and Sign
the information contained above is true and correct. I
tion, along with the plans and specifications and other
lì- ?o _ tq
Date
!ottrerElectric
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PropaneType of Heat:Natural Gas
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oFFrcrAL usE oNLY l¿a.tt tt(3ol t8 4ræ.Ø
Special Conditions:
Adiusted Valuation:'Nrtru Plan Check Fee:\\IA Permit Fee:$lort.æ Manu home Fee:\\\ q Misc
rotålie'es': '
$ Í cn.oo
rees Pbid:
ölæ.oo
Balance Due:66-oo BP NoL:
?(nÞ- 55Ê3
OWTSTNo:
N\IIA
Setbacks:OCC Group:j'p( ,
Const Type:'tÐo.Zoning:
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BUILDING / PLANNING DIVISION
Signed Approval