HomeMy WebLinkAboutApplicationI✓ Garfield County
RECEParPmunity Development Department
108 8th Street, Suite 401
tk)' Glenwood Springs, CO 81601
G4RF1ELD COUNTY (970) 945-8212
commuigy 0EVEL.OW.garfield-county.com
TYPE OF CONSTRUCTION
Commercial/Multi-Family
n Manufactured Home (Single or Multi -Level)
I—I Residential (SF, Duplex orTownhome)
BUILDING PERMIT
APPLICATION
=Demolition
n Reroof
I—I Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
I INVOLVED PARTIES
Property Owner: /.?v,c C1: r'trt.c" Phonee::( 17° ) 6 ( ?337
Mailing Address: ] all I�[, (� he i 7 TY- .I~- -z- co. ct' l -)'
Email Address:
Contractor:
Mailing Address:
Email Address:
Phone: (
Architect:
Phone:(
)
Mailing Address:
Email Address:
Engineer:
Mailing Address:
Email Address:
Phone: (
Manufactured Home Installer: Phone: (
Mailing Address:
Email Address:
PROJECT DETAILS
Describe Work: S'e e dC Sl.. Vri p ! 1 oii of Work
siF an (MAW( &place 0/ aVatc(poctib
Job Address: 9 eX 2 -to (2._(10-
1 -(F0-
1
Assessor's Parcel Number:
Sub, Lot Block
Owner's Valuation of Work: $ 7.57A - Property Size (Sq. Ft. or Acres):
24 -7-/ # of Floors:
Sq. Ft. of Building'
Class of Work:
Garage: i l L.
X(New
Remodel/Alteration nAddition
Attached
Detached
�F. I"b
Septic:
71, BD,�¢'.'.
Community
Other
a
1`OWTS
Type of Heat:
�
II
❑ Propane
Driveway1
Permit:
-
n
Permit #:
at
Authority. This application
•fl
for a Building Permit must be signed by the
If the signature below is not that of the Owne
provided with this Application.
Permit cannot be issued without proof of legal
by the Building Division.
separate permits may be required: (1) State
required for use on the property identified above,
Discharge Permit.
Permit becomes null and void if the work authorized
and if work is suspended or abandoned for a period
Owner
, a
and
Electrical
e.g. State
Mt
of the property, described above,
eparate letter of authority, signed by
adequate access to the property for
Permit, (2) County OWTS Permit,
or County Highway/ Road Access
is not commenced within 180 days
of 180 days after commencement.
or an authorized agent.
the Owner, must be
Legal Access. A Building
purposes of inspections
Other Permits. Multiple
(3) another permit
or a State Wastewater
Void Permit. A Building
of the date of issuance
4t
I hereby certify that I have read this Application and that the information contained 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 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. In 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. 1
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
designer, engineer 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.
:
Property Ownerand Sign
Date
Special Conditions:
Adjusted Valuation:
1,14 2V'l-. `fit
Total'
N ees:
8°1
Setbacks:
Plan Check Fee:
III14
Fees Paid:
Z NO.gl
Permit Fee:
In, • R-5
Manu. Home Fee:
Balance Due: BP No:
2r 1.2r;- 5g21
Misc. Fees:
OWTS No: -Cy
.4481 .)
OCC Group: G
Const Type: lac
Zoning: R
BUILDING / PLANNING DIVISION :
aura„,
Signed Approval
Date
PD. 4tfo, ✓*INS) le(w(M
4