HomeMy WebLinkAboutApplicationRECEIVED
AUG 0 2 2019
GARFIELD COUNTY
COMMUNITY DEVELOPMENT
Garfield County
Community Development Department
108 8e' Street, Suite 401
Glenwood Springs, CO 81601
(970) 9454212
LV wsv.g aa-rpunty.com
TYPE OF CONSTRUCTION
Commercial/Multi-Family
O Manufactured Home (Single or Multi -Level)
Residential (SF. Duplex orTownhome)
INVOLVED PARTIES
BUILDING PERMIT
APPLICATION
0 Demolition
Q Reroof
Property Owner: i77f (C Met, ol Phone<S02_) g 6 3
Mailing Address: z33 x(.7,7 y. fr'c� 107 L� r��r; 4a 4.,Email Address: ccuri j� n Q rt /Cr] f„ .'r, boo _e m
Contractor. L(. L Q (1 j0i LI
�3 Irr Si •
Mailing Address:
Email Address:
Architect:
Phone: (7Q) 4eE"-4 36
Mailing Address:
Email Address:
Engineer:
Mailing Address:
Email Address:
Phone: { )
Manufactured Home installer.
Mailing Address:
Email Address:
Mita WAS
Phone: (
Describe Work: (a• 0 i� e , [
_ L bagGI-�
1 71 V p—& {{ r'texd r LCC " ] r
Job Address: 43 j r7 !_ pry %2r1 7 Z ai T[ v
Phone:( )
R •
Assessor's Parcel Number:
Sub.
Lot Stock
Owner's Valuation of Work: $ 5c 1,o. aD 0 Property Size (Sq. Ft. or Acres):
# of Floors:
Sq. Ft. of Building: Height:
2
ov9(
Sr'sre17 ,� r�
Class of Work: ❑ New ❑ Alteration 0 Addition ['Repair n Move/Relocation
Garage: Attached Detached
PROJECT DETAILS CONTINUED
!Septic: ❑Owls EI Community
Type of Heat: EJ Natural Gas fl Propane Electric Other
Driveway Permit: Q Exempt DPermitA:
NOTICE _
Authority. This application fora Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. If the signature below is not that of the Owner, a separate letter of authority, signed by
the Owner, must be provided with this Application.
Leeaf 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 Penults. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
(3) another permit required for rxsr: na tt..e ry ,rpeasr) WiLLTyyki,e, e.g.-Rate or County Highway/ Road Access
or a State Wastewater Discharge permit.
' Vold Permit. A Building Permit becomes mull and void if the work authorized is not commenced within 280 days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
t hereby certify that 1 have read this Application and that the information contained above is true and correct. I
understand that she Betiding 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 1 and my agents will
comply with provisions of any federal, state or local law regulatIne the work and the Garfield County Building
Code, OWTS regulations and applicable land use regulations (County Regulationis)), 1 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.
1 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 notptevemthe enehd`mgC O:1'11 am:11'I
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(les) 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.
1 hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the r . ed information which is correct and accurate to the best of my knowledge.
Property Owner rint and S
ra'7,
Gt-r- v
Date
OFFICIAL USE ONLY
Special Conditions:
Ad)usted Valuation:
Total Fees:
100.00
Setbacks:
Plan Check Fee: Permit Fee:
(D0.00
Fees Paid: Balance Due:
i 00.00
-er
OCC Group: 1 gt.",
BUILDING,/ PLANNING LVVJ )ON:
Manu home Fee:
Misc Fees:
Const Type: ■ Zoning: g
Date
Signed Ar
�.!loo.00 c c grit_