HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
RECEIVED 108 8th Street, Suite 401
Glenwood Springs, CO 81601
sEP ì 0 ?01$
GARFIELD COU
COMMIJNITY
lp7ol94s-82L2
www.sarf¡ eld-cou ntv.comr
BUILD¡NG PERMIÏ
APPLICATION
TYPE OT CONSTRUCTION
Comm Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)I Reroof
Dwelli Unit - MAX¡MUM SIZE OF FEET
INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
f +{Phone:
t L Phone:,q1
l6¿(
Mailing Address
Email Address:
Arch¡tect:Phone: ( )
Mailing Address:
Email Address:
Engineer:Phone:(
Mailing Address:
Email Address:
Manufactured Home lnstaller:Phone: (_)
Mailing Address:
Email Address:
PROJECT DETAITS
f&^r,/çç ¡f[^ø].¡$t
Job Address:I
Assessor's Parcel Number:
s,bit/L(âtrvictÇ ,Lot _ Block
Owner's Valuation
Sq. Ft. of Building:
of Work:c)Propertysize (sq. Ft. orAcres): lr?nÔ a tl-
Heightr f of Floors:_
Class of Work:(:v;Remodel/Alteration Addition
Garage:Detached
CommunityCWTSSeptic:
Electric OtherPropaneNatural GasType of Heat:
Driveway
Permit:
PROJECT DETAITS CONTINUED
NOTICE
Author¡tv. This application for a Building Permit
or an authorized agent. lf the signature below is
Permit #:
must be signed by the Owner of the property, described above,
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.
Other permits. Mult¡ple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
13) another permit required for use on the property ¡dentified 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 acknowledge that I have read an dun derstand the Notice and Certification above, as well as, have
provided the required ¡s correct and accurate to the best of my knowledge,
tq
Property Owner Print a nd Sign Date
nd that the information contained above is true and correct' I
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 subm¡ttals 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.
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
construct¡on or use of the structure(s) orfacility(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
or builderdesierra
I hereby certify that I have read this Application a
understand that the Building Division accepts the
OFFICIAL USE ONTY Ø*
Special Conditions:
Misc.Manu. Home Fee:\\ì¡+'"riw"roPlan Check Fee:\\\E\Adjusted Valuation:
OWTS No:
l'.\ I AQOdF-5qqLI
BP No: ''fl¡314"Fees P'aid:
# tr\Ò.oo".iii'Åä'
'"fäbConst. Type:
:rPC-OCC Group::rf c-Setbacks:N\ ìT\
^
o'' ''' N/ 'iBUILDING / PLANNING DIVISION
Signed Approval Date