HomeMy WebLinkAboutApplicationGørfield CountY
BUILDING PERMIT
APPLICATIONngCgn¡ffimunity Development Department
108 8th Street, Suite 401
ktfìïf ¡\ :1 ?i!t[] Glenwood Springs' CO 81601
r,¿irv !' ii¡i' (9701 945_g?lz
cARFIË.LDtOUN@
co ¡,tt'lu utrv DEVELoPM E NT
Commercial/Multi-Fa milY
Manufaciured Home (single or Multi-Level)
E Demolition
llïl Reroofi E Residential (5F, Duplex or Townhome)
i lS-votyEe P¡\RrlFs
Property Owner:
Mailing
Emall Address:
' Contractor:
Mailing Address:
Email Addressl
Architect:
Malllng Addressr
Ernail Address:
Englneer:
i Maillng Address:
Emeil Address:
Manufactured Home lnstaller¡
Malling Address:
Email Address:
Describe Workr
Phone: fl1ltt¿187' - î -gl t e
)(t
c
())
)Phone:
Phone:
Phone:
Phone: (
lob Address:
i Assessol's Parcel Number:
I
,Sub.lot -- Block ---
Owne/s Valuatlon of Work:S 3fktf Propertvsize(sq. Ft'orAcres):
Heightr
-
â olSq. Ft, of Buildlng:
Class of Work:
lc"ì"æ1
flr.rew
flRttactred
$att"r.tion ER¿oition lnenair i ¡ Move/Relocation
' Io"t..h"d
Septic:
Type òf Heat:
i oriueway Þermlt:
'l I Natural Gas
'¡ r*..pt
i I n.opan"
I
owTs Community
'flEl"rtri. iEo*t"t
l-l eermit fi:
-
; g¡þ¡!¡y. This application for a Building Permit must be signed by the Owner of the properry, described above,
or an authorized agent. 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'
Lesal 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 permit¡. Multiple separate permits may be required: (1) State Electrical Permit, (2) County oWTS Permit,
, (3) .rth", frmit required for use on the property identified above, e.g. State or County Highway/ Road Access
; or a State Wastewater Discharge Permit'
i Vo¡d perm¡t. A Building Permii 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.
i other applicable law'
! I t,.r"¡y lr"nt permission to the Building Division to enter the property, described above, to ¡nspect 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 subm¡ttals, if any, discovered after issuance; or (21 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 âcceptance 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
anO CountV Regulat¡ons rest with me and my authorized agents, including without limitation my architect
designer, engineer andl or builder.
I hereby acknowledge that I have read and understand the Notice and Certlfication above, as well as, have
provlded the required information which ls cofrect and accurate to the best of my knowledge'
?
Property Owner Print and Sign Date
Special Conditions:
MiscFee:Fee:ooPlanFee:
Due:oooo0
+]wEUttDrNG / PIANNING DIVISION :
Signed Approval