HomeMy WebLinkAboutApplication$ffiij ;;ürû
RECE .. CommunityDevelopmentDepartment
Nil\.f i .{ /"iliii toss'hstreet,suite4'l
ss,i SlFi B.l,?.u,ll-"
u'
" "*i3lsìi[ï# I 1 60 1
www.garfield-countv.com
Garfield County
BUILDING PERMIT
APPLICATION
E DemolitionCommerciaUMulti-FamilY
Reroofor Townhome
or MuManufactured Home
Residential
Phone:tfrOr E?("- ?J¡l
e
".\\^\-r"....^ \. *
EmailAddress:
Property Owner:
Mailing Address:
co 8l
Phone:Contractor:
Mailing Address:
Email Address:
Mailing Address:
EmailAddress:
ìPhone:I\"n .tArchitect:
Mailing Address:
EmailAddress:
lùlr
Describe Work:
Phone:
I
o.rPo\\\\q.\€.\
Height:
Phone:
Owne¡'s Valuation of Work:
tl
\ôN - å'¿rL .rOlO\N
Manufactured Home lnstaller:
Engineer:
Sq. Ft. of Building:
Sub.
Property Size (Sq. Ft. or Acres):
#of
Assessol's Parcel Number:
Job Address:
Mailing Address:
EmailAddress:
rot'7 -S Block..._
Move/RelocationE Rddition I nepatrClass of Work:[ Ñew is.ahet.t¡on
DetachedAttachedGarage:
PROJECT DETAITS CONTINUED
Sept¡c:Iowrs Community
! Èrèctii.I lottrerType of Heat:Natural Gas
Driveway Permit:Exempt
Propane
i
I
ì_l
Permit #:
-
NOTICE
Authoritv. This aPPlication for a Building Permit must be signed by the Owner of the pro perty, described above,
of authority, signed bYor an authorized agent. lfthe signature below is not that of the Owner, a separate letter
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 p"tritt 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'
void permit. 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 CÊRTIFICATION
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 upo n my certification as to accuracy' Assuming
comp leteness of the submittals and approval of this Application,a Building Permit will be issued granting
perm ission to me, as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by
the Bu¡lding Division. ln consíderatíon of the issuance of the Buíldíng Pe rmít, 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 susPe nded 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 correctíon of errors in the submittals, if any, discovered after issuance; ot (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 const¡tute 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 l¡m¡tat¡on my architect
neer or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the regu¡red information which is correct and accurate to the best of my knowledge'
ir " {3-f.1
Property Owner Print and Sign Cr..tre \.t41
<1.-
Date
't}r-2o|f-{û
OFFICIAL USE ONIY
Special Conditions:
Manu Fee:itJee:Adjusted Valuation:
h &-b0æ6øFees Paid:
.ç
Zoning:ConstoccGrory.P
Due:nce
Setbacks:
^qÉ'
BUITDING / PTANNING DIVISION :
Date