HomeMy WebLinkAboutApplicationRuruDrñ6
Community Development DepartmentnËCËtVËD roag,h streåt, suite 401
Glenwood Springs, CO 81601
l970l94s-82t2
GARF|ELDroUNT@
OOMMUNITY ÐËVELOPMENT
Gørfield County
BUILDING PERMIT
APPLICATION
E Com mercial/Multi-Family Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
Accessory Dwellinc Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
Property owner: 6r¿:fl- Bsvu, f ld*to¿Phone
Mailing Address: t4@Lt doA¿ ,9A"3 /4;'/ le casto
Email Address:f
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Phone:
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Contractor:
Mailing Address:
Email Address:
Phone:Architect:
Mailing Address
Emall Address:
Mailing Addressl
Email Address:
Phone:Engineer:
Phone:
PRO.IE(T'DEIAITS
Manufactured Home lnstaller:
Mailing Address:
Email Address:
Describe Work:
lob Address:3 âAry / /^/ \ /n*¡,Q9 4_?
Assessol's Parcel Number:
Sub.
Ownefs Valuation of Work:
Sq. Ft. of Building:å ÖOer
Atnn tttocs'3 ¿:r
Lot Block
Property Size (Sq. Ft. or Acres):aê
Height:/5/# of Floors: I
Clnsc of Work:t[--ln¡"*
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iF Rpmnr{ellÂltpratinn I lAdditinn
FROfiCTDËrÂlls €OFITIûIUED
, Septic:
Driveway
Permit:
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ral Gas Propane Electric
Permit f:
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NOTICE
AuthoriW. This application for a Building Permit must be signed by the Owner of the property, 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.
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 Dívísion.
Other Permits. Multiple separate permits may be required: (1) State Electrical Permit. (2) County OWTS Permit,
(3) another perm¡t 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 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 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. 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 abovg 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
construction or use of the structure(s) or facility(ies) if such is ¡n v¡olat¡on of County Regulation(s) or any other
applicable law. Review of th¡s Appl¡cation, including submittals, and inspections of the work by the Bu¡lding
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 w¡th federal, state and local laws
and County Regulations rest with me and my authorized agents, including without limitation my architect
and/ or builder
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
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provided the required information
Saø"|-f ieR Y t-¿
and accurate to the best of my knowledge.
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Property Owner Print and Date
oNrYq!ò /OFFICIAT USE
Special Conditions:
Manu. Home Fee:
N/D
Misc. Feeç:
hJ /d\
Plan
1,
Fees
Valuation:
Total Balance BP lrlo:
GFñ-10+.<l
OWTS No:
N\/A
Setbacks:o'ful 4,7k5 I t"nt#ä,&?,HJ\YT Ió
Rt ilr nrNrî , Dt ÀNN|Nê ñlrflctñN 3'22.^ zclz'l
NOTE: lf any required information is missing, delays in issuing the permit are to be expected. lf
determined by the Building Officialthat additional information is necessary to review the application
and/or plans for compliance, the application may be placed on hold until the required information is
provided. Work may not proceed without the issuance of a permit.
The Building Division will collect a Plan Review fee at time of application submiüal. The Permit Fee, as
well as any Road lmpact fees will be collected when the permit is issued'
The permit application must be signed by the owner or by a person having written authority from the
owner to act as their representative.
I hereby acknowtedge I have read, understand, and will abide with the requirements of this
checklist.
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Property Owner Print
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