HomeMy WebLinkAboutApplicationGa,rfield Counfii
Community Development Department
RECEIVED 108 8th Street, Suite 401
". . ,¡ ¡ ,-,,,"Glenwood Springs, CO 81601
i,iii.i lt { /'i,,lr (g201945,82L2
9,î,i5'iFi3'r,?l'w
WPE OF GRAÐIN6
tr MAJOR El vrrruoR
Phone:{ qlo 1234'5'l/86L¡o G"çc,J
Ger-k-(^I*.,À"lu (o 8,û43
EmailAddress:
Property Owner:
Mailing Address:
L,tØJ lno tn*E< Phone: ( q?0
)
--.....---.__
uru3@í.'olrryil"um
ï'.lu-¡r7,o
EmailAddress:
Mailing Address
Contractor:
å GÅ¡',Å"Iþ @
EW., A.¿l',;'hdr^te Phone: ( q}o ) Ll01-1't1O
&"
Architect:
Mailing Address:
EmailAddress:
P.0' ß.x 6?ø ó^',fu co ¡0t¡:
S'^^& ribfàPåTqn . cnr''
h3 l3E- eâ?e5,-,ÀEngineer:Phone:
Mailing Address:
EmailAddress:
Job Address:
lZ'oØ 3þo
Í{AME.ANE'LOCATION
6*Ên"¿ Re¡bo.
N¿"t tr R¿r.'å.n¿¿,
Aç^ 6l¿n115 ßr.r fu'k t"+ Frl
Earthwork (Cubic Yards|:
Describe Work:
Project Name
Assessor's Parcel Number:
Earthwork (square feet) :
Sub.Lot _ _Block
AtL UTILITIES MUST BE LOCATED PRIOR TO ATUY GRADIHG
At¡üodly, Thls application for a Euilding Permit must be sþed by Ownerof the FrcÞerty,ãbovÊ, or
an authori¡ed agenL lf the rignåture below ls not thet of the Owner, a separate letter of authorlty, signed by the
OwnÊr, must be prw¡ded $tth this Application.
lËfitl åcfs. À Buildine Permit cannot be lss¡ed wlthout proof of legal and adequate acccss to t*re property fior
purposes of inspectiorls by the Bullding Division.
Çtter Perçút¡. Multiple septrat€ permits may be required: l1| State Electrical Permit, (21 County OWfS Perm¡t,
{3} another permit required for use on the prop*rty identified aboræ, e.g. SÞtê or côunty Highway/ Road Access or
â Stste ïlra;te4¡rrater D¡scharße Permit.
Vold Fermß A Buílding Perm¡t beÕDmës nulland r¡oid if the work autñorized is not commenced within 180 da¡¡s of
the dãtã of lssuance and ¡f work is suspended or abandoned fora period of t8O days after commêñcemúnt
certi¡y thãt I heve read this Applicatiør and that tt¡e intormadsl contalned above ls üue and corrrst. I
undersand that the Build¡ng Dluision acrepts the Applietion, along with the plans end speclflcations and other
datå iubmittÉd by me tr on my behalf (rubmfüalsf, based upon my certification as to accurac1. Assuming
completeness of the sr¡bmlttals and appronal of thls Applhation, a Building Fermlt will be issued grånt¡ng
permlss¡on to me, as Oìirner, to ctrnstruct the struaure(sl and tadlltles dêteiled on the subrnfttals reviewed by the
Buildlng Divislon. ln consideration of the lssuance of the Building Permit, I agree that I and my agentl wlll compþ
¡vith provlslons of any federal, state or local law regulating tùe work and the Garfleld Countl Building Code, OWTS
rqulalions and applicable land use rÊg¡¡lätlôns lCounty Regulation{s}}. I acknorrHge that the Euilding Permh
may be $¡spênded or revoked, upon notÌce from the County, Íf the location, construct¡on or use of thestructurefsl
and faciltty{ies}, describêd atrove, are not ln compliance with Ëounty Regulatlon{s} or any other applicable lau
I hereþ grant pcrmission to the &uilding Dlvis¡on to enter the prop€rty, descrihed above, to inspect the work- ¡
further acknowledge that the issuance of the Buildiirg Fermit does not pretent t'tre Building Official from: {1}
requirlng tfie correction of errors in thè subm¡ttals, if any, discovered afrer issuance; or 12) stopplng construÉton
or use of tåe s$ucture{sl or facillty(lesf lf zuch is ln vlolation of County Regulatlon(s) or any other applicable law.
Revleu, Df this Application, including subm¡ttals, and inspect¡öns af the urork by the Building Division do not
constitute an âcceptance of responsibllfi or liabilrty by the County of enors, ornissions or dls*epancies. As the
O$rnar. I acknowledge thãt rÊspons¡bllity for compliance with federal, state and local laws gnd County Regulatlons
nêst ur¡th me and my authorÍred agents, including without limitat-¡on my arch¡tect d€signer, engineer and/ or
builder.
I herêby acknodedge tlut I haye read and undeËþ¡d tlre tlotlca üd Certifhation ¡boye .s wGll ¡s
hava provided the required lnüormatlon which is correct end aæurätß to the ücet of my knonledge.
P Fpa.Ð 2
Property0umer Print ild SiSa Datc
&ç
00
Sprri Cotdnlon*,?---='---'_GrRp/xq ar
þ,^tt-ør,nç 77+,*ur
O^trn's
,8rú/E¿u/
fr,,JK Parø*q
Ðåi'*,Wff**Yìin,*l¡¡scÍ€t':
lc¡r¡c lht¡:Hct/*,at Pr):I>
ZÛldnEF€redhgF:mie
GaÉÐ-tÆ3,
üuslooB¡hncc
É¡¡,,
sunÞ!il0, lLÂilÍllNG Dñlls'loll :
I
Dttc