HomeMy WebLinkAboutApplicationGarfuld. County
Communlty Development Department
108 8d'SÛeet, Suite 401
Glenwood Springs, CO 81601
l970le4s-82t2
www.sa rfield-counw.com
BUILDING PERMIT
APPLICATION
Demolition
Manufactured Home (Single or Multi-Level)
ReroofResidential {SF, Duplex or Townhome)
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF LOOO SQUARE FEET
EmailAddress: , -,..,, - , ,. ,, . ,- ,
LL Phone ztgogt 229.2224Property Owner:
MailingAddress:
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Phone:t3o3t z|q -??.z4
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Contractor:
MailingAddress;
Emall Address¡
Archltect: Phone:
Maillng Address:
Email Address:
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Engineer: Phone:
MalllngAddress:
Emall Address: -
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Manufactured Home lnstaller:
MailingAddress; .- .. . . -. _-
Emall Address: . -
Sub. øt %
Owne/s Valuatton of Work: 5 13t322 .g PropertySlze {Sq. Ft. or Acres}:
Descrlbe Work:
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Phone: ( I
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Block
Sq. Ft. of Building:tltfr¡
Job Address:
# of Floors:
Assessol's Parcel Number:
Height:
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ftlsemodeValteration' ". JL€{ass of,Work:ñew
DetachedGerage:
Type of Heat:Natural Gas
Driveway
NOTICE
Authoritv. This application for a Building Permit
or an authorized agent. lf the signature below is
Electric Other
must be signed by the Owner ofthe property, described above,
not that of the Owner, a separate letter of authority, signed by
the Owner, must be provided wíth this Applicatíon'
Lesal Access. A Building Permit cannot be issued wíthout proof of legal and adequate access to the property for
purposes of inspections by the Building Division'
Othgr perm¡ts. Multiple separate permits may be required: (1.) State Electrical Perm¡t, (2) County OWTS Perm¡t,
(¡lanott'er permit requíred 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 authori¿ed 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.
CEf,TlFrcATþII
I hereby certify that I have read this Application and that the information
understand that the Building Division accepts the Application, along with
contained above is true and correct. I
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 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) 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 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
e íneer and/ or builder
I hereby acknowledge have read and understand the Notice and Certiflcation above, as well as, have
provided the required which is correct and accurate to the best of my
Property Owner Print and Slgn Date
oFFtct¡AlttsEof'¡[v ?d s,rt¿.Ll cc ült'tlt"l
Special Conditions:
Misc. Fees:Manu. Home Fee:
Ñ/rPermit Fee:7b7.25Plan Check Fee,l Irq . ¿t
Adiusted Valuation:t3 323
BP No:
Br-c6 - 6EZg
SIS-Ng:
r¡/e
Balance Due:2b7 2{Fees Paid:t ls.{..'Total Fees:r
391,1u
LZoning:cConst. Type:
¿ÆoccSetbacks:
*D-\o7l
Date
BU|LDTNG / PIANNING DIVISION