HomeMy WebLinkAboutApplicationCounty
Community flanelopment Department
108 8ü Street, Suite ¿Í11
Glenwood Springs, CO 81601
(9701!}fs-8212
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Demolition
Manufactured Home
Residential
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Unit - MÆ0MUM S|ZE OF 1,000 SQUARE FEET
PropertyOwner¡
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Email Address:
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MailingAddress:
Email Address:
Engineer:Phone:{ I
MailingAddress:
Email Address:
, Manufactured Home lnstaller: Ñr ü I Phone:
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I IROJECTPEr_AIU¡
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lob Address:l t \ÀJ .- ß¡r¡a.¡ zra. Pu*c r. P+ø"tcwrrç. Co , *l l;16
Assesso¡'s Parcel Number: Lu\ o? \'l.'?-Þ3 t? O I
: sub.lot Block
of Work:tL,Property Size (Sq. Ft. or Acres):
Classof Work:
I Garage:
1 Owne/sValuat¡on
i SC. Ft- of Building:ILqq Height:6r #of
Detached
PROI ECT DETAII.S CONTINUTD
Septic:
Type of Heat:
&
Propane
Community
Electric
Permit #:
Other
Driveway
Permit:Irxemet
Authoritv. This application for a Building Permit must be signed by the Owner of the propefi, described above,
or an authorized agent. lf the signature below is not that of the Owneç a separate letter of authority, signed by
the Owner, must be provided with this Application.
Leral Access. A Building Perm¡t cannot be issued without proof of legal and adequate access to the property for
purposes of inspections by the Building Division.
Other Permits. Mult¡ple separate perm¡ts 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 cert¡fo 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 Perm¡t, 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 Count¡ if the location, construction or use
of the structure(s) and facility(ies), described above, are not in compliance w¡th County (ggulation(s) or any
other applicable law.
, I hereby grant perm¡ss¡on 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) j
i requiring the correction of errors in the submittals, if any, discovered after issuance; or (2) stoppíng
: 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 const¡tute an acceptance of responsibility or liability by the County of errors, omissions or
, discrepancies. As the Owner, lacknowledge that responsibility for compliance with federal, state and local laws
: and County Regulatíons rest with me and my authorized agents, includíng without limitation my architect ,
1 desigqgr, engineer and/ or b¡1ildeJ, -...-I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required information which is correct and accurate to the best of my knowledge.
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Print and Date
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Special C.onditions:
Ad¡usted Valuation:Plan Check Fee:Permit Fee:Manu. Home Fee:
N/A
Misc. Fees:
Total Fees:
d too. oô Fees Paid:
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Ealance Due:+./BP No:
lZooî.'7o15
OWTS No:
x/e
Setbacks:OCC Group:lRc Const. Type:
tRc
Zoning:
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