HomeMy WebLinkAboutApplicationGorfield CoanSt
Com munity Development Department
lOB 8th Street, Suite 401
Glenwood Springs, CO 81601
lpTols4s-8212
www.garfi eld-countv.com
BUILDING PERMIT
APPLICATION
WPE OF CONSTRUCT¡ON
Commercial/Multi-Family Demolition
Manufactured Home (Single or Multi-Level)
I Residential (SF, Duplex or Townhome)v Reroof
Accesso Dwelli Unit DU - MAXIMUM SIZE OF FEET
INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
Phone: 0þ) L t 9- e?73
o
Phone: t"' I ?87'htf 91
&
Contractor:
Mailing Address:
Email Address:
Architect: Phone:
Mailing Address:
Email Address:
Phone: I )Engineer:
Mailing Address:
Email Address:
Mailing Address:
Email Address:
Phone:IManufactured Home lnstaller:
su¡. l?onct. € R.oqri,n, ñrI ¿ff tot ZÔ Block-
PROJECT DETAITS
Describe Work 7
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t6tt co
Job Address:
Owner's Valuation of Work:
Sq. Ft. of Building:Height:f of Floors:_
Property Size (Sq. Ft. or Acres):
Assessor's Parcel Number: 2
AdditionNewl/Alteration{emodeClass of Work:
DetachedGarage:Attached
PROJECT DETAITS CONTINUED
Permit #:
NOTICE
Authoritv. ThisapplicationforaBuildingPerm¡tmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
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 permits 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.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinlS0days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIF¡CATION
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 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
construction or use of the structure(s) or fac¡lity(ies) if such is in violation of County Regulation(s) or any other
applicable law. Review of this npplication, 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 w¡th me and my authorized agents, including without limitation my architect
designer neer or buildere
I hereby acknowledge that I have read and understand the Not¡ce and Certification above, as well as, have
provided the required information which is correct and accurate to the best of my knowledge.
Property Owner Print n Date
CommunitySeptic:f,WÏS
Propane Electric OtherType of Heat:Natural Gas
ExemptDriveway
Permit:
OFFICIAT USE ONLY Pà, *loô. oo Cc toltÍ/zozt ¿i^r
Special Conditions:
Adjusted Valuation:Plan Check Fee:Permit Fee:
tto6,o'
Manu, Home Fee:
u,/¡
Misc. Fees:
Total Fees:Fees Paid:
f loô. ôo
Balance Due:BP No:
ÍZoôF -1 tq G
OWTS No:
N/*
Setbacks:OCC Group:
f R-c
Const. Type:
l2- c
Zoning:
7 UÞ
to/t E/zoz¡
Date
BUILDING / PLANNING DIVIS