HomeMy WebLinkAboutApplicationC'ttttttl¡r l
Community Development Department
108 8d'Street, Suite 401
Glenwood Springs, CO 81601
l970le45-8212
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TYPE OF CO]TSTRT'CIION
Manufactured Home or
orTownhome)
Þweìling Unit (ADU)- MAXIMUM SIZE OF 1,000 SQUARE FEET
ITIIIOLVED PAßTIES
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Reroof
1zc -Property Owner:
Mailing Address:aaçç úi.oStÂ*rgt- Þß¡.iú ALV- Çlfq*eS i\o Þr
Email Address: - -
i
Contractor:D.¡\ Ñeupu*L: Cost..Co.
Mailing Address:
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Email Address:\a Ç¿r @ 4p:-^ iVlê.tl , CO'7¡
Architect:
Mailing Address:
Engineer:
Email Address:
Phone:ít
Phone:
Phone:
t{ltn
Mailing Address:
Email Address:
Manufactured Home lnstaller:
Mailing Address:
Email Address:
Phone:
Iþscribe Work:Pt¿rr 'ß-Ê¡r6,b bot^rñ, Nl
?o 'Rg¡,t tÈj lñl
Job Address:€L Ëò
0 1Assessor's Parcel Number:
5ub.EuY- ç ,ñc(S Lot Block _
Owne/s Valuation of Work: $D C).Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building:
Class of Work:
tl.{ böl
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Height:<'75 fioflloors: L
dition
BUILDING PERMIT
APPLICATION
Garage:
New
loo
Remodel/Alteration
Detached
PROJECT DETAITS CONTINUED
Septic:
Type of Heat:I Gas Propane
X.
Other
Community
E lectric
Driveway
Permit:
pt Permit f;
lroTtcE
Authoritv. 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.
Permitcannot be issued'without proof ûf legalandadequate accÊssto-the property for
purposes of inspections by the Building Division,
Other Permits. Mult¡ple 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.
Void Permit. A Building Permit becomes null and void ìf the work authorized is not commenced within 180 days
ofthe date of issuance and if work is suspended or abandoned for a period of L80 days after commencement.
CERTIFIGANON
I hereby certify that I have read this Application and that the information contained above ¡s 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 certificðtion as to accuracy. Assuming
completeness of the submittals and approval of this Application, ä Bu¡ld¡ng Permit will be issued granting
permissíon to me, as Owner, to construct the structure(s) and facilities detailed on the submittals revlewed by
the Building Division. ln consideration of the issuance of the Bu¡lding 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
Euilding 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 Regulatíon(s) or any
other applicable law.
I herebygrant permission to the Building Division to enterthe property, described above, to inspect the work. I
further acknowledge that the íssuance 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 (21 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
state and local laws
my architect
I hereby acknowledge that I have read and understand the Not¡ce and Certification above, as well as, have
provided the required !s and accurate to the best of my knowledge.
Irxem
:
\¿\
Owner Print Sign Date
oFECrAtusEoNtY p¿. *4çoo aa. ltío3/"êat éarL
Special Condltlons:
Adjusted Valuation:Plan Check Fee:Perm¡t Fee:Manu. Home Fee:
ñ/À
Misc. Fees:
Total Fees:Fees Paid:
* as.oÈ
Balance Due:Io BP Nor
Þuxo'T3t?*
OWTS No;
r¡ /A
Setbacks¡OCC Group:
l.Ê.€.
Const. Type:
l. B. Ç.
Zoning:
P.tl .D.
nfon haet
Date
BUILDING / PTANNING D
Signed