HomeMy WebLinkAboutApplicationGørfield County
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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l97Ûl94s-82L2
www.garf ield-cou ntv.com
OF CONSTRUCTION
Commercial/Multi-Fa mily
Manufactured Home or Mult
Residential (SF, Dup lex or Townhome)
Demolition
Reroof
Accessory Dwell ils llnLl MUM S¡ZE OF 1,000 SQUARE FEET
I
INVOLVED PARTIES
Property Owner
Mailing Address
Email Address:
Contractor:
Mailing Address
Email Address:
Phone:
V1^-'e:7
J
ArchÍtect:Phone: I I
Mailing Address
Email Address:
Engineer:Phone: (_)
Mailing Address:
Email Address
Manufactured Home lnstaller: Phone:
Mailing Address:
Email Address:
pno¡Ècr oeiarri
Describe Work:
Job Address:
Assessor's Parcel Number:oih
Sub.Lot
-_
Block _
Owner's Valuation of Work: $û0 Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building:Height:# of Floors:---
Class of Work:New Addition
BUILDING PERMIT
APPLICAT¡ON
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I
Garage:Attached
Remodel/Alteration
Detached
i PROJECT DETAILS CONTINUED
septrc:
I
I Type of Heat:
\
t.
Driveway
I Permit:
I
NOTICE
ruaturàl cai
Community
Ol"her
pt
nuiñòritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,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.
Legal Access. A Building Permit cannot be issuecl without proof of legal and adequate access to the property for
purposes of inspections by t,he Building Division.
other Permits. Multiple separate permits may be requíred: (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 Disclrarge Pernrit.
Void Per¡¡-it. A Building Permit becomes null and void if the work author¡zed is not commenced withiir 180 clays
of the date of issuance and if work is suspended or abandoned for a period of L80 days after commencement.
CERTIFICATION
I hereby certify that I have read this Àpplication and that thc 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 Perrnit will be issuecJ granting
permission to me, as Owner, to construct the structure(s) and facilities detailed on the sr-lbmittals reviewed by
the Building Division. ln consideration of the issuance of the Building Permit, I agree that I and my agents will
complywith provisions of anyfederal, state or local law regulating [he work and the Garfield County Building
Code, OWTS regulations and applicable land use regulations (County Regulation(s)), lacknowledge that the
Building Permit may be suspended or revoked, upon not¡ce 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 gratrt pertnission 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 thc correction of errors in the submittals, if any, discovered after issuance; or (2) stopping
construction 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 inspectíons of the work by the Building
Division do not constitute an acceptance of responsibility or lìability bV the Countv 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
qg_sis_ngl, gl€ineer and/ or builder
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
/-25"2a;21
Propane Electr ic
Permit #
de4¿4'<.-
Print and Sign Date
oFFtclALUsE oNry pAtD ttOO.oo c.c. 6+121 ZZ çl.t*
Special Conditions:
Adjusted Valuation:Plan Check Fee Permit Fee:
4lô0. ôo
Manu. Home Fee:
br/A
Misc,. Fees:
Total Fees Fees Paid:
$ loo.oo
Balance Due:+ø BP No:
R,ôoF-1{12
OWTS No:
Ñ/¡
Setbacks:OCC Group:Const. Type:
t. R.c
Zoning:
P.t.Þ
o,l/zt/zu¿
Date
BUItDTNG / PIANNtNG DtVIStON :
Signed