HomeMy WebLinkAboutApplicationGaffield County
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Demolition
Reroof
Community Development Department
1Og 8th Street, Suite 401
Glenwood Springs, CO 81601
(e7ole4s-82t2
www.garfield-countv.com
TYPE OF CONSTRUCTION
Commercial/Multi-Family
Manufactured Home (Single or Multi-Level
Residential (SF, Duplex or Townhome
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INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
Contractor:
Mailing Address
Email Address:
Architect:
Phone: êfi> | 17.O-q1ru
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Phone: (_)
Mailing Address
Email Address:
Engíneer:Phone:
Mailing Address:
Email Address
Manufactured Home lnstaller:Phone:
Mailing Address:
Email Address
PROJECT DETAI[S
Descri be Work:
Job Address:
Assessor's Parcel Number
5ub.¿h
Owner's Valuation of Work: S
Sq. Ft, of Building:
Class of Work:New
o,rt Lot Block
Property Size (Sq. Ft. or Acres):
# of Floors:
ft)
c
Height:
dition
BUILDING PERMIT
APPLICATION
Garage:Attached
Fo¡þ
Remodel/Alteration
Detached
ÌPROJECT DETAI tS CONTINUED
Septic:
it:Perm
I Type of Heat
1i Driveway
Natural Gas Propane Other
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
thc Owncr, must bc providcd 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: (L) 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
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Void Permit. A Building Permit becomes null and void if the worl< authorized is not commenced within 18C days
of the date of issuance and if work is suspended or abandoned for a period of 1"80 days after commencement.
CERTIFICATION
lherebycertifythatlhavereadthisApplicationandthattheinformationcontainedaboveistrueandcorrect. 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 submittalsand approval of thisApplication, a Building Permitwill 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 gratrt pertnission to tlre BuilcJirrg 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 thc submittols, if any, discovcrcd oftcr issuancc; 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 inspections of the work by the Building
Division do not constitute an acceptance of responsibìlity 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
designer, engin r 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.
Community
Electric
Permit #
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Property Owner Print and Sign Date
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Special Conditionsi
Adjusted Valuation:Plan Check Fee:Permit Fee:
S roô.oo
Manu. Home Fee:x/¡Misc. Fees:
Total Fees Fees Paid:
4loo.oa
Balance Due:+ø BP No:
Rootr-7{ ?4
OWTS No:
N/A
Setbacks:OCC Groupr Const. Type;
r.a.c
Zoning:
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Date
BUILDTNG / PLANNTNG D|VISION :
,/ signed ffival