HomeMy WebLinkAboutApplicationGørfield County
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Community Development Department
1Og 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l945-8212
www.garfi el d-cou ntv.com
OF CONSTRUCTION
Com ulti-Fam
Manufactured Home gle or Multi-Level)
Residential (SF, Duplex or Townhome)
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
]l=lDemolition
I
Reroof
INVOLVED PARTIES
Property Owner:
Mailing Address
Email Address:
Contractor:
Mailing Address
Email Address:
Architect:
R\rc
?e;
Phone:
Mailing Address:
Email Address:
BUILDING PERMIT
APPLICATION
Engineer:Phone: ( )
Mailing Address:
Email Address:
Manufactured Home lnstaller:Phoner (_)
Maíling Address:
Email Address:
PROJECT DETAITS
Describe Work:
Job Address:
Assessor's Parcel Number: Z ,G tô ool
sub. Rcneh @ Roar¡aq ÊrlL Iot
Owner's Valuation of Work:
Sq. Ft. of Building:Height
Class of Work:New
Block
Property Size (Sq. Ft. or Acres):
# of Floors:
Addition
Garage:Attached
Remodel/Alteration
Detached
to
Septic:
PROJECT DETAILS CONTINUED
Tyfe of Heat:ruatuiit cas j
I
Propane
Community
Electric
Peimlt tt:
Other
Driveway
Permitr
NOTICE
mpt
Authoritv. ffrisappti-ationtoruBuildingPermitnrustbesigrreclbytheOwrrerof theproperty,describerl ahove,
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.
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 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 nre or on my behalf (submittals), based upun rny cer[ifical"ion 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 worl< 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 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
discrepancies. As the Owner, I acknowledge tlrat resporrs¡b¡l¡ty for conrpliarrce witlr federal, state and local laws
and County Regulations rest with me and my authorized agents, including without limitation my architect
d ,en gilee r 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.
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Owner Print and Sign Date
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Special Conditions:
Adjusted Valuation:Plan Check Fee:Permit Fee:{lôo . oê Manu. Home Fee:
N/A
Misc, Feesl
Total Fees Fees Paid:
Sloo, oo
Balance Duetø BP No:
ßooF -?{8 0
OWTS Nor
N/A
Setbacks OCC Group:Const. Type:
t. R.C.
Zoning:
?.u.Þ.
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Date
BUILDTNG / PTANNtNG DtVtStON
pproval