HomeMy WebLinkAboutApplicationGurfield County
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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(e7ol94s-8272
www.parflel -countv.com
OF CONSTRUCTION
Commercial/Multi-Famil
Manufactured Home (Single or Multi-Level
Residential (SF, Duplex or Townhome)
Accesso Dwellin Unit
INVOTVED PARTIES
Property Owner:
Mailing Address:
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ll lDemolition
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tMUM SIZE OF 1,000 SQUARE FEET
Phone:
2 a
Email Address:
Email Address:
Contractor:one:
Mailing Address:
Email Address:
Architect:Phone: (_)
Maíling Address
Engineer:Phone:
Mailing Address:
Email Address:
Manufactured Home lnstaller:Phone: (--)
Mailing Address
Email Address;
PROJECT OrrÁirs
Describe Work:
Job Address: I
Assessor's Parcel Number:
Sub Lot __ Block _
Owner's Valuation of Work:,0O Property Size (Sq. Ft. or Acres):
Sq. Ft. of Building:Height:# of Floo
Class of Work;ñ;,Addition
BUILDING PERMIT
APPLICATION
Garage Attached
Remodel/Alteration
Detached
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PROJECT DETAITS CONTINUED
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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P Owner Print and Sign Date
CommunityfWTSSeptic:
Propane Electric OtherType of Heat:Natural Gas
Permit #:Driveway
Permit:
Exempt
NOTICE
Authoritv, This application for a Building Permit must be signed by the Owner of the property, described above,
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 andvoidiftheworkauthorizedisnotcommencedwithinl80days
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 subm¡tted 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 facility(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 Build¡ng
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 with me and my authorized agents, including without limitation my architect
designer, engineer and/ or builder
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Special Cond¡t¡ons:
Adjusted Valuation:Plan Check Fee:Permit Fee:* loo.Ò.
Manu. Home Fee:
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Misc. Fces:
Total Fees:Fees Paid:
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Balance Due:
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BP No:
RooF-7t183
OWTS No:
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Setbacks:OCC Group:Const. Type:l.R. C
Zoning:
P. u. D.
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Date
BUILDING / PLANNING DIVISION :