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Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-8212
www.garfield-cou ntv.com
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Demolition
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oF coNsTEUCTr.gN
Commercial/Multi-Family
Manufactured H
Residential (SF, Duplex or Townhome)
r)
Dwellin DUnit - MAXIMUM SIZE oF 1,000 SQUARE FEET-
BUILDING PERMIT
APPLICATION
I INVOTVED PARTIES
Property Owner:
Mailing Address:
Emaíl Address:
Contractorl
Mailing Address
Email Address:
Architect
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e:
Phone:
Maíling Address:
Email Address:
Engíneen Phone:
Mailing Address:
Email Address:
Manufactured Home lnstaller;Phone:
MailÍng Address
Email Address:
PROJECT DETAILS
Describe Work:
Job Addressl
Assessor's Parcel Number
Sub
Owner's Valuation of Work:
5q. Ft. of Building:
Class of Work:New
Lot
Height:
w
t )
Block __
Property Síze (Sq. Ft. or Acres):
# of Floors:__
Addit¡on
I
Garage Attached
Remodel/Alteration
Detached
PROJECT DÊTA¡LS CONTINUED
Septic:Community
Electric
Permit fl:
Other
i
I Type of Heat:
I
Natural Gas Propane
Driveway
Pêrmlt:
NOTICE
Authoríty. ThisapplicationforaBtrildingPerrnilrnustbesigneclbytheOwnprofthepro¡-rerty,describedal¡ove,
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 Perm¡t, (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 me or on my behalf (submittals), based upon my certificat¡on 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, lagree 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 thisApplication, includingsubmittals, and inspectíons of the work bythe Building
Division do not constitute an acceptance of responsibility or liability by the County of errors, omissions or
discreparrcies. As tlre Owtrer, I acknowledge that responsibility for cornpliance witlr federal, state and k¡cal laws
and County Regulations rest with me and my authorized agents, including without limitation my architect
designer, enginee¡ gndl 9 r builder
I hereby acknowledge that I have read and understand the Notice and Certif¡cation above, as well as, have
provided the required information which is correct and accurate to the best of my knowledge.
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Property Owner Print and Sign Date
OFFICIAL USE ONtY PA|D tloo.oô c.g 6u27/2-or¿ é0n_
Special Conditions:
Adjusted Valuation:Plan Check Fee:Permit Fee:
$ loô,oo
Manu. l-lome Feertlt Misc. Fees:
Total Feesl Fees Paid:
$rðo.ro
Balance Due1ø BP No:
Qoor-718*
OWTS No:¡t/t
Setbacks:OCC Group Const. Type:
t.ß,.c.
Zoning:
P. u.Þ.
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Date
BUILDING / PLANNING DIVISION :