HomeMy WebLinkAboutApplicationGarfield County
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OFFI C B
il_loemolit¡on
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l s4s-82t2
www.garf¡eld-countv.com
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OF CONSTRUCTION
Commercial/Mult¡-Fam
Manufactured Home (Single or Multi-Level
BUILDING PERMIT
APPLICATION
Residential (SF, Duplex or Townhome)
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOLVED PARTIES
Property Ownen
Mailing Address
Email Address:
Contractor:
Mailing Address
Email Addressl
Architect:
Phone:
2 e-L
f
/ô
Phone: (_)
Mailíng Address:
Email Address:
Engineer:Phone: ( )
Mailing Address:
Email Address:
Manufactured Home lnstaller:Phone: (_)
Mailing Address:
Email Address
PryOJE€T DETATLS
Describe Work:
Job Address:
Assessor's Parcel Number 2
Sub.
Owner's Valuation of Work:
Sq. Ft. of Building
Class of Work:New
Lot
Height:
Block
Property Size {Sq. Ft. or Acres):
# of Floors:
Addition
Garage Attached
RemodeUAlteration
Detached
PROJECT DETAITS CONTINUED
Type of l{eat:
Septic
Driveway
Proparre
Community
Electric
Permit S:
OtherNatural Gas
Exempt
Permit:
NOTICE
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided witlr tlris Applicatiorr.
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
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Void Permít. 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 1-80 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 certification as to accuracy. Assuming
completeness of the submittals and approval of this Application, a Building Permit will be issued grant¡ng
permission to me, as Owner, to constructthe 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 atry federal, state or local law regula[ing Lhe wurk ¿rrd tlre G¿rl-ieltl CuunLy BuiltJirrg
Code, OWTS regulations and applicable land use regulations (County Regulation(s)). lacknowledgethatthe
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 Perm¡t does not prevent the Building Officialfrom: (1")
rcquiring thc corrcction of crrors in thc 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 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, engi neer 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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Proptfrlwner Print and Sign Date
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Special Conditions:
Adjusted Valuation:Plan Check Fee Permit Fee:.t ¡¿¡1.oo
Manu. Home Fee:
N/A
Misc. Fees:
Total Fees:Fees Paid:
f/ôo. oo
Balance Due+øl BP No:
RooF-1{8f
OWTS No:xh
Setbacks;OCC Group:Const. Type:
l. R. C.
Zoning:
P,l),Þ,
ov/¿t/tozz
Date
BU¡LDTNG / PLANNTNG DtVtStON :