HomeMy WebLinkAboutApplicationRËCE
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F,îii^iFin,tg#ffi'rH;Li.Htnepartment
Glenwood Springs, CO 81601
l970l94s-82r2w@
Gørfield Coanty
BUILDING PERMIT
APPLICATION
WPE OF CONSTRUCTION
Com mercial/M u lti-Fami ly Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)I Reroof
Dwelli Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOTVED PARTIES
Fr. è Phone: Ú'Ð 3 4cl ^9,/d9r" ¿^
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Property Owner:
Mailing Address:
Email Address:
2L
Phone:
($P t 2-1 FepContractor:
Mailing Address:
Email Address:
Arch¡tect: Phone:
Email Address:
Mailing Address
Engineer: Phone: (-)-
Mailing Address
Email Address:
Mailing Address:
Email Address:
Phone:t)Manufactured Home lnstaller:
PROJECT DETAITS
Describe Work:ê
Ò,Ç,
0 JS.u
oof Work:
Sub.
Property Size (Sq. Ft. or Acres):
# of Floors:-
Assessor's Parcel Number:
Job Address:
Height:
Lot Block
Owner's Valuation
Sq. Ft. of Buildingr
AdditionRemodel/AlterationClass of Work:New
DetachedAttachedGarage:
PROJECT DETAITS CONTINUED
Septic:f,WTS Community
Type of Heat:Natural Gas Propane Electric Other
Driveway
Permit:
mpt Permit #:
NOTICE
Author¡tv. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. lf the signature below is not that of the Owner, a separate letter of authority, signed by
the Owner, must be provided with th¡s Application.
Legal Access. ABuildingPermitcannotbeissuedwithoutproofof legal andadequateaccesstothepropertyfor
purposes of inspections by the Building Division.
Other permits. Multiple separate perm¡ts 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 andvoidiftheworkauthorizedisnotcommencedwithinlS0days
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 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 compliancewith County Regulation(s) orany
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 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
I hereby acknowledge that I have read and understand the Notice and Certification above, as we ll as, have
the required information which is correct and accurate to the best of my knowledge.
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Property Owner Print and Sign Date
orÈrcnrusEoNtY PAtD. *¡69.oo C.C.a'U%/æzzçfr*-
Special Conditions:
Adjusted Valuation Plan Check Fee:Permit Fee:
*too. oo
Manu. Home Fee:
ñ/A
Misc. Fees:
Total Fees:
{ t oo.¡o
Fees Paid:
$t00.æ
Balance Due:+y'BP No:
RôoF-11ô9
OWTS No:
ñ/r
Setbacks:OCC Group:t.R.C.
Const. Type:
l.?' C.
Zoning:
BURA L
otfzc/zozz
Date
BUILDING / PTANNING
proval