HomeMy WebLinkAboutApplicationGarfuId CounQt
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(97Ole4s-82L2
www. garfi eld-countv.com
BU¡LDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercia u Demolition
Manufactured Home Sin e or Multi-Level)
Residential (SF, Duplex or Townhome)I Reroof
Dwell Unit - MAXTMUM SrZE OF 1,000 SQUARE FEET
INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
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Contractor:
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Mailing Address:
Email Address:
Email Address:
Phone: f )Arch¡tect:
Mailing
Phone:
Mailing Address:
Email Address:
Engineer:
Phone:
Email
Manufactured Home lnstaller:
Mailing Address:
PROJECT DETAITS
Owner's Valuatioil of Work: S Ñ /A Property Size (Sq. Ft. or Acres): t (,-Ioo d
Describe Work:
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Height:/2',
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Assessor's Parcel Number:
Sq. Ft. of Building:
.?2 t¿- U"f of Floors: t
Job Address:'l N'"-'
lot l? Block 5
AdditionClass of Work:New ,1]1emodetTalteration
DetachedGarage:Attached ñ A
r N/A Community
PROJECf DETAItS CONTINU ED
Septic:
Type of Heat:_lNaturalGas Propane Xl¡Electric Other
Driveway
Permit:¡r/rpt Permit #:
NOTICE
AuthoriW. 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 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 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
furtlrer acknowledge Lhat the issuance of the Building Pernrit dt¡es not prevent the Bu¡lding Official front: (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 well as, have
provided the required information which is correct and accurate to the best of my knowledge.
a/. ,/. --
Property Owner Print and Sign Date
OFFICIAT USE ONIY PAtÞ. * loo.oo C,C. oï/ozleszZfi*
Special Conditions:
Adjusted Valuation:PIan Check Fee:Permit Fee:
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Manu. Home Fee:ñ/r Misc. Fees:
hl/A
Total Fees:Fees Paid:
t to o,oo
Balance Due:+d BP No:
ßo o F-172f,
OWTS No:
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Setbacks:OCC Group:
l,ß. (.Const. Type:
t'R. q Zonins:
K.È(.!.1. P.
ostozlzozz
Date
BUILDING / PLANNING DIVISION I
Approval