HomeMy WebLinkAboutApplicationGadield Coun
RECE Communlty Development Department
\i ir ,r i ')iì,, ¡ 108 8ü Street, Sulte 401
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€lenwood Springs, CO 81601
3.îiSlFiB'i'?y'iffi
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TYPE OF
Agçe$ory owe!
!
j !g_ y-n !!-(åo,u-)- MÐ(IMU OF FETT
INVOLVED PARTIES
Property Owner:Phone:,+t;at 6s6-4o+7
i maillng nddress:
Email Address:
1 Contractor:ácltttr,', d.\ o-Vl¡.Jå---Phone:
i Malllng Address:
Ernall Addres¡:
MaillngAddrcss:
Emall Address:-*"-'\nr;
snglneer: Phone:rfttll 1ÎP SCea
Malllng
r Emall Address:
i Manufactured Home lnstaller:Phone; I I
: Malllng Address:
Archrtect: -Po.--- .ar M'¿BTa14*ët4 i
Com m ercl a l/M u I lif_a¡l ly Deñol¡t¡on
Reroof
u!!l:lqyell.HomeManufactured or M(Slngle,
Resldentlal or
Descrlbs Work:
Job Addras¡;
Assesso¡'¡ Parcct t{umben' LÉn\ Zo 4Ð | <b
Sub.Lot Block
Owne/s Valuatlon of Worlc @
tÈ
Property Slre (5q. Ft. or Acrcr¡, ?9'f¡\ aAC
Helght:\Z f*f f of Floors:-l-Sq. Ft. of Bulldlng:
Class ol Work:
GaregE:Attached
s
Remodel/Alteratlon
DetechÞd
CommunltyScptfc:
f
I
I
L Electrlc OtherPropanel,¡aturatgât.l|òF-
Exempt_
PROJECÍ DËTAIIS COT{TINU ED
l,lrpa of Heat
, Drfuwry \gfTLtC,n Permlt f:
f{oncE
Authorltv. Thls appllcatlon for a Bulldlng Pêrmlt must be slgned by the Owner of the property, descrlbed above,
or an authorized agent. lf the slSnaturc below ls not that of the Owner, a separate letter of authorlty, slgned by
the owner, must be provlded with thls Appllcatlon.
l¿¡al Acceps. A Buildlng Permlt cannot be lssued wlthout proof of legal and adequate access to the property for
purposes of lnspectlons by the Bulldlng Dlvlslon.
othcr pcrmlts. Multlpte sepðrate perm¡ts may be regulred: (1, state Electrlcal Permlt, (2) county owTS Permlt,
(3) another permlt regulred for use on the property ldentlfled above, e.g. Stâte or County Hlghway/ Road Acces
i or a Stâte WestewâteÍ Discharge Perm¡t'
i Vold Permlt. A Bulldlng Permlt becomes null and vold lf thê work euthorhed ls not commenced wlthln 180 days
1 of the date of lssuance and lf work ls suspended or abandoned for a perlod of 180 days after commencement.
I hereby certlfy that I have read thls Appllcatlon and that the contalned above ls true and correct. I
undeßtând that the Eulldlng Dlvlslon accepts theAppllcatlon, along wlth the plans and speclflcatlons and other
data submitted by me or on my behalf (submlttals), based upon my certif¡ç¡tlon as to accurecy. Assumlng
ompleteness of the subm¡ttals and approval of thls Appllcatlon, a Bulldlng Permlt w¡ll be lssued grantlng
permlslon to me, as Owner, to construc{ the structure(s} and facllltles detalled on the submlttals reÚewed by
the Buildlng Dlvlslon. ln cons¡deretlon of the lssuance of the Eullding Permlt, I agree thet I and my agents wlll
comply wlth provlslons of any federal, state or local law regulatlng the work and the Garfleld County Euildlng
Code, OWTS regulatlons and appllcable tand use regulations (County Regulatlon(s)). I acknowledge that the
Eulldlng Permlt may be suspended or revoked, upon notlce from the County, lf the locatlon, construction or use
of the structure(sl and facllity(les), described above, are not ln compllance wlth County Regulatlon{s} or any
other appllcable law.
I hereby grant permlssion to the Building Division to enter the property, descrlbed above, to lnspect the work. I
further acknowledge that the lssuance of the Bullding Permlt does not prevent the Bulldlng Officlal ftom: (11
requlrlng the correctlon of errors ln the submlttals, lf any, dlscovered after lssuance; or (2) stopplng
constructlon or use of the structure(s) or faclllty(les) if such ls ln vlolatlon of County Regulatlon(s) or any other
appllcable law, Revlew of thls Appllcatlon, lncludlng submlttals, and lnspectlons of the work by the Bulldlng
Dlvlslon do not constltute an acceptance of responslbilfty or liablllty by the County of errors, omlsslons or
dlscrepancles, As the Owner, I acknowledge that responslblllty for compllance wlth federal, state and local laws
and County Regulatlons rest wlth me and my authorlzed egents, lncludlng wlthout llm¡tat¡on rny archltect
or builder
that I have read and under¡tand the and Cêrtlflcetlon ¡bove, ¡s wcll as, h¡vl
¡nfonnâtlon whlch l¡ correct end accürete to the best of my knowledç.
hcreby
provlded
Owncr and Slgn
rìr¡lz¡ L>
oate' I
oFFrcr,ArUsEoilrt ?Ál¡. c.c. +?z.ll o7/tz/zt?¿- ¿lh-
æe â*a lb/naAl-ESpcdelf¡ndltlon$
Manu. Home Fcc:ñ/r ^wuWïii'zEAdlusted Valuatlon:6u rrrtø.æ g?2:Ür*
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DateApproval