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Community Development Department
1OB 8th Street, Suite 401
Glenwood Springs, CO 81601
(e70) 94s-82L2
www.garfield-cou ntv.com
GarfuIú CounQt
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercial/M ulti-Fami ly Demolition
Manufactured Home si or Multi-Level
Residential (SF, Duplex or Townhome)I Reroof
Dwelli Unit U - MAXIMUM SIZE OF SQUARE FEET
INVOLVED PARTIES
Property Owner:
Mailing Address:
Phone:197o ¡ ÇOcl-2427
Email Address:
Phone: 14Zo ¡ 27r/ 8E/O
Mailing Address
Email Address:
Architect: Phone:(
Mailing Address:
Email Address:
Engineer Phone: I )
Mailing Address:
Email Addressl
Manufactured Home lnstaller:Phone:T
Mailing Address:
Email Address:
PROJECT DETAITS
Describe Work:fr--- n#Eooê
Job Address:t
Assessor's Parcel Number:
Sub. Lot
-
Block
-
owner,svaluationofwork: S lg 1fl PropertySize(Sq.Ft.orAcres)r
Sq. Ft. of Building:Heightr f of Floors:_
Class of Work:New Remodel/Alteration
Garage Attached Detached
PROJECT DETAILS CONT¡NUED
Community
NOTICE
I hereby acknowtedge that I have read and understand the Notice and Certification a bove, as well as, have
provided the required information which is correct and accurate to the best of my knowledge.
¡l¿r-ü-' L Q-z 2- 22
Property Owner Print and Sign Date
Sept¡c:f,WTS
OtherElectricNatural Gas PropaneType of Heat:
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 perm¡ts. Multiple separate permits may be required: (L) 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.
Permit #:pt
Authoritv. This application for a Building Permit must be
or an authorized agent. lf the signature below is notthat
signed by the Owner ofthe property, described above,
of the Owner, a separate letter of authority, signed by
Driveway
Permit:
nd that the information contained above is true and correct. I
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, construct¡on or use
of the structure(s) and facilÌty(ies), described above, are not in compliance w¡th 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
construct¡on 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
CERTIFICATION
I hereby certify that I have read this Application a
understand that the Building Division accepts the
r, engineer an or builder
oFFfcfAtusEoNLY P*rÞ S lOO.- C- C- o7/z¿lzoz:iL
Special Conditionsl
Adjusted Valuation:Plan Check Fee:Perm¡t Fee:l toa.ø Manrfäe Fee:Misc. Fees
Total Fees:Fees Paid:*t oô.ı'
Balance Due:-4Ø BP No:
-RöoF:IEIY
OWTS No:
rl /n
Setbacks OCC Group:Const. Jype:f .R.. q.'on'nþ,r).Þ .
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Date
BUILDING / PLANNING DIVIS
Signed