HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(s7ol94s-8212
www.garfi eld-countv.com
BUILDING PERMIT
APPLICATION
TVPE OF CONSTRUCTION
Commercial/M ulti-Family Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)T'Reroof
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
Phone
€.mY<'-Phone:70 6t9')Qq o
CI
Contractor:
Mailing Address:
Email Address:
,J
Architect: Phone:
Mailing Address:
Email Addressl
)Phone:(Engineer:
Mailing Address:
Email Address:
Phone:Manufactured Home Installer:
Mailing Address:
Email Address:
PROJECT DETAITS
Assessor's Parcel Number: Zl'7 7 631 oo 5 ZZ
\0{r SI,Descri Work:
I
Sq.Ft.ofBuilding: 23tq Heightr # of Floors: /
Job Address:
Sub l-ot i Block
-
00Owner's Valuation of Work:Property Size (Sq. Ft. or Acres): 5 ' I t î
Remodel/Alteration AdditionClass of Work:
DetachedGarageAttached p g ÈA--ZF
PROJECT DETAII.S CONTINUED
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 Iand 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
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
r and/ or builder
that I have read and understand the Notice and Certification above, as well as, have
requ n and accurate to the best of my knowledge,
Pro Owner Print and Sign Dete
]WT5 CommunitySeptic:
Type of Heat:Electric
Driveway
Permit:
PropaneNatural Gas
Exempt
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 ¡s not that of the Owner, a separate letter of authority, signed by
the Owner, rnust be provided with this Application.
ng 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.
VoidPermit. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
Permit #:
Other
lesal Access. A Buildi
NOTICE
CERTIFICATION
oFFrcrALusEoNry qno stoo,* c.e. rc(o*fzø>z
Special Conditions:
Adjusted Valuation:Plan Check Fee:Permit Fee:4 too. *Manu. Home Fee:,!/¡n Misc. Fees:
Total Fcas:
4 too eÉ
Fees
4
Paid:
loo, "'ø
Balance Duel1r'BP No:
RooF--t8+2-'¡-l*
OWTS No:
ñ
Setbacks:OCC Group:
Cf?t
Const. Type:
l. r¿. c.t-Zoning:
f¿_ue..*
BUILDING / PTANNING DIVISION :
Signed App
o4to
Date