HomeMy WebLinkAboutApplication4
Development DePa rtmqnt
108 8d' Street, Suite ¿t{11
Glenwood Springs, CO 81601
: (970194s.82L2
www:sârfi eld-cguntv.com
Garfield County
Home
Residentlal
Unlt stzEoF FEEf
Property Owner:
Malllng Address:
Emall Address:wi
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C,oa4.:
w1
fContrâctor:
Mailing Address:
Emall Address:
Maillng Address: , '
Mr :lcqPhone:Architect:
Emall Address:
86îdt'i,
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Englneer:
MalllngAddress:
Emall Address:
Manufactured Home lnstaller:
Emall Addreas:
Phone:
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fÞscrlbeWork:
3,Ç5 /Wq*
a,
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a(6117
,ob Address:
Helght:t1
Nup.(J}/ìf1-Êt
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Ft. or Acresl:Slre (5q.
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? tØlo't36.loot',
Co.¡n\
Assessol's Parcel Number:
Sub.mt l- Bbck-
Owne/s Valuatlon
Sq. Ft. of Bulldlng:
of Work¡
6L4
-?-L-
RemodeUAlteratlonClass of Work:
DetachedGarage:
,1,
6)
Septic:
Type of lleat:Gas Propane
Drlueuray
Permit:
or 3n author¡zed agent. lf the sþature below ls not that of the O*rner, a
the Owner, must be provided with thisApplication.
lesal Aæess. A Building Permit cannot be issued without proof of legat
purposes of ¡nspect¡ons by the Building Division.
other Permits. Mult¡ple separate permits may be required: lll state Electrlcal
(3) another permit required for use on the property identif¡ed above, e.g. stete or
or a State Wasteurater Discharge permit.
void krmiL A Euilding permit becomes null and void if the work authorized is not
of the date of issuance and if work is suspended or abandoned for a period of lsO days
Authoritv. This application for a Building Perm¡t must bes¡gned brythe
this Application and that the lnformation contained abor¡e is true and correcù I
understand that the Building Division accepts the Application, along with the plans and speciffcatlons and othei
data submitted by me or on my behalf (submittals|, based upon my certification as to acqrracy. Asuming
completeness of the submittals and approrral 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 Bu¡ld¡ng Division. ln consideration of the issuance of the Euilding Permlt, I agree that I and my agents w¡ll
comply with provisions of any federal, state or local law regulating the work and the Garfield County Euilding
Code, OWTS regulations and applicable land use regulations (County Regulation{s}}. lacknowledge that the
Building Permit may besuspended or revoked, upon notice from the County, if the location, construct¡on or use
of the structure{sl and facilþ(iesf, described aboræ, ãre not in compliance w¡th County Regulation(s) or any
other applicable law"
I hereby grant perm¡ssion to the Bu¡ld¡ng Division to enter the property, described above, to ¡nspect the work. I
further acknowledge that the issuance of the Building Perm¡t does not prevent the Bu¡ld¡ng Official from: (1)
reguiring the correction of errors io the submittals, ifany, discovered after issuance; or {21 stopping
construcl¡on or use of the structuretsl or facility(iesf if such is in violation of County Regulat¡on(s) or any other
applicable law. Review of this Application, including submittal5 and inspections of the work by the Building
Division do not const¡tute 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 Rqulations rest w¡th me and my authorized agents, including without l¡mitat¡on my architect
I hereby certify that I have read
or builde¡
I hereby acknowledge that I harre re¡d and understand the l{otloe ¡nd C.crtlffcatbn above, as well as, have
provided the requlred Information whkh is correct and accur¡te to the best of my knowledge.
lVov. 4 âola
Property Owner Print and Si6n D¡te
oFnqAtusE9iltY
ç- r\ñ^ìc\
\Dq_\SÒ
t
Speclal Gordltiom:
\resP - ,s'ì\
Ílb¡ul Home Fee¡k\ I f'd
Permlt he:
TA
Mlsc.
t\lAdjusted vàluatlon:Plan Ched¡ Fee:
8P ìlo:
ß,f2ç -?qô(a
rBalance Due:) só.*OWTS Norr\l1lTotal Fees:Fees Paid:
Èiò,*lS{S
'"Tl'Setbacks:
BU¡tDtr{G / Pt¡NNtilG DwtStOt{ :
Slgned Approval Date
a Framing plans for each floor tevel and roof. All beams,
specifi ed. Pre-manufaeturcd structures require the engineers
Framing /connec{ion details,braced wall lines'shear wall
The Building Division will collect a Plan Review fee at time of aPPlication
wellas any Road lmPact feæ will be collected when the permit is issued.
ïhe permÍt application must be signed by the owner or by percon having writtel
to act as their rePresentative'
I hereby acknowledge I have read, unde¡stand and wlll abide by the requlrements of thls
checltlist
q il
Print and Sign Date
à ÇlAb has nirtiltl bornt '(m/l¿'kC 02
yr(hf'Wr#W{y tþØ 'l' fr'ot
t,/"nd4qrt- Wptirn h uz a,t "ta þ [eer.
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