HomeMy WebLinkAboutApplication9 (
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-8212
www.ga rfield-cou nty.çqm
Gørfield County
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Com mercial/Multi-Family Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
Accessorv Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,000 SQUARE FEET
INVOTVED PARTIES
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Phone:
Mailing Address:
Property owner: 3"7¿l&
Email Address:/*rtrna LZåe. AoL, c22t4,1
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Ø34 /56¿Bø T Phone:Contractor:
Mailing Address:
Email Address:
Arch¡tect: Phone:
Mailing Address:
Email Address:
Phone:Engineer:
Mailing Address:
Email Address:
IPhone:Manufactured Home lnstaller:
Mailing Address:
Email Address:
PROJECf DETAITS
Describe Work:
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Lot
Owner's Valuation of Work: S
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Job Address:
Block
Assessor's Parcel Number:
Sub.
Property Size (Sq. Ft. or Acres):
#ofF5q. Ft. of Building: Height:
New Remodel/Alteration Add¡tionClass of Work:
DetarhedGarage:ached
PROJECT DETAITS CONTINUED
CommunltySept¡c3 SWTS
Type of Heat:
INaturalGas
Propane Electric Other
Driveway
Permit:
pt Permit #:
NOT¡CE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
Legal Access. ABuildingPermitcannotbeissuedwithoutproofof legal andadequateaccesstothepropertyfor
purposcs of inspcctions 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. ABuildingPerrlitbeconresrrull aridvoidiftheworkauthorizedisrrotcorlrrrencedwithinlB0days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
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 deta¡led 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
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
County Regulations rest with me and my authorized agents, including without limitation my architect
e neer or builder
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Special Conditions:
Adjusted Valuat¡on:Plan Check Fee:Permit Fee:Manu. Home Fee:Misc. Fees:
OWTS No:Total Fees:Fees Paid Balance Due:BP No:
Setbacks:OCC Group:Const. Type:Zoning:
BUttDtNG / PLANNtNG D|VTSTON :
Signed Approval Date
CERTIFICATION
acknowledge that I have read and understand the Notice and Certification above, as well as, have
the information which is correct and accurate to the best of my knowledge.
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nd Sign Date