HomeMy WebLinkAboutApplicationGørfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-82t2
www.qa rfield-countv.com,
BUILDING PERMIT
APPLICATION
CommerclaUM q1!!-Fam ily Demolition
Manufactured Home {single or Multi-Level)
IResldential (SF,orTownhome)Reroof
Accessorv Dwelline Unit - MAXTMUM S|ZE OF 1,000 FEET
INVOLI'GDPARTIES
Address:5 Baker Hill Place, Parachute, CO 81365
EmailAddress:
Property owner: Cheryl Pickett Phone:1970 ì274-9338
Mailing
Address: 168 E. Carson Circle, Parachute, CO 81535
567-7955
Emait Addresr. johnsedillo2l0@yahoo.com
707Phone:Contrastor:Mile High City Roofing, LLC
Mailing
Email Address: _
Phone:( )Englneer:
Mailing Address:
Mailing Address:
Email Address:
Phone: { IManufactured Home lnstaller:
PRSJECrDETAIIS
JobAddress:5 Baker Hill Place, Parchute, CO 81365
lot
Describe Work:Replace existing roof.
Owne/s Valuation of Work:('
Block
Assessol's Parccl Number:
Sub.
* of Floors:_
Property Size (Sq. Ft. or Acres):
Sq. R. of Building: Height:
Clas¡ of Work:New Remode/Alteratíon
Attached
Architect:Phone:
Mailing Address: _
EmaílAddress:
Garage:Detached
Permit #:
NOttcE
Authoritv.This application for a Building permit must be signed by the Owner ofthe property, described above,
or an authorized agent. lf the signature below is not that of the Owner, a sepârâte letter of authority, signed by
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 Permitç. Multiple separate perm¡ts 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 St¿te Wastewater Dlscharge 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.
CERTIFICATION
Septic:
PROJECÍ DETAITS CONTINUEP
Community
Gas Propane Electríc OtherType of Heat:
Drlveway
Permit:
I hereby cert¡fy that I have read this Application and that the information contained above is true and correct. I
understand that the Buildlng 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 facilitÍes detailed on the submittals reviewed by
the Building Division. ln consideration of the issuance of the Building Permi! lagree that land my agents will
comply with provisions of any federal, state or local law regulatlng the work and the Garfield County Buildlng
Code, OWTS regulations and applicable land use regulations (County Regulation(s)). I acknowledge that the
Building Permit may be suspended or revoked, upon not¡ce 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) stopp¡ng
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 responsibilíty or liability by the County of errors, omissions or
discrepancies. As the Owner, I acknowledge that responsibility for compliance wíth federal, state and local laws
and County Regulations rest with me and my authorized agents, including without limitation my architect
and/ or builder.
I hereby acknowledge that I have read and understand the Notice and Certiflcatlon above, as well as, have
provided the required information whlch is correct and accurate to the best of my knowledgc.
Owner Print and Date
USE.ONLY
Speclal Condltions:
Adjustêd Valuation:Plan Check Fee:iäd:b"Manu. Home Fee:Misc. Fees¡
Fees Paid:lcn.oo Balance Due:
€-friç,eHK OWTS No:Itöö.""_
Setbacks:OCC Group:Const. Type:
BUTTDTNG / PLANNTNG
Signed Approval
,s-/?-2<
Date