HomeMy WebLinkAboutApplicationGørfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(e7ol94s-82L2
www.ga rfi eld-cou ntv. com
BUILDING PERMIT
APPLICAT¡ON
TYPE OF CONSTRUCTION
Com mercial/Multi-Family Demolition
Manufactured Home (Single or Multi-Level)
Residential (5F, Duplex or Townhome)T Reroof
Accessorv Dwellins Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
I¡¡VOLVED PARTIES
Property Owner:Dan & Vivian Surin Phone:970 379-0975
Mailing Address: 1587 Odin Drive, Silt, CO 81652
Email Address:vndsurin@gmail.com
contractor: Owner Phone: { )
Mailing Address:
Email Address:
Arch¡tect: N/A Phone: ( )
Mailing Address:
Email Address
Engineer:N/A Phone:
Mailing Address:
Email Address:
Manufactured Home lnrt"ll"r, N/A Phone:
Mailing Address
Email Address:
PROJECT DETAITS
Describe \ r.r¡. Waterproofing roof,
lnstallation of necessary roof metal and new asphalt shingles
Job Address:1587 Odin Drive, Silt, CO 81652
Assessor's Parcel Number
5ub.Lot Block
owner's Valuation of wort'-5 8000'00 Property Síze (5q. Ft. or Acres):
Sq. Ft. of Building:Height:N/A # of Floo N/A27
6
Class of Work:New r'Remodel/Alteration Addition
Garage:Attached Detached
PROJECT DETAITS CONTINUED
Septic:
Type of Heat:ural Gas Propane Electric Other
Driveway
Permit:I lrermit
#:
NOTICE
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. 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 Permits. Mult¡ple 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.
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 L80 days after commencement.
CERTIFICAT!ON
lherebycertifythatlhavereadthisApplicationandthattheinformationcontainedaboveistrueandcorrect. 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 ccrtification 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)). All County development requiring a permit, except for
residential uses, are subject to Article 7 of the Land Use and Development Code. 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 compllance wlth County Regulation(s) or any other
applicable law.
I hereby grant permission to the Building Dìvision 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: (L) 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 designer, engineer and/ or builder.
Community
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the required which is and accurate to the best of my knowledge.
Vìvi4n Strr'rn I
t eo
Property Owner Print and Sign Date
OFFICIAI- USE ONLY
Special Conditions:
Adiusted Valuation Plan Check Fee:Fee:_ÃC)U'Manu. Home Fee:Misc. Fees:
Total Fees:\Õo,&'"Tëb *Bala Due:BP No:Krp-mq,OWTS No:
-Setbacks:OCC Group:Const. Type Zonir+g:
Y'..
6-4 -¿"4
Date
BUtLDTNG / PLANNTNG DtVtStO
Signed Approval
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