HomeMy WebLinkAboutApplicationGørfield CountyRE
, i., Co¡nmgnity Development Department
¡i ¡; t' 108 8th Street, suite 401
GA [{ F: lF t. i i { Flenwood Springs, CO 81601
0Of,.4l'tir\trtr l' jrì,,, ,' (g71lg S-gZLz
www.ga rfi eld-countv.com
BUILDING PERM¡T
APPLICATION
TYPEOF CONSTRUCTION
u Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)T Reroof
Accesso Dwell Unit U - MAXIMUM SIZE OF SqUARE FEET
INVOTVED
Property Owner:
Mailing Address:
Email Address:
phone: (17q2@'Zotôr-f
At :
l. I
'è""7le8.
tþ
Phone:grr!tfttvtContractor:
Mailing Address
Email Address:
L
n(*nalu^eâ.ytf¿)
Phone:Architect:
Mailing Address
EmailAdd
Phone: I IEngineer:
EmailAdd
Mailing
PhoneManufactured Home
Mailing Address:
EmailAdd
PROJECT DETAITS
84et farø-eL<,F-
os(Describe
Ð
þ s h// /o I iae-- t *^1.'r^
P-t,
þ+ zu
Mw4 P lrault
Job Address
Assessor's Parcel Number:
Sq. Ft. of Building:Height:f of Floors:_
Owner's Valuation of Work:Y.fo Property Size (Sq. Ft. or Acres)
Sub.Lot
f
Block
Class of Work:New Remodel/Alteration I lnooition
DetachedGarage:Attached
PROJECf DETAITS CONTINUED
Septic:OWTS Community
Type of Heat:Natural Gas Propane Electric Other
Drivcway
Permit:
Pcrmit ff:
NOTICE
AuthoriW. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. lfthe signature below is not that ofthe Owner, a separate letter of authority, signed by
the Owner, must be provided with this Application.
Legal Access. A Building Perrnit 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 requircd: (1) Statc Elcctrical Pcrmit, (2) County OWTS Permit,
(3) another permit required for use on the property ident¡fied 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 180 days after commencement.
CERTIFICATION
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 certif¡cation 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 CorJe. I acknowledge th¿t 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) stopplng constructlon or use of the
structure{s) or facil¡ty(¡es) 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 responsibil¡ty for compliance with federal, state ancl local laws and County Regulations rest with
me and my authorized agents, including without limitation my architect designer, engineer and/ or builder.
I hereby acknowledge that I have read and understand the Not¡ce and Certification above, as well as, have
provided information which is correct and accurate to the best of my knowledge
8/. r /,2 .s
Property Owner Print and Sign Date
OFFICIAL USE ONIY I
Special Conditions:
Adjusted Valuation:i¿lp¡tø Permit Feez n r\\oo.""Manu. Home Fee:Misc. Fees:
\"ffi'',cr c/'i'ö''å,o'Balance BP No:mPBAt.e OWTS No:
Setbacks:OCC Group:Const. Type:'"u1'-
(,91-93
Date
BUITDING / PLANNING D
Signed Approval