HomeMy WebLinkAboutApplicationGørfield County
BUILDING PERMIT
APPLICATION
Community Development Department
108 8th Street, Su¡te 401
Glenwood Springs, CO 81601
(97Ols4s-82L2
www.ga -com
TYPE OF CONSTRUCTION
Demolit¡onCom mercial/M ulti-Family
Manufactured Home (Single or Multi-Level)
I ReroofResidential (SF, Duplex or Townhome)
Accessorv Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
Property Owner:
Mailing Address:
Email Address:
INVOTVED PARTIES
(ec
((Phone
s'. 1
(
U-IÒZContractor:
\þ co, t røBMailing Address:
Email Address:
Architect:
Mailing Address:
Email Address:
Phone: ( )
Pho ne: (Engineen
Mailing Address:
Email Address:
Mailing Address:
Email Address:
Phone:
Describe Work:I
Height:
Lot BlockSub.
Property Size (Sq. Ft. or Acres):
# of Floors:_
Manufactured Home lnstaller:
Assessor's Parcel Number:
Job Address:
Owner's Valuatiqn of Work:
Sq. Ft. of Building:
PROJECT DETAITS
,!New Remodel/Alteration AdditionClass of Work:
Garage:Attached Detached
PROJECT DETAITS CONTINUED
Comrnunity
Electrlc Other
Permit #:
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 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 detailed on the subm¡ttals 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
appllcable land use regulatlons (County Regulatlon(s)). All County development requlrlng a permlt, 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 compliance with County Regulation(s) or any other
applicable law.
lherebygrantpermissiontotheBuildingDivisiontoentertheproperty,describedabove,toinspectthework. 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) orfacility(ies) if such isinviolation of County Regulation(s) orany otherapplicable 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.
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
the required information which is correct and to the
/^'
best of my knowledge.
/0-Àz -2_l
Property Owner Print and Sign Date
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. lf the signature below is not that of the Ownerf a separate letter of authority, signed by
the Owner, must be provided with this Application.
Lesal 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. 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.
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.
NOTICE
OFFICIAT USE ONtY
Speclal Condltlons:
Adjusted Valuation:Plan Check Fee:Permit Fee:\cn c)c)Manu. Home Fee Misc. Fees:
Totâl Fêês:oc)\CIÕ 'i"ödo Balance Due BP No:6oÇ-Wfií OWTS No:
Setbacks:OCC Group:Const. Type:Zonþg:
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has-es
Dete
BUILDING / PLANNING DIVISION:
Signed Approval