HomeMy WebLinkAboutApplicationGarfield County
,r r " n 9,9{4,T1'!4ity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 816d1
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BUILDING PFRMIT
APPLICATION
Com mercial/M u lti-Family Demolition
Manufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
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Phone:47a
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qraProperty Owner:
Mailing Address
Email Address:
Email Address:
Phone:
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Mailing Address:1 o
contractor: lrt aF A\ G t\gu P
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Email Address:
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Mailing Address
Email Address:
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Engineer;
Owner's Valuation of Work: $_ property Size (Sq. Ft. or Acres):
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Height:
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Lot
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Mailing Address: X
Describe Work: oO
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EmailAddress:
Job Address:
Block
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Sq. Ft. of Building:64,Do
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Manufactured Home lnstaller:w C^euu(-6l $;rJ{,,
Assessor's Parcel Number
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Phone:(3&-l )Ft55 {bqq
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Class of Work;New Remodel/Alteration onI lnaaiti
Garage:Attached Detached
Septic
Driveway
Permit:
Permit #:
Community
Type of Heat;Natural Gas Propane Electric other Ntfv,o
Exempt Lll sYlrI
ng 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. 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.
Authoritv. This application for a Buildi
ication 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 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 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 and County Regulations rest with
me and my authorized agents, including without limitation my architect designer, engineer and/ or builder.
I hereby certify that I have read this Appl
I hereby ack that I have read and understand the Notice and Certification above, as well as, have
provid rmation which is correct and accurate to the best of my knowledge.
L^ . 5-Lb
and Sign Date
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84sa rr r 31 .88 -'srq1.q tSpecial Conditions:
Adjusted Valuation:
i14q nL Plan Check Fee
_t-3-U
Permit Fee:q1.L5 Manu. Home Fee Misc. Fees:
Fees Paid:
-?t.ea
Balance Due:
(>1 .n BP No:
Buo-qAs+
OWTS No:lb4,6
Setbacks: \
Total Fees:
OCC Group:Const. Type:-Hl_
t- (LL4BUtLDtNG / PLANNTNG DIV|SION :
Approva Date
NOTE: lf any required information is missing, delays in issuing the permit are to be expected. lf
determined by the Building Official that additional information ii necessary to review the application
and/or plans for compliance, the application may be placed on hold until t-he required info#ation isprovided. Work may not proceed without the issuance of a permit.
The Building Division will collect a Plan Review fee at time of application submittal. The permit Fee, as
well as any Road lmpact fees will be collected when the permit is issued.
The permit application must be signed by the owner or by a person having written authority from the
owner to act as their representative.
I hereby acknowledge I have read, understand, and will abide with the requirements of thischecklist.
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P sign Rgw F6g'F\jct LNaNGLI
Date