HomeMy WebLinkAboutApplicationGorfuld Coanty
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
l970l94s-82L2
www.garfi eld-countv.com
WPE OF CONSTRUCTION
BUILDING PERMIT
APPLICATION
DemolitionCommerciaUMulti-Family
Manufactured Home (Single or Multi-Level)
I ReroofResidential (SF, Duplex or Townhome)
Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
Property Owner:
Mailing Address:
L Phone:L
(o
Email Address:
Contractor:I Phone: (lLot t4\ 6 -?q Z S
Mailing Address:
Email Address:
Architectr Phone: ( )
Mailing Address:
Email Address:
Engineer:Phone: ( )
Mailing Address:
Email Address:
Manufactured Home lnstaller:Phone: (_)
Mailing Address:
Email Addressr
PROJECT DETAILS
Describe Work:o IJ
Job Address:
Assessor's Parcel Number:
Sub.Lot Block
owner's Valuation of Work: 5 | (), OO C2 Property Size (Sq' Ft. or Acres):
Sq. Ft. of Building:Height:f of Floors:_
Co"
Class of Work:New Remodel/Alteration
Garage:Detached
Driveway
PROJECT DETAITS CONTINUED
Septic:Community
Type of Heat:Natural Gas Propane Electric Other
pt Permit #:
Permit:
NOTICE
AuthoriW. 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 Owner, a separate letter of authority, signed by
the Owner, must be provided with this Application.
Lepal 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.
CERTIFICATION
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 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 acknowledge that I have read and understand the Notice a
provided the rgyired information which is correct and accurate to the
C ,-4' /1ou^-_ 1/uz_
nd Certification above, as well as, have
best of my knowledge.
i .r1 n' ) ) ^.".'7a-)/--L)L*/\)!
Property Owner Print and Date
CAgOFFICIAL USE ONtY \
Special Conditions:
Adjusted Valuation:Plan Check Fee:
bro
Permit Fee\oo Manu. Home Fee:Misc. Fees
Total Fees:\on oo crc)Fees Paid:
\c)o.
Balance Due:o-BP No:mF,gslS OWTS No:
Setbacks:OCC Group:Const. Type:'"$KD.
lerc ,4 R-p-'/BUILDING / PLANNING DIVISION :
Signed Approval Date