HomeMy WebLinkAboutApplicationGarfteld County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-8212
www.garfi eld-countv.com
INVOLVED PARTIES
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
ulti-Fami Demolition
Manufactured Home or Home (Single or Multi-Level
Residential (SF, Duplex or Townhome)I Reroof
Accessory Dwelli Unit - MAXTMUM S|ZE OF 1,200 FEET
Property Owner:
Mailing Address:
Email Addressl
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Phone:nTotSlq.zs/z-
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Email Address:
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AIa^. b-'zz3 1,(lContractor:
Mailing Address:
Phone:
Email Address:
)Phone:(
Phone: ( )
Email Address:
Architect:
Mailin
Engineer:
Mailing
Email Address:
Phone:Manufactured Home lnstaller:
Mailing Address:
PROJECT DETAITS
Describe Work:
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Heightr
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Lot
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tl so
BlockSub.
Property Size (Sq. Ft. or Acres)
f of Floors:_
Owner's Valuation of Work: S
Sq. Ft. of Building:
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34
Assessor's Parcel Number:
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Job Address: Z7 8f C K
Remodel/Alteration AdditionClass of Work:New
DetachedAttachedGarage:
PROJECT DETAILS CONTINUED
CERTIFICATION
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
required information which is correct and accurate to the best of my knowledge.
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Septic:
Type of Heat:Propane Electric
Community
Other
Authoritv. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
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.
VoidPermit. ABuildingPermitbeconresnull andvoidiftheworkauthorizedisnotcommencedwithinl80days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
Permit #:
NOTICE
Natural Gas
ExemptDriveway
Permit:
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 constnlct the strrrctrrre(s) and farilities detailcd nn the srrhmittals reviewpd hy the Brrilding Divisinn. 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
resldentlal ljses, are subject to Article 7 of the Land Use and [Jevelopment 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) orany other
applicable law.
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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 ofthe
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
acceptanceof responsibilityorliabilitybytheCountyoferrors,omissions,ordiscrepancies. AstheOwner, 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.
Property Owner Print and Sign Date
OFFICIAL USE ONtY \
Special Conditions:
Adjusted Valuation:Plan Check Fee:Permit Fee:
Ic>C)rr6)Manu, Home Fee:Misc. Fees:
'\tJE'.o'Fees Paid:9 C,tt
Balan;:qDue:tr ffrmvA*ffi OWTS No:
Setbacks:OCC Group:r-n 0
Const. Tvoe:a-in Zo4!ng:
G.
^|t/,t lV-,1:U2/BUTLDTNG / PLANNTNG Drvrst
Signed Approval Date