HomeMy WebLinkAboutApplicationGurfietd Cowrutlt
- 9gFn11grlily Development Department
iil;(,r* r " 1b'g gth Street, Suite 401
rltlt: i flc Springs, CO 811601
945-82L2
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TVPE OS COI{STRUCIIION
Cornmerrcia[1M
Manufactu,qed Horne orT-i.1y !-lorne (Sjngle or Multi-Level)
Residential . (sr. Dyp|q1 o,1row$gm-e)
Accessory Dwelling Unit (ADU)- MAXIMUM SlzE OF SQUARE FEET
INVOLVED PAR:IiIfis
Property owner: Jq.c( Ql;f*
Dernotition
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I Reroof Y-
Mailing Address,:6lc^
Phone:17r)bsl-g(lt
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BUILDING PERMIT
APPLICATION
Email Address:l-t L7 ,ra,
Contractor:P.'*.+ G;s\Phone: tc(le_.)'(btt - L6tq
Mailing Add'ress:
Email A.ddr"ess:
Architect: P /g
A)I srD
Phone:
Mailing Address
Ernail Address:
Engineen Nl4 Phone:
Mailing Address:
Email Addr:ess:
Manufactured l'{ome l'nstaller: l"l 0 Fhone -t
Mailing Add'ress:
ErnailAddress:
PROJECT DETAIIIS
Describe Work:
Job,Address: l-l t+ir1( C+
Assessor's Parcel,Nrlrnber: 231 5of I obool
sub. 9ar. lt4!vl Vi cr^J
Owner's,Valuation of Work: $
Sq. Ft. of Building:TJtg
Lot 6 Btock
Property Size (Sq. Ft. or Acres):33,q37
l.leight:g s'6 r'f of Floors:--
Addition
Detached
Class of:Work:
Garage:
New
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Attached
l8,ooD
Rernode l/Alteration
PROJECT DETAI|IS, CONIIIN,IJ ED
Septic:
ivpe ot neat,
Drivew,ay
, Ferrnlt:
CIWTs Cornrnu'niW
dlectricNatur:al'Gas P'ropane Other
Exernpt Perrnit #:
r{oTrcE
Authoritv. This application for a Building Permit must be signed by the Owner of the piop"rty, described above,
or a:n au,tho.rized a,gent" lf the signa,ture below i5 not that of the OwneL a, separate letter of authority, signed brT
the Owner, must be provided with this Application.
l.esal Access., A Buildring Permit cannot be issued with'out proof of legal and adequrate access to the pr.operty for
puriposes of inspections by the Buildi'ng Division"
Other P€rrnits. Multiple separate perm,its marT be requiredr: {1} State Efectr:ical Fermlt, (2) County O\I/TS Perrnit,
{3} another perrnit required for use on the proper:ty identified above, e"g. S'tate or County Highwayl Road Access
or a Staie Wastewater Discharge Permit.
A Building Ferrnit becornes null and void if the work authorized is not comnnenced within 180 days
issua.nce and if worrk is suspended or abar,rdoned for a period of n80 days after comr'nencement.
CER.:IIIFICATION
I hereby'cer:tify that I have rea,d this Application and that the inforrnation eonta,lned above is true and co,r:rect. I
understand that the Building Division accepts the Application, along with the plans and specifications and other data
subrnittedr by r,ne or: on my beh,al,f (submittals), based upon mr7 cerrtification as to accuracy. Assunting completeness
of the submittals and appr,oval of this Application, a Building Per:rnit will be issued granting perrnission to me, as
Owner. to construct the structure{s) and facilities detailedl on the submittals r:eviewed b,y the Building Division. ln
consideratio,n of the issuance of the Building Perrni! I agree that I and my agents wilt compty with provisions of any
fed'eral.. stafe or loca,l law regulating the worik and the Garfield, County Bttitding Code, OWTS regulations and
appticable land use regulations (County Regulation(s)}. All Couilty development requiring a perrnit. except for
resid.ential uses,. are subject to Article 7 of the l-and Use and Development Code. t acknowledge that the Buitding
Per:mit rnarT he suspended or revoked. upon notice frorn th,e County, if the location, construction or use of the
structure(s) and facility(ies), described above. are not in connpliance with County Regutation(s| or any other
appticable [aw.
lherebygran,tper.missiontotheBuildingDivisiontoe,n,tertheproperty,describedabove.toinspectthework. I
fulrtheri acknowledge that the issuance of the Building permrit does not prevent tlre Building Offjrcial fr,ont: (L] requiring
the correction of errrors in the subrnittafs, if anr7, discovered a,fter issuance; or (2), stopping construction or use of the
structur:e{s) or fae ili,trT(ies} if such is in violation of County Regula,tion(s) or any other applicahle law" Review of this
Application, including submittals, and inspections of the work br7 the Building Divisiolt do not constitute an
accepta:rice o responsibility or liability by the County of errors. omissions, or discrepancies" As the Owner, t
acknowledge that responsibility for cornpliance wi'th federa[, state and l,ocal laws and County Regulations rest with
nre and my ar.rthorized agents, including withou,t limitation my arrchitect designer, engineer andl or bu,ilder.
I hereb acknowledge that I have read and understand the Notice and Certificati'on above, as well as, have
provided the which fs correct and accurate to the best of rny knowledge.
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Print and Sign,Date
o@fusE oNtY
Speciali Conditions:
Manu. Horn,e Fee,:Misc. Fees:Plan Check Fee:(3,A Ferm:it Fee:9t-tsAdiusted Valuation:Ylue
BP N,o:
NTtr-r.,rssf<
OWTS No:Total Fees:
t60 ,4L
Fees Paid:
b4.sl
Due:5Balanceq7,
Const. Type:zonrpSetbacks:OCC Group:
e,7V'4BrJlr-DrNG / pTANNTNG DrVlSrON :
Date
