HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
1Og 8th Stree! Suite 401
Glenwood Springs, CO 81501
(e7ol94s-82L2
www.Farfi eld-countv.com
BUILDING PERMIT
APPLICATION
DemolitionCom mercial/M u lti-Family
Manufactured Home or Tiny Home (Single or Multi-Level)
t ReroofResidential (SF, Duplex or Townhome)
Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
1e t &'Oloa
Email Address:
Mailing Address: 5-f lfuLsl
Property Owner:5)'..-L Phone:\?o
A(^* D,n e,^P Phone: 14b 1 Gft't-"t-<-+
*tt-{u
'/*.^t+fta
223 <{rF,'-A^,\Contractor:
Mailing Address:
Email Addressr
)one:Architect:
Mailing Address
EmailAdd
Email Address:
Phone:
Mailing Address
Engineer:
Phone: ( )
Email
Manufactured Home lnstaller:
Mailing Address:
Describe Work:
.OJob Address:
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{, "uu ou
Lot
Owner's Valuation of Work:
Block
Assessor's Parcel Number:
Sub.
Property Size (Sq. Ft. or Acres):
# of Floors:_Sq. Ft. of Building: Height:
el/AlterationNewffi"toa AdditionClass of Work:
DetachedAttachedGarage:
Septicl
PROJECT DETAITS CONTINUED
Type of Heat:Natural Gas Propane
Community
Electric Other
Driveway
Permitr
Exempt Permit #:
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. ABuildingPermitbecomesnull andvoidiftheworkauthorizedisnotcommencedwithinl80days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
NOTICE
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, lagreethat land myagentswill complywith 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 herebygrant permission tothe Building Division to enterthe property, described above, to inspectthe 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 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
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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
provided the required information which is correct and accurate to the best of my knowledge.
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Property Owner Print and Sign Date
OFFICIAI USE ONtY
Cnarirl fnndi+ianc.eF!wiqr
Adjusted Valuation:Plan Check Fee '(U6".oo Manu. Home Fee:Misc. Fees:
&Tota\\
I Fees:
LI.J (nFees Paid
\(r1
Balance Due:n_v-*8rya- t^^t){.( Y )t- vI lfl
OWTS No:
Setbacks:otc e rouD:- \_vJr.
Const. Tvoe:tltii,Zonjqg:- -tl. l_L-
BUTLDTNG / PLANNTNG DtvtstON
Signed Approval
//6A9
Date