HomeMy WebLinkAboutApplicationGurfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81501
(970194s-82t2
www. garfi eld-countv.com
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Com mercial/M u lti-Family Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)I Reroof
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
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Email Address:
Property Owner:
Mailing Address:
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Phone: (7o)'?L{-Cz-z,a
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Contractor:
Mailing Address
Email Address
Pho ne: (Architectr
Mailing Address:
Email Address:
Ensineer:Phone: ( )
Mailing Address:
Email Address:
Phone:Manufactured Home lnstallen
Mailing Address:
Email Address:
PROJECT DETAILS
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Lot
Height:
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BlockSub.
Owner's Valuation of Work: $
Sq. Ft. of Building:
Property Size (Sq. Ft. or Acres):
f of Floors
Describe Work:
Assessor's Parcel Number:
Job Address:
Remodel/Alteration ditionClass of Work:New
DetachedAttachedGarage
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PROJECT DETAILS CONTINUED
Septic:
Type of Heat:
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.
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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, lagreethat land myagentswillcomplywith 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 notrce from the County, if the locatton, constructron 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 enterthe 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
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I hereby acknowledge that I have rebd 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
fWTS
Natural Gas Propane
Community
E lectric
Driveway
Permit:
Other
Exempt Permit #
NOTICE
OFFICIAT USE ONtY
I
Special Conditions:
Adjusted Valuation Plan Check Fee:THU":tot Manu. Home Fee:Misc. Fees:
Total Fees\oo e'eJ oc)Fees Paid:
\@,
Balance Due:
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BP No:ffirAoLlq Q! /TS Nq:
Setbacks:"cjffu'cry]'oUtiD
BUTLDtNG / PTANNTNG DrvtstO
Signed Approval
l-w'95
Date