HomeMy WebLinkAboutApplicationGarfuId CounQr
Community Development Department
108 8th Street, Suite 401
Glenwood SPrings, CO 81601
(970194s-8212
www.ga rfi eld-countv.com
BUILDING PERMIT
APPLICATION
WPE OF CONSTRUCflON
DemolitionIti-FamCommercia
Manufactured Home or Ti Home (Sin e or Multi-Level
I Reroofex or TownhResidential (SF
Accessory Dwell - MAXIMUM SIZE OF 1,200 SQUARE FEETUnit
INVOTVED PARTIES
Phone:619lZZb*Zo'?Z
I
Email Address:
Property Owner
Mailing Address
Phone: t1l" I qtG--qLiz.\
Contractor:
Mailing Address:
Email Addressl
Architect:
Mailing Address:
Email Address:
)
Engineer: Pho
Mailing Address:
Email Address:
ne: (
Manufactured Home lnstaller:
Mailing Address:
Email Address:
Owner's Valuation of Work: 5 I et ,'? 5f^ Property Size (5q' Ft' or Acres):
PROJECT DETAITS
le>Describe Work:
Height:
(
Sq. Ft. of Building:
Sub
T-
sof
Assessor's Parcel Number:
Job Address:
Lot
-
Block
-
ditionRemodel/AlterationNew€lass of Work:
DetachedAttachedGarage:
Septic:
Type of Heat:Propane
Driveway
Permit:
Exempt
PROJECT DETAITS CONTINUED
Community
Natural Gas Electric
Permit #:
NOTICE
Authoritv. ThisapplicationtoraBuildingPermitmustbesignedbytheOwneroftheproperty,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 ahove, e.g. State or County Highway/ Road Arress
or a State Wastewater Discharge Permit.
Void Permit. A Buildir-rg Pertnit becotnes null and void iI 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
I hereby certify that I have read this Application and that the information contained above is true and correct. I
uncierstancj that the Buiiciing Drvrsron accepts the Application, along with the plans and specitications and other data
sirbmitted by me or on my behalf (submittals), based upon my certification as to accuracy. Assuming complctcncss
of the submittals and approvalof thisApplication, 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
considcration of thc 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 trse regrrlations (Corrnty Regrrlation(s)) All Cor.rnty 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) orany other
applicable law.
lherebygrantpermissiontotheBuildingDivisiontoentertheproperty,describedabove,toinspectthework. 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
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 and Certification above, as well as, have
provided the uired information whie h is correct and accurate to the best of my knowledge.
^j1^7,n -'L9
Property Owner Sign Date
Other
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation:Plan Check Fee:Permit Fee:
\oo.cJC)Manu. Home Fee:Misc. Fees:
Total Fees:
-/Att (f ') .uv
Fees Paid:
r ^ hA\cr(\.w
Re langiue
V
BP No:
-- ,- .-\ - llz...ni--q(V7
OWTS No:
)
Setbacks:OCC Group:Const. Type:si?o
BUTLDTNG / PLANNTNG DtVtStON :2-fu.X
Signed Approval Date