HomeMy WebLinkAboutApplicationGarfield County
Co4munity Development Department
MAR I 3 ?fi'/b 108 8th street, suite 401
,i r ', i.li iFleqwood Springs' co 81601
r. .:r ,i ,rri'r:id'[ l970l945-82L2
www. garfi eld-countv.com
BUILDING PERMIT
APPLICATION
WPE OF CONSTRUCTION
Com ulti-Fami Demolition
Manufactured Home or Home e or Multi-Level
,Residential (SF, Duplex or Townhome)Reroof
Accessory Dwelling Unit (ADU)- MAXTMUM SIZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
Property Owner:Phone: ttTb f 7ffi ^ )a7a
EmailAddresr, * 3 C'./"nA
tcO\Mailing nddress: Z\0 '(r:
r).COr.y-)
Architect: Phone:
Mailing Address:
Email Address:
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-t J$l
)
6Ll\\o
Contractorl ,s
Mailing Address
Email Address:
Engineer: Phonel (
Mailing Address:
Email Address:
Manufactured Home lnstaller: Phone:
Mailing Address:
Email Address:
PROJ DETAITS
Describe Work:
6u.a
{n
of work: S \l?- , beb
Job Address:7V'4
- f)rn{rA Or.g1S+ \reu.
Block
Assessor's Parcel Number:
Property Size (Sq. Ft. or Acres):
Height:
Sub. Lot
# ofFloors: 2-
Owner's Valuation
Sq. Ft. of Building:
X AdditionNewRemodel/AlterationClass of Work:
DetachedAttachedGaragel
PROJECT DETAITS CONTINUED
Natural Gas Propane Other
pt Perrrrit #:
NOTICE
AuthoriW. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
lesal 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 issuanee and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
I lrereby certify that I have read this Application and that the information contained above is true and correct. 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 issuanceof the Building Permit, lagreethat land myagentswillcomplywith provisionsof 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 cnunty, if the location, construction or r.rse 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 Buriciing 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 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
me and my authorized agents, including without limitation my architect designer, engineer and/ or builder.
I hereby that I have read and understand the Notice and Certification above, as well as, have
the correct and accurate to the best of my
er Print Date
USE ONtY
Community
Electric
Septic:
Type of Heat:
Driveway
Permit:
Special Conditions:
Adiusted Valuation:to.60 Plan Check FeeIt7.st Fee:
25
Permit
t8l,
Manu. Home Fee:Misc. Fees
Z1q,.oc
Total Fees:Fees Paid:fllta.. Balance Due:
h le t.z5
BP No:pl-j.-n-Qt3Ft OWTS No:
Setbacks:OCC Group:Const. Type:Zonins:.l,tr{J.
3 -to.ZSBUILDING / PLANNING DlVlSlON I
Date