HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970194s-8212
www.ga rfi eldcountvco.Bov
PROJECT DETAITS
Describe Work:lnstall propare gas line for new BBQ/picnic area
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCTION
Commercial/M u lti-Family Demolition
Manufactured Home (Sin eorM I Gas Pi
Residential (SF, Duplex or Townhome)Reroof
Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOTVED PARTIES
Property owner: George Daniels Phone: t41O l4*l ffih
Mailing Address: 176 GH Daniels Blvd, Gypsum, CO 81637
Email Address:ghdgrowit@aol.com
contractor: Pro Gas Phone: QXO I g}g' \oo\
Mailing Address Po Box 44, Loma, CO 81524
Email Address:office@progas 1 00 1 .com
{Alteration AdditionClass of Work:
Natural Gas PropaneType of Heat:
JobAddress: 126 Quicksilver Ct, Rifle, CO 81652
Assessor's Parcel Number:
Sub.Lot Block _
Gas Pipe tength/ Diameter:2401. f .,314 IPS gas line
Appliances Serviced By Gas Line (list all, include BTU):C^rl\t
NOTICE
Authority. 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.
Qlher P.g_rmits. 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.
V_Ojid_PCfnj!.A Building Permit becomes null and void if 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.
I hereby 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 asto 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, I agree that I and my agents will
comply with 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)). 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 hereby grant permission to the Building Division to enter the 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 me and my authorized agents, including without limitation my architect
designer, engineer and/ or builder
I hereby acknowledge that I have read and u and Certification above, as well as,
to the best of my knowledge.
f/z-/zo'aJ'
have provided the required information
Prope Print and Sign //Date
nd the N
and
OFFICIAT USE ONLY
Special Conditions:
Adjusted Valuationr
N/A '[FF;'ocs Misc. Fees
Total Fees\oo Fees Paid
1er)ffi Balance Due:
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BUILDING / PLANNING DIVISION
Signed Approval Date