HomeMy WebLinkAboutApplicationGarfield Courtty
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 8L601
(e7ol94s-8212
www.garf ieldcountvco.gov
WPE OF CONSTRUCTION
Commercial/M u lti-Fa mily Demolition
Manufactured Home or Tiny Home (Single or Multi-Level)
Residential (SF, Duplex orTownhome)I Reroof
AccessorV Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
Phone: tQttl
ne:Contractor:
Mailing Address
Email Address:
Phone: ( )Architect
Mailing Address:
lmail Address:
Engineer:Phone: ( )
Mailing Address:
Email Address:
Phone: (_)
PROJECT DETAITS
Email Address:
Manufactured Home lnstaller:
Mailing Address
owner's Valuation of Work: S Q, O0 € t
Sq. Ft. of Building: Height:
Describe Work:
s
Lot Block
--
Sub.
Property Size (Sq. Ft. or Acres):
# of Floors:_
Assessor's Parcel Number
Job Address:
Class of Work:New Remodel/Alteration Addition
Garage:Attached Detached
Septic:
Type of Heat:Nalrrtal Gas
PROJECT DETAI tS CONTIN U ED
Community
PrnJrane Fleclrir:Cllher
Driveway
Permit:
NOTICE
Authoril.v. Tlris appliuaLiurr fur a Buildirrg Petrrit trrusl be sigrred by lhe Owlrer o[ llre ploperty, descliLed abuve,
or an authorized agent, lf the signature below is not that of the Owner, a separate letter of authority, signed by
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 pennit required for use on the property identified above, e.g. State or County Highway/ Road Access
or a State Wastewater Discharge Permit.
Void Perntit. A Buildirre Pet trriI becorlres rrull arrd vr.lid if the work aulhorieed is rrol currrnerrcetl wilhilr 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. !
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 DMsion. 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 Codg 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, ifthe location, construction or use ofthe
structure(s) and facility(ies), described above, are not in conrpliance with County Regulation(s) or any other
appiicabie iaw.
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 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 bythe 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 understand the Notice and Certification above, as well as, haue
providcd the rcquired information which is correct and accurate to the best of my knowlcdgc.
sls I
Print Date
Permit #:
A5
,nOFFICIAI. USE ONLY
Soecial Conditions:
Adjusted Valuation:Plan Check Feel Permit Fee:loo .oo
Manu. Home Fee:Misc. Fees:
Total Fees:Ioo oo Fees Paid:
t oo.oo
Balance Due:+-BP No:
fuY=tr.qqk-,
OWTS No:
Setbacks:OCC Grouo:T,OII Const.'iffiiDB,;BUITDING / PLANNING
Signed Approval
F'r?.2-r
Date