HomeMy WebLinkAboutApplicationGarfield County
Com munity Development Department
1O8 8th Street, Suite 401
Glenwood Springs, CO 81601
(9701 94s-8212
www.ga rf ieldcou ntyco.gov
WPE OF CONSTRUCIION
Commercial/M ulti-Family Demolition
Manufactured Home or Tiny Home {single or Multi-Level}
Residential (SF, Duplex orTownhome)I Reroof
Accessory Dwelling Unit (ADU) - MAXIMUM SIZE OF r"2OO SqUARE FEET
INVOLVEE:PARTIES
Phone:
b 3J
Email Address:
Property Owner:
MailingAddress:
Phone
t
Cnntractor:
MailingAddress:
Email Address:
Mailing Address:
Email Address:
Phonel ( )Architect:
MailingAddress:
Email Address:
Phone: ( )Engineer:
MailingAddress:
Email Address:
Phone:Manufactured Home lnstaller:
PROIECTDETNLS
6C f 6' ,n2,,. P[ i\'f'l\err*t.rcl.^ C., S{r:E\
Describe Work:
Height:
Sub.
Property Size (Sq. Ft. or Acres)
fl of Floors:_
owne/s Valuation of Work:
Sq. Ft. of Building:
Assessor's Parcel Number:
Job Address:
Lot _ Block
Remode/Alteration AdditionClass of Work:New
Garage:Attached Detached
PROJECT DETAI|S CONTIN UED
Septic:Community
Propcnc Elcctric
pt Permit #:
I hereby acknowledge that I have read and understand the Notice and Certification above, as well as, have
provided the requlred information which ls corect and accurate to the best of my knowledge.
b oBl B/zoz-5
Property Owner Sign Date
Type of Heat:
_lNaturalGas
Otherl
I l'*'Driveway
Permit:
NOTICC
Authorltv. Thls appllcatlon for a Bullding Permit must be signed by the Uwner of the property, described above,
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.
Void Permit. 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.
CENNFKATION
I hereby certify that I have read this Application and that the information contained above is true and correct. I
understand Lhal the Building Division accepts the Appllcatlon, along wlth the plans and speclficatlons 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 ot 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, lagree 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)), All County dev'elopment requiring a permit, except for
residential uses, are subject to Article 7 ofthe 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) or any other
-nnli-].la l^'.,oPPirasre rqw.
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
thecorrection 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 witlrout limitation nry architect designer, engineer and/ or builder.
OFFIGIAT USE ONLY
Special Conditions:
Adjusted Valuation Plan Check Fee Permit Fee:tcD.oo Manu. Home Fee:Misc. Fees:
Total Fees:\oo 90'
Fees Paid:
loo.@
Balance Due:e-BP No:
ll,nAu Aq?r+
OWTS No:
Setbacks:OCC Grouo:fl(t-Const. Typelflq,'"Suo
BUTLD|NG / PLANNING DtVtStON
JrH,ilEU Alrpruvdr
F-/?-ar
Lrdtts