HomeMy WebLinkAboutApplicationGarficld Coanty
Community Development Department
108 8tt'Street, Suite 401
Glenwoo{Springs, CO 81601
plolg+s-eztz
www.garf ieldcou ntyco.gov
BUILDING PERMIT
APPLICATION
Commercial/Multi-Family Demolition
I Gas PipingManufactured Home (Single or Multi-Level)
Residential (SF, Duplex or Townhome)Reroof
Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1,200 SQUARE FEET
Phone: t9?o f ttts -5$t5
Email Address:
Property Owner:
Mailing Address:
rrri\ ",,(r>,nsfi\sclna ni n DfA arna-i-\"
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C-orvr->Email Address:
CL
Malllng Address:
Contractor:
Describe Work:
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Gas Pipe tength/ Diameten
Appliances Serviced By Gas [ine (list all, include BTU):
LKI
I
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Lt
Sub.
a3q43(12-\ 59&1
4 Z Btock_
Assessor's Parcel Number:
Job Address:
Ko''""t'on AdditionClass of Work:
Type of Heat:Gas[|ru"turut Propane
&tftodty. thlr lppllcetlon for r Eulldlng Permlt murt bG rlgnrd by thc Owncr ol thc ptoqttl, dcxrlbcd tbvc,
or rn luthorlnd rFot. lf th! illnlturc brlow ls not thrt of ths Ownir, s srptrntc httcr of authotlli, tigtt'd W
thc Owncr, must be provldcd wlth thls Applicetlon,
h!f A bultdlng Parmlt crnnot bc lrcucd wlthout proof ol lcgrl Nnd sdcqurte eccesr to tbc properfi lor
purpsrcs of intpcctlons by thr Bulldlng 0lvlrlon.
Oh13."$rtttr. Multlplc s€prrlt€ permltr mry bo rrqulredt (11 Sratc Elcctrlcal Pcrmlt,l7l County OWTS Psrmit,
(3! rnothrr pumlt riqulrrd for ust on the propcrty ldontlflrd abovc, c.g. srts 6r County HlghwtV/ Razd ,,/cc','s
or r strtc wrstewstrr ohchrrgc Permit.
\hld.?lEe"A Bulldlng Permlt becomes null and vold lf th6 work authorlred ls not comm€nced within 1&l days
of tfu drtr of lssuancc and lf wo* le su$end6d or abandoned for r pzrlod of 180 dryr after commcnctmcnt.
I hereby certlfy thrt I have rerd thlr Appllcatlon and thrt the lnformation contained above ir true and cnrrect, I
undenund thrt thc Bullding Division sccepts thc Applicatlon, along wlth th6 planr and speclffcatlonr and othrr
dats submittcd by me or on my bchalf (submlttals), based upon my crtltlcetlon t' to accuncy. Asrumlng
conplctcnesr of the submlttsls and approval of thls Appllcatlon, a Bullding Permit will be lssued grantlng
permlssion to me, as Owner, to construct the rtructure(s) and facllitlcs detalled on the submlttals rcvlewed by
the Bullding Dtvlslon. ln €onrld€ratlon of the lssuance of th€ Sulldlng Parmlt, I agree that I and my agents will
cornply wlth provlslons of any federal, state or local law regulatlng the work and the Garffcld Courlty Eulldlns
Code, OWTS regulatlonr and appllcable land use regulations tCounty Regulation{s}}. I acknowledge that the
Bulldlng Permlt may be suspended or revoked, upon notice from the County, if the location, construction or us€
of the structure(s) and facllltV{ler), descrlbed above, are not ln compllance with County Regulation(s} or any
othcr rpplicable law.
I hcrcby grant permission to the Bullding Dlvlslon to enter the property, described above, to lnspect thc work. I
further acknowledge that the lssuance of the Buildlng Pe.mlt does not prevent the Euildlng Offtcial from: {1)
requlring the correction of errors in the submittals, lf any, discovered after issuance; or (21 stopping
constructlon or use of the rtructure(s) or faclllty(les! lf such ls in vlolatlon of County Regulatlon{s} or any olher
appllcable law Revlew of thls Appllcation, includlng submlttals, and lnspections of the work by the Bullding
Divislon do not constltute an acceptance of responslbility or llabillty by the County of errors, omlssions or
dlrcrepancles. As the Own€r, I acknowledge that rerponslbillty for compllance with federal, itate and local lrnrs
end County Rcgulatlons rest with me and nry authorized agents, lncludlng without llmltatlon my architect
desiSner, engineer andl or builder.
I hrrsbV rcknowlcdrc thrt I hrvc rcrd rnd undcrslrnd thc Notlcc and Ccrtlflcetlon ebow, rs srull .N,
thc rcqulrcd whlch lr conect lnd sccur.te to the best of
Proprrty Onmrr Prlnt rnd
Sprdrl Gondttlonr;
tdtafi.d Vrlurllon:
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Totrl Fcr:
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5[ncd Approvrl