HomeMy WebLinkAboutApplicationGa{rcltl County
Co mm unity Development Department' 108 8th Street, Suite 401
Glenwood Springs, CO 81601
teTo) e4.s-Bzxz
www. garf ieldcountvco. gov
Commercia Demolition
Manufactured Home or Tiny Home (single or Multi-Level)
Residential (5F, Duplex or Townhomc)T Reroof
Accesso Dwelling Unit . MAXIMUM SIZE OF SQUARE FEET
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lmail Address: _.-, * -. .. .
-
Phone:
Phone: ftb"p .l- ttt6--=wS
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Email Address:
Malllng Address
Property Owner:
Mailing Address:
Contractor: :
Architect: Phone:(
Malllng Address:
Email Address:
Englneer:
Mailing Address; . ". . . ., --.
Emall Address: .. - ,,.,,
Phone:
Email ^Addressi - - -. - . , --
Phone:{lManufactured Home lnstaller:
Mailing Address
Sub. ,, ' ' 'Lot : Block
--
Describe Work;
d
Height:
A-+.rtn l-
S of Floors
Assessor's Parcel Number;
Job Address:
owner's Valuation of Workt Property Size {Scj. Ft.'or Apres};
Sq. Ft. of Buildlngr
AdditionNewRemodel/AlteiationClass'of Work:
6arage:Attached Detached
PROTECTiDETAII.s::t ;:' i.:irr.iiir:r 1 r::l"llrj::,t:.:'::
Septic:)WTS ity
Type of Heat:atural Gas Propane Electric f Other
Driveway
Permit:Tmffils$
Permit #:
Authoritv, This application for a Building Permlt rnust be signed by the Owner of the property, described above,
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.
Leeal Acce$s. A Building Permit cannot be lssued wlthout 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 Cou.nty Highway/ Road Access
or a State Wastewater Dlscharge 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.
:::,. :
I hereby certify that I have read this Application and that the information contained above is true and correct. I
urrdersl.arrd LhaL the Buildlng Dlvlslon accepts the Appllcatlon, along with the plans and specifications and other data
submitted by me or on my behalf (submittats), based upon my certification as to accuracy. Assuming completeness
of the submittals and approval of this Application, a Buildlng 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, statef 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 permlt, 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 frorn the County, ifthe location, construction or use ofthe
structure(s! and facility{ies), described above, are not in compliance with County Regulation(s) or any other
annllr:hla laur
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 Suilding Perrnit does not prevent the Building official fiom: {L} requiring
the correction of errors in the submittals, ifany, 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 othel applicable law. Review of this
Appllcation, including submittals, and lnspeitlons of the work by the Building Division do not constitute an
cceptance of responsibility or liability by the County of errors, omissions, or discrepancies. As the Owner, I
acknowledge that responsibillty 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, have
provided the required information which is correct and accurate to the best of my knowledge.
'f/ / r/e r
Propbrty Owner Prlnt and S Date 0
Special Gonditions:
Adjusted Valuation:Plan Check Fee txiT:ao Manu. Home Feel Misc, Fees:
Total Fees:
I on.oo 'io?i'.t o Balance Due:-+ffi,e -qugc
OWTS No:
Setbacks:OCC Groupr--I:t) n'
,""WU -U,Ll)
BUILDING / PTANNING DIVIS'ON 4.Kr'4,5
Signed Approval udac