HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs; CO 81601
l970le4s-82L2
www.garfieldcountvco.gov
BUILDING PERMIT
APPLICATION
TYPE OF CONSTRUCflON
Commercial/Multi-Family Demolition
Manufactured Home or Multi-Level I Gas
tesidential (SF, Duplex or Townhome)Reroof
Accessorv Dwelling Unit (ADU) - MAXIMUM SIZE OF 1,200 SQUARE FEET
INVOLVED PARTIES
Property Owner:Phone: 6Dl ) Lt\t'4-7Ll
Mailing Address:t{il c8 zbt 3) l.t Lo. g Ila,SL
,I
Email Address:a.
Contractor:Phone:(
Mailing Address:
Email Address:
PROJECT DETAITS
Describe Work:
Job Address:{{
Assessor/s Parcel Number:
Sub.rotAELL- Brock-
(I
Gas Pipe Length/ Diameter:
Appliances Serviced By Gas Line (list all, include BTU):
Class of Work:EW ffakeration Addition
Type of Heat:ffiaturatcas Propane
NOTICE
Authority. ThisapplicationforaBuildingPermitmustbesignedbytheOwneroftheproperty,describedabove,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
Legal Access. A Building Ferrttit cunnot be issued without proof of legal and adequute access tr.r ttie property for
purposes of inspections by the Building Division.
O_thgf-PCLmits. 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_SlEPSIfi!.fl 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 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 Br-rilding Division. ln consideration of the issuance of thd 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 understand the.Dbtice
have provided the required information which is correct aryfficcwate
Sn o*,\n ?,(o /v( --'fl 4'/ {
Property Ourner Print and Sign ' l/'''r
and Certification above, as well as,
to the best of my knowledge.
Date
OFFICIAL USE ONtY
Speclal Condltlons
Adjusted Valuatiorr Permlt Misc. Fees:
lotal Fees CP Fees oc,Bala Due:Zon
BUILDING / PLANNING
Signed Approval Date