HomeMy WebLinkAboutApplicationGar.field County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs , CO 81601
(970) 945-8212
www.garfield-county.com
TYPE OF CONSTRUCTION
D Commercial/Multi-Family
D Manufa ctured Home (SF or Duple x)
D Re sidential (SF , Duple x, or Townhome)
INVOLVED PARTIES
I D Demolition
I ~Reroof
-c~,h L / Phone :(~ _ _) '5'i!->--J 'i' z. ,.--Property Owner: .J ,
/ '--~~ /":.. Mailing Address : C//;ff7 _.. ..c.-.tl 2..~ 5 .:;!.J/,. rn
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Contractor:;/.,, tf~"=:. ~t:::t.~ L ~ Phone: ($'k.._) 6L-f,.... ,2?_r./
/ 1 ;f,fl Mailing Address : .51 t/ // /,. 1l .;,4,,, {..,., «u ro
r I
Architect:
Mailing Address:
;J;fi Phone:( __ )
Engineer: D Lt±_,
I
Phone:{ __ )
Mailing Address :
Manufactured Home Installer: l,} l ,4 Phone:( __ )
Mailing Address: I
PROJECT NAME AND LOCATION
Describe Work: Urltr;,.X <~£,/' iL& y.:>~ ~-y t'.~ 16 ~fo./n~v 2 J
~j£k (-/:_ sf.7/' ,awf-u,.--Job Address: ~ 3 '--C. ~
Assessor's Parcel Number: Sub . Lot Block --
Owner's Valuation of Work: $ f .tj_o. 6 U?
I
Property Size (Sq.Ft or Acres):
Sq .Ft of Building : Height: #of Floors:
Class of Work: D New I D Alte ration I D Addition D Repair I D Move/Relocation
Garage: D Attac hed D Detached
Septic : OOWTS D Community
Type of Heat: D Natural Gas
I
D Propane I D El ectric I D Oth er
Driveway Permit: D Exe mpt D Permit#:
NOTICE
Authority. This application for a Building Permit must be signed by the Owner of the property, described above, or
an authoriz ed agent. If the signature below is not that of the Owner, a separate letter of authority, signed by the
Owner, mu st be provided with this Application.
Legal Access. A Building Permit cannot be iss ued 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 th e property identifi ed above, e.g. State or County Highway/ Road Access or
a State Wastewater Discharge Pe rmit.
Vold Permit. A Building Permit becomes null and void if the work authorized is not commenced within 180 days of
the date of iss uance 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. I
understand that the Building Divi sion accepts the Application, along with the plan s and speci fications and other
data submitted by me or on my behalf (su bmittals), based upon my certification as to accuracy. Assuming
completeness of the submittals and approval of this Applicatio n, a Building Permit will be iss ued granting
permission to me, as Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by the
Building Divi sion. In consideration of the issuance of the Building Permit, I agree that I and my agents will comply
with provision s of any federal, state or local law regulating the work and the Garfield County Building Code, OWTS
regulations and applicable land u se regulations (County Regul ation(s)). I acknowledge th at the Building Permit
may be suspe nded or revoked , upon notice from the County, if the location, con struction 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 Divisio n 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 re spo nsibility or liability by th e County of errors, omissions or discrepancies. As the
Owner, I acknowledge that responsibility for compliance with federal, sta te and loca l laws and County Reg ulation s
rest with me and my author ized agents, including without limitation my archi tect designer, eng ineer and/ or
builder.
ledge that I have read and understand the Notice and Certification above as well as
e required information which is correct and accurate to the best of my knowledge.
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation : Plan Check Fee:
$f0
Permit Fee:
Y/OCJ , oo
~alFees : 00
Setbacks: OCC Group: Const Type:
BUILDING/ PLANNING DIVISION : ~ a . l u "Un'bf'h.J ii
Signed Approval
?a\\\ C\. ~~·l'-\ '1-¥r-\530 I .:/Jr 60 , ~
Date
Zoning:
Date