HomeMy WebLinkAboutApplicationce Garfield County
Community Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www .garfield-cou nty .com
TYPE OF CONSTRUCTION
D Commercial/Multi-Family
D Manufactured Home (SF or Duple x)
D Residential (SF, Duplex, or Townhome)
INVOLVED PARTIES
I D Demolition
/
I 0 Reroof
Property Owner: J,Ji.i /· 1Jt111 t/tl~e-4 Phone: ( ,9/q ) ______ _
Mailing Address : oot/i 5 . lf.,,,,,11,,v ~ ,1 Cf
Phone: ( :zro ) Hf -z6y-'6
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Architect: __ __..7-:..;.~'-ftf-'+---------------Phone: ( ________ _
Mailing Address: ----------------------------
Engineer: 1)' / 4
Mailing Address :/ ----------------------------
Phone:( ________ _
Manufactured Home Installer: -~<--=---, ...... 4 ...... 1.__ ________ Phone: ( ________ _
Mailing Address : ______ / _____________________ _
PROJECT NAME AND LOCATION
Assessor's Parcel Number: 2'1Qs/5?(il\0 \ I Sub. lot __
I
Owner's Valuation of Work: $---"~)"""6'"'"'.f'--'-/"""" .. o'--"()"------Property Size (Sq.Ft or Acres):-------;
Sq .Ft of Building: Height: #of Floors : ____ _
Class of Work: D New D Alteration D Repair D Move/Relocation
Garage: D Attached D Detached
Septic: OOWTS D Community
Type of Heat: D Natural Gas D Propane D Electric D Other
Driveway Permit: D Exempt D Permit#: --------
NOTICE
Authority. This application for a Building Permit must be sig ned by the Owner of the property, desc ribed above, or
an authorized agent. If the signature below is not that of the Owner, a separate letter of authority, signe d 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
purpo ses of inspections by the Building Divi sion .
Other Permits. Multiple se parate 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 Acc ess or
a State Wastewater Discharge Permit.
Void Permit. A Building Permit becomes null and void ifthe 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 Division accepts the Application, along with the plan s and specifications and other
data submitted by me or on my behalf (submittals), based upon my certification as to accuracy. Ass uming
completeness of the submittals and approval of this Application, 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 si on . In consideration of the issuance of the 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 th e Building Permit
may be suspended or revoked, upon notice from the County, if the location, construction or us e of the structure(s)
and facility(ie s), descri bed above, are not in compliance with County Regulation(s) or any other appli cable law.
I hereby grant permission to the Building Division to enter the property, described above, to inspect the work . I
further acknowl edge that the iss uance 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 submitta ls, and inspections of the work by the Building Division do not
con stitute 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
r est with me and my authorized agents, including without limitation my arch itect designer, engineer and/ or
builder.
OFFICIAL USE ONLY
Special Conditions:
Adjusted Valuation: Plan Check Fee : Permit Fee : Manu home Fee:
$~ QQ__
Balance Due~ ty
~~
Setbacks: OCCGroup:
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BUILDING/PLANNINGDIVISION: ~//-{J. ~
Signed Approval
lo -z o -Zv rL/
Date /
Misc Fees:
10 ·&>· t<(
Date