HomeMy WebLinkAboutVoided ApplicationANN
Garfield County
unity Development Department
108 s"' Street, Suite 401
G nwood Springs, CO 81601
GARFIHD COUNTY
~1MUNITY DEVELOPMENT
(970) 945-8212
di ld-coun
TYPE OF CONSTR
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INVOLVED PARTIES
0 De molition
D Re roof
Property Owner: _Q~~~~~~~~w:...._ ____ Phone:('-..a.S"11.'t6 ..... ·_,_.......,..,._.-c;.;;.;:30=0 ....... _-1
Malling Address: ...J:Udo~~~c.....i:!l;!.l.~~J.::.~~..¥!0::!::!!!!!!!!....:~~1..!::::1:~.::U:Uc.,;;L..---
Contractor: ___ ~--------lt:---f----+-.-----
Maillng Address: _______ --lt"""-~=--..:..u-_;__..:....:::.__----!:iilrrlitr..:......1o..-.r-+--+-
Engineer: _j~;:f2i~~fil!&!fl~~~~rn;u ____ Phone: ( toe ) ;1~· U)C\2.
Malling Address: ....M:Ul...J:.....llmir&.U!!l~~u:....~u.E~~'.-l...l2!iii!S2.lliE........i....u:;L-~w.::::!£... ___ _
Manufactured Home lnstaller: _______ __,1r----Phone:(..__ ____ -------
' MailingAddress =-~---------~-----li-------------
I PROJECT NAME AND LOCATION
Assessor's Parcel Number: ---1CL.11..1:1.l1Z.1-.i~~-Lot 6 Block __ _
Owner's Valuation of Work: $ CD~~. q ~I . ti). Property Size ( .Ft or Aaes): 2.lt fl S .f .
s: 'l + "'6bt'~ Sq.Ft of Building: 1~~ s.r. Height: 2A '-Cz 1/tp ,.
Class of Work: New CJ Alteration D Add iti on D Repair
Garage: Attached
Septic: Community
Type of Heat: Natural Gas D Propa ne 0 Electric
Driveway Permit : D Ex e m pt D Permit#: \ -------
Authority. This application for a Building Permit must be signed by the Owner of the property, described above, or
an authorized agent. If the signature below Is not that of the Owner, a separate letter of authority, signed by the
Owner, must be provided with this Application .
Legal Access. A Building Permit cannot be Issued without proof of legal and adequate access to the property for
purposes of Inspections by the Buildlng 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 County Highway/ Road Access or
a State Wastewater Discharge Permit. ·
Vold 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
CERlif FICA TIBN
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 submlttals reviewed by the
Bulldlng Division. 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 Regulatlon(s)). I acknowledge that the Bullding Permit
may be suspended or revoked, upon notice from the County, If the location, construction or use of the structure(s)
and facllity(les), described above, are not In compliance with County Regulatlon(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 submlttals, If any, discovered after Issuance; or (2) stopping construction
or use of the structure(s) or faclllty(les) if such Is In violation of County Regulation(s) or any other applicable law.
Review of this Application, includin submlttals, and Inspections of the work by the Building Division do not
constitute an acceptance of resp slbllity or liability by the County of errors, omissions or discrepancies. As the
Owner, I acknowledge that resp slblllty for compliance with federal, state and local laws and County Regulations
rest with me and my author! agents, Including without limitation my architect designer, engineer and/ or
builder.
I hereby atf owl~g t~have rear a understand the Notice and Certification above as well as
have provide(7d the req red informati n htch is correct and accurate to the best of my knowledge.
~t-iz./ 1t
Date
. GFFICIA~ USE GNl!Y
Spedal Conditions:
Adjusted Valuation: Plan Check Fee : Manu home Fee : Misc Fees :
600 9 S7.tlJ 24?5",79 -
Total Fees:
0/BZ .J+ Fees Paid:
¢, ,455. '3'1
Setbacks: OCCGroup:
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