HomeMy WebLinkAboutApplicationGarfield County
BUILDING PERMIT
APPLICATIONå{T,Cfr unity Development Department
108 8th Street, Suite 401
il0\, 2 2 101? Gtenwood Springs, co 81G01
rìARflËLD r;cluNTY le70le4s'82L2
ininiUi f in bny6¡6pgg1ç1 www.sa rfield-countv.com
WPE OF CONSTRUCTION
PARTIES
[l DemolitionE Commercial/Multi-Family
E Manufactured Home (Single or Multi
t ReroofE Residential (SF, Duplex or Townhome)
Phone: t41b t b4 -5114
Email Address:
Property Owner:
Mailing Address:
EmailAddress:
çL t4T0 tþ14 -t\?lePhone
Mailing Address:
Phone: ()Architect:
Mailing Address
Email Address:
Phone: ( IEngineer:
Mailing Address
Email Address:
Manufactured Home lnstaller: Phone:
Mailing Address;
Emall Address:
Owner's Valuation of Work: $-
PROJECT DETAITS
Describe Work:
# of Floors
lot _ Block
-
,\-
! wtove/nelocation
Property Size (Sq. Ft. or Acres):
Job Address
Sq. Ft. of Building: Height:
Assessol's Parcel Number:
Sub.
E Rdd¡t¡on ffi nenairClass of Work:New f ]Rlteratíon
DetachedGarage:!nttached
PROJECT DETAITS CONTINUED
Septic:OWTS
Type of Heat:
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
oranauthorizedagent. lfthesignaturebelowisnotthatoftheOwner,aseparateletterofauthority,signedby
the Owner, must be provided with this Application.
Lesal Access. A Building Permit cannot be issued 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 the property identified above, e.g. State or County Highway/ Road Access
or a State Wastewater Discharge 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.
CERTIFICATION
lherebycertifythatlhavereadthisApplicationandthattheinformationcontainedaboveistrueandcorrect. 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
permíssion 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 land 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) orany
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 Rpplication, 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
d ner,er and/ or builder
I hereby acknowledge read and understand the Not¡ce and Certification above, as well as, have
provided the requi ion which is correct and accurate to the best of my knowledge.
Property Sign
g
ll rtectric f
Community
Otherfl eropanel_l ltatural Gas
Permit #:ExemptDriveway Permit:
NOTICE
OFFICIAT USE ONLY
Special Conditions:
Misc Fees:UIAPlan Check Fee:
N\ l'+$'iiÄ1.,Manu home Fee
l.-ll FAdlusted
TaHtion:
OWTS No:
1..1 / f\'Säl'Ëo BP No:
Donr -:Y)3^iriiÅä: *00Fees Þaid:
sr nn.
flffi'uPConst Tvoe:rÍ2rSetbacks:
N\ IA OCC Grouo:TR[\-
BUITDING / PLANNING DIVISION ulaa/r